0:00:00 > 0:00:00- .
0:00:01 > 0:00:06- It's a new term and the cameras are - back at the School of Medicine...
0:00:06 > 0:00:08- ..following young students...
0:00:09 > 0:00:11- I don't know where I'm going.
0:00:11 > 0:00:12- ..on a unique course.
0:00:13 > 0:00:15- I'm looking for scrubs.
0:00:15 > 0:00:18- Stepping into the medical world - for the first time.
0:00:19 > 0:00:22- I'm opening the airway - and tilting the head back.
0:00:23 > 0:00:25- Facing the emergencies - of our health service.
0:00:26 > 0:00:30- Every bed is taken, - especially after the bank holiday.
0:00:30 > 0:00:34- People sitting in corridors, - it's the reality of a busy hospital.
0:00:34 > 0:00:37- That's alcohol free.
0:00:39 > 0:00:43- The women's ward is full. - One casualty patient is waiting.
0:00:43 > 0:00:46- It's become so busy - during the past 20 minutes.
0:00:46 > 0:00:49- Treating life-threatening illnesses.
0:00:49 > 0:00:51- Is this patient high risk?
0:00:52 > 0:00:56- They assessed the patient and - there's a high risk of fatality.
0:00:57 > 0:00:59- Fragile lives.
0:00:59 > 0:01:02- How long have I got?
0:01:02 > 0:01:06- He's been worried about today - since the scan three weeks ago.
0:01:06 > 0:01:09- What's going to happen - with my family?
0:01:09 > 0:01:12- These are tomorrow's doctors.
0:01:12 > 0:01:14- I want to help people.
0:01:14 > 0:01:15- I want to help people.- - Thank you, Mos.
0:01:28 > 0:01:32- In Newport's Gwent Hospital, - some of the third-year students...
0:01:32 > 0:01:36- ..receive practical experience - in different departments.
0:01:36 > 0:01:39- Eben joins the surgery team.
0:01:39 > 0:01:42- I'm on my way - to the anaesthesia department.
0:01:42 > 0:01:47- I'll be going to the theatre where - they specialise in emergencies.
0:01:47 > 0:01:52- I've never been to a theatre where - I can watch the anaesthesia before.
0:01:56 > 0:02:01- Today we'll see a patient with - a femoral hernia in the groin.
0:02:02 > 0:02:08- Mrs Haynes is in her 70s. This - operation is not without its risks.
0:02:08 > 0:02:13- To lessen the risk, she'll only - receive a local anaesthetic.
0:02:13 > 0:02:16- She'll stay awake - during the operation.
0:02:16 > 0:02:18- It's not a common hernia.
0:02:19 > 0:02:21- Inguinal hernias are more common.
0:02:21 > 0:02:26- They do happen and when they do, - they're removed by surgery.
0:02:27 > 0:02:33- Two teams work together - - the surgeons and the anaesthetists.
0:02:33 > 0:02:37- The patient receives a cannula - into her hand.
0:02:37 > 0:02:41- She'll receive - the anaesthetic through her back.
0:02:41 > 0:02:44- There'll be no pain from here down, - in the legs.
0:02:45 > 0:02:49- The patient will be awake - during the surgery...
0:02:49 > 0:02:51- ..but they won't feel a thing.
0:02:54 > 0:02:58- She doesn't have great bones - in her back - she has arthritis.
0:02:58 > 0:03:01- Her back isn't straight.
0:03:01 > 0:03:06- There's more bone - than there is in a normal person.
0:03:06 > 0:03:09- It took quite a while - to give her the injection.
0:03:09 > 0:03:11- Can you feel this here?
0:03:12 > 0:03:14- To test - whether she feels pain at all...
0:03:15 > 0:03:18- ..they spray her - with some water droplets.
0:03:19 > 0:03:23- They do that because the - spinothalamic tract in the body...
0:03:23 > 0:03:25- ..can detect pain and sensation.
0:03:25 > 0:03:28- She can still feel the water.
0:03:31 > 0:03:35- The doctors decide to administer - a general anaesthetic...
0:03:36 > 0:03:38- ..to send her to sleep.
0:03:39 > 0:03:44- Communication between all parties - is now as important as ever.
0:03:45 > 0:03:49- They have to get everything right. - There's no room for error.
