 You just like, make a noise. Does it exist in one, two, three? Oh yeah, it's fine. Hello, my name is Claire Carmichael, final year adult nursing student. I'm here with Oli. I'll get Oli to introduce himself and what he's doing. Hi, I'm Oli, I'm one of the second year, about to go into third year, medical students at Warwick Med School, and I think we're here to talk about med school and nursing school. Amazing. So, I've got all of your questions for Oli in my little book of Wonders. So, the first question I've got is, do you get a bursary like nursing? I know they've cut the bursary now. Yeah, we do, but not in the same way that a nurse or a nursing student would have done. Basically, the way ours works is it's more like, if you were doing a normal degree, you'd get your maintenance loan. That's what we get from the NHS as medical students, and they do contribute to our tuition fees, but they make up the shortfall that's not paid for by student finance England, if that makes sense. You have to pay part of it, but... Yeah, it ours is a loan, like we do pay course fees. So, I'll be 100 grand in debt by the end of my medical programme. So, we do get some money, but it doesn't cover out everything like it might have done for a nursing student. Okay. So, the second question. What are the main differences in what we're talking between nursing and medics? It's an interesting question. Yeah, let's kick them off really. I live with a nurse, so one of my housemates is a qualified A&E nurse, but is in the same year of the medical programme as me. I feel like this may be completely wrong. Yeah. The feeling that I get from the nurses that I speak to in hospital and the nursing students that I see is that you guys are taught a more holistic model of care, whereas medical school, particularly early on, the focus seems to be on the kind of textbook anatomy, physiology, pharmacology, that type of thing. But I assume that nurses need that as well. Yeah. So, in our course, I know our university at Birmingham City, I'm assuming other universities structure theirs differently, but we're taught the professional values at the start, NMC code, conduct and law and all of that, what to do, what not to do. And then we go into the first year's basic anatomy and physiology. So, it's more learning the structures, the different body systems. And then second and third year sort of builds on them. So, we'll go into more case studies and conditions, but we'll look at the physiology of the conditions. So, we're only taught so many conditions. We're not taught everything. I think in doctoring, probably. Doctoring, medics. You're probably taught a lot more. It's difficult because that sounds, at least in theory, that's the same model as how we, you know, first year, particularly for us, the four-year programme is basic anatomy, physiology of like all the body systems. And then second year and beyond is the cases and learning, you know, how to differentiate someone with cardiac pain from pleuritic pain or whatever. In terms of, yeah, the actual content differences, I don't know, like we can get very molecular and things genetic, but you might have the same. It's difficult. I think you probably go into more depth of the patient's, is my guess. I have to assume maybe, but I honestly don't know. Like for our case studies, we'll have the patient, a pretend patient, and then they'll go into, okay, so this patient's got MI, so then we have to know what the condition is, what the treatment is, sign symptoms, how as a nurse you're going to treat that patient and what you're going to monitor, and then how you're going to care for them, not care for them, but plan ahead and get discharged back in the community, making sure they're safe and not re-emitted back into hospital. Okay, so MI, I mean, that's a good example. So I guess what we'd be taught is, in first year we'd have done, you know, the relevant anatomy of the heart and the kind of electrophysiology of the heart and how to read an ECG and how... ECG? No, no, okay, so that might be... So that's how it would look on an ECG, how to differentiate the different types of MI and things like that, and then, like, the pathophysiology of acute coronary syndromes and the pharmacology and the molecular action of how they all, you know, the classes and actions of all the different drugs, the statins and beta-blockers and inhibitors and all those and where they... the different receptors that they all act on and that. So... It sounds similar. Yeah. Just sounds similar. Yeah, it's the same. Yeah, it's the same. Did you ever think about nursing? I thought this was a good one. That is a really good question. I didn't, but in retrospect, like, not for a good reason. I did the same thing that I think a lot of people do wrongly, which is when you get to, you know, 14 or 15 or whatever and you're thinking about what you're going to do, you jump to, well, I'm going to be a doctor. And I've said this before that actually, at that time when I was thinking about applying for med school the first time around, I had no, like, good idea of what the different health professions did. Like, my mum trained as a nurse and works in management now in the NHS, but her background is kind of mental health nursing and that type of thing. And yeah, in retrospect, there is no good reason why I shouldn't have thought about nursing as much as I should have thought about medicine. Well, it's like me, I didn't really think about being a doctor. I just went straight for nursing. Yeah. It's difficult, isn't it? Yeah. I mean, there's obviously all the differences between what the two roles do, but that's maybe another question. I don't know. Okay. Thank you for your honest answer. Okay, number four, what specialism