#maccs

This week I think I've made some progress! I've passed another couple of my maccs (mandatory assessed core clinical skills) - this time examinations of the central and peripheral nervous system, and Ive taken some more histories from patients, I feel I'm really starting to get the hang of it in terms of remembering what conditions have which symptoms, then matching that to potential questions to ask. I still need a lot of practice - it's hard to thinks about so many things at the same time! You've got to remember the different 'sections' you need to cover, like family history and past medical history, you've got to remember what questions you've asked and still need to ask, you've obviously got to pay attention to the patient and remember their answers while also trying to put it all together in your head so you can figure out what the most likely problem is, then work out which questions you need to ask to confirm it is that, as well as important questions to make sure it isn't something else (especially if that something else could kill them super quick!). So it's a lot to think about all at once! This week I also had a really good meeting with my 'reflective tutor'. She's a foundation doctor (meaning she's just qualified) and her role is to give me advice etc. One of the things I have to fill out in my logbook is a couple of 'reflections' on my experiences as a CP1 student to basically make sure I'm turning up to things, and thinking about what I'm learning. Anyways, this meeting was really helpful because we had a discussion about my reflection, then I got to present one of the histories I'd taken earlier in the week and my tutor gave me tonnes of really good advice about the condition the patient had, how to treat it, and how to take a better history and present it better. Super useful. My reflection was on another experience I've had this week: I went to an endoscopy list and saw a colonoscopy and an 'OGD' - which is where they stick a camera down your throat to look at your throat, stomach, and the start of your small intestine. One thing that stuck with me was how unpleasant it was for the patients, at best it was unpleasant but for some it can be painful! This made me think about other times we have to cause some harm to patients in order to help them. For example, even just taking blood for a blood test can be painful, and inserting cannulas so that they can be given important medications can take numerous painful attempts. Suddenly, the lectures on medical ethics from the last two years seem a lot more relevant - the four principles of justice, autonomy, non-maleficence and beneficence aren't just for special occasions, they able to everyday practice. Sometimes it's obviously the right thing to do, the blood test might reveal what's wrong with the patient, or the cannula might let them receive life-saving treatment, but it's not always like that. So that's just a couple of things that happened last week. This week is my 'AMU' week where I spend the week on the Acute Medical Admission wards to get a taste of how patients are managed when they first arrive in hospital. It also involves doing to late shifts until 10pm during the week, and one 9-5 day at the weekend. Hopefully this week I'll be able to take some more histories, get some more stuff signed off in my logbook, and maybe even help admit people to hospital by filling in the forms about their history and exam etc. I want to talk about one last thing that happened this week: I got taken on a mystery day out by some of my friends as a belated birthday celebration and it was awesome! I had no idea what was planned (which was completely strange to me as I tend to plan everything!), all I was told was to be ready to go out at 11am.  First I was taken for a picnic and a couple of hours exploring the gardens at Newstead Abbey in the beautiful sunshine. Now, when we got in the car to come back to Nottingham, I thought that was it and was happy with my lunch in the sun, so I was really surprised when I was then taken to play crazy golf! This involved a lot of laughter and some very questionable attempts at putting. And that's not all! The next stop was an all-you-can-eat buffet with food from around the world, including Chinese, Indian, incredible British roast beef, and numerous varied desserts - a favourite of mine being the vast bowl of melted chocolate. By this point I didn't know how to react anymore, it was so much more than I was expecting! We then waddled our way back to watch the last two harry potter films...after they gave me a present too! I know have an 'Australia survival kit' with bug spray, sun cream, a guidebook, travel shampoo and conditioner and so on. I felt very spoilt to say the least! Anyways, I've got some ironing to do so I have something smart to wear for my first day on AMU. Have a great week guys!

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One of the more important stories to come out of this year’s CinemaCon is one that didn’t even get announced until more than a week after the show ended. By then anyone who follows such news was already well aware that the cinema exhibition software firm Vista Entertainment Solutions had acquired a stake in MACCS International, the developer of market leading distribution software.  This post provides a summary of why this is a significant industry development.