I’m about to get operated.

I know I’m in my fifth year of medical school, I know I’ve grown up hearing about operations, I know I’ve seen countless surgeries… But somehow I’m still somewhat scared. Even though this is a quick and non-invasive surgery. 

It’s definitely a completely different experience being the person on the other side of the bed now. Now I understand what patients feel when they come to the hospital. Now I’m one of them lying here waiting for my turn to get operated on.

In a few hours my five years of pain in my right arm will be over. Soon, I can play the violin again! 

Wish me luck and prayers are warmly appreciated! Time for me to become the patient! 😊

PrimĂ€rvĂ„rd (primary care) placement – done!

 

During one of my first lectures during my first year of medical school, our lecturer asked how many of us in my class wanted to be surgeons. More than half of the room raised their hands up including myself. Afterwards our lecturer asked how many of us wanted to be general practitioners/family practice doctors/distriktslĂ€kare. About five people raised their hands up. I wasn’t one of them.

Why is it that primary care is often perceived as one of the “lower,” “less interesting,” “boring” specialities? Statistically, more than half of all medical students in a class end up in primary care in the end. I guess people eventually realise how great the specialty is, after one overcomes the social stigma of the “super-shiny” status of surgeons and other specialists. And there is a high demand for primary care doctors too of course.

Here are some examples of the privileges of working in primary care:

  1. You do medicine, surgery and other different types of treatment approaches on a daily basis so it’s hard to get bored
  2. Patients come in with literally any symptom possible, and it’s up to you to decide which system they belong to – exciting detective work
  3. You really get to personally know your patients and their families through the years, as families tend to stay within the same practice/clinic/VĂ„rdcentral
  4. It’s easier to plan your time and time-offs as the patients are not acutely ill
  5. NORMAL OFFICE WORKING HOURS – what night shifts?
  6. It’s very well paid, especially in rural areas

I could definitely see myself pursuing primary care in the future with those perks.

I have been in VĂ€rnamo for my primary care placement for the past two weeks and absolutely loved it. It’s such a varied specialty with all sorts of patients, you never knew what people would come in with as they walked through the door. And they always have the most amazing stories to tell. Definitely far from boring, which most have an understanding of primary care to be.

This is my fourth primary care placement ever, after three 4-week placements in the UK. Because of this I wasn’t really looking forward to this placement thinking it’s a repetition of the past. But this has been the best placement I have ever had so far.

The people have been most welcoming (like amazingly welcoming, they even hugged my goodbye!), even giving me an office for both weeks to make sure that I felt like a part of the team/family. I was given lots of responsibilities, and they really pushed me to my abilities. Everyone has been super friendly, even have driven me home sometimes and had coffee or fika outside the clinic! I’m sure these experiences I gained here I will have use for throughout my career.

VÀrnamo, thank you very much for an amazing two-week placement in primary care. My four-week tour around SmÄland is now over, and I can finally return to Linköping. No more travelling, I can finally settle back in my new home in Linköping until the summer.

See you soon Linköping, I’ve missed you! 🙂

Samuelle Valles name outside office door for patients to come in. Red light showing that I am inside or busy. Upptaget in Swedish. Being a medical student or lÀkarstudent/lÀkarkandidat in Linköping is fun!

Closed the door to my office for the last time. See you my-name-by-the-door again soon when I finally can call myself Dr. Sam!

Dermatologists for the day

It’s coming to the end of our dermatology placement here in Jönköping and apparently as always, during this week they give us the opportunity to have our own clinic. It may just be me but I was slightly worried, but excited to have our own patients. I remember enjoying this when I got the opportunity in the UK. But this time it’s dermatology though. Do I know enough about skin?

My first patient came in and luckily he was a jolly man coming to check on a skin lesion on his head. After a few minutes of conversation, our doctor supervisor knocks on the door to take me out of the room for discussion together with my classmate, who also had his own patient. After the discussion, we decided to see my classmate’s patient first and then mine. However when we went to my patient, he was gone!

Great, my first own patient ever in Sweden vanished into thin air. Well that wasn’t a very good start now was it. (We called him later on and found out he didn’t leave because he was unhappy with the care but because he had an appointment to keep.)

Nevertheless, I had to put my worries aside and take my next patient in.

I let in my next patient who was a woman around my age with acne problems. I don’t know if it was because we were of similar age or that I also have had acne problems in the past, but we got along really well! She was telling me of the negative impact her acne has had on her mental well-being, and I definitely could relate. So I decided to give her the same self-care advice I was given which helped me with my acne – “off the record” of course. I told her I will now step out of my “doctor” role and now into my role as a girl helping another girl out.

