Keen as keen can be

I just finished my first week of my clinical rotation in cardiology.

It was the most freaking awesome week I've ever had.

The first couple of weeks in the first clinical year are where you find all the super-keen students; everyone itching to learn the mundane tasks of writing in notes in ward rounds, learning how to do discharge summaries and *gasp* cannulating patients! Except they are far from mundane right now; everything is new, and everything is exciting. Write in the next patient's notes? What a privilege! Asked to interpret the patient's ECG? Wouldn't miss it for the world! Want to hold the patient's charts? I could hold it all day and night!

Okay, so I'm probably just a little bit abnormal. But the buzz of starting the hospital rotations has not really left, and I sure hope it continues for a good few weeks. This honeymoon period is what I need to catch up on my laziness in the last couple of years, making it up by focusing all my efforts on learning what I need to understand to best understand the patients now under my team's care.

There are of course a few things that I've garnered from this first week. The most important thing was that I realised I would've benefited an enormous amount if I had exerted as much effort studying in the pre-clinical years as I am sure to do this year. This is, in hindsight, quite a difficult thing for me to have done because there was not really as much stimulus to study (i.e. no patient list to care for), but nonetheless, I keep thinking about all those hours gaming away and feel it's just a little bit lost. Oh well. This is one of the reasons why I don't like super notes (which are like condensed study notes produced by students in the years above) for PBL cases (and subsequently never used them); it takes away the (imaginary) patient's role in stimulating learning, and I think that is one of the key advantages to a PBL-centred course. It doesn't last very long, true, but I think that part of the reason is because classmates begin to use supernotes, so discussion begins to be a little bit hampered by the fact that, in essence, the PBL tutorials are rendered accessory and auxiliary. The second thing I realised was that it would be difficult to then revise all that pre-clinical stuff if it was never really absorbed well, since the clinical side has now taken over and many questions to registrars are along the lines of why or how questions, as opposed to the what. The third thing I've realised is that, paradoxically, I'm now playing more piano than I ever was. Random, yes. Applicable, well... I consider piano-playing to be a form of productive procrastination, like wikipedia (as opposed to, say, eBay, or watching toddlers pinch each other). So my procrastination (if any) seems to now take a more productive form. Which is a nice thing to happen. It's a phenomenon that many may experience throughout their periods as a student; the more pressure there is to complete a task in a limited amount of time, the more likely it is that the amount of time devoted to that task is increased. A rather curious phenomenon indeed - but something I'm going to take advantage of; 50-hour weeks are shrinking my potential study time by a good amount.

Oh, and I've still got extracurricular roles back at Campbelltown campus and UWS in general. Well, at least I don't have to cook.

And off we go!

I've got to say, the standard of teaching seemed to have increased dramatically from second to third year. That, or my attention span increased as well, because there were few times when I actually caught myself not paying attention - which was just as well, given the important details that we covered over our first Conference Week.

Conference Week was not as crazy as I first imagined; we did get breaks for lunch and there was a good balance of workshops (small group and practical learning) and lectures. The workshops were overall a fantastic experience - we covered lots of practical things from reading ECGs and X-rays to revisiting resuscitation, physical examinations and oxygen marks, and definitely were the highlight of the week. The lectures were overall pretty great as well - interesting and important stuff on managing fluid levels, suturing, communicating with Aboriginals, and shock, and filled with case studies to increase clinical relevance - the only ones which I thought could be improved were the cardiac lectures, in which a lecturer was droning on and on, reading off slides. Which brings me to another good aspect of the conference week - the last half-hour where our Year Co-ordinator hosted a feedback session on everything done in the conference week; great to hear the whole grade (in one of the rare times we're together) chip in on what could be improved and what should be included, and an excellent demonstration that the School held our feedback in high regard.

In contrast to the brilliance of Conference Week, O-Week for the Medicine in Context (MiC) students (i.e. me) wasn't so flash. Maybe it was because we had, in effect, two days off (one day, as you know, was Australia Day; the other was a 'call-your-MiC-supervisors-day'), or maybe because the E-learning lab that we were in was freezing (I brought a jacket with me the next day, people that saw me on the train probably thought I was crazy because it was so hot, even at 9am). Whatever it was, it wasn't as inspiring as the Conference Week. Nonetheless, there were some key highlights - a seminar on Child Abuse which was very well delivered and gave us a lot of new information, presentations by a fourth-year student on MiC, and a rather amusing session on grammar and the use of apostrophe to indicate possession (in amongst how to write academically, of course - grammar was not a lecture by itself). These were the only real gems I could remember from the week, however, as the remainder was about library resources (an important thing to know about, but rather droll and not as informative as we would've hoped - there was also another session on this in Conference Week), and why MiC was so great. The consensus opinion seemed to be that they could've packed a lot more into this week for us, as the students starting Medicine and Surgery rotations were going right into their teams from mid-day of the Monday of O-Week.

These couple of weeks, I was also hard at work co-ordinating O-Week efforts for Campbelltown campus. The student society at Ctown, Engage, finished technical details with setting up a web presence (at engageuws.com.au) and so I was busy updating that and working out details in our forums on Australia Day. We also had a couple of meetings to determine activities for O-Week, and I also had the UWS Chess Club (which I also run) to concern myself with. Both of these (and the Chair position I have with the student union) will be dropping off in the next couple of months, as I cannot see how this is very sustainable; but it's still an exciting thing to be part of, and if I could go back a year, I wouldn't have changed a thing. These efforts, though, conflict with me reading a 70-page document on guidelines to treating hypertension. Which is rather droll, I might add (and you might expect) - and which I should be finishing off now. These two weeks mark the end of the orientation, and so for the next ten weeks I'll be on my rotations for disability and mental health respectively - and am looking forward to learning a lot more about the services that cater for these tremendously important areas of health. So, until next time :)

Summer times!

