Today the mark breakdowns for us in MD2 for our PCP2 subject (the main one this year) were released. As I had expected, it was the OSCEs which brought my mark down. However, it is good to see the individual breakdown to analyze where I did well and where I did things badly.
For the MCQ, there was not much of an issue. I scored above average; just one point less than in the final progress test actually (both were out of 80).
For the SAQ, my score as a percentage was not as high, but it was still above average and just one point from the "H1" standard.
Now the OSCEs. Overall, I did worse than average, but this was a mixed picture:
There were two stations where I had actually scored above average. Now this is actually the first time I scored any OSCE stations above the average, so I was happy about this fact. These were the respiratory exam (COPD) and iron deficiency anemia (bowel cancer) stations.
There was one station where I had scored within a point of the average. This was the surgical abdominal exam (acute cholecystitis) station. After the exam I realized that I forgot to assess for rebound tenderness. I would have remembered if it was appendicitis signs but forgot for cholecystitis! Ah well.
Then for the other two stations, I scored below the average. Perhaps that is an understatement though - I scored below the "cut scores" (aka pass marks) for both of these. These were the headache history (SAH) and weight loss (T1DM) stations. Actually this is worse than I had expected to score. However, I do think that I have a tendency of narrowing in a diagnosis and not asking enough things to rule out other diagnoses, or in the weight loss station case, not even thinking of T1DM as a possibility in that station! I also don't know if I am particularly good at getting the "rapport" or "global" types of marks in the OSCEs for history taking. It is something that I need to work on for the future.
Overall, it seems like I have improved slightly on the OSCEs this time around compared to last time, although I have not tested to see if it is statistically significant. Last time my exams were worse than my history stations on average, but this year it seems to have reversed into the other direction. It seems like I will need to work on history taking in general for next year.
Anyway, scoring worse overall this year (by about 3-4 points) was mainly because the OSCEs were worth more this year and SAQ/MCQs were worth less overall. Actually scoring some OSCE stations above average for a change this time was a promising trend, but two history stations below the "cut scores" is a bit concerning. I will have to improve this into the future. Hoping for a turn-around like the Australian cricket team this summer. So far they have been quite spectacular!
Monday, December 16, 2013
Tuesday, December 10, 2013
[update] 2013 MD2 - results release, year in review and looking ahead
Today the final results were released for MD2. I did not do as well as I would have liked to, but I have passed quite comfortably. We have not received our OSCE marks yet, but it is most likely the OSCEs are where I have lost marks again this year. Ah well. At least it seems like I won't have to sit any supplementaries or repeat this year!
I guess maybe a reason why I would have liked a better result was because I did a lot better in the progress test. For the final progress test, I received a score of 70/80, which is a major improvement from the first one I posted at the start of the year! That said, the progress test is only testing on MCQs, and I think it is in the OSCEs where I have not scored that well.
In terms of knowledge and MCQs, I think that practicing BMJ onExamination questions was very useful in gaining knowledge. There is a free subscription through the medical school. Being interactive, it can facilitate learning more than reading over lecture notes or books. The other thing for exams is because the university repeats many questions, well... fill in the rest of the sentence yourself.
Generally speaking, this has been an interesting year, in the clinical environment and learning about things which are directly related to clinical management which build upon our basic sciences in first year.
There were a few highlights for me this year in medicine personally. There was once a patient who we were examining in a bedside tutorial, and everyone in our tutorial group took turns to listen to his heart. When it was my turn, he jokingly asked me: "are you too young to do medicine? How old are you? 12?" I laughed a bit at this, and said to him "Yeah, I'm probably the youngest in the tutorial group. Just switch around the two digits." The ironic thing is that back in the times of undergraduate entry, my age would be average for the first clinical year. It was only "young" because this was a graduate entry course!
There were quite a few times where doctors and other staff at the hospital asked us medical students what courses we did before medicine or what other life experiences we may have had prior to doing this. Although there was the occasional person who did something quite different, usually the answer from most students would be science or biomedicine/biomedical science. This was exemplified once when a dermatologist was taking one of our lectures. He asked everyone to introduce themselves with their names and what they did before medicine. Almost everyone in the lecture theater systematically said their name and indicated that they previously did biomedicine, biomedical science or science! It was quite humorous and ironic indeed!
Another thing which was the highlight in the hospital was when I was following the ward round of the Director of General Medicine. One of the patients did not feel like eating their food that morning, and the professor noticed the full bowl of food on the table. I was very surprised when I saw her spending the time and effort to spoon up the contents of the bowl and help feed the patient herself! Very remarkable!
Another highlight was that I was part of the winning team for the Inter-Clinical School Quizbowl Championship. In fact, this was a total accident! I was planning to attend the final of the competition so that I could eat some free pizza and learn some medicine from the quiz answers. I wasn't part of the team which was supposed to represent St Vincent's, but one of the team members was having a rural GP placement and unable to attend the final. One of the other team members suggested that I take their place. I was quite nervous when we were sitting there waiting during the first round since we played in the second and third rounds that night, and even more so when taking the position ready to answer the questions. But I managed to get the first question of that second round right, and quickly got settled and got a few random questions right in that round, making a contribution to the team. It's funny what happens sometimes when you least expect it!
Looking ahead to next year, I am not that keen on some of those rotations, although some others might be interesting. I start off with the mental health rotation, then aged care, then GP. Semester 2 will consist of women's and children's health. I am not looking forward to the first two so much, but the later few should be better.
It has been just over three years since I first made this blog. I am already halfway through medicine! Time has gone by very quickly!
The blog post graph still has this annoying glitch which displays some years incorrectly, so I have corrected them in the diagram above. Although my blog views are higher than I would have ever imagined when I started the blog, I have lost readers recently. This would have been unexpected for me at the start of this year since I thought that people would be more interested in clinical medicine over preclinical medicine. However, the requirement to protect the confidentiality of patients precludes us from sharing too many of the interesting events which sometimes occur on the wards. I have erred on the safer side in not posting too much where confidentiality can be impaired, and thus I have not made as many posts this year compared to last year.
Perhaps another factor is because I have made some more posts about politics this year due to the election, and the "Scrap the cap" campaign issues. I have a feeling that many of you are not so interested in politics. But politics is quite important and as the scrap the cap campaign has highlighted, policies have quite a significant impact on our future not only in medicine but also in life in general. As such, I will continue posting on these matters whenever I feel it is necessary. However, given the electoral cycle, it is unlikely that I will post as much on these matters next year.
Regardless of all these factors mentioned, I guess I have to lift my game to make my blog more engaging to everyone in the future to get back to where I was before!
Finally, to everyone who enjoys reading my blog and commenting, thank you very much for your continued reading. I hope you continue to enjoy reading my blog into the future!
I guess maybe a reason why I would have liked a better result was because I did a lot better in the progress test. For the final progress test, I received a score of 70/80, which is a major improvement from the first one I posted at the start of the year! That said, the progress test is only testing on MCQs, and I think it is in the OSCEs where I have not scored that well.
In terms of knowledge and MCQs, I think that practicing BMJ onExamination questions was very useful in gaining knowledge. There is a free subscription through the medical school. Being interactive, it can facilitate learning more than reading over lecture notes or books. The other thing for exams is because the university repeats many questions, well... fill in the rest of the sentence yourself.
Generally speaking, this has been an interesting year, in the clinical environment and learning about things which are directly related to clinical management which build upon our basic sciences in first year.
There were a few highlights for me this year in medicine personally. There was once a patient who we were examining in a bedside tutorial, and everyone in our tutorial group took turns to listen to his heart. When it was my turn, he jokingly asked me: "are you too young to do medicine? How old are you? 12?" I laughed a bit at this, and said to him "Yeah, I'm probably the youngest in the tutorial group. Just switch around the two digits." The ironic thing is that back in the times of undergraduate entry, my age would be average for the first clinical year. It was only "young" because this was a graduate entry course!
There were quite a few times where doctors and other staff at the hospital asked us medical students what courses we did before medicine or what other life experiences we may have had prior to doing this. Although there was the occasional person who did something quite different, usually the answer from most students would be science or biomedicine/biomedical science. This was exemplified once when a dermatologist was taking one of our lectures. He asked everyone to introduce themselves with their names and what they did before medicine. Almost everyone in the lecture theater systematically said their name and indicated that they previously did biomedicine, biomedical science or science! It was quite humorous and ironic indeed!
Another thing which was the highlight in the hospital was when I was following the ward round of the Director of General Medicine. One of the patients did not feel like eating their food that morning, and the professor noticed the full bowl of food on the table. I was very surprised when I saw her spending the time and effort to spoon up the contents of the bowl and help feed the patient herself! Very remarkable!
Another highlight was that I was part of the winning team for the Inter-Clinical School Quizbowl Championship. In fact, this was a total accident! I was planning to attend the final of the competition so that I could eat some free pizza and learn some medicine from the quiz answers. I wasn't part of the team which was supposed to represent St Vincent's, but one of the team members was having a rural GP placement and unable to attend the final. One of the other team members suggested that I take their place. I was quite nervous when we were sitting there waiting during the first round since we played in the second and third rounds that night, and even more so when taking the position ready to answer the questions. But I managed to get the first question of that second round right, and quickly got settled and got a few random questions right in that round, making a contribution to the team. It's funny what happens sometimes when you least expect it!
Looking ahead to next year, I am not that keen on some of those rotations, although some others might be interesting. I start off with the mental health rotation, then aged care, then GP. Semester 2 will consist of women's and children's health. I am not looking forward to the first two so much, but the later few should be better.
It has been just over three years since I first made this blog. I am already halfway through medicine! Time has gone by very quickly!
The blog post graph still has this annoying glitch which displays some years incorrectly, so I have corrected them in the diagram above. Although my blog views are higher than I would have ever imagined when I started the blog, I have lost readers recently. This would have been unexpected for me at the start of this year since I thought that people would be more interested in clinical medicine over preclinical medicine. However, the requirement to protect the confidentiality of patients precludes us from sharing too many of the interesting events which sometimes occur on the wards. I have erred on the safer side in not posting too much where confidentiality can be impaired, and thus I have not made as many posts this year compared to last year.
Perhaps another factor is because I have made some more posts about politics this year due to the election, and the "Scrap the cap" campaign issues. I have a feeling that many of you are not so interested in politics. But politics is quite important and as the scrap the cap campaign has highlighted, policies have quite a significant impact on our future not only in medicine but also in life in general. As such, I will continue posting on these matters whenever I feel it is necessary. However, given the electoral cycle, it is unlikely that I will post as much on these matters next year.
