Work Experience Flashcards
Give a list of interesting things you saw on work experience.
- Gastric sleeve resection
- Stitches on strong-looking man
- Venous ulcers incident
- Hypochondriac old lady
- Depressed lady
- Difficult drug lady
- Liver operation to remove 7 tumours
- Physics department planning for radiotherapy
- Woman relieved to have cancer
- Mastectomy
Gastric sleeve resection (Warsaw)
• Laparoscopic operation
• Reduces the volume of the stomach, leaving behind a sleeve
• Makes the person feel full quicker, by reducing volume and by reducing the production of ghrelin
• Can result in vomiting and digestive problems
• Professor led the operation, but I was surprised to see that he didn’t know how to use one of the cutting tools. It was clearly a new technology and he had to be shown how to use it. This showed how the respect the doctors had towards him was reciprocated.
SKILLS:
• Teamwork, Communication, Respect, Challenge, Life-long learning
Stitches on strong-looking man (Warsaw)
• Man got two stitches for a deep cut on his leg
• Despite anaesthetic, the process would be painful, so the doctor eased the man by mockingly saying “don’t cry”
• This eased the atmosphere and distracted the man from his pain.
• I saw a similar thing at the GP with the young man receiving an injection into his plantar fascia, when the GP used the man’s nephew to ease him
SKILLS:
• Communication, Empathy, Respect
Venous ulcers (Warsaw)
• Elderly man comes in with his son. The elderly man is in a wheelchair and his legs have huge welts on them. These were probably venous ulcers.
• The father and son are both distraught about the situation, but after a short examination, the doctor explains that this is a chronic illness and that it is not a case for A&E.
• Despite complaints and almost tears from the son, the doctor calmly refers them to see a specialist.
SKILLS:
• Communication, Empathy, Challenge
Hypochondriac old lady (GP)
• Elderly woman, very anxious comes in with minor concerns about her back and ear.
• The GP explains in advance that the lady frequently comes in with very minor concerns
• She carefully reassures the lady but does it in a time efficient manner
• She prescribes some antibiotic for the back eczema
SKILLS:
• Communication, Empathy
Depressed lady (GP)
• 50 year old lady comes in, having lost her brother some time ago, nearly losing her brother recently, as well as work stress.
• She is clearly tearful and clearly upset.
• They agree to continue an antidepressant that she had been easing off for a while.
• The GP shows plenty of understanding, by repeating how difficult it must be, while focusing on positives, including the importance of her supportive husband
• She also asks if the woman wants time off work.
• I was particularly intrigued by the way the GP didn’t over-promise in terms of effects, but used a plane metaphor to explain how the effects should “take off” by two weeks.
• The patient seemed hopeful and the GP was keen to understand the patient’s expectations of what the drug would achieve.
SKILLS:
• Communication, Respect, Empathy, Challenge
Difficult drug lady (GP)
• Woman comes in with a speech impairment that makes her difficult to understand
• First, she asks for a letter from the GP to the council to say that she is a responsible owner of her dog. The GP calmly refuses and explains why he cannot do this.
• Second, she wants painkillers for her knees after a knee replacement a long time ago. The GP gives her these.
• Thirdly, she wants sleeping pills and other drugs, which the GP firmly refuses. He suspects she wants to sell these on the black market, especially since she smells of cannabis. The GP later also explains that at the start, the use of the phrase “Oh, never seen you before” is akin to saying “Hey, maybe you could prescribe me what the others refused”.
• When the patient asks for an MRI scan and back examination, the GP subtly encourages her to leave, since she is starting to waste time.
SKILLS:
• Communication, Challenge
Liver operation to remove 7 tumours (Royal Marsden)
• Casual atmosphere in operating theatre
• One quite senior doctor was having problems and struggling to reach the area of removal due to fat
• He was having trouble since he couldn’t clamp the operating area appropriately
• He was venting his frustration in an unproductive manner, blaming the patient for being so fat, but a team member was quick to come and assist him.
SKILLS:
• Teamwork, Respect, Challenge
Physics department planning for chemotherapy (Royal Marsden)
• Shows the diversity of care as part of an MDT
• Are responsible for arranging and planning all X-rays, MRIs and other scans
• They can then help with diagnosis using the results of these scans
• They are also needed in research and teaching
SKILLS:
• Teamwork, MDT
Woman relieved to have cancer (Royal Marsden)
• As part of a breast clinic, a woman was told that the tumour that had been found was of a new cancer, not a recurrence of one she’d had before
• This made it less dangerous, so the woman was relieved to be told she had cancer essentially
• The doctor had to respond with a mixture of comforting as well as happiness
SKILLS:
• Communication, Challenge
Mastectomy (Glenfield)
- Bilateral mastectomy that was nipple and skin sparing
- Cosmetic outcome was hugely important for young lady
- First had a lumpectomy to remove lump, as well as sentinel node biopsy, which came out clean. She had chemotherapy to stop distant metastasis for 4 months.
- After this, she would’ve had radiotherapy to the local area, but blood tests in the meantime showed that she had the BRCA 1 mutation.
- Therefore, it was better to remove the breasts entires (prophylactic, i.e. preventative). This is since the lifetime risk is 80% of breast cancer and 40% of ovarian cancer.
- The operation was 5 hours - removing tissue, stitching mesh and placing expanders.
- Surgeon needed to show both physical and mental skill to support the patient into the best choices.
What volunteering experience do you have?
- Football coaching and refereeing
- Reading at Fairfield
- Dissection club
- Debating society
- School council + Deputy Head Boy
Football coaching and refereeing
• Child who cries when he concedes -> Developing over time, becoming more accepting
• Managing players alongside refereeing
• Controversial decisions
SKILLS:
• Communication, Respect, Leadership, Empathy, Challenge
Reading at Fairfield
• Variety of abilities and skills
• Conversation skills
SKILLS:
• Communication, Listening, Conversation
Dissection club
• Providing basic understanding of anatomy to younger students -> e.g. Heart dissection
• Teaching like a doctor would
SKILLS:
• Teaching, Communication, Leadership
