The importance of considering lifestyle when choosing a career

As a doctor now in my second year of training, the time is soon approaching for me to choose a specialty which I would like to do for the rest of my career.

Up to this point, my whole drive has been towards a career in emergency medicine and everything I’ve done including my electives, research and portfolio has been geared towards that.

However, something has changed in the past few months where I’ve started to
look at the bigger picture of what I want my life to look like. The past few months, during this covid pandemic, have, at times, consisted of busy, overworked and underappreciated night shifts and late shifts and long shifts, meaning I’ve had to miss out on valuable time with family and friends.

Driving to work for a night shift when you’d much rather be spending precious time with your family because they’ve come from abroad or missing out on a friend’s birthday because of your shift pattern, is not ideal in the least and at times it can be depressing.

Although my heart lies in emergency medicine and everything I’ve done prior to now has put me in a good position to get a training post, I’ve realised that there is more to a good, fulfilling life than simply what job you do or how much you enjoy your job.

I have hated having a rota coordinator telling me when to work, telling me when I have my night shifts or weekend shifts and telling me when I can have my days off. Not being in control of what I do with my days is extremely frustrating.

I’m lucky. The plan for me originally was to do Emergency Medicine for 15-20 years and then switch to General Practice anyway because I have always enjoyed GP too.

However, the more I realise the importance of being your own boss and choosing the lifestyle you want, the more I realise that our mind, just as much as our heart, has to be a part of the decision process when choosing a career.

For me, the idea of being a self-employed GP and having the flexibility to work essentially when I want to and still make a good living doing a job I love, is vastly more important than choosing a job that, yes I may enjoy the thrills of more, but will have little-to-no say over when I work.

When choosing a career, you shouldn’t focus on what life will be like as you’re in the training process but what life will be like once you’re fully qualified/specialised because this is what the majority of your life will consist of.

I need to have flexibility in my life so I can attend important family events, go on holidays when I want, have my evenings and weekends protected to nurture relationships with family and friends and to also have a comfortable income, allowing me to make smart investments so I can slowly work less hours.

At medical school, we are unfortunately not really taught to focus on the lifestyle aspect of being a doctor. However, the present-day doctor is someone who wants to “have it all” in terms of an enjoyable and fulfilling career, a good and comfortable income, time to spend with loved ones and go travelling and also opportunities to explore other interests.

I’m not advocating for any one to choose a career they would hate just because the lifestyle is better, but I am advocating for keeping what you want your life to look like in the forefront of your mind when choosing a career and consider whether or not compromises can be made to allow you to have more of what you want and more of what you will have wished you had when you’re on you’re deathbed and for me that is ultimately having more time with loved ones.

Talking about income and lifestyle and how much someone actually enjoys their job can be a taboo subject sometimes but I urge everyone to have these conversations with their seniors or with those doing a career you think you would want to do as it will help guide your own career decisions

As always, stay happy, stay healthy.

The importance of personal finance as a doctor

Something we are not taught about at medical school is the importance of personal finance. We study for countless years, accrue massive amounts of debt and then are unleashed into the ‘real world’ where we are expected to be able to then manage with all the intricacies and difficulties of the modern financial world.

As a doctor in the UK, we earn a modest salary from which we have many different expenses such as tax, national insurance, pension (optional), student debt, medical indemnity, GMC fees, living costs, travel costs, savings and investments etc. As such, it is easy to lose track of all your incomings and outgoings, especially if you leave it all to chance and are not organised with it.

I have been interested in personal finance from a very young age and have always been interested in savings, making money, spending wisely and how to keep more of the money you make.

I believe it is important for all doctors and medical students to understand at least the very basics of personal finance so that we can live a more comfortable life where we do not have to live a life revolved around the need to work solely for the money it provides.

Below I will list a few key, actionable things we can all do to get our finances looking healthier and manageable. Hopefully these will help us go from a place where thinking of our bank accounts makes us anxioius to a place where we feel confident in our financial health.


1. Understand your payslip.

August, 2017 - HDFT pay

You should ensure your payslip contains the right details, especially the tax code which is the code set by HMRC. It determines how much tax will be deducted from your pay. You can check which tax code you should be on by going on the HMRC website.

Next, look at how much your are being paid. Is it the right amount, taking into the account the unsocial hours or overtime you have done? Then look at the deductions and ensure there are no unusual deductions for anything your do not recognise or opt in for.

I keep a folder on my Google Drive with all my payslips, organised neatly so I can clearly see my salary each month.


A few months ago, I realised it was on the wrong tax code so I went onto the website above and corrected it by filling in a quick online form. It was a painless process.


 2.  Pay yourself first and compartmentalise your bank accounts.

For me personally, what works best is to have different bank accounts for different things, all of which are automated which is key.

architectural-design-architecture-banks-barclays-351264

So for me, my salary gets paid into a primary bank account from which I have set up standing orders and direct debits all on the same date (the day after pay day). 

The standing orders take money from this primary account and send them to my other accounts which include my savings accounts, my daily spending debit card, charities etc. The direct debits go off to certain bills e.g. phone as well as to automated investments such as ISAs.

The philosophy of paying yourself first means to ensure that the first thing your do with your salary is to ensure it goes to your savings and investments first before using it to make other people/companies richer by purchasing goods / paying bills.

This way, you’re able to guarantee that you are slowly accumulating money each month.

3.  Have a budget.

As boring as this point sounds it is absolutely crucial to know your exact incomings and outgoings and use a ‘zero-based budgeting’ system whereby your can account for each penny your make.

So to begin with, it’s important to write down what percentage of your salary your want to save and invest each month. A good figure to start with is 30% (but this could be a lot higher if you live at home and do not have to pay rent etc). This would include having a seperate account which contains an ’emergency fund’ which should ideally be 3-6 months worth of living expenses but this will probably need to be built up slowly over time.

black-calculator-near-ballpoint-pen-on-white-printed-paper-53621

After this, the rest of your money should be budgeted towards crucial expenses such as rent and car payments. Depending on your personal situation and how careful you are with spending, this will either be a larger proportion of your salary than your savings or lower.

And now the remaining part of your salary (maybe 10-25%) should be used towards your ‘guilt-free’ daily spending e.g. lunches, going out, clothes etc.

Each month, whatever money is still leftover, I then tend to put into my savings account so that each penny is accounted for in that particular month’s payslip.

Some people advocate to use a spreadsheet for budgeting which is probably the most accurate way to do it, however I personally opt to use a word document as well as my automation as explained above.

I think it’s important to check your accounts daily too to ensure everything is in order.

4. Read books and watch YouTube videos on personal finance.

A few books I recommend are:

  • The Total Money Makeover – Dave Ramsey
  • The Intelligent Investor – Benjamin Graham
  • I Will Teach You To Be Rich – Ramit Sethi
  • The Richest Man in Babylon – George Clason

golden-cup-and-basket-with-books-6332

A few YouTube channels I recommend are:

  • Mama Furfur
  • The Break Platform
  • Med School Insiders

By constantly updating your knowledge about personal finance, you will then be able to be build the keystone habits, as I’ve detailed above, and understand the reasoning behind them. You will also realise that building wealth, slowly over time, does not need to be a complicated process.

