Redefining Resilience as a Medical Student

Hi all, exams are over and it has been so nice to not have the pressure of work looming over me. I can finally rest! But what does this mean…

It has been really hard figuring out what rest looks like for me. Over the last decade, mental health has become more widely spoken about and of course, with the pandemic, there seemed to be a shared understanding of struggling with a lack of purpose. We all sipped our Dalgona coffees with our banana bread, after a grueling run that our Couch to 5k app guilted us into (hey, don’t bash it until you try it!) I am so grateful that these lockdown trends are a distant memory that I can joke about, but at the time, it was really hard to be living with this constant unshakeable uncertainty.

chocolate chip banana bread made by me (and yes, it is zoomed in so you don’t see the burnt bits)

As lockdowns passed by, and Trump came and went, our lives may be feeling slightly more normal, but the importance of looking after our mental health is still as great as ever. I am not afraid to say I struggle with my mental health (though much easier to say behind a screen), but the stigma and silence around it is pervasive. This is especially true in Medicine where the traditional definition of success often looks like long working hours, relentless competition, and constant pressure, all while maintaining a smile for the patient. We are told to be resilient, and this is what makes us good doctors.

Here are some ways I hope to redefine resilience. I want to allow myself to feel all the difficult feelings. It is okay to have bad days and to need help. I want to learn to be more compassionate towards myself, to be curious about what looking after myself means, and to not feel guilty for resting. I hope to lean into my community and not isolate myself when I struggle. I want to be an open vessel and still know when to close myself before I am full to the brim. I hope to continue to speak up for adjustments I may need (without feeling guilty for taking up space). Resilience doesn’t have to mean pushing on when times are tough. It can mean stopping, taking a break, calling a friend (or a therapist), and practising self-compassion before you carry on.

So yes, exams are over… And still, I have been feeling a bit anxious and struggling to fully relax (and feeling frustrated for not being able to when I have been waiting for this for so long!) But, I am going to try and just let it be, and trying to be kind to myself. I am where I am, and there is nowhere I have to be. Apart from maybe the clinic I said I would join later this afternoon…

NDCS Families magazine front cover!

Hi! It has been a very long time, and I promise to start writing again as soon as my finals are over! I have so much to talk about, but have had a busy few months with ups and downs, and have been trying to not feel guilty about taking rest when I need to.

So, as you may know, my work with ITV started (read my last post!) because I reached out to the National Deaf Children’s Society. And I have since been invited to be interviewed for their Summer 2023 Families magazine!!

It was such an amazing opportunity and such a big platform to talk about my experiences that of course, I said yes! I was interviewed and shortly after, photographed at Gonville & Caius College with a few friends. Yes, it was a bit awkward pretending to talk to them about what they had for lunch with a camera glaring at me. Yes, I was very aware of all the students staying in college who did not(!) choose the scenic garden-facing windows to see me floundering about. But, wow, it was such a great opportunity and I am so grateful!

So here is the article: https://www.ndcs.org.uk/information-and-support/parenting-and-family-life/families-magazine/your-stories/stories-of-deaf-young-people/making-it-in-medicine/.

Please read through and share with anyone who may be thinking of applying to medicine or anyone who thinks deaf people can’t be doctors! Okay, there is a chance I may not be a doctor if I don’t get back to studying for tomorrow’s exam, but it sure as hell won’t be because I am deaf!

Ashna x

To hear or not to hear!

Stethoscopes! They were the bane of my life in Year 4. In Cambridge, the first three years of our course are pre-clinical, with very little clinical exposure and many, many essays… Come Year 4, we are thrown in at the deep end and suddenly I needed to know where the heart and lungs were! Towards the end of my third year, I knew I had to start looking into amplified stethoscopes when I tried a friend’s normal stethoscope and I realised I couldn’t hear their heart (or mine!)

Looking for answers, I emailed many people in the Clinical School, my university’s Disability Resource Centre (DRC), my current audiologist at Cambridge and even my paediatric audiologists from Guy’s and St Thomas’ Hospital, London. Everyone was really lovely and tried their best to help, but I was surprised at how little information there was on amplified stethoscopes, and how confusing it all was. I wanted to write a blog post to compile all the research I did.

I had several factors to consider, which you may too:

  • How severe is your hearing loss – what level of amplification might you need? – I could not hear with a normal stethoscope.
  • What brand of hearing aids do you have? – I had Oticon Engage hearing aids, but halfway through this process, I switched to Oticon Sensei Pro hearing aids (causing some further confusion!)
  • Wireless connection (Bluetooth) or wired to your hearing device? – I use a wired option.
  • If wired, do you want earphones, headphones, or hearing aid shoes? – I use shoes.
  • What is your budget? Are you able to apply for funding from your university or place of work? – I was able to apply for funding from my university Disability Resource Centre and my college (Gonville & Caius College)

Stethoscope

I did some research, and I found out about the Thinklabs One Digital Stethoscope, which I had seen other health professionals recommending on Facebook groups and online. Their stethoscope claims to exceed the amplification of a regular stethoscope by 100x, addressing the needs of health professionals with hearing loss.

Thinklabs One Digital Stethoscope (https://www.thinklabs.com/)

Their website has a page specifically for people with hearing aids. They explain how their stethoscope can be used with a table summarising how it can be used with different types of hearing devices (click here).

