Blog #1 – Industrial Action

The whole country is talking about the resident doctor strikes. Everyone seems to have an opinion. And everyone seems to have quite a *strong* opinion at that.

So how are we, the medical students, faring during the strikes? Well first up lets talk a bit about how we were briefed.

Rule number one: you MUST go to placement. (It seems that our previous cohorts of medical students decided to strike in solidarity with the resident doctors. Why would they do this, you ask? Its quite evident from Rule number two).

Rule number two: you must NOT complete any doctor’s duties during the strikes. (This is quite telling- apparently when the resident doctors disappear, the med students get roped in to do their job. Kind of defeats the point of the strike… no?).

Anyway, with briefing in mind and ready for another day of ward rounds, we make our way to the doctors handover. What is the first thing we hear? “Good, the medical students are here. You can step up today- help out with the SHO’s jobs”. Oh good- I’m glad they read the briefing too. But, of course, no-one wants to piss off their senior, so the day begins and we get on with clerking our patients. This is fine- because taking histories is a great learning opportunity and helps us refine our skill set. It’s actually what med students often like doing. Its fun, and gives us a taste of what it might be like to be a doctor one day.

But, after all, we are in the midst of industrial action. And so some doctors (in their distress) might resort to a new level of task setting. “Do you want to write up all the discharge summaries?”. Interesting use of the word ‘want’. “Can you just prescribe x, y, z?” Well, no. I’m not qualified to do that. “Oh, you can just use my login details”. Hmm. Still not sure that’s allowed. Is now a good time to mention our industrial action briefing? “Gosh, I’m just so glad you are here. What would we do without our SHOs”. I’m not an SHO- but thankyou.

Its lunch time. I’ve gone on my phone and my news feed is filled with anti-doctor rhetoric. “Morally Reprehensible” “Reckless action” “Irresponsible and unnecessary” “Cartel-like behaviour” “Disgrace”

Emotionally, it’s a pretty tough read. We spend 6 years of our lives looking up to the resident doctors, hoping one day we might be them. Hoping one day we might have as much clinical knowledge, as much patient understanding, as much empathy. And then one morning you wake up, check your phone, and the top notification on the BBC news app is that Wes Streeting is calling those very same doctors ‘morally reprehensible’ for going on strike. Striking, may I add, because the current bottleneck on training posts is leaving many doctors (and med students) extremely worried about becoming unemployed in their not-so-distant future. Striking, in fact, on our (the med students) behalf, because realistically by the time any change comes about, those resident doctors will already have a) left medicine or b) left the country to do medicine elsewhere.

So how are we supposed to feel during the resident doctor strikes? Grateful that someone is standing up for our future selves? Ashamed of our ‘morally reprehensible’ colleagues? Proud that the doctors are holding the government accountable for the current state of the NHS? Angry that our teaching has been cancelled because the doctors are busy covering the strike action? Satisfied with our personal contribution to the days work on the ward?

Its hard to say. But one thing I do know, is that the lack of nuance in our political discourse is not helping anyone.

Blog #2 – Virtual Reality Teaching is Wild

Story time.

I put on my virtual reality headset and find myself in paediatric A&E with a child, dad and nurse. I introduce myself to all three. The child tries to fist bump me. I fist bump back, only to realise he was actually showing me his patient identification wrist band. Awkward. I hope the med students watching me didn’t see that.

I start my A-E assessment and ask the dad to tell me the child’s history whilst I’m doing this. “Does he take any regular medications” “Uh, you’ll have to ask his mum about that” (Who programmed the dad to give this response?). I try to take obs, but the virtual reality clicker button won’t let me pick up the sats probe. I pick up a thermometer instead (temperature normal). Not particularly helpful.

I decide the patient needs oxygen and salbutamol (he’s having an asthma attack). I try to get the meds out the cupboard. The nurse tells me I need a prescription first. I search the room for prescription paper. I discover a sink that I had not noticed before. I wash my hands (probably should have done this before starting the consultation).

The virtual reality administrator tells me that I am not a doctor. Turns out I cannot prescribe. I must call a senior and handover. I (eventually) discover the phone. The monitor behind me starts beeping SO loudly that I start to get a headache (I try to turn it off- I couldn’t figure out how to do this in virtual reality land, so headache persisted). My senior says they are coming.

I click on a button that says ‘update and reassure the patient’. A voice comes on through the headset: “I have updated you and reassured you” “Thankyou”

Simulation Over.

I go to home. I tell my non-medic friends about what a crazy day I had (isn’t that the best bit anyway?)

Okay but lets get real. What did I learn from the experience of Virtual Reality teaching. Well first up, I was the first one in my group to enter the Virtual Reality Simulation. It was all very new and I had no idea what to expect so its probably natural that my first attempt can be described as a little bit chaotic whilst I was getting my bearings. I think it could give it a much better go next time round.

And isn’t that exactly what medicine is all about? Your first attempt often IS a bit chaotic. There are so many situations you’ll be confronted with where you don’t fully know what you’re walking in to. You WILL be thrown off- you WILL be caught off guard. So really the virtual reality simulator is replicating a lot of the surprises you might encounter in real life. Disclaimer- the above ‘story time’ review of my virtual reality teaching session was actually my Strava caption that day. And, to my surprise, a lot of my graduated-already-so-actually-real-doctor friends commented saying how it was actually a fairly realistic representation of a day in A&E. Chaos. Surprises. And, specifically, not what you might expect based on your practice sessions. Because in medicine, you can practice all you want but every day will be a new situation. And isn’t that just the fun in it all?

There are so many aspects of Virtual Reality Teaching that we could go into in a lot of detail. But for today I’ll just leave you with that. Medicine is unpredictable and getting used to that will get you a long way.

Overall great experience. Would VR again.