5. Keep more of the money you make.

With all the deductions the government takes from us, it’s important to look into how we can actually keep more of the money we make and also be more tax-efficient.

For example, as a doctor in the UK, I must pay a yearly fee to the General Medical Council. However, we can get tax-relief on this amount which, although depends which tax bracket you are in, is better than nothing.

Moreover, as doctors we can also get tax-relief on exam fees we pay. Also, I would not recommend paying your student loan off early. The student loan is more of an extra tax we pay, and I will not be paying it off early as I’d rather use the money now to invest/save. 

accounting-analytics-balance-black-and-white-209224

Another way to be tax-efficient is to opt into the NHS pension as the pension is taken before you have paid tax meaning you pay tax on a lower amount. Currently, however, I have opted out of the pension as I’d rather have the money now to build up a deposit for a house but I am planning to opt back in when I start specialty training.

There are also certain ISAs which are tax-free up to a certain amount each year, usually £20,000, which again is a good way to pay less tax on investments.

Finally, becoming a self-employed doctor can also open to the door to gaining more control over your finances and your taxes.

This is a great place to start about optimising your finances as a doctor and keeping more of your money.


Hopefully the above steps and information will provide you with the basics of managing your finances as a person new to the world of working full-time and paying taxes and bills. By doing these things we can also set ourselves up for further income and investment opportunities and build that ever-elusive ‘passive income’.

With the guidelines above, I am confident that we can live a life that is more focussed on the important things such as family, relationships and fun rather than feeling depressed about money or chasing money too much. 

In summary, I will say that it is important to spend less than you make, don’t let finances control you (instead you need to control your finances) and finally, do not compare yourself to others as all this does is lead to misery and feelings of inadequacy. We are all in different stages and circumstances and whilst money is important, I have learned it is not the determinant factor of feeling gratified.

 

Low Information Diet

In this era of ever-increasing pieces of information via social media, news outlets and the internet in general it is easy to get lost in the matrix of facts and figures.With around 600 hours of content uploaded to YouTube every minute, half a billion tweets per day and an endless selection of news outlets to choose from, it’s easy to feel overwhelmed and exhausted by all this choice and all this content, a lot of which is designed to be addictive and also anxiety-causing in nature.

If we look at the news for example during this pandemic. There are so many different opinions, views and figures floating around about coronavirus that it can make us, as the public, extremely confused and worried. Moreover, the amount of click-bait headlines circulating on top of the bias towards printing negative stories rather than positive ones leads to a feeling of fear and anxiety which is incredibly damaging to our mental health, self-esteem and sense of security.

I stopped following the news and deleted my social media accounts a couple of years ago after I made this realisation that it is designed to keep us anxious and fearful rather than confident and hopeful. I have been able to replace this time with reading books, studying, reflecting, keeping active, writing, catching up with friends and getting more done from my to-do list.

You may ask: does this not just make a person ignorant?

I would argue that the majority of “news” is completely useless and arbritary. I do not need to know most of it and anything crucial or genuinely important, I will hear from my family, friends and colleagues very soon after anyway.

So what can we do to combat the anxiety and overwhelm that the news and an infinite amount of information brings us?

  • Reduce your exposure to the news. Maybe limit it to once a day for 15-20 minutes. And slowly decrease this further if you find benefit. The expected benefit from doing so is to free up more time do higher value things.
  • Use only two or three reputable news/information websites such as science articles or government websites when wanted information on a topic. This will allow you to streamline your thoughts and increase the reliability of the data.
  • Take time to switch off from social media and ensure you get rid of any negative people on your timeline. Thoughts become things and it’s important your thoughts are positive and realistic because it really is NOT all doom and gloom. You become the average of the five people you hang around with most too, make sure there’s a positive influence around you.
  • Create something. It’s easy to consume, consume, consume. It’s much more difficult but also a much more rewarding to create something such as a piece of writing, a piece of art or even trying a new recipe.

As a doctor on the frontline during this pandemic, I have not been following the death rates during this pandemic. For me, it just felt too depressing and too detached from my job which is to treat every patient that I am responsible for as best as I can. Don’t get me wrong, I always hear of the figures from colleagues the same day, but I didn’t bombard myself personally by checking the news every hour and seeing the number of deaths pop up all the time.

This allowed me to concentrate on the task at hand and remain hopeful.
Hope you guys are staying safe and healthy. Thanks for reading.

Life as a front-line doctor during the Covid-19 pandemic

Understandably, the only topic on everyone’s mind is Covid-19 caused by SARS-Coronavirus 2. We are long past the days where this disease seemed like something happening in a distant land, far far away and that it wouldn’t affect us. As someone from the UK, March has been the month in which Covid-19 has become increasingly rampant and has swept across the country. Initially, there were a handful of cases in the UK, mainly dotted around highly-populated areas like London but now it has spread across the nation. It has affected the way we now live our lives with schools, gyms, museums, places of work all closed and all forms of travel have been limited or stopped altogether.

The ward I work in has been converted into a Covid-19 ward for the past 3-4 weeks, meaning since the pandemic took a grip of the UK, I have been on the front-line of assessing, investigating and managing the patients presenting with suspected or confirmed Covid-19. The classical symptoms are fever, shortness of breath, cough and hypoxia (low oxygen levels) however increasingly we have also noticed these patients can have stomach upsets too. When these patients are subsequently x-rayed, their chests all show the same pattern of bilateral patchy infiltrates and their blood tests show lymphopaenia (low level of a form of white blood cells which are crucial in fighting infection) as well as raised inflammatory markers.

Chest X-Ray of a Covid-19 patient

Having clerked many patient’s in A&E and on the wards presenting like this, I am now able, to a high degree of certainty, to reliably predict which patient’s will have a positive Covid-19 swab result based on the symptoms, chest x-ray and blood tests.

Initially, the patients would mainly be over 60 years of age, but more and more we are seeing patients in their 30s and 40s with no underlying conditions. As there is currently no treatment for this disease, our aims as doctors is to provide “supportive care”. Essentially, this means optimising the level of oxygen in the patient’s blood by providing oxygen when needed, controlling their fever with paracetamol, replacing any fluids they are losing, treating any superimposed bacterial infections with antibiotics, treating any concurrent influenza with Tamiflu and observing the patient carefully for any signs of deterioration. Although some patients can appear to be stable, they have a propensity to suddenly tip-off and deteriorate without any warning signs leading them to have massive decreases in the level of oxygen circulating around their body. These are the patients that worry me the most as a doctor as it can be extremely unpredictable but equally extremely fatal.

At this point, if the patient continues to deteriorate, a decision is needed as to what level of care they would be suited for i.e. are they a candidate for ITU so that they can be intubated and ventilated or do they have such a poor physiological reserve due to multiple co-morbidities (other underlying conditions) that they would not be suited for such intensive therapy. Typically, when it gets to this stage of needed ITU admission, the mortality rate sky rockets. For under 50 year olds needing ITU admission, the mortality is 25% and for over 50 year olds, it is 50%.