Unfortunately, as I was giving her my acne care and makeup tips, the doctor came in to bring me out for discussion. Darn, I was in the middle of something I thought.

After discussing my classmate’s and my patients, we decided to see my classmate’s patient before mine once again, mainly because I asked for some time to speak with my patient some more afterwards. Then we came to see my patient.

We discussed at length with my patient regarding the etiology of acne and its treatment, which she greatly appreciated. We also discussed the negative impacts it has for my patient. At the end of the consultation we came to a treatment plan that both she and we were happy with. After this she said:

“At first annoyed that I had to come to the doctors this morning because it’s my birthday today. But now I feel that I’m getting something from you so I’m happy I came. It’s like a present for me, so thank you!”

Touched, we all said goodbye to her. As I said goodbye however I asked if she had more questions for me. She then asked me for more acne care and makeup tips, and I was happy that I could continue where I left off!

I told her the importance of moisturising (which I learnt from my sister), and informed her of the type of make up she should use and not use. I also quickly told her how I usually do my makeup to hide all the spots (perhaps a video tutorial in the future?). She was happy to hear my tips and told me she will buy the products I recommended. I was happy I could talk makeup in a medical setting. Afterwards, we happily said goodbye, and wished each other all the best. I greeted her happy birthday once again, and apologised that I missed that it was her birthday today from the medical journals.

Shame, shame, shame on me. But at least this time, this patient didn’t disappear!

As a doctor, my goal is for my patients to leave the clinic the same way that my second patient left – happy, and with the feeling that we did something that helped them. Even if it is on a day like their birthday. Who knew being a “beauty expert” was part of the job!

image

 

The Nobel Prize Museum with Nils from LĂ€karstudent.se

 

Ever since I e-mailed Nils from LĂ€karstudent.se (Sweden’s largest independent website for previous, current and future medical students) regarding contributing my guide on applying to medical school in the UK to his website, we’ve had small e-mail conversations regarding medicine and other things about life and all. Now that I’m at home in Stockholm for a relatively long period of time ever since leaving for Linköping, I thought it was a good time to meet! Where else better than the Nobel Prize Museum, which celebrates people’s revolutionary ideas through the years?

It is always a treat to meet like-minded medical students: generally interested in a lot of things with a passion for research. I thoroughly enjoyed our earlier discussions about potentially revolutionary ideas, historical fun facts and current events especially regarding the medical educational system. The Nobel Prize Museum could definitely not be any more fitting of a location. Until next time! I wonder where to next, the bar is definitely raised high after today.

Nevertheless, as this post has the Nobel Prize Museum in its title, I should probably write something about the Nobel Prize. My favourite Nobel Prize laureate is Marie Curie and Nils’ Röntgen (the discovery of the X-ray). I think those we chose do say something about us, because in the end you would choose something that resonates with you right? Nils’ one is understandable as he has a great interest in the field of radiology, but for me, I wouldn’t really say that I have a great interest in radioactivity, which is Marie Curie’s most famous discovery.

Marie Curie is definitely my favourite Nobel laureate not because I have a great interest in her work, but rather because I have a great interest in her. Marie Curie was the first woman to win the Nobel Prize, the first and only woman to win twice, the only person to win twice in multiple sciences and was part of a Curie family legacy of five Nobel prizes. She had everything that it takes to become a successful researcher: brains, patience and dedication. Oh, and luck too of course. She is not only a role model for us women, but for everyone wishing to discover something that can really make a difference in the world. It was an honour to work at the Curie Institute in Paris, on Pierre and Marie Curie street, where the laboratory they worked in and made their discoveries was located and stands until today. It was definitely a pleasure to visit their old laboratory during one of my lunch breaks, and attend a lecture in the lecture hall where they used to teach.

My dream is to be like Marie Curie. Find an idea I’m passionate about and believe in, and follow it until the end. Maybe it could make a difference in the world, or perhaps even lead to a Nobel Prize. Who knows, but only time will tell!

“Vad bra svenska du talar!”

“Vad bra svenska du talar, verkligen!”

Translation: “You speak really good Swedish, really!”

Ever since coming here to Linköping to continue my studies, I seem to get this quite a lot. Once I tell them about my background of course.

