This is a slightly misleading title, as I don't actually have breasts, but this week I do get to don a pair of fake-boobs and have my other class mates examine me. This is good practice for a beast cancer clinic I sit in on later in the week. I have a number of lectures this, and every week, a lot more than in my third year, which is a shame but it is nice to be spoon-fed information again. I am also assessed on my elective this week, by having to present a poster based around my experience there. All in all, quite a quiet week.
In our teaching sessions, we are often taught how to do an examination or procedure then expected to practice it, such as abdominal examinations or auscultating the heart with a stethoscope. This session was a about breast examinations, and as they had decided that letting us practice on the female members of our class was not the best idea (probably a good idea, as it could get awkward), so had a pair of fake breasts for someone to put on, and let people examine them. These breasts had a range of strange lumps in them that the people examining could try and find. When the seminar leader asked if anyone wanted to be the person wearing them, and be examined, no-one volunteered. Secretly I really wanted to, but I thought it would look strange if I jumped up straight away shouting "Me! Me!", and was relieved with the couple of seconds of silence that followed the question meaning I could volunteer while looking as though I was doing it to save anyone else from having to do it. I do not secretly want to have breasts (but if it was a secret, would I tell you?) but I love wearing fancy dress to parties, and being examined by 20 people is a great way to learn the examination yourself. Win win! The only awkward part came when it was an ex-girlfriend's turn, and she was clearly not impressed that she she had to examine my breasts. Awkwardness aside, a great learning experience, though I am definitely not confident that I could spot small lumps at all.
The breast cancer clinic I did the day after this session was very useful in putting these skills to practice. I was with a male consultant, and so he made sure that there was a female nurse in with him every time he examined a patient as a 'chaperone'. With what is seen as an intimate examination, I suppose its sensible not to take risks, and have women claiming that a doctor and a medical student molested them in an examination room. It is a bit of a shame that female doctors are trusted not to molest people, and hence do not need a chaperone, while male doctors do, but unfortunately I suppose that this is based on history, and the fact that most of the doctors who do behave in a sexually inappropriate way are men. Anyway, it turned out that carrying out these examinations on real breasts and feeling real lumps was a lot easier than it was on the foam breasts. While breasts could be examined to exclude breast cancer, many of the women there were because they were being treated, or they had presented to the GP with a lump they had found in their own breast and been referred. This made things very useful, as they could say where the lump was.
The type of examination breasts I wore. Not the most realistic things, but probably a good idea to get used to these, as they will be used in my examinations
All of the lectures that we are having this year are starting to become a little boring. I thought I had escaped lectures after leaving my 2nd year, then had a year of them in my intercalated degree, now have another year with quite a few in them now. My third year didn't have nearly this many in it. I hope its just the oncology rotation that will be like this, and the other rotations will have a lot less lectures.They are no bad thing, I mean being told the information is better than the third year where you constantly had to seek it out while at the hospital, but I was looking forward to getting back on the wards and practising clinical medicine. I suppose I have the rest of my life to enjoy that, so perhaps I should enjoy the more laid back pace of the lectures while I can. This week we had three, yes three, lectures on how NOT to prescribe chemotherapy. I know this is a serious topic, as poor prescriptions will kill people (it is a toxic drug after all), but we are not expected (or even allowed) to prescribe chemotherapy as a foundation years doctor, and then hopefully we would be taught properly if we became an oncology registrar? Perhaps I am just feeling grumpy as I need to get up for lectures at 9 again.
At the end of this week, I had the assessment for my elective. I had to sum up my 6 amazing weeks onto one A1 sheet of paper. If I was to say my elective was life-changing it wouldn't really be much of an overstatement, but this isn't really the sort of thing you can write on an assessed poster. Working out how to fit all of the experiences down into such a small space was (almost) harder than eating the disgusting sweet-spaghetti (which I made sure not to mention). Despite all the work, the presentation went very differently to how I expected it to. I got one of the academic professors assessing mine (luck of the draw) and instead of asking all around the subject, as I was expecting, I just got asked academic question after academic question. What were the three main forms of malaria after Plasmodium falciparum? (Fortunate I did that immunology degree, really!), If a young patient presented with low heart rate low blood pressure what would the most likely diagnosis be? (No idea with that one, snake bite?) and so on. I do not think I performed very well at all, unfortunately, but what can you do. Still do not have my mark back, but I would hope that I would have been told by now if I had failed. One more assessment out of the way, and one step closer to being a doctor...