Sunday, 29 April 2012

GP Work Experience

This is Wallingford Medical practice. It's a building on the side of a small stream in a town just a few miles from a train station which is two stops from my station. To the right of the picture, there's a community hospital, including a maternity ward. My week's work experience was spent mainly in the consultation rooms, but I did get to see the hospital too; thanks to everyone's hospitality, I managed to see pretty much everything.
Work starts early in GP practices; I knew that already in theory, but the reality is coffee and morning discipline. Which I actually enjoyed - getting up to do something you are really looking forward to is a great feeling.
One difference between salary doctors and partners is that partners have to work the hours to finish the work, and salary doctors only have to work the hours they're paid. I was shadowing a partner, so I was in bright and early, and was allowed to sit in on the practice meeting. Practice meetings are great at showing the business side of the general practice, something that is not so prevalent in other areas of the NHS, and it gave me an insight into how everyone worked as a team, despite spending most of their days shut off from each other in their rooms. The other thing I gleaned from the meetings was that no matter how many years you've been a doctor, there's always more to learn. In the practice meeting, two doctors were asking for study leave to go on different courses to learn about more in fields they're interested in, and in another meeting, a consultant physiotherapist came and talked about what she did and how GPs can help (when to refer, what to expect etc.).

Each day is split into morning surgery, then coffee, then visits, then lunch (meetings and paperwork), then afternoon surgery. There is also ward rounds of the hospital (which I got to shadow on the last day) in the morning, to check up on patients in the wards and reissue any drugs that needed a new prescription for.
It's hard to pick a favourite part of GP work, because each patient is so different that it's difficult to generalise. I'll probably post one or two of the cases I thought were the most interesting as individual blog posts, but the thing I noticed the most, in visits and in consultations, and in the hospital, was how much the atmosphere was moulded around the patient. Every person was different - an excited visit from an expecting young mum, a calm talk about testicles with a nervous teenage boy, a veeeerryy sloowww conversation with a depressed woman -  I could go on. 
The relationship with the doctor is also different each time, and that's one of the challenges of general practice, I think, because you don't only have to have gone through umpteen years of medical training and have the responsibility of looking after all of your patients, but also you have to be able to communicate with whoever walks through that door. Communication is different to making friends with, as well. In a lot of cases, it would be easy to let the patient tell you what they think is wrong with them and exactly what drugs they want, write a prescription, and let them go. But often, that's not what's needed, and it can be hard to tell someone that they need nothing at all, or a different treatment, or tests. Cooperation is important, and the needs of the patient come first, but a confident, misinformed person could be more of a danger to themselves than the disease they have.

I'll post more about GP work later, but this post is long enough. Bite sized work experience!

Wednesday, 11 April 2012


Finally finished my 2011 in science series. That took a LOT longer than expected. But now that means I am free to post whatever I want!
I have just finished a week's work experience in a GP surgery, which was fantastic, so I'm sure the next few posts will be devoted to that. Also making an Easter resolution to add pictures to my blags so they look less boring.

December: Microbots and Mutants

Okay, so the title is a bit of a lie. Again. But scientists did manage to grow eyes on the side of tadpoles' heads. Which pretty much makes them mutants. Why did they do this to the poor baby frogs? Well, it revealed an entirely new form of control over the formation of organs in the body. By altering voltage gradients, they were able to produce eyes in parts of the body that would never normally have eyes. While this may not have any clinical applications, it is an interesting find in the world of embryology.

Nanorobots were also new to the world in December. These are small (<1mm) machines that can be steered using magnets to the right place in the giant 3D maze of the circulatory system to detect disease and deliver the drugs needed. They have been in the pipeline since 2007, but development started in December last year.

In other science: 2 earth size exoplanets and 1 hospitable exoplanet in the Kepler system (Kepler-20e, 20f, and 22b respectively); engineers at MIT make a camera with 1 trillion frames per second, fast enough to capture light travelling across surfaces, and a potential vaccine for HIV goes into production.

November: elderly embryos and erotica

This month in stem cell news: induced pluripotent cells were created from people as old as 101, a feat which was previously thought impossible due to the ageing process of living organisms. The elderly stand to gain the most from therapies involving stem cells, so the news that they might be able to culture their own could open up new doors in regenerative medicine. Or it could confuse us even more about ageing. Stem cells were also coaxed into specialising into the dopamine producing cells that are damaged in Parkinson's disease early in the month.

On the slightly less serious side of medicine, a woman masturbated in an MRI scanner. Kayt Sukel stimulated herself to orgasm while held still in the device so that her brain activity could be monitored. It's hoped that the data might help both men and women who have problems climaxing, and also that it might offer an insight into how we feel happy.

In other science: a one molecule "car" is built; Scottish engineers start to sell their bionic legs, and the six men put into isolation 520 days previously to simulate a trip to Mars are released.