Many people get terribly nervous (understandably) when attending interviews, traditional interviews are often 20 or so minutes long and you find yourself answering questions from a small panel of 2 or 3.
This week I was fortunate enough to attend an informal question and answer session with the Dean of Medicine at Bristol University. During this session he brought up the possibility of the use of MMIs (Multiple Mini Interviews) in the selection process at Bristol University instead of traditional interview. I had not heard of these before and he also said that some universities already use MMIs in their selection process.
As the name suggests instead of one long interview you would have several "mini" interviews (somewhere between 6-10) moving from station to station to answer a question, describe your experiences or solve a problem for example. MMIs originated in Canadian medical schools and the idea behind their use it that they give a better representation of each candidate. For example if one station goes badly or you feel you didn't "click" with the interviewer you can compose yourself and improve on the next station. A collective decision is then made at the end of it all.
The point he stressed most was the importance of formal interview practice in order to prepare you for the "real thing" if you are lucky enough to get one! He understood that it is hard to come by but he said to practice in whatever way you can, it doesn't have to be a medic asking the questions and its most effective when the interviewer is someone you don't know very well, if at all.
Sunday, 29 January 2012
Sunday, 22 January 2012
Euthanasia
This week the aspiring medics at my school met to have a discussion on the ethics surrounding euthanasia with the aim of coming to a conclusion as to whether it should be legal or illegal.
The dictionary defines euthanasia as "the painless killing of a patient suffering from an incurable and painful disease or in a irreversible coma. The practice is illegal in most countries."
I found this website useful for finding out some background information and information on the issues surrounding euthanasia, both for and against.
Few people (including myself) could come to a decision and "sat on the fence." Similarly most people found it easier to argue against making it legal (perhaps one of the reasons why it is illegal.) However there were shared views both for and against. The most common included:
For:
- Death is a private matter and a patient should have a right to die if they feel their suffering is too great.
- Although difficult, it would be possible to regulate. For example if guidelines were clear and several appropriate consultants had to approve the procedure.
Against:
- If made legal over time it may become common procedure, not preserved for the terminally ill but "for the old or simply the inconvenient" and the power could be abused (often described as the "slippery slope".)
- Euthanasia undermines the commitment of doctors to prolong life and if made legal it would discourage the research into treatments for the terminally ill
The dictionary defines euthanasia as "the painless killing of a patient suffering from an incurable and painful disease or in a irreversible coma. The practice is illegal in most countries."
I found this website useful for finding out some background information and information on the issues surrounding euthanasia, both for and against.
Few people (including myself) could come to a decision and "sat on the fence." Similarly most people found it easier to argue against making it legal (perhaps one of the reasons why it is illegal.) However there were shared views both for and against. The most common included:
For:
- Death is a private matter and a patient should have a right to die if they feel their suffering is too great.
- Although difficult, it would be possible to regulate. For example if guidelines were clear and several appropriate consultants had to approve the procedure.
Against:
- If made legal over time it may become common procedure, not preserved for the terminally ill but "for the old or simply the inconvenient" and the power could be abused (often described as the "slippery slope".)
- Euthanasia undermines the commitment of doctors to prolong life and if made legal it would discourage the research into treatments for the terminally ill
Sunday, 15 January 2012
Advice from a successful medical student
An ex-pupil who is now in his third year (studying medicine) at Sheffield came into school to give advice this week.
His "top tips" were:
- to make sure you look around the cities surrounding the universities you apply to because even if you do like the university you must like the city as well because ultimately you're going to be spending 5 or more years of your life there! If you don't like the city then the university probably isn't for you.
- to research beyond the entry requirements for each university, for example which type of dissection do they offer and when does clinical work start? This is to ensure that you don't end up applying for a course which doesn't suit you.
- to practice for interviews as these are often as important as the other parts of the application process.
I found his advice very useful and I hope anyone reading this will too.
His "top tips" were:
- to make sure you look around the cities surrounding the universities you apply to because even if you do like the university you must like the city as well because ultimately you're going to be spending 5 or more years of your life there! If you don't like the city then the university probably isn't for you.
- to research beyond the entry requirements for each university, for example which type of dissection do they offer and when does clinical work start? This is to ensure that you don't end up applying for a course which doesn't suit you.
- to practice for interviews as these are often as important as the other parts of the application process.
I found his advice very useful and I hope anyone reading this will too.
Sunday, 8 January 2012
An Ethical Dilemma
I recently read an article in the Student BMJ which I found very interesting. The article describes a woman who was admitted to A&E with an overdose and had perviously been admitted for self harm at an earlier date. After her treatment for the overdose (whilst still on hospital grounds) she covered herself in lighter fluid and set herself alight however the paramedics spotted her and she was readmitted. It was in theatre during the scrubbing of the burnt skin before a surgical tracheostomy took place that the dilemma arose.
The theatre team spotted a tattoo which read: DNR Do Not Resuscitate
The team proceeded to initiate further resuscitative treatment as they believed it was in the patients "best interests" and failure to do so immediately would have led to deterioration, there was no time to seek advice from an ethicist.
The article describes a method which can be used to analyse ethical issues using four broad topics:
"Medical indications, patient preferences, quality of life and contextual features. The approach is also entirely compatible with the widely used four principles of medical ethics (respect for autonomy, beneficence, non-maleficence and justice)"
(Briefly applied to the case described) With regards to medical indications the proposed treatment would prolong life along with a high probability of success. Patient preferences are made clear by the tattoo although the message may not have represented her current wishes. Failure to resuscitate would lead to grave consequences and no risks could be taken. Quality of life again presents problems, would the patient be grateful for another chance at life or would she be devastated and feel her wishes been contradicted? Finally contextual features considers legal factors, in terms of the tattoo, it was not a legally binding contract.
