20 May 2011
General Practice Rotation, I'll miss you!
This is our clinic dragon, where we practice suturing. For the last 8 weeks, I was on rotation at Chermside Medical Centre, which also happens to be the same place that I work as a receptionist. With increasing student numbers and NOT increasing doctor's offices, it is getting challenging to find a placement! So I was very fortunate. And even better, it was walking distance!
I have to say I really enjoyed my time there. I had 8 different docs I could sit in with, and everyone had their own style. Some prefered for me to take the consult and just sign the paperwork, discussing the case after the patent left. Others wanted me to remain silent and observe, saving questions for later. I got the chance to do flu clinics, infant checks, skin checks, pap smears, observe excisions and insert long term contraception. We had lots of gastro and respiratory bugs (common things are common) but every once in a while see something extraordinary. One little patient was 1 of 130 people in the world with that condition. In the middle I had the chance to attend the Clinical update course for GP's on the Gold Coast. This was a great chance to continue networking, learning new skills, and seeing what was at the forefront now. The GP rotation seriously made me think about doing this as a career. The things I like about it is the variety of stuff to deal with, and the chance to do procedures regularly. I also enjoy dealing with mental health issues, which most commonly present first to the GP. My favourite feature, though, is to follow someone's story, and find out what happens next with a patient and his or her situation. I also like the quasi normal hours and no on call time. It makes having a life that much easier.
The stuff I'm not thrilled about is the huge amount of pediatrics that comes into it. I like kids, but they are not my first choice of people to hang around. And the margins for error in diagnosis and treatment are just that much smaller, and I find that kind of scary. However, being in a larger practice, I found that the doctors tend to self-select the patient demographics they like. Dr. Ball prefers geriatrics, Dr. Morgan likes kids, Dr Jones likes minor surgeries. And the right people seem to end up seeing the right Dr for them. So altogether, GP was a very positive rotation for me.
The exam consisted of 3 parts: 2 oral exams and 1 written. The oral exams were divided into a diagnostic case and a management case. You need to solve the problem of a patient's presentation in 13 minutes. In my case, the man was "tired". Oh CHEEZ!! Do you know how many things can make a person tired?!!? (not sleeping, sleep apnea, cancer, anemia, diabetes, depression, thyroid, malabsorption, stress, anxiety, adrenal failure, drugs, cardiac, liver or renal failure.... you get the picture). I at least eliminated the scary ones, and recommended appropriate tests. So hopefully I got it right. The management case involved explaining to a patient about their mini stroke (TIA) due to atrial fibrillation, and managing their care now that they had been discharged from hospital. Again, in 13 minutes. I did get a big compliment from the actor-patient at the end: "you can be my doctor ANYTIME!". I was also told my communication skills were "superb" by the examiner. So confidence definitely got a boost there. Now I just have to wait and see if the marks agree.....
On to General Medicine, which will start Monday at the Redcliffe Hospital!