Pennod 6 Doctoriaid Yfory

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-Malo e lelei -

-that's welcome in Tongan.

-Our cameras have been following

-students at Cardiff University.

-You see things you'd never normally

-see. You're forced to grow up.

-15 individuals on an unique course.

-We get the creme de la creme.

-I'm the most competitive person.

-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 doctors are like chicks.

-Remember that? It was hilarious!

-Facing the greatest challenge

-of their young lives.

-This year was the first time

-I'd seen 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.

-Medicine is hard,

-the course is hard.

-We chronicle their every step

-to become the doctors of tomorrow.

-We'll be the doctor on the scene.

-We'll be in charge.

-This is superb.

-What made me want to do this?

-This is not about elitism.

-You have been given a gift.

-You must use that gift...

-..to do good.

-The final year is the highlight of

-the five-year course for students...

-..as they arrange placements

-in hospitals all over the world.

-They gain medical experiences

-in very different circumstances...

-..so the elective placement...

-..is a highlight for many students.

-We hope that this course...

-..prepares our students to practise

-medicine anywhere in the world.

-For an unique experience...

-..Guto travels

-to the other side of the world.

-To Tonga,

-a small island in the Pacific Ocean.

-I knew I wanted

-to travel somewhere far from home...

-..and make the most

-of the opportunity.

-I wanted to gain as much

-diverse experience as possible.

-I think it'll be a very different

-experience in Tonga.

-This is the highlight

-of the entire course.

-I'm going to Tonga

-to do my elective...

-..and take a holiday

-at the same time, hopefully!

-This is

-what everyone looks forward to.

-We talked about it in the first year

-but it felt so far away back then.

-I haven't thought about it

-for ages...

-..and now it's here.

-It's nuts

-that it's finally happening.

-I'm trying to decide

-how many T-shirts I should take.

-It's surreal, in a way,

-because the time's flown.

-To think we're nearing the end,

-ready to start a job...

-..it's quite scary too.

-I've a six-week placement

-at a hospital in Auckland...

-..and then I'll travel for

-a fortnight before returning home.

-We've been looking forward to this

-since the first year.

-It's kept a lot of us going.

-You reach halfway and you think

-you'll never be ready...

-..but placements

-put theory into practice.

-I'm ready to finish now.

-Now everything's been covered

-and the exams are over...

-..it all feels very real now.

-I'm looking forward to it.

-Tonga provides an opportunity to

-relax and experience working abroad.

-It's hard not to enjoy yourself

-in a place like this.

-I have to pinch myself sometimes.

-It's so nice here.

-It's so picturesque.

-It's obviously

-a poorer country than ours.

-What strikes you right away

-is how friendly the natives are.

-The welcome we've received here

-has been incredible.

-While the fifth year

-offers exotic experiences...

-..third-years begin their placements

-in hospitals across Wales.

-For the first time in Newport...

-..Elen experiences the reality

-of the A&E department.

-I'm on my hospital-front-door block

-in Newport.

-It covers A&E and...

-A&E, basically!

-I was in the A&E department as well

-as the Medical Assessment Unit.

-In the third year,

-they go on placement in hospitals.

-The main objective is to see

-what the patients themselves see...

-..out in the community.

-It's really busy here compared to

-the other hospital I was at...

-..where two, three or four patients

-were arriving each day.

-Here, as many as 80-90 patients

-are seen every day...

-..which makes it very hectic.

-I doubt I'd be able to do this

-every day for the rest of my life.

-It's non-stop, you're seeing

-one patient after another.

-It's very busy...

-..and incredibly full-on.

-Any person can walk through the door

-in the A&E department...

-..and the patients

-are very different.

-I'm a third-year medical student.

-Is it OK if I sit on the bed?

-I've been walking too much!

-The first man I saw,

-I didn't think he was too bad.

-His leg was swollen and I

-went through all the conditions...

-..that could potentially

-cause swelling in my head...

-..and each one was a possibility.

-72-year-old male with a two-week

-history of painful leg swelling...

-..that has been getting worse

-and moving up to his abdomen.

-He's got an enlarged pancreas,

-asthma, COPD...

-..diabetes, angina, hypertension...

-..and he's an ex-smoker.

-He gave up drinking

-two months ago...

-..but he used to drink three bottles

-of wine a day since he was 18.

-He was very ill, his heart,

-liver and kidneys weren't working.

-I didn't have a clue

-what to do with him.

-This could be a problem with

-the heart, the liver or the kidney.

-Any of those three

-can cause problems.

-In a text-book case, different

-symptoms fit certain diseases...

-..but in the real world,

-all that goes out the window.

-Watch his belly.

-Lift your neck up off the bed.

-Rest it back down. What's that?

-Looks like a hernia.

-Looks like a hernia.

-

-No. Everyone says hernia.

-His rectus abdominis muscle

-has torn a little...