0:03:49 > 0:03:54- They must get the right amount - of medicine in the right place.
0:03:54 > 0:03:56- It all looks very complicated.
0:04:00 > 0:04:06- They'll burn her skin, then stretch - it open to see the hernia.
0:04:10 > 0:04:14- They've had to move the structures - such as the femoral artery.
0:04:16 > 0:04:19- They pushed the hernia - under these structures...
0:04:20 > 0:04:22- ..to stop it re-emerging.
0:04:22 > 0:04:26- After doing that, they'll put - a mesh over it to keep it in place.
0:04:34 > 0:04:39- What I find interesting is how many - people from different departments...
0:04:39 > 0:04:42- ..in this hospital work together...
0:04:42 > 0:04:45- ..to provide the best care - for the patient.
0:04:48 > 0:04:51- I learnt a lot - from the anaesthetic team.
0:04:52 > 0:04:55- I didn't realise - there was so much communication...
0:04:55 > 0:04:58- ..between the anaesthetists, - surgeons and patient.
0:04:58 > 0:05:00- I've learnt a lot.
0:05:11 > 0:05:16- Surgery is over. We're moving - the patient to recovery now.
0:05:19 > 0:05:21- I was on telly!
0:05:23 > 0:05:24- Bye.
0:05:24 > 0:05:28- The patient was very buoyant - which made it all so much easier.
0:05:29 > 0:05:32- There was a relationship there - from the start.
0:05:32 > 0:05:37- It's so important to have a good - relationship with the patient.
0:05:37 > 0:05:39- No problem.
0:05:40 > 0:05:44- It was lovely to meet you. - You get better soon, alright?
0:05:45 > 0:05:47- You're very, very welcome. Bye.
0:05:47 > 0:05:50- How many children have you fostered?
0:05:50 > 0:05:54- Between 60 and 70 but some - were called supporting lodgings.
0:05:55 > 0:05:57- I still called them my foster kids.
0:05:57 > 0:05:59- That's amazing.
0:05:59 > 0:06:01- This woman is incredible.
0:06:02 > 0:06:05- She has 21 grandchildren too.
0:06:05 > 0:06:06- 21 grandchildren.
0:06:07 > 0:06:10- She's 74 years old. - She's done remarkably well.
0:06:10 > 0:06:13- My grandchildren can talk Welsh.
0:06:13 > 0:06:16- Better than their Welsh grandmother.
0:06:26 > 0:06:29- As the academic year - draws to a close...
0:06:30 > 0:06:34- ..Eleri completes her fifth year - as a medical student...
0:06:34 > 0:06:36- ..on a placement near her home.
0:06:37 > 0:06:40- It's strange being back - in Ysbyty Gwynedd.
0:06:40 > 0:06:45- When I had appointments as a child, - I'd come to Ysbyty Gwynedd.
0:06:45 > 0:06:48- It's nice to be close to home - for the final block.
0:06:48 > 0:06:52- Many patients speak Welsh - which isn't the case down south.
0:06:55 > 0:06:56- Good morning.
0:06:56 > 0:06:58- How do you feel?
0:06:58 > 0:07:00- How do you feel?- - Quite good, thanks.
0:07:00 > 0:07:03- Today, Eleri is responsible - for Mr Jenkins.
0:07:03 > 0:07:07- He's having problems - with his gall bladder...
0:07:08 > 0:07:10- ..which has caused - a case of jaundice.
0:07:11 > 0:07:13- You were meant to go home last week.
0:07:13 > 0:07:20- I had the stents inserted last week - to unblock the gall bladder.
0:07:21 > 0:07:23- My blood hasn't recovered.
0:07:24 > 0:07:27- They're checking every day, - fair play to them.
0:07:27 > 0:07:30- It's nice speaking Welsh - to the patients.
0:07:30 > 0:07:35- It's so important to get a community - of Welsh-speaking doctors...
0:07:35 > 0:07:39- ..who can speak - and treat patients in Welsh.
0:07:39 > 0:07:44- The hope is that the stent can make - the blood tests on the liver easier.
0:07:44 > 0:07:46- That's right.
0:07:46 > 0:07:48- It makes the treatment - more personal.
0:07:49 > 0:07:50- Thank you very much.
0:07:50 > 0:07:54- They can speak Welsh to the team, - the doctors and nurses.
