My GP placement

Some of you might be wondering why the long silence. The answer is simply laziness, specifically the post-exam laze, although at the moment it seems ages ago since I've had my last OSCE. Time really flies....

I'm now on the third week of my SSC attached to a GP practice. Unlike ordinary practices, we specialise in providing primary care for asylum seekers only. In February this year when I volunteered in an event organised by the Manchester Refugees Support Network, I met this GP (who is now my supervisor) who works here and I asked if I could do a placement with her, which she happily agreed. I was naturally looking forward to this placement as (many of you might have know) I am passionate about issues surrounding refugees.

It couldn't have been a better placement. We see lots and lots of patients with post traumatic stress disorder. Although it was quite boring for me to see the GPs prescribe antidepressants after antidepressants, I enjoyed listening to their stories. It was extremely rewarding to see a patient who started off obviously unable to trust anyone and almost mute, to start to give bits of eye contact on the next visit, to start talking, to joke and finally to trust us enough to tell us their horrible ordeal. I have seen the most terrible scars from torture while examining these patients, yet it is often the unseen scar deep in the heart which is even more worrying. The sufferings that the asylum seekers face make the biggest problem in my life so minute, so insignificant. Similarly, because the close knit staff here know what's more important in life, they never complain about petty things. They are the nicest people ever, like the buddha, they are always calm and smiling and I get along with all of them very well.

I don't mind the heavy emotion involved, instead I usually get quite excited about it. But I can't help but notice that many of the patients see the doctor not for medical reasons. Many of them come in for a letter from the doctor for various reasons, eg to support an legal appeal, for a bus pass, to complain against the housing provider, even to report a hate crime etc. I mean some of these things are not even a doctor's job, but I have never seen the staff here refusing to help a patient. These asylum seekers are really desperate people. Besides having to deal with the stress from previous trauma and leaving home, they have to deal the the painful process of applying for asylum in the UK, at the same time not able to speak English and not allowed work. If we don't help them they just have no where to turn to. Thus the staff in this GP practice spend lots of time making phone calls and writing letters to sort out logistic/practical day to day things for the patients. I have helped a patient write a complain letter and another patient write a claim letter for compensation of lost item in the post. They were just tiny favours but the patients were extremely grateful, which gave me much satisfaction in helping them. Medically, I learn a few useful stuff not seen in ordinary GP practices in the UK. For example in unexplained anaemia I have to think about tropical diseases like tape worm, which is a deviation from the standard differential diagnosis; or in generalised myalgia before I write off one as a heart sink patient I would remember to exclude vitamin D deficiency.

At the end of the placement I need to submit an essay related to a chosen topic. I thought about the people I have seen and helped, and I thought about why I became so passionate about refugee issues since the college days. It was because I have a great family, and a warm home, a place I can seek shelter in and feel secure no matter what happens. And I think everyone should have a good home No one should be left homeless. And if you must know, the house that asylum seekers in the UK are provided with are often of the lowest standard. So I have decided to write an essay on the housing problems faced by asylum seekers and how their health are affected.