After I tell people about moving to Sweden as a 7-year-old from the Philippines and being in medical school for four years in the UK, somehow, people seem to only focus on that. I chose to study in the UK, because I have studied in English ever since moving to Sweden – international schools from elementary to university. However, I did grow up in Sweden in the end. Somehow, the fact that I’ve been raised in Sweden is overshadowed by my immigrant background and international education.

Should I take this as a compliment? That I learnt how to speak good Swedish after living in Sweden for over 10 years? And didn’t forget it whilst abroad?

Or should I feel offended that because I look and am from a different country, I was expected to speak Swedish badly?

Nevertheless, I must understand, I’m a minority. Not everyone have met us modern Swedes with international backgrounds. In that case, I can be an ambassador to show that assimilation into Swedish culture from another background is possible. Maybe next time they meet someone like me, they won’t be as surprised.

My patient hugged me goodbye :)

For the past two weeks, I have been placed in Infection, and this final week I have been placed in the wards. But I’ll write more about this Infection placement some other time.
During the entire week, I have been in charge of a patient ever since he came into the ward. I was there when he came in, and watched him improve with the antibiotics as the days went by. I was sent in to take a quick history with him alone, and I even met his wife in the corridor. She was looking for him, and luckily I knew where he was.
Today, his infection had improved so much, that he was ready to go home.
I typed out his discharge notes, and came to him with the doctor in charge. Since he was my patient, I was going to discharge him. I gave him my papers, explained what we had done and asked him if he had any questions. At the end of the consultation, I stretched out my hand to say goodbye and to wish him well.
He took my hand and shook it, but then afterwards, he pulled me in for a big hug, thanking us for taking good care of him during his stay.
“I have felt very well taken care of during my entire stay here! At first I was quite angry about it, but you all have been so nice towards me. Thank you very much!”

It is not always you actually manage to reach out to a patient, and for them to understand that you want what is best for them. But when you do reach out to them, the feeling of knowing that something you have done has helped someone else feel better, and for that person to actually appreciate it, is priceless.

giphy

One month in, I’m a step closer to my MD PhD dream

In high school, I remember my schoolmates and I dreaming to become doctors. About a handful of us specifically dreamed to become double doctors, aka MD PhDs. Combining clinical practice and research, that was our shiny dream in the stars.

During my first research internship at Stockholm university when I was 16, I mentioned our dream to my supervisor. She then asserted me that doctors are primarily meant to be clinicians. The doctor interviewers at Karolinska (the most difficult medical school to get into in Sweden) were tired of hearing applicants say they want to do research she told me. They want doctors who want to be doctors. But what if one wants to be both?

Maybe this MD PhD dream was just a naive, juvenile dream that will disappear over time.

Call me doctor Sam first lab internship as a 16-year old at Stockholm University

Self-proclaimed nerd since 2010, at my first lab internship as a 16-year old at Stockholm University

Medical school applications started coming up, keeping in mind the primary focus of doctors, I didn’t mention my shiny dream. I started medical school with the same mindset, keeping away from the lab. Two years into medical school, somehow something made me explore my research curiosity. I was back in the world of academia, and haven’t left ever since.

I started with a summer research internship within genetics in Karolinska, which then continued to a genetics publication in St Andrews. The following summer it was working with drosophila and cancer therapy in France. When I started my clinical years, it became clinical trials within brain cancer therapy. At The same time during all those years, I started presenting at student and national conferences in the UK, then proceeded to international ones. Last March, I was presenting at a conference once a week. I guess you could say I was hooked.

However, throughout my years of medical school in the UK, although they encouraged my research interest, they couldn’t do more than give me projects to do on the side to satisfy my curiosity – without pay of course. Apart from the lack of financial compensation, I felt that something was missing. I wanted more. This, among many others, contributed to my decision to move back home to Sweden.

I made the bold move of moving back to Sweden to finish my medical studies, hoping to get more and bigger research opportunities. I was accepted and warmly welcomed to Linköping, and continued where I left off from the UK. A month in (last week), I decided to look at the research groups available and sent an e-mail to the one I found most interesting. I received a reply within a day, met the Professor a few days later, the research group a week later, and now, I have taken my first few steps towards my MD PhD.

You know that feeling despite things going well, it still doesn’t feel right? Like as if you’re meant for something else? That’s how I felt anyway, and luckily, my gut feeling was right.

anigif_enhanced-28305-1428440837-9

One month into Linköping, somehow I’ve taken a step closer to realising my shiny dream in the stars. I don’t know how it happened, but I do believe in fate, destiny, God’s plan – or whatever you want to call it. Turns out, this MD PhD dream wasn’t just a phase after all.

