{"id":681,"date":"2023-07-26T11:01:51","date_gmt":"2023-07-26T11:01:51","guid":{"rendered":"https:\/\/blogs.cardiff.ac.uk\/carer\/?p=681"},"modified":"2023-07-26T11:01:51","modified_gmt":"2023-07-26T11:01:51","slug":"student-teacher-carer","status":"publish","type":"post","link":"https:\/\/blogs.cardiff.ac.uk\/carer\/student-teacher-carer\/","title":{"rendered":"Student, Teacher, CARER"},"content":{"rendered":"<figure id=\"post-682 media-682\" class=\"image align-none\"><img decoding=\"async\" src=\"http:\/\/blogs.cardiff.ac.uk\/carer\/wp-content\/uploads\/sites\/555\/2023\/07\/20221210_083103-scaled.jpg\" alt=\"Aberystwyth Harbour\" \/><\/figure>\n<p>&nbsp;<\/p>\n<p class=\"Arialdefault\">Four years ago to the day I was probably writing for this same blog. At that time I was 22 years old and I was nearing the end of the academic year in July. I was a third year medical student, and I\u2019d done about eight months of clinical placement: seven in G.P. and one month in hospital. I lived in the outskirts of Aberystwyth with other medical students also in general practice, and Spring was in full swing all around me in the wonderfully verdant countryside.<\/p>\n<p class=\"Arialdefault\">I\u2019ve re-read the articles I posted here during that year in 2018 and 2019, and also the summary article I wrote in 2020. As I say, the earliest of those were four or five years ago. I have re-read them in the hope that, to some extent, I\u2019d be able to walk once again in the shoes of the person I was at that time. I also hoped it\u2019d help me remember the feelings and the thoughts I had back then, some of which might have changed in my own memories in the intervening years. I\u2019ve also read all the other articles posted over the years from the Aberyswyth arm of CARER, now spanning a few years and plenty of individuals. This was because those other stories have common ground with mine, and while we all use different words and tell different tales, they all revolve around a remarkably consistent experience.<\/p>\n<p>&nbsp;<\/p>\n<p class=\"Arialdefault\">In a final piece of writing from me to go up on the CARER blog I wanted to make final reflections on that year. However, I make them in a very different position now. No longer am I a fellow student to any who might be reading these words. I graduated from Cardiff in 2021, I received my medical qualification, and duly I began to be approached by family members at get-togethers and by health-anxious relatives at weddings \u2013 because now I was a doctor, and it was official, and well, what <i>did<\/i> I think that lump on their neck was?<\/p>\n<p class=\"Arialdefault\">I spent 2021 and 2022 in FY1 rotations in Cardiff, in the Heath and in Llandough. Then I chose to return to Aberystywth to complete the FY2. I\u2019ve worked in T&amp;O; Endocrinology; Vascular; Orthopaedics (again); A&amp;E; and Paediatrics. In that time I\u2019ve earned money (<i>finally<\/i>, is the universal feeling); I\u2019ve cried because of work (<i>and that\u2019s ok<\/i>, is what me and my colleagues told each other); I\u2019ve watched my own parents have health problems of their own, watched a grandparent continue to lose her independence; I\u2019ve become more self assured, I\u2019ve become more assertive, and I\u2019ve probably become more cruel and less empathic (there are good data on this as a common experience in junior trainees, I\u2019m not talking with proof about myself, it\u2019s a general comment, but hey, maybe I specifically really have become much less empathic, who knows?). I\u2019ve forgotten a lot of my training, and I\u2019ve had some of my training hammered so deep into my bones that it might be some of the last information I ever forget.<\/p>\n<p class=\"Arialdefault\">Just as in my previous year in Aberystwyth, the area has completely charmed me. More than ever I am aware of the amazing strengths it possesses. These are various, and so numerous that I will now manage to bore 100% of whoever\u2019s been foolish enough to read this far. And, I hesitate to add, few of the strengths will be exclusive to Aberystwyth, and none of them are guaranteed to be perceived by others who work here. I hope I\u2019m not a starry-eyed or delusional representative of the area, or my own experience.