Tips and tales from the foundation years #2

So in my second post about tips for junior doctors, here is what one friend told m.

Remember to follow #tipsfornewdoctors on Twitter

Me (at stupid o’clock on facebook): Mate I need help with this F1 businees.

Friend (who instantly replied to my annoying message): Day ones starting you realise after 4 months off travelling and coming in 5 of those days of travels for clinical duties you know little and you’re the FY1. It’s fine we all fell like we know nothing unless you’re a sad person who went to *** uni who didn’t really have an elective and had to a month of shadowing and still is a crap doctor.

It’s nice to know what you’re doing but I would focus on the clinical things as that’s the most important.

Always rememember,  if you don’t know always ask!! Arrogance causes errors! Especially if you’re not certain yourself. You are never alone!

Beautiful beach and  waves of Caribbean Sea
Beautiful beach and waves of Caribbean Sea

Humility goes a far way. There are a lot of egos amongst doctors but your team will appreciate you more if you listen and can learn from them. But don’t take abuse or be bullied; that’s important. Speak up if someone is making you feel like you’re being bullied. Also trust yourself as well you are a doctor!

Time will build confidence and that will come as soon as you survive your FY1 on call.

Ok, I’m gonna sleep now.

 

 

Massive thanks for my friend who wants to stay anon for this.

Tips and tales from the foundation years #1

Before me and a lot of my friends begin our first jobs around the country as junior doctors (where on earth has the time gone because this is terrifying) I thought some blog posts from people who have been there before would be in order.

Hope you find them useful and feel free to share these posts! Also if you’re on Twitter (and if not get involved, I’m such a fan) follow #tipsfornewdoctors for more gems.

Today post was written by my friend Hattie

Firstly, congratulations to all the new doctors, you’ve earnt your new title! F1 is a bit like learning to swim at the deep end but with arm bands. It’s a big step. You know the theory but actually doing it is different. However you are not the first batch of new doctors to learn to swim. Your SHOs, SpRs, and even consultants will remember, however vaguely, what it was like. They are your arm bands. They will support you, guide you and save you and your patients on countless occasions this year as you splash your way through your first diagnoses, prescriptions and decisions. If you don’t know something, just ask, help is only a bleep away. Just make sure you’re got the information at hand to help your colleague make decisions. (Notes, drug chart, obs, examination findings, any imaging, bloods and in an acutely ill patient the ABG result). Everyone feels like an imposter at some stage.

You will get scared/tired/feel useless at some point and you are not alone, we have all felt like this. When this happens, speak to your fellow F1s or SHOs, they will support you, reassure you and tell you they feel or have felt the same. There’s nothing quite as demoralising as not being able to bleed a patient or get a canula in. But it’s happened to us all, don’t be too disheartened. The nurses and especially senior nurses are some of your greatest allies. They’ve been there, done it and have the t-shirt. If they say a patient isn’t well, listen to them.

Never be rude to a colleague whatever their job role or grade – it’s unprofessional, not conducive to good team work or good patient care. Mistakes happen, be supportive and sympathetic of your colleagues. One day it will be you making the mistake.

F1 is a rite of passage. You are the most junior doctor in a team. You do the jobs that have to be done. Sometimes you may feel like all you do is paperwork and canulas, but you will still learn a lot of clinical skills. The year will fly by.

e-Portfolio is something we all have to do. Start early and chip away at it and link the curriculum as you go. It’s far less painful than doing it all last minute, when invariably you’ll be on nights, oncall or have a cold.

Look after yourself and don’t let work consume you. Keep up that hobby/sport/activity that you love. It’s easy to come home feeling too tired to do anything but make an effort and it will help you realise work isn’t the be all and end all. Socialise; vent about your frustrations, discuss things you’ve found hard and talk about things other than work! Eat well and sleep.