A lot of patients who are sadly passing away are above the age of 60. Decisions need to be made early on as to which level of care they are best suited for, taking into account the patient’s wishes, their baseline condition and function, the family’s wishes and ultimately whether or not the clinician in charge of their care believes they would survive intensive therapy or if it would prolong their suffering. We call these decisions ‘Treatment Escalation Plans’ and during a pandemic, they are proving to be vital in ensuring patient’s receive the appropriate level of care. DNA-CPR orders are also signed appropriately very early on. These orders not only ensure the patients don’t undergo the unnecessary trauma of CPR, but they also help the junior doctors on the ward to prioritise which crash calls to attend, especially if there are multiple cardiac arrests simultaneously.

My job as a junior doctor in general medicine has been to optimise the ward-based care of these patients as described above and then to refer to ITU as appropriate. The buck stops at ITU. This is where the majority of the strain of doctors, nurses, allied healthcare professionals and the resources will be felt as there is a limited number of ventilators in any given hospital which is why ITU doctors have to make difficult decisions all day long as to which patients will be the most ideal candidates (i.e. most likely to survive) such intensive therapy.

In A&E and on the wards, my ability to tolerate risk has increased whereby as clinicians, we need to make decisions quicker but still as safely as to when we can discharge these patients so we can free up beds for those who need them next. On a daily basis, I carefully analyse each patient, their clinical picture, their ability to cope with the symptoms at home, their breathing, oxygen requirements etc so that we can aim for early discharges. On discharge, we advise patients to self-isolate for 14 days and point them towards NHS advice for Covid-19. https://www.nhs.uk/conditions/coronavirus-covid-19/

The fact that there is no treatment for this disease and the fact that a lot of patient will have DNACPRs in place can make doctors feel a bit helpless sometimes. It can be highly-stressful seeing multiple patients succumb to this condition every single day at work and there was nothing more we could do for them. It is also quite easy to become cynical that this is just the way it is or to lose empathy for these patients because there are so many dying that feeling each death would destroy a doctor and lead them to burn out.

This is why in times like this it is important to remember the quote: “To cure sometimes, to relieve often, to comfort always”. Above all, we need to ensure we maintain our ability to comfort patients in such times of distress, anxiety, uncertainty, stress, pain, discomfort. Regardless of whether or not we can treat the disease, we should always treat the patient and their concerns. So this is what I have taken on board from this first month of dealing with Covid-19 when I go to work every single day.

Another aspect of being on the front line is personal protective equipment (PPE). Currently, Public Health England recommends the use of a surgical mask, plastic apron and gloves for assessing and seeing these patients. For those taking part in aerosol generating procedures, the mask needed is of a higher calibre. There is daily uproar from front line staff that the PPE we have is not safe enough and every day at work, I live in anxiety that I will either contract the disease myself or I will take it home with me by accident and spread it to my family. The government need to do more to protect us. There are reports of NHS staff being forced to stop highlighting the inadequacies of PPE despite doctors and nurses around the world dying unnecessarily due to over-exposure. https://www.theguardian.com/society/2020/mar/31/nhs-staff-gagged-over-coronavirus-protective-equipment-shortages


It’s not all doom and gloom. Hospitals across the UK appear to have have put amazing and organised plans into place and once we have better PPE, more ventilators, Covid-19 testing for front-line staff, we will overcome this pandemic in the coming weeks and months, especially with the ever-increasing research and development into a cure.

Reflections – my first 6 months as a doctor in the UK

It has now been 6 months since I qualified and started working as a doctor in the NHS. Time has flown! In these 6 months, I have successfully completed my obstetrics and gynaecology (O&G) rotation (see my previous post) and I am now halfway through my general medicine rotation. As such, I have been exposed to many different types of shift patterns, departments, teams, patients and responsibility.


my first job

Going all the way back to August, I can still remember  my first official day of being a newly-qualified doctor. The O&G team were absolutely lovely and the consultant gave me the best first day I could have asked for by doing all the jobs for me and we were finished by lunchtime. Moreover, one of the senior Registrars ordered KFC for us and it was the ultimate first day of work – long may this continue i thought!

Throughout this rotation, I had the privilege of helping pregnant women with their medical problems and also assisting with c-sections along with helping women of all ages with any serious gynaecology problems like ovarian/endometrial cancers and endometriosis. I learned a great deal from the daily teaches and ward rounds and became more and more confident on the wards, even when I was a lone for most of the time. One senior nurse even asked me how long I’ve been a doctor since she said I was very good and confident and efficient – when I replied ‘only four weeks’ she was astounded an thought I was going to say a ‘few years’! this was a massive compliment to me and helped me feel less like an imposter.

The O&G team treated me with so much kindness and adoration, especially since I was the only foundation year 1 (FY1) doctor in the department, doing his first ever job. Moreover, the fact that I was born in the same department also gave me a good way to break the ice with members of staff and I even got to meet the midwife who delivered me!

Some of the hardest aspects of this job included being involved with antenatal complications with the foetus whereby there would be a high risk of miscarriage or stillbirth and we would have to explain this to the mother and partner. These were always difficult conversations as there is a lot of emotion and attachment involved understandably. Moreover, the fact that each patient I was looking after, was in fact two patients (if you count the foetus), meant that I had to be extra careful with every medication I prescribed or every investigation I requested. Also, ensuring that the father is kept involved in all of the plans and discussions was also crucial to ensure nobody felt left out of such an important moment in their lives.

I enjoyed myself thoroughly in this rotation because of how amazing the team was and the learning. In addition, the lifestyle for me was amazing because as an FY1, I was supernumerary which meant I worked office hours only Mon-Fri, meaning I also had time to meet up with friends, carry on with things i enjoy, go on holidays and also look after my health and sleep.

my second job

In December 2019, I moved onto my next rotation which was general medicine. The ward I was going to join was notoriously one of the busiest wards in the whole hospital, and every time I would tell other doctors I was about to join hat ward, they would have a look of worry and pity on their face! The doctors I was going to replace, finished on average an hour late every single day (mainly due to staff shortages and really unwell patients) – so suffice to say, I was a bit apprehensive.

However, to my gratitude, it seemed the hospital had taken this feedback on board and ensured staffing levels were improved on this ward. This ensured that there was a good ratio of doctor to patients, and we could actually enjoy our role of looking after patients on the ward instead of constantly stressing and running around doing  myriad jobs. The ward i’m on is seen as a ‘dumping ground’ as it is not a truly specialised ward, this means that our ward accepts any time of medical patients (sometimes even surgical!) and this often means that we tend to have a lot of ‘sickies’ on our ward, who require a lot of input and often critical care.

To this end, it was a start contrast to my previous rotation whereby in O&G, i was always protected with the help of my senors, but now I have to step-up more, do my own ward rounds and sometimes there isn’t readily-available senior support. In this manner, it has been quite a rapid learning experience, it has expedited my learning process of prioritising sick patients and jobs and I have also been able to come across meany different conditions so it also keeps the job interesting.