0:07:55 > 0:07:56- That makes such a difference.
0:07:58 > 0:08:04- We want more students - from Wales...
0:08:04 > 0:08:08- ..to study medicine in Wales - and then stay in Wales...
0:08:09 > 0:08:11- ..to work as doctors.
0:08:11 > 0:08:13- That's the course.
0:08:15 > 0:08:20- Mr Jenkins has seen a few changes - in his blood tests over the weekend.
0:08:20 > 0:08:22- They've been deteriorating.
0:08:23 > 0:08:26- He's going to have another stent - inserted.
0:08:26 > 0:08:29- He had one last week. - They think the stent has moved.
0:08:29 > 0:08:32- The plan is to insert another - to see if it works...
0:08:32 > 0:08:36- ..in the hope of getting him home - soon because he's been here so long.
0:08:37 > 0:08:40- We're going down - to the X-ray department...
0:08:40 > 0:08:43- ..where the procedure will happen.
0:08:46 > 0:08:48- It's tight in here.
0:08:49 > 0:08:54- I hope it doesn't break down and - we're stuck here for half an hour.
0:08:55 > 0:08:57- You're on a bed if we do get stuck!
0:09:01 > 0:09:01- .
0:09:05 > 0:09:05- Subtitles
0:09:05 > 0:09:07- Subtitles- - Subtitles
0:09:15 > 0:09:18- On a placement in Ysbyty Gwynedd...
0:09:18 > 0:09:22- ..Jess can practise - her blood-taking skills.
0:09:22 > 0:09:25- Are you happy for me - to take your blood?
0:09:25 > 0:09:27- Yes. It'll be the second time today.
0:09:27 > 0:09:30- Have you had your blood - taken already?
0:09:30 > 0:09:32- Make sure you leave some behind.
0:09:33 > 0:09:37- I'll try my best. I need a lot.
0:09:37 > 0:09:38- Oh, yes?
0:09:42 > 0:09:44- Not too painful?
0:09:44 > 0:09:46- No, it's fine.
0:09:46 > 0:09:51- I definitely want to stay in Wales - when I start working.
0:09:51 > 0:09:55- I grew up here, - it's where I come from.
0:09:56 > 0:09:59- It's a wonderful place to work.
0:09:59 > 0:10:01- I'm bleeding you dry!
0:10:02 > 0:10:06- The opportunity to speak Welsh - in work is a great help.
0:10:06 > 0:10:08- That's alcohol-free.
0:10:10 > 0:10:14- That's one of the main reasons - I want to stay in Wales.
0:10:14 > 0:10:16- Thank you. - Thanks for letting me do that.
0:10:17 > 0:10:20- Not many people like having students - doing that.
0:10:20 > 0:10:22- You have to learn.
0:10:22 > 0:10:26- It's a great feeling when - you're doing it for the first time.
0:10:27 > 0:10:30- You've seen a doctor doing it, - you've seen it on TV. It looks easy.
0:10:31 > 0:10:34- When you're there for the first - time, you forget everything.
0:10:35 > 0:10:38- I managed to get some blood.
0:10:38 > 0:10:42- I needed quite a lot, four bottles. - It's a good feeling when you get it.
0:10:43 > 0:10:44- These are going to the lab.
0:10:47 > 0:10:50- I'm very nervous thinking - that in two years' time...
0:10:51 > 0:10:54- ..I won't be able to hide behind - my student lanyard.
0:10:56 > 0:10:59- People will look up to me - as a real doctor.
0:11:00 > 0:11:03- I'll be treating patients - and making decisions.
0:11:05 > 0:11:10- I've grown so much this year - and learnt so much.
0:11:10 > 0:11:15- Within two years, I hope I'll be - ready to go out into the world...
0:11:16 > 0:11:17- ..to treat people as a doctor.
0:11:18 > 0:11:23- Every single patient, you should - ask yourself, "Is this sepsis?"
0:11:23 > 0:11:26- I want you to spot it. - It will not get through.
0:11:28 > 0:11:30- As the third year - draws to a close...
0:11:30 > 0:11:33- ..Rhodri also feels - the pressure mounting.
0:11:35 > 0:11:38- During my time in medical school...
0:11:38 > 0:11:41- ..the expectations rise every year.