The first time I was asked to see a patient in pulmonary oedema, their breathing sounded bubbly from the end of the bed. I had never seen or auscultated proper pulmonary odema before. I thought it was pulmonary oedema but still asked the sister if the patient sounded wet to her. She replied calmly and without being patronising, that they did. Then I stood, looking at her, so calmly she asked me if I would like her to give some fruesemide…50mg? Needless to say she was guiding me, not asking me. On her return she said gave me an x-ray form and told me that she’d rung the radiographer to come to do a portable. I hadn’t asked for a form or thought of an x-ray at this point, but she knew what needed to happen, prompted me through my first acute pulmonary oedema and kept that patient safe. She also handed me an ABG syringe with the x-ray form!

There will be many firsts, just do your best, enjoy yourself and ask for help whenever you need it. You will be fine!

case_study29_image1

 

 

Big thank you to my friend Hattie for kindly taking the time to write this. 

Dr Roberts: Inspirational Women

Why is Danielle an inspirational woman?

At medical school, I was surrounded by “high achievers”  but what is most impressive to me, are the people who are brilliant and humble. My friend Danielle is one of them. At the end of 4th year, she was the top ranking student in the whole Medical School. And she didn’t tell a soul. I lived with her for 5 years and she never boasted about how great she was. I once asked her why and she said “I don’t share too much, unless it brings praise to Jesus”. I rest my case. We could all (including me) learn to be more like that!

I asked Danielle a few questions, have a read below!

11113349_10152860742771790_1393450461211578877_o

Tell us a bit about yourself

Danielle: I have just qualified as a junior doctor…which has been my lifelong dream, so I’m really excited about that! But more importantly, I am a proud mum of a beautiful boy and I am a strong Christian.

You are one of the most driven people I know. Where does that come from?

Danielle: Throughout my life, focus and determination has been my hallmark. But it’s interesting because I wouldn’t describe myself as being overly competitive. I mainly compete against myself! I always strive to better myself and disappointment for me is when I fall short of what I know I can achieve. I am never satisfied with stagnancy; but rather work to make sure I am moving forward in one way or another. For example, I took 2 years out of studying when I was pregnant and when my son was a baby; but in that time I passed my driving test, I achieved my Duke of Edinburgh Gold Award and I completed the British Sign Language Level 1 course. We all have 24 hours each day,the difference between success and failure is how you use that time. I always plan how I will use my time, and that leads to productivity; rather than watching the hours pass by being wasted.

For people with children who also want to study, what tips can you give them?

Danielle: As you can imagine, it’s not easy at all! My advice would be to look ahead, because at the time all you want to do is be there for your child and you would happily sacrifice your desire to study. It’s true that there is nothing more rewarding than staying home and spending every minute with your child. But you also have to think about the long-term. I knew that I would be able to provide a better life for my son if I got a medical degree. At the time you feel like such a bad parent and that your child hates you, but you have to fight those feelings and hold on to the reason why you are doing it. For 6 years, I travelled back to London from Bristol every other weekend to spend time with my son. Every Sunday when I would leave to go back to Bristol, I would feel so down and dejected. So many times I would be sitting on the train fighting back the tears. That’s when I would pray for God’s strength to carry on. At the end of the day your children will be so proud of what you have achieved, and those short years of struggle will be long forgotten.

11011810_10152860742716790_5452703815664035728_o

What kept you motivated at medical school when you had a child too?

Danielle: My passion and motivation stems from my childhood dream to become a doctor. If you have a dream and you are serious about it, then the desire to achieve it will drive you to do whatever it takes. Similarly, if you don’t have a dream then there is nothing to strive for. Also, children can be a massive motivator. I was always determined to complete medical school; but the added pressure of having to achieve in order to be able to finish studying quickly and get back home to my son, just pushed my drive up several more notches! I wouldn’t allow myself to fail because I owed it to my son not to. Everyone thought I just wanted to be the best, that I was chasing that number 1 ranking, but actually I just wanted to not fail! With each exam, my thinking was “the closer I get to 100%, the less likely I am to fail”! I just wanted to give myself as big a cushion as possible because I wasn’t going through all this emotional pain and struggle, and putting my son through it too for nothing!