-I feel a bit incompetent

-when the consultants do something...

-..and I think to myself,

-I should've remembered to ask that.

-I also have to remind myself

-that I'm still a student...

-..and it's my first time

-on the ward.

-As a third-year, I remember feeling

-completely useless on the ward.

-I didn't feel part of the team

-because you can't contribute...

-..and you're unsure

-of what's going on...

-..but it's an important part

-of your development as a doctor...

-..because you won't always know.

-But you just have to get on with it

-and learn as you go along.

-We know

-what is going on but not why.

-We need to tailor the treatment

-to the cause.

-She picked a complicated case

-to start off with.

-The organs

-which can cause fluid retention...

-..are the liver,

-kidneys and heart.

-He has potential to have illness

-in any one of those three.

-You work through them in turn to see

-which one is causing the problem.

-Our job

-is to build their confidence...

-..around

-their knowledge and ability.

-It's not only about, "I know

-everything about medicine."

-You also need to know everything

-about human interaction.

-I've been in Tonga for a week...

-..and I'm a few days into

-my placement at the hospital.

-This is Vaiola Hospital.

-The hospital is relatively small.

-I'm hoping to take on

-a lot of responsibility...

-..in order to look after

-the patients.

-I've been put on a paediatric ward.

-I'm enjoying it so far.

-The staff are very nice.

-The team is very good.

-There are a lot of

-interesting patients to treat too.

-I'm on my way in now and I have

-a ward round to do this morning.

-I'd better go.

-There are major differences.

-There are

-fewer resources and so on...

-..and they have to rely

-on a limited budget...

-..compared to our

-resources and budget back home.

-When we take a blood sample,

-we take it for granted...

-..that we'll only have to wait

-a couple of hours...

-..for the results to come back.

-In Tonga, they have to send

-some samples to New Zealand...

-..and wait up to a week

-for the results to come back.

-It goes to show some of the things

-we take for granted.

-Dr George's daily ward rounds is

-a chance for Guto to experience...

-..the extreme cases that are

-dealt with on the children's ward.

-The first child we saw

-has cerebral palsy.

-The fact he has cerebral palsy...

-..affects lots of things.

-I think they're a little concerned

-about his weight gain.

-He has tubes in his nose which

-go straight down to his stomach.

-The parents

-are responsible for feeding him...

-..but he's not getting enough.

-The father said he'd been ill

-himself and couldn't feed him.

-Dr George said

-it was unfair on the small child.

-You can see by him that he's

-emaciated. There's nothing of him.

-It's hard to see someone like that.

-A small child can't help himself,

-can he?

-It's hard to watch someone suffer...

-..due to the negligence

-of someone...

-..who's meant to be

-responsible for him.

-Things like that happen at home too.

-Obviously something

-needs to be done.

-Nobody's healthy if they're

-as underweight as that child.

-It needs to be sorted out, I'd say.

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-For students, the elective placement

-is the highlight of the course.

-Work experience,

-anywhere in the world.

-I've decided to do my elective

-in Auckland, New Zealand.

-I'll be doing Obs and Gynae

-for six weeks in hospital.

-The placements put

-the information you've learnt...

-..and your communication skills

-into practice.

-The current fifth years

-are brilliant.

-We effectively expect them

-to be able go out and be doctors...

-..and be shadow doctors and have

-the clinical skills necessary...

-..by Christmas of the fifth year...

-..to go into the final part of the

-course and be surrogate doctors.

-Doctors, all but in name.

-On placement in Tonga...

-..Guto deals with the challenges

-of working in the developing world.

-I did a placement on

-a paediatric department last year.

-Children obviously come with

-their own set of problems.

-Treating adults

-is completely different.

-It was different again in Tonga.

-There were ailments

-we'd never see in Wales.

-The patient we've just seen

-was interesting.

-The patient has heart failure.

-When you hear about heart failure,

-you assume the patient's old.

-But this female patient

-has rheumatic fever...

-..which is something

-I've never encountered.

-Apparently, it's very prevalent...

-..in the Pacific Islands.

-Not as big as here.

-No.

-Her heart is very big...

-..and you can see

-the heart beating in her chest...

-..because she's very thin.

-When the doctor examined her,

-she could feel the heart pumping...

-..and she could feel

-the blood flow.

-They fear there's a build-up

-of fluid in her lungs...

-..and that's why

-she finds it hard to breathe.

-She has pneumonia.

-She's very ill.

-It's sad to see, really.

-As I said, it's not something...

-..you associate with children.

-Heart failure.

-Back at the A&E department

-at the Royal Gwent Hospital...

-..Elen tries to deal with

-the workload...

-..due to a high volume of patients.

-I'm an insulin-dependent diabetic.

-I couldn't hold down food or water

-last night.

-Are you feeling tired at all?

-Are you feeling tired at all?

