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Day in the Life as a Doctor (Gynaecology)

2020-07-17 · Vlog or day in the life · Ali, Subhadeep Roy · recording, 9:51 · watch on YouTube

Topic: Medicine and his doctor years · mode: Demonstration and walkthrough

Ali walks through a gynaecology on-call day as the senior house officer at West Suffolk Hospital, filmed before COVID-19 with representative patients: the handovers and ward round, referrals for a suspected ectopic pregnancy and a possible ovarian torsion, the options for managing a miscarriage and chasing swab results; the registrar Subhadeep Roy describes who does what in the unit.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — Two caveats: filmed before COVID-19, and the patients are representative composites

  • ★★ The day-in-the-life footage was filmed many months earlier over several days, before COVID-19, so no one wears masks or keeps social distance. — 00:00:00 · COVID-19
  • ★★ For patient confidentiality, the patients Ali describes are not real: they are aggregate patients he made up to represent each scenario, as most medical journalists and writers do. — 00:00:00
  • ★★★ Ali takes viewers through a day in his life as a junior doctor on the gynaecology rotation at West Suffolk Hospital in the east of England. — 00:00:22 · Obstetrics and gynaecology

00:00:36 — Morning: the commute, the obstetrics and gynaecology handovers, the ward round and typing the notes

  • ★★ On the gynaecology rotation Ali wakes at 6.30am, drives to work at 7am, usually picking up an oat milk latte from Starbucks, and arrives at 8am to change into scrubs and bright orange trainers. — 00:00:45
  • ★★ At West Suffolk Hospital the day starts at 8.05 with the obstetrics handover, where midwives, obstetricians and anaesthetists discuss the women on the labour suite, then at 8.15 the gynaecology night team's handover. — 00:00:45 · Obstetrics and gynaecology
  • ★★ Ali says he will talk more about the obstetrics handover in a future video about life on call for obstetrics. — 00:00:45 · Obstetrics and gynaecology
  • ★ Ali explains that hyperemesis gravidarum means severe nausea and vomiting in pregnancy. — 00:01:15
  • ★★ Ali explains that an ectopic pregnancy grows in a fallopian tube instead of the uterus; the woman on his list is about to have a laparoscopy, in which the surgeons put a small camera into her abdomen and will probably remove the tube. — 00:01:15
  • ★★ At 8.30 Ali, the registrar and the consultant do the gynaecology ward round: seeing patients in their beds, how they have been overnight, and their blood results and observations. — 00:01:46
  • ★★ As senior house officer Ali types up the notes on the ward round and keeps up with the consultant or registrar as they speak, which he jokingly credits to years spent at a computer since childhood. — 00:02:13
  • ★★ Whatever Ali does not understand about a patient's diagnosis, investigations or management, he asks the consultant or registrar after they have seen the patient; they are usually very happy to explain. — 00:02:13

00:02:42 — Gynaecology referrals: a suspected ectopic pregnancy from A&E and a possible ovarian torsion from a GP

  • ★★ Once the consultant and registrar leave for the labour ward, Ali runs the gynaecology ward with the nurses and healthcare assistants, handling queries and seeing patients referred by the emergency department or GPs. — 00:02:42 · Obstetrics and gynaecology
  • ★★ A representative case: a woman about eight weeks pregnant with left groin pain and bleeding is sent from A&E as a possible ectopic pregnancy; after a history, an examination and an ultrasound showing a viable intrauterine pregnancy, Ali sends her home reassured. — 00:03:12
  • ★★ Ali explains ovarian torsion: the ovary twists in on itself, which can be very painful and cause nausea and vomiting, and is dangerous because if its blood supply is lost the ovary can die. — 00:04:10

00:04:55 — Coffee with the registrars at Time Out, the hospital restaurant

  • ★ Ali says Time Out, the restaurant at West Suffolk Hospital, is probably the nicest of all the hospitals he has worked in. (hedged) — 00:04:55

00:05:24 — The registrar Subhadeep Roy on who does what and on the West Suffolk unit

  • ★★ Subhadeep Roy, the obstetrics and gynaecology registrar on call at West Suffolk Hospital, says gynaecology patients are usually referred to the SHO on call. — 00:05:24 · Obstetrics and gynaecology
  • ★★ Subhadeep Roy says the workload in obstetrics and gynaecology can be unpredictable and sudden, but West Suffolk, a smaller unit, is manageable, tight-knit and friendly, with consultants keen to involve trainees. — 00:06:08 · Obstetrics and gynaecology

00:06:50 — Afternoon: teaching on maternal sepsis, options for managing a miscarriage, chasing swab results, physiology preparation

  • ★★ In a representative case, the woman a GP sent to A&E with possible ovarian torsion turned out to have appendicitis and was taken over by the general surgery team. — 00:06:50
  • ★ At 1pm a senior doctor teaches the juniors about maternal sepsis and the signs to watch for in the weeks after birth, which Ali finds very helpful. — 00:06:50
  • ★★★ Ali explains three ways to manage a miscarriage: expectant management, waiting for it to pass naturally; medical, a tablet that makes the uterus expel the tissue; surgical, suction under general anaesthetic. — 00:06:50
  • ★★ When no patients are waiting, Ali chases investigation results logged in a book of outstanding tests; a patient whose swab grows an infection such as E. coli is called and offered antibiotics in hospital or via her GP. — 00:08:06
  • ★★ Ali runs weekly physiology supervisions for first-year medical students; on a quiet day at work he reads through the lecture notes on his iPad over a coffee. — 00:08:36 · iPad

00:09:05 — End of the shift, handover to the obstetrics on-call doctor, thanks to West Suffolk Hospital

  • ★★ At West Suffolk Hospital the gynaecology on-call shift runs from 8am to 5pm, and the junior hands over anything left to the obstetrics on-call doctor, who works from 8am to 9pm. — 00:09:05 · Obstetrics and gynaecology
  • ★ Ali calls West Suffolk Hospital a great place for a career in any healthcare specialty and thanks it for letting him film on site. — 00:09:34

In the description and comments

  • ★★ Ali Abdaal (channel): Asked how a junior doctor's day splits between desk work and patients, the channel answers that it is more like 80/20, desk work to patients. — creator comment
  • ★★ Ali Abdaal (channel): To a viewer shocked that a junior doctor spends most of the week on paperwork, the channel answers that medical record keeping is an important part of good medical care. — creator comment
  • ★ Ali Abdaal (channel): Asked whether everyone in the hospital types as fast as Ali, the channel answers: nowhere near. — creator comment

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Mentioned

Central: Obstetrics and gynaecology · West Suffolk Hospital

Also: COVID-19 · ectopic pregnancy · General surgery · iPad · miscarriage · social distancing · Starbucks · Subhadeep Roy

Also centred on West Suffolk Hospital: Finding out my Foundation Year Jobs - Quick update

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