So, a couple of days ago, I finished with exams, hoorah! The actual exams were a kind of mixed bag...once again, an SAQ (Short answer questions - marks ranging anywhere from 1 through to 5), MEQ (Mini Essay Questions - generally short questions based on a scenario, in total worth 10-20 marks per scenario, 7 questions), and two MCQs (Multiple Choice Questions - yeah, I'm sure you're all more than familiar with them). Found the SAQ and the last MCQ difficult, MEQ and the first MCQ bearable but only slightly - which hardly raises my confidence levels, but what the heck - its OVER! Celebrate! *party poppers!* *streams of paper cover the room* *smiles all around*

Shame we had such a party pooper for our main supervisor in our last exam. Was really rather strict about no talking after the exam... I know, that's what is meant to happen, but it is nice to smile around, mouth "how did you go?", mouth back "omg that was so hard" and grin without being scolded for it.

At any rate, with the holidays now here, endless opportunity abounds. I could continue to learn guitar, start learning mandarin, maybe read some medical journals or finish summarising Boron... or continue dreaming, continuing procrastination methods, starting new games. Hmm. Endless opportunity... I would like to be optimistic these holidays, and believe I will at least moderate the two extremes and meet somewhere in the middle, like the good negotiator I am now supposed to be after intense training in student politics. I guess one can only simply start doing it rather than think about it, since thinking about it rarely leads to anything productive (for me, it leads to a game of minesweeper - reaching the 100 second mark on expert btw). Speaking of student politics stuff, these holidays will most likely represent my only significant chunk of time I can dedicate to it for this and next year; I'm getting the feeling that things like extracurricula are going to have to take second priority and be slotted in amongst the clinical attachments, which is probably a feeling amongst almost every full-time worker in the workforce; that everything seems to take second priority after work. Mulling on this, things like a family and religion may become difficult to maintain, and time management is really a rather critical thing to learn when young; when you hear statements like "your most precious asset is time", you think "hey, that makes sense, I agree!" but in real life I think that I, personally, forget about that, especially when procrastinating. Value your time, for it only comes around once...

On a more interesting note, I've just got wind recently of an exciting new project happening at UWS! A person that I'm working together with as part of the Campbelltown Campus Life Committee (mostly UWS Staff, and the sole student rep, me) is heading a new inter-professional project, whereby students of different professional pathways (Occupational Therapy, Physiotherapy, Nursing, and of course Medicine - with a few more maybe added in together) are mentored by professionals of their own chosen pathways, as well as of others. The goal of this project is to foster holistic, integrated and thus (hopefully) a better standard of healthcare in our future professionals. I'm not entirely sure as to how much I can reveal, but essentially, the sessions of the project would occur in an integrated clinic that already exists, whereby clinicians take up students and guide them to facilitate the treatment of real patients, rather than be a wallflower and observe passively. This is the most exciting thing of this development - more clinical exposure, to better prepare us for the future! A friend of mine commented on how this would have been great if it were introduced earlier, seeing as my cohort will be in full-time clinicals next year anyway; but nonetheless, it will most likely be a wonderful opportunity for the future students at UWS. Hopefully it goes to plan and produces some positive results!

Anyway, I hope you have an awesome break, especially those of you who've just completed the wonderful journey that is secondary school, and I'll see you around!

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...

What a day.

Today, I managed to miss Macarthur (which was one stop from Campbelltown). Let me explain - there's no direct train from where I catch the train to get to Macarthur - our uni's unofficial train station. So today I would catch a train to Campbelltown, the station everyone thinks is the end of the southern train line, and catch a train from Campbelltown to the 'real' end of the southern train line - Macarthur. This train doesn't stop at Macarthur though, it heads all the way to Moss Vale, which is approximately 40 kilometres away. Me being me, I managed to miss that one stop, and ended up at Menangle Park, the next stop. Herewith, upon finding the next train was an hour away, and thinking that one stop would be approximately 2km or so, I hatched the brilliant idea to walk back to Macarthur. Boy, was I wrong. The road that appeared to follow the train station turned left...and then turned left again...and there was no end in sight. So after 20 minutes I arrived back at the station, caught the train back to Macarthur, and was on my way.

Our first real anatomy practical was pretty super (abdomen/groin region) - having surgeons/surgical registrars were pretty cool, they were really knowledgeable and knew how to teach (very important, one would think), so yeh pretty awesome. Only bugger was that whenever they'd ask some questions about stuff, they'd draw a blank look from us and in general, we felt very stupid. We also did some surface anatomy, though only for a half hour or so.

We also got exam results back - I passed with a 60 average, but as a result, was in the bottom 3rd of the cohort. Still satisfied though, gave it a fair amount of effort and will be looking forward to improving that result. I felt that my mark was quite equivalent to my effort in the HSC, maybe a little more (so, ATAR of about 98 as a guesstimation) - obviously theres not really any comparison, since there are so many other factors that come into play, but that could give an idea as to what to expect. Looking for a 70+ in the finals so I can even up with a Credit average for the year, so I've got a big task ahead of me... *nods*

Our first physical examination for ICM was also pretty interesting...pity our patient though, who persevered with us (well, only one of us was performing the examination, but I digress) for an hour as we learnt how to percuss (tapping the abdomen, listening for the resonance of sounds to indicate hollowness and the presence of liquid and solid) and to palpate (fancy word for using our fingers to search for organs), and were assured (or amazed?) at our tutor's statement that the entire examination should take, at most, 5 minutes. Which reminds me, I should be writing up some notes so I can recollect what she said about signs and symptoms...

I also got email notifications that my stