Tuesday, 17 September 2013

Broken bones in Elgin...


Someone recently asked me ‘how was Sierra Leone’, to which I replied ‘better than Elgin!’ Maybe a reply influenced by a week of long days and not enough sleep!

One of the ‘downsides’ to taking a year out, which I was aware of while organising my OOPE, was losing previously allocated jobs I had in Inverness. Although disappointing, it didn’t put me off (obviously), especially since past experience of working in smaller peripheral hospitals (Oban and Orkney), which I may not have chosen over Inverness, have been so positive. Let’s hope Elgin will be as enjoyable…I start in orthopaedics, then move on to O&G and A&E.


It’s been quite a shock getting back into full time work in an orthopaedic department. I was staggered by the number of junior doctors at our induction/welcome on my first day (maybe around 30, not including doctors already working at the hospital, and not including consultants), compared to one in Kambia, which has a catchment population three times that of Dr Gray’s in Elgin. The systems’ are so incomparable though. In some ways work feels much busier here in Elgin; expectations and pressures are so much higher.

I am working as one of four ‘middle grades’ in orthopaedics, and we cross cover general surgery ‘out of hours’. There are 5 orthopaedic consultants, all of whom are very approachable, and put up with a lot of phone calls and questions whenever I am asked for an ‘orthopaedic opinion’, usually from someone far more senior than me! An advantage of working in smaller hospitals is working closely with consultants, a privilege I have become used to working in North Scotland. We are also needed to assist in theatre, so knowledge of the anatomy of the hip and knee is getting better, and seeing first hand the complications of joint replacement surgery...

Last week was a busy week, travelling down to Stirling on Wednesday for a Practice Based Small Group Learning (PBSGL) facilitator course (which I would definitely recommend, if only for the free food which included a 2 course hot lunch!), back to work in Elgin on Thursday, then over to Inverness for GPST2 induction on Friday. Despite being a lot of travelling, it was really refreshing to have time out of the hospital to see that there is life beyond orthopaedics, and to see how much support there is for trainees from the deanery, and to get an idea of the GP ‘community’ and opportunities for ongoing learning/development after finishing training.

It’s also nice to be ‘taught’ instead of ‘teaching’; although I miss having the time to prepare and plan teaching sessions, and also the time to work on quality improvement projects. Despite being so much more developed there are still so many improvements/interventions that could be made to improve quality of care here, it’s just a challenge to find the time to tackle such projects when you’re working full time. 

And life goes on in Kambia; Hannah and Noemi are continuing the teaching programme, and have recently been joined by a retired GP, and are awaiting the arrival of a paediatric nurse. The next teaching trip is in November, and is focussing on severe malnutrition, and I am trying to produce a ‘malnutrition manual’, to give to all the hospital staff and form the basis of the teaching week. It’s really nice to still feel a bit involved with work out in Sierra Leone.

It’s been a difficult transition moving from a Kambia, where you can really feel like you’re making a real difference, to becoming a small cog in a much bigger system of the NHS. But I’m getting there…and trying to get back into the dreaded e-portfolio…

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