Regardless of all these factors mentioned, I guess I have to lift my game to make my blog more engaging to everyone in the future to get back to where I was before!
Finally, to everyone who enjoys reading my blog and commenting, thank you very much for your continued reading. I hope you continue to enjoy reading my blog into the future!
Friday, November 29, 2013
Free webinars on GAMSAT preparation from PrepGenie: The Eureka Webinars
This is a message from PrepGenie. PrepGenie, a medical test prep company is conducting a series of free online seminars on GAMSAT preparation: The Eureka Webinars.
This series consists of 4 webinars which will be delivered by GAMSAT toppers:
- Sumudu Perera (95 percentiler)
- Michael Marazita (98 percentiler) and
- Reuben Lim (99 percentiler).
What to expect from the webinar:
- Exam Strategies, smart tips and silver bullets in your pocket from the toppers.
- Live demonstration of solving difficult GAMSAT questions.
- Special Eureka Q&A session to get your queries resolved.
If you are still wondering if this is for you, check out what we will discuss in the four back to back webinars:
- GAMSAT: The New Perspective
- GAMSAT Humanities and Essays
- GAMSAT: Science Demystified
- GAMSAT Strategies Explained
What's the catch? We designed this as an exclusive workshop for only those who are serious about taking action, so we are limiting the seats. Grab yours now!
Simply CLICK HERE and you will be sent to a registration / checkout page and you will be off to the races.
If you have any questions please feel free to contact support@prepgenie.com.
Friday, November 22, 2013
Microbe Invader game
During swotvac, someone from my year in the MD course posted a link to a game called Microbe Invader. This is a highly addictive game which helps people learn microbiology diagnoses and presentations, and the different tests to distinguish microbiological organisms. It is based on the Pokemon console game. After successfully diagnosing the patient, you throw different antibiotics or antivirals or antifungals at patients, or just wait turns if you expect the infection to clear by itself, and heal the patients with normal saline. Unlike some other applications etc featured, I don't personally know the person who made this game.
As above, right now there seems to be a bug which makes interferon treatment count as first line therapy for viruses where supportive care is first line, but this is a minor point. There are a few errors, and a few things where you don't need to do things like you would for real life (ie no need for multiple drug therapy TB or HIV), but overall the game is nicely done and best of all free! The main drawback is that it is based more on an American context, with various organisms which we will not see commonly in Australia. However, it is a very fun game regardless. Maybe good if you want to do the USMLE and want some entertaining preparation!
So for the link again, it is http://www.microbeinvader.com/
As above, right now there seems to be a bug which makes interferon treatment count as first line therapy for viruses where supportive care is first line, but this is a minor point. There are a few errors, and a few things where you don't need to do things like you would for real life (ie no need for multiple drug therapy TB or HIV), but overall the game is nicely done and best of all free! The main drawback is that it is based more on an American context, with various organisms which we will not see commonly in Australia. However, it is a very fun game regardless. Maybe good if you want to do the USMLE and want some entertaining preparation!
So for the link again, it is http://www.microbeinvader.com/
[update] 2013 MD2 OSCE done! Available for GAMSAT/VCE tuition.
Today I did my last exam for the year, the OSCE. We had two examination and three history stations.
I now realize a few things which I forgot to do during the stations. Also, there was a weight loss station, where the correct diagnosis was apparently type 1 diabetes. I did not get that diagnosis right, and many people I talked to didn't either. Some people did, but others had answers ranging from hyperthyroidism to cancer.
Ah well. I hope that I did better than in last year's OSCE. For now, all the exams are done. I should be able to tutor people now. Keep in mind that it will be more convenient for me to tutor in Monash on the holidays than Melbourne. For more information, see the GAMSAT Science 100 + VCE tutor page at the top of the blog.
I will do a longer post about this year after the results come out. In the past I made some annual posts on the anniversary of my blog creation, but it is more logical to make them at the end after results come out and not have repetition.
I now realize a few things which I forgot to do during the stations. Also, there was a weight loss station, where the correct diagnosis was apparently type 1 diabetes. I did not get that diagnosis right, and many people I talked to didn't either. Some people did, but others had answers ranging from hyperthyroidism to cancer.
Ah well. I hope that I did better than in last year's OSCE. For now, all the exams are done. I should be able to tutor people now. Keep in mind that it will be more convenient for me to tutor in Monash on the holidays than Melbourne. For more information, see the GAMSAT Science 100 + VCE tutor page at the top of the blog.
I will do a longer post about this year after the results come out. In the past I made some annual posts on the anniversary of my blog creation, but it is more logical to make them at the end after results come out and not have repetition.
Wednesday, November 20, 2013
[update] 2013 MD2 MCQ and SAQ exams finished, OSCE on Friday
On Monday and Wednesday, I completed the MD2 MCQ and SAQ exams for this year. In general, I think they were very fair exams. There were a few harder questions which were there to separate out people.
I generally like MCQs better than SAQs, although I find SAQs a lot better than essay questions/extended response. It is hard sometimes to know what the examiners want you to write for extended response. And SAQ is better, but sometimes it is also hard to know exactly what they want. With MCQs, it is a lot less ambiguous, unless the question is worded badly. An example of this would be: what exactly is the "best" approach?
I got a bit put off by today's SAQ paper with the number of lines given for some responses though. In some of them, I feel like I can answer the question fully in three lines if answering exactly what is asked (eg giving a list). But because there was more space, I was wondering if they wanted more of an explanation, so I gave some anyway. At least in this year's SAQ, unlike last year's MD1 SAQ, we were not required to write completely non-stop from start to finish as a test of our writing speed.
There was one question where they asked eight different causes of seizures though. Eight causes! Not precipitants. I was struggling with this, but then realized that hemochromatosis and Wilson's Disease were probably causes (wasn't 100% sure though) so I wrote them down and it seems like they were right. What was frustrating though was that I wrote MEOS instead of MELAS as a cause of seizures! Argh! So close... I had 60% of the letters there!
I also recall giving quite a few pretty "out there but possible" answers after my standard answers when I couldn't think of anything else to write in the space, just to see if I could score a few extra points. One of them was regarding the possibility of the patient having a hemolytic anemia before the first HbA1c reading for their diabetes, explaining why the HbA1c rose this time compared to 6 months ago. I hope the examiners have a laugh at that.
Finally there is something else which I was somewhat amused by, although it may sound strange. Following on from my table tennis "ACE inhibitor" comments from my med jokes, I have been joking that "if a multiple choice option is ACE inhibitor, and you don't know the answer, choose the ACE inhibitor". Actually, ACE inhibitors are first line for hypertension, heart failure with reduced ejection fraction and chronic kidney disease. They are very useful for reducing cardiovascular events.
Although it was a joke which stemmed from table tennis playing, from personal experience of practice tests, the advice is actually mostly true. As an example, the best treatment for reducing progression of diabetic nephropathy is not actually good blood glucose level control. This sounds very counter-intuitive indeed! But the best treatment is actually using an ACE inhibitor. One of the nephrologists told me: "The three most important things for chronic kidney disease are: 1: good blood pressure control. 2: good blood pressure control. 3: good blood pressure control".
However, even though there have been 1-2 questions when using an ACE inhibitor was the correct answer in MCQs in some practice tests I have done, there was not one question with ACE inhibitor as a possible answer in the MCQs this year! Such an oversight of one of the most important drugs in medicine...
Oh and final point on the MCQs and SAQs, unless I missed something completely, there were absolutely no questions at all regarding EP! I am very grateful that the University of Melbourne has not overemphasized this portion of the course (which may be known in other unis as PPD) to the detriment of the more "traditional" aspects such as basic sciences, history taking, clinical examinations and hard knowledge of conditions, aetiology and presentations; which I hear is the case sadly in some other medical schools in this country. At least so far in the Melbourne medical course, we had none of this rubbish of reflective essays with rigid marking criteria. Well, we did have reflective essays, which were a bit annoying, but at least they were pass/fail and we could properly reflect on experiences. At no stage was I required to bend the truth and give a false reflection in order to pass an illogical marking scheme like what some people from unis in NSW were required to do.
Anyway, OSCEs are on Friday. I did not perform as well as I would have liked in the OSCEs last year, although I feel that I have improved my clinical skills this year significantly. I hope it shows up in the results.
I generally like MCQs better than SAQs, although I find SAQs a lot better than essay questions/extended response. It is hard sometimes to know what the examiners want you to write for extended response. And SAQ is better, but sometimes it is also hard to know exactly what they want. With MCQs, it is a lot less ambiguous, unless the question is worded badly. An example of this would be: what exactly is the "best" approach?
I got a bit put off by today's SAQ paper with the number of lines given for some responses though. In some of them, I feel like I can answer the question fully in three lines if answering exactly what is asked (eg giving a list). But because there was more space, I was wondering if they wanted more of an explanation, so I gave some anyway. At least in this year's SAQ, unlike last year's MD1 SAQ, we were not required to write completely non-stop from start to finish as a test of our writing speed.
There was one question where they asked eight different causes of seizures though. Eight causes! Not precipitants. I was struggling with this, but then realized that hemochromatosis and Wilson's Disease were probably causes (wasn't 100% sure though) so I wrote them down and it seems like they were right. What was frustrating though was that I wrote MEOS instead of MELAS as a cause of seizures! Argh! So close... I had 60% of the letters there!
I also recall giving quite a few pretty "out there but possible" answers after my standard answers when I couldn't think of anything else to write in the space, just to see if I could score a few extra points. One of them was regarding the possibility of the patient having a hemolytic anemia before the first HbA1c reading for their diabetes, explaining why the HbA1c rose this time compared to 6 months ago. I hope the examiners have a laugh at that.
Finally there is something else which I was somewhat amused by, although it may sound strange. Following on from my table tennis "ACE inhibitor" comments from my med jokes, I have been joking that "if a multiple choice option is ACE inhibitor, and you don't know the answer, choose the ACE inhibitor". Actually, ACE inhibitors are first line for hypertension, heart failure with reduced ejection fraction and chronic kidney disease. They are very useful for reducing cardiovascular events.
Although it was a joke which stemmed from table tennis playing, from personal experience of practice tests, the advice is actually mostly true. As an example, the best treatment for reducing progression of diabetic nephropathy is not actually good blood glucose level control. This sounds very counter-intuitive indeed! But the best treatment is actually using an ACE inhibitor. One of the nephrologists told me: "The three most important things for chronic kidney disease are: 1: good blood pressure control. 2: good blood pressure control. 3: good blood pressure control".