do you want to do? That's a great question. I'm sure everybody asks you that. Asked a lot. Yeah, that's the first thing. Whenever someone asks what you're doing and you say it is maybe the same for nursing. Yeah, it is. It's like, oh, what type of, what do you want to do when you grow up? It's quite complicated, actually, because I publicly, and again, I've said this before, I am aiming for neurosurgery, which is really exciting. It's a really cool specialty if you can ever get into neurosurgery theatres. It's amazing. There is a small caveat to that, though, which, again, I don't know how it works for nursing, but the specialty in medicine is really competitive. You can be up to 20, 25 plus people per one specialty training post. And for some specialties, particularly things like neurosurgery, cardiothoracic surgery, the kind of high-intensity, sort of well-esteemed ones, you have to begin quite early if that's what you're thinking of doing, just because you do med school for five years. The first year, you probably don't know what's going on. And the last year, you're concentrating on your finals. So those two are out. And then you have two years of foundation training as a medic, and then it's immediately after that that you'd be starting specialty training for neurosurgery. So basically, I'm prepping myself as if, you know, I'm like 99% sure that that's what I want to do. But if I at least behave as if that is what I'm going to do, it means I'm doing all the extra kind of things. And even if I don't do neurosurgery, I've still got the audits and the research and the placements. So you're doing extra things sort of around university to look good on the CVR, I suppose. So that when you apply, you can say, I've done this and I've done this. It's unfortunately kind of the way it is. To make you sort of stand out. That's it. I'm certainly not a qualified medic yet, and I'm a while away from being one. And I may decide in my first two years before that training that I want to do something completely different. But the problem is, is that if you get to that point, having not done any of the extra things, you're going to lose out to the people who have as you should, because that's, you know. I think that's a really good idea to do as well. I think this is a nice question, but it's very open. So what does being a doctor mean to you? Oh, that's a huge question. I'm really sorry. No, I mean, obviously. Blame. People asking the question. Obviously, I'm not a doctor to start with. What do I think a doctor is? The problem is, is that a lot of this is going to overlap with one nurse. A scientist who is trained in order to clinically solve problems of the human body. Oh, like. That's how I kind of they sort of talk about doctors as being sort of the scholar and the scientist. That's kind of how I I see it. Someone who is almost like engineering, but for the human body, someone who is using science to work out what the problem is and then come up with a plan or something using your other science knowledge to solve a problem. But there's also the person facing element. I nearly started a PhD after my first degree in something like genetic engineering. Completely not human facing and I just decided ultimately that I think I need that personal connection that you get. I wouldn't want to be stuck in a lab all day. I think I need that person. They say the same with nursing. It's like the science and the art hand in hand. Thanks. What do you think doctors think about student nurses? Okay, I thought you were going to say nurses in general. Oh, nurses in general, a bit of both. Right, okay. Sorry. No, okay, fine. As a medic, right. I'll start as a medical student so I don't get myself in trouble. As a medical student and I've heard that this doesn't change when you're a junior doctor and it probably doesn't change when you're working up to a consultant as well. Nurses are your lifeline on the wards because while the consultants expect us to... I get the feeling that the consultants expect us to know what to do because the medical school or someone will have told us that's never, ever the case. We don't get loose onto the wards. We have absolutely no idea what's going on. And unlike student nurses we can't be useful a lot of the time because we don't have the skills to be. So definitely nurses, nursing students they all know kind of infinitely more what's going on than we do. So, you know, if I have a problem student nurses are a great person to us because they might judge me for what I don't know. Yeah, that's true. In terms of this is real and I kind of wish it wasn't, but definitely a couple of times when I've been in theatre the consultant surgeon was much, much nicer to me as a medical student than they were to them. I got the feeling that the nursing students were kind of an annoyance to them. But it shouldn't be like that. That's a rare case. I've had that twice, literally. But that really kind of stuck with me and it was like these two have as much to learn from this as I do. In fact, they probably know more about what's going on. I understand the anatomy in terms of attitudes sometimes that doesn't always bear itself out. I think that's how I would put it. And I think in defence of some people there are some bad students. They give those other students a very bad name. So they're a bit more cautious. Yeah, that's true for medical students as well. Medics or nurses. Moving on. What's the hardest part of your degree so far? I will say this until I think my dying breath, which is that medicine as a course and how you feel about nursing, medicine in terms of the knowledge that you actually have to acquire is not hard. It's like A-level biology. If you can do A-level biology you can do medical