0:11:41 > 0:11:46- By this time of year, we've almost - completed the third year...
0:11:46 > 0:11:48- ..we're expected...
0:11:49 > 0:11:51- ..to be able to diagnose a patient.
0:11:51 > 0:11:54- What could be causing - these symptoms?
0:11:54 > 0:11:58- While taking - a patient's medical history...
0:11:58 > 0:12:02- ..students should spot significant - changes in their condition.
0:12:03 > 0:12:06- Do you have any family history - of medical conditions?
0:12:06 > 0:12:08- A heart murmur when I was born.
0:12:08 > 0:12:14- With Mrs Hodgson, there's concern - about her recent weight loss.
0:12:15 > 0:12:18- How long has that weight loss - gone on for?
0:12:18 > 0:12:19- Since January.
0:12:20 > 0:12:23- How much do you think you've lost?
0:12:24 > 0:12:25- About 50kgs.
0:12:26 > 0:12:28- 50? Gosh, that is a lot, isn't it?
0:12:29 > 0:12:30- That's serious.
0:12:30 > 0:12:34- I've got no clothes that fit me. - I put things on and they hang.
0:12:34 > 0:12:36- The rings don't fit your fingers?
0:12:37 > 0:12:39- No wedding ring, no engagement ring.
0:12:40 > 0:12:42- There's a history of reflux.
0:12:43 > 0:12:45- Every time she ate, - she gets a reflux.
0:12:45 > 0:12:48- She also has a pain in her chest.
0:12:49 > 0:12:51- Right now, - sometimes she starts gagging...
0:12:52 > 0:12:57- ..which causes her a lot of pain - and she can't eat a thing.
0:12:57 > 0:12:59- How much are you managing to eat?
0:12:59 > 0:13:00- How much are you managing to eat?- - Just about nothing.
0:13:00 > 0:13:02- Just about nothing.
0:13:03 > 0:13:05- You mentioned about the crackers.
0:13:05 > 0:13:08- How many of them - would you have in a day?
0:13:08 > 0:13:10- Maybe one.
0:13:11 > 0:13:14- Have you had the camera tests? - How were they?
0:13:15 > 0:13:18- Everything came back fine.
0:13:18 > 0:13:21- Any other medical conditions? - Do you have diabetes?
0:13:22 > 0:13:27- I have had diabetes but my doctor - says I've lost so much weight...
0:13:27 > 0:13:30- ..there's no way - I've got diabetes now.
0:13:31 > 0:13:32- Do you drink any alcohol?
0:13:32 > 0:13:33- Do you drink any alcohol?- - I do but not much.
0:13:33 > 0:13:36- How much alcohol do you drink?
0:13:36 > 0:13:39- Brandy diluted in a glass like that.
0:13:39 > 0:13:40- Every night?
0:13:40 > 0:13:43- Every night. - It's the only way I can sleep.
0:13:44 > 0:13:45- OK.
0:13:45 > 0:13:49- When you're in so much pain, - you need something.
0:14:00 > 0:14:04- It's apparent that Mrs Hodgson's - problems are complex...
0:14:05 > 0:14:07- ..and she requires more tests.
0:14:10 > 0:14:13- There are simple tests you can do.
0:14:14 > 0:14:18- I'm going to write everything up - about everything we discussed.
0:14:19 > 0:14:23- Then I'll research some - of the conditions or illnesses...
0:14:23 > 0:14:25- ..she could have.
0:14:25 > 0:14:29- I'll then start thinking - about a plan for her...
0:14:29 > 0:14:31- ..and get her home - as quickly as I can.
0:14:32 > 0:14:35- After a month of tests and treatment - in hospital...
0:14:36 > 0:14:39- ..Mrs Hodgson gained enough weight - to return home.
0:14:46 > 0:14:49- Jess has taken - Mr Jones' medical history...
0:14:49 > 0:14:52- ..after he was admitted - to the emergency department...
0:14:52 > 0:14:53- ..short of breath.
0:14:54 > 0:14:57- She will present the information - to the consultant...
0:14:57 > 0:14:59- ..Dr Subbe.
0:14:59 > 0:15:03- He has left-sided chest pain - but I think that's more muscular...
0:15:03 > 0:15:07- ..because he's had several rib - fractures after falling from a tree!
0:15:10 > 0:15:11- You fell out of a tree?