Watch out, in a few years, you can call me Dr. Dr. Sam! 😀

 

A night in Radiology

giphy7

Evening shifts at Manchester wasn’t really a thing, unless it was within obstetrics, so I was quite happy to find out that we had a evening shift at our first clinical placement. I didn’t really know what to expect but, who knew sitting in front of a computer looking at images for several hours could be so tiring. I’m in bed writing this and it’s not even 10pm…

If I could summarise the night with one word, it would be -ish. Or the Swedish equivalent, typ. For example:

  • “It is bigger-ish from the last image”
  • “There is -ish a lot of gas and faeces in her bowel, probably the reason for her constipation-ish symptoms?”
  • “There is a white-ish, shaded area on the inferior-ish lobe of the lung. Infiltration/inlammation/infection-ish?”

Like the Radiology trainees/registrars/ST-lĂ€kare told us all, even after a few years they’re still getting the grips of analysing radiological images. Many of the times, they’re pretty clueless too. You’ll never really know for sure they said.

tumblr_lpuigli0si1qabfx1o1_500

Nevertheless, despite our lack of radiological expertise, it was still quite an exciting and educational evening. Sure, sitting in front of a computer for hours might not sound that great, but when you get to see images of medical emergencies happening literally at that moment, that makes it pretty damn exciting. For example, we saw images of someone who fell off an apple tree, someone who jumped in front of a train, and lastly ended the night with images of an aortic dissection (when the biggest and most important artery from the heart gets a tear and could lead to a rupture). As you see, knowing that the correct analysis of those images could lead to saving a person’s life, makes what we were doing a lot more than just sitting in front of a computer looking at images. Pretty damn exciting. I was happy to be a part of that, at least for one evening.

My groupmate and I luckily had a very nice doctor who showed us so many different types of radiological cases, and gladly explained them all. When we were looking droopy, tired and hungry, he gave us a break for however long we wanted. Possibly the best part in my case, he had patience for my Swedish-as-a-second-language difficulties. Luckily.

At the end of the day, my head was just such a big mush. I was wobbling from side to side on my way home, and accidentally bumped onto lamp posts a couple of times. My first 12h “shift” at the hospital done, and I’m sure there will be many, many more to come. Until then, hats off to everyone who works at hospitals who can keep their minds sharp even until this hour. I am clearly not there yet.

But tomorrow is another day. Another 8am start at Radiology. Our second to last 8am start at Radiology that is. Better make the most of it. Good night! 🙂

Being a medical student in the UK vs Sweden

Third medical school, third country. Third time’s a charm, right?

Two weeks has passed and I’m slowly transitioning from being a British medical student to a Swedish lĂ€karkandidat. Slowly, I’m leaving the feeling of being a tourist only observing from the outside, to being a part of Linköping’s LĂ€karprogrammet T7. On good days when I overcome the language barrier of course. It’s okay, I didn’t expect the transition to be easy. But so far, I’m happy. And that’s what’s important.

Nevertheless as expected, I can’t help notice differences between my previous British medical education to my current Swedish one. So far, this is what I’ve noticed during my two weeks of Swedish medical school.

1. People don’t judge you if you admit you didn’t understand

giphy1

Sweden: Someone in my class raised their hand up during a lecture and said: “Sorry I didn’t quite understand that, could you explain it again?” and no judgemental murmurs were heard in the room. I was shocked. In a positive way of course.

UK: You don’t understand something? Tough luck, go over it on your own later. Or ask the lecturer on your own time, and not waste precious lecture time.

2. Student life is based on a lot of singing

Sweden: Aside from the alcohol of course, a lot of the traditions are based on singing. It is even a requirement for the main event organisers to sing. It doesn’t matter if you have a good singing voice or not, but you sing anyway. And everyone knows the lyrics. If not, there’s a songbook.

UK: Traditions differ, but it’s all based on doing silly things with alcohol, and not that much singing. Unless you call drunken screaming singing. Not as melodic.

3. Breaks are a necessity not a privilege

giphy3

Sweden: For every lecture we have that is over 2h, it is a MUST to have a break in the middle. Otherwise the lecturer gets a negative comment for forgetting on the evaluation form. Also, every time the lecturer asks whether we want him/her to continue the lecture without a break but a longer lunch break instead, that suggestion is always quickly shut down. Breaks are sacred. They’re for stretching your legs and getting coffee.

