I've been based mainly in Lerwick Health Centre, but have enjoyed a couple of weeks doing single-handed practice in Unst: the UK's most northerly GP practice! By road from Lerwick (where our district general hospital, the Gilbert Bain, is located), Unst is an approximate two and a half journey by road and two ferries. I thoroughly enjoyed my time there: a great opportunity to get to know your patients better (less time pressure compared with bigger practice) and that is thoroughly satisfying. The other aspect of things which I enjoyed was the out-of-hours work. In Unst, there is no NHS 24: you are it!! My two-week period there saw me admit four patients - two out of hours (quite a lot for a small practice!). For one of these admissions, we needed to call out the helicopter: critically unwell collapsed adult, likely septic shock. I can't quite describe to you the challenges and drama of carrying out resuscitation in a croft-house living room, with a patient not known to you (minimal contact with health centre), and an understandably upset spouse; arranging for emergency retrieval with scanty mobile signal (landline essential!) and trying to communicate the relevant details to the receiving hospital team in Lerwick. Oh yes - and how to extricate the patient through a very narrow croft-house porch with tight corners!!
So, exams are done - what now?!! Well.....
1. I need to keep up-to-date with my e-portfolio
2. Looking forward to a forthcoming ski holiday in February
3. Planning the Rural Track GP trainee conference, here in Shetland this March
4. Planning the remainder of my training, including making best use of study leave to prepare me for life beyond training.
I have decided to stay here in Shetland beyond the end of training in September. I am intending to work roughly two thirds in GP, and one third obstetrics. Dylan Murphy, my trainer, is a GP Obstetrician, so I am intending to learn a lot in the next few months to prepare me for taking part in the on-call rota. Hopefully I will recall some of my obstetric knowledge from working in Christchurch Women's Hospital. In addition to obstetrics, I hope to do a bit of A&E. This will be a salaried position. It just feels like the right thing to do! I am happy here: great colleagues, good friends, super community with LOTS going on!
Think that's all I want to say for now!