Orchestra and Epilepsy

The brain is like an orchestra, with everything running smoothly and in harmony with one another. An orchestra is usually playing together to play something nice. However every now and again a Lady Gaga appears and disrupts the whole bloody thing.

That is how you explain epilepsy to an eight year old

Ward 401

Not a very enticing name for a medical documentary about life on the geriatric wards. We have plenty of programs dealing with sick kids who people can very easy feel sorry for and go "oh, isn't she sweet," or "what a brave little soldier he is," etc etc.

How about a program about life on the stroke unit or the geriatric ward?

 (SHIT! I MEAN HEALTH CARE OF THE ELDERLY WARD - WHAT? THATS POLITICALLY INCORRECT TO NOW? SORRY - HEALTH CARE OF THE OLDER PERSON WARD).

Ahh, I see. Talking about Mrs Jones who has dementia, cant wipe her own bottom and has come in because she has had a fall doesn't make very good television.

OSCE or SSCE?

Is it an Objective Structured Clinical Examination or a  Subjective Structured Clinical Examination?

On paper is should be objective but in real life its down to whether or not the examiner takes an instant like or dislike to you.

The FM passed a resit OSCE yesterday. On her first sitting she got 31/32 for the head and neck station. Second time round she failed this station, despite her examination being exactly the same, a neck lump in exactly the same place and her suggested differentials being the same.

This time round she got full marks in the lower Peripheral NS and Breast station, despite failing them first time round. Her examinations were exactly the same, down to the same way she introduced herself and held the tendon hammer. This time round the OSCE gods were smiling.

There is also the fact that OSCEs are a game. First time round she passed the critical care station but dropped a couple of marks. After getting feedback she realised there was a mark for commenting on the values of observations given to her in the station. Second time round she scored much highly for saying things like this...

"This blood pressure of 80/40 is low, I am concerned by it."

Repeat above statement but for pulse rate, respiratory rate, oxygen saturation etc.

A similar example is in the radiology station. Two bloody marks for simply stating that this is a "PA chest radiograph."

Is this really the best way we have to decide who is suitable to be a doctor or not?

On another note she got 29/30 for her abdomen examination (on both times), saying to the examiner that she would admit this patient who had an ileostomy two months and was in an incredible amount of pain, was probably the right thing to say.

IS THERE

The Fuddled Medic is now DR FUDDLED MEDIC. You heard me - A DOCTOR!

Assuming she does not have any outstanding library fines that could prevent graduation!

Weekly review

The FM has been stuck in a district hospital for a revision week. She thought they would bring patient in with signs for us to examine. Nope, mainly practicing on each other and answering questions such as "what are the causes of clubbing?"

Here is another video from the chasers for you to enjoy

Back in the UK

Where has the FM been? Here is a clue..

But anyway, back where money isn't water proof. And back to the grind, today she is going to have a fried breakfast, then she's going to the gym. Having lunch with a friend and then doing OSCE practice.

In other news she is no longer going to do four months as an FY2 in opthalmology -  its been changed to ENT.

Max and Spartacus

I've met Max Pemberton, he's a top notch bloke and I agree with his views on the NHS. I also agree that virgin trains are a pile of poo (thankfully the FM has a car and doesn't have to rely on the choice provided by railway companies).

Is the telegraph going to be sued? According to twitter, NO.

But his article is still worth a read