Do you have any tips for work experience for medicine for those with no medical contacts?

Danielle: The road is harder if you don’t come from a medical family. Opportunities won’t be handed to you on a silver platter, so you have to seek them out yourself. That means making lots of phone calls and writing lots of emails. But if you show passion, people will happily help. Have an open mind about work experience. You should try to get a placement in a hospital, but also think outside the box and cast your net wider. Elderly care homes, orphanages, homeless shelters etc. The key is how you reflect on your experiences and what you learn from them. Any experience of working with and caring for people can be related to medicine, and as long as you can make the link then you can successfully talk about it in your personal statement and interviews.

When you achieve so much, how do you stay grateful and humble?

Danielle: By remembering it’s not because of how great I am, but because of how great He is! I’m talking about God. My faith in Jesus is my rock and it keeps me grounded. With each test and struggle I pray for God’s help and He has brought me through every time. My gifts and abilities come from God and so I boast only in Jesus…. not in my own strength.

All grown up
All grown up

 

Since I last shared this blog post, my dear friend Danielle has completed an academic foundation job in London and has begun a masters programme. She has also just got married.

Screen Shot 2017-09-15 at 23.22.41.png

 

I hope her story helps to inspire you too!

Until the next post!

Salma xx

transitional state:med student to doctor

Having recently officially completed my years at medical school, I have been receiving a lot of congratulations from friends and family. It has been lovely. But in amongst this I have noticed a few funny reactions!

Below I have shared a few. Can any of you relate? Let me know!

1.) People have started to ask intrusive questions about my love life (or lack of) which is followed swiftly by the “well don’t you want to get married?” Erm, give me a break aunty I have never met before!

2.) People think that you can now fix your own medical problems. Erm no. Dear family member, if I come to you with a funny spot on my finger I expect your full sympathy and theory on what could have caused it. Telling me “you’re the doctor” is unacceptable.

3.) People make assumptions (incorrecty) based on how much money you will be earning. You go from being the broke student to the millionaire in their eyes. FYI I’ll probably still be broke. Just dressed better.

4.) You will be told not to think you are not anything special. “Even doctors have to cook for their family”. Groundbreaking information.

5.) You will have to sit through and politely nod at several versions of “that time I was ill: season 1-9”.

6.) Without even asking, someone will tell you “my family are all doctors” or “my neighbour is a doctor”. Shout out to the Pakistanis for this one…

I hope no one takes offense to these!

Until the next post!

Salma xxx

ps: have a look below for a bit of nostalgia.

image
Post exams! Not quite photo ready
image
When you are unexpectedly given the afternoon off! I shall miss this..
image
Cheers @ Graduation Ball.
image
“Let’s try and take a nice picture take #1”

“Get off my boat. Please.” A tale of lost friends.

In your 20’s, at uni, you are surrounded by friends. There is always someone to go shopping with or to that exhibition. But at some point you realise that you have accumulated people in your life who don’t add anything. If you think of life as a river and your life as the boat, without realising it, people hop onto your boat. People who aren’t going to help you paddle when things get tough. When you have to deal with not getting that promotion you worked really hard for or the illness of a family member, whatever. If they aren’t helping, you don’t need that in your life. Hear me when I tell you these people need to go. You do not need dead weight.

You might not be able to identify these people straight away, but a crisis is usually the way I get that clarity in my life. Who is there for you when things go wrong? It may be surprising, but I’d rather find out now than later.

Those people to have fun with are something else. They are people to have fun with. And we all need those. But this isn’t an investment. These people won’t show up for you when things go wrong and to think otherwise is foolish in my opinion. But those friends who do show up for you are diamonds, and should be treated as such. Some of my friends I have known since I was 4 years old (hi Kourtni). Those friends who would hop on a bus to see your Mum in hospital are the ones who will paddle with you. Wouldn’t you rather spend more time with them than waste time running time for people who will never show up for you like that.