However, even though there have been 1-2 questions when using an ACE inhibitor was the correct answer in MCQs in some practice tests I have done, there was not one question with ACE inhibitor as a possible answer in the MCQs this year! Such an oversight of one of the most important drugs in medicine...
Oh and final point on the MCQs and SAQs, unless I missed something completely, there were absolutely no questions at all regarding EP! I am very grateful that the University of Melbourne has not overemphasized this portion of the course (which may be known in other unis as PPD) to the detriment of the more "traditional" aspects such as basic sciences, history taking, clinical examinations and hard knowledge of conditions, aetiology and presentations; which I hear is the case sadly in some other medical schools in this country. At least so far in the Melbourne medical course, we had none of this rubbish of reflective essays with rigid marking criteria. Well, we did have reflective essays, which were a bit annoying, but at least they were pass/fail and we could properly reflect on experiences. At no stage was I required to bend the truth and give a false reflection in order to pass an illogical marking scheme like what some people from unis in NSW were required to do.
Anyway, OSCEs are on Friday. I did not perform as well as I would have liked in the OSCEs last year, although I feel that I have improved my clinical skills this year significantly. I hope it shows up in the results.
Friday, November 8, 2013
PrepGenie GAMSAT Comprehensive Series 20% off
I was involved in reviewing questions for PrepGenie last year and this year. PrepGenie’s GAMSAT Comprehensive Series consists of 10 full length tests and 20 sectional tests on Humanities, Biology, Chemistry and Physics along with 10 sets of free essay evaluation. PrepGenie also wants to give all readers of my blog a 20% off on this course. The price set for the package is 475 AUD but you get it at 380 AUD, unbelievably low.
To take advantage of this offer, use the discount coupon "BOBBYLI". To purchase multiple courses with discounts, please contact support@prepgenie.com.
The GAMSAT Practice Test Papers can be found here: http://prepgenie.com/gamsat/gamsat-test-papers/
To take advantage of this offer, use the discount coupon "BOBBYLI". To purchase multiple courses with discounts, please contact support@prepgenie.com.
The GAMSAT Practice Test Papers can be found here: http://prepgenie.com/gamsat/gamsat-test-papers/
Wednesday, November 6, 2013
$2000 CPD cap scrapped
Today it was announced that the coalition government was not going ahead with the previous Labor government's plans to implement the $2000 CPD cap. You can read more about it here: http://www.medicalobserver.com.au/news/govt-scraps-the-cap-for-good
While there are a number of policies from the current coalition government which I disagree with, this policy is a win for continuing medical education and continuing education of other professions which have high CPD costs.
It is true that doctors and other professionals should not rort the system with benefits such as tax deductions from continuing education related expenses. However, that is also true for politicians. Claiming allowances to go to people's weddings? Seriously?
While there are a number of policies from the current coalition government which I disagree with, this policy is a win for continuing medical education and continuing education of other professions which have high CPD costs.
It is true that doctors and other professionals should not rort the system with benefits such as tax deductions from continuing education related expenses. However, that is also true for politicians. Claiming allowances to go to people's weddings? Seriously?
Thursday, October 31, 2013
2014 entry UniMelb and Monash local medical school places released
Today the University of Melbourne and Monash medical school places for local students were released. Congratulations if you have received an offer!
If I have tutored you for the GAMSAT, I would like to know how you went in this cycle of the admission process. You may post a comment, or if not, send me an email to my email address. If you forgot the email address, you may see it when clicking on "comments".
To prospective students, I will likely resume tutoring after my exams finish (after 22 November).
If I have tutored you for the GAMSAT, I would like to know how you went in this cycle of the admission process. You may post a comment, or if not, send me an email to my email address. If you forgot the email address, you may see it when clicking on "comments".
To prospective students, I will likely resume tutoring after my exams finish (after 22 November).
Wednesday, October 30, 2013
2014 entry: most GEMSAS offers released. Melbourne still to go.
So today, most of the GEMSAS medicine offers had been released, along with the emails of unsuccessful application (for now). Commiserations if you have received an email of unsuccessful application, although there is a chance of being offered a place still as people decline a place for one in USyd or dentistry etc.
Melbourne and Monash still have to release their offers though. Well, the other universities have been remarkably efficient this time! Monash used to be one of the earliest releasers in the past two years, but not this year.
Anyway, good luck if you're still waiting for an offer, particularly from Melbourne!
Melbourne and Monash still have to release their offers though. Well, the other universities have been remarkably efficient this time! Monash used to be one of the earliest releasers in the past two years, but not this year.
Anyway, good luck if you're still waiting for an offer, particularly from Melbourne!
Tuesday, October 29, 2013
2014 GEMSAS medicine offer list completed. Offers out next few days.
Today the 2014 GEMSAS medicine offer list was completed. Offers for all the different GEMSAS universities will be out in the next few days. In particular, the University of Melbourne MDHS facebook page indicates a 1 November 2013 release.
Good luck for everyone waiting for an offer!
Good luck for everyone waiting for an offer!
Saturday, October 26, 2013
2013 Unimelb end of undergraduate classes
Yesterday was the last day for undergraduate classes for undergraduate students for the University of Melbourne. Good luck for all your exams if you have them soon! We still have two more weeks left of MD2 to go, due to longer semesters for medicine. Meanwhile, in MD2 our multiple choice exam is only worth 17.5%, compared to 40% of semester 8/9 back in the MBBS course. They have also added in a SAQ component. Boo! What do they expect to do? To see if we have doctor's handwriting yet?
I guess all the first round of GEMSAS med offers should be coming out within the next few weeks then. Ah sorry... I just reminded you again. In any case, good luck for any offers!
I guess all the first round of GEMSAS med offers should be coming out within the next few weeks then. Ah sorry... I just reminded you again. In any case, good luck for any offers!
Tuesday, October 15, 2013
NAE's medical jokes
Since Drug Lion has commented that he wants to hear my med jokes, I'll post my original compilation of variable quality here. I assure you that all of these are my own, but there may be a possibility of others having come up with them before.
As with many jokes, if you abhor anything not 100% politically correct or are easily offended, then read no further.
Many of these jokes are puns, so you have to imagine them being read out.
On a more serious note, it was with some sadness that I have learned by checking the medical records that one of the patients I saw in the hospital has died. This a patient that I put a cannula into too. There are other patients which I see who also have terminal diagnoses in oncology with poor prognosis. It is sad, but these are some of the things we need to learn to cope with in medicine.
As with many jokes, if you abhor anything not 100% politically correct or are easily offended, then read no further.
Many of these jokes are puns, so you have to imagine them being read out.
On a more serious note, it was with some sadness that I have learned by checking the medical records that one of the patients I saw in the hospital has died. This a patient that I put a cannula into too. There are other patients which I see who also have terminal diagnoses in oncology with poor prognosis. It is sad, but these are some of the things we need to learn to cope with in medicine.
Sunday, October 13, 2013
What do you call the worm that ate Mozart?
original link: https://www.facebook.com/photo.php?fbid=630221933664634
Credit: Beatrice the Biologist on Facebook (photo seen through I fucking love science on Facebook)
This was so gold that I needed to share it with you. It's a lot better than most of my jokes that my fellow med students have to listen to. Although if you want to hear any of them, leave a comment and let me know.
Thursday, October 10, 2013
[update] MD2 GP placements
Yesterday, I undertook my first GP day out of four that I have in the GP placement (weekly) this year. It was a refreshing change being assigned to a GP clinic which was a lot closer to my home than the clinical school was, in contrast to the case for many of the other people I have spoken to. They were also kind in letting me share the lunch that was bought for those in the clinic!
The first session was very interesting, and I was encouraged by the GP I was with to participate and attempt to take the history and examinations first for some patients myself. In that way, I consider myself lucky, comparing against some of the other stories I hear around.
In general, it was interesting to note the contrast between "undifferentiated" patients visiting GP and those visiting the ED; those going to ED were sicker. That said, it also hit home that we didn't have much practice interviewing in some of the more common (compared to hospital) GP presentations like URTIs and neuro/muscular type pain, so I was a bit unsure of what to do at times. I also had the practical experience of seeing a final year medical student pick up on systems review something important which was not the presenting complaint of the patient, which I did not ask about myself, reinforcing the usefulness of the systems review as part of the medical interview. So it was all a useful experience. Looking forward to the placement next week!
The first session was very interesting, and I was encouraged by the GP I was with to participate and attempt to take the history and examinations first for some patients myself. In that way, I consider myself lucky, comparing against some of the other stories I hear around.
In general, it was interesting to note the contrast between "undifferentiated" patients visiting GP and those visiting the ED; those going to ED were sicker. That said, it also hit home that we didn't have much practice interviewing in some of the more common (compared to hospital) GP presentations like URTIs and neuro/muscular type pain, so I was a bit unsure of what to do at times. I also had the practical experience of seeing a final year medical student pick up on systems review something important which was not the presenting complaint of the patient, which I did not ask about myself, reinforcing the usefulness of the systems review as part of the medical interview. So it was all a useful experience. Looking forward to the placement next week!
Saturday, October 5, 2013
Unimelb 2014 entry medicine interviews finished
Yesterday was the last day of the interviews for 2014 medicine entry at the University of Melbourne. I have heard that they have had a shake up on the topics being assessed in the interview!
I hope you have all done well in your interviews. Now it is the long wait until offers.
I hope you have all done well in your interviews. Now it is the long wait until offers.
Sunday, September 22, 2013
[update] ED shifts!
As you may know from reading my previous posts, right now I am in the ambulatory/ED rotation. I have completed most of my ED shifts now, with one more to go in just under a week.
ED has been an amazing experience! It has been very fast paced at times. However, it is not overwhelming so, at least at the hospital I am in. There are some quiet times in between.
I enjoyed putting in IV cannulas and doing some suturing for closing wounds. I am getting better at both of these as time goes by.
Putting in cannulas successfully in one go is very satisfying. However, there have been a few frustrating instances, even apart from missing the vein completely.
One time, I put in the needle for the cannula and there was flashback initially, but it stopped abruptly - it looks like I went straight through to the other side of the vein.
Even more frustrating, I once put in the cannula and bung covering it successfully. But then when I wanted to take bloods, I accidentally took out the cannula from the vein! Not only did I need to reinsert another cannula, I also had to change the pillowcase of the patient's pillow.
On the bright side however, on the same day, there was a patient who needed a relatively large cannula inserted quickly for blood tests and fluids due to hematemesis, and I did manage to get that one in on the first go without pulling it out. So I feel like I redeemed myself.