On a recent weekend shift, where i was the only doctor on the ward – covering 32 on the ward and about 10-15 outlier patients, there was a few patients who were extremely unwell all at the same time, and at moments like this, it is easy to become overwhelmed. I just had to take a breath, and stick to the basics, fortunately the med reg on-call that day was extremely helpful.

As part of this rotation, I also have to clerk medical patients on my long days in the emergency department. I enjoy this part of the job as it feels like I’m doing what I was trained to do – assess new patients and come up with an investigation and management plan.

During these two months of my medical rotation so far, some of the difficult parts have been looking after the incredibly unwell patients who appear to be on their last few days of life and having to break bad news to patients. I have been involved in breaking bad news to patients, by myself, a few times recently and I tend to follow the SPIKES model to do so. It’s always emotive foe the patients and their loved ones to hear it and there are often tears. As sad as the news is, it’s always nice to hear a ‘thank you’ from them because it tells me I’ve done a good, empathetic job. Quite a few of of my patients have sadly passed away recently, and I’ve now learned how to complete death certificates and cremation forms and have also had discussions with the medical examiner – this is all good learning experience and is shaping me into a more complete junior doctor.

The parts I have enjoyed most of this current job is making decisions on my own, ensuring the emotional needs of patients and their loved ones are met, and managing unwell patient, because this presents a different level of challenge. Although on some occasions, I do finish work late, usually I finish on time as long as we have adequate staffing. This means i have been able to carry on with life outside of medicine, including recreation, sports, meeting family and friends, going abroad, going to weddings etc. I’m a big believer in having a life outside of medicine, otherwise if you let medicine consume everything you do, it’s quite a boring and fulfilled existence.

money

After years of studying, it feels good finally being able to make my money, and although as a first year doctor, my basic salary is about £2000-2200 per month after deductions, I have the privilege of living at home and not having to pay rent, which means I can save the bulk of my income and use the money to by essential things like a better quality bed and mattress and a car.  I have also done the occasional locum shift to generate extra income each month which I can save and put towards my aim of buying a house. I’m a big advocate of all people using their money wisely, saving and investing it correctly and not being frivolous with it. Money is a tool which I use to pay for goods and services and experiences that will enhance my life. It’s important to build financial literacy and I’m using my free time to do so.

my aims

I am incredibly grateful for being a doctor, on a daily basis i have the privilege to improve people’s lives and ease their suffering and concerns. Although it can be an extremely challenging job at times and very frustrating at others, I would not want to be in any other career (unless I could get paid a decent salary for eating good food all day).

Going forward, I want to continue to develop my knowledge, my skills, my communication skills and confidence and strive to be the type of doctor who, when they are in the room, the rest of the room feels at ease and confident that when shit hits the fan, I’ll be there to handle it. I’m still deciding on which speciality to pursue, but it looks likely that I will choose emergency medicine.

I want to continue to make medicine an important part of my life along with other important parts such as my family, friends, personal development goals and travelling ambitions.

my message

For those looking to become a healthcare professional, I would urge you to get some volunteering experience or shadowing to get an insight into what it is like. Speak to those who are healthcare professionals and keep an open mind. Although healthcare does have a lot of days where you question yourself why you chose this career, the good days do outweigh the bad and it’s important to seek support from those around you when you feel weighed down. Look after yourself before trying to look after others too.

My message to the general public is to say thank you for always supporting those who work in healthcare, and although  resources are currently strained, please know that all of us are working hard on a daily basis to deliver the best possible care.

Unimaginable pain, lots of screaming and cute babies – My four months as an Obs & Gynae doctor!

Having graduated from medical school as recently as July 2019 and having secured all of my first choice rotations, my first four month job has been in Obstetrics and Gynaecology (O & G) aka Maternity and Women’s Health.

Image result for new doctors
How it felt as a newly-qualified doctor (!)


Now, I won’t lie to you, I did not like O & G at medical school. This may have been primarily because as a medical student I just felt like I was always in the way and the midwives and doctors, as lovely as they were, always seemed too busy to get us involved. I did, however, get to witness a cesarean section whilst at university and this was such a profound and emotive moment. Having spoken to doctors specialising in O & G, they too confessed they did not always enjoy their O & G placement at medical school. You might be wondering why the heck did I choose it as my first job then?! The reason I chose to do O & G as my first job was primarily because I see myself as a generalist and I intend to specialise in Emergency Medicine (EM) eventually. To this end, I wanted to gain knowledge and confidence in an area of medicine i.e. O & G that most EM doctors don’t in order to be able to deal with O & G emergencies and know more about the health needs of half the population.

A secondary reason for choosing O & G was because I actually managed to get a job at the maternity unit I was born in and this meant that a few weeks ago I actually bumped into the the very same midwife who delivered me all those years ago! Incredibly she still works at the ripe age of 70-ish! Meeting her felt like coming full circle and it was incredibly heartwarming for both of us. This event quickly became known in the whole department and the response from everyone was very wholesome and humbling.


Newly-qualified and let loose:

As a newly-qualified foundation year 1 (FY1) doctor, I felt extremely prone to a bit of ‘imposter syndrome’ whereby I felt like I hadn’t earned the right to be working in a hospital and that I was eventually going to be ‘found out’ that I was a fraud. This was compounded by the fact that seemingly overnight I had gone from being the most senior of medical students to the most junior of doctors – so it felt like I was now in the ocean as opposed to a swimming pool.  I think this feeling is not all too uncommon amongst other newly-qualified doctors and healthcare professionals. Concurrently, however, I also felt very privileged to now hold the title of  ‘doctor’ because I had worked extremely hard for the past decade to finally make this dream a reality. I was now going to be ‘let loose’ on the wards officially and it meant I now had real responsibility for patients. I was very excited for the weeks and months ahead as I envisioned becoming a competent, efficient and well-rounded foundation doctor.


My Roles:

In the department, there are maternity wards and there is one gynaecology ward. There are also clinics, theatres and triage areas. As the only FY1 in the department, my week – on average – comprised of a couple of days in each of the maternity and gynaecology wards as well as a day or so in theatres or clinics. On the wards, we’d have ward rounds and a jobs list would be generated. Typical jobs would include prescribing medications, ordering investigations, chasing results, phoning other departments and doing discharge letters. It’s imperative to rank these jobs in order of importance and urgency and complete them as such. If patients become acutely unwell on the ward, it would also be my duty to assess and manage them and escalate to a senior as necessary. This aspect of my rotation is similar to any other specialty and after a while most FY1 doctors come to the realisation that ward work is simply ‘glorified admin work’ as I like to put it.

The parts of my week I enjoy most are when I’m scrubbed up and assisting with c-sections. Although, this mostly consists of me holding instruments, cutting sutures, ensuring the surgeon has a good field of vision, and applying fundal pressure to help the baby out, I also got the opportunity to cut the cord, suture and catheterise which was always enjoyable and meant I was improving my practical skills. I also occasionally scrubbed for gynae surgery which I didn’t enjoy as much but there was one memorable moment where it was my task to pull the uterus out from down below after the surgeon had cut off its connections via laparoscopic (keyhole) surgery.

