Friday 10 October 2014

From A&E in Dr Gray's to GPST3 in Fort William


So it’s been a while since I posted on here. Since my last post in O&G in Dr Gray’s, I spent four months in A&E in Dr Gray’s and have moved down to Fort William for my GPST3 year.

A&E was a great job. It’s not a particularly big department, but sees it’s fair share of action and acute problems, as well as minor injuries. It’s smaller size also means less staff, so on those freakishly busy days and nights it could feel pretty crazy, I sometimes wondered where all the patients came from! But there were also quieter days too, with ice creams and the commonwealth games, and time to discuss cases with colleagues and seniors, and some impromptu teaching sessions in resus.

The department is run by two enthusiastic Consultants, Emergency Practitioners (who are GP’s with an interest in Acute Medicine) GP trainees, FY2’s and some great nurses. As a junior doctor there I felt a really valued member of the team, getting weekly teaching from the consultants, and lots of shop floor teaching from the EP’s and consultants. As a GP trainee it was particularly good working alongside GP’s and seeing their approach to patients and their follow up, getting used to managing patients, making decisions, dealing with acute problems like MI’s, asthma attacks and anaphylaxis, as well as minor injuries, pulled elbows, dislocated fingers, suturing, and general problem solving for mysterious presentations.

Having thoroughly enjoyed working in A&E I was a bit worried I would miss acute medicine, and the social side of working in a hospital, but I haven’t really. It’s such a relief not to be working antisocial shifts, nights, and having no routine. It’s amazing being able to plan out evenings and weekends away, without the stress of having to rearrange shifts and work ridiculous hours to make the time back. And there have been plenty of interesting diagnoses in GP, and you get to follow them up.

My GP practice has a practice population of about 3000 patients, 3 GP partners, a salaried GP, myself, an FY2 and the reception team. It’s in a lovely new building, alongside two other GP practices, a dentist surgery, health visitors, physio, social work and community psych team (and prob a few more..) The Belford Hospital is only a few minutes drive away in the centre of Fort William.

The view from the practice this morning:


My week is made up of about 6-7 surgeries, an on-call session, a tutorial session, a self study session, and every month we have a day of GPST group work – this year we are joining with GP trainees in Oban – so we meet alternately in Fort William and Oban, for a group led morning, and a facilitator led afternoon. Last month we managed lunch at a seafood cafĂ© on the pier in oban, some paddling and a trip to the chocolate shop in Oban in our lunch break...

I have enjoyed my first couple of months in GP land much more than I did in ST1 – despite the GP practices having a similar feel to them. I think the extra experience I have gained from ST2 and my OOPE, and having done 6 months GP before, has given me much more confidence in managing patients – I don’t have as many awkward moments hovering in the corridor to ask simple things like what to do with someone who has wax in their ears?!

So it’s been a good start to ST3 – I had better stop writing this and get on with some AKT revision…and then start thinking about the CSA… I was warned it was going to be an intense year, but so far it’s been really enjoyable. It’s great things coming together, and putting things into practice. Mastering the art of good consulting is going to be a challenge, but as my trainer says, it is the purpose of ST3… Hopefully the beautiful scenery will keep my sane.