-

-I've been sleeping a lot.

-20 hours out of 24 hours I tend

-to be asleep over the last few days.

-Now I've seen the patient, I need

-to track down the consultant...

-..and give him

-her history and her symptoms...

-..so he can figure out

-what to do next.

-When I spot him.

-There were very few people

-available that day.

-The doctors on call

-were either ill or absent.

-The poor consultant

-was running around.

-That's the reality of the situation

-in busy departments...

-..where there are too many patients

-and not enough doctors.

-It's very busy - there are

-loads of beds and trolleys...

-..where people

-are waiting to be seen...

-..and there are even more outside

-because there's no room for them.

-The doctor's rushed off somewhere.

-We'll have to wait

-till he gets back.

-I hope a doctor arrives soon because

-the patient's been waiting...

-..since the early hours and she just

-wants to know what's wrong with her.

-She wants to know... Oh, here he is.

-I hope I can ask him.

-Maybe not.

-A&E departments

-in South Wales are frenetic.

-There's no time to take a break.

-But that's the nature of the NHS.

-Every doctor tries to see every

-patient as quickly as they can...

-..but it's not always

-as simple as that.

-She takes injections

-four times a day.

-She's usually well controlled

-with insulin...

-..but she's been vomiting

-and couldn't keep any water down.

-She's had a UTI for 1.5 weeks

-and only had Trimethoprim yesterday.

-Your diagnosis, doctor?

-I think she has pyelonephritis...

-..or an ascending UTI.

-That's what it looks like, isn't it?

-I assumed it was a UTI that had

-travelled up to her left kidney.

-They're going to give her

-an antibiotics IV.

-So what are you going to do?

-So what are you going to do?

-

-Can you give IV Methoprim?

-Doesn't exist.

-Doesn't exist.

-

-What about IV Nitrofurantoin?

-You can't give Amoxicillin

-because it's resistant to it...

-..so, um...

-You can learn all you want

-about UTI, about urine infections...

-..and diabetes but then you have

-someone with a urine infection...

-..causing a decompensation of their

-diabetes and everything falls apart.

-No, doing grand.

-Thank you.

-It makes you realize

-how much pressure we'll be under...

-..in two years' time.

-but it also makes me realize...

-..that I know quite a lot

-and we're only halfway through.

-It's a bit daunting to think

-that in two years' time...

-..we'll be

-prescribing medication for people...

-..and deciding which treatment

-to give patients who are brought in.

-It's obvious that all the staff

-are tired by now.

-It's nearing the end of the day...

-..and some will work

-into the early hours.

-It's odd to think

-that in two years' time...

-..it'll be us who are here

-from dusk till dawn.

-Preparation time

-is running out for Guto.

-In a few months,

-he and his fellow students...

-..will graduate.

-..will graduate.

-

-I've finished the ward round.

-It was a general ward round...

-..checking

-on the same patients as yesterday.

-Checking to see if they're stable.

-Each one is in the same state

-as yesterday.

-The baby checks are next,

-so more hands-on experience.

-How's the baby? Good, yes?

-Have the bowels opened?

-Can you ask

-if the bowels have been opened?

-Yes? OK.

-The foot seems to be nice and flat.

-In the Pacific Islands...

-..club feet are quite prevalent...

-..though there are few back home.

-I have to look out for that...

-..if the foot is odd.

-What we do here

-is the same as we'd do back home.

-We have to check everything,

-from top to toe.

-We're all done. Baby's fine, OK?

-Today we get to know

-where we'll be working in August.

-I've put Wales

-at the top of the list...

-..and I hope I get a place in Wales.

-But we'll see. I'm a little nervous.

-I just hope I get Wales.

-After years of hard work...

-..Guto's dream of gaining employment

-as a doctor in Wales has come true.

-While I was away...

-..I heard that I'd been

-offered a job in Wales.

-Yay!

-Relief.

-I was very relieved because

-it's what I wanted from the start.

-I wanted to stay in Wales...

-..and find employment in the south.

-I was nervous about it.

-I didn't want to go anywhere else.

-Working in a hospital the other side

-of the world was incredible.

-It was interesting

-to see how they worked over there.

-The chance to travel was incredible

-too. The elective was amazing!

-The elective

-was a highlight for me.

-It was a remarkable experience.

-That was the best thing

-about the course for me.

-I miss the place already,

-to be honest.

-It was completely different...

-..from hospitals in Wales.

-It made me realize how different

-healthcare services work...

-..and how lucky we are in Wales

-to have the NHS.

-We have 100% employment

-when they graduate.

-Some individuals stay in Wales,

-some travel abroad...

-..some go to all parts of the world.

-So when you travel around...

-..chances are you'll bump into

-a Cardiff graduate at some place...

-..and sometimes

-in the most unusual of places!

-S4C Subtitles by Adnod Cyf.

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