NB! This article is incomplete and lacks a review of multiple courses.

5th Year of GUMed

This post is entirely inspired by Hugo Monteiro’s blogpost, A beautiful winter. Hopefully, I can help someone else out there just like how he helped me through the year.

Orthopaedics and Traumatology

Cartilages flying everywhere, babies having their legs hanging and reattaching cut nerves with microsurgery were some of the hallmarks of this course. The teachers were great and most of the seminars were interesting. This course was a good way to start 5th year off. The final test was a piece of cake.

• Weeks: 2
• Questions: 30
• Repeated questions: 100%

Family Medicine

A course with lots of variety. One day obesity, the other ECG. Speaking of which, a great time to refresh your ECG knowledge. Most of the teachers were great and made the 6 hour seminar days more bearable. Yes, you read that right. The first monday was 6-7 hours of sitting in seminars. There is no room for clinical classes in this course, instead there was lots of clinical cases to discuss which was a great learning experience. This is a specialty I could consider, but until then I need to see family medicine in action. Which is next year. The final exam was the exact replica of previous years exam.

• Weeks: 1
• Questions: 20
• Repeated questions: 100%

Surgery

Personally, the surgery course in 5th year was more rewarding than the one I had in my 4th year. Here I got to assist in a surgery, learn how to perform minimal surgical procedures in case I would find myself in a remote location outside of a hospital and practice tying knots and suture. The seminars were long and at times dull and boring. As a way to finish the course we got to pick any topic we wanted in the field of general surgery and present it. Great way to learn something that might interest you. In my case I presented the process and procedures in Organ procurement. The final exam is at the end of the year after everyone has completed the course.

• Weeks: 1
• Questions: ??
• Repeted questions: >90%

Infectious diseases

For this one I had to take the train to Gdynia back and forth. The schedule is straightforward with one seminar in the morning, a practical or exercise class followed by another seminar. For this week of infectious diseases I had to read an observational paper and present it during one of the exercise classes. Unfortunately, despite spending a few hours on the project there was no time to present the paper… How great.

The second week of this rotation was held at the end of the semester for some unknown reason. Nevertheless, we had to take ourselves to Gdynia once again. This time, however, only for practical classes which comprised of two days. During the first day we had this textbook example of a case. Middle aged man presenting with Hepatitis A Virus(HAV). A good anamnesis and some physical examination was all that was required to diagnose this patient. Patient presented with jaundice, vomiting (no nausea), dark colored urine and pale stool. (I am not copying off of Kumar’s book ). The wife’s whereabouts and the incubation period suggested HAV. Perfect case. The rest of the week was uneventful and comprised of online seminars and an additional practical class.

• Weeks: 2
• Questions: 30 closed + 5 open
• Repeted questions: Open questions

Oncological surgery

An interesting seminar and a long, rather dull, Roux-en-Y gastrectomy procedure summed up this course. It felt surreal to see the surgeons remove the most distal part of the esophagus to the proximal part of the duodenum and throw it away.

• Weeks: < 1 (2 days)
• Questions: 10
• Repeted questions: 10

Urology

Due independence day 11/11 and rectors hour 12/11 we had to squeeze this course into 2 days. There were several seminars taking place followed by an exam the second day. The questions were easy.

• Weeks: < 1 (2 days)
• Questions: 10
• Repeted questions: ~90%

Palliative medicine

Palliative medicine is a unique type of medical practice. In this course we got to interact both with physicians and with psychologists. I enjoyed their holistic approach to the patient, but disliked the deterministic approach to their patients’ outcome. Indeed, it was only for a week and I did not get to see much, but this was my impression. Some patients were in dire condition and there was not much to do but to give them pain relief - opioids and COX-inhibitors of all sorts. Which, I did have my reservations about, but never had the opportunity to discuss them.

We also got to create our own MCQs after each seminar and the organizer of the course used a few of those questions for our final exam.

• weeks: 1
• questions: 20
• repeted questions: most of them

Medical jurisprudence

The teacher is highly qualified and has been working for the polish National Health Fund where he had undertaken several projects for public health during his carrier. His engagement does not go unnoticed, however, there is a noticable language barrier. The most interesting part was where he discussed the futile and soft measurements that had been undertaken as a response to the wuhan virus. Where he emphisized the lack of evidence for these measurements and the political forces behind them. Also, he mentioned the lack of doctors’ involvement when devising the response to the outbreak.

• weeks: 1
• questions:
• repeted questions: ~90%

Organization & Economics

This course was interesting and, unfortunately, confirmed some of my notions of being working as a physician. Doctors have little to no control of their immediate surrounding and their work. As a doctor you work more as a servant rather than performing the art of medicine. The week in this course ended with a group presentation on the health system of a freely chosen country. The more exotic, the better. In my group we chose Nepal. The teacher and our colleagues were amused and interested. A much approved course and it was enjoyable. I know that many of my colleagues would disagree.

Exam takes place at the end of the semester.

