GP - a conclusion

Well I am finally all done. I sat the theory exam this morning. I was actually pleasantly surprised considering how random the exam was rumoured to be. I really ran out of time at the end though and I am (in the back of my mind) a bit stressed that when I very hastily transcribed my answers onto the electronic marking sheet (this exam comprised of MCQ) I may have made some errors. I hope they are not all out by one! If so, I will be in a world of hurt.

For the clinical exam I was not so lucky. Two cases: one diagnostic, the other management. The management one was a little different than what was expected, but I think I did OK (I definately left out a few things though), but I froze in the diagnostic. I forgot to be systematic and missed the diagnosis completely. In hindsight, It was staring me in the face! I hope the management case will pull me through - or I will have to do a resit. Now I have a pounder of a headache...and I am off to get my Age of Empires on.

Finishing up my general practice rotation

My last clinical session for the GP rotation was Friday. I think it all went pretty well. By the end, I was interviewing and examining patients and prescribing treatments (with Dr M's close supervision and signature on the scripts etc). I would like to think I did some good. Dr M slightly (in some cases) altered his choice of Antibiotics more in line with the current therapeutic guidelines (where there was any major difference) and some new protocols were established due to patient experiences while I was there.

The "First" major excision I did, turned out to be an SCC...I now find myself questioning...did I allow a 4mm margin? I think maybe a little less. The current recommendations require a 4 mm (SCC) and 3mm (BCC) clinical margin and at least 1mm microscopic margin. The pathology report indicates, I got it all. I guess I will always have times when I think back and wonder if I should have made a different decision. oh well. Dr F is very diligent, I am sure she will keep an eye out with him. No infection or ischaemia with the wound, just a nice fine scar without bunching or hatch marks, very impressive if I do say so ;) The excision from Dr F was benign, but at least it won't cause her concern anymore. Sometimes it is not worth the "wait and see" approach, esp when therapy is so simple and the consequences of delay are so disastrous.

Now, time to study. Less then 47hrs to my clinical exam. 71 hrs to my written (not that I am counting!)

Operation on Dr F

Wow three blogs in less than a week! I don't think that is sustainable (I will try to increase frequency though). Just a quick update on the removal of the skin lesion.

Dr F came straight in, I anaesthetised the area for excision. I "played" with the skin and told her my margins (no marker this time) she agreed and went to see another patient while I scrubbed up and prepared. She came in and sat on the bed, wrist on a pillow and I went ahead. Her skin was a lot thicker than the leg skin on the older gentleman from yesterday. I cut too softly, I was scared of hurting her. EVENTUALLY I got through and stitched it up , very carefully! Quite neat in the end, I was proud. I will find out for sure in about 10 days.