lunar.soliloquy

So I've been working at my General Practice attachment in Manurewa over the past three days, and its made me realise just how much I'd forgotten since 2nd and 3rd year. Essentially I feel I know absolutely nothing and I'm finding I have to look stuff up for every case and everything just seems so foreign even though I know at one stage I studied and learnt everything I had to. I guess the way you look at things in GP is which diseases fit this symptom, whereas in uni you learned disease processes which lead to symptoms, and it puts a whole new perspective on the way I learn things. Also the history taking is quite different from what we were learnt in uni and GPOPS and you won't get many points for empathising with the patient (although its still a good thing to do, but really it's a waste of time in my opinion to go over the top with it like we're taught) or doing a complete history since most of the background stuff is already in the patient's file. It seems that there's more of a focus on asking relevant questions to do with why the patient has come in today and formulating a differential from which you hone in on key questions you should be asking to exclude diagnoses and identify risks. I like that style better; going straight to the point. The whole "That must be very hard for you. Can I get you a tissue?" bullshit felt just too fake. Unfortunately those years of training to use a cushy-pillow-to-cry-on type of interview style seems to have dulled my ability to actually get the information I really need from the patient since there was very little focus on actually diagnosing patients who had real illnesses. I feel I just don't know the questions I should be asking and it just pisses me off since I feel like I should know these things. I duno, I guess I didn't study hard enough in those 2 years to actually remember anything. Guess it's back to square one for me, relearning 2 years worth of rote-learned material is gonna be annoying.

Apologies for the lack of structure and positivity in this post. I haven't been getting great sleep over the past few days for some reason. Probably going to bed too late, just feel real tired after clinic.