The other thing which can be frustrating is when you successfully puncture the vein but the venous flow is bad when using a vacutainer to collect blood. That has happened to me a few times. I feel as if I should try using a syringe to see if it works better like I see some of the doctors and nurses doing.
I would like to thank all the readers of my blog who have allowed students to practice their skills, including taking bloods, putting in cannulas, and suturing. It is greatly appreciated.
All in all though, ED has been quite a refreshing experience. It is now one of the specialties which I am considering for the future. Now for the rest of the ambulatory/ED term which consists of hematology/oncology/dermatology...
ED has been an amazing experience! It has been very fast paced at times. However, it is not overwhelming so, at least at the hospital I am in. There are some quiet times in between.
I enjoyed putting in IV cannulas and doing some suturing for closing wounds. I am getting better at both of these as time goes by.
Putting in cannulas successfully in one go is very satisfying. However, there have been a few frustrating instances, even apart from missing the vein completely.
One time, I put in the needle for the cannula and there was flashback initially, but it stopped abruptly - it looks like I went straight through to the other side of the vein.
Even more frustrating, I once put in the cannula and bung covering it successfully. But then when I wanted to take bloods, I accidentally took out the cannula from the vein! Not only did I need to reinsert another cannula, I also had to change the pillowcase of the patient's pillow.
On the bright side however, on the same day, there was a patient who needed a relatively large cannula inserted quickly for blood tests and fluids due to hematemesis, and I did manage to get that one in on the first go without pulling it out. So I feel like I redeemed myself.
The other thing which can be frustrating is when you successfully puncture the vein but the venous flow is bad when using a vacutainer to collect blood. That has happened to me a few times. I feel as if I should try using a syringe to see if it works better like I see some of the doctors and nurses doing.
I would like to thank all the readers of my blog who have allowed students to practice their skills, including taking bloods, putting in cannulas, and suturing. It is greatly appreciated.
All in all though, ED has been quite a refreshing experience. It is now one of the specialties which I am considering for the future. Now for the rest of the ambulatory/ED term which consists of hematology/oncology/dermatology...
Saturday, September 21, 2013
Subscription feed link (Atom) fixed
Today I had the late realization that due to the policies of Google changing at the end of last year, my news feed site did not work and update as it should anymore. Now this is very annoying! I should have kept a closer eye on it, and the thought should have crossed my mind when the update occurred.
Anyway, I have updated the link to it now, so using the new link there should be no problem with subscribing to my blog. The new atom link is here: http://additionelimination.blogspot.com/feeds/posts/default
Sorry for any inconvenience!
Anyway, I have updated the link to it now, so using the new link there should be no problem with subscribing to my blog. The new atom link is here: http://additionelimination.blogspot.com/feeds/posts/default
Sorry for any inconvenience!
Wednesday, September 18, 2013
GAMSAT SIII 100: Win The Day (Team SIII parody)
For some reason, today I've decided to make a subtitled video regarding GAMSAT SIII.
I will most likely resume GAMSAT tutoring after my exams in November. For more info, visit http://additionelimination.blogspot.com.au/p/blog-page_8.html
GAMSAT SIII 100: Win The Day (Team SIII parody)
I will most likely resume GAMSAT tutoring after my exams in November. For more info, visit http://additionelimination.blogspot.com.au/p/blog-page_8.html
Sunday, September 15, 2013
Ace Physics free iOS app
One of my friends in the Melbourne MD program has made a new iOS app called Ace Physics (Android app not yet available). I have tried a few of the questions and had a look at this app myself. This is a question bank app with questions of varying difficulty and random number generation, together with very detailed, comprehensive worked solutions for each question. It is an excellent way to consolidate physics knowledge on the go.
This app has trial questions which are free to try, with extra topics able to be downloaded with additional charge of 0.99 c (notation parody intended) if you are satisfied with the trial questions and solutions.
Download the free trial version at http://www.acephysics.com/ and send any feedback to the form on that site at http://www.acephysics.com/contact.php.
There may be instances when the numbers do not make sense. If this happens, then an app reset or phone/tablet restart is required.
This app has trial questions which are free to try, with extra topics able to be downloaded with additional charge of 0.99 c (notation parody intended) if you are satisfied with the trial questions and solutions.
Download the free trial version at http://www.acephysics.com/ and send any feedback to the form on that site at http://www.acephysics.com/contact.php.
There may be instances when the numbers do not make sense. If this happens, then an app reset or phone/tablet restart is required.
Sunday, September 8, 2013
New Prime Minister Tony Abbott. Kevin Rudd resigns as Labor leader.
Today, Tony Abbott was elected as the new Prime Minister of Australia. As a result of this, the former Prime Minister, Kevin Rudd, has resigned as the leader of the federal Labor Party to allow for renewal within the Labor Party.
Whilst I disagree with several of the Liberal Party's key policies, most notably their position of "direct action" being more cost-effective than a price on carbon in reducing emissions (which is at odds with most current economic thinking), I note on the medical front that the Liberal Party have maintained a commitment in funding medical research, particularly for Alzheimer's Disease. Alzheimer's Disease has been quite a "black hole" in terms of finding effective disease modifying treatments of late, although a few agents are currently in the clinical trial stage. Let's hope we can get something better than Souvenaid out of this research, which we were talking about for EBM.
I realize that some or even many of you may not want to say anything at all positive with regard to Prime Minister Abbott. However, while I disagree with several of his main policies, there are a few which are commendable. Furthermore, we will be spending at least three years under his government; which will be a long time; unless of course he miscalculates on a double dissolution election repealing the carbon tax. If you really feel strongly about it, then maybe you could join the ALP. I don't know if there is any waiting period, but given the new rules, you may even get a say in who the new leader is. Otherwise, it may be prudent to wait a while for the dust to settle and see if they have ended their bitter infighting and see what their new team and policies are first.
Whilst I disagree with several of the Liberal Party's key policies, most notably their position of "direct action" being more cost-effective than a price on carbon in reducing emissions (which is at odds with most current economic thinking), I note on the medical front that the Liberal Party have maintained a commitment in funding medical research, particularly for Alzheimer's Disease. Alzheimer's Disease has been quite a "black hole" in terms of finding effective disease modifying treatments of late, although a few agents are currently in the clinical trial stage. Let's hope we can get something better than Souvenaid out of this research, which we were talking about for EBM.
I realize that some or even many of you may not want to say anything at all positive with regard to Prime Minister Abbott. However, while I disagree with several of his main policies, there are a few which are commendable. Furthermore, we will be spending at least three years under his government; which will be a long time; unless of course he miscalculates on a double dissolution election repealing the carbon tax. If you really feel strongly about it, then maybe you could join the ALP. I don't know if there is any waiting period, but given the new rules, you may even get a say in who the new leader is. Otherwise, it may be prudent to wait a while for the dust to settle and see if they have ended their bitter infighting and see what their new team and policies are first.
Tuesday, September 3, 2013
[update] St Vincent's ED simulation
Yesterday and today, I was in a group doing simulations for various situations in ED, with a mannequin which had a pulse, pupilliary responses and various other responses; with a monitor and facilitator giving speech as a patient. We were asked to pretend we were doctors and initiate the management of the patient in front of us. We were also video recorded and they played back some portions of our performance to show us, although it is not part of our assessment.
It was very fun! Unfortunately, due to confidentiality agreements, I am not able to say what the situations were. This was not a university wide thing for medical school though. It was just at St Vincent's. So the ED simulations are another reason to come to St Vincent's, apart from the rigorous teaching. And of course the table tennis.
It was very fun! Unfortunately, due to confidentiality agreements, I am not able to say what the situations were. This was not a university wide thing for medical school though. It was just at St Vincent's. So the ED simulations are another reason to come to St Vincent's, apart from the rigorous teaching. And of course the table tennis.
Saturday, August 31, 2013
[update] end of Surgery block
Last Friday was the end of my Surgery block in the MD degree. In some aspects, surgery is very interesting and technical. I have not ruled it out as a career, but so far I think some other specialties are more likely. I have some interest in anaesthetics, and I was exposed a bit to it during this surgery term.
As per the other terms beforehand, I needed to write another hurdle EP (ethical/empathic practice) reflective piece essay. These essays are widely detested throughout the medical school student cohort. As with the conference essays, I imagine that there would be a lot of superfluous word usage in many essays to make up word counts.
There will also be another formative test next week to see how we are going. It will be interesting to see how I go. This term I have been using the BMJ onExamination app a lot to revise and reading the pathology and clinical examination texts, but I haven't been keeping up with the lecture revision very well.
As per the other terms beforehand, I needed to write another hurdle EP (ethical/empathic practice) reflective piece essay. These essays are widely detested throughout the medical school student cohort. As with the conference essays, I imagine that there would be a lot of superfluous word usage in many essays to make up word counts.
There will also be another formative test next week to see how we are going. It will be interesting to see how I go. This term I have been using the BMJ onExamination app a lot to revise and reading the pathology and clinical examination texts, but I haven't been keeping up with the lecture revision very well.
Friday, August 30, 2013
2014 entry: GEMSAS medicine interview offers and UQ offers released
The GEMSAS medicine interview offers and UQ medicine offers were mostly released yesterday and today, with the GEMSAS unsuccessful application notice also coming out two days ago. To all my students and readers of this blog, congratulations if you have received an interview or offer at UQ. Good luck for your interviews!
Also, commiserations to all of you who may not have received an interview or offer at UQ.
Also, commiserations to all of you who may not have received an interview or offer at UQ.
Sunday, August 18, 2013
[update] Finished review of MD1 conference reflective pieces
As part of the student conference assessment in the MD course at UniMelb, in second year, apart from writing our own reflective piece, we were required to also review and provide feedback on the reflective pieces of two students from MD1 (pass/fail). I managed to get both of the reviews done this morning, so that is the end of my assessment for the conference for this year.
For next year's student conference there will be four cohorts doing the MD program, so we should be able to see the MD4s present their research results during the conference. That might be interesting to see.
For next year's student conference there will be four cohorts doing the MD program, so we should be able to see the MD4s present their research results during the conference. That might be interesting to see.
Sunday, August 11, 2013
Context is everything - in the economy and in medicine
During the past week, there was the usual bickering of politicians about interest rates policies, with the RBA dropping the overnight cash rate target from 2.75% to 2.5%. As expected, Labor seized the opportunity to announce that the interest rates are lower, which makes it better for working families with home loans; directly contradicting the former coalition government's advertising campaign that interest rates "will always be lower under the coalition". To counter this, the coalition opposition mentions that "context is everything", and the only reason why the interest rates are low is because the "economy is struggling", which is a bad thing.
