Lottie Roessler: 'My experience of the LwP3 course'

My name is Lottie Roessler, and I am a 3rd year Medical Student at Exeter College. My experiences in general practice in years 1 and 2 were very rewarding and informative, and I signed up for the Learning with Patients 3 (LwP3) course at the end of year 2 without hesitation. I hoped it would provide something different and broaden by activities in an FHS year primarily filled with independent study. At present, my clinical interests include paediatrics and obstetrics, however primary care is certainly an attractive speciality – especially after such a great experience this year! 

One of the highlights of my Final Honours School (FHS) year was the longitudinal primary care placement featured in the ‘Learning with Patients’ year 3 course. This course is designed to ‘bridge’ the gap between preclinical and clinical school and was a valuable opportunity to develop my professional identity and satisfy clinical motivation in a year of study primarily focussed on biomedical research.  

Having been exposed mainly to adult and geriatric patients during GP sessions in years 1 and 2, I expressed my interest in seeing a paediatric patient. One of the advantages of this course being the chance to specify an area of medicine we want to focus on. I was assigned a young child with a degenerative condition. A truly eye-opening experience, I gained insight into the management of a complex clinical case involving multiple interdisciplinary teams, and experienced crucial opportunities for self-reflection and personal growth.  

As future doctors on such a scientific preclinical course, our default reaction can sometimes involve immediately viewing a patient through a ‘medical lens’. Indeed, during my first meeting with the patient and their mother, much of my discussion was focussed on the clinical history, symptoms and features of the condition – as well as discussion about current medical challenges they were facing.  

However, during Hilary term, I was able to observe a physiotherapy and occupational health home-visit. Here, I truly appreciated the benefits of a holistic therapeutic approach which considers much more than just the clinical presentation of disease. It also helped reinforce the benefits of cooperation between allied healthcare professionals, an aspect of medicine which had remained theoretical up until this point, having not yet been exposed to wider healthcare teams.  

At a personal level, visiting the patient at their home facilitated a deeper connection and more candid conversations about the realities of living with a disabling condition. Left alone to navigate sensitive topics, concerns and hopes for future, was a challenge at first. Prior patient interactions in years 1 and 2 had been fairly structured and usually took place at a GP surgery with other student colleagues.  

Through these interactions, I found myself growing in confidence, gaining a greater understanding of my own style of communication, and becoming more comfortable in unknown situations. The feedback sessions at our assigned GP practice that accompany this course allowed for further self-evaluation and the sharing of experiences. In this way I think the LwP3 course fulfils a dual purpose; on one hand helping to apply our theoretical knowledge to real-life cases but also helping to develop our interpersonal skills.  

Lastly, perhaps my favourite part of this year was the feeling of perspective I had after each patient meeting. On the journey back to the laboratory or lecture theatre, I was struck by the strength, capability, bravery and pragmaticism of the patient and their family. Something which I think has helped remind me what practicing medicine is all about; helping people in times of illness but also using the resilience of our patients to inspire us to better the care we provide. I would like to thank my patient and their family for the way I was welcomed into their lives this year, especially given the precious nature of time when living with a life-limiting condition.  

In my final session, it was rewarding to notice many of the issues brought up in our first meeting were being managed, and the prospect of joining school had brought a certain level of optimism for the future. I genuinely believe the LwP3 course will become a formative step in my medical education, and that I will look back with fondness on this patient interaction which has enriched my FHS year.