Pennod 2 Doctoriaid Yfory

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-I can't wait to be a doctor.

-Our cameras have been following

-students at Cardiff University.

-You see things you'd never normally

-see. It forces you to grow up.

-15 individuals on an unique course.

-We get the creme de la creme.

-I'm the most competitive.

-I'm itching for the responsibility.

-From the classroom

-to hospitals across Wales.

-It's going to be more challenging

-than anything they've done before.

-Entering the medical world

-for the first time.

-Young medical students

-are like little chicks!

-Do you remember that?

-It was hilarious.

-Facing the greatest challenge

-of their young lives.

-This year was the first time

-I saw someone die.

-It really hit me

-because she's not going to recover.

-I feel like I'm drowning,

-that I'm not doing enough work.

-The course

-is going to be difficult.

-We chronicle every step

-to become tomorrow's doctors.

-We'll be the doctor on the scene.

-We'll be the one in charge.

-This is superb. Why did I

-think I was cut out for this?

-This is not about elitism.

-You have been given a gift.

-You must use that gift to do good.

-The new year offers exciting

-opportunities for students...

-..as the term of scientific study

-is behind them.

-First-years are looking forward...

-..to clinical placements

-for the first time.

-I can't wait to go and visit

-real patients in hospital...

-..because that's why I'm here.

-I want to be a doctor

-and mix with patients.

-Come January

-and things change, of course.

-They start to feel like doctors.

-They start feeling like,

-'This is why I want to be a doctor.'

-Elin is on placement

-at a surgery in Newport.

-Today she meets her first patient.

-We've just run through

-what we're doing.

-We're meeting a patient but

-we don't know what's wrong with him.

-We have to offer a diagnosis.

-Just do that to begin with

-and we'll see where we lead to.

-I don't know what's going to happen.

-You're the doctor.

-You have to introduce yourself.

-You have to introduce yourself.

-

-As a doctor? No, as Elin.

-Do I need to stand up

-or shall I just sit here?

-Who knows? I'm freaking out.

-KNOCK ON DOOR

-Hello. Hi, I'm Elin,

-I'm a first-year medical student.

-If you'd like to take a seat.

-It was nerve-racking at first...

-..because

-I didn't know what to expect.

-Could I just check your name,

-please?

-Yes, Martin Pugh.

-They are regular people

-interacting with people who are ill.

-The first time that you have

-that interaction, it's scary.

-It's all about breaking down

-that barrier and very rapidly...

-..they become

-brilliant communicators.

-OK, so it was an acute attack.

-You started feeling breathless

-suddenly.

-It's just so helpful.

-It makes it more practical.

-I learn more this way...

-..than I do reading about

-how to perform an examination.

-It's so useful.

-I'll remember that now.

-They collapsed

-the top part of my lung.

-What sort of diagnosis

-are you thinking of at the moment?

-Emphysema?

-Asthma?

-It's a different way of learning.

-It's a more dynamic way

-and you get to see real patients.

-People with all these ailments

-you've heard of.

-You realize and you're reminded...

-..of how excellent this is and

-how hard you've worked to get here.

-You realize, 'This is why I'm here,

-to help these people.'

-Thanks for coming in today.

-You've been really helpful.

-Following an investment of 18m...

-..the students' second home

-is Cardiff's School of Medicine.

-A pioneering centre

-offering students a chance...

-..to practise their skills

-before dealing with real patients.

-We've been given sessions on

-how to break bad news to patients...

-..especially those with cancer.

-It's probably nothing but I think

-I've found a lump in my breast.

-In your breast?

-It helps, doesn't it?

-We're practising

-with actors, of course...

-..and they're given a script,

-so we go along with it.

-If things go wrong

-and you say the wrong things...

-..they're only actors

-at the end of the day.

-Out on placement, it's not

-a case of practising any more.

-It affects people's lives

-in a big way.

-You have no time to mess it up.

-You don't have a second chance

-to break bad news to someone...

-..or their family members.

-So I've had a look

-and I've had a feel.

