Archive | Medical Students

Reflections on an LIC in Lochaber

Lewis Mundell, student of Dundee University, recently completed a Longitudinal Integrated Clerkship in Fort William as part of his medical school training.  This article featured in Lochaber Life Magazine earlier this month.  It has been reproduced here with the kind permission of Iain Ferguson of the Write Image (picture credits to Iain too).

Training to be a Doctor in Lochaber

Lewis Mundell, LIC Student

I have spent almost a year in the Lochaber community, training as part of a project undertaken in partnership between the University of Dundee and Tweeddale Medical Practice. This is a trial project and a first in the UK. The purpose: to improve the teaching of medical students.

Other Medical Students in Dundee mainly spend their time in hospital in the form of four-week placements in different medical wards. The project I have been doing under the supervision and guidance of Dr Jim Douglas is focused on learning in the community where 90% of healthcare takes place. A focus is spent on patients, to learn from them rather than tutorials or textbooks.

Although the majority of my time has been spent in Tweeddale, 40% of my time has been spent in Raigmore and the Belford Hospital as well as working with Physiotherapists, District Nurses and Pharmacists. By being in the community, I have gained a better perspective of health care, understanding the challenges patients face when the GP simply says ‘visit the Physiotherapist’.

The most unique part of this year has been the ‘Patient Journey’. This has allowed me to follow people through their health care experience from ‘cradle to grave’. I have followed mothers through pregnancy; seen children cope with infections; learned from teens struggling with depression; saw life-saving surgery; watched a patient fight cancer and the hardest part – the privilege of being present at the end of life. Each of these experiences has been humbling and I will never forget the people involved.

Many medical ‘experts’ have said ‘how can a student learn everything he needs to know without being trained in a city, in a ‘centre of excellence’? I would argue that a community like Lochaber is a centre of excellence as it is a centre of people, all actively engaged in training a medical student. In comparison to cities, where community is reduced, Lochaber can recognise its own need for doctors and other health care professionals and therefore its need to train these professionals locally.

Once again I would like to thank you all for allowing me to join your community. I have learned so much! I will definitely consider returning to this area for future training and possibly long-term employment when I’m qualified. It is impossible to list the many people who have helped me, but a special thanks goes to Dr Jim Douglas and all the staff at Tweeddale, Dr Amy Macaskill and the CMHT, Theresa Mackay and the Midwifery Team, Belford Staff, Jaquai Parfitt, Staff at Raigmore, Fleming & Fleming, Lloyds Pharmacy, Macmillan Cancer team and not least the Scottish Ambulance Service.

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Students present Bright Ideas for Rural Practice

This year, the Rural GP Association of Scotland has once again run its student conference scholarship programme.  This is a significant investment for RGPAS, which uses money raised into its Educational Trust fund to support these scholarships.  The scholarships offer heavily-subsidised tickets to enable undergraduate students in the UK to attend and participate in the annual RGPAS conference.

To apply, students were asked to submit a 60 second sound or video clip explaining their Bright Idea for Rural Practice.  We are delighted to feature the winning entries below.

A number of these will be selected for PechaKucha-style presentation at our conference in November.  You can read more about the scholarships here, and also a great write-up of last year’s conference by one of the scholarship holders then, Catherine Lawrence from Hull & York Medical School.

There is still time to sign up to the conference, which takes place from 2-4 November 2017 in Inverness.  £130 for GPs or £65 for trainees gets you two-and-a-half days of quality CPD, along with a conference dinner (and wine).  It’s a great way to catch up with like-minded colleagues, and hear updates on clinical and non-clinical topics that are relevant to rural practice in Scotland.

Well done to all our scholarship winners.  We look forward to meeting you in Inverness!

