My Experience with the Medic Mentor and University of Birmingham’s Live Virtual Work Experience
For the past six months, I have been involved with the Medic Mentor and University of Birmingham’s Medical Live Virtual Work Experience. Due to the pandemic, in-person work experience has not only been more challenging to find, but also less safe, so this opportunity has been incredibly insightful as a prospective medicine applicant.
On one Saturday every month from October to March, over 5000 students internationally attended this work experience programme; to not only learn how a multi-disciplinary team (MDT) of healthcare professionals support a person from the start to the end of their patient journey, but also how they play an active role in the patient’s progress by asking questions, offering suggestions as to how a medical history should be taken and much more.
Although the patient cases were fictional (for safety & patient confidentiality), the MDT worked together as if the patients were real. Personally, I gained a particularly perceptive insight into the daily life of several different types of healthcare professionals and observed amazing role-models embodying skills that physicians have, the good quality of care domains and the values of the UK’s National Health Service (NHS). I will explore some of my reflections of these three items within this article.
Skills
Leadership
Leadership is about embodying the essence of teamwork through guiding, planning and strategizing for a team whilst having the “big picture” in mind. During one of my work experience sessions, a specialist obstetrician managed the patient’s case expertly, guiding medical students and junior doctors as to the actions they were to take when the patient’s condition grew more critical. In this case, the option of a C-section had been offered, the prospect of which the patient was very anxious about. The specialist obstetrician expertly engaged with her team to discuss alternative options, and especially took note of the specialist nurses' opinions. Through this, she highlighted that leadership is not about the stereotypical 'commandeering' that some people may believe is fundamental. Rather, it is about working fluently with a team, and learning from one another - in this case, especially nurses, whose work is often undervalued. Thus, it is incredibly important in medicine to ensure that the team is working effectively to deliver a high standard of patient-centred care. In this way, the patient will also be much more comfortable with their course of treatment; and in this case, the patient agreed to a successful C-section.
Holistic Care
Holistic care in medicine is implemented to ensure that a patient treatment plan considers all important perspectives for a patient; from their physical to their emotional and mental well-being. It also includes assessing that a certain treatment plan is appropriate for a patient from all angles, to select the most appropriate course of action. This is vital in medicine as it allows for the patient to be provided with the most personalised method of treatment, as it is tailored to them and their needs fully. I observed how a team of experts from different specialities - such as the specialist nurse, the radiologist, and the urological surgeon - discussed different methods of treatment for patients with tumours, from conservative and ablation plans to surgical and invasive methods. They took into consideration all the factors with relation to the patient, including the patient’s worries and also the technical aspects, such as the size of the tumour and whether it had metastasised, and the quality of life that they would have and their independence thereafter. This holistic approach helps professionals in medicine to make the best decisions for their patients. Books such as Henry Marsh’s Do No Harm that explore the many sides of a patient’s treatment plan reflect this approach of holistic care as well.
Communication
Being able to clearly and eloquently express thoughts and decisions is what communication means to me in medicine, as well as listening patiently and carefully to the patient. Communication skills are incredibly crucial to be able to not only reassure a patient during treatment, but also to educate them on their condition, as well as their next of kin so that they have a full understanding. During one of the sessions, the speech and language therapist was very patient in listening to and eloquently expressing their thoughts to a patient who had had a stroke. The stroke was in the right hemisphere of their brain, leaving them unable to talk fluently or form words accurately. The therapist effectively reassured the patient of the process to regain the ability to talk due to the brain’s plasticity, and set out a plan which put the patient at ease with the treatment plan.
These skills closely link with the values of the NHS constitution, some of which I will reflect on with regards to how the medics and healthcare professionals exemplified them. For example, the skill of being empathetic, and the NHS value of compassion are very closely linked, and were demonstrated excellently by a general practitioner (GP).