school. But the problem is the pace and the extent of things that you're expected to know. That's the thing that makes it hard. And it's something that a lot of people even myself who came in who in theory knew how to study I had to completely change the way that I approached learning. And there's a lot more I think actually some of the stuff that I've struggled with is the clinical hands-on being with patients because I came from a degree that had no I think it was like a life sciences degree. I had a bit of medical work experience but nothing patient facing particularly. So retrospect actually I think I would have benefited from taking some time to work as a healthcare assistant that's been quite difficult in some cases, particularly breaking bad news and things like that. I've been fortunate I've actually skipped breaking bad news so far to anybody. I've had to do it a bit and you also get into circumstances where you're not expecting to have to do it. But say I was talking to a stroke patient and I was the first person there when they woke up and like paralysed down one side and they're saying, well am I going to get better? I don't know probably not can't really tell but that's the thing you can be really put on the spot like that so that stuff can be difficult. Question 8 is have you ever done personal care with patients? It's going to sound really bad I'm really sorry don't hate Ollie. This is the thing it's a term I've heard nursing students use I think in medical school we're taught this under different guys we're taught the importance of the biopsychosocial model of care and you know at least so on there's total model of pain and all that type of thing when you say personal care what exactly do you mean? The first personal care is more like washing, dressing, brushing teeth sorry hygiene which I can see with doctors it's a completely different role and I wouldn't expect a doctor to come and wash a patient so don't kill me again for saying this it's just a completely different role for me I wouldn't go and get a doctor unless I was desperate because it's short on the wards doctors there's very sorry I'm answering your question just in my opinion you've got so many patients whereas we've got one nurse to eight patients so there's a little bit more nurses to patients I think to do that and we've got healthcare assistants as well to help and doctors I think with your role it's more diagnosing treatments the thing I think yeah what I would say to people is that if there's a med student I can't speak for junior doctors but if there's a med student and and a nurse asks us to do something it doesn't happen very often because again I think they tend to leave us alone but but if a nurse asks us to do something personal care wise we will do it we'll take any opportunity to kind of ingratiate ourselves with people because we're frightened of everyone and med students do look scared don't we? and we I think what you said it's not I don't want to give the impression that it's not that we don't want to do it we it's just something that we're never taught to do or is asked of us usually whether that's right or wrong particularly for med students but they are just different our goal when we go on to the ward is different for better or worse I think that's understandable so next question is someone wanted to know if you could go into medicine after nursing do you think it would be easier? that's a good question I mean as I've alluded to already given that my housemate is a nurse and she is doing exactly that yes you can there is nothing medicine particularly graduate entry medicine kind of as it's going particularly at places like Warwick it doesn't matter what degree you did before all that matters is you hold a degree to one standard they don't care what you did if you did philosophy, if you did zoology, if you did molecular biology whatever it doesn't matter graduate entry medicine is always going to be open to you nursing is you might correct me if I'm wrong but it's usually BSC so some graduate entry medicine schools demand a science degree and then some of them go further to demand like a life science I mean obviously nursing being what it is I think satisfies virtually any criteria they're going to have that in terms of it being easier that's a really difficult thing to answer because the entrance process is quite rigorous and just so it's kind of clear they won't look upon you more favorably just because you're a nurse if that makes sense it's more you have to do well on the entry exam and do well in the interview but then obviously if it comes to an interview situation and you're being asked why do you want to do this are you good with patients if you've been a nurse and been through that process you're going to be good at all those things so I think that's the part that would be easier and I think you would find adapting to clinical placements a lot easier and you'll know a lot of the clinical skills and things that you know how to take manual blood pressure how to maybe do an ECG if you've worked in that department how to manage a deteriorating patient nurses tend to be really good at that they're saying about the entry exams is it just maths in English or do you have a whole separate it's its own thing that's interesting so you just have maths in English and then the interview but that's like a test that they make you do maths in English does it have a name? maths in English you receive English you receive literacy as an official we have a test it's usually called the UK cat it's called the UK cat now which is what they call an aptitude test and a lot of the questions can seem very like random and obscure but it's just general comprehension there's a bit of abstract reasoning and kind of situational judgment that they ask about but it's more I would say it's more a screening tool and then if you do well for your particular medical school you get a high enough score you'll then be asked to interview and then obviously you go from from there thanks you did your three years undergraduate degree before and now you're doing medicine so are you now self funded and how do you manage that's a good question graduate entry medicine is one of the few courses in the UK that allows you to receive two lots of funding so I did my first degree and received the standard student finance package for that I got my tuition paid for I got my maintenance loan and that was enough to cover all of that graduate entry medicine if you study on a four year program you get that again although there is some crossover the NHS starts to fund you and student finance gives you less but the NHS covers more the only thing you do have to find I think just over 3,000 you have to pay is like a lump sum and that's the only input that you have to have into your medical tuition which I was very lucky to have in savings from kind of working because I knew this is what I wanted to do so I saved before my first degree and through my first degree and that so once you've done that in theory it works the same way if you do a five year program as a graduate you are not entitled to that student finance so you would have to self fund 45 grand or whatever it would be that's the main yeah exactly so that's why when I was applying I was only applying for a year program how many hours of clinical practice do you do well it says meds versus nursing in terms of who does more how many hours do you do the GMC stipulates that we have a certain amount of contact hours I don't know what that number is in reality and I think we were talking on the way here this is going to be one of the biggest differences nurses from what I understand you basically have to be there from 8 to 8 all day it depends on the trust some places are 8 to 8 some are 7 to half 7 where I'm at now the community is 9 to 5 but I mean even 9 to 5 every day in practicality at least in my experience we do nothing like that so I'm on clinical placement in cardiology for a week they might want me at the ward round every day so you know a couple of hours I might go to a clinic in the afternoon and see patients and kind of be with the consultant I might be in the library studying or something but the big difference is that usually and it depends on your consultant normally we don't have to be anywhere at the time as some of you might know we have the 2,300 hours that we have to do over 3 years and we have to do that before we get onto any register if we don't do it we don't get our pin basically and we have a time sheet for every placement we have to get the mentor to sign and then we submit it to uni to show what hours my answer may change because 2nd year we did 3 lots of 10 weeks after this assuming I go through into 3rd year it will be full-time clinical education again so that may be different there may be time sheets I may have to be here and there at given times this past year that hasn't been my experience and I've been in every day so I think you should absolutely do that get in theatres get on the wards be examining patients go to the MDTs do the ward around all of that because I think that's the best way to learn but if I haven't done those things I'm pretty sure that no one will notice it's a bit more relaxed so somebody would like to know how to aim for a first and how hard is balancing everything wait do you get classified we were talking about this in med school there's not firsts don't exist in my undergrad degree I was very lucky and did manage to come out with a first I should very quickly say not because I'm a good student the reason that I got a first was because of the way that my degree was weighted so heavily towards the dissertation I just did very well for the dissertation which dragged literally everything else up to such a degree my average performance was like probably high 60s that's good which I was perfectly happy with but isn't our first crucially so what I would say what I did certainly in my second year I did a really stupid thing which was deciding to take all the modules that sounded really clever to be like so when I was applying for jobs I've done all these modules in statistical management of this and my evolutionary genetics that's not how you get a first how you get a first is by picking modules that you know you're going to do well in or that are really easy to do very well in and don't demand much in my third year I did a module in it was like enterprise innovation for scientists an ethics module that was based the entire module was assessed on one 1000 word essay no exam no compulsory lecture so it sounds like I think the way you get a first is either by being really smart and studying all the time which is probably the more optimal way or you gear your situation in such a way that it makes it more likely that you'll do well or some combination but don't be that bothered about getting a first it doesn't matter for like anything no one asked your grade at the end of the day it's nice as a personal gain like I was always first year I got really high grades so I was like yes I can get a first and then second year they were like 60 70 and then third year it's just gone down a little bit so I'm like 60 I'm not going to get a first now but it's fine I'm happy with that I've literally never that's not true I've met one thing that asked me for a first and that was applying to Birmingham Medical School I don't know whether they say it on paper but they do want a first that university of Birmingham but that's