Now, both these arguments have some element of truth behind them. That said, if the government was to support the economy further, perhaps the only way to do this would be to increase the budget deficit even further, which is not desirable. Now, even for budget debt and deficit is context very important. The coalition talk of debt and deficit as if it is the "be all and end all". However, while it is very true that debt should not be ever increasing, and there should not be continual deficits, it is also true that temporary deficits are justified to support the economy in bad times; to be made up with surpluses when the economy is strong. As such, the government was quite justified in spending in the stimulus package at the peak of the financial crisis in order to support jobs and growth, even though this resulted in a larger deficit for the budget.
One thing I have realized though is that "context is everything" also applies to medicine. I recall an interaction with my CSC (clinical skills coach) tutor, who was quizzing the group about the effects and side effects of certain medications. The interaction was as follows:
CSC: What does aspirin do?
(At this stage, my pharmacology major instincts kicked in)
Me: Aspirin is a non-selective, irreversible cyclooxygenase inhibitor. It inhibits both COX-1 and COX-2, by irreversible acetylation of the active site. This reduces the amount of prostaglandin production. In this case, for this patient, the wanted effect is a decrease in TXA2 to decrease platelet activation, and we want an irreversible inhibitor because platelets don't synthesize new COX and other tissues can...
CSC: What you said was all true, but if you can summarize this in three words, what would you say?
Me: Stops blood clotting?
CSC: Close. "Thins the blood"
Now I was actually quite surprised that we were allowed to use this terminology, because aspirin doesn't actually decrease the viscosity of blood; it just stops the platelets from aggregating. But it seems like it was OK in this circumstance.
Another interaction was with a cardiologist in cardiology outpatients.
Cardiologist: How would you tell the difference between someone with fluid retention due to kidney failure and heart failure?
Me: Heart failure might have displaced apex beat, additional heart sounds, valvular regurgitation, murmur...
(seems like he was after investigations, rather than examination findings)
Me: BNP level...
Cardiologist: The BNP level might give you some idea. But what else?
Me: Echo
Cardiologist: Yes. An echo!
In contrast, there was a question of some similarity but also considerable differences asked in a tutorial I had later in ICU.
Intensivist: How would you assess if his heart and circulation is working well?
(I had the cardiologist experience in my mind)
Me: An echo
Intensivist: Get out. You won't have an echo everywhere you go.
Now it seems like the answer to the same question depends on the context in which it is asked. In pharmacology class, the molecular mechanism is important, but in the clinic, the CSC tutor is after the end broader effect. And in cardiology, the echo is very useful in determining heart failure, but not practical for immediate measurement of cardiac function. So as it is the case in many other things, context is everything in medicine too.
Now, both these arguments have some element of truth behind them. That said, if the government was to support the economy further, perhaps the only way to do this would be to increase the budget deficit even further, which is not desirable. Now, even for budget debt and deficit is context very important. The coalition talk of debt and deficit as if it is the "be all and end all". However, while it is very true that debt should not be ever increasing, and there should not be continual deficits, it is also true that temporary deficits are justified to support the economy in bad times; to be made up with surpluses when the economy is strong. As such, the government was quite justified in spending in the stimulus package at the peak of the financial crisis in order to support jobs and growth, even though this resulted in a larger deficit for the budget.
One thing I have realized though is that "context is everything" also applies to medicine. I recall an interaction with my CSC (clinical skills coach) tutor, who was quizzing the group about the effects and side effects of certain medications. The interaction was as follows:
CSC: What does aspirin do?
(At this stage, my pharmacology major instincts kicked in)
Me: Aspirin is a non-selective, irreversible cyclooxygenase inhibitor. It inhibits both COX-1 and COX-2, by irreversible acetylation of the active site. This reduces the amount of prostaglandin production. In this case, for this patient, the wanted effect is a decrease in TXA2 to decrease platelet activation, and we want an irreversible inhibitor because platelets don't synthesize new COX and other tissues can...
CSC: What you said was all true, but if you can summarize this in three words, what would you say?
Me: Stops blood clotting?
CSC: Close. "Thins the blood"
Now I was actually quite surprised that we were allowed to use this terminology, because aspirin doesn't actually decrease the viscosity of blood; it just stops the platelets from aggregating. But it seems like it was OK in this circumstance.
Another interaction was with a cardiologist in cardiology outpatients.
Cardiologist: How would you tell the difference between someone with fluid retention due to kidney failure and heart failure?
Me: Heart failure might have displaced apex beat, additional heart sounds, valvular regurgitation, murmur...
(seems like he was after investigations, rather than examination findings)
Me: BNP level...
Cardiologist: The BNP level might give you some idea. But what else?
Me: Echo
Cardiologist: Yes. An echo!
In contrast, there was a question of some similarity but also considerable differences asked in a tutorial I had later in ICU.
Intensivist: How would you assess if his heart and circulation is working well?
(I had the cardiologist experience in my mind)
Me: An echo
Intensivist: Get out. You won't have an echo everywhere you go.
Now it seems like the answer to the same question depends on the context in which it is asked. In pharmacology class, the molecular mechanism is important, but in the clinic, the CSC tutor is after the end broader effect. And in cardiology, the echo is very useful in determining heart failure, but not practical for immediate measurement of cardiac function. So as it is the case in many other things, context is everything in medicine too.
Friday, August 2, 2013
2013 Student Appeal: Students with a cause
In 2011 and 2012, I was part of the University of Melbourne Student Appeal, part of the team raising money for students who were finding it hard to meet with living expenses. This year I will be unable to continue doing so since my clinical school is not right next to the university and we don't have very long breaks usually. However, the Student Appeal is a very good cause, so I recommend supporting it if you have some spare time or money.
If you want to become a volunteer or donate, see the official website or their Facebook page. Donations of $5 or more are matched by the university.
$2000 CPD cap deferred for 12 months
The government has decided to defer the $2000 CPD cap for at least 12 months pending further discussion as to the best way to continue to support education without allowing the perceived abuse of the system from using the money for holidays etc too. This is a good move from the Labor government, which is discussed on the Australian Doctor and Medical Observer sites. Now we should hope for a more common sense approach to this matter. Ideally we should see the new policy before the election because as it stands it is not out of the equation for Labor to return to this $2000 cap. But without too much rushing, so that it can be a good policy.
USyd 2014 entry local applicant interview offers out.
It seems like today the USyd 2014 entry local interview offers are out. It seems like the cutoff was 68 this year. If you have an interview, good luck with it.
Thursday, July 25, 2013
Coalition backs "Scrap the Cap"
Today, the coalition opposition indicated support for the "Scrap the cap" campaign. They have yet to announce their full policy decision, but it seems unlikely that they would do nothing in their policies after they have put their words of support for this campaign. Now it would be good if Labor did the same and reversed their policy of the cap.
For more commentary, see the articles from Medical Observer, #Scrapthecap, or Australian Doctor.
For more commentary, see the articles from Medical Observer, #Scrapthecap, or Australian Doctor.
[update] Surgery rotation, theater time
As you may know from reading my blog, this term is my surgery rotation. While the basic skills of history taking, examination and investigations have much in common with the medicine term, surgery not surprisingly does have a different flavor to it.
I have recently been in theater to witness some of a surgery. It is quite an interesting experience to go into the operating theater and see the whole team of surgeons, anaesthetists and nurses working together to ensure the successful operation. This was a very long operation - double mastectomy and full reconstruction. This was going to go for 10 hours, and I only saw the first two hours before I had a tutorial to attend.
I have recently been in theater to witness some of a surgery. It is quite an interesting experience to go into the operating theater and see the whole team of surgeons, anaesthetists and nurses working together to ensure the successful operation. This was a very long operation - double mastectomy and full reconstruction. This was going to go for 10 hours, and I only saw the first two hours before I had a tutorial to attend.
Sunday, July 14, 2013
What is your favorite clinical sign?
What is your favorite clinical sign? I got asked this question by someone last week at my clinical school.
It was something I had not thought about very much in fact. However, the first thing I shall say is that as medical students and doctors, we should be wary of referring to patients as their clinical sign instead of as a person with their clinical sign when there is a possibility of them hearing. It is understandable that doctors and medical students want to take shortcuts with their language amongst themselves to convey information quickly, but some patients take offense to referring to them as "the murmur in 1.1" for instance rather than "the person with a murmur in 1.1" or "Mr A with a murmur in 1.1".
The other thing to take note of is that pathological signs while "cool" to medical students and doctors may not be "cool" to those patients experiencing the pathological processes associated with them.
Now that all that is said, what is my favorite clinical sign? There are quite a few which I have found interesting, and a few others which I have heard of but have not seen myself.
Of those which I have personally seen, the first one is aortic stenosis. I have mentioned this one before in my blog, since this I have examined a few patients with this. The change in the loudness of the murmur with full expiration and sitting upright is quite remarkable!
Another one is the prominent v waves on the JVP of tricuspid regurgitation. It is quite fascinating to see the jugular vein pulsating up and down very prominently on the right side of the neck.
Another one is clubbing. Clubbing has many causes; some respiratory, some cardiovascular and some other causes. Very marked clubbing can be quite a sight to see when compared to normal fingers.
The other one is an upgoing plantar response. Usually the plantar reflex is down in adults, but it goes up in upper motor neuron pathology such as MS or with strokes. It was quite spectacular to see the first time around.
The last one I have personally seen which I will mention (which I find interesting but not as much as the other ones) is the "shifting dullness" of ascites.
Of those which I have not personally seen, Pemberton's sign sounds quite spectacular to see. I have heard that a medical student was particularly amazed when eliciting this for the first time during an exam that they had to be prompted by the assessor to continue the examination.
The last one I will put on my list is the flashlight test for hydrocele.
So that's my take. What's your favorite clinical sign?
It was something I had not thought about very much in fact. However, the first thing I shall say is that as medical students and doctors, we should be wary of referring to patients as their clinical sign instead of as a person with their clinical sign when there is a possibility of them hearing. It is understandable that doctors and medical students want to take shortcuts with their language amongst themselves to convey information quickly, but some patients take offense to referring to them as "the murmur in 1.1" for instance rather than "the person with a murmur in 1.1" or "Mr A with a murmur in 1.1".
The other thing to take note of is that pathological signs while "cool" to medical students and doctors may not be "cool" to those patients experiencing the pathological processes associated with them.
Now that all that is said, what is my favorite clinical sign? There are quite a few which I have found interesting, and a few others which I have heard of but have not seen myself.
