A clinical focus...

So, over the last month or so, me and one of my good friends have decided to stay back after our compulsory ICM (Introduction to Clinical Medicine) tutorials with our awesome doctor, who kindly agreed to letting us tag along for the remainder of the afternoon. Over the weeks we've decided to make this permanent, since we've actually been learning a lot and getting significantly more patient contact than if we just sat on our bums and let all our clinical experience come from our ICM and PCS (Procedural Skills) - a total of 3 hours per week. In addition, the last few weeks have been difficult in terms of integrating the content of ICM tutes and patient contact, as we've been doing all the sensitive topics - the reproductive system and other things like illicit drug histories; so we've only had a couple of patients over the 7 weeks we've had of this semester. A few events that transpired today were quite noteworthy, and I will remember for as long as I live: (a) I was walking out from the hospital after ICM with my friend when I turned my head casually, just looking around, when I noticed a lady lying on the ground, spread out with a car stopped a few metres behind her. Fearing the worst, my friend and I rushed to the lady, who did not in fact get run over (and in this situation I was quite perplexed, for I was sure I didn't hear any screeching or noise generally accompanying a motor incident) but instead was lying down as a protest, determining not to budge as she didn't get the medication she wanted from the docs. I never really followed up on this, as another lady who she knew got her back up and convinced her that this was not the right way to go about it. (b) I was on ward rounds when, a few metres away, there broke an altercation between a patient and her doc, the patient demanding to know why her medication was reduced. The doc tried to explain but was probably a little bit tired or somewhat out of it, accounting for her snappy response and not as-friendly-as-demonstration-doctors-in-teaching-videos are, resulting most probably in.... (c) a MET call on the same ward; at the time we (my doc, a resident, my friend and myself) were attending to another patient in a different room; it turned it out that it was that same patient who probably did not receive a response she quite liked and decided to protest against it by trying to hang herself. From this, I saw first-hand the lessons of PPD (Personal and Professional Development) which included the fact that (a) docs can be snappy, and because of this, could lead to (b) an emotive, distraught patient doing things that are not good for themselves or anyone around them. Reflecting on this, amongst my friends and those who've met me, I'm often considered a very even-headed person who is slow to anger and is generally helpful; but I know that, especially in times when I'm exhausted, I become really apathetic to anything not concerning some shut-eye, and I don't know how or even if I can prevent that. Something to think about, perhaps.

In another related thought, I've started to see myself less of an annoying medical student and more as a part of a healthcare team. The ward rounds have somewhat impacted this shift in attitude, but in addition to that, one specific thing: me and my friend (yes, the same one; we're good buddies, hehe) were on our own, going to interview an elderly patient. Only a couple of minutes into the interview, the patient suddenly displayed signs of distress due to some chest pain. Whilst my friend went to get a nurse (as the patient said she thought she had heartburn), I went into autopilot, doing a pain history just to make sure it was really heartburn. A small and insignificant event, you say? I agree as well, but I think that helped me remember the whole point of being a medical student; in the midst of the studying, the shrieks of disgust when viewing rather horrendous skin diseases, the procrastination and the enthusiasm of discovering new differential diagnoses, I often forget the "medical" part, and I just feel like a uni student, studying to get good grades, to pass and hopefully do honours. Stuff like this makes me feel more relevant when talking or doing exams on patients, and less like a really useless accessory walking around the wards with nothing to contribute.

This is shaping up to be an interesting year.

As an update on the UWS student union elections, I was voted in as the Campbelltown Chair for the 2010-11 period. I think this year will be very interesting; both on campus and personally, as I figure out how to balance studying for medicine and aiming for at least a Credit (I want to do Honours, not for the additional letters on the end of my degree, but rather the experience; I don't really mind not being awarded an Honours afterward if I don't meet the 5.5 GPA requirement), whilst doing my best involving myself with student life and organising activities on campus. I often wonder at how students like Ross Roberts-Thomson (AMSA president) manage to balance their own learning process and such a huge responsibility like that position; in a sense, I hope this chair position for me will teach me time management skills, as well as prioritisation and drifting away from procrastination.

Speaking of which, I've found recently that my interest in computer games has dropped, compared to last year. It's something about the countless hours essentially wasted on a game that really got to me, as I realise the importance of other activities. In my view, even movies seem more of a worthwhile time-waster than games, with an opportunity to discover something new, something hopefully thought-provoking. Issues like religion and politics are starting to take huge chunks of my dedicated 'wind back and relax' time (no, I'm not insane, for me these are genuinely relaxing topics), and I'm finding that it's helping me mould my views on the world, hopefully for the better.

I'm toying with the idea of moving on campus next year and going to Campbelltown Hospital; the idea of moving away for a while and learning essential life skills (I know the basics of ironing, but it still takes me 10 minutes to iron a shirt well) is attractive to me; unfortunately, the cost of obtaining said lessons is not so. Moving onto residence may help me continue to be involved in campus life next year as well, even if not as a chair. Oh, so many thoughts, so little time.

In the meantime, whilst my mind is rattling off somewhere in the great beyond of next year (my mind tends to do this at most inopportune times; I have an amusing navigating story that I shall unravel later), exams are only 3 weeks and 5 days away. This has been the busiest semester so far, and once again, it will be interesting for me to see how much I can learn, re-learn and summarise in this relatively short time. Since there are still PBLs going on, my study would most probably be hopping around between renal and neuro, in addition to completing my part of a group EBM (Evidence-Based Medicine) assignment and finishing my week's PBL notes for my group to use as study material.