-I recommend that we refer you

-to the rapid access breast clinic.

-I do need to warn you...

-..that we would be

-looking for cancer, potentially.

-Once you've told them the news

-and given them the results...

-..all the patient hears after that

-is white noise.

-They don't listen to you afterwards.

-Once you say the word 'cancer'...

-..they won't listen to you

-for the rest of the consultation.

-You have to say everything you

-want to say before the diagnosis.

-I'm Ainsley Richards,

-I'm a third-year medical student.

-We've been practising

-breaking bad news to patients.

-I did

-a rectal examination on a dummy...

-..and talked the patient

-through the process.

-So, Mr Moses, I'm going to look

-just at your back passage, OK?

-I'm going to have a look to see if I

-can see any blood, swelling or pus.

-I'm just going to be

-just having a feel around, OK?

-Can I ask you to cough,

-please, Mr Moses?

-It's hard to go

-straight into intimate examinations.

-The patient's really vulnerable...

-..and you're lacking confidence,

-so it's nice having the practice.

-It's hard

-to find the words sometimes.

-Was that OK, Mr Moses?

-I'll just allow you to get dressed.

-I'll cover you back up, OK?

-In your own time.

-I'm afraid of breaking bad news...

-..but we're lucky that we're

-being led through the process...

-..because it is a process.

-What I've found,

-it wasn't what I was hoping for.

-Unfortunately, I've found a lump.

-Oh.

-As I was breaking the news, I

-could tell the patient had cancer.

-It was scary. I think

-I was more scared than the patient.

-You have to be

-both sympathetic and empathetic.

-Patients are the focus

-of the students' education.

-Third-years go on clinical

-placements across Wales...

-..proving the reality of the job.

-I'm loving the third year

-at the moment.

-The placement

-has been absolutely fabulous.

-It really feels like

-we're studying medicine.

-We're on the wards,

-we see patients first-hand.

-Ainsley is on placement in Bridgend.

-Today she will observe the biopsy

-of a patient with kidney cancer.

-Mr Thomas is really nice. He

-lets me ask all kinds of questions.

-As you can see,

-I look like Simon Cowell.

-Very pretty!

-I like being in theatre.

-I like the excitement.

-A lot of the time I don't

-like just being in the common room.

-It's so boring.

-Then again, I don't like wearing

-these because I look like an alien.

-But I have to wear them

-because I have long hair...

-..so it'd get in the way.

-As you can see,

-I look like a Martian!

-Will you help me hold a few wires?

-Will you help me hold a few wires?

-

-Yes, sounds good.

-Because she's passed blood each time

-she's gone to the toilet...

-..they think

-she has a tumour in the kidney.

-See the white here?

-That should be all white.

-That's the tumour there. See that?

-That darkened area should be white.

-They've just performed a biopsy.

-They entered the ureter, which

-connects the bladder to the kidney.

-They took a biopsy of the tumour.

-These are our instruments.

-That's the way that that's

-going to get up into the kidney.

-You pass this instrument

-over the wire.

-You can see

-by moving the deflector...

-..you can bend the fibre

-around many, many angles.

-You can actually

-rotate the instrument...

-..and it gets past the kidney.

-It gets into

-lots of nooks and crannies.

-These cost about 20,000.

-Oh, my gosh!

-Oh, my gosh!

-

-They last about 10 cases per week.

-Because the tumour was big...

-..they have to

-remove the kidney and ureter...

-..so it doesn't affect the bladder.

-This'll happen

-in a couple of weeks' time.

-I have a massive interest

-in trauma orthopaedics...

-..especially after

-spending weeks on placement.

-In the third year, we've performed

-examinations and seen X-rays.

-We've interpreted everything.

-It's cool having that responsibility

-because we've wanted it for so long.

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-Subtitles

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-Before the third-years go

-on their placements across Wales...

-..it's an opportunity to practise

-their skills in the medical school.

-This is really hard to push.

-I don't think it's in.

-I don't think it's in.

-

-It's really hard to do.

