I know that I said the number of posts would reduce, and they will. It’s just that I’ve had a couple of things that were relevant to this blog happen over the last week or so.
On Wednesday I took part in a MOSLER (Modified Objective Structured Long Examination Review). It’s a test that Newcastle University uses to assess 5th year medical students. I was seen by 8 students and was genuinely impressed with the standards. They were all polite, listened and diagnosed me correctly.
On top of that they demonstrated a good working knowledge of the rest of the diagnosis process and treatment options available. HLA-B27, ESR & CSR levels, a few of them mentioned that it was a seronegative condition so they wouldn’t expect results from a standard arthritis test (RF).
The process was simple, a taxi came to pick me up and take me to the hospital. I was met by a couple of really friendly ladies who checked my name and took me through to the waiting area. I’d guess that there was about 20 or so of us. Breakfast was provided (fruit and pastries) along with the question of the day… “Would you like a drink? Tea, coffee, water, juice?”
After a short wait we were then taken to the examination room and the assessing doctor joined me. She (like everyone else) was really nice and patient. She knew what my condition was but not much detail so she asked me about AS, what diagnosis techniques were used, what effect it had and any other complications that could occur.
I loved the fact that she took me seriously, listened and trusted me. I’m not a doctor, I’m not even an expert on AS as a layman. But I’m quite well informed and know the basics. I know what I’ve been through and a bit about the tests and screening. (I’m one of the patients who asks what each test is, what it’s for, and what the results suggest. Some doctors like that, others not so much. I don’t really challenge them, but I like to know what they’re doing to me!)
The students were provided with a brief overview (37 year old male, stiff and painful in the morning, getting better as the day goes on, 2 of my medications and that the pain was getting worse). They were given 5 mins to prepare then came into the room where they needed to gather my history.
Consent was the keyword throughout the sessions, every single one of them asked permission before going through my history. I tried to provide the right amount of information for the questions that they asked, but I threw in the red herring of my accident for them. Mostly they asked open and probing questions before narrowing to the closed.
Then it moved on to the examination. Again, consent was the keyword. Every single one asked me if I was comfortable removing my t-shirt. They all also asked permission before touching my back, checked in regularly that I wasn’t uncomfortable or in pain and apologised for cold hands. One did go a bit further and asked if I would take my trousers off, but when I declined she accepted gracefully and carried on.
The tests were all pretty similar and the ones that I go through regularly (Schober’s test – bend over and touch your toes, look up, down and side to side, etc…) Although there were a couple who did reflexes too for some reason.
They then provided their findings to the doctor who was assessing them and their recommendations for further treatment. All of them discussed physio, and medication while also touching on the option of surgery but only for extreme cases. And all but one wanted to refer to Rheumatology.
All in all, if this is the future of the NHS then I feel really comfortable. Polite, friendly and competent student doctors who respect their patients and actually listen? That’s another reason why the NHS is envied by so many, and it says a lot about the people who choose to train as a doctor, as well as the people who teach them.