Rohan Bald (Glasgow): Tackling Loneliness

Emma Bean (Glasgow 5th Year): Drones

Josephine Bellhouse (Glasgow): Improving Use of Communication Technology

Katherine Cox (Glasgow 4th Year): Developing Videoconferencing Peer Support

David Gibson (Glasgow): Awareness of Rural Medicine as a Career

Haiyang Hu (Glasgow): Access to Mental Health Services

Saskia Loysen (Glasgow): Increasing the use of Telemedicine (and pyjama bottoms)

Eloise Miller (Glasgow): Develop Rural Medicine Intercalated Degrees

Danielle Parsons (Aberdeen 4th Year): a Rural Medical School for Scotland

Gregor Stark (Glasgow 5th Year): Rural Research Consortium

Rosslyn Waite (Dundee): Improving Connectivity

Hannah Webb (Glasgow 2nd Year): Access to Sexual Health Services

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RGPAS Conference Student Scholarships 2017

 

Twitter hashtag: #RGPAS17

Student workshop at RGPAS16

Things are heating up for this year’s RGPAS 2017 conference, to be held in Inverness on 2-4 November.  A full programme is planned, spanning a range of topics relevant to rural general practice.  Click here for the latest conference programme.

We are pleased to announce that following the success of student scholarships being offered for the last 3 years, we will once again be offering RGPAS Conference Student Scholarships.

Year on year we aim to build on feedback, including a session specifically for students and trainees which is being led by the current NES GP Rural Fellows – should be a great session.

Never have I been to a conference so friendly, so relaxed, and so full of life.

Read more in student Catherine Lawrence’s conference review

What’s on offer?

Student scholarships are available for a greatly reduced rate: £10 (reduced from £130) for the full programme – including the conference dinner with wine too!  We will also provide accommodation (bed & breakfast) for Thursday and Friday nights – shared twin room, same gender – of up to ten students who register for the event.

The cost of this is being funded from the RGPAS Educational Fund.  Income for this fund includes the proceeds of the donations made for advertising on RuralGP.com, our conference sponsors and other activities that RGPAS carries out to fundraise over the year.

Who’s eligible to apply?

You must be an undergraduate medical student at a UK university (intercalated, international and mature students welcome to apply).  We are keen to hear from any students who have an interest in general or rural practice.

How do I apply?

We want to hear your ideas!  We ask all scholarship applicants to record 60 seconds of audio or video, outlining your bright idea for the future of rural practice.  Is there a technological innovation that you think is untapped?  How do we use new clinical approaches to improve the care of our patients?  How do we improve the working lives of rural GPs and their colleagues?

 

 

Email us at hello@ruralgp.scot with the subject “Students #RGPAS17” along with your submission (a file, or even better a link to a Dropbox/YouTube/Vimeo movie, or Soundcloud audio) and the following details about yourself:

  • Your name
  • Your university
  • Contact address & mobile
  • If you require accommodation, and confirmation of whether this is required for both nights
  • Confirmation that you intend to attend the conference from Thursday lunchtime to Saturday lunchtime
  • Title of your submission
  • “I consent to my presentation being made available on RuralGP.com, RuralGP.scot and affiliated websites/social media”.

Closing date for applications is 15th September.  Successful applicants will be notified by the end of September at latest.  Those successful applicants will then be invited to register and make £10 payment using our online booking facility to secure their place.

Present your vision

We will be featuring a special session on the Friday afternoon of the conference, aimed to bring together students’ visions for the future of rural practice.  From those students who have received a scholarship, we will select several to present a short powerpoint presentation – of 20 slides each advancing after 20 seconds.  This format is often called ‘Pecha Kucha’ and there is a wealth of advice and tips on the internet about how to make a good Pecha Kucha presentation.

The format allows us to feature a number of short, snappy presentations of just over 6 minutes each, and give students and trainees a podium to share their views on the future of rural practice.  Slides can include text, but the more photos the better!  We will let you know if your ideas have been selected for presentation very soon after the deadline, and you can download a template powerpoint file here.

Any questions?  Email hello@ruralgp.scot

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Aberdeen Uni showcases pilot Rural GP exposure for first year students

Aberdeen University Medical School have just released this video to report on a project which enabled first year medical students to experience rural general practice.  A new initiative by the University, made possible by a donation from Mr Joe Officer, saw 14 first year medical students taken on a two day adventure to Cairngorm national park and the surrounding area, to speak to those working in rural practices and to see first-hand the benefits of living and working in the countryside.

It’s increasingly recognised that career advice is essential for the earlier stages of medical school.  Role modelling and creating career aspirations early on can be hugely helpful to students who are thinking about their future career options.  As exposure to rural general practice tends only to be available in the later stages of medical school, this project highlights some of the reactions of students who were given the opportunity to learn more about Rural GP earlier on in their careers.

It’s pretty eye opening just how much can be done in a rural setting when you have a purpose built GP hospital

Kudos to Aberdeen University for recording the experience in such a vibrant and professional manner, and to the students for giving such articulated reflections and comments through the video too.  Maybe this is something that could be rolled out on a wider level?

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Elective Report: Isle of Arran 2017

Hannah & Louise

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:

Pros Cons
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

Top Tips

  • 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.

All photos by Hannah & Louise.
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New Edinburgh University Remote & Rural Medicine Society!

Kirsty Reid, who is a medical student in Edinburgh and newly-appointed President of EURRMS has written this to highlight the work being done at Edinburgh University to engage with RGPAS and other opportunities for undergrads in Scottish rural medicine…

It is my pleasure to introduce the first Edinburgh University Remote & Rural Medicine Society! We are a new student society here in Edinburgh with the aim to promote remote and rural medicine.

We hope to hold talks and workshops from remote and rural medics and surgeons, encourage Edinburgh students to attend next year’s undergraduate conference and help to promote medicine as a career option in remote and rural schools, among other goals. We have lots of ideas and are keen to hear any suggestions or advice!

If you would like to get in touch, please do not hesitate to contact myself or Iwan Williams via email. If you would like to hear about what we are getting up to, please visit our Facebook page which will be updated as we start back next term.

Kirsty Reid
EURRMS President
Email: s0700316@sms.ed.ac.uk

Iwan Williams
EURRMS Vice President
Email: s1206781@sms.ed.ac.uk

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Podcast from @fakethom and @RuralGPScot highlights #ruralLGBTQ work in #ruralGP

Back in March, the Rural GP Association of Scotland (RGPAS) launched a range of guidance designed to make rural practice in Scotland more accessible to lesbian, gay, bisexual, transgender (LGBTQ+) patients.

At the annual RGPAS Conference last year, held in Inverness, we were delighted to welcome Dr Thom O’Neill to talk about LGBTQ+ inequalities in rural areas, and some of the practical ways that as GPs we can reduce barriers to healthcare.

Thom’s presentation stimulated a lot of discussion, and led to a project whereby he worked with RGPAS to develop factsheets, posters and other materials to help rural GP practices ensure that their services are welcoming to LGBTQ+ patients – especially younger patients.

You can find out more about these resources at: www.ruralgp.scot/lgbtq-plus.

We are aware that since then a number of GP practices have had discussions in their teams about how to make their health services more LGBTQ+ accessible.  We’ve also had a number of international enquiries about this work – including from Canada, New Zealand and Australia – who have been keen to use this work to increase awareness.

Thom has also been asked to adapt the factsheets for secondary care use in some parts of Scotland too.  So, as expected, the theme seems to have resonated with a wide number of clinicians and service managers.

Thom and David recently caught up to discuss how these guidelines came about, and to explore some of the themes of why LGBTQ+ patients seem to face specific inequalities of access to health care – and how rural practice has some unique opportunities to improve this.  We hope to have Thom back to this year’s RGPAS Conference (2-4 November, once again in Inverness – details soon) for an update on what how this work has been developing.

You can listen to the podcast here:

In the podcast above, we make reference to the work of Alex Bertie about recording his experience of seeking help and assistance with gender dysphoria.  Alex’s videos make for some insightful and compelling viewing, but this one is specifically about his thoughts about the GP consultation – and the difference that a more supportive and informed consultation can make particularly at a challenging and difficult time.

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Protective personality traits for LICs

Assoc Professor Diann Eley

Today I attended a session at #ruralwonca which was delivered by Associate Professor Diann Eley from the University of Queensland on the role of personality traits on student experience of Longitudinal Integrated Clerkships.

