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Aarifa’s blog

The only dentist who is destined to have no teeth

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A stressy rant from a final year flop

Ehehehehe *nervous laughter*
I have delayed this for so long.

Truth be told, I don’t know where to begin. It is my fifth and final year at Cardiff University and the thought of leaving this happy bubble of existence for the real world absolutely terrifies me. To my core I am petrified. If I am to psychoanalyze myself right now…I think I’m being a bit wacky. It’s still only November, and the monstrous trek to graduation day has barely begun so I don’t know why my brain is so happy to raise my cortisol levels off the roof. It’s like half of my skull contents are hyperventilating like it’s the end of the world, and the other half is cuddled up in pyjamas singing show tunes and eating Nutella. #psychotic #break
Speaking of breaks other than in my mental status, let me break down my current position in life…

Dead.
No I’m joking…just my insides are dead.

For real though, I’ve just come back from a two week placement at the Royal Gwent Hospital, where my mind was literally blown and I developed a whole new zeal and excitement for my career…Only to remember that I now must face…

Final year project deadline, clinical case reports, clinical vivas, competencies AND MOST LOOMINGLY…The mother of all scary job interviews…The DF1 interview

[Curls up in a corner and pretends to be one with the slugs.]

Now most of that will sound like garble to those just starting out or thinking about dental school, so allow me to explain. We at Cardiff sit our final exams at the beginning of this year, so as soon as we get those results and we’re in the clear, that’s when final year really kicks off…It’s all about the clinics, and it’s all about your numbers. Gaining as much experience as is physically possible is the goal. But it’s so much harder than it seems.

My advice to the current fourth years is to be pro-active!

Book in as many drop-in sessions* as you can because they are your lifeline, and don’t be afraid to ask for help! If your extraction total is low, go to some extra sessions! If you feel you’re not confident with a procedure, book in more of those for yourself. Hone your skills. Force yourself to practice and master the things you hate. Most importantly, don’t compare yourself to your peers. Everyone will have procedures they love, and others they struggle with. Learn from each other, get tips off each other, but don’t let it get you down! We know the gold standard we’re aiming for with everything we do, and we know how long it should take us…but speed and skill develop with time, experience and practice. You have control over how much you practice, after that you need to chill out with a cupcake and forget about the world.
Also do not underestimate the benefits of reflection. If you walk off clinic and you haven’t learnt something new then you’re doing it wrong. When you walk onto clinic there’s a certain level of expectation that every supervisor will have…they will want to know that you know what you’re doing…but they appreciate that 90% of the time your knowledge is just text book spiel. This is when you use them. They can elevate your understanding in ways a textbook can’t.
One last thing to do is to try and get as many competencies as you can done this year, so in fifth year you can be a little bit more relaxed. With 4 weeks’ worth of placements you actually have much less time on clinic in final year compared to fourth year…so use your time to your advantage!
Enough about that though, let’s get back to the good stuff!

Placement.
It was so fun.

I sound like a nerd, but it really was! When we qualify, we go straight into something called a DF1 post, where you work for a year in general practice. After that you can go down one of two roads…either you stay in practice, or you adventure out into hospital life for a bit and become an SHO (Senior House Officer.) On placement we shadowed the SHO’s and basically lived their life and it was fascinating. We got to do a lot of stuff as well, like assist during surgery and do some simple tooth extractions…but the best bits for me were when we followed “On call” and I saw some crazy stuff! I’ll set the mood…
Its 1pm. The common room is quiet. The S.H.O I’m shadowing is typing notes furiously into the computer, literally punching each key like they’ve personally offended her. It’s like sweet music to my ears cause it masks the fact that I’m chomping on a particularly gooey and cariogenic brownie just behind her. The morning was rough…a stream of people came in with facial lacerations that needed to be sutured down in A&E. I held many clammy hands and reassured many injured souls whilst the S.H.O sutured like a queen. So slick, so smooth. She literally jogged back down to the common room, inhaled her salad and began aggressively typing all within the space of 6 minutes. My calves were low key burning and I was panting like the overweight adipose ball that I am, so the brownie was providing me with much needed comfort when she suddenly spun on her spinning desk chair and looked me straight in the eye balls…”Go get food. Rendezvous back here at precisely 1400 hours.” I nodded back and shuffled out. Catching my reflection in the mirror I spotted brownie goo all over my face and cringed. I considered wiping my face on my scrubs for 0.08 of a second before realising that would be so gross and a little bit of an infection control issue…and people may think it was poop. So I did a quick change and went for a casual stroll on the hunt for something yummy and high in fat. That was when I spotted it. KFC [pause for heavenly music.]

