[update] 2015 Doctor of Medicine Graduation! Reflections of the last four years.

After three years of Biomedicine and four years of Medicine, I have just graduated from the Doctor of Medicine!

Over the past four years of Medicine, I have learned a lot, both inside and outside of medicine. Looking back, it is incredible to think of how much I have learned and done throughout this time, some of which I would never expected to have done four years ago.

Medicine is very fun and exciting! Sometimes even more so than I had anticipated when starting out on this course. There are many different medical conditions, which makes the history, examination, investigation and management skills very difficult, but also makes the diagnostic dilemma challenging. As a combination between science and art, there is much to do as a doctor, treating the whole patient. There have been many inspirational doctors of different specialties who have shaped the way in which I would like to practice medicine in the future.

Apart from finishing my medical degree, I have managed to attend a conference and had an abstract accepted as a second author. It was an interesting experience to stand in front of a poster of an international conference and speak to people about our research. There are a few other abstracts we have submitted and will submit to other conferences. Hopefully some of them get accepted and we can attend more conferences next year, and get to publish some work in journals too.

Outside of medicine, I have been doing voluntary tutoring every weekend for these four years of my medical course, as well as GAMSAT and other tutoring. This has given me an appreciation of how difficult it may be to learn certain things which I take for granted, particularly basic math arithmetic skills. It also reinforced the importance of "constant repetition" as a crucial aspect of learning, where a student "gets" something after a session one week, only to forget it the next time I see them; although every week the knowledge sticks a little better. It has been great to see the "aha moment" when students finally understand what you have been trying to teach them. However, it was also eye-opening to see how some of these skills, among others, appear to have been neglected in the schools teaching some of these students who have been in the Victorian education system from the start.

I managed to spend a lot of time enjoying table tennis at the clinical school. At the start of my time there, I was very rusty, having not played for quite a while. However, after a lot of practice, I came back to the level that I was before, and may have improved somewhat. I don't know how much I will be able to play in the future, but it has been a fun time playing table tennis in the clinical school during breaks.

During the past two years, I have also begun running regularly, and a couple of months ago I ran my first marathon! This is something I would never have expected to have done four years ago. I used to get injured when running even short distances, but I have now sorted that out for distances less than 22 km. Anything greater is still a challenge though; especially a 42.195 km marathon! I hope to be able to continue running regularly and in events in the future, although running in events may be difficult if I don't have those weekends off as a doctor. I hope that I can run a marathon in under four hours next time. We'll see how possible that is next year.

More recently, I decided to restart learning piano songs, for the first time in over ten years. No classic songs though; I started with K-pop songs and have continued on to learn some Yiruma songs. I became disillusioned with practicing piano in year 7, although now I have come to appreciate the magic of piano music, and the feeling of accomplishment of being able to play a song.

These past four years have reinforced various lessons in life too. Although I have learned and developed considerably during the past four years, these four years have made me realize that I have a lot more to learn and to improve myself in the future.

Unfortunately in life, you cannot always get what you want. However, you should try anyway, and learn new things and become a better person. Many things require a lot of hard work; "constant repetition" as the head of Surgery says. Almost four years ago, I was trying to be funny and came up with a quote: "Life is like Angry Birds. Some things are easy. Other things need hard work, strategy, timing, and luck." But even though it was intended to be humorous, I feel that it still rings true.

On the other hand, there may be surprises in life where something almost miraculous happens which you would never expect. Even though I always believed that I was good a science during high school and expected to do well in that section of the GAMSAT, I would never have expected to receive a score of 100 in the science section of the GAMSAT two times in a row! I also didn't expect to receive excellent topics in my second GAMSAT which combined with my extra preparation and strategy with essay planning and structure which helped my section 2 score rise by 18 points! This test is a significant proportion of what got me into the course in the first place, and led me to the journey to where I am today.

In some way, even though you cannot always get what you want, these events remind us that we must appreciate the many things that do happen as we want them to, or even better than expected. If everything was easy, then life would be too boring, wouldn't it?

Anyway, I will be working as an intern next year, and continuing to learn both inside and outside of medicine. There is a long journey ahead still.

Malcolm Turnbull replaces Tony Abbott as PM

Last night, Malcolm Turnbull won a ballot within the Liberal Party to replace Tony Abbott as the Liberal Party leader. Today, Malcolm Turnbull became the Prime Minister of Australia.

While many in the public will be welcoming of Malcolm Turnbull's style and less conservative politics, it appears that he has kept some of the more conservative policies of the government under Tony Abbott in topics such as climate change and same-sex marriage in an attempt to appease the conservative members of the party. As such, it remains to be seen whether his government will be significantly different to the government of Tony Abbott in the future. Unfortunately, whoever the PM is, I don't think there will be a move to discontinue the plans for a new medical school in Australia, even though that is a really silly thing right now when final year medical students are missing out on internship places.

The next federal election is due some time next year.

[update] The last MDSC reflection/e-Portfolio reviews ever!

I just finished my last MDSC reflection/e-Portfolio reviews ever! As usual, this seems to be a rather tedious pass/fail assignment where we are required to assess other people's e-Portfolios, which is another tedious pass/fail assignment in itself.

You might be surprised when comparing with the length of my standard blog posts, but I managed to add many meaningless words and sentence structures in order to drag out the reviews to reach the word count targets. Unfortunately, I am unable to share them here as they may get plagiarized.