• weeks: 1
• questions:
• repeted questions: ~90%

Clinical Pharmacology

Much of this course is a repetition from Clinical Pharmacology I from 4th year and Pharmacology from 3rd year. I did not mind the repetition and enjoyed the seminars. There was this one seminar where it felt as if the teacher gave us a 45 minute ad about the newer group of drugs on the market - SGLT2, GLP-1 receptor agonists and DPP-4 inhibitors. I hope they will perform as well as the early studies suggested. Personally, I’ll remain sceptical for at least 7 years from their initial approval.

Exam takes place at the end of the semester.

• weeks: 1
• questions: ??
• repeted questions: Enough to pass

The courses Medical jurisprudence, Organization & Economics and Clinical Pharmacology was during the same week.

Allergology

This field of medicine was fun albeit me being tired during some of the rotations. Here you have to think more holistically when taking anamnesis from a patient to get to the root cause of the disease. The most important of what you will learn from this course is how to diagnose and treat asthma and anaphylaxis. This is of outmost important for your future work and for the oral exam. The oral exam is somewhat dependent on the teacher you get but generally speaking it’s an easy exam. If you do show interest and knowledge during the practicals the teacher will be much more inclined to giving you a better grade. This probably goes for most rotations that have an oral examination.

• weeks: 1
• questions: 3

Pediatric Surgery

Seeing people suffer is disturbing. Seeing children suffering is unbearable. This felt like a short rotation with two days of outpatient clinic, one day of surgery and two days of seminars. The patients coming in were very diverse in their presentation. We saw everything from a teenager that kept growing in length and presented with pectus excavatum to a young child with an imperforate anus. It was all in all, a good rotation.

• weeks: 1
• questions: 60
• repeted questions: ~80-90%

Forensic medicine

A stomach as the size of a balloon, a bursting pancreatic cyst, skulls being opened with a machine saw and how to chemically degrade DNA on instruments are some of the few things we saw and were taught during this rotation. Despite the first two days being made up of seminars for 6 to 8 hours it was a fascinating subject. Everyday was exciting in forensic medicine. Probably because it’s a unique and foreign subject and the cases presented during the seminars were intriguing and horrifying. We were taught a lot and the teachers were very engaging and fun. It was overall a great way to start the new year.

There was no exam at the end of the week. Instead it is a common exam with the rest of the students situated in the simulation room, as they like to call it. I failed this one so I had to take an oral examination with a teacher. There were 3 oral questions and they were basic to the course. First one related to lividity. Second one related to the differentiation of male and female by observing the bones only (pro tip: learn the diameters of the pelvic cavity). Third one related to the ethanol content in the body post-mortem (pro tip: fermentation).

• weeks: 1
• questions: 30
• repeated questions: Prob ~20. Enough to pass.
• Oral questions: 3

Cardiology 2

It’s all about guidelines. The holy guidelines. In the second rotation of cardiology they try to hammer the algorithms found in the guidelines. It seems dulling to the field. The stark contrast between the first rotation of cardiology is that this one is a lot easier and less stressful. No need to read a book and solve 100 ECG questions. Simply attend the seminars, answer questions during the practical and take the final test which comprises of mostly old questions.

• weeks: 1
• questions: 30
• repeted questions: ~80%

Pneumonology

Our practical teacher was a laidback, fun and engaging young doctor. He made sure we saw and learnt a lot. Out of my experience there were three notable events during our rotation. 1) We had a patient being admitted due to severe respiratory distress as a complication of late-stage lung cancer. A starved 50-something year old that looked at least 70 was put on non-invasive ventilation and given steroids to keep him alive. A few moments later that same patient passed away. Now in aftermath when I look back he had the hippocratic face which happens moments before someone dies. Let this be a lesson for the future. 2) We took anamnesis and performed physical examination on a young patient which later turned out to have confirmed TB. 3) I had a spirometry test performed on me.

Overall a positive experience from this rotation. The final exam was easy and we had lots of time to answer the questions.

• weeks: 1
• questions: 30
• repeted questions: ~80-90%

Toxicology & Emergency medicine

This was a short, interesting and worrying week. It’s worrying because youngsters, especially females, tend to frequent this ward. They are suicidal and have attempted suicide. The frequency of these kinds of patients have been on the rise these last few years and especially exploded during the quarantines of 2020 to 2021.

• week: 1
• questions:
• repeted questions:

Gerontology and Geriatrics (OBGYN)

Finally got to observe my first live birth. I also had the privilege to assist in a cesarean section.

Oncology

• week: 2
• questions:
• repeted questions:

Otolaryngology

Very interesting subject, however, the seminars become too detailed and tedious. Funny enough there are only a few core concepts that you will need to know for the final exam. This will be highlighted during the seminars and the old questions. Nothing to worry about.

• week: 1
• questions:
• repeted questions:

Radiology

Sitting in a room in front of a screen looking at images all day is certainly not a preconceived notion of being a radiologist. Much can be derived from imaging, but it’s never conclusive without proper anamnesis, physical examination and further diagnostics. Furthermore, the doctor-patient contact is extremely limited which is a deal breaker for me.