0:15:11 > 0:15:12- You fell out of a tree?- - Yes.
0:15:14 > 0:15:16- That's good enough, yeah.
0:15:17 > 0:15:22- Given that we know he climbs - into trees, he's normally very fit.
0:15:22 > 0:15:27- I'm 72, my brother is 74. - They can't stop him.
0:15:28 > 0:15:30- The other one is 76. - They can't stop him.
0:15:30 > 0:15:34- Not everybody over the age of 70 - is still in trees.
0:15:36 > 0:15:40- I was a patient in A&E a few times - when I was younger.
0:15:41 > 0:15:44- I was just clumsy, I broke bones.
0:15:44 > 0:15:48- These haven't disconnected. - They're really free.
0:15:48 > 0:15:51- Family members - have attended hospital.
0:15:51 > 0:15:55- It has changed how I see patients.
0:15:55 > 0:16:01- That's a good perspective to have - when you're on a placement.
0:16:01 > 0:16:06- You're looking for lung markings, - those lines going to the periphery.
0:16:07 > 0:16:09- In most areas, I can see that.
0:16:09 > 0:16:13- We're happy there's no obvious cause - of breathlessness.
0:16:16 > 0:16:17- Two minutes.
0:16:17 > 0:16:19- Two minutes.- - You're getting Welsh on me now!
0:16:22 > 0:16:26- We'll have a look at your tracing - of the heart to see what's going on.
0:16:26 > 0:16:28- You have a slow pulse.
0:16:30 > 0:16:34- There's a beat that looks different. - It could be a ventricular ectopic.
0:16:35 > 0:16:39- That would give you also - different morphology, wouldn't it?
0:16:39 > 0:16:43- The heart has got a pump - and it's got electricity.
0:16:43 > 0:16:47- The electricity normally starts - at the top bit of the heart.
0:16:48 > 0:16:50- The normal is always like this.
0:16:52 > 0:16:55- So now, that only works - when all the electricity is proper.
0:16:56 > 0:16:58- What happens in your case is...
0:17:00 > 0:17:02- Pop, pop, pop.
0:17:02 > 0:17:05- Occasionally you miss a beat there.
0:17:05 > 0:17:09- That means your heart is much slower - than it would otherwise be.
0:17:09 > 0:17:13- If you would run up a tree, - the pulse should go faster.
0:17:13 > 0:17:17- The heart needs to pump more oxygen. - In your case, it drops a few beats.
0:17:17 > 0:17:21- Then you start getting short - of breath. That's what happens.
0:17:22 > 0:17:25- Would a clock thing sort that out?
0:17:25 > 0:17:27- If you would have a pacemaker...
0:17:28 > 0:17:31- ..then it might do extra beats...
0:17:31 > 0:17:35- ..and you might have better function - and more oxygen delivered...
0:17:35 > 0:17:38- ..and you might be - less short of breath.
0:17:38 > 0:17:40- Is that alright? OK.
0:17:40 > 0:17:42- Thank you.
0:17:43 > 0:17:44- Thank you.
0:17:44 > 0:17:46- Thank you.- - Thank you.
0:17:52 > 0:17:56- On the Tryfan ward, on her - final placement on the course...
0:17:56 > 0:18:01- ..fifth-year student Eleri - is treating Mr Jenkins.
0:18:02 > 0:18:05- I'm expecting - I'll get another camera.
0:18:05 > 0:18:07- Another camera?
0:18:07 > 0:18:11- He has stomach problems - and jaundice.
0:18:13 > 0:18:15- My blood isn't recovering.
0:18:16 > 0:18:21- He feels OK himself. He doesn't have - the symptoms he had when he came in.
0:18:21 > 0:18:24- He just wants to get - his blood back...
0:18:25 > 0:18:28- ..to the base line it was - before these symptoms started.
0:18:28 > 0:18:30- OK, great.
0:18:32 > 0:18:35- He's on his way to theatre...
0:18:35 > 0:18:39- ..to have a small camera - inserted down his throat.
0:18:40 > 0:18:42- At the moment, - they're just sedating Mr Jenkins.
0:18:45 > 0:18:48- I haven't seen - this procedure before.
0:18:50 > 0:18:54- Last week, the doctors - inserted a stent in his stomach.