-If you did this on a patient,

-they'd be drenched in blood.

-Not many people have experience

-of ill health when they're young.

-Some do, some don't,

-but the vast majority don't...

-..so they have to learn

-how to interact with patients...

-..to support and serve them.

-So now... No!

-You have to push it all the way in.

-Before you take it out...

-..make sure that's pushed

-all the way to the skin.

-It's a chance to practise

-these clinical skills...

-..and it allows us an opportunity to

-make mistakes and get flustered...

-..without having to do it

-in front of a patient.

-I don't want to be

-that person in A&E...

-..who the doctor shouts at

-to get fluids...

-..and I've no idea what's going on.

-Also, these dummies

-don't feel any pain.

-Real patients will say, "Argh!"

-and you have to apologise.

-I'm afraid to do my first ABG.

-An ABG is when you

-insert a needle into an artery...

-..to get a sample of the gases

-present in the blood.

-You go in quite deep.

-They say it's very painful too.

-It looks painful, but you never get

-it the first time, so it's fiddly.

-And the blood goes everywhere.

-By the third year, they will have

-found the first term challenging.

-They go from being taught in

-a safe, comfortable environment...

-..to going on placement

-in a hospital in the real world.

-Patients don't come with a script

-and students must cope with that.

-And there was blood

-dripping everywhere.

-The floor was covered in blood.

-The floor was covered in blood.

-

-Seeing blood makes you panic.

-Everything you're meant to do

-goes out the window.

-I was there with blood on my hands,

-going, help, please!

-Hoping not to spill too much blood

-is Mared in Cardiff...

-..whose placement

-is in the A&E department.

-Yesterday

-was one of the best days I've had.

-The air ambulance brought in an

-82-year-old who'd been hit by a car.

-20 minutes after that,

-a trauma call was put out...

-..and two more patients who'd been

-in a car accident were brought in.

-I just stood in the corner,

-watching everyone...

-..but I was still tired afterwards.

-They took on roles straightaway.

-Someone was in charge and

-they each had their own jobs to do.

-It was great seeing that.

-It was great seeing that.

-

-It's really exciting in A&E.

-Everything's going on.

-There's a buzz in the atmosphere.

-Back on the ward, the doctor

-has given Mared a task to perform.

-She must take a patient's blood.

-She was feeling unwell this morning.

-I'm looking for some bottles.

-I like getting everything ready.

-I want to make sure I have enough

-cotton wool and tape if they bleed.

-I'll pop these down here, OK?

-If it's too tight,

-just let me know, OK?

-There we are.

-Are you quite hard

-to get blood from?

-Sometimes.

-I'll try my best. If I fail, I'll

-get one of the nurses to help me.

-A sharp scratch, OK? I'm very sorry.

-Yay!

-There we are.

-Put some pressure on that.

-I didn't think I'd get any! Yes!

-How do you feel?

-How do you feel?

-

-Really good.

-I'll pop some tape on it, OK?

-Sorry if I hurt you.

-No, you're fine.

-No, you're fine.

-

-It's hard when you miss.

-You have to explain to someone,

-"I missed."

-I feel good.

-During the first week

-of my placement...

-..I was in A&E and

-I took the history of a woman...

-..who'd had a heart attack.

-I thought, wow, OK, this isn't

-on TV now, this is real life.

-I'm actually on placement,

-this is happening.

-That'll always stand out for me.

-I enjoyed it but I don't think I

-could turn up every day and do that.

-The pace is just...

-I really enjoyed my week in A&E.

-After that we had a week

-of anaesthetics and I loved it.

-They got you to insert tubes down

-patients' necks. It was really cool.

-On the other side of the hospital...

-..Gwenllian is on placement

-on a haematology ward...

-..meeting patients with leukaemia.

-It's an interesting field

-and I love the science behind it.

-In terms of the patients, I think

-it'll be incredibly difficult.

-The highs are really great

-and they fill you with joy...

-..but when

-there's relapse after relapse...

-..especially in a young person...

-..I find that

-very difficult to deal with.

