PDP

Whimsical musings aside...now down to the practicalities of how to make the most of what is essentially now 3 months left.

Today we trialled out our home tutor/babysitter and I slipped into the hospice for the morning. I left her braiding the girls hair so all was calm. 

My biggest question after a full clinic and review of palliative inpatients is will this blog count as enough reflection for my GP appraisal learning diary? Or do I dutifully fill in my learning diary? Inevitably I always leave my annual paperwork to the last minute...tempting this year just to write ‘see blog’ in every section. My PDP for this year was pretty simple.....arrange our adventure to Tanzania and then do it!

I have a natural tendency to self doubt, and even now, many years down this medical road I often feel like I’m just pretending to be a doctor. There are so many things I feel I don’t know enough about and there’s a large part of me wondering what the hospice team here will think of me and what I can possibly offer them. And then I remember that this year I will have been a doctor for 16 years and a GP for half of that. 

Mentoring in clinic today knocked that doubt firmly out the window and boomeranged right back with the knowledge that I am overflowing with offerings....where to begin; teaching, questioning, reflecting, challenging. I have been tentative in wondering about presumed diagnosis.....there is a strong habit here of trying to make a round peg fit a square whole. I shall stop worrying about my scanty knowledge of antiretrovirals!

So many differences; introductions between doctor and patient are presumed (perhaps because the usual round of greetings can take some time!);as is the use of mobile phones, people thinking nothing of breaking off midsentence to reply to a WhatsApp or take a call, both dr and patient alike ; the consulting door left wide open throughout with a shared ownership of the running of the clinic with the next patient being called in by the one who is leaving. On the wards there is limited scope for privacy, but the ladies respect each other’s space, moving away from neighbouring beds if needed, and there is a small side room for more intimate examinations (albeit with clear glass windows at just the wrong height). Could they find me a speculum on the gynae ward, no....though I’m sure M had some in the stuff we brought out. It is stiflingly hot on the wards, the smells that go with cervical cancer require a stiff constitution. Cervical cancer is the commonest cancer in women in sub Saharan Africa......and it is certainly a miserable fate. How fortunate we are for our screening program in the U.K. I have established that they do the vinegar cervical screening here both in the HIV clinic and the family planning clinic, but still so many women only come forward with their symptoms once it is too late. 

I think it will prove satisfying to be working on a more regular basis over the next few months. The time so far has already yielded so much, but it will be far less confusing for all concerned if I have a pattern to when I am available.