Should get off Blogger and start studying, shouldn't I?

The University Experience

I'm not quite sure whether this is the phenomenon in other universities, but for us at UWS, our cohort in medicine tends to be pretty friendly but also insular and exclusive to our own cohort. This may be due to various factors, such as different starting dates of our course versus other courses in the university; the geographical proximity of the rest of the university from our building; the self-sufficience of our totally awesome building; or simply that we can't really be bothered extending ourselves socially to the rest of the university when we seem to have no reason to (after all, having 400+ potential friends to meet and greet is quite enough). Thinking about how 'student life' is promoted so heavily as a strong point by my friends who attend other universities, I can't help but see that my own personal view of UWS as a university without much 'student life' could simply be due to my own indifferent attitude to involving myself in it, and thus, having no idea as to what could be either offered, or initiated. As a comparatively young university, with a comparatively young student union (after the last one went insolvent...), I see the 'lack' of student life as an opportunity to innovate, to be involved, and to improve this ourselves. The pre-clinical years of our course are hardly contact-hours heavy, so we do have some time to pursue this. Our own UWS Medicine Society is, in my opinion, brilliantly run, with a dedicated Executive and other involved students who are really keen on enriching the extracurricula experience of university; this does not line up with what is happening at the moment. This is why I think that the upcoming student union elections at the end of April will be an important turning point. I've joined a very keen and energetic team of students who call ourselves 'Action!' - an initiative to turn this around. Med students can exert an enormous effect on the university, simply by voting in the elections - getting the most enthusiastic and innovative students into the union, allowing them to change the blase attitude held by those in office now, and to think and act for the benefit of the students.

My friends that attend those other universities joined endless strings of clubs on O-Week. They did not bother to follow this up; and considering their circle of friends are still the same, I struggle to see how they could boast about student life. Taking action and being involved will do far more than sitting on the laurels of those coming before them.

So how do I begin...

My previous blogs have all fallen in a state of disrepair, forgotten and alone in the little corners of the vast cyberspace. So here I go, restarting afresh, anew, and hoping this will not end up disused.

A little introduction is necessary: My name's Luke, and I'm a medical student at the University of Western Sydney (UWS). I, if not undertaking the Bachelor of Medical Research or repeating a year, will graduate in 2013, as the MBBS degree at UWS is 5 years in length. I decided to start this blog on a spur-of-the-moment, hopefully sharing my experience as a medical student here in Australia. To understand where my opinion henceforth is based upon, heres a little of my background:

~ I'm of Chinese descent, though my parents were born in Malaysia and I was born very locally (Westmead Hospital in Sydney, NSW, Australia) and raised my whole life in Australia. As such, I consider myself pretty Australian, though I am pretty hopeless at sports, contrary to the stereotype. I come from a low-middle class background, and I'm the first of my immediate family to go to university.

~ I entered medical school in Australia by a rather typified method: through OC Class, Selective School, HSC marks, UMAT, and an interview. I entered med school straight out of high school, and though there are reasons not to do so, I don't regret it at all.

~ Culturally, the pressure to achieve academically, for me, was fairly high, which is probably not unlike most medical students in Australia. However I procrastinated a lot, also not unlike most medical students in Australia; so it's kind of ironic to enter a career where maintaining academic effort is of extremely vital importance.

~ I consider myself EXTREMELY blessed to have entered medical school in my first attempt, straight from high school. My procrastination was the bane of my parents and as a result I did not score a 99, or even 98+ UAI (seen by many as a given for medicine in Australia), I was a Greater Western Sydney student and thus had local advantages given by UWS to encourage local students, I was only offered my spot in the Late Round of UAC Offers (University entrance offers), and it was a Bonded spot (requires a contractual obligation to spend 5 years after specialisation, working in a District of Workplace Shortage - i.e. where there are not enough doctors of your speciality). So I guess this can give some of you hope in regards to medical school entry.

~ I was and still am really keen on Medicine. Along with the altruistic nature of the profession, Medicine ticked my boxes because it was a secure job with a decent pay, was extremely broad and yet you could find a speciality that could occupy your entire life, was one of the few occupations where there is continuous learning and expansion of your knowledge, made my parents quite happy, was a field where I had an interest in (my other interest is Computer Science), and allowed the undertaking of responsibility of lives but also the privilege of being able to treat patients and play a significant role in their lives. In exchange, I considered the rather long hours, lengthy time to finish training and specialising in comparison to other courses, high stress and emotional situations, and a huge amount of (expected) study for the rest of my life, but they didn't deter my decision. It is important to see whether another career/degree suits you better, although in my case I'm overwhelmingly happy with my decision. This will hopefully not change as I progress through the registrar years, and I hope not to become a disillusioned junior doc in the future.

~ I keep an open mind towards anything and everything, including country practice, all types of specialities, conference attendance, anything. So I will hopefully cover a large spectrum of the medical student experience in Australia and in particular my university.

That's probably enough introductory information to show where I''m coming from, so I'll leave it at that. I hope this blog will have two purposes: firstly, to share what I have gathered through personal research and communication, and secondly as something to look back on when I am old and grey. So thank you for dropping by!