Of those which I have personally seen, the first one is aortic stenosis. I have mentioned this one before in my blog, since this I have examined a few patients with this. The change in the loudness of the murmur with full expiration and sitting upright is quite remarkable!
Another one is the prominent v waves on the JVP of tricuspid regurgitation. It is quite fascinating to see the jugular vein pulsating up and down very prominently on the right side of the neck.
Another one is clubbing. Clubbing has many causes; some respiratory, some cardiovascular and some other causes. Very marked clubbing can be quite a sight to see when compared to normal fingers.
The other one is an upgoing plantar response. Usually the plantar reflex is down in adults, but it goes up in upper motor neuron pathology such as MS or with strokes. It was quite spectacular to see the first time around.
The last one I have personally seen which I will mention (which I find interesting but not as much as the other ones) is the "shifting dullness" of ascites.
Of those which I have not personally seen, Pemberton's sign sounds quite spectacular to see. I have heard that a medical student was particularly amazed when eliciting this for the first time during an exam that they had to be prompted by the assessor to continue the examination.
The last one I will put on my list is the flashlight test for hydrocele.
So that's my take. What's your favorite clinical sign?
Friday, July 5, 2013
[update] 2013 Melbourne MD student conference
The MD student conference finished yesterday. This conference is something which is quite unique to the Melbourne medical school, and contains topics which aren't in the curriculum generally. For instance, it has among other things some social science topic symposiums and other things with some relevance to medicine but not clinical or basic sciences per se.
For the conference we had to also write an assignment of 1500 words and as MD2 people we have to review two MD1 assignments (both pass/fail). I decided to get my assignment over and done with yesterday and today.
Next week we will resume class in the hospital again. My next term is the Surgery term.
For the conference we had to also write an assignment of 1500 words and as MD2 people we have to review two MD1 assignments (both pass/fail). I decided to get my assignment over and done with yesterday and today.
Next week we will resume class in the hospital again. My next term is the Surgery term.
Wednesday, June 26, 2013
Kevin Rudd regains Labor leadership 57-45
Today has certainly been a very eventful day in Australian politics. It began with the declaration of two key independents, Oakeshott and Windsor, that they would not seek reelection.
This was followed up with a vote on the Labor leadership at 7 pm tonight. This time, there was a major swing towards Kevin Rudd, with many in the caucus seeing the writing on the wall. Bill Shorten's support, while not sufficient alone, helped Kevin Rudd over the line.
Now the election looks a lot tighter. This will be interesting. Now I hope that Labor under Kevin Rudd will scrap the plans for the $2000 self education cap and the Medicare cuts. It will be interesting to see what his policies will be and who will form the new cabinet.
This was followed up with a vote on the Labor leadership at 7 pm tonight. This time, there was a major swing towards Kevin Rudd, with many in the caucus seeing the writing on the wall. Bill Shorten's support, while not sufficient alone, helped Kevin Rudd over the line.
Now the election looks a lot tighter. This will be interesting. Now I hope that Labor under Kevin Rudd will scrap the plans for the $2000 self education cap and the Medicare cuts. It will be interesting to see what his policies will be and who will form the new cabinet.
Monday, June 24, 2013
Scrap the $2000 Cap on Medical Self-Education
As I mentioned before on this blog, the federal government wants to impose a $2000 cap on self-education. This will be a strong disincentive for doctors hoping to keep up to date with the latest developments in their area of practice.
The Scrap the Cap campaign has been launched as an online petition to raise public and political awareness of the adverse effects that this cap will have. There is a substantial list of supporters:
Founding supporters of the #ScrapTheCap campaign are:
The Scrap the Cap campaign has been launched as an online petition to raise public and political awareness of the adverse effects that this cap will have. There is a substantial list of supporters:
Founding supporters of the #ScrapTheCap campaign are:
- Australian College of Rural and Remote Medicine (ACRRM)
- Australian General Practice Network (AGPN)
- Australian Medical Association (AMA)
- Australian Medicare Local Alliance (AMLA)
- General Practice Registrars Australia (GPRA)
- Royal Australian College of General Practitioners (RACGP)
- Rural Doctors Association of Australia (RDAA)
- Australian College of Rural and Remote Medicine (ACRRM)
- Australian Doctor
- Australian General Practice Network (AGPN)
- Australian Medical Association (AMA)
- Australian Medical Students’ Association (AMSA)
- Australian Medicare Local Alliance (AMLA)
- General Practice Registrars Australia (GPRA)
- General Practice Students Network (GPSN)
- National General Practice Supervisors’ Association (NGPSA)
- Royal Australian College of General Practitioners (RACGP)
- Rural Doctors Association of Australia (RDAA)
Wednesday, June 19, 2013
Labor needs a "fair shake of the sauce bottle" if it is to win the election
At this late stage, Labor are still performing very badly in the polls. To add insult to injury, it seems like Gillard's comment about "men in blue ties" has put male voters offside, resulting in 1/4 of Labor's male vote disappearing, without a significant increase in female voters. Not surprising either. It is hard to imagine how she would not forsee the consequences of saying that, but for some reason she said it.
It seems like a lot of the public think that the current government under Gillard has gone a "bridge too far" on many issues. They've even managed to get doctors offside by cuts to Medicare and a $2000 per year limit on Continuing Professional Development! It is almost certain that if nothing changes, Tony Abbott will be the next prime minister. There is talk of Kevin Rudd getting more support within the Labor caucus, but after last year's endorsement of Gillard by the caucus 71:31, it seems like Rudd does not want to challenge again without the public support of most ministers, while Gillard does not want to give up her position.
It will be interesting to see how things play out. If Labor is to win, they need a "fair shake of the sauce bottle".
It seems like a lot of the public think that the current government under Gillard has gone a "bridge too far" on many issues. They've even managed to get doctors offside by cuts to Medicare and a $2000 per year limit on Continuing Professional Development! It is almost certain that if nothing changes, Tony Abbott will be the next prime minister. There is talk of Kevin Rudd getting more support within the Labor caucus, but after last year's endorsement of Gillard by the caucus 71:31, it seems like Rudd does not want to challenge again without the public support of most ministers, while Gillard does not want to give up her position.
It will be interesting to see how things play out. If Labor is to win, they need a "fair shake of the sauce bottle".
Saturday, June 8, 2013
[update] End of medicine rotation
Yesterday was my last day of the medicine rotation. In second year MD, after the initial foundation term, we rotate between the terms of medicine, surgery, and ED/ambulatory/GP, with 1/3 of the cohort in each rotation at any time.
There were fewer lectures in this term, but at my clinical school there certainly was no lack of lectures. Compared to foundation term though, there was plenty more ward time and other patient contact time in outpatients and bedside tutorials. I do wish that we had more opportunity to follow ward rounds, but then again the lectures teach us things we should know, so there has to be a compromise between them. I think the balance has been quite reasonable so far.
I learned a lot in this term, and ECGs are becoming less and less mysterious. I'm also becoming more accustomed to hearing the murmur of aortic stenosis in different patients who have it. However, I still need to improve my history taking skills.
Next week is intersession week when we will have some more lectures and another progress test. Then there will be a break before the student conference. In MD2 at Melbourne, there is no big exam midyear. The subjects are year long, so the big exams (OSCE and written) are at the end of the year.
To all those in undergrad, good luck for your exams.
There were fewer lectures in this term, but at my clinical school there certainly was no lack of lectures. Compared to foundation term though, there was plenty more ward time and other patient contact time in outpatients and bedside tutorials. I do wish that we had more opportunity to follow ward rounds, but then again the lectures teach us things we should know, so there has to be a compromise between them. I think the balance has been quite reasonable so far.
I learned a lot in this term, and ECGs are becoming less and less mysterious. I'm also becoming more accustomed to hearing the murmur of aortic stenosis in different patients who have it. However, I still need to improve my history taking skills.
Next week is intersession week when we will have some more lectures and another progress test. Then there will be a break before the student conference. In MD2 at Melbourne, there is no big exam midyear. The subjects are year long, so the big exams (OSCE and written) are at the end of the year.
To all those in undergrad, good luck for your exams.
Sunday, June 2, 2013
Unimelb undergrad semester 1 swotvac 2013
The past Friday was the last day of semester 1 for 2013 for UniMelb undergraduate students. Now it is the swotvac, and exams start in one week.
Good luck for your exams!
Good luck for your exams!
Sunday, May 26, 2013
Temporary postponement of intake of GAMSAT and VCE students
Effective immediately, it is unlikely that I will take on any new students for the tuition of VCE or the GAMSAT until the end of the university year 2013 for my year of the MD program (University of Melbourne MD Year 2). According to the Melbourne Medical School website, this is until 22 November 2013. I have decided to focus more on my studies. I apologize for any inconvenience caused, especially if you were seeking to undertake the GAMSAT UK.
Friday, May 17, 2013
GAMSAT 2013 results released
Today the GAMSAT 2013 results were released. To my students and readers of this blog who sat the GAMSAT, I hope you went well. Now it will be time to decide preferences if your score combined with GPA and/or portfolio gives you a reasonable prospect of getting in somewhere.
If I tutored you for the GAMSAT this time, especially if we had several sessions, I would like to know how you went this time; and also compared to your last sitting if you did the GAMSAT previously as well.
If I tutored you for the GAMSAT this time, especially if we had several sessions, I would like to know how you went this time; and also compared to your last sitting if you did the GAMSAT previously as well.
Tuesday, May 7, 2013
GAMSAT 2013 results in 1-2 weeks
Today is the last day of the first week of May. Going by historical release dates, I would expect the results to be released in one to two weeks.
Most of the wait is over now! To my students and other readers of the blog, good luck if you are waiting for results.
Most of the wait is over now! To my students and other readers of the blog, good luck if you are waiting for results.
Wednesday, April 17, 2013
MD2 Progress test 1
I just got results back from that first progress test which was part of a research project to see what type of feedback was beneficial. The test did not contribute to our overall mark, and the questions were of things we should know by the end of the year though, rather than at this stage of the year, so I was clueless on quite a few of them. Nevertheless though, I felt quite comfortable with some of those questions.
Apparently I got 38/80 overall; Ambulatory 44%, Medicine 50%, Surgery 50%. It is kind of a relief that it seems like I know quite a significant portion of what we are expected to know at the end of the year, but there is still quite a way to go. At my clinical school they decided to move several of the rotating term lectures into the foundation block though. I wonder what my score would have been if that didn't happen. Anyway, I should look at the more detailed feedback when I have time after revising more lectures from foundation block.
