Hannah Kennedy and Louise Black are two third year medical students at Glasgow University, who have just completed a 4 week elective in rural GP on the Isle of Arran. They kindly agreed to have their elective report published on RuralGP.com…
Our time was split between the five practices that make up the Arran Medical Group, as well as the small community hospital in Lamlash. This allowed us to experience a wide range of rural clinical practice in both primary and secondary care settings. We attended GP surgeries led by various doctors, many of whom also have interests in other specialties, including dermatology and gynaecology. We also had the opportunity to sit in on nurse-led clinics. This meant that we were able to see a range of clinical presentations, as well as practice history taking and clinical examinations. Going on home visits also allowed us to get a flavour of the island community.
Time spent at the Arran War Memorial Hospital was divided between the A&E, the four inpatient wards and outpatient clinics. Taking part in daily ward rounds and seeing patients on the ward provided an opportunity to practice clinical skills and examinations. The size of the hospital also meant that we could get to know patients and follow their care journeys through from admission to discharge. Attending a discharge planning meeting gave us a useful insight into the challenges involved with discharge and social care in a rural setting.
Emergency care on Arran was a highlight of the elective. Accident and Emergency consisted of one bed – a lot different to what we are used to! We got the chance to see patients as they arrived at A&E and fill out casualty cards, which was a first for both of us. This allowed us to practice presenting patient cases and form a list of differential diagnoses, which we found very useful. We also got to experience evenings and weekends on-call. During this time, we witnessed our first emergency helicopter transfer, which was very exciting. It was interesting to learn about the factors that contribute to the decision on whether or not to transfer a patient to the mainland, including weather and availability of transport.
Other things that were useful to observe were consultations at care homes, social work meetings and AMG team meetings, where topical issues were discussed in the group.
As well as experiencing a variety of clinical practice, we also had plenty of time to explore what the island has to offer. On our first day we were sent round the island on a treasure hunt, to get our bearings and see some of sights such as Brodick Castle and the ruins at Lochranza. Arran is a beautiful place with an endless number of walks; a few of which we enjoyed were the Machrie Moor Standing Stones, North Glen Sannox and Goatfell, the highest point on Arran! We also enjoyed spending sunny days at the beaches around the island and eating a lot of tasty Arran Dairies ice cream!
Doing our elective on Arran has given us a great insight into what rural medicine is like. The small, close-knit island community was something neither of us had experienced before. We noticed that this raises issues in medical practice, for example in terms of confidentiality, however, it means that doctors know their patients well and so there is a greater level of patient trust and care provision. Something that stood out for us was the enthusiasm of the AMG team to improve the healthcare for the people on Arran, despite the limited availability of resources on the island. We felt really welcomed by all members of the team during our time, which has added to our positive experience. Overall, an enjoyable and educational elective and an experience both of us have benefitted from.
For future students looking to organise a placement on the Isle of Arran, we have created a “Pros and Cons” list of the elective and “Top Tips” to help you prepare:
|Made to feel part of the AMG team||Hospital can be quiet at times – but this can give you more time to explore or catch up on work in the library|
|Flexible timetable – have the opportunity to see and do things you want to||Expense of travel and accommodation|
|Variety of experiences available within placement – from lifeboat and mountain rescue training to GP surgeries to specialist clinics||Poor weather can sometimes limit outdoor activities|
|The opportunity to get involved with practical skills
|Transport around the island can be tricky without a car – as buses don’t come frequently and practices are quite spread out|
|A lot of outdoor activities on offer on the island|
|The island is busy during the summer with many events held in each village – something else you could get involved in|
- Organise accommodation well in advance.
- Be prepared for a more relaxed style of placement.
- Grab the opportunity to get involved in placement as the AMG team are keen for you to make the most of it.
- Walking boots, suncream and midge spray are essential!
- If someone tells you a walk will be leisurely, do not believe them, you are in for a trek.
- Try Arran Dairies ice cream.
- Make the most of sunny days and time off by exploring.
We’d like to thank David Hogg for organising our elective and making it possible and the whole of the AMG team for looking after us.