The student voice - making the most of a final-year Elective “pandemic style"

A “Literary Elective”

Due to current international travel restrictions preventing a ‘classical’ Medical School Elective, many of the current cohort of final year students have found themselves searching for novel ways to piece together a placement. In May, myself and Jonny Drake were lucky enough to spend three weeks with Dr Alison Convey, taking part remotely in a three-week Medicine and Literature Course, drawing on Dr Convey’s experience both as a GP and previously a director at the Globe Theatre.

As well as the luxury of having time to enjoy reading, the aim of the Elective was to try to understand different challenges we will face in the medical profession from new perspectives. With no restrictions on the scope of the course, we were able to explore various mediums including film, theatre, fiction and poetry.

In the first session we discussed addiction, comparing perspectives from Danny Boyle’s film Trainspotting with the legendary Coleridge poem Kubla Khan. An overarching theme of the three weeks was gaining further insight into cultural factors behind the HIV/AIDS pandemic in the 1980s and 90s. We discussed Alan Hollinghurst’s 2004 Booker Prize Winner, The Line of Beauty, and the seven-hour theatrical marathon, Angels In America, both of which caused a healthy divide in opinion. However, the films Pride, I, Daniel Blake and the play The Deep Blue Sea were unanimously loved. The viewing of I, Daniel Blake sparked a two-hour discussion of the interaction between health and social care and the role of the GP in co-ordinating the two. We both found discussions of this ilk invaluable, as the tempo of the medical school curriculum does not often allow for in depth discussion of social issues. Arguably the highlight of the Elective was sitting down to read Hamnet, a new novel by Maggie O’Farrell. This features a stunning portrayal of one woman’s grieving process and felt particularly pertinent in the context of the ongoing pandemic.

As the short elective concludes, I could not be more convinced of the value of recreational reading as a doctor. It can help us to be well-rounded and empathetic clinicians, who are better able to appreciate the context of the patient we find in front of us. I hope that in two years’ time, after a busy foundation programme, I will still maintain the same viewpoint and motivation to read.

Elective Part 2 – Rural Scotland

When it became clear that the dreams of an elective spent in Costa Rica were entirely unrealistic, I decided to head for the next destination on everyone’s lips: Dunoon in Argyll. Although travel agents seem to find the once popular destination on the Cowal peninsula a tough sell, rural medicine in Western Scotland proved an inspired Elective choice. I spent three weeks in Cowal Community Hospital, a hospital with one active ward of 12 beds, an outpatient department with visiting specialists and a 6-bed casualty department. As I am currently torn between a career in Emergency Medicine and General Practice, this seemed a fantastic amalgamation of the two. At any one time, casualty was staffed by one GP only, who also acted as the on-call GP for the area overnight. The immense responsibility was heightened by the fact that any referrals needed to be sent across the Clyde to the mainland by ferry or helicopter.

It was fantastic to be able to learn from clinicians who were able to work in such isolation. Among the vast skill-set required, key attributes were brilliant fundamental clinical skills and the ability to assess patients without the safety-net of immediate blood tests or a CT scanner to hand (of course, if someone needed a CT head, they could still get one across the water). As I clerked patients, it struck that it must take years of experience to have the confidence to send some of these patients home without the array of investigations that may be run in a larger hospital. On my return to Oxford, my final placement of Medical School was again in A&E. I feel that having had this experience in Scotland, my history and examination skills were notably more thorough.

Although exhausting, the variety in the job and the degree of responsibility seem very alluring. That said, some of the tales I was told of doctors having to manage a patient completely alone, whilst the Highland weather prevented the retrieval team’s arrival, are hard to fathom. Furthermore, I felt more routine work could be difficult without the comfort of a short discussion with a medical colleague in the next-door room. Although I wonder if such isolated work would be right for me, there’s undoubtedly a lot to be said for being able to stop for a freshwater swim amongst breath-taking mountains on your drive home from work.