literally the only time that has ever become relevant interesting I didn't get it anyway how hard is balancing everything for you is he in manic in terms of balancing medical school like life don't have one it sort of goes yeah it goes like that in health care I don't know I'd probably make it harder than it needs to be in that I like to do a lot of extra things can you do your vlogging in store we're here today doing this I like to be busy all the time having research projects I like to be active and I feel very guilty and a bit like I'd be a bit jittery I actively have something to do but the thing is particularly with grad entry medical school is that everyone is in that situation I think it's the same for nursing because you're all you're on the same timetable like you have a slightly I would say a slightly warped view of reality just because of your placements and the things that you've seen and how you interact with people you know get up early and just I think trying to have a plan for what you're going to do each day and if you catch yourself this has been my biggest thing if you catch yourself in a spot where you've just kind of completely zoned out and you're not doing anything that's when you have to consciously make an effort to do something productive now not that every second of your life needs to be productive because it absolutely doesn't stop and smell the flowers just trying to exercise a degree of control I think over what you're doing is good yeah nursing's the same really intense course and sometimes it is hard to fit things in so it's just finding that balance and everybody's different I'm like you I like to be 100 miles an hour doing everything every day something and I get a bit edgy if I'm not doing anything but then other people they've got children they've got families so it's going to be hard to balance those things but yeah, let's find out what works for you someone is thinking of nursing but loves paramedics can you start as a nurse and then work with the ambulance well then this is a question I put to Twitter it was a question I wanted to know in general I don't know so I'm hoping so yeah so I put this one to Twitter and basically you can now work on the ambulance as a paramedic nurse so you're on the paramedics but you're just a nurse I'm not just a nurse you're on the paramedics with your a nurse I wouldn't be taking that so that's it so you're a nurse that's not like a subdivision of paramedics that's a nurse you're a nurse paramedic but you're not a paramedic that's very exciting so I suppose it would be like working in the emergency department but out on the road in your paramedic van paramedic van also you can't there's loads of different options but you can't there's no short course to paramedics if you're a nurse first you can't just suddenly skip it a year or two most of the health professions are like you have to train I think they're all regulated by their own I can't remember who it is that is in charge of the paramedics but they have their own regulatory body so it's like what we were saying before about the interviews like simply having already worked in a healthcare environment doesn't fast track you to any other healthcare role because you still have to meet the same standards that anyone of that role would like if I wanted to if I qualified as a doctor and then wanted to become a nurse I'd still have to start from zero and do the nursing course you know but that's very cool I had no idea no I didn't know until people were saying oh my god I'll try and put the tweets on there somewhere so people can see because there's different routes into paramedics as well there's like different courses you can do but of course I think but you still have to do I don't know there's loads of different routes anyway that people are commenting on maybe if you just work in ED because I know my housemate did and she ended up in ambulances a lot but that would be like transparency so yeah oh how are the relationships between doctors, nurses and the hierarchy this is basically what we're talking about the NHS is massively hierarchical like I think it's one of those things that you see like printed on posters everywhere like you know everyone's on a level playing field and you should be able to speak up in front of you superior isn't it it just doesn't work like that in practice and that's true I think across like it's definitely true within tribes as it were they'll be nurse practitioners and consultants and junior docs and medical students but probably across specialties across areas as well I still yeah it's very rank sensitive it's the same I don't want to say it is but it is and I was just saying actually to the team I'm with at the minute because I'm out in the community with the district nurses it's the first time I've ever seen I don't know if you know the banding of nurses I know and 2, 3, 4 a sort of healthcare assistant nursing associate roles and then 5's of staff nurse 5, 6, 7, 8 8 AMB I think there is yeah so on the ward you'll have all of those so where I am at the minute we've got our band 5's who are amazing we've got HCA's, band 3's HCA there's a band 4 then we've got the band 5 nurse band 6's who sort of organise the day and then we have band 7 who's the top of the the chain and she sort of oversees everybody the nurse in charge of that whole team is that what a nursing charge is yeah I suppose kind of but I don't know on the wards it's very different so the nursing charge can actually be a band 5 as well just basically someone that they've appointed to take control of the day if anything goes wrong to deal with any patients someone that they've just appointed but what was I saying oh yeah so in my team you've got this band 7 nurse who's