Diann has gained considerable experience in this area, and specifically on how best to support and mentor students effectively whilst encouraging them to reflect on their own personalities – and how that impacts on their clinical decision-making.

I was delighted that Diann gave me a few minutes of her time after her presentation to discuss this in more detail, particularly as this work is highly relevant to the development of LICs in Scotland.

You can listen to our discussion here:

 

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Clinical courage: an evolving concept crucial to rural practice

I was introduced to the concept of clinical courage when attending an International Rural Research Symposium last year at Tromso University in Norway.  Dr Lucie Walters, of Flinders University in Australia, ran an enthralling workshop about some work that she and her team are doing to quantify and understand what we mean and can learn from clinical courage, particularly in the context of professional isolation and delivery of rural health services.

It’s a concept that seems to resonate easily with rural health practitioners, particularly rural GPs.  Despite this, there is relatively little that I have found to expand on the concept.  Two very helpful resources are a “President’s Message. Clinical Courage” by Dr John Wooton (found in Can J Rural Med 2011; 16(2)) and two comments from Peter Dunlop and Keith MacLellan in the followup issue (found in Can J Rural Med 2011; 16(3)).  The latter comment introduces another concept of ‘learned helplessness’, and I suspect that this will be of increasing importance as debate evolves regarding the fragmentation of undergraduate curriculums and the need to consider generalist undifferentiated training versus teaching in more specialist settings.

So, I was delighted to be asked to participate in an interview run by two of the Flinders University students Ella and Laura who are assisting with the project, whilst here in Cairns at the WONCA World Rural Health Conference.  They interviewed me, and they kindly agreed to me interviewing them!

You can hear about their experiences of medical teaching so far, and also more about the concept of clinical courage in the audio clip below:

 

Ella and Laura, 2nd year medical students at Flinders University

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RuralGP.com at #ruralwonca

Today marks the start of the 14th WONCA World Rural Health Conference, being held in Cairns, Australia.

The programme is set to contain a fantastically diverse range of research and workshops covering everything from improvements in patient care, to developing new and effective ways to collaborate across boundaries in rural health.  You can follow the events on twitter using the #RuralWonca hashtag, and already there has been a huge number of comment and links

View the WONCA Rural Conference programme

So far, the vibe at #RuralWonca has been great… benefitting from Cairns hospitality (boosted by a dynamic and helpful team from ACRRM) and a stimulating range of input from stalwart experts in rural medicine, to young, enthusiastic students and young doctors.

Thursday saw a full day of proceedings for the WONCA World Working Party for Rural Health – with the annual Council meeting held in spectacular surroundings of a seminar room looking directly onto rainforest.  As well as hearing about events from the last year, and sorting out logistics for yet another busy year ahead, there was debate about how best to support member organisations and do everything possible to support the growing number of student and young doctor organisations.  The highlight of 2018 is set to be the 15th World Rural Health Conference.  Crumbs, we haven’t even started the 14th conference yet, but for a taster of what’s in store – in New Delhi – see the video below!

Friday brought the World Summit on Rural Generalist Medicine.  The concept and importance of rural generalism in health ecosystems is reaching high levels of resonance now within Australia (where political support for recognising this is higher than ever), and much further afield in both ‘developed’ and ‘developing’ nations.  It is clear that empowering rural generalism within healthcare systems has never been more important, with absolute needs to train future doctors in medical complexity, meet the demands of an ageing population and achieve the levels of health service efficiency that are often more easy to find in the generalist setting.

The Summit also saw the launch of the Japanese Rural Generalist Programme: a major achievement and indicative of the direction that other countries are likely to go too, not least through the inspiration that these developments bring.

You can follow tweets from the Summit meeting using the hashtag #RuralGeneralist

And now for the main event.  This looks set to be a stimulating and busy few days ahead, bringing together an enthusiastic and dedicated group of international confreres giving the opportunity to recognise and drive forward international innovation and collaboration in rural health.  We hope to feature a number of interviews and reports on RuralGP.com over the next few days, like we did with the last conference in Dubrovnik, between a very packed and interesting programme of events.

Follow the WONCA World Rural Health Conference on Twitter:

#ruralwonca

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