...to expect a 3rd year NHS GUM student to know what a Canestan pessary is?

[LividofLondon]

Seriously, she didn't know what I was talking about which I thought was piss poor considering it's a well known (and well advertised), widely available product used to treat a very common genital problem. Then when I explained to the GUM doctor who was supervising her that I had vaginal soreness brought on by sex, like a graze up there, he seemed to think I meant soreness as in tenderness/bruising and poked and prodded me inside to try and find the bruised patch. He was even talking about possibly doing a scan to find the problem. In the end he couldn't see anything wrong and gave me a thrush pill to take orally just in case I had that. It turned out that quite simply I suffer from vaginal dryness and sex was making my skin sore (think friction burn inside), which was causing thrush-like symptoms. Thank you Google, MN and Replens.

[LividofLondon]

I've explained up thread that I treated her with the utmost patience and respect, and never let on I was surprised she'd never heard of the widely advertised Canestan pessary. As for my driving, no, I don't act like a twat on the road. I cut drivers a hell of a lot of slack as I assume any mistakes they make aren't deliberate and probably born from inexperience/nerves/unfamiliarity with the road, etc. I am especially patient to anyone with a L or P plate.

I was unreasonable to not understand what 3rd year trainee actually means. I'm even more confused since reading the replies on this thread.

I realise medical staff are trained to use the proper names for drugs rather than the brand names. I WU to be inwardly surprised that she hadn't seen and/or absorbed one of the many Canestan adverts out there (especially given her interest in medical issues).

I was unreasonable to have a little rant on here and use the phrase "piss poor" when I really meant "feckin' surprised". And I would've been really unreasonable if I had made a face at her, but I didn't. No one was harmed in my little online vent, least of all the trainee.

[MammaTJ]

NurseRoscoe, I am a 2nd year and distinctly remember a clinical skills session in the first year where they went through routes drugs are given. Pessaries were mentioned.

[NurseRoscoe]

I'm a 3rd year student nurse and I know what this is. We don't know everything though, I just happened to have come across one before having had thrush myself. Whether I would of known that or not if I hadn't I do not know. I've never given one to a patient. We don't really spend much time on that sort of thing at university and the whole point of her being there was to learn, therefore if she didn't know what it was before she does now!

[Pandora37]

I probably would have expected her to know what a canestan pessary is but I've had thrush. Sometimes I forget just how little people know if they haven't experienced things themselves.

I said something incredibly stupid the other day as I was nervous and under time pressure. I was telling a woman that as part of the induction of labour process she might have her waters broken but she was being induced because her waters had broken. Doh! Didn't realise what I'd said till after she'd gone, she must have thought I was a right idiot. Although technically she could have had her forewaters broken as sometimes they remain intact even when the hindwaters have gone but I didn't explain that.

Anyway, she may have just been nervous. I like to think I'm intelligent but I forget the most basic things when I'm being watched by someone. I've worked with one person who I found so intimidating I suddenly became really clumsy and I probably would have forgotten my own name if she'd asked me. If you're one of the first patients she's seen I expect a lot of it was down to nerves.

[raltheraffe]

"All grades pre-cct (ie below consultant/GP) are referred to as 'junior doctors'. Some of these are also 'trainees' - they are in a recognised royal college training scheme, culminating in certificate of completion of training - either as a GP or in a specialist area. This can be up to 10 years full time post qualification in some specialties"

Disagree. Specialist registrars are NOT junior doctors.

Junior doctors are foundation trainees (2 years) and SHOs (normally 3 years). NOT SpRs.

[raltheraffe]

I am not sure whether she was a 3rd year student doctor, or a qualified doctor who has spent 3 years practising (so that would be 2 years as a foundation trainee and one as an SHO).

When I did my medical degree we did not see any patients for 3 years. The first 2 years were the basics of anatomy and physiology and then I did a masters in neuroscience.

Met my first patient in year 4 and at that stage I had a high degree of knowledge of normal anatomy, biochemistry, genetics etc but knew very very little about disease.

I went to Cambridge which is an unusual course as it is far more academic and less patient centred. When I taught at Manchester University they phased in patient contact in year 3, but the first 2 years had an integrated approach so for example they would study the anatomy and physiology of the stomach, alongside stomach cancer and ulcers.

If this is some 3rd year student you are being incredibly unreasonable. The whole point of being a student is to learn things and that GUM clinic was her opportunity to learn about GUM.

If it is an SHO then she really should know it, but from what I have read it looks like she was a year 3 student, so you are probably one of the first patients she has ever met.

She did not harm you in any way. She did not have the opportunity to be clinically negligent as she was there as an observer and so did not treat you.

You remind me of one of those aggressive drivers who toots their horn at some poor sod doing 15 in a 30 when it is obvious they are a learner driver in a driving school car.

[AlphaBravoHenryFoxtons]

You don't receive full GMC registration until the end of F1 year (you get a preliminary registration with the GMC on successful completion of medical school but you need to complete successful foundation 1 year training in order to be fully registered with the GMC as a doctor). Up until the end of F1 you are only a doctor in designated training posts.