Image result for lion king
This is how it felt whenever I held a new born baby during c-sections

I also enjoyed clerking new patients as this is in essence what we train for at university – to see, assess and come up with a management plan for a patient. It was also interesting learning about new pathologies and to refresh my knowledge of things I already knew. My examination skills have also improved and I now feel confident performing speculum examinations, something that my future Emergency Medicine counterparts probably aren’t so proficient in.

Image result for maternity ultrasound scan
Generic obstetric scan I found online

As the only FY1 doctor in the entire department, the other doctors, midwives, nurses, HCAs etc always made sure I was well-supported and looked after by means of asking how I was getting on, always being there when I needed help and always being patient with me as I learnt new things. I am extremely appreciative of how amazing everyone in the department is and above all a lot of kindness was shown to me. On my first ever day in the department, the consultant took it upon herself to ‘give me the best first day ever’ by doing all the ward round jobs for me and also making me a cup of coffee. This display of awesome-ness and kindness really left me in awe and inspired me to in turn increase my levels of kindness and empathy. This particular consultant is simply THE best!


Teaching

Another role of the junior doctors in this department is to attend daily teaching first thing in the morning. There is a rota for who has to present and I always enjoyed this aspect of work since very day I came in I learned something new and it also felt similar to medical school in the sense that it’s a small group tutorial. I delivered a several teaches to the others doctors – one of endocarditis in pregnancy, one on vomiting in pregnancy and another on menopause. I really enjoyed this role and received really positive and encouraging feedback from the others, including the consultant in charge of departmental teaching.

Moreover, we also had medical students with us every week. This, at first, was a very surreal moment as not too long ago I was in their shoes, shadowing the junior doctors and asking for tips and advice. Now, here I was teaching and mentoring medical students. I really relished these opportunities as I saw it as ‘paying it forward’ as other doctors had done for me. I definitely had to pinch myself the first time I signed a competency for a medical student!

Image result for medical teaching cartoon


The not-so-good parts:

This rotation has been an absolute dream start to my career as a qualified doctor. My rota was that of a supernumerary doctor meaning I didn’t work any evenings or weekends and the actual job itself was extremely rewarding and interesting. Not to reiterate how incredible my colleagues were. Of course, there were some occasions that were more frustrating than others or moments where a particular consultant wasn’t as nice, however these times were fleeting and either due to flaws in the system or inherent flaws in the character of that doctor.

Without doubt, the most difficult part of this job has been the emotional toll of witnessing and hearing about the fetal, neonatal and maternal deaths. Miscarriages and stillbirths are traumatic events for the families involved and being part of the teams that would have to explain these poor outcomes was very challenging. I vividly remember seeing a lady after after she had miscarried an 18-week foetus. The foetus, although not viable, had a face, body and limbs formed and was just extremely small. I found it really difficult witnessing this.

The pain these losses cause the mothers and families is absolutely terrible. For this reason, there are specialist bereavement midwives in the department who help the families who have suffered these tragic losses. Adam Kay, in his famous book ‘This is going to Hurt’, talks about how O & G doctors witness a bus full of dead babies by the end of their careers. This is a truly harrowing thought.

Image result for bereavement
We’d occasionally have an area filled with candles to remember these losses


Reflections:

These past four months as a doctor in maternity and women’s health have been absolutely incredible. I have learned, done and see so much that will go forward with me into my next jobs as well as into my life too. I feel extremely privileged and blessed to have been a part of this team.  I know feel a lot more confident in my ability to assess unwell pregnant patients as well as know more about gynaecological pathologies. What’s more, having now been in the working world for four months I have managed to come up with a work-life balance whereby I still ensure I am doing a lot outside my career such as social events, fitness and travelling and also learning more about personal finance to ensure I can keep hold onto the money I am now making.

For anyone is is unsure about which jobs to pick when they become a doctor, I implore you to pick Obs & Gynae! This job, without a doubt, is going to go down as the best job I’ll do as a FY1 doctor!

 

Thanks for reading 🙂

my final year of medical school

After recently finding out which hospital I’ll be working in for my first two years as a doctor, the culmination of medical school feels very much in sight. I officially finish in the first week of June 2019, marking the completion of six years of medical school. After a six week break (in which there will be a lot of travelling abroad), I will begin work at the very same hospital I was born in. Moreover, my first four-month rotation is in Obstetrics & Gynaecology which means that I will be returning to the exact maternity unit I was born in 25 years later, only this time I’ll be working there!


My final year of medical school has comprised five different blocks, each lasting six weeks. We get to choose which blocks/specialties we want to do and if you’re lucky enough (like me) you get your first choices. I started the year on Renal Medicine, which I quickly discovered is an incredibly interesting and fulfilling speciality. It involved looking after patients with an array of conditions including inflammatory conditions, acute life-threatening conditions, diabetic complications and kidney transplants amongst others. Furthermore, the team I was a part of was absolutely fantastic and Renal ending up being my favourite block of the year and by the end of the six weeks, I had learnt and achieved so much, that I felt ready to start my foundation years as a doctor.

Next up was cardio-thoracic surgery. This is the type of surgery that deals with heart problems such as valvular defects and blocked coronary arteries as well as lung and other chest problems such as lung cancer and lung resections. As someone who does not find surgery all too interesting, I chose this type of surgery because it always fascinates and interests me how it is possible to make the heart completely stop beating, put the patient on a heart-lung bypass machine and then fix whatever needs fixing. It was a true pleasure to be a part of and I got to be involved in harvesting leg veins that were used for the bypass surgery.

My third block was Emergency medicine which I was very excited for since this is the specialty I will be pursuing in the future. It was great to be a part of the emergency department team again and the learning and experience I had gained from my electives and my intercalated BSc in Emergency Care paid dividends. This block just further cemented my love for EM and as part of this block we also did a pre-hospital shift with the ambulance service which was a great day filled with a variety of presentations, including the need for us to drive the ambulance onto a ferry to cross a river so we could help a road traffic collision patient who was trapped in the car!

My penultimate block was Paediatric anaesthetics. Although this is a very specialised field, I was given the opportunity to get stuck in right from day one by doing airway manoeuvres, putting in airway devices and cannulating small children//babies. I had one-to-one time every single day with a Consultant which meant that by the end of the block, I had progressed massively in my knowledge of anaesthesia and in my practical skills to the point that I was even complemented by a Consultant as being better than some of the Registrar doctors!

I am now finishing up my six years of medical school with a six week block of General Practice. I really enjoy GP, despite the sometimes negative stigma that is wrongly attached to it. As a student, I am given more time with each patient which means I can fully explore their concerns and ensure that any underlying anxieties or hidden agendas are addressed. It feels very gratifying when, just by simply reassuring a patient or offering a treatment for a condition they thought they would just have to put up with, I’m able to make a difference to someone’s life. Sadly, we are also seeing more and more ill mental health in GP and by being the person they can trust completely and open up to, I feel able to build a rapport with these patients and ensure they can get the help they need.