0:18:54 > 0:18:58- There seems to be - some kind of blockage there.
0:18:59 > 0:19:01- We're looking for - the bilirubin level.
0:19:02 > 0:19:05- That's created in the gall bladder.
0:19:05 > 0:19:08- The bile can't travel out.
0:19:09 > 0:19:11- That's blocked right now.
0:19:11 > 0:19:13- We're trying to insert a stent - to release it.
0:19:14 > 0:19:18- When the bile is released, hopefully - the bilirubin will come down.
0:19:19 > 0:19:22- The bilirubin - has caused his jaundice.
0:19:24 > 0:19:27- The blood tests will improve, - as will his skin colour.
0:19:30 > 0:19:35- They've inserted the stent - to help release the bile.
0:19:38 > 0:19:40- It looks as if it's working.
0:19:49 > 0:19:51- That was really interesting.
0:19:51 > 0:19:55- It's the first time - I've witnessed that treatment.
0:19:55 > 0:19:57- It was uncomfortable to watch...
0:19:57 > 0:20:01- ..since they inserted a tube - while he was still awake.
0:20:02 > 0:20:05- He was sedated but not too much.
0:20:06 > 0:20:10- I could see the stent - they'd inserted last week.
0:20:10 > 0:20:14- They've stretched the stent - with another balloon...
0:20:14 > 0:20:16- ..to help release more bile.
0:20:22 > 0:20:25- As her fifth year - draws to a close...
0:20:25 > 0:20:28- ..Mr Jenkins will be one - of the final patients...
0:20:29 > 0:20:31- ..Eleri will treat as a student.
0:20:31 > 0:20:34- The next step is to start work - next month.
0:20:35 > 0:20:36- It's huge.
0:20:36 > 0:20:40- Taking that step, taking this - lanyard off and starting work...
0:20:40 > 0:20:45- ..I don't think one person can - say that without feeling some fear.
0:20:46 > 0:20:48- Hello, how do you feel now?
0:20:48 > 0:20:49- Hello, how do you feel now?- - Better, thanks.
0:20:49 > 0:20:53- We have more responsibility - when we start work...
0:20:54 > 0:20:56- ..but we've learnt to work - as a team.
0:20:57 > 0:21:01- We don't work alone. There are - so many people around us to help.
0:21:01 > 0:21:03- I'll see you tomorrow.
0:21:03 > 0:21:08- That makes me feel more comfortable - about starting the job.
0:21:12 > 0:21:14- From their first lecture...
0:21:14 > 0:21:17- From their first lecture...- - I'll introduce something else...
0:21:18 > 0:21:22- ..to the graduation ceremony - at the end of the course...
0:21:22 > 0:21:25- ..it's a long journey - for tomorrow's doctors.
0:21:26 > 0:21:28- Is that cold?
0:21:28 > 0:21:31- It's quite fiddly. - Do you pull it towards you?
0:21:31 > 0:21:36- This year, they've mastered - all kinds of new skills.
0:21:36 > 0:21:38- This is a difficult skill.
0:21:38 > 0:21:41- This is a difficult skill.- - It's uncomfortable for the patient.
0:21:42 > 0:21:44- I'm going to pretend to be a doctor.
0:21:44 > 0:21:46- I'm going to pretend to be a doctor.- - Yay!
0:21:47 > 0:21:51- They've seen patients - at their most vulnerable.
0:21:56 > 0:21:59- They've learnt how to build - a relationship with them.
0:21:59 > 0:22:02- How are you feeling - about going in today?
0:22:02 > 0:22:04- Really nervous.
0:22:04 > 0:22:06- That's such a weight off my mind.
0:22:07 > 0:22:09- Lovely. Thank you, Mos. - Thank you very much.
0:22:10 > 0:22:12- Some of them have matured.
0:22:12 > 0:22:18- It's taken four years but I think - I've found the right balance.
0:22:18 > 0:22:23- They're all a step closer - to becoming tomorrow's doctors.
0:22:23 > 0:22:26- They're very special young people.
0:22:26 > 0:22:28- We want more of them.
0:22:31 > 0:22:34- Is it an honour to be a doctor? - Yes, it is.
0:22:35 > 0:22:36- It's a wrap.
0:22:56 > 0:22:58- S4C Subtitles by Testun Cyf.
0:22:59 > 0:22:59- .