<\/p>\n<p class=\"Arialdefault\">There is the landscape: a landscape which when I first saw it on a clear day in September 2018 seemed to showcase the arms of coastline to the north and south stretching out far, far into the sea; a landscape full of old woodland, gentle narrow green valleys, harsh and exposed cliffs, rich rolling rivers and burbling streams, moss-covered walks and bleak mounds of slate. There are patches of forestry pine but these are interspersed with ancient oaks, beech, ash, willow, gorse, heather, bluebells and snowdrops, daffodils and wildflowers. They surround woodpeckers, owls, squirrels and rabbits and hares and foxes and swifts and swallows and kites and ospreys; and of course in the fields there are new lambs, old ewes, cows and calves, mares and foals and farming sheepdogs.<\/p>\n<p class=\"Arialdefault\">There are also the people: and these are unique to Aberystwyth, because they are completely attached to Aberystwyth. They don\u2019t want to transfer to the bigger, shinier hospitals for their operation or for life saving treatment. Most have lived here for years, some for generations. Some of them are so tough they laughed in my face when I raised the subject of pain relief for their broken bones. They are dairy farmers, they are sheep farmers, they are craftsmen, carpenters, brewers, pub owners, forestry officers, teachers, cleaners, policemen, secretaries, lecturers, professors, students, cooks. They frequently bump into a neighbour or a friend or a relative whilst in the four walls of the hospital \u2013 whether it is the hospital porter, the nurse treating them or the A&amp;E consultant. They gossip about each other\u2019s children and parents, and they gossip about whatever else they have in common. I\u2019ve been teased for being English, partly because being English is a tolerated crime when living in Wales and partly I suspect for the flaw of not being from Ceredigion more specifically.<\/p>\n<p class=\"Arialdefault\">Anyway.<\/p>\n<p class=\"Arialdefault\">My point (if there\u2019s a point in there) is that I was once a student, and in Aberystwyth; and I\u2019m now a doctor, and once again I\u2019ve been in Aberystwyth.<\/p>\n<p class=\"Arialdefault\"><strong>What\u2019s it like on the other side?<\/strong><\/p>\n<p class=\"Arialdefault\">And, interestingly, what\u2019s it like putting new students under the looking glass?<\/p>\n<p class=\"Arialdefault\">Because, channelling my inner <i>sensei<\/i>, to some (rather limited) extent the student has become the master. Throughout this year I have taught the current third year medical students &#8211; the current CARERs, the fifth iteration of them. My former tutor, Dr Sue Fish, will have had to adjust to the bizarre fact that the hopeless case called Ed that she taught at the start of all this reappeared in July 2022 asking her if she thought there was a role for a \u2018graduate\u2019 of CARER in this year&#8217;s teaching. I inhabit two roles in CARER simultaneously, that of the student and that of the teacher. That is why I re-read the other articles here: to make sure I have one foot in each camp, to make sure I speak to the students who will read this with an attempt at balance.<\/p>\n<p class=\"Arialdefault\"><strong>What do students feel during their year here?<\/strong><\/p>\n<p class=\"Arialdefault\">At first, they are nearly overwhelmed \u2013 they are, whelmed? They\u2019re given so many things to do that they will spend months subconsciously working their way through it, and it will be months until they feel familiar with all the new things they\u2019ve had to learn and all the new ways of thinking they\u2019ve had to accommodate. Separate from most of their peers in university, they are being asked to learn the ropes of general practice, settle into a small town, keep up with studies for all the same exams as everyone else but see an order of magnitude more patients \u2013 patients with conditions they\u2019ve never heard of, on treatments they\u2019ve never heard of, complaining of symptoms they\u2019ve never heard of. Patients with conditions they <i>have<\/i> heard of, which doesn\u2019t help you at all when they come in worried about the bleeding that won\u2019t stop since the weekend or the breathlessness that\u2019s stopping them getting up the stairs without pausing to gasp or the headache that has them worried they have something seriously wrong. Perhaps the difference\u00a0 &#8211; apart from the sheer number of patients the CARER students see &#8211; is that it is just the student and the patient in the room, and to some extent until the GP walks in the student has responsibility in a way that does not occur on a large hospital ward round or shadowing a consultant outpatient clinic.