[update] American Heart Association Conference acceptance

One of the abstracts we submitted to the American Heart Association (AHA) conference got accepted! I was the second author on the abstract, but I will be going too. It will be an exciting opportunity to be able to go to a proper international medical conference to present and see other people's research. It is great timing too; after our classes finish, and before our graduation.

It was quite a surprise that this particular abstract was accepted though. We thought that some of our other abstracts were more interesting. In the end, it seems like a lot of things with regards to conferences and publications is based on luck. Then again, that is true with many things in life. I have a saying: "Life is like Angry Birds. Some things are easy. Other things require timing, strategy, dedication, and luck."

I hope to be able to present things in more conferences in the future and get some publications as a doctor.

[update] Intern offers

About a month ago, I got my PMCV (Postgraduate Medical Council of Victoria) intern offer as I was a local student in Victoria. I didn't get St Vincent's which was my current clinical school, but I did get a network which is close to my home and my second preference, so I am reasonably happy about it.

The priority two applicants for PMCV (international students studying in Victoria) got their offers two days ago. Some people have received offers but many have not. Yet with all the tsunami of medical students and not enough internship places, the government still plans to open a new medical school at Curtin! Despicable...

[update] SS2 over, student conference next week.

The past week was the last official week of the scholarly selective program for research. Overall, although things were a bit uncoordinated at the start, I have enjoyed research. Separate to the scholarly selective requirements, our research group has submitted some abstracts for the American Heart Association conference, and I hope we can present there and get some publications later on.

I have printed out my poster for the student conference. Right now though I am still working on my journal monograph. This is probably the tedious part of research apart from ethics approvals... but I guess it has to be done. I hope to be able to write a few more to get more publications too; we have done the analysis required to do so, although AHA does have an embargo policy if we do get accepted. We'll see what happens.

Running and jogging tips for beginners

For several years, I had been trying to get into jogging or running as a form of fitness and exercise. However, initially I always kept getting knee injuries when just jogging about 5 km. Now I think I've managed to sort things out on the injury side, and right now I am jogging about 21 km per week.

From http://www.freestockphotos.biz/stockphoto/15257

Anyway, here's a few things I wish I knew earlier, and some general tips:

• When you run, there's a few things which can limit performance. In my simplified view, I break them down into cardiovascular, muscle conditioning, nutritional, hydration, and injuries
• For the first two, cardiovascular and muscle conditioning, they will probably improve with more training.
• For the hydration, it's important to drink enough if when you run. Heat stroke is very bad!
• If you run longer distances (> about 20 km at a time), electrolyte drink is good to have as a source of sugar (energy), salt and water to replenish losses from sweat. Personally I mix my own. I used to use similar proportions to that found in standard electrolyte drinks for sports, but now for my usual training I cut the sugar in half because I am trying to lose some mass (that is, weight divided by g for those sitting the GAMSAT, or just "weight" for laypeople) and still don't feel like I'm running out of energy too much.

Now for injuries:

• Stop if you have an injury; you don't want it to become more serious and long term
• While technique and footwear probably play a part, in my experience, footwear is very important.
• However, even if you get injuries with your current footwear, it doesn't mean you need to change everything. One of the things I learned from sitting in consultations in GP land is that insoles are very useful too. In fact, when I changed my insoles in two different pairs of shoes that I have used, my injury rate went down substantially. It wasn't even an expensive pair of insoles either; in fact they were this pair: http://www.ebay.com.au/itm/Men-Gel-Orthotic-Sport-Running-Insoles-Insert-Shoe-Pad-Arch-Support-Heel-Cushion-/141323894352
• So to reiterate, it's the combination of shoe + insole (and probably socks) which is important. If you are getting injured and notice your foot rolling in or out, it's probably good to get different shoes or insoles to correct that specifically to avoid injuries. Otherwise, it might just be cushioning... but probably experiment a bit until you find the right shoe + insole + sock combination (if injuries persist, get some professional advice)

Yes... I really wish that I knew about the insoles earlier! That said, I have ordered some new shoes because I am running longer than I used to. Hopefully they're good.

Finally, you don't need to run too much, or every day. Any jogging is good! In fact, although studies have been variable, this study suggests that 1-2.4 hours per week and 3 times per week or less is associated with the lowest mortality (less than or equal to 1 time per week has the same hazard ratio for mortality as 2-3 times per week) http://www.ncbi.nlm.nih.gov/pubmed/25660917


Disclaimer: Although in general the benefits of jogging outweigh the risks, I accept no responsibility for any harm which may occur from following any guidance on my blog. If you have recurrent injuries or chest pain etc, or a family history of sudden cardiac death, seek medical advice.

[update] Intern applications etc

It's been a while! This semester, I have been quite busy with research. I am enjoying the research so far, and I hope to be able to publish something in some journals and present some research in conferences. We'll see.

Right now we are going through the intern application process. I have applied to several places in Victoria and interstate. It is quite a tedious process in Victoria with all the cover letter writing and applying to almost all hospitals directly as well; as well as most hospitals having interviews. Ah well. It should be good practice for my essay writing and interview skills.

One of the weird things is the idiosyncrasies of various HR staff and admin staff. Sometimes they seem to be rather inconsistent. Much like ethics departments. It would be slightly amusing if it wasn't annoying.