Wired options

Wired options give a more robust connection, and potentially a better sound quality than wireless Bluetooth options. This would potentially give the user more security in knowing they have not missed any important heart or lung sounds. I have BTE (behind-the-ear) hearing aids, so from the above table, I could use either on-ear or over-ear headphones. Thinklabs recommend Beats Executive headphones, but these are quite expensive. However, for me, I knew I did not want headphones over my hearing aids. I have always found them to be very clunky and uncomfortable over my hearing aids, and the sound quality was never that good anyway.

Alternatively, I could have used earphones connected to my stethoscope. With my level of hearing loss, earphones usually transmit enough sound for me to take most phone calls and listen to music. However, I thought earphones would not be a good option for me as I would have had to remove my hearing aids to use them and this would mean I would miss any other sounds happening in the room, including anything the patient may say.


Wireless option

Apart from wired options, I also had the option to use streamer devices to deliver sound directly to my hearing aids, such as the Roger Pen. This is a portable microphone that can wirelessly transmit sound in noise and over distance. This would however require me to wear my hearing aids, Oticon shoes, and Roger receivers, allowing me to wirelessly connect to the stethoscope. With this option, I would not have to connect anything at the time of use, as it would all be automatic. The Roger Pen could also be useful in other situations such as lectures or conferences.

At the time, I had Oticon Sensei Pro hearing aids. This brand requires FM9 shoes to be put attached to the bottom. At the time of research, the pricing for all of the equipment was as follows on Connevans (after VAT relief for disabled customers):

  1. Thinklabs one digital amplified medical stethoscope = £444.00
  2. Phonak Roger pen Ruby microphone transmitter = £510.00
  3. Two Oticon shoes FM9 for ear level receiver = £21.84 x 2 = £43.68
  4. Two Phonak Roger X receivers (type 02) for Oticon hearing aids = £510 x 2 = £1020.00

This would come up to a total of £2017.68, and I found this to be too expensive for me, especially as my college (Gonville & Caius) and the Disability Resource Centre at Cambridge were both helping me fund my stethoscope.


My first purchase – Oticon Sensei Pro hearing aids

Alternatively, the cheaper option was to have direct input leads that connect my hearing aids (and shoes) to the stethoscope. This is, admittedly, more clunky to carry around in hospitals compared to a wireless option, like the Roger Pen. I would also need to attach the direct leads to my stethoscope each time I need to use it, requiring me to take my hearing aids out very briefly. At this time, I still had Oticon Sensei Pro hearing aids, but I would need another type of shoe (Oticon AP900 shoes) for the direct input leads. At the time of research, the pricing for this was as follows on Connevans (after VAT relief):

  1. Thinklabs One Digital Amplified Stethoscope = £444
  2. 800mm binaural V direct input lead = £21.50
  3. Two Oticon audio input shoes AP900 = £22.75 x 2 = £45.50 

This came up to a total of £518.95 with delivery, and this is the option I went with!


My updated (and last!) purchase – Oticon Engage 105 hearing aids

A few months later, however, my hearing aids had been upgraded to Oticon Engage 105, which has Bluetooth function. This was amazing as I could now stream music directly to my hearing aids! However, with regard to my stethoscope, the equipment I had would no longer work with my new hearing aids. I wanted a new option that would require me to buy the least amount of equipment.

After lots of research and help from my audiologists, I found out that I would need the Oticon AP1000 shoes. These would however require me to replace the battery drawers of my hearing aids using the Oticon Corda Hearing Aid Service Tool. This replacement drawer has it own specific shape and size to allow the AP1000 shoe to connect to the Engage 105 hearing aids. Luckily, my audiologist was able to send me a service tool that I could use, but otherwise, I could have bought it here. Therefore, finally, at the time of research, the pricing for the new equipment was as follows on Connevans (after VAT relief):

  1. Two Oticon audio input shoes AP1000 = £22.75 x 2 = £45.50
  2. Two battery drawer shoe adaptor = £10 x 2 = £20

This came up to an additional £73.40 with delivery, so that I could use my stethoscope with my new Oticon Engage 105 hearing aids. I then just had to replace the battery drawers using the service tool, where I found instructions online (click here!)

Finally, I had everything!


I hope this helps you in finding the right stethoscope for you. I would recommend reaching out to as many sources of support as you can, your audiologist, your university/work, Occupational Health, your supervisors, and even me! All of this research took a long time for me, and I could not have done it alone. All information was accurate at the time of purchase, around a year ago, so please make sure you double-check any of the details before you buy a stethoscope for your own hearing device. Be especially careful with buying the correct shoes, and finding out whether your hearing aid battery drawer needs replacing (but your audiologist should be able to help you)! Finally, do try and apply for funding as you should not have to pay for needing reasonable adjustments for your work.

Well done for getting this far! Thank you for reading, and I hope it has been of some help!

Ashna x

Hello World!

Hi! This is my first post, and I just wanted to introduce myself!

I am 21 years old, and currently in my 4th year of medicine at the University of Cambridge. It’s been an incredible experience, with some amazing highs and some deep lows, but I truly have had the best few years of my life, and I can’t wait to see where this goes.

I wanted to start this blog to talk about a few things:

  • Applying to Cambridge
  • Life as a Medical Student
  • How my deafness impacts me
  • Ongoing and Future Projects

I look forward to building this page! Stay tuned!

Ashna x

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