The news of Brexit is finally hitting me

Yesterday, my newsfeed was filled with news of my friends’ graduations from St Andrews (it’s graduation week over there), midsummer photos from my friends in Sweden and lastly of course, the EU referendum results. What was supposed to be a happy day, was tainted with sadness with the news of the UK leaving the EU.
 
I must admit however, my initial reaction to the results was a somewhat relief, as it further affirmed my decision of leaving the UK. But with the news following the result like the resignation of David Cameron and the crash of the pound, I cannot help but worry about the unpredictable future of the UK. However now that the results are set, we can only hope that the political leaders will steer this result into a mutual positive outcome for both the UK and the EU.
 
Two years ago, I graduated from the most amazing university in the world: the University of St Andrews, Scotland. St Andrews was a university filled with tradition and world-class teaching, attracting students from all over the world. From my time there, I believed that the UK was a welcoming country of opportunity, which valued ambition and talent. Please, let the future international students like myself and other professionals feel as welcome as I did. Please, don’t change 💔
me on my graduation day with a BSc Medicine (Hons) from the School of medicine in St Andrews Scotland

Me on my graduation day with a BSc Medicine (Hons) from the School of Medicine in St Andrews, Scotland

 

 

UK, you will be missed in the EU

Around this time year, I made the bold decision to leave my future in the UK, after four years of medical school there. While most who didn’t know the real story behind it (that’s a story for another day) told me this was a bad decision, I somehow knew my future was elsewhere. A few months later, my newsfeed was flooded with news of my friends on strike for better conditions for Junior Doctors. Today, the UK has now voted to leave the EU. 

If I had stayed, I would’ve had worse conditions as a newly graduate doctor than if I had worked in Sweden. However after today’s events, I wouldn’t even be able to work as a doctor in Sweden with a British medical degree. 

Earlier this week, I overcame my fear of officially leaving Manchester University (I’m currently on leave) and began the process of withdrawing my enrolment. Sure, I had to undergo a traumatic year to make me finally leave the UK, but somehow I feel that that was the universe/God’s way of directing me to where I’m supposed to go. If I had stayed, what would have I done now? 

To all my friends (especially those from the EU) in the UK, I hope the decision of the UK leaving the EU doesn’t affect your future plans in any way. UK, I wish you all the best in standing on your own two feet. Thank you for giving me a free BSc Medicine (Hons) from St Andrews when I could.

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Revision Week vs Tenta-P

I can’t believe it. I just finished my first medical school exams in Sweden. I’M FREE!!! 😀

So I just underwent my first “Tenta-P” (Tenta = exam, P = period) aka revision week followed by exams. I must say, it is very different from my past revision weeks in the UK (at least in St Andrews). Here are a few reasons why.

Revision week – UK; Tenta-P – Sweden

Also, see my previous blog post on Being a medical student in the UK vs Sweden.

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1. Tentagrupp/exam study groups

Revision week: Your exam grade depends on the normal distribution of how the rest of the class does on the same exam. Owing to this competitive nature, preparing for the exams tend to get competitive as well.  You’re on your own, good luck!

Tenta-P: This is probably the best thing about Tenta-P. It’s more social, and you’re not alone. Most join a tentagrupp or an exam study group (including myself) where you meet everyday to go over topics and past exam questions according to your revision week schedule. It’s basically a way to keep yourself (and each other!) motivated and on track, since you know you have to go through the topic before you meet the rest!

community study group group work gif

2. Previous exam questions

Revision week: As previous exam questions tend to get reused, the medical school don’t provide a database with previous exams. Knowing this however, students of previous years collectively made their own “previous exam database.” After one’s exam, one writes all the questions one could remember that came up, to share to the coming students the following year (thug life). This document is constantly growing and is being secretly passed down year after year like an heirloom.

Tenta-P: On our internal school website, we have a database of previous exams (from several years ago up to the one from last semester) available for us to study on, including answers. The questions also have a tendency to be reused, so there were many moments when I was beaming during the exam – that meant I had seen that question before.

simpsons happy paper writing gif

3. I’m still on Facebook

Revision week: Every revision week every semester, I usually deactivate my Facebook to minimise my procrastination and hopefully increase my concentration. My friends were used to this so as revision week approaches, they would normally ask me when I plan to take my Facebook down – and make sure they have my number so I’m reachable.

