I'm Trying Hard

If you are a quiet type of person, with tendency to think much and say little, prepare to be interrogated by your PBL tutor. It doesn't always happen - some PBL tutors are nice enough to realise that you try to contribute and give you a pass mark (PBL marks are formative and only matter if you actually fail it or borderline failed your exam; in which case it can act as a vote to keep you in the course). Other PBL tutors are smart enough to realise that you only contribute when there's something new to add to the discussion, and keep quiet when the basics are being discussed by 10 (most likely) extroverts heatedly. I actually like PBL. I love how we get a new case every week; I love how everything is centred around a particular case, thus focusing the learning and giving it some sort of clinical perspective. I don't love how my PBL tutor has to give me a talk every second week about contributing. I'm not by nature a selfish person; I don't keep things to myself when I think they can help the group. So to be "talked" to is rather annoying, and rather pointless on the PBL tutor's behalf. The other thing is that I'm not particularly smart or hard- working compared to my cohort; nor do I have any relevant knowledge when it comes to PBL discussion (e.g. having been held back a year, or having done some sort of Science in uni - Science in High school barely counts). As a result, I don't exactly have much in the way of unique contributions to add. Because I'm really sick and tired of these end-of-PBL talks, I'm going to change this because this is clearly one area I can fix (I can't fix my personality) - I guess it will probably prepare me better for our exams too. It's just grating that it has to come to that; and moreover, I love how our group is active, talkative and quite knowledgeable. *Sigh*
On a happier note, yesterday was UWS' first Open Day for '10 entry (I think we have 3 or 4 Open Days, at various strategic times). Volunteering was quite fun; there was plastering and talking to various interested parties about our experience in Medicine and entry into the course. Lunch was pretty swell too; above standard fare I'd say. Ironically, I still haven't met the entire grade - shocking I know. So I talked to a few first and 2nd/3rd years that I hadn't met before; twas cool :) Finally, we got a little gift voucher as a token of appreciation by the university, and our Open Day T-Shirt - except they thought I was part of staff, so I got a staff polo shirt instead, hehe. I really shouldn't have kept wearing it though (as well as the lanyard with the word "Staff" in huge lettering) - when I walked into Best and Less, I was assumed to be a member of their staff.
And oh hey! Last day of Winter!!!! Yippee - today morning was such a stark reminder of the Winter season, I even wore my beanie. Then again, it was 7 oclock in the morning...

So Tired...

I thought I'd name some of my posts in honour of several of our PBL cases. So this one's an appropriate one to start off with. PPD today - a 3rd party recollection and informal presentation based on our patient barriers to care interview - was alright. It kind of killed the mood for the day though - 2 hours listening to person after person speak; it was HSC English speeches all over again, except a little bit more interesting, haha. I did concentrate though, which may or may not have been the right thing to do, as I was phased out for the rest of the day (it was first thing in the morning). I think our PPD tutor is getting better (obviously, no names); he genuinely does care, although presenting with a few rather conflicting ideas. Our next two sessions are all going to be about talking about ourselves. And our life experiences. YAY...
I've found that taking a few lectures off and a friday PBL session really knocks you back hard in terms of keeping up with what's happening. Everyone is talking about the cardiac cycle this week, and I feel that I don't really understand them. I'm not exactly a model student, but I do make a serious effort (this is medicine after all) - this kind of thing worries me; not because of whether I'll do good in an exam or not, but rather just the feeling of inadequacy. I guess one gets used to it as the entire field is littered with over-achievers; but still, it is nice to feel like you know something.
ICM though was once again as interesting as always. We had a patient with an arteriovenous (i.e. arteries and veins) fistula (a bulge or protrusion) in his wrist; the turbulence in the vessels was so noticeable, both via a stethoscope and by simply resting one's fingers on the area. We started the cardiovascular system exam; I do feel like we're making serious progress in ICM, with the abdominal exam out of the way in just a few weeks, cardiovascular for these few weeks, and probably respiratory in the weeks to come before our big OSCE (clinical examinations). ARGGGH SCARY
It's before our theoretical exams, in October. So close. Yikes.

Fun fun fun

Today was the funnest day in our course so far. Even though I was half-dead thanks to a(nother) throat/lung infection (it seems to be a side effect of my pneumonia from years ago), today was the best day ever, and there's only one phrase to describe it: practical practicals.
Why the tautology, you may ask? Because some practicals are not practical. But the practical practicals are the most fun, because you always see the whole point of it. It's the reason most (I say most, since some nuts love all that biochemistry, which is fine; each to their own heh) of us go into medicine; not to be a medical student, but to be a doctor.

So first off, after the morning dose of Vitamin C and Panadol, we had a Blood Pressure practical. Awesome. And then everyone took out their steths, and I think we were quite excited and all to start using them (although some groups in ICM seem to have used them right at the start of semester...). And then we hooked up a sphyg...(two seconds)...Sphygmometer (the rest of the nuts who don't love biochemistry do Medicine purely for the long and difficult-to-pronounce words) into some PowerLab equipment with input ports. And then we took our BPs. Multiple times. Above our head, at level with the chest, below the chest, it was all done. Eventually the excitement of measuring BPs faded off, before turning into...