Right now at the clinical school, I am in the "medicine" rotation. There are a lot less lectures this week than in foundation block! I've also had some more practice with the table tennis, so my skill level has returned to near the level I was before; although I wish there was more space around the table tennis table at the clinical school. We can run into chairs and other obstacles trying to return shots!
Apparently I got 38/80 overall; Ambulatory 44%, Medicine 50%, Surgery 50%. It is kind of a relief that it seems like I know quite a significant portion of what we are expected to know at the end of the year, but there is still quite a way to go. At my clinical school they decided to move several of the rotating term lectures into the foundation block though. I wonder what my score would have been if that didn't happen. Anyway, I should look at the more detailed feedback when I have time after revising more lectures from foundation block.
Right now at the clinical school, I am in the "medicine" rotation. There are a lot less lectures this week than in foundation block! I've also had some more practice with the table tennis, so my skill level has returned to near the level I was before; although I wish there was more space around the table tennis table at the clinical school. We can run into chairs and other obstacles trying to return shots!
Monday, April 15, 2013
University funding slashed in Labor's "Gonski reform"
On the weekend, Labor announced that they would fund the reforms to school funding by cutting money out of university funding. Here is an article from The Age about it: http://www.theage.com.au/national/university-sector-to-be-hit-in-gonski-reforms-20130413-2hry2.html
I think it is a very silly move. Universities in Australia already are underfunded as they are. They have been relying heavily on full fees from international students for funding for a while, and the reform a few years ago to disallow local students taking full fee undergraduate courses has compounded the impact. Now this hit just adds insult to injury to the university sector. It is counterproductive to cut funding from universities. This will result in a decline in the quality of both teaching and research done in our universities.
Now I don't approve of many of Tony Abbott's policies and views, but this policy by Labor is just silly. Many voters are indeed waiting with their baseball bats for the next election. If Kevin Rudd's government had "lost its way", then the current Labor government under Julia Gillard seems to have found itself stuck in the Southern Ocean in between the Nisshin Maru and a whale about to be harpooned. The Labor caucus had the opportunity last year to choose between Kevin Rudd (who most voters preferred) or Julia Gillard, but Julia Gillard won in a landslide; 71 to 31. Perhaps this is indicative of a more fundamental structure problem with the Labor Party with "faceless men" having too much power, but I don't know enough to comment.
While Prime Minister Gillard had made a few gains in the opinion polls, she has slipped back considerably and there appears very little prospect of gaining back ground before the next election. If nothing changes, it looks almost certain that we will be having an Abbott government after this year's election. And while I don't condone that campaign with Margaret Thatcher's death last week, I would be unsurprised if "Ding Dong! The Witch Is Dead" shoots up to the music charts in Australia if the current prime minister loses this election in a landslide.
I think it is a very silly move. Universities in Australia already are underfunded as they are. They have been relying heavily on full fees from international students for funding for a while, and the reform a few years ago to disallow local students taking full fee undergraduate courses has compounded the impact. Now this hit just adds insult to injury to the university sector. It is counterproductive to cut funding from universities. This will result in a decline in the quality of both teaching and research done in our universities.
Now I don't approve of many of Tony Abbott's policies and views, but this policy by Labor is just silly. Many voters are indeed waiting with their baseball bats for the next election. If Kevin Rudd's government had "lost its way", then the current Labor government under Julia Gillard seems to have found itself stuck in the Southern Ocean in between the Nisshin Maru and a whale about to be harpooned. The Labor caucus had the opportunity last year to choose between Kevin Rudd (who most voters preferred) or Julia Gillard, but Julia Gillard won in a landslide; 71 to 31. Perhaps this is indicative of a more fundamental structure problem with the Labor Party with "faceless men" having too much power, but I don't know enough to comment.
While Prime Minister Gillard had made a few gains in the opinion polls, she has slipped back considerably and there appears very little prospect of gaining back ground before the next election. If nothing changes, it looks almost certain that we will be having an Abbott government after this year's election. And while I don't condone that campaign with Margaret Thatcher's death last week, I would be unsurprised if "Ding Dong! The Witch Is Dead" shoots up to the music charts in Australia if the current prime minister loses this election in a landslide.
Friday, April 12, 2013
White coats
"Excuse me, are you the doctor?"
It has been an ongoing joke in the hospital how we as medical students are confused as doctors by various staff and patients. Without knowing people by their face, there is no way to tell easily who is a doctor (and their level) and who is a medical student.
Some doctors lament that up until quite recently, the doctors and medical students at our hospital wore white coats. The length of the white coat also was different if you were a medical student or a doctor of varying seniority. Back then, you could easily tell who was who, and there would have been less confusion among staff and knowledgeable patients on the level of the medical student or doctor. However, now the only way to tell is by looking at the person's ID card, and if you're close enough to do that, you may as well just ask.
One of my tutors also commented that the white coat was also useful to have since it had many pockets to put items in. Now we have to carry everything in our hands, which is a lot less convenient. There have been a few studies in the literature demonstrating that patients still preferred white coats though.
On the other hand, the reason why white coats were phased out was because of infection control. They were worried that we would spread infections from patient to patient through the coats. Apparently the coats supplied by the hospital were not washed every day. It would probably have been possible to minimize spreading infections by washing the white coats every day, but perhaps it was too expensive for the hospital.
It has been an ongoing joke in the hospital how we as medical students are confused as doctors by various staff and patients. Without knowing people by their face, there is no way to tell easily who is a doctor (and their level) and who is a medical student.
Some doctors lament that up until quite recently, the doctors and medical students at our hospital wore white coats. The length of the white coat also was different if you were a medical student or a doctor of varying seniority. Back then, you could easily tell who was who, and there would have been less confusion among staff and knowledgeable patients on the level of the medical student or doctor. However, now the only way to tell is by looking at the person's ID card, and if you're close enough to do that, you may as well just ask.
One of my tutors also commented that the white coat was also useful to have since it had many pockets to put items in. Now we have to carry everything in our hands, which is a lot less convenient. There have been a few studies in the literature demonstrating that patients still preferred white coats though.
On the other hand, the reason why white coats were phased out was because of infection control. They were worried that we would spread infections from patient to patient through the coats. Apparently the coats supplied by the hospital were not washed every day. It would probably have been possible to minimize spreading infections by washing the white coats every day, but perhaps it was too expensive for the hospital.
Tuesday, April 9, 2013
[update] back after semester 1 midsemester break (MD2)
Today I am back at the clinical school after the midsemester break. It was nice to be able to use the proper common room at our clinical school, and I got to try some table tennis. But I was quite shocked at how much my skills have deteriorated through lack of practice! Ah well... I have time to get it back up again.
I had a Basic Life Support assessment today (pass/fail) which I passed. I think most people would have passed though.
I had a Basic Life Support assessment today (pass/fail) which I passed. I think most people would have passed though.
Thursday, March 28, 2013
[update] MD2 Semester 1 midsemester break
I am now on my midsemester break for semester 1 this year, due to Good Friday being a public holiday.
This will be a good time to rest, although there are a lot of lectures to revise. I still have to submit two more de-identified patient cases as part of a pass/fail hurdle we have to clear (total 24 in the year).
After the break, we'll move back into the "proper" clinical school which was undergoing renovations. I'm looking forward to playing some table tennis on the breaks.
The university still has not told us specifically when we are allocated to go on our rural placement though. Australian CSP students need to do at least 4 weeks of rural placement. We were supposed to do it in our third or fourth year, and they initially planned to inform us when at the start of the year, but we still haven't been told. Ah well, I guess it's still a while to go anyway. I hope I don't have to go during my scholarly selective though... that may be a bit problematic; especially with only 6 months to do some sort of research project.
For everyone who did the GAMSAT last Saturday, and especially my students, I hope you went well.
This will be a good time to rest, although there are a lot of lectures to revise. I still have to submit two more de-identified patient cases as part of a pass/fail hurdle we have to clear (total 24 in the year).
After the break, we'll move back into the "proper" clinical school which was undergoing renovations. I'm looking forward to playing some table tennis on the breaks.
The university still has not told us specifically when we are allocated to go on our rural placement though. Australian CSP students need to do at least 4 weeks of rural placement. We were supposed to do it in our third or fourth year, and they initially planned to inform us when at the start of the year, but we still haven't been told. Ah well, I guess it's still a while to go anyway. I hope I don't have to go during my scholarly selective though... that may be a bit problematic; especially with only 6 months to do some sort of research project.
For everyone who did the GAMSAT last Saturday, and especially my students, I hope you went well.
Friday, March 22, 2013
GAMSAT 2013 tomorrow
The Australian GAMSAT for 2013 is tomorrow. To everyone I have tutored and to the readers of my blog sitting for the GAMSAT, good luck for this GAMSAT!
Get enough sleep before tomorrow, remember to bring your lunch and water, and remember to think and use good exam strategy.
Get enough sleep before tomorrow, remember to bring your lunch and water, and remember to think and use good exam strategy.
Tuesday, March 12, 2013
PrepGenie: GAMSAT Booster series introduced. 25% off other courses.
I was involved in reviewing questions for PrepGenie last year and this
year. PrepGenie has now introduced a GAMSAT Booster series consisting of
3 FLTs and 4 sectional tests along with 3 sets of free essay
evaluation. The price set for the package, 50 AUD, is unbelievably low.
PrepGenie also wants to give all readers of my blog 25% off on all other
courses.
To take advantage of this offer, use the discount coupon "BOBBYLI". To purchase multiple courses with the discount, purchase each item and check them out separately.
The GAMSAT Practice Test Papers available from PrepGenie can be found here: http://prepgenie.com/gamsat/gamsat-test-papers/
To take advantage of this offer, use the discount coupon "BOBBYLI". To purchase multiple courses with the discount, purchase each item and check them out separately.
The GAMSAT Practice Test Papers available from PrepGenie can be found here: http://prepgenie.com/gamsat/gamsat-test-papers/
Sunday, March 3, 2013
GAMSAT in 3 weeks
The GAMSAT is now just under three weeks away. If you are sitting it this year, I hope the preparation is going well. You may be interested in some of the tabs on the top if the page.
Meanwhile, I'm still getting used to the clinical school. It is cool how we get free tea, coffee and Milo supplied. Our clinical school is undergoing renovations at the moment though so we don't have table tennis or pool tables, but we should have them back soon.
Meanwhile, I'm still getting used to the clinical school. It is cool how we get free tea, coffee and Milo supplied. Our clinical school is undergoing renovations at the moment though so we don't have table tennis or pool tables, but we should have them back soon.
