The Medic Journal

The musings of a fourth year English medical student

Tuesday, 7 November 2017


Something weird has happened. Somehow, I am already in fourth year and I’m prepping for the infamous final medical school exams.

Despite how astonishingly quick this is all going, I absolutely love fourth year. The timetable is almost entirely composed of hospital placements, with only two lecture days in the whole year! I cannot tell you how much I hate lectures, hence why I’m loving this year so much.

The structure of the year is as follows:
  • Four days per week of placement, 8am-4pm or 9am-5pm
  • 1 tutorial day each fortnight 9am-3pm at university
  • 1 day each fortnight for self-study

People treat you differently when you’re in the older years. You are given more responsibility; people are more interested in your opinion. You actually get to practice being a doctor. While some jobs like ringing the pathology lab are very boring and tedious, others like scrubbing in theatre or helping clerk a patient in SAU feel fantastic.

Of course it’s not always perfect. I didn’t enjoy the five hour ward round, where I hadn’t eaten or had a sip of water while the patients tucked into their fish and chips. My heart sank when a CT1 was continuously bleeped, who turned to me and said, “I hate my life”. It was frustrating seeing some patients repeatedly readmitted for non-medical reasons. I’m stating the obvious here, but the NHS is in crisis. It’s not an exaggeration. I do worry how this will affect my training; will I still enjoy the job if the pressures continue to rise to unprecedented levels?

My other issue is the dreaded e-portfolio that you never ever escape from. It is incredibly strict. You have a list of the minimum number of histories, exams and procedures you must carry out during your placement. The first challenge is finding someone who is free to supervise you. However, you can’t use the same person more than twice. Ideally you should be doing these tasks in front of consultants, as they are more experienced. Then you have compulsory study modules to attach and reflections on clinical practice. It’s a pain, but I may as well get used to it, as its demands will only increase throughout the training.

This is such a fantastic year. In spite of the negatives, I feel reassured that the hard work will be worth it. Loving placement has to be a good sign, right?


Sunday, 10 September 2017


Well, Summer is over and so it’s back to placement.

Going into fourth year feels scary. At my university, we sit our medical finals in fourth year, not fifth year. Cue immense pressure and frantic worrying! Most of the time spent this year is in clinical placement. I chose to change hospitals and am in a small district general. Personally I think the smaller the hospital the better the teaching. I was in a large university teaching hospital in second year, where nobody knew my name. Then in third year I moved to a district general, where I felt like I had a place and people didn’t just look straight over my shoulder. Now I am in an even smaller district general and I cannot say enough good things about it. Everyone seems to have more time to teach; everyone wants to teach, which is ironic now that I’ve left my ‘teaching’ hospital.

In spite of how wonderful I think the placement is going, I am lacking so much confidence. When I’m asked to do some bloods or a cannula I have 5 seconds where I freeze up – I dread that I’m going to mess it up. Sometimes I am too scared to speak up and ask to be involved more. It can be hard to pipe up and say “I want to go to theatre, too, please”. I really have to force myself to be brave, because what you put in is what you get out of the placement.

On Friday I was really struggling. I felt as if I had got to know a patient and they seemed to be very polite and sweet. Then we had a long chat about this patient with the consultant and the problems they faced. We were all dodging the elephant in the room, until the consultant said: “I don’t think [they’re] going to leave hospital”. I have been involved in the care of dying patients before, but this felt so much worse. This person was not actively dying, but things weren’t getting better. Now that I felt I knew them better, I felt even more sorry for them and cried quite a lot when I got home. I’m not sure how I’m going to feel when I next see them.

I do feel drained and scared, but I also know there’s nothing else I would rather be doing. I can’t think of any job more rewarding or interesting.
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