Tenta-P: I didn’t close down any of my social media accounts, instead I even added another one – Jodel. It proved to be quite a fun method of procrastination.

https://www.instagram.com/p/hcGmjkIN24/?taken-by=fileea

4. More space to study

Revision week: Back in St Andrews, we only had one central university library for all 9000 students. One could say that it definitely was not big enough to fit us all. Especially during revision week. Once, I walked around the library for over an hour trying to find a space with no luck – I just ended up going home. To be fair though, it was also a form of procrastination since you see everyone there during revision week, as everyone take their exams at the same time. Because of this, an early version of Jodel and Tinder combined begun called Spotted at St Andrews Library, where students could post about their library crush anonymously. Procrastination at its best.

Tenta-P: There are several study spaces across campus and I studied in my campus which is part of the university hospital area. To my surprise, I never had a hard time to find a spot to study, and I still seemed to see my fellow medic friends at the medical school. Where do they come from? Where do everyone else study? Wherever they may be, I’m definitely happy they left me a spot to study at the medical school anyway.

https://www.instagram.com/p/hlDgnmoNxc/?taken-by=fileea

5. I’m actually sleeping

Revision week: At first, I would set some alarms at about 6/7am to make sure I wake up and study. After a while, my body gets used to waking up so early, that I don’t need an alarm clock anymore, regardless of the time I go to bed the day before. My body gets used to the 5h a day sleep routine. However, when it’s an extra harsh study day, I can’t afford 5h of sleep. That’s when the caffeine pills come in. Believe it or not, all-nighters with the right company are actually quite fun!

Tenta-P: I never had an alarm during the entire time and I think I got about 7h sleep each night. I never pulled an all-nighter nor took my typical caffeine pills to help me study. I feel so much healthier – and definitely more well-rested.

https://www.instagram.com/p/Y_7vC1IN2l/?taken-by=fileea

6. Packed lunches

Revision week: Bringing food to university isn’t really a thing in the UK – well at least in St Andrews as there are no microwaves in campus. So during study breaks from the library, you go to a fast food place and get take out, or to a nice restaurant to eat. Considering one could get a three-course meal from Jahangir (my favourite Indian place ever) for £5 (at the time about 50kr), it wasn’t really a big deal eating out everyday. Which definitely explains why most of us gain weight during revision week. For example, a friend of mine gained over 3kg from eating take out pizza everyday during revision week. But pizza is bae so it’s okay ❤

Tenta-P: To save time, you prepare your packed lunches for the entire week you will be spending in the library during tenta-P, and keep them in the fridge. Then you bring them one by one, and eat with your fellow medic classmates with their packed lunches at the medical school. You end up eating the same thing everyday but who cares, it’s revision week. And definitely more economical (#studentlife). Thank God for microwaves in campus.

https://www.instagram.com/p/ZAwGDCoN2s/?taken-by=fileea

7. One doesn’t study in the evening

Revision week: As previously mentioned, late night studying and all-nighters is a thing back in the UK. I used to do at least one all-nighter every revision week and mastered the 5min nap. Literally, I’d put my head down and my friend would time me, but I would automatically get up after 5min anyway and keep going. Also, it’s so much calmer in the evening hence so much easier to concentrate!

Tenta-P: In general, the medical school clears out around 5/6pm during tenta-P. I tend to study more effectively during the evening, so I usually stay on until nearly midnight. Which is apparently unheard of as most during this time are at home relaxing – or better yet sleeping – after the day’s study schedule. I often wished I was them.

sheldon cooper from big bang theory gif all nighter don't need sleep need answers

8. I’m actually doing other things apart from studying

Revision week: Life is wake up, study, eat while studying, sleep (if you can), study. Breaks every now and then if you deserve it. Repeat.

Tenta-P: So my friend Arianne from St Andrews came to visit over the weekend (yes, the few days before the exam), and I also celebrated a friend’s graduation back home in Stockholm. Arianne was a regular revision week study buddy of mine back in St Andrews, and I must say she was quite surprised by how “normal” I was. Not sleep deprived, not talking medical jargon to myself and lastly, not too stressed to not have a good time out!

https://www.instagram.com/p/BGT9SrxINwm/?taken-by=fileea

9. The fear of failing

Revision week: In the UK, passing is not the difficult part and passing is not enough. You need to get a good grade as well because the better you get, the better it will be for you later. Also, your grade once again depends on the normal distribution of your class’ results. The fear was never about passing, so in a way I never had the anxiety of failing. Rather, the fear was getting a bad grade.