Empathy (Skill) & Compassion (NHS Constitutional Value)
Empathy and compassion involve embodying what a person would feel in any situation and having a genuine concern for a patient, like one would to oneself or for a loved one. Empathy is crucial in medicine as it is an effective way to build good rapport with a patient and care for them in the most intimately genuine way, which is more likely to make them feel comfortable, and is crucial for person-centred care. I observed this quality of compassion during my work experience through the appointment of an elderly patient with a medic. Although it was virtual, the physician masterfully listened to the patient and engaged in conversation by asking questions. I felt that the patient had really felt heard, especially since the patient had been embarrassed to call in and talk to their GP as it was about his mental health. The physician was successfully able to not only reassure the patient that he had done the right thing to book an appointment but was also able to listen to the patient masterfully.
NHS Constitutional Values
Working Together for Patients
During the virtual work experience, it was demonstrated to be integral to work collectively on a patient case to ensure that the patient receives the most suitable method of treatment. Escalation of a patient from the Emergency Department to the specialist team to ensure the patient receives appropriate treatment really demonstrated how different healthcare professionals work together for their patients. It is important that escalation is done timeously, and the decision to escalate a patient to the specialist team was made as a team, to ensure that all sides of the patient coin were analysed. The same applies for when the specialist team escalated the method of treatment. To intubate, or not to intubate, that was the question, and this question was considered by the whole team to ensure the most appropriate method of treatment was delivered to the particular patient.
Everyone Counts
Personally, I interpret this to mean that we aspire to provide every single patient with the same level of person-centred care, omitting any ounce of prejudice or judgement as to lifestyle choices that may have led to their condition. This value is quite important in medicine because it ensures that all patients receive the highest quality of care, which is the absolute expectation to ensure that justice is upheld. During my work experience, I acutely felt how doctors genuinely cared for their patients, specifically, where they ensured a high quality of patient care to a kidney cancer patient, regardless of whether they were smoking (a factor which may have influenced the cancer development). The doctors were professionally setting all forms of prejudice aside to focus on the patient to help them as best as possible.
Commitment to Quality of Care
This value embodies how the NHS will stay and remain with the patient from admission till the very end, through different types of services and MDTs to be able to support the patient in the most exhaustive way possible. This is incredibly important as it ensures that the trust built with a patient is maintained and that the quality of care never wavers, ensuring the patient is at the centre of care. This was clearly demonstrated by the whole MDT when treating a patient who had suffered from stroke. From the emergency admissions team to the surgical team, and thereafter the rehabilitation team, each and every health care practitioner supported the patient in the best possible way they were able.
These NHS values, in turn, are associated very closely with the ‘Good Quality of Care Domains’, some of which I will reflect on below. These qualities really bring together all the skills and NHS constitutional values nicely together.
Good Quality of Care Domains
Consent and Confidentiality
Consent involves ensuring that a patient is informed as to the treatments to be taken and ensuring the patient agrees with the treatment, while confidentiality is the embodiment of respect, to ensure that the privacy of a patient is maintained. These two qualities play a key role in medicine to ensure that there is a sufficiently excellent patient-doctor rapport and so that patients can trust medical health professionals. It was incredibly reassuring to see how the obstetricians explained to the patient the risks of two types of pregnancy deliveries and the specifics of each, and supported the patient throughout making their decisions for the delivery.
Motivation to Study Medicine
Motivation to study medicine is absolutely crucial because medicine is a long journey of learning and adapting and learning once more. I saw this demonstrated excellently to me as the lead surgeon discussed the development of key-hole surgeries. They showed how it had been a learning experience even after becoming a fully qualified doctor to ensure that surgeries are as minimally invasive as possible.