-I saw people yesterday

-the same age as me.

-I didn't know what to say...

-..because my life's been so easy

-in comparison.

-It did upset me.

-I went home last night and

-I couldn't stop thinking about it.

-There's no denying the course

-is difficult because it is...

-..especially the science element

-and also the emotional element.

-You see things you'd never see

-if you weren't on this course.

-It's a privilege

-to meet patients on placement...

-..and when you're with the GPs,

-but you have to grow up very fast.

-There are two or three patients

-that stay in my mind.

-They never go away...

-..but I think...

-..you have to show

-some degree of humanity...

-..because it's difficult.

-Some situations

-are easy to leave in work...

-..but other situations

-touch you in a different way.

-This year,

-since going on placement...

-..I've had

-some profound experiences...

-..and I certainly

-take them home with me.

-To learn more about leukaemia,

-Gwenllian is on her way...

-..to the hospital's laboratory to

-see patients' bone marrow samples.

-We've got two bone marrows.

-This is a patient's.

-This is what a normal, healthy

-bone marrow should look like.

-There should be

-a lot of different cells.

-Can you see the difference

-between the two?

-Yes.

-Yes.

-

-This is a patient with leukaemia.

-This one is just completely packed.

-It's really dense.

-This is a packed particle.

-The bone marrow's

-clogged full of stuff.

-After seeing

-the marrow in the laboratory...

-..Gwenllian

-is keen to meet the patient.

-Phillip, yes?

-Hi, I'm Gwen. I'm a medical student.

-Phillip was diagnosed with leukaemia

-a month earlier.

-Up till then he was a fit man

-who swam a mile and a half a day.

-So, on Christmas Eve

-they started chemotherapy.

-I've got to have

-some more chemotherapy.

-But it's like a garden now.

-There's no weeds in it,

-there's no flowers in it.

-It's completely bare.

-I don't want to be here,

-I want to be home with my family.

-Of course you do.

-Of course you do.

-

-But with what I've got...

-..it's all on time.

-You've got to wait.

-It's frustrating for you.

-It's frustrating for you.

-

-Yes, but I won't let it get me down.

-If I let it get me down...

-..it'll collapse.

-The treatment will collapse...

-..my family.

-You're trying.

-I'm alright.

-All I needed to do was just listen.

-For a young person

-who's been healthy all my life...

-..I don't know what to say.

-If I say,

-I can sympathize with you...

-..I don't really know

-what that's like at all.

-It's such

-a great privilege being a doctor.

-People are willing

-to put their trust in us.

-The responsibility we're given

-because patients trust us...

-..irrespective of their illness...

-..in the end,

-it's the patient who's important.

-It's about the trust

-that patient has in us...

-..and what we do in return.

-It's important to try and

-get that across to the students.

-In terms of dealing

-with someone who's crying...

-..or who's becoming emotional,

-you can't prepare for that.

-I just do what feels right. Giving

-someone a hug isn't always possible.

-Getting the balance right is

-something I'm still working out.

-On this block,

-I've come to realize...

-..what medicine can't do.

-It can't cure everybody, and that's

-something that will always upset me.

-What we try to do

-in the third year...

-..is build a good doctor.

-A good doctor

-equipped with basic skills...

-..who can communicate, listen...

-..talk and explain.

-It's a big responsibility...

-..which is why I work so hard.

-It's like a clock ticking down...

-..until the responsibility

-falls on me to treat the patient.

-It spurs me on to work hard.

-There are days when you think,

-why on earth am I doing this?

-Of course there are.

-But when you come back to

-what else would I do...

-..I can't imagine

-doing anything else.

-That's when you know

-you're meant to be a doctor.

-It hasn't been easy.

-It's obviously going to be hard.

-But it's definitely worth it

-because that's what I want to do.

-If you really want it, then of

-course it's going to be worth it.

-Phillip is doing well, convalescing

-at home with his wife...

-..while he awaits

-a bone marrow transplant.

-S4C Subtitles by Adnod Cyf.