Tenta-P: The day before my exam, I had the biggest pre-exam anxiety ever. So bad I even had to go to church to calm myself down – God was the only one who could help me now. As we don’t receive grades but just a pass or fail on our exams, the fear was on passing as there’s nothing else to aim for unlike before. 65% total minimum was the goal, otherwise you gotta come back in August to do the resits!

spongebob rips in half gif

10. Meh, I’ll just do the resits

Revision week: If you fail an exam, you have one chance of redoing it during the summer. No matter how well you do on the resit, the maximum grade you can get is a pass. Also, it will state on your academic transcript upon graduation that you had to do a resit. If you fail the second time however, you need to repeat the year – touch luck! In other words the mentality is: failure is not an option.

Tenta-P: Once I overcame my pre-exam anxiety of failing, I accepted the fact that I know what I know and I can simply only do my best during the exam. I accepted my highly likely fate of returning for a resit in August. I listened to my friends’ advice who have this embedded within them – doing a resit is not the end of the world. At least the information will be fresh in your mind when the next semester starts! Meh if I fail, whatever there’s always next time 🙂

cat rolling psh whateva whatever i'm out gif

Time for summer vacation. Ehh, Linköping see you during resits in August? 😂

Thank God May is over – tenta-p!

May has been such a crazy month. Let me summarise my month in bullet points:

  • I got operated on at the end of April/beginning of May
  • I underwent post-op hell
  • I moved three times with my newly operated arm
  • My phone got stolen

Oh and of course, I’m a medical student + researcher on top of that. Now May is coming to an end which means soon summer vacation, but before that even sooner, EXAMS.

Normally during what I used to call revision week in the UK but here tenta-p, I would turn off all social medias (especially Facebook), pull all-nighters with the help of caffeine pills and stop eating. However it seems like it’s not the case here in Sweden. My friends even had plans to do things during the exam period. Much healthier I’d say.

Nevertheless, I have my game face on. I’m gonna study everything I need to know, and I’m gonna pass these exams. Until then, wish me luck guys!

https://www.instagram.com/p/BF8mPqloN0S/?taken-by=fileea

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! 😊

https://www.instagram.com/p/BEvA76lIN3l/

Primärvård (primary care) placement – done!

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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/distriktsläkare. 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/Vårdcentral
  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 Värnamo 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.

Värnamo, thank you very much for an amazing two-week placement in primary care. My four-week tour around Småland 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 läkarstudent/läkarkandidat 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!

Dermatology: expectation vs reality

I’m going to admit, dermatology wasn’t one of the placements I was looking forward to. I’m sure I wasn’t alone in this either. Luckily, after two weeks at dermatology, one can say I was very much positively surprised!

Here are some of my expectations from before the placement and my insights of the specialty after my two-week placement.

1. You see acne and eczema everyday

arnold schwarzenegger it's not a toomah gif

On the contrary, most of the times it was a toomah.

During our two weeks there, I saw two acne patients and probably around five eczema patients. Skin cancer patients on the other hand? I definitely lost track. They came by the truckloads. Perhaps the reason why I thought dermatology = eczema and acne is because those are the only two skin problems I ever sought medical help for. Also, I’m brown. So what skin cancer?

2. Apart from acne and eczema, it’s all about too much sun

ross from friends back with a failed tan gif

So many patients come in with different skin lesions, many explained by too much sun exposure. However, when I was studying about the different diseases we saw at the hospital, I was surprised that it is so much more than that. This really became apparent for me when I was reading about psoriasis. I mean in this case, it is even the opposite.

Psoriasis is a skin condition which has a complex immunological pathogenesis – a lot more than just simple skin damage. It has been shown that sunlight has a therapeutic effect, improving the patients’ disease. Consequently, psoriasis patients in Sweden actually get offered a free three-week “therapeutic” vacation in the south of Europe. Not bad eh?

This is just one of the many skin conditions that is not because of sun damage.

3. There is a cream for everything

shaq holding a lotion bottle gif

Rash? Take this cream. Acne? Take this cream. Palmoplantar pustulosis? Take this cream.