I feel very fortunate and blessed to be finishing medical school with such a fantastic final year filled with a great variety of specialties, allowing me to immerse myself in a whole host of learning experiences that will undoubtedly hold me in good stead going forward. I now feel adequately prepared and ready to start work after graduation rather than nervous, which is a massive credit to my medical school. I am very much looking forward to the upcoming challenges of being a doctor as this presents an opportunity for personal and professional growth.

Overall, this final year has been extremely relaxed as at our medical school we sit our finals at the end of the previous year, meaning the only assessments we had throughout the year were the placement-based assessments e.g. cased-base discussions and CEXs and competencies as well as two MCQs that we had to pass and the SJT and PSA. Now that all of these have been done, it is just a case of cruising through the next few weeks and enjoying my last few moments as a medical student.


This academic year has been filled with many new experiences already including multiple holidays, meeting new people, charity dinners, teaching other medical students, interviewing future students, ventures with family and friends, reading many amazing books and planning ahead for the ‘real world’ including searching for a new car and familiarising myself with the junior doctors’ contract. I have also just began fasting today as it is the month of Ramadan which adds even more excitement as this is a great time for introspection, charity, reflection and strengthening ties with family, friends and my community. I feel extremely grateful and privileged to have had such an incredible six years, allowing me to work towards my dream life.

My Air Ambulance Elective!

‘It was now night time and as we pitched up at scene, I noticed the debris scattered all over the road with signs of a potential fuel leak nearby, there was a massive ‘bulls-eye’ on the windscreen and there were sirens wailing and bright blue lights flashing as Police and Fire Service crews worked hard to secure the scene. Bystanders, including family members were crying out for help and screaming for something to be done as they witnessed their loved one go into traumatic cardiac arrest. This was the first job I attended with EHAAT and it was a motorbike vs van collision at high speed. ‘Welcome to pre-hospital medicine’, I briefly thought to myself’

Screenshot 2018-10-31 at 22.40.26.png

 

After returning from my trauma elective in South Africa, I had another SUPER exciting elective lined up. The day after returning from SA, I moved to Essex to start a 4-week attachment with the Essex and Herts Air Ambulance Trust (EHAAT).

I felt so grateful for this opportunity but also had major ‘imposter syndrome’ and up until my first day with EHAAT, I kept feeling like this was all a dream and that when I’d turn up for my first shift, they would be like ‘who the heck are you?!’

Thankfully, my worst fears weren’t confirmed and I was officially part of the student elective programme!

EHAAT

So for those who don’t know, Essex & Herts Air Ambulance Trust is a Charity Air Ambulance service providing a free, life-saving Helicopter Emergency Medical Service for the critically ill and injured of Essex, Hertfordshire and surrounding areas (around 3-4 million people). It is not funded by the NHS – only by charitable donations and it costs around £6 million a year to fund the service.

My Experience

As part of my elective, a typical week consisted of two clinical shifts, two shifts where I would focus on a project and a day of clinical governance/death & disability discussions. I really appreciated the variety on the timetable because it gave me a much more realistic insight into what life is like for a pre-hospital doctor.

The jobs we attended were quite mixed; from road traffic accidents and suicide attempts to medical cardiac arrests and paediatric choking incidents. One of the main decisions that need to be made in the pre-hospital environment is deciding which hospital the patient should go to. Essex/Herts is a large area and there are not many major trauma centres (MTC) within a small area like there is in London. For this reason, the decision to bypass a trauma unit for a MTC requires more clinical acumen. Moreover, for those with specific injuries such as head injury or conditions such as MI, they need to transferred to the appropriate hospitals based upon what the hospital specialises is. I vividly remember transferring a cardiac arrest (secondary to STEMI) patient to Harefield hospital and I was so impressed with how the cath lab team greeted us at the door for the handover and allowed us to watch the Primary PCI (procedure to restore the blood flow to the block coronary artery). Also, their staff room had Nutella which was an added bonus!

Although flying in a helicopter to jobs was very exciting, it was the actual ‘job’ itself that provided the most cognitive-stimulation and excitement. It was incredible to be a part of the team deployed to critical cases. My duties included exposing the patient fully with the help of shears, getting the monitoring equipment on and providing traction to fractures etc. Seeing a patient in the pre-hospital setting adds a whole different element to your decision-making process. You have to use all of your senses and experience to figure out the mechanism of injury and the most likely subsequent injuries. This allows you to preemptively treat, package and triage the patient. I found this whole process both incredibly challenging and enjoyable. I feel that the experience I had in the ED and during my trauma elective allowed me to keep a cool head when confronted with dying patients to ensure I was thinking through the clinical situation as clearly as possible. Being able to remain calm in critical situations is definitely a skill that can be learnt and practised and I hope to continue doing this.

Another case that was extremely critical was a motorbike collision which led to a catastrophic pelvic bleed. The patient’s blood pressure was very low and continued to be unstable and venous access was difficult. We were also the first on scene which meant we were starting from scratch. We had to move quickly because it was clear that this patient needed blood and blood products. We packaged him after getting a line in and reducing his fracture and flew him to the local MTC.

Then in the ED, I noticed a lot of human factors issues such as a lack of situational awareness from the trauma team leader, there was also a faff with the Belmont Rapid Infuser and there was no closed loop communication. Moreover, there also made a comment about there being only one venous access. This raise an important point. The ED teams who receive a patient from the pre-hospital team don’t always fully appreciate how difficult it is out on the road where resources and time are extremely limited. So although, patients may arrive via HEMS nicely packaged with all the monitoring on etc, it takes a lot of work to achieve this so I had renewed appreciation for the HEMS team.

Screenshot 2018-10-31 at 22.47.19.png

One of my favourite days of this elective was my shift with the Hazardous Area Response Team (HART). To me, HART is basically the SAS of paramedicine and they attend all the chemical incidences, difficult extrication jobs and jobs involving water, tunnels or even terrorism. They are highly-trained and highly-skilled paramedics and on my shift we attended a variety of jobs which I won’t go into for confidentiality reasons but I learnt a lot about their crucial role.

It was always an incredible privilege to be a part of the team in the pre-hospital environment and it was truly beautiful to see how well the emergency services worked together to ensure the best outcome for the patient

Clinical Governance Days (CGDs)

Pre-hospital teams take quality improvement and feedback from colleagues very seriously. I feel that to be a successful member of the pre-hospital team, you need to be somewhat of a perfectionist – someone who is constantly striving to improve their practice with the help of others.

Part of this learning is achieved with the help of monthly CGDs which involved auditing patient cases from the past month and seeing what went right and what could have been improved. There are also sessions on latest guidelines and important learning issues. All of this results in an enjoyable and interesting day of learning.