Time is a gift and you can choose to invest it in those friends, or run after people who will never paddle for you.

Just a thought.

Until the next post! xx

The start of a beautiful thing
The start of a beautiful thing
Thanks for posting this Chrissie! Kourtni sitting at the front with another good egg, Rosa.
Thanks for posting this Chrissie! Kourtni sitting in the front with another good egg, Rosa (to her left)
GCSE
GCSE “revision” in Victoria Park
My surprise part before heading to uni.
My surprise party before heading to uni.
IMG_3433.JPG
Celebrating Kourtni graduating

 

 

How to stay focused

No matter what is going on in my life. Exam season or no exam season. A busy day or a lazy day, the underlying mission of my day is always “how can I be better”.

I extend this to every aspect of my life and this mission to be better could range from learning a better way to look after my skin to a better technique to perform a clinical procedure. Whatever.

If I see someone doing something well I always think, how can I do that? How can I better myself? It’s not a competitive thing with that person, it’s purely me wanted to improve myself.

My friend once commented that it must be quite tiring being me, and I do understand her point, because always  trying to be the best in every aspect could be tiring. But it’s only tiring if you don’t accept that you will fail. Because no one is perfect.

I fail to be the best me all the time. If you have seen me around exam season you can vouch for the less than best Salma coming out. Less Carrie Bradshaw and more Coco, the homeless sister they never let on screen. But even getting half way there, ok, a quarter of the way, is better than where I started off. Which suits me just fine. And I’m not afraid to fail.

Obviously my motivation fluctuates. And on those days that I feel like I need an extra boost I will actively work on re-focusing on what is important to me and getting my life together or “fixing-up” as I call it.

I thought I would share what I do help keep myself focused as it might help on of you. I would love to hear what you do.

1- Look at “Project 2015”.

2015-06-10 21.23.48

At the start of this year I sat down with a folder, some A4 dividers, A4 lined paper and a pen and tried to divide up every aspect of my life.

My first page instead of “resolutions” has “Main aims” that I want achieve by the end of the year. Some are very specific and some of more general. I would love to share them but I think I already share a lot of myself on this blog and would prefer to keep this to myself.

An example could be:

Buy a car

Run a 10 K

Since this is on my first page, I see it every time I look at my folder and it’s a good little push to fix up if I’m way of target! Things might change and that’s fine, but it’s always good to re-evaluate.

Next I divided every section of my life up. I have a section for everything that is important for me. Over 20 dividers…what can I say, I care about a lot!

An example of sections I have are:

Finances

Relationships- to make sure that I give my friends and family enough time. I made a list of all the people I want to spend time with to make sure that it is never too long before I see someone. I am generally quite good at keeping in contact but it is useful to have a list.

Religion- things I want to do more often, or learn about

CAPS – a logbook we had to fill out at Med School…

Usually looking at this folder is enough to help me get back on track. It helps that I have already spent the time dividing up my life (or trying to).

Obviously, these dividers don’t solve all of life’s problems but it helps having them in small chunks!

This is the first year that I have ever done this but it has really helped so far. I use to envy super organised people and it has been a real effort for me to try and be more organised but it is worth the effort.

2- If I’m really stuck I will listen to a great TED talk.

I tend to listen to the same talks again because there is a message that I feel I need to get.

One of the best TED talks I have ever watched is “Why 30 is not the new 20” by the brilliant Meg Jay: https://www.youtube.com/watch?v=vhhgI4tSMwc

It is terrifying and but also very motivating for me. Guaranteed that at the end of the talk I will want to go for a run or eat some goji berries and do some yoga. Ok I exaggerated, but you know what I mean. It gives me a clarity of thought that can get lost in the general noise of life.