Although there is some truth in this (yes, the main treatments for those conditions I mentioned are creams), it’s only a very, very small part of what dermatologists do to treat patients. Dermatologists also prescribe other forms of medication like injections and tablets, and also perform surgery of course – via liquid nitrogen “freezing” or excision! They also treat their patients in different baths and therapeutic light therapy, which is basically therapeutic solariums. Also, did you know that dermatologists in Sweden are  venerologists (STD-specialists) too? Yup, if there’s some funny business going on down below, you go to a skin doctor.

4. Most dermatologists are women

beyonce who run the world girls

When we came to the clinic during our first day, I was positively surprised that our supervisor was a very friendly and jolly male överläkare or consultant. There were actually a lot more male dermatologists than I thought, because he wasn’t the only one I met at the three hospitals I visited. At our main hospital there were at least three!

5. Most patients are vain

cat looking at the mirror saying I am beautiful gif

My thinking before the placement: “Patients who come to dermatology are vain which is why they’re super self-conscious about their skin.” Boy was I wrong.

In cases of acne and eczema, I thought patients come in because they want to make themselves even prettier by treating the disease. I realised that they come in because they want to be pretty. Because they don’t think they are.

There is apparently a link between acne and negative mental well-being, and this I could definitely see from some of the patients I met. Many develop low self-esteem and even a form of dysmorphism, because of their skin problems. Definitely the opposite to what I thought in the beginning.

6. Dermatology is a “clean” specialty

a pig taking a bath being clean gif

What I mean by clean is that there is no need for messy tubes here and there, sputum/faeces/sweat etc. samplings, no need to open patients up etc. The speciality relies mainly on the visual evaluation of a person’s condition. See, clean. Although it might be so most of the time, there are definitely exceptions.

During our first visit to the dermatology ward, we visited a patient with a rare but severe cutaneous vasculitis called pyoderma gangrenosum. If you’re curious, do google it, but be wary of what you will see. I warned you. Keep in mind though, the photos you will find on google are very, very far from what I saw. The patient we saw basically had no flesh all the way down to his tendons, on both feet extending above his ankle. Exactly like how you would see a fixed cadaver model of feet muscles for anatomy. But this time the specimen is alive. That is not what I would”clean” at all, and I don’t even want to start about the smell…

7. Skin lesions will no longer be dots for me after two weeks

Jokes nope, still dots.

elmo shrugging gif

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!

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The Nobel Prize Museum with Nils from Läkarstudent.se

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Ever since I e-mailed Nils from Läkarstudent.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!

If I didn’t choose Oncology I would’ve probably chosen Infectious Diseases

During the first week of my Infectious Diseases placement, I recall attending a teaching session by one of the specialists. With much enthusiasm she said: “All diseases start with an infection!” I pondered about that statement for a while and realised that maybe she has a point.

In cases like rheumatic fever leading to heart problems etc later on in life, or H pylori infections leading to gastric ulcers that could eventually lead to cancer, maybe there is truth to her statement.

Infections occur in all systems, and has a multiple-system effect. They don’t always present themselves in the same pattern either. By giving the right antibiotic/antiviral etc among the masses available, you can save a life. Pretty exciting indeed.

During my placement, I met several patients who were in severe sepsis (basically dying) one day, seemed unaffected the next. Magic. One patient around my age came in and was barely able to open his eyes and breathe (he was breathing about >30 breaths per minute). He was losing his breath whilst talking to me. We administered antibiotics and when I visited him the next day, he was back to normal. Magic.

Perhaps my mom had a point when she was encouraging me to pursue Infectious Diseases as a specialty. She has always spoken highly of the specialty, ever since she worked very closely with them as a clinical epidemiologist. I recall the days when mom would travel to Vietnam with the WHO to help eradicate malaria. Perhaps it is due to my early exposure to the specialty that I took a natural interest to infectious diseases. Or perhaps it’s actually in the blood.

Nevertheless, after these two weeks at the Infectious Diseases department, my commitment to oncology is still as strong as it has always been. But my respect and interest for the specialty has definitely grown.

I maybe won’t become an Infectious Diseases specialist in the future, but if there’s someone I would entrust to save the lives of the masses, I would definitely turn to an Infectious Diseases specialist to save the world.happy dancing cats