"The patient continued to be depressed after recovery. She did not complain or display any anger about the intervention; nor did she express any gratitude."
The complexity and difficulties surrounding the case made it very interesting to read but imagine if you had been in the theatre team, what would you have done?
The theatre team spotted a tattoo which read: DNR Do Not Resuscitate
The team proceeded to initiate further resuscitative treatment as they believed it was in the patients "best interests" and failure to do so immediately would have led to deterioration, there was no time to seek advice from an ethicist.
The article describes a method which can be used to analyse ethical issues using four broad topics:
"Medical indications, patient preferences, quality of life and contextual features. The approach is also entirely compatible with the widely used four principles of medical ethics (respect for autonomy, beneficence, non-maleficence and justice)"
(Briefly applied to the case described) With regards to medical indications the proposed treatment would prolong life along with a high probability of success. Patient preferences are made clear by the tattoo although the message may not have represented her current wishes. Failure to resuscitate would lead to grave consequences and no risks could be taken. Quality of life again presents problems, would the patient be grateful for another chance at life or would she be devastated and feel her wishes been contradicted? Finally contextual features considers legal factors, in terms of the tattoo, it was not a legally binding contract.
"The patient continued to be depressed after recovery. She did not complain or display any anger about the intervention; nor did she express any gratitude."
The complexity and difficulties surrounding the case made it very interesting to read but imagine if you had been in the theatre team, what would you have done?
Sunday, 1 January 2012
Volunteering 2012!
Happy new year everyone!!
I learnt about deep vein thrombosis (DVT) this evening which is medical condition that can develop when someone is ill or having an operation.
What is DVT?
A DVT is a blood clot that forms in a vein inside the body, for example in the leg. This clot may partially or completely block blood flow in the vein. This can consequently cause skin warmth, redness and/or tenderness. Although research also shows that sometimes a DVT can form without causing any of these symptoms.
Sometimes part of the clot can break off and travel through the veins to the lungs where it is deposited and therefore blocks blood flow, this is known s a pulmonary embolism (PE). A large PE can cause chest pain, breathing problems, coughing up blood and even sudden collapse or death.
What causes a DVT?
Sometimes DVT occurs for no apparent reason. Others inherit or develop an increased risk of DVT. Finally being unwell and having reduced mobility can lead to changes in the blood and sluggish blood flow, particularly in the veins in the legs. These changes in flow make clotting more likely and the formation of a DVT.
"Risk factors" for DVT:
- 3 days reduced mobility
- You are much less active, are having an operation or have suffered from a serious injury and you fall under one of the following categories ; receiving treatment for cancer, 60+, thrombophilia (a condition which makes your blood more likely to clot) or BMI 30+
- You are dehydrated
- Having an operation that takes longer than 90 minutes (reduced to 60 minutes if the operation is on the leg, hip or abdomen)
How do doctors/nurses reduce the chances of a patient developing a DVT?
An assessment is carried out to calculate the risk of a particular patient developing DVT. Afterwards preventative measures are recommended which are carried out in the hospital and for a few weeks after the patient has left the hospital. Theses may include:
- Avoiding dehydration
- Mobilising early and as frequently as possible
- Use of elastic support such as stockings
- Intermittent compression boots
- Injections of heparin (an anticoagulant or "blood thinner")
- Tablet anticoagulant medication
I learnt about deep vein thrombosis (DVT) this evening which is medical condition that can develop when someone is ill or having an operation.
What is DVT?
A DVT is a blood clot that forms in a vein inside the body, for example in the leg. This clot may partially or completely block blood flow in the vein. This can consequently cause skin warmth, redness and/or tenderness. Although research also shows that sometimes a DVT can form without causing any of these symptoms.
Sometimes part of the clot can break off and travel through the veins to the lungs where it is deposited and therefore blocks blood flow, this is known s a pulmonary embolism (PE). A large PE can cause chest pain, breathing problems, coughing up blood and even sudden collapse or death.
What causes a DVT?
Sometimes DVT occurs for no apparent reason. Others inherit or develop an increased risk of DVT. Finally being unwell and having reduced mobility can lead to changes in the blood and sluggish blood flow, particularly in the veins in the legs. These changes in flow make clotting more likely and the formation of a DVT.
"Risk factors" for DVT:
- 3 days reduced mobility
- You are much less active, are having an operation or have suffered from a serious injury and you fall under one of the following categories ; receiving treatment for cancer, 60+, thrombophilia (a condition which makes your blood more likely to clot) or BMI 30+
- You are dehydrated
- Having an operation that takes longer than 90 minutes (reduced to 60 minutes if the operation is on the leg, hip or abdomen)
How do doctors/nurses reduce the chances of a patient developing a DVT?
An assessment is carried out to calculate the risk of a particular patient developing DVT. Afterwards preventative measures are recommended which are carried out in the hospital and for a few weeks after the patient has left the hospital. Theses may include:
- Avoiding dehydration
- Mobilising early and as frequently as possible
- Use of elastic support such as stockings
- Intermittent compression boots
- Injections of heparin (an anticoagulant or "blood thinner")
- Tablet anticoagulant medication
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