If that hasn’t helped (and that would be very unusual for me) I will watch some Oprah Super Soul Sunday.

Just as a little disclaimer, this might sound like a lot of organisation but my life isn’t a cardboard cut out of perfection! It is messy just like everyone else’s, but I just wanted to highlight some of the useful things that I do in my life that help me out. I think if you have something to work towards, it makes getting what you want a lot easier.

Until the next post!

Salma xx

A tale of egos and instagram

Recently I had a little break from social media. Well Instagram and Facebook and anyway.

I was using them too much and I concluded that it wasn’t very healthy. I noticed that apart from the obvious unnecessary time consumption they were also making me quite vain. Or were bringing out the vain side of me. I’m still not quite sure if Instagram made me like that or I was already like that.The 21st century chicken and egg conundrum perhaps! A break away, too many “babe, you ok” WhatsApp messages later, I was back, but this time I had changed. I am trying (the operative word being trying) to use social media more responsibly from now on because for something that is just a ‘bit of fun’, the negative impact to someone else and indeed to ourselves can be very real.

Our lives on social medical can become so fake that we now have to attach hashtags to show when something is real. You know the #nofilter or #nomakeup or #noediting. #Justsayin. There is nothing wrong with showing your best self, or best parts of your life, but something about the fakeness of it all irks me and no more so than when I feel like I am being a victim or perpetrator of it. Both of which I am gulity of. We all show our great meal, but not the pile of dishes we have to wash up. It’s a small example, but this sort of selective sharing, because let’s be honest, we are all hiding more than dirty dishes, must be having some sort of negative impact.

Hence my new resolve to only show that which serves some sort of purpose. For example, sharing a picture of me looking great will only inflate my ego (which I don’t want to do) or make someone else feel bad on some level because they may not be looking great at that moment (again I don’t want to do this). Like when you pick up Vogue on a Sunday when you’re looking a bit rough. Bad idea. But sharing a post about £1 lip sticks (you’re welcome ladies) might actually help someone. And that is something that I want to do. You might will definitely catch me slipping, or selfying (is this a word, and if it is, oh dear) but hopefully not for too long!

Have you ever thought about how you use social media?

Me walking away from social media into the land where apparently a hairbrush didn't exist. Frightening stuff.
Me walking away from social media into the land where apparently a hairbrush didn’t exist. Frightening stuff.

Inspirational People part 5

Today’s blog post has a slightly different feel to it.

There are a lot of things about being a Medical Student that aren’t talked about and repeating a year at Medical School is one of them. For every “passed my exams” Facebook status, every year there are a people who have to deal with having to re-take the year. For whatever reason.

This post below was written by someone I know who has been there and come out the other end. I hope it can help someone.

I have put in the inspiration people section because seeing someone deal with something like this and come out of it the other end is inspirational to me.

Have I seen you before?

Repeating a year can be frightening, embarrassing and frustrating or it can give you a second chance – a chance to take things slowly and start again. Press the refresh button and rewind. When you enter E29 or Lecture theatre 1.4, half the year have no idea of your back story and the other half may have vague recollections of you from their original year. Both sets of groups will be making assumptions about you and questions will arise, but remember it is not their information. It is yours.

You can go through the year in two ways: 1) Tell people you are repeating if they ask or 2) Don’t tell them anything.

Accepting that I had to repeat the year was most helpful in tackling the way I would handle the year again. Having the perspective of what the year entails and the knowing the terror of exams was key in forming a timeline in my head. Use this to your advantage to keep on top.

Another important thing to remember is that you are not alone. There will be other people in your shoes. Support one another.

I went through 4.5 (second 4th year) telling people I was repeating as I had met somebody who had done the same in my first fourth year. I thought that showed a lot of courage and honesty and I respected the way they handled it. However the first person on my placement that I told would never let this fact go. They took it upon themselves to inform the rest of the group or act as a constant reminder at any chance they got.