Ethical Principles
The ethical principles of medicine are the pillars on which decisions are made. Autonomy embodies the right that the patient has to take an active role in the development of their treatment plan, beneficence involves the practice of maximising benefit to the patient, and nonmaleficence is the way that healthcare practitioners should always minimise harm. Finally, justice is not only justice to the patient, but their next of kin, in terms of providing them the best and most appropriate type of treatment and in communicating effectively as to how the patient’s condition would progress. For example, during the work experience, a patient had suffered from a fatal stroke that the doctors knew the patient would not be able to recover from. In this case, the most just option was to firstly communicate this with the next of kin and set out a palliative care plan, which would maximise the patient’s quality of life during the last few days of their life. By making them as comfortable as possible and not letting them go through resuscitation (which is incredibly exhausting on the body) the MDT minimised harm, and ensured that the patient’s wishes were taken into consideration throughout.
Overall Reflections
Figure 1 - Segmented cycle demonstrating the interlinking of the three domains explored in this article. Figure constructed by Author.
Overall, I would like to stress the interdependence of all these three different compartments of being an excellent healthcare professional. All of these values are incredibly interconnected – one leading to another (Fig. 1).
These were some of my reflections from the work experience that I have been attending for the past 6 months and I am planning to continue attending to learn more and more from the experience of physicians such as Dr. Quinn, Dr. Alex and Dr. Liv and Ciera the medical student (you will get to know them if you join the programme!). They were instrumental, in not only putting the programme together, but presenting a friendly, and exceptionally nurturing environment to learn in, so I want to say a huge thank you to them and the whole Medic Mentor and University of Birmingham Team!
Opportunities such as these are rare - even in a world without a pandemic, and this is an issue. For young people to be able to make well-thought through decisions about their future careers, there needs to be opportunities for them to experience what potential careers involve. This is especially the case for healthcare careers, as these are often portrayed unrealistically in TV shows and stories. Young people should have access to such opportunities all over the Earth. However, this hope is far from reality. As estimated by UNESCO UIS, 24 million children will never set foot into a classroom, with girls being the most disadvantaged, especially in South and West Africa. It is simply shocking that 80% of school-age girls are not likely to start school at all. It is even more shocking that this statistic for boys is at 16% in the aforementioned locations [1]. The inequity, the disparity, is shocking. 258 million children and youth (as of 2018) do not have access to education, let alone work experience [2]. This needs to change. The success of this programme clearly demonstrates that technology can help with the inequities in education across the world. If technology can help to deliver medical work experience, live, from a real hospital setting, then there is little we cannot achieve, and all of us can play a part in this. Supporting organisations that aim to increase access to education is one key way to go about this. The work of organisations such as Medic Mentor, Childhood Education International, and Plan International is pertinent to make the world a fairer, more equitable place for all, where education is realised as a right, not a privilege [3, 4]. All of this allows for multiple United Nations Sustainable Development Goals to be addressed such as SDG 5: Gender Equality and SDG 4: Quality Education, both of which can directly and indirectly translate into progress towards SDG 1: No Poverty, SDG 2: Zero Hunger, and SDG 3: Good Health and Wellbeing. If equality & equity in education is established, I firmly believe that less people would suffer from poverty, and thereby from hunger and lack of medical care and support.
If you are interested in finding out more about how to get involved with this medical work experience programme (I would thoroughly recommend it!), check out their website and apply to join the programme via the short application form - it’s quite short, and you will be able to join wherever you are in your journey, as there are no right or wrong answers! In fact, the programme has now extended to not only aspiring medics, but also for aspiring vets, dentists, and allied healthcare professionals, each with their own specific programme! their website
References
[1] "#YouthStats: Education", United Nations. [Online]. Available: https://www.un.org/youthenvoy/youth-statistics-education/. [Accessed 24 May 2021].
[2] "Out-of-School Children and Youth," UNESCO Institute of Statistics, 2018. [Online]. Available: http://uis.unesco.org/en/topic/out-school-children-and-youth. [Accessed 24 May 2021].
[3] "Homepage - Childhood Education International," Childhood Education International. [Online]. Available: https://ceinternational1892.org/. [Accessed 24 May 2021].
[4] "Plan International," Plan International. [Online]. Available: https://plan-international.org/. [Accessed 24 May 2021].