Alongside the CGDs, there are weekly D&D’s which is where cases from the previous week are discussed, particularly focusing on death or disability and if anything could have been improved or done differently. I always found it super humbling to be allowed to sit in on these conversations where doctors discuss their cases in an open and honest way, all in the hope of improving patient care going forward.

Screenshot 2018-10-31 at 22.53.31.png

Research Poster

As part of this elective, students undertake a project/audit alongside a doctor/paramedic in order to answer a question or improve practice. I looked at the drowning victims that were attended to by EHAAT and analysed outcomes to figure out what interventions were being used and to what effect. With the help of my EHAAT mentors, I managed to create a poster and presentation which I presented at the D&D and I hope to submit my poster to future pre-hospital conferences.

Increased passion

All in all, I had the most incredible month in the pre-hospital environment. This experience definitely confirmed for me that I want to pursue pre-hospital medicine as a career because of the variety in the cases, the incredible nature of the teamwork and the constant desire to improve. I feel really appreciative that I was able to have this opportunity as a medical student and feel so grateful to all the staff at EHAAT for guiding, helping and teaching me. I learnt an awful lot about what true teamwork is all about in addition to clinical decision-making and patient assessment.

Now I’m back at my normal medical school for my final year and life is definitely a lot more mundane now that I’m back on the wards –  I miss emergency and pre-hospital medicine a lot!!

Screenshot 2018-10-31 at 22.50.18.png

My trauma elective in Johannesburg

Women running aimlessly in the trauma department and wailing with deafening screams after being told their children are dead, patients with gunshot wounds to the head being carried in by horrified friends, other patients presenting with projectile arterial bleeding from their neck from knife wounds whilst in the background the smell of burnt flesh lingers in the air due to 95% total body surface area burns and fights are breaking out between patients/enemies. This was my experience of just a single shift on payday weekend at Bara hospital in Johannesburg in Aug-Sept 2018.


About three years ago during my first clinical year at medical school, I often heard UK doctors talk about their elective experiences in South Africa and in particular at ‘Bara’ hospital (Chris Hani Baragwanath Academic Hospital). I was immediately enthralled by their ‘war stories’ and vowed to myself that one day I will go to Bara for my own elective and create my own story that will live with me forever.

I organised my 4-week trauma elective at Bara about 18 months ago since it is notoriously difficult to get a place both due to the competitive nature of the elective and due to the administration process not being as streamlined as it should be. So in mid-August 2018, I travelled to Cape Town (CT) to enjoy a week of sightseeing (see previous post). This was one of the best weeks of my life due to the shear beauty of CT.

Next on the agenda was to travel to Johannesburg and start my elective. Johannesburg is very different to CT. The whole vibe is a lot more dog-eat-dog and you can definitely feel the presence of safety-issues as soon as you arrive, hence why people who can afford to do so live in houses with barb-wired fences, which resemble those of a prison.

Screenshot 2018-09-22 at 13.53.06.png
The security-controlled entrance/exit to Bara

On my first shift at Bara I was immediately aware of the resource limitations that plague this beautiful country. Pieces of equipment that I normally take for granted here in England were not always present at Bara such as scalpels, tourniquets, gloves, gauze, tegaderm, bandages, scissors, tape, sterile instruments etc and there was significant under-staffing too, made worse by the fact that a lot of the nurses were not… how do I put this in a diplomatic way… particularly helpful or engaged in patient care.

Screenshot 2018-09-22 at 13.51.40.png
There are 15 resuscitation bays in Bara’s trauma department

It’s difficult to summarise all of my experiences into one blog post. I am only just fully registering some of the things I saw and did at Bara and there are some incidents which I have not fully acknowledged yet but I’m sure I will further down the line. There are a lot of gory images that I have both in my memory and in my photo album but I won’t be sharing those in this post both due to confidentiality reasons and due to the fact that once they are seen, they cannot be unseen.

Screenshot 2018-09-22 at 13.58.26.png
‘The Medical Corridor’ – where I’d often sit and have my lunch if I had time

One of the most haunting aspects of my time in Soweto was witnessing how brutal and traumatic the violence against women is. On a daily basis I saw women who had been beaten by their partners, brothers and other male figures in their life. They were being beaten to a pulp with fists, sticks, bricks and sometimes even knives and what makes it worse is the fact that most of the men responsible will walk away scot-free. I have never seen such relentless and barbaric violence against women before and it pained me that I couldn’t do much other than to patch up the wounds, ensure there’s no life-changing/life-threatening injuries and then talk to the women about their experiences and their feelings. Most of these women brought police documents with them and asked us for help to build their case but I knew from speaking to the senior doctors that sadly justice would not be delivered to these poor survivors.

Hijackings are also very common in Johannesburg. I arrived at 7pm to start my night shift in the department during the final week of my elective. As soon as I arrived, a couple of off-duty paramedics walked in and said there’s someone who has been shot in the back of a car parked outside. We ran out after donning gloves and saw two people outside a car crying for help and there was a large male patient in the back. I’ll never forget the look of hope being wiped from their faces once we assessed the patient and found him to be cold and pulseless with no breath sounds or pupillary reflexes. The pure horror and tragedy in their response as they learned that their pastor of many years was now dead is something very vivid in my memory.

Another day that was extremely unique was the day of the strike. All the nurses in the entire hospital planned a day of protest against the hospital’s CEO due to allegations of corruption and pay disputes. Now, when nurses protest they like to have all the other hospital staff join them too including radiographers, lab workers, porters, security etc etc. So the only people left working were doctors, medical students and a couple of radiographers who would only scan life-threatening trauma patients. I was the only medical student on shift that day and suffice to say, my workload was pretty full as I worked with the doctors to ensure patient safety and patient care remained a priority. We had to put the hospital on divert and used the major incident protocol to issue patient files as the clerks were also out striking. Patients still filtered in either by walking in or via ambulances. We didn’t have access to the drugs cupboard so for nearly an entire shift, patients in resus did not have access to pain and sedation medication such as morphine and propofol. At certain points, due to the lack of staff, I was the most ‘senior’ person in the department and I had to co-ordinate the process. To sum up, this was a crazy day haha.

Screenshot 2018-09-22 at 14.11.05.png
Taking patients to the CT scanner was always very ‘interesting’. On one particular shift, I transferred a ventilated patient with one of the doctors and just as the scan finished the ventilator stopped working due to the battery suddenly dying without warning. We then had to quickly scoop the patient onto the trolley and make a rapid dash to the resus room and connect him to the mains all the while seeing his o2 sats slowly drop during the journey.

Due to the lack of staffing but massive workload, at Bara the ethos is very simple: ‘see one, do one, teach one’. After seeing certain procedures such as chest drains and central lines, we were taught to get stuck in and start doing them ourselves. Initially we’d do them supervised and once we were confident in our own competence, we could even do them ‘unsupervised’ (the doctor would have one eye on us instead of two). I still remember the gush of air from the first intercostal drain I inserted, the sound was like music to my ears as it confirmed I was in the pleural space and had released the pneumothorax.

Screenshot 2018-09-22 at 14.47.55.png
This comment by the radiologist regarding my chest drain made my day!