Keep in touch with your friends from whatever year. They are sanity. Don’t cut yourself off no matter how embarrassed or disheartened you may feel. Make new friends as well. When your old friends are gone after their graduation, knowing you still have people around for your final year will be a comfort.

Turn to things which de-stress you. Whether this is friends, family, books, music or religion. You will need something to take your head off of medicine. Don’t assume that you need to be studying 24-7 to pass after failing. You just need to find a balance.

Having your notes from the previous year is helpful, but don’t rely on them alone. Make new notes or add to your existing ones. Go to the lectures you feel are appropriate, especially ones that you knew made no sense the first time around. Have a timetable or plan from day 1. Stick to it as much as you can but remember to relax as well. You don’t want to burn out.

When revising try and understand things rather than memorise. Having revised them the year before, the topics will make more sense and may take less time to get through them. Keep revising until you are satisfied and start early. Do everything before you did the year before.

At the end of the day, believe in yourself. Ignore what others may assume or even say. You may have failed once, but looking at what you failed and why will be more productive then blaming the system. Learn from the previous year and make changes.

The mantra that worked for me was written on a post-it note by one of my friends:

Step 1: Accept

Step 2: Challenge

Step 3: Persevere

Step 4: Be unafraid

You will get through.

Aawaz would like to thank the writer of this post for such honest and helpful insights.

Checklist: stethoscope, badge, pen torch, kindness.

“Please. Stop. You’re intimidating me and I can’t think.”
“Oh. Really? Am I?”
There was no sarcasm. This was a genuine question. She had no idea.
“Yes you are”. I mustered. “You’re a consultant and I’m just a medical student. You need to give me a second to think”.
It was about 3pm in the afternoon and I had cracked.
 
 
Let me give you a bit of background.
I was doing anaesthetics and this particular Monday morning I was up at 6.30am to drive to placement in time for the 8.30am start.
There was an admin issue and so I ended getting to the anaesthetic room a few minutes late and missed the first intubation. But to the anaesthetist, I was late. And that wasn’t acceptable.
The surgery was long and I had missed all the airway management so I watched the surgery instead. An hour in I mustered up the courage to ask for a patient to see pre-op, intra operatively and post op for a presentation had the next day.
“Oh, you can do my pre-op assessment clinic for me”.
I panicked but the anaesthetist was brilliant and explained everything that I had to ask really well. But I was still terrified. And because I terrified. I was slow. Obviously things were checked again but I wanted to make sure that I personally didn’t miss anything.
What I did end up missing was my lunch but such is the way some times.
After doing the clinic it was time for the afternoon list. I presented each patient in turn and did everything. Every drug, every cannula, every fluid bag. At the same time I was being grilled with question.
Having missed lunch, being petrified of this doctor and not knowing the answer to all of her questions I cracked. By this point I was doing well not to have fainted. So I said it how it was.
“Please. Stop. You’re intimidating me and I can’t think.”
This might sounds like the last thing on earth a medical student should ever say to a consultant. But it was the truth. It could no longer hear her questions. They were too quick for my glucose deprived brain and I had burnt out.
I told her that I hadn’t had anything to eat and she had no idea how long the clinic took me. I was sent away to have something to eat, (a rather sad looking sandwich) and when I came back there was a much warmer reception.
At the end of the day she told me “well Salma, you might not like me but at least you learnt a lot” and I agreed. You don’t need your teacher to be your best friend but you don’t need a bully either.
I think it’s difficult for some people to remember how their position can impact another. If you are a 4th year medical student you will be intimidating to a first year. Empathy is key here.
One of my favourite doctors, a consultant ENT surgeon confessed to me, “Salma, I still feel like a 10 year old boy and yet these people look up to me”.
There are 2 lessons here. 1- Stick up for yourself.  2- As your progress as a medical student and then doctor, empathy is key. Try not to lose sight of what you were like on your first day of a new placement. No one starts off as a rock star. So be kind.  
20150212_123523