<\/p>\n<p class=\"Arialdefault\">The CARER students talk to their friends in Cardiff, who seem to be watching really complicated operations, or having to prepare a presentation on a syndrome that has four different dead professors in its name, or on a super-specialist ward round, or in a clinic you\u2019ve never even heard of. At that moment the CARER students risk feeling isolated or cut off, or as if they\u2019re being treated harshly, or that they\u2019re just missing out, plain and simple. All Cardiff students now also have quite a lot of exams to work toward \u2013 definitely more exams than I had to do, and with higher pass-marks.<\/p>\n<p class=\"Arialdefault\">However. There comes a point for the CARER students \u2013 I\u2019ve felt it, and now I\u2019ve seen it in others \u2013 where everything seems to\u2026 click, somehow. Not necessarily in an instant. But watching, teaching, observing &#8211; overnight, the cases seem to make more sense to the students, their management is more confident, their medical identity is more secure. And not for lack of experience: any confidence they\u2019re building up is coming from seeing patients, seeing an endless number of patients with any number of issues. And since so many problems need checking on\u2026 those same patients come back, and who knows how they\u2019ve been in the meantime, if they\u2019ve taken their medication, if they\u2019ve had a trip to hospital, if the tests have been done or the consultant review taken place, if their family is alright. Roughly speaking, this occurs from about March onwards, or five to six months in. The students know what they\u2019re doing, they can build on what they\u2019re seeing, they can stay afloat and do one better. In a quiet, hardworking way they are already seeing more patients than some junior doctors do \u2013 maybe even working harder!<\/p>\n<p class=\"Arialdefault\">Teaching medical students can be difficult. Often, one is given no warning; they simply appear on the ward, or in clinic, or at your side in the corridor. There\u2019s not always a warning they\u2019re coming \u2013 or a briefing for how long you\u2019ll see them. Perhaps you are asked to help cover a teaching session, to fill in a gap. It goes without saying that it is an act of goodwill with no remuneration to speak of. When you meet a group of students, you have to find out what university they\u2019re from, what year group, what they\u2019ve already seen, what rotation they\u2019re on\u2026 it is difficult to find out who they are and what they know. You also have to figure out where they <i>each <\/i>are in their learning. In a big enough group, there are some who are ahead, and some who are behind \u2013 not globally, but for every single topic, disease, examination, idea. Teach them too much too soon and you\u2019ll lose them all to confusion; teach them too little and they\u2019ll be gone to boredom.<\/p>\n<p class=\"Arialdefault\">Teaching the CARER students all year has, thankfully, been relatively straightforward; perhaps a perk of the structure of the year. It is the same group of students each week after all \u2013 it has been the entire year (although we have had some CD1 students visiting!). As they\u2019ve gotten to know me, I\u2019ve gotten to know them. There is a benefit I cannot state to simply knowing the other people involved. A better atmosphere; less confusion; a knowledge of how much the others there already know, or don\u2019t know.<\/p>\n<p class=\"Arialdefault\">The students have to juggle all sorts of work, all kinds of forms, and exams, and projects \u2013 they have to prove they can do various procedures and skills \u2013 and then whilst ticking all these important boxes they have the (not so insignificant) task of learning medicine as well.<\/p>\n<p>&nbsp;<\/p>\n<p class=\"Arialdefault\">I must write now, that it has been a pleasure and a privilege to live once again in Aberystwyth; and it has been a pleasure and privilege to teach this current group of students. I wish them all the best. They are hardworking, caring, knowledgeable people and when they stick the landing they will make good doctors.<\/p>\n<p class=\"Arialdefault\">If you are a Cardiff student \u2013 a current first or second year student \u2013 and you have the chance to do CARER, please consider it. It is not an exaggeration to call it a life-changing experience! There will be nothing quite like it, perhaps ever again in your career; certainly not until you are in a post or a job with the same team for a year (which won\u2019t happen until after you complete the foundation programme). You will see more, learn more and do more than your colleagues; you might even enjoy it.<\/p>\n<p class=\"Arialdefault\">Dr Edward Hatfield<\/p>\n<p class=\"Arialdefault\">2<sup>nd<\/sup> June 2023<\/p>\n","protected":false},"excerpt":{"rendered":"&nbsp; Four years ago to the day I was probably writing for this same blog. 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