Anatomy Excitement! Behold, the most important organ (according to cardiologists at least, from Talley and O'Connor) of them all; the heart! I'm not sure about you, but I've never dissected anything before. And today we got super-sharp scapels and sheep hearts to rip open! We also seemed to have a lot more surgeons in the lab than usual, so I was in a group of three who were supervised by a surgeon (I think; we were too engrossed in the heart to pay attention to his tag). Or, in other words, pure awesomeness.

I need to recover from all of that excitement, not to mention my infection. So I think I'll just do a brain dump into my notes from today, and take a nice, long, nap. zzzzzzZZZZZ...

ISAN09! Rawwwrrrrrr

I'm pumped for Sept 5&6, because UWS' School of Medicine is hosting a satellite meeting for ISAN09! ISAN is short for the International Society for the Autonomic Nervous system, which has it's biennial congress in various cities - this time around it's in Sydney. If you have no idea what the Autonomic Nervous System is (which is in the second week of our PBL), it's the part of the nervous system that controls all the non-voluntary, or autonomous actions; such as regulating blood pressure, sweating, etc - essentially keeping our body's internal environment constant (a concept which is also introduced at about the same time as the ANS). So, being a first year med student with little idea on the ANS, I jumped at the opportunity to attend this meeting, as well some 20-odd students from our course, which our school provided complimentary registrations for. Happy happy happy :)

In other news, I'm always constantly surprised at how med students manage to keep the drinking culture alive, whilst learning about the very unpleasant side effects of binge drinking (defined as 6 or more standard drinks, which, ironically, seems to be about standard for a regular meddie's night out). We were introduced in ICM today to the alcohol screening test - a quiz with some quite heavy-hitting and personal questions (such as: how often do you drink 6 or more standard drinks, has anyone been injured due to your drinking), which may be a non-issue for non-drinkers (like me! yay!) but a significant issue for those who've relied on that 'liquid gold', as we discovered during patient rounds...
It's not like alcoholics don't know what they're doing; its just our culture; our 'mates' positive perception of alcohol, it's place in common culture as a synonym for a good time. Unlike the smokers who get really bad rep, the alkis are getting none. And, sadly, its always 'I am going to stop' and meaning it, but much of the time, being unable to stop the cycle until they meet a doctor, or the pearly white gates.

Anyway, anatomy practical tomorrow! Yippee! Nothing like a quick (2 hours?) squizz at cadavers to brighten a week up :)

Time passed so quickly...

I've always known that talking with a few of your best friends can take up hours of your time, and you don't realise it. It was a surprise to me though, that our patient interview for our PPD assignment went by so quickly. We (me and my partner for the interview) interviewed a really nice couple who lived in a self-contained villa in a retirement village; time just flew by as we listened to them talk. There were a few interesting things of note; they seemed quite satisfied with the public health system; the husband was in hospital many times and was really happy with how he was treated. So that was a really good thing to hear :) They were also happy with the retirement village and the social activities provided; something I will be mentioning to my parents in the years to come, as an option in the future (for some reason, my dad is very pro-retirement village, whilst my mum is very anti... I wonder why). The last thing I thought was notable was how positive they both were, how happy they were to have us over, and were in high spirits; this despite the significant medical conditions they had (over a dozen between the two of them) and their relatively moderate socioeconomic position.

That was pretty much the highlight of the day. Our 2-hour liver practical was a pretty hard slog (not an anatomy prac, just going through a program in our computer labs), and the PPD tutorial before that (discussing death and how it impacts patients and us) was quite intense as well. Follow that with two more lectures in the afternoon, and so it was with delight that, upon reaching home, I took a nice long nap. Ahhhh....

ICM this week was unremarkable, save for one spectacular patient who let us (all five of us) do an abdominal examination on him. I felt pretty bad once we said our goodbyes though, when we saw another group waiting outside, inevitably about to ask him for permission to examine him...eek. There seems to be a lack of patients willing to allow us to do physical examinations; I'm guessing part of the reason is the invasiveness of the procedure, compared to history taking. So for the patients who have allowed us to practice our clinical skills, and who will allow us in the future, I am really grateful. Our ICM tutor is awesome, she's learnt all our names by heart already! I wish we could just keep her for the rest of clinical teaching; it appears that ICM tutors can be a mixed bag, which is a shame.

On that (sad? disappointed?) note, PBL seems to have lost it's lustre. The excitement of diagnosis has, much like House MD episodes (at least, to me), vanished. Then again, interest in medicine shouldn't be propped up by styles of teaching; but yep, PBL seems to be more about learning issues related to that case (which is what it's meant to be) versus the case itself. If that makes sense. Which I'm sure it doesn't. Anyway, speaking of PBL, I should be working on the first learning issue for this week...