UK: “Oh look, we have a short break in between our lectures! I’ll just put my head down for a few min and then I’ll look over the next lecture.” Breaks were a privilege, and such a privilege must be used wisely. For the past few years in medical school in the UK, I haven’t had a lunch break. Lunch break for me has always meant quickly eating then studying. Or eating whilst studying. Now breaks in between lectures/classes/for lunch are for socialising. And additionally for my case, fighting my urge to take a quick nap or running off to the library.

4. Taking an interruption during one’s studies is normal

giphy4

Sweden: Apparently I wasn’t the only one who was new in our class because many returned from their leave of absence(s). Also, many in my class have told me that they too have taken a break from their studies in the past. Some are even planning on going on another semester’s leave. When you ask what they did during their leave, a common response is: “travel, work, have fun.”

UK: You can only take a break from medical school if you have a valid reason such as taking a Masters, illness or personal/family issues. Also, your application on taking a leave of absence has to be assessed and evaluated, with reasonable documented evidence. I recall seeing several doctors at the medical school about mine. The final being the medical school psychiatrist assessing whether I was “mentally stable” to make such a decision.

5. It’s okay to admit you didn’t prepare for the session

giphy6

Sweden: I had a meeting with the co-director of the medical program at Linköping, who explained to me about their medical program. When she came to the part about our group sessions (PBL sessions like in Manchester), she said: “If you didn’t prepare, just say so. You may have had an event in the weekend and didn’t have any time. It’s okay, we all have bad days!”

UK: In St Andrews, if you came unprepared to a session you get a “yellow card.” Three yellow cards means a meeting with the disciplinary head. So if you’re unprepared, fake it until you make it!

6. Exams are 6h long

View this post on Instagram

Goodbye exam ✋

A post shared by Dr Sam (@samvsworld) on

Sweden: 100-something point exams are normally 6h long and most use up the entire time.

UK: We have 2.5h for our 130 point test? Perfect, that gives us just about over a minute for each point!

7. You failed? Just take the resits like the other 30%

giphy

Sweden: To pass, you need 65% and above on the exam, and it is normal for 30% or even more to fail. It is actually expected. And if you fail, it’s okay, just take the resits. If you fail the resits, just take them again. And again. And again. Until you pass.

UK: Passing depends on how the rest of your class does. So if you’re in a pretty studious class (my class in St Andrews broke records for having the highest averages…), you better study. Because if you fail, you only have one chance to redo the exam, otherwise you have to repeat the year!

8. Internationalising is encouraged

Sweden: Within my two weeks of medical school in Sweden, I already applied for going on a semester’s exchange (with scholarship of course) and also got my application for doing a clinical rotation in the US signed and accepted. I got my application back with a note saying: “Happy trip and placement!”

UK: Doing clinical rotations abroad or even at a different hospital in the UK was basically impossible, unless special circumstances like in my case. I was doing medical French as a part of my European Studies, so I was allowed to do a clinical placement in Geneva. Otherwise, you have your final semester of medical school after finishing your final exams to do a clinical elective abroad, not earlier!

9. Group work is actually group work

wereallinthistogether_zpsfe029b7a

Sweden: Group work (in this case I mean PBL sessions) means discussions and encourages inquisitive thinking, and everyone contributes with something. You think together and share ideas, and together come up with a conclusion. Also, you don’t look at your notes because if you forgot a detail, someone else probably remembers it and fills that detail in.

UK: Group work (PBL sessions) was an opportunity to show off the random rare things you learnt from books with complicated names and from newly published research. Did you actually memorise that? No one knows, since you’re just reading from your notes anyway.

10. Medical school isn’t a competition, but team work

Sweden: As a final tip, one of our lecturers said: “Do not compare yourselves to your classmates, because you will all get there in the end”

UK: I used to describe entering the lecture theatre as entering a battle field. Your grades depend on your classmates, and your rank in your class will determine your future. Like what a classmate told me, “We’re all on the same race, and our goal is to come first.”

*

Both systems are different with its own pros and cons. Looking back, my years in the UK were difficult, but until now, I still say that my first three years in the UK are the best three years of my life so far. The British system had its own hardships especially coming as a Swedish student. However, through my years there, I feel that I was hardened. I learnt self-discipline and how to work hard. Now, I’m hoping I can use my four years worth of experience in Sweden. I am grateful for the past four years and am looking forward to my final two years of medical school. Doctor Sam, finally, here I come!