OSCE stations 2011 End-Yr

1. Paeds FTT with baby's weight falling off a bit associated with bouts with loose, smelly diarrhoea - DDx coeliac disease
2. post-natal depression in new mum 10wks post-partum
3. breaking bad news of grade 2 invasive ductal carcinoma.
4. phone call with RN in community hosp 2h away about lady with chest pain and initial management. ECG showed ischaemic changes.
5. Lower abdo and Hernia exam + focused history in male who felt pain in L groin but no visible lump while lifting something at work
6. counseling pt about needlestick injury and explaining occupational health protocol because foreign elective student pricked himself while disposing of cannula needle.

Hard Work Pays Off!

HAPPINESS! :D

Got my uni results yesterday! Full marks! 4 out of 4! Which is awesome! I was totally afraid that I would fail one of the stations because it totally threw me off but after hearing from a friend that the examiner only failed one student in our session, I felt über confident that I would get 4 out of 4. The other 3 stations were relatively easy.

1. Take a history in a 25yo G1P0 22/40 lady presenting with PR bleeding. Just don't misread it as PV bleeding. Some of my friends did. And so did i initially until I saw that I'm the 'surgical intern'. Differentials and management.
2. Take a history from 50+ yo man with sudden onset chest pain with a hx of trauma to L shin after being kicked by the horse (yes we're in Australia). List of differentials and investigations. 
3. Shoulder examination of a 30+ yo male who presented with shoulder pain after vigorous window cleaning over the weekend. Dx - supraspinatus tendonitis. This was the one that threw me off because I don't exactly know how to examine a shoulder but still managed to do the basic Look-Feel-Move-Special Tests
4. Motivational Interviewing - 45yo lady who came in for >45yo screening test. Impaired fasting glucose. Explain to her what that means, the next investigation and advise her on lifestyle changes. She also had a daughter with Asperger's which made it difficult for her to exercise because she had to keep an eye on her. ><

Anyway.. So what does this REALLY mean? It means that I would most probably pass 4th year and make it to my final year of studies! And actually become a doctor! I only need 2 out of 6 for my end of year OSCEs now! :) And of course hopefully pass the written MCQ/EMQs which are supposedly harder than the OSCEs because ANYTHING can come out.

It made me think how far I’ve come these 3.5 years. It has been a harrowing journey (actually just last year) but it’s all good now. I love what I’m doing and although I still feel inadequate, I feel like I am capable of at least doing the basic for my patients now.

For example, I inserted a catheter into this patient today and although I have not done one in over 6 months, I knew what I had to do and having the consultant praise me for my good work and to see the catheter draining well is so rewarding. It was a difficult patient as well as there was a lot of swelling in the area. That made me feel like I can be useful, even now, just as a medical student.

Just had a palliative care session with the palliative doctors. It is so different - the management of palliative treatment. Why would the other doctors continue prescribing simvastatin for a patient who only has 3 weeks to live? Would you prescribe Clexane for a patient who has advanced lung cancer and is immobile? Would you prescribe anti-depressants for a patient who has recently deteriorated and is dying in the next few weeks?

How do you make a patient comfortable? What does palliative care really mean?