PHEM Experiences

Paroxysmal palpitations, panic attacks and the Pandemic

Molly is currently an Interim FY1 in Scotland after graduating in Medicine from the University of Glasgow during the COVID-19 pandemic. She continues to fleetingly don her green cargo trousers when she wants to return to her former life as a Paramedic. She remains the current Chairperson of the Faculty of Pre-hospital Care Student and Junior Trainee Group which aims to provide opportunities for individuals with an interest in Pre-hospital Care.

The last year of medical school is a wild rollercoaster; from the unrealistic dilemmas of the SJT which painted out the grim prospects of medicine where all my colleagues will be crying in cupboards to finally accepting I probably need to move into the library with a suitcase. In amongst the seemingly constant chaos, there is the very faint light at the end of the tunnel that evokes the fear of finally being a doctor but an overwhelming sense of relief that it is actually over. After a decade of waiting for that moment due to taking a slight career detour, if you had told me I would be graduating in a global pandemic, I would have been in sheer disbelief alongside the rest of the world.

The thought of finals still manages to give me paroxysmal palpitations, even now. This period is one of insurmountable pressure. The whole of your degree is riding on the last few remaining exams. I had spoken to many doctors who shared their wise words on how best to approach them; start revising 6 months before, just make sure you get a ‘D’ for Doctor and know the difference between thrombocytosis and thrombophilia. But funnily enough, no one offered me any advice on how to prepare for an evolving crisis on the exact same week.

Whilst I felt relatively well prepared to sit in a sports hall full of 300, palm-sweating, anxiety-stricken medical students, there were others across the UK and Northern Ireland who had their exams brought forward by a whole 2 months. By that point, my head had barely been in a medical textbook, let alone being able to recognise Waldenstrom macroglobulinaemia on a blood film. Medical students adore preparation and control, yet this was no longer an option with last minute surprises predominating.

For me, OSCEs instill an impending sense of doom within me. Especially when I’m expected to perform an ophthalmic examination and I still haven’t learned to close one eye. Following the written examinations, I spent the next 2 days laying on a table in the library, taking it in turns to be the patient or the doctor, practicing the never-ending list of potential clinical scenarios. However, my focus was never in that room. Instead I was glued to watching how the Coronavirus was rapidly taking over the entire world. Selfishly, I was praying that I wouldn’t have to undertake the gruelling 4 days of OSCEs that I had ahead of me. Although this wish came true, in hindsight I can see that this was not for the best.

I feel like I am now followed around by a lingering sense of incompetency. I needed to finish my exams to prove to myself that I was worthy of my registration and the position I have now found myself unexpectedly in. I cannot help but feel that I will forever be remembered as the cohort of doctors who never truly completed their course. From having spoken to numerous other new graduates across the country, I realise I am not alone in these fears. Perhaps this is purely the expectation we have inadvertently placed on ourselves, or is reinforced by the disbelief from colleagues that we managed to escape our exams.

The prospect of entering my new career in such unprecedented and unpredictable times has been daunting yet is perhaps the most poignant. To start this journey early was an unnecessary rhetorical question for me. As a doctor, I feel strongly that it is now my duty to help patients in this crisis and to work alongside my colleagues who had no option in the matter. Before starting, the worst case scenario was painted out to me. Although I knew I would not be allowed in COVID positive areas, I still knew that there would be patients on the wards who were yet to be confirmed. I was oblivious to what I was about to face, especially as the world was still trying to understand how to manage these patients. This picture I had created, heavily influenced by media reports, was not what I was greeted with on my first day as a doctor. The ward was half empty, had more staff than patients and we were treading on each other’s toes for things to do. This has left me incredibly well supported in a role I thought I was being thrown in at the deep end and would struggle to swim in. It has been entirely the opposite and moving forward into Foundation training should be a seemingly smooth transition.

However, for those who have been unable to become ‘Interim’ doctors are likely feeling horrendously underprepared. Without any ‘preparation for practice’ to ease the move from medical student to doctor, the thought of having a wealth of knowledge but no experience of how to apply this in real-life must undoubtedly be intimidating. The saving grace to this is that I would like to hope that Foundation doctors will come together to help and guide each other. On reflection, not only did the NHS need to create roles for us during the pandemic to assist with staffing levels, but also they would have found themselves with a cohort of doctors reinforcing the true meaning of ‘Black Wednesday’.

In amongst this pandemic, in amongst the statistics and the politics, I have experienced an overwhelming sense of humility. When you strip everything else away, you realise that we are all humans in a time of uncertainty. The impact of this will weigh heavy and unite us all in a way we would never have previously considered. I have seen the the raw grief that COVID has left behind. Families not wanting their loved ones to become a number. I am appreciative that I have age on my side, unsure how my younger colleagues who have never seen death have found these harrowing times. The aftermath is yet to come for NHS professionals; are there going to be enough services to help unpack the traumas of working through this pandemic?

I want to highlight the unwavering strength of everyone I have crossed paths with during this experience. The incredible continuing efforts of staff in such a rapidly evolving global crisis has been astonishing. Thank you to every single person who is part of the NHS and all other key workers for the part they have played. The solidarity is something I shall carry forward with me into my new career will shape me into the doctor I become.

Molly Greenaway, MBChB BSc(Hons)

@Molly_FG

The content above may contain the personal or professional views and opinions of the author(s) and does not necessarily reflect the official policy or position of the RCSEd or the FPHC. Further information can be found in the website Terms and Conditions.

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