Screenshot 2018-09-22 at 14.14.31.png
My first central line. Photo used with consent from the patient.

I know so far I have made it seem like it was all doom and gloom but it really wasn’t. The doctors at Bara are absolutely incredible and I view them as heroes for being able to cope with such harsh situations on a daily basis. I learnt an incredible amount and I was doing procedures that are usually only reserved for middle-grade registrars and above here in the UK.

With the help of a very kind gentleman and doctor in Johannesburg called Dr V, I managed to organise an air ambulance shift with HALO who are based all over South Africa. We got to fly to a patient who had sustained an injury to her spine after a fall and had reduced power and sensation in her lower limbs as a result. The job involved packaging the patient safely and administering a higher-level of analgesia and transferring her to the appropriate hospital. This pre-hospital experience was absolutely incredible and the team at HALO are, in my opinion, second-to-none in south Africa in terms of pre-hospital critical care. That was a great day and one I will treasure for many a year to come.

Screenshot 2018-09-22 at 14.20.16
The views of Johannesburg from above were stunning!

Screenshot 2018-09-22 at 14.20.01

Other notable times/things I won’t forget from my time at Bara are:

  1. Taking a bullet out of a patient’s leg
  2. Scrubbing down the countless burn patients with the help of ketamine +/- propofol
  3. The mob assault patients who were patients brought in after being beaten to within an inch of their lives after committing a crime in their community
  4. Being in charge of the new interns for a couple of days as out of all the junior staff I had been there the longest (2 weeks!) hahaha
  5. Constantly living in fear of sustaining a needle-stick injury

Screenshot 2018-09-22 at 14.30.02.png
The bullet I removed from the very happy patient. Photo is being used with consent from the patient (he actually asked me to take it!).

Whilst in Johannesburg, I also had time to visit the beautiful mosques, the apartheid museum which was extremely eye-opening and emotional, Mandela Square (WOW, just WOW!) and Pilanesberg Game Reserve (where I saw the ‘big 5’, including lions eating a zebra, a leopard who had killed an impala and hung it up a tree and then I drove right behind a massive elephant for a while!).

Screenshot 2018-09-22 at 14.45.51.png

Screenshot 2018-09-22 at 14.37.41

Screenshot 2018-09-22 at 14.36.30

Screenshot 2018-09-22 at 14.35.29
“To be free is not merely to case off one’s chains, but to live in a way that respects and enhances the freedom of others” – Mandela

Screenshot 2018-09-22 at 14.35.00
Find the Madiba in YOU

I had THE most incredible time in South Africa and since being back for a week now, I can’t stop thinking about it and I love talking about my experiences with others, especially if they themselves have been there. I’ll definitely be going back there at some point in the future (I also would love to travel to Swaziland, Mozambique and Botswana the next time I go SA) and it would be awesome to go back to Bara as a registrar and learn some more!

Aeesh! Screenshot 2018-09-22 at 14.41.30

Cape Town – An absolutely stunning city (Photos)

I recently spent 5-6 days in Cape Town (CT) prior to starting my Trauma elective at the world-renowned Bara hospital in Johannesburg. I fell in love with Cape Town and its beauty immediately. The mountains, the oceans, the beaches, the sunsets and the scenic drives are unparalleled. My close friend planned my itinerary for me.


Tuesday

District 6 Museum – museum about the Apartheid. Very eye-opening.

Truth coffee – ‘World’s Best Coffee shop according to the Telegraph’

Kirstenbosch botanical gardens

 

Screenshot 2018-08-31 at 15.01.45

Signal hill for the sunset

Screenshot 2018-08-31 at 15.03.14Screenshot 2018-08-31 at 15.02.40
Wednesday

Lion’s Head

Screenshot 2018-08-31 at 15.09.11Screenshot 2018-08-31 at 15.08.33Screenshot 2018-08-31 at 15.08.05Screenshot 2018-08-31 at 15.07.32Screenshot 2018-08-31 at 15.06.55

Screenshot 2018-08-31 at 15.14.33

World’s first heart transplant museum

Screenshot 2018-08-31 at 15.12.52Screenshot 2018-08-31 at 15.11.57Screenshot 2018-08-31 at 15.11.40

90 mins before sunset do Chapman Peak drive. This was the most beautiful drive I’ve ever done in my life. Photos do not do it justice!

Screenshot 2018-08-31 at 15.17.39Screenshot 2018-08-31 at 15.16.37Screenshot 2018-08-31 at 15.16.18Screenshot 2018-08-31 at 15.16.05Screenshot 2018-08-31 at 15.14.21
Thursday

Get up early drive to Cape Point (coastal drive route on google maps) & Cape of Good Hope (most southwestern point of Africa and it’s where the Indian and Atlantic oceans meet!)

On the way we stopped in this really nice village and had breakfast at an amazing small outdoor café called Café Roux in Noordhoek

After breakfast/ brunch, still on the way to Cape Point there is an ostrich farm on the way aswell, stop off there to see some cool ostriches if you want

Simon’s Town and Boulder’s beach (penguins on the beach!!)

Screenshot 2018-08-31 at 15.36.48Screenshot 2018-08-31 at 15.36.26Screenshot 2018-08-31 at 15.35.00Screenshot 2018-08-31 at 15.34.44Screenshot 2018-08-31 at 15.34.06Screenshot 2018-08-31 at 15.33.47Screenshot 2018-08-31 at 15.33.36Screenshot 2018-08-31 at 15.33.22Screenshot 2018-08-31 at 15.32.58
Friday

Pray at Masjid al Auwal (first mosque in South Africa) and check out Bokaap. Bo kaap is Malay Muslim area of CT. It has cool houses and Malay food.


Camp’s Bay where there’s boat cruises to see seals.

I also visited the aquarium which was amazing

Screenshot 2018-08-31 at 15.47.36Screenshot 2018-08-31 at 15.47.00Screenshot 2018-08-31 at 15.45.02Screenshot 2018-08-31 at 15.44.21Screenshot 2018-08-31 at 15.44.08

Saturday

Table mountain (you could also see Robben Island from the top which is where Mandela was imprisoned for nearly 30 years).

Screenshot 2018-08-31 at 15.55.33Screenshot 2018-08-31 at 15.55.16Screenshot 2018-08-31 at 15.54.40Screenshot 2018-08-31 at 15.53.56Screenshot 2018-08-31 at 15.53.15Screenshot 2018-08-31 at 15.52.46Screenshot 2018-08-31 at 15.52.05Screenshot 2018-08-31 at 15.51.50

Screenshot 2018-08-31 at 16.02.23

(Old Biscuit Mill and) VA Waterfront Mall- cool little market and Mall with entertainment

Screenshot 2018-08-31 at 15.50.31.png

Screenshot 2018-08-31 at 15.31.59.png


Cape Town was a trip of a lifetime and its full of incredible views and astonishing history.  I highly recommend all to go visit it!

Stay tuned for my Johannesburg post which will include stories about my time at Bara!