Thursday, February 21, 2013
Transition from university to hospital
Over the past few weeks, I've had to adjust to the hospital environment. Unlike at university where people can let their guard down at times, at public places in the hospital we must be prudent in our manner so that patients and doctors do not have a bad impression of us.
We are required to dress neatly, and at my clinical school, males are required to wear ties. They also like to send us txt messages to make announcements to us. So I guess they've kept up with the 21st century, unlike some primary and high schools. That reminds me of a UTAS professor who advocated for this kind of contact with high school students a few years ago. He said (paraphrased) "imagine the effect of a txt saying 'the principal wants to see you now'". Anyway, that's an aside.
Maybe our clinical school is old fashioned in some ways, but we are advised to refer to patients, other students and staff by their surname when on the wards, unless a patient told us they preferred their first name. That reminds me of a study showing that generally speaking, those who preferred to be referred to by surname rather than first name were older.
There is also the aspect of confidentiality. I am not someone who likes to talk about other people's secrets. However, for the purpose of improving our interview skills, I do have to debrief with my buddy and/or other people present at the time when I was doing the interview. During this time, we must make sure that others who were not present are not around. Another issue of confidentiality is that pulling the curtains around a bed when interviewing patients really doesn't prevent sound going through, but aside from bringing people into other rooms (which generally isn't done), we really don't do anything to stop others in the room hearing.
And finally, sometimes when I want to go from A to B quickly, I sometimes like to go down steps quickly and jump the last few steps before turning around to the next set of steps. Of course, it's not as extreme as sliding down the rails. But I was instinctively running and jumping down stairs a few days ago one or two times before realizing that maybe it wasn't such a good thing to do in a hospital as a medical student wearing a tie and having a hospital ID card.
We are required to dress neatly, and at my clinical school, males are required to wear ties. They also like to send us txt messages to make announcements to us. So I guess they've kept up with the 21st century, unlike some primary and high schools. That reminds me of a UTAS professor who advocated for this kind of contact with high school students a few years ago. He said (paraphrased) "imagine the effect of a txt saying 'the principal wants to see you now'". Anyway, that's an aside.
Maybe our clinical school is old fashioned in some ways, but we are advised to refer to patients, other students and staff by their surname when on the wards, unless a patient told us they preferred their first name. That reminds me of a study showing that generally speaking, those who preferred to be referred to by surname rather than first name were older.
There is also the aspect of confidentiality. I am not someone who likes to talk about other people's secrets. However, for the purpose of improving our interview skills, I do have to debrief with my buddy and/or other people present at the time when I was doing the interview. During this time, we must make sure that others who were not present are not around. Another issue of confidentiality is that pulling the curtains around a bed when interviewing patients really doesn't prevent sound going through, but aside from bringing people into other rooms (which generally isn't done), we really don't do anything to stop others in the room hearing.
And finally, sometimes when I want to go from A to B quickly, I sometimes like to go down steps quickly and jump the last few steps before turning around to the next set of steps. Of course, it's not as extreme as sliding down the rails. But I was instinctively running and jumping down stairs a few days ago one or two times before realizing that maybe it wasn't such a good thing to do in a hospital as a medical student wearing a tie and having a hospital ID card.
Monday, February 18, 2013
[update] Grand Rounds
Today I sat in a Grand Round presentation for the first time. In the Grand Rounds, a few interesting cases are presented for doctors and medical students to listen about.
At my clinical school today, the topic was Paroxysmal Nocturnal Hemoglobulinuria; a rare disease. Cases were presented with a benefit with treatment of eculizumab, an inhibitor of C5; subsequent to which quality of life was improved and there was often no need for subsequent blood transfusions. Data from studies was also presented which showed a reduction in mortality with eculizumab treatment. However, the cost was not cheap; I think it was about $300000 per year for each patient. That raises a question about how much society is prepared to pay; there is a clear benefit to the patient, but money is limited.
The other thing I noticed at the Grand Round was all the pagers and mobile phones of doctors going off. Although I've been to the wards, I've only had two weeks at the clinical school so far so I haven't been attached to a team (that will come later). As such, although I've interviewed a few patients, I haven't really observed any consultants, HMOs or interns in action. All those pagers and mobile phones going off during the Grand Round just reinforces how busy they are!
At my clinical school today, the topic was Paroxysmal Nocturnal Hemoglobulinuria; a rare disease. Cases were presented with a benefit with treatment of eculizumab, an inhibitor of C5; subsequent to which quality of life was improved and there was often no need for subsequent blood transfusions. Data from studies was also presented which showed a reduction in mortality with eculizumab treatment. However, the cost was not cheap; I think it was about $300000 per year for each patient. That raises a question about how much society is prepared to pay; there is a clear benefit to the patient, but money is limited.
The other thing I noticed at the Grand Round was all the pagers and mobile phones of doctors going off. Although I've been to the wards, I've only had two weeks at the clinical school so far so I haven't been attached to a team (that will come later). As such, although I've interviewed a few patients, I haven't really observed any consultants, HMOs or interns in action. All those pagers and mobile phones going off during the Grand Round just reinforces how busy they are!
Saturday, February 9, 2013
[update] First clinical week completed.
Yesterday I finished my first week of clinical school. My clinical school decided to give us a relatively light first week. We only started at 8.30 on two days and only finished later than 3 pm once. We will definitely get longer hours in future weeks.
This week, our clinical groups were assigned to look at different parts of the hospital and report back. Our group looked at the kitchen. Our hospital is not small and also supplies food for other places, so the kitchen has an efficient production line process, where people at different parts of the process have different jobs; while still rotating the meals from day to day. Very impressive!
Another thing I have to do this year is get used to receiving online lectures, although the vast majority will still be in person; especially at the clinical school I go to. We didn't have any last year, and it took me a while to find them on the new IT system they have for medicine, but I've managed to find them now.
This week, our clinical groups were assigned to look at different parts of the hospital and report back. Our group looked at the kitchen. Our hospital is not small and also supplies food for other places, so the kitchen has an efficient production line process, where people at different parts of the process have different jobs; while still rotating the meals from day to day. Very impressive!
Another thing I have to do this year is get used to receiving online lectures, although the vast majority will still be in person; especially at the clinical school I go to. We didn't have any last year, and it took me a while to find them on the new IT system they have for medicine, but I've managed to find them now.
Thursday, January 31, 2013
[update] MD2 starts next week.
Tomorrow will be the last day of my Immediate level Intensive Summer Course in Chinese. As I said earlier in my blog, my Chinese is not as good as I would like it to be, so this summer I decided to enroll in a course to improve it. If it doesn't clash with the start of the year for medicine next year, I might join it again next year if they have it available.
Today we were able to purchase the subject guides for second year medicine in the bookshop for $36. Here's what the whole pack looks like:
Since I'll be starting medicine again next week, I won't be available as often for GAMSAT and VCE tutoring; definitely not available during morning and afternoon of weekdays. Since I won't be able to satisfy all prospective demand as the GAMSAT approaches, anyone new who initiates contact regarding tuition from now on will have slightly increased fees. That said, the fees are still a lot lower than other GAMSAT tutors I have seen. See the GAMSAT Science 100 + VCE tutor link on the top of the page for updated information regarding tutoring.
Today we were able to purchase the subject guides for second year medicine in the bookshop for $36. Here's what the whole pack looks like:
Since I'll be starting medicine again next week, I won't be available as often for GAMSAT and VCE tutoring; definitely not available during morning and afternoon of weekdays. Since I won't be able to satisfy all prospective demand as the GAMSAT approaches, anyone new who initiates contact regarding tuition from now on will have slightly increased fees. That said, the fees are still a lot lower than other GAMSAT tutors I have seen. See the GAMSAT Science 100 + VCE tutor link on the top of the page for updated information regarding tutoring.
Wednesday, January 9, 2013
Happy new year!
I think it's safe now to say that we have survived 2012. I hope that 2013 will be a good year for everyone.
This year I'll be spending most of my time in the hospital. It will be a different experience to sitting in lectures and classrooms for most of the day, but there will be some lectures still. I'll have to improve my clinical skills a lot this year if I want to get good grades.
Good luck if you are sitting the GAMSAT this year and trying to get into medical school. Right now I am available to tutor for the GAMSAT or VCE math methods, specialist, chemistry or physics at the University of Melbourne or Monash. See the GAMSAT Science 100 + VCE tutor tab at the top of the blog for more information. Right now, I can tutor most times apart from around 1.30 to 3.30 pm. However, when university starts for Medicine again on 4 February, I will be more restricted to tutoring after uni hours and on weekends.
In more unrelated news, Girls' Generation released a new song recently, but I don't like it as much as most of their previous songs. Nowadays I listen to other artists more, including IU. I linked a music video of one of IU's songs in one of my posts one or two months ago (아이유 - 너랑 나), although it was all in Korean, and with some "improper" word usage.
Also, it seems like the computers in the biomedical library at UniMelb have very annoyingly had their sound disabled, even when putting in headphones! Not only does it mean that we can't watch youtube videos properly, it also means that anyone who actually wants to study and re-listen to lectures through echo360 cannot do so. Silly idea I think. I can anticipate an influx of complaints once the standard semester starts if it's not changed!
This year I'll be spending most of my time in the hospital. It will be a different experience to sitting in lectures and classrooms for most of the day, but there will be some lectures still. I'll have to improve my clinical skills a lot this year if I want to get good grades.
Good luck if you are sitting the GAMSAT this year and trying to get into medical school. Right now I am available to tutor for the GAMSAT or VCE math methods, specialist, chemistry or physics at the University of Melbourne or Monash. See the GAMSAT Science 100 + VCE tutor tab at the top of the blog for more information. Right now, I can tutor most times apart from around 1.30 to 3.30 pm. However, when university starts for Medicine again on 4 February, I will be more restricted to tutoring after uni hours and on weekends.
In more unrelated news, Girls' Generation released a new song recently, but I don't like it as much as most of their previous songs. Nowadays I listen to other artists more, including IU. I linked a music video of one of IU's songs in one of my posts one or two months ago (아이유 - 너랑 나), although it was all in Korean, and with some "improper" word usage.
Also, it seems like the computers in the biomedical library at UniMelb have very annoyingly had their sound disabled, even when putting in headphones! Not only does it mean that we can't watch youtube videos properly, it also means that anyone who actually wants to study and re-listen to lectures through echo360 cannot do so. Silly idea I think. I can anticipate an influx of complaints once the standard semester starts if it's not changed!
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