Day 2: Reflection on the InvestIN Young Doctor Internship

Image credit: Independent nurse*

The InvestIN Young Doctor Internship was a five-day course from 15:30 to 21:00 IST that aimed to give students knowledge, experience, networking opportunities, and advantages in terms of studying medicine in the UK. Day two (01.08.21) consisted of teaching consultations (role of a GP), giving experience in “The Ward Round”, learning about specialty doctors and a question/answer panel. This was one of my favorite days because it had a good balance between clinical experience and the social health of a medical professional.

The GP clinic presented by Dr Lucia was an interactive session where a “patient” would come into frame and students would pretend to be a general practitioner and carry out a consultation. The first patient came in complaining of a dry cough and difficulty breathing. At first I thought it was asthma because this is the only illness I could connect to “difficulty breathing”. When taking her history, I thought of questions like; “when did it start,” “how often,” “how is this affecting your life.” When listening to my peers I heard new perspectives and questions like; “what triggered this,” “what makes it get worse,” “do you have any chronic illnesses or allergies,” “do you work/live in polluted areas,” “are others around you facing this,” and “does your family have similar issues.” This made me understand that doctors require a holistic view of a patient before formulating a diagnosis. With the questions asked, we got information such as her allergy to penicillin, her hayfever, how her breathing gets worse with exercise, how she maily spends time at home and the fact her family does not suffer the same conditions. Dr Lucinda helped the class to come up with ideas on what to do next:

• Take vitals; to investigate potential infections and measure oxygen levels

• Administer and allergy test: to find out if an allergy is impacting the lungs

• Use a stethoscope: to listen to the chest and heart rate

• Chest x-ray: to assess lungs

• Peak flow test (how quickly you can blow out air): to assess breathing

• CT scan on the lungs (though this is a high dose of radiation): assess lungs

As a GP, I would be able to prescribe antihistamines, rest at home, and potentially and inhaler. A similar round was done with another patient with a different condition to give new perspectives to consultations and to convey the different cases a GP would have. My main learning was scientific knowledge; there’s a difference between reading the symptoms of an illness on google and connecting a patient’s symptoms to an illness.

Next, the “Ward Round” was an interactive presentation, held by a junior doctor and doctor of a higher rank (possibly a consultant). They went through patients in the ward and did consultations and discussed potential diagnosis (prognosises). What was especially interesting about this section was the etiquette taught and the tools/data doctors have to aid their investigations. Similar to GP consultations, the doctors asked about the history of a patient and linked them to illnesses. Similar to the virtual clinic (on day 1), the doctors referred to data (blood tests, stool tests, urine tests, x-rays and CT scans). This is when I discovered a new term, “news score.” A news score is a scale that NHS hospitals use to determine the severity of a patient’s condition; the higher the score, the more seriously ill the patient is. Moreover, I learned the etiquette on how to communicate with confused/delusional patients. The presenters explained that doctors need to find out if a patient is orientated to time, place and person by asking questions like; “do you know what time it is,” “do you know where you are,” and “do you know who I am.” This would give the medical professional information about the patient's state. Speaking to patients who are not willing to help, or able to communicate was one of my worries since I have social anxiety. I wouldn’t want to be alone with a patient, that I’m expected to help, who isn’t able to share their issues because I would seem incompetent. This session assured me that doctors work in teams to help both medical professionals and patients in the most effective manner, and there is a structure in place for patients who can’t express their problems. This awareness motivated me and contributed to my admiration for the national healthcare service.

The next session on specialty doctors consisted of patients who suffered/are suffering from conditions that needed the involvement of a consultant. This session built my medical knowledge as it discussed the patients’ conditions. Especially the first patient who talked about her hyperthyroidism. I learned about the solutions to this issue and I was shocked to learn that removing the thyroid gland was the best option. I thought removing body components was reserved for the most serious issues so this was surprising. I learned about how radioactive iodine solution was given to the patient to remove the glad. The patient then had to take supplements for thyroid hormones. She discussed that not taking it made her experience the opposite symptoms like giving her heavy flow (on her period).

Lastly, the question and answer session helped develop my understanding of the true hardships of being a doctor. All medical professionals on the panel discussed the emotional impacts and how they hate having difficult conversations with families through the phone (because of the pandemic). They talked about the difficulty of losing patients after they developed a relationship. Listening to these stories help me realize that the academic part or the scientific work isn’t the most difficult aspect. Therefore, I will try to improve my communication and social skills as much as I try to advance my scientific knowledge.

In conclusion, this was one of my favorite days since I felt better contributing to the conversation and I received ample clinical experience. I was able to connect my biology lessons and personal experiences to today’s sessions. Overall, this helped me correct my goals and improve my medical knowledge.

*Image adress: https://www.independentnurse.co.uk/professional-article/how-to-read-the-news-the-new-early-warning-system/218551/