[Happyringo]

Its quite common not to be too familiar with trade names for drugs, prescribers are not meant to use them, so I wouldn't taken that as any reflection on competency. Obv can't comment on the rest of your consultation, having not been there. I am surprised you're still thinking about it months later though, are you usually so anxious?

[sashh]

So YABU to expect someone who has spent 2 years sitting in lectures and classrooms and possibly cutting up a corpse and may well have arrived at the hospital that morning and been told there is a change of plan and she is working in GUM clinic that morning to know the word pessary.

She probably knows the words clotrimazole and fluconazole and vaginal suppository

[PiperIsTerrysChoclateOrange]

Perhaps she doesn't watch TV and never had thrush.

[TeacupDrama]

once you graduate you are a doctor not a trainee doctor, there is still loads more training but you call yourself doctor as soon as your name is on GMC register normally within a couple of weeks of results often before graduation ceremony

no-one that has graduated would describe themselves as a trainee

a 3rd year student in december will generally only have been on clinics since september and in rotations, students are not taught trade/brandnames as when prescribing must use generic name

medical students start by taking histories these are then checked later, they have to then present cases

[CalleighDoodle]

Chocolate up your chuff

Love it

[Musicaltheatremum]

It's the trainee that is the problem word. Once you qualify you now to foundation years 1 &2 then you go back to being a trainee in the speciality you want to do so for GP it is ST1 2 3 and sometimes 4. ST = specialist trainee. So you could be in your 6th year post qualifying and still be a trainee. But then you never stop learning.

[VivaLeBeaver]

And I've noticed a lot of medical students now Introduce themselves to women as "trainee doctors". It slightly annoys me. They freely admit they do it to try and get away from the negative connotation of being a student.

So that they're kind of hoping the woman thinks they're a qualified Dr who's training in obs and gynae. Whereas its actually the qualified SHOs, (or Vts or st1 or st2 as they're now known) who are training, either in the specialist discipline or on their GP rotation. Its naughty of them. But they're meant to see so many births and they're worried a woman will say no to a medical student but yes to a trainee Dr.

I don't let them go and ask the women themselves as I think it puts the woman in an awkward position. I ask on their behalf and the student has often said tto me "can you tell her I'm a trainee dr not a student". Eh, no I won't.

And they do go and take histories on their own. They then have to go back to a qualified person and tell them word for word what's been discussed.

I think if anyone introduces themselves as a trainee you can safely assume they're a med student.

[VivaLeBeaver]

I don't think I'd have known what canestan was when I was in my early 20s.

[ScrambledEggAndToast]

Not even trained nurses seem to know what pessaries are. When my sister was in hospital, one of the nurses tried to give her one to take orally Luckily she was on the ball and pointed out her mistake.

[LividofLondon]

Fair enough Pished. You're right, I suppose we notice adverts for thrush more if we've had recurrent thrush ourselves.

[LividofLondon]

Widow, as I've mentioned upthread, I'd been self-medicating but whatever the problem was it kept recurring. Therefore I thought it best to get the underlying cause looked into by a HCP.

[Pishedorf]

OP she's a 20-21 year old girl. Just because she has a vagina doesn't mean she will automatically know what canestan is! I only did at that age as I suffered with the most horrendous recurrent thrush (shudders at the memories). Some lucky girls don't experience it!

[WidowWadman]

If all you needed was a canesten pessary, why didn't you just go and buy it off the shelf?

[LividofLondon]

"My tuppence worth ..... Canesten is a brand name, she may have been more familiar with the drug name of clotrimazole"

I've used both "Canestan" and clotrimazole (only use the latter now as it's a fraction of the price!) and quite possibly mentioned both to her (arrgh, wish I could remember!). But putting aside her medical training I'm still surprised at a woman not having heard of Canestan, whether she's had thrush before or not. I mean, I'm not a man but I still notice adverts for products aimed at men. It's almost one for a general knowledge pub quiz question

[Pishedorf]

It may not highlight a communication issue as you can't remember what she said. Laypeople don't understand the medical hierarchy and that's not their fault, it's confusing and the names of the job roles are changed all the time.

[Pishedorf]

Yes OP she would be taking a consultation on her own at that stage because students have to learn how to take a medical history and the best way of learning it is to take a history. I was doing it at that stage. What happens is she will have taken the history and reported it back to the doctor and then they come in, ask questions as necessary and then he did the examination.

If she was a qualified doctor training in GUM then she would have done the examination and introduced herself as a doctor.

But she wasn't a junior doctor therefore your AIBU is moot. Yes, I would be surprised if a junior doctor didn't know what canestan was but I am certainly not surprised that a student didn't know as they are still learning. Some facts don't always stick straight away given the massive amount of knowledge we need to learn.

I also don't think it's reasonable to expect her to know by virtue of her gender. She may never ever have experienced thrush herself and I doubt she sits at home watching TV and seeing the canestan adverts either.