Tuesday, January 23, 2007


Firstly, thanks to all the people who posted comments in relation to my last post and my new additions to my blogroll. It is very flattering to think that there are medical students and medics out there who enjoy my writing and can relate to it. It makes me think that this blog is worthwhile and it is not just me who is going through this crap of Mucking-Up Medical Careers (oh, sorry that meant to read Modernising Medical Careers - what a silly mistake).

I don't really have a lot to say. There have been a lot of minor incidents in the department, a few major ones and a few I'd rather forget. There have been a lot of people screaming at me, a fair few vomiting over me and a few discharging themselves only to be brought back in by an ambulance crew 10 minutes later because they were found collapsed at the hospital entrance.

The most exciting thing to be happening in my work life at the moment is that we have acquired two groups of 4th year medical students in the department doing their Student Selected Choices (SSCs). They are like chalk and cheese. One group wants to work extremely hard and they offer to do anything (including tasks that they aren't allowed to do) and the other group saunter in late and spend most of their time sitting at the workstation drinking coffee and trying to chat up nurses and ambulance staff. I even caught one girl trying to chat up a severely ill patient yesterday!

It must be incredibly boring being a student on your SSC in A&E. When I look at other specialities that I have worked in and look at the students doing placements in things like paeds and hepatics and then compare them with the students in A&E then the A&E lot aren't allowed to do anything. In fact the student nurses complete more hands on experience than the med students will. They are there to observe how an A&E department works, and I think to learn that emergency medicine is not like ER or Casualty, but although that by their 4th year they will have learnt plenty of clinical skills that they could put into practice (or supposedly will have learnt the skills) due to health & safety and the fact that an A&E department really isn't the place to continuously mess up (not that all students do, in fact some of the students are amazing) they cannot practice most of their newly acquired skills.

They are left to deal with the paperwork (which is good as no one else round here does their paperwork), take histories, take blood samples, cannulate patients, help interpret ECGs & X-rays, run up to the lab and try and bully the bioscientists into getting the sample results faster, administering activated charcoal, acting as mental health liaison by sitting with patients on DSH/suicide watch when the mental health nurse cannot be bothered to tear themselves away from their tea break and if they have a nice mentor, possibly even attempt an ABG or steri-stripping (although they are not allowed to suture).

So I warn you potential med students and med students alike. If you consider completing a placement in A&E during your time at med school, then reconsider because it is by far one of the most boring and non-productive placements, in my opinion, that you will complete. And I am passionate about emergency medicine.


Anonymous said...

I both agree and disagree!

A&E is the best place to clerk patients, because then you can see where they started their journey, and how they were dealt with and what happened afterwards. You get to see the complete picture.

Also, I get to do the most practical stuff in A&E - stuff like cannulation, venepuncture and suturing (we're allowed to suture! Under supervision, of course.) - I was offered to do an ABG with the supervision of a reg, once, but I chickened out! A femoral stab? Hmm, maybe when I'm a little more confident!

Time passes weirdly, though. At times, you are so rushed that it's impossible to catch your breath, and I'm saying that as a medstudent dogsbody!

Other times, you hang around, and there's nothing that great going on, and there's nothing to do apart from fill out forms.

Though, I've never been asked to do paperwork in A&E.

the little medic said...

I think this must vary a lot between hospitals. It even seems to vary a great deal based on who is working whenever your around. When I spent my time in A&E I was either stood around in the way or completely in the thick of it pretending to be a doctor from clerking to ABGs. I chickened out of catheterising people and unfortunately missed a chance to do some suturing - although some of my friends did this under supervision.

I enjoyed my time on A&E but I don't think i'd choose to do an SSC in it. The experience is too unreliable and based on who you can latch onto.