From textbooks to treatments

Silvan: For me, it was the GP time on placement. I got to do suturing on a patient. It was really good to be able to do the entire thing in full, rather than the last two to three stitches, with the assistance of the supervisor. It felt like I was taking that next step up.

Cheyenne (MBBS4): I had a sensitive case that sticks in my mind. I took a patient history for a patient with a difficult case and reported it back to the Senior Medical Officers. It was a really good learning opportunity, because being a more sensitive case, I had to focus on my problem-solving skills while also practising clear and compassionate communication. There was also the opportunity to follow up with the patient and to be helpful in what was a very challenging situation for them.

Nicholas: For me, it was a patient who came in with chest pain. Under the direct supervision of the Senior Medical Officer, I was allowed to take a history, do a physical exam and let the Senior Medical Officer know what I’d like to do next. I felt like I could back my clinical knowledge on the case in terms of decision-making and understanding of pathophysiology, investigations and management. It was an awesome learning experience.

How have you found stepping up with more responsibility?

Silvan: As a fourth-year, this placement has translated preclinical knowledge into a clinical perspective quite well. It does stretch you in many ways; having to collect and synthesise a lot of information on the spot and relay it back to your supervising doctor. It hones everything you’ve learned over the past three years. Overall, I feel like this placement has really shifted my thinking to that clinical mindset.

Callum: In the pre-clinical years (MBBS1-3), I did feel sometimes that I was ‘going through the motions’ as my studies geared towards assessment rather than clinical practice. Now being in fourth year, with the emphasis on putting skills into practice, you can see the point of the foundational learning.

It feels like you can place confidence in the baseline understanding of pathology and use it to contribute to diagnoses. It makes you feel a bit more competent. You’re helping someone's journey as opposed to it being purely about your own learning.

Silvan: Yeah, even things like taking blood for instance, in second-year it was more micro-managed and you had a clinician following your every step. Whereas now, when you're out here, you’re not just doing these skills to tick the box of your training. Yes, we are here to learn, but you do feel more like you are part of a healthcare team working for the patients.

Cheyenne: Yeah, I definitely agree. In this placement, you actually felt like you're contributing something to the hospital, which is a really nice feeling. Especially in the emergency department, it is very hands-on. You put the theory into practice, and you also see that the patient you’re treating might be different to the ‘textbook patient’. It encourages you to revisit your previous learnings, while adding brand new experiences.

Nicholas: It’s been great. As a sixth year, I’ve been given a lot of autonomy and responsibility. It’s been great to develop professional relationships with the staff and gain their trust, but also to become comfortable and proficient at the everyday jobs expected of me during my internship next year. I really feel a part of the team, and that I can positively contribute to patient care.

Silvan: I didn’t expect to see the kind of unique and rare tropical medicine cases we’ve been reading up on in textbooks and lectures — things like Daintree ulcers, or this one case of post-streptococcal glomerulonephritis (a rare kidney disease) in a young child that I saw at Midin Clinic.

It was surprising to see it in a place like Atherton. But we’ve seen a bunch of those kinds of cases, and it’s been fascinating to be able to learn more about this.

Callum: I wasn’t sure how active we were going to be as fourth-year students. I thought maybe you would end up just shadowing doctors around the hospital! But the doctors expect more of us than I thought, which is good. There are not as many doctors here as you have at city hospitals, so they don’t have the time to babysit us.

The doctors place a level of trust in you and your abilities and give you a bit more free rein. It means we’ve been quite busy! There is always plenty to do in terms of what you can get involved in as a student, and that’s allowed me to work in different areas of the hospital.

What would you say to our third-year students who will be going on their first major placement next year? What should they be doing to make the most of their placement experience?

Nicholas: I would say don't be afraid to take your time with patients. You don’t need to see people at the pace the doctors do, nor are you expected to! When you are in fourth year, you are still learning how to properly do patient-focused exams, so really take your time and use it as a learning opportunity.

Silvan: It sounds cliché, but you do get out of placement what you put into it. You’ve got to be proactive to seek out and offer help where you can. Don't be afraid to make mistakes because that's the only way to really learn medicine.

Placement is definitely the time to get comfortable and confident in things like taking bloods and inserting cannulas. I think these are the foundational skills that will set you up to be a good intern.

Callum: There's still a lot to do in fourth-year, so keep on top of it, but make sure you’ve got the time for yourself! Go out there and enjoy your placement and make the most of the amazing location. There’s plenty to do in a place like the Atherton Tablelands!

Cheyenne: Yes, you’ve got to keep up with learning and studying while you’re here but focusing only on that could lead to burnout. With the right balance, your placement can be reinvigorating!

Nicholas: I’d say the team are quite eager to have you there because they can use you as a resource as well. So don’t be afraid to get involved and integrated in the team. You learn by doing!

Cheyenne: Make friends with the nurses and appreciate them! They’re awesome and they can get you involved in some of the more hands-on procedural tasks, which are very important to be practicing now.

As Nicholas said, get involved in the hospital, and also outside of it. We went to pub trivia, local events, and have explored the Tablelands. So, branch out and don’t stay in your own little world!