I’m going off topic.

The afternoon was better/worse depending on how you look at it. Her on-call bleeper thing bleeped at precisely 1405, and when she called to answer it I heard the words “Ludwig’s Angina” float up into the atmosphere. The S.H.O choked on her goji berry smoothie and I snorted my fruit shoot up my nose as our innards flopped to the floor and rolled around screaming. Ludwig’s Angina is something you do not want to hear. For the non-dentists reading this (you sexy bunch) Ludwig’s Angina is when a dental infection has tracked down into the soft tissue spaces in the floor of the mouth. The patient will feel unwell with a high temperature, nausea, and they’ll feel like they can’t open their mouth fully and that their tongue is being pushed up to the top of their mouth so breathing becomes hard. It’s the fact that breathing is compromised that makes Ludwig’s Angina life threatening…and therefore scary for the S.H.O’s. But this goji berry drinker was a pro. She swooshed down there at warp speed, bleeping the anaesthetist and registrar on the way. What they do next is give the patient IV antibiotics, pain management and an operation to put drains in to clear the infection that’s there. These drains are left in until all the yummy infection juices are cleared, which usually takes 48 hours. The patient is then given follow up appointments to check that everything is going okay. I saw them for their first follow up and oh it was beautiful. The swelling had gone down dramatically, they were still quite sore but they looked so much happier and well in themselves. For the S.H.O to manage that high pressure situation so seamlessly and thinking that in a few years’ time that could be me gave me the magical tingles. I was a happy chappy.

Shadowing the Oral Cancer consultant was a totally different experience. In dental school we know the signs for oral cancer. We’re taught what to identify and urgently refer, but what happens after that point was just a text book flow diagram in my head. Seeing it first hand, seeing the wonders the surgeons could do and feeling relieved that my anatomy knowledge wasn’t so far gone that I couldn’t keep up felt pretty good. Then there was the pretty bad side of things. Palliative care patients hit home for me that medicine isn’t magic. I felt quite sad and frustrated that there are still so many walls to break down when it comes to cancer, but if anything it made me realise how key our future role in general practice will be. The dentist is the first point of contact when it comes to checking oral health. We can spot things early and we know what to watch for sinister changes. The earlier the diagnosis the better the prognosis. That’s obvious to most, but we can make it happen.

My conclusion from placement was that I’m definitely aiming for that S.H.O year, but where I’m heading after that I have not a clue. This blog post has been weirdly cathartic for me, I think I have managed to counsel myself out of my panicked state by realising I’m worrying about a million future scenarios that aren’t going to happen for a while and may not even come true. The only way to progress is to take it one day at a time, one task at a time. Hell if I manage to survive these last 7 months of dental school I’m going to throw a rave. Like a monstrous PG/Universal film rating rave with zero alcohol and really rubbish snack foods…But it will be a rave to me. Probably alone. With one of those disco ball lightbulbs you get from Tiger and a playlist of feel good Katy Perry songs. #Yum

I’ll let you guys know how the interview goes!
Until then, I bid you adieu!

Love Aarifa x

Glossary of things that may have bamboozled the brain

  • *drop-in sessions are extra labs where you can practice procedures on plastic teeth under the supervision of the legendary Dr Wills
  • *competencies are when each different clinical procedure you do is assessed by a supervisor to see if you’re capable of doing it independently and to a good standard. You need to complete a competency for every procedure in order to qualify.
  • *Final year project is basically our dissertation, and mine is going SLOW #tears #crying #sadness
  • *Clinical vivas are when we are given 3 unseen cases and then questioned on them under exam settings. It is horrifying. I am low key horrified.
  • *When I mention numbers, I mean numbers of each procedure we have to hit to be able to register with the GDC and qualify.
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