top of the ranking I suppose she organises everything it's the first time I've ever seen a band 7 nurse don't mean to offend anybody out there that's watching this I'm sure you're all amazing but the first time I've ever seen a band 7 care for a patient she's got her own patients she's also her office isn't in a separate office the rest of the nurses she's organised it so that at hand over we have hand over at half past one every single day but then that hand over is also integrated with lunch time so everyone can sit together have lunch together and she's so lovely and down to earth and that's the first time I've seen that because on the wards you don't see it you don't know where the band 7 is half the time the matron or the manager of the wards usually in their office again don't mean there's just what I've seen out there and it does feel like sometimes there is a bit of a hierarchy and people don't speak up or anything like that but where I am at the minute it's amazing I haven't seen anything like it and they've just introduced as well so on Friday they have Feel Good Friday and this is what the band 7 nurses introduced where she's said after hand over when they're having the lunch at the end of the day they're all going to put all of their drama on the table they're going to say right what's happened what's gone wrong, what's annoyed them that week and just get it all out the air clear it off the table and move on, have a good weekend and carry on and I think that was really just really good that's actually really good why can't everyone do that sorry I waffled then my experience in seeing the medical team again like the MDTs and the ward rounds and things tend to be like a consultant maybe a specialty registrar a junior doctor or a foundation doctor and a couple of medical students and most of the time despite it being in theory very hierarchical my experience has been that they're very good at making you feel part of the team like you have something worthwhile to offer which you don't but they're good at making you think they're good at making you think you might which is obviously really nice and it's really it allows you to be more involved and participating and stuff the flip side of that is that particularly established consultants if they say to either a young doctor or a medical student it's very I say this you do it unquestioningly it's almost like military sometimes and if you hesitate or don't immediately do the thing there's problems there is more of a movement now to not count how to what seniors say unquestionably but it does happen so someone wanted to know because she's just had second year I think really sorry if I got that wrong she's second year nurse and she's just had this massive break up we see this a lot on nurse in where relationships sort of break down because how intense the course is and I think she just wanted to know one of her questions was do you think relationships can work if you're medical or nursing like clearly like I'm not the best person to ask not having had like a long lasting relationship through medical school like can it work yeah definitely obviously people do so it can it is difficult it's been my personal experience is that it's been very difficult to have the specific conversation about because of the nature of what I'm doing whether it's nursing or medicine or whatever I need some time in which I'm focusing on that and I need to compartmentalize my time and I can spend some of it with you know a partner and some of it there and but basically you ultimately come to the point where you're saying I need some time that doesn't have you in it and most people don't perfectly understand and don't like to get on that because why would you so I think you just need someone who's going to understand but I think if your relationship's going to break down or whatever whatever course you're doing not just nursing there's obviously problems with the relationship because if you were too good people meant to be for each other this is just my own opinion you would make it work you would get through it and that person would support you through it yeah that's the thing is so a friend of mine I was talking to when she was applying to med school asked me this exact question she was with long term partner at the time and I think in my sage Lee way said the way that you the way you avoid breaking up when one of you goes to med school is that you don't break up because as you say just like if you want it to work as you say well enough you'll make it work there are harder things in the world that people have to deal with you know a bit of long distance or it obviously depends on the situation but just having a partner who is either very understanding of what you're doing or equally needs the time away from you that you need away from that focus on your own thing then yeah that's fair yeah and that was it that was all my questions I think it's kind of out of ground you survived it well I've really enjoyed that there's some questions I thank you anyone who submitted those I wasn't expecting there were yeah I had it on my Instagram my Twitter YouTube everything so yeah so thank you so much it's been a pleasure don't give doctors a hard time out there doctors are amazing actually in all genuine honest opinion the junior doctors the FY2s and the students are so good I've never encountered anyone that's been poor or bad or they've all been so knowledgeable some of them are really knowledgeable and I think oh my god so yeah so thank you well thank you for sending me the questions thank you Claire thank you everyone for the questions and maybe another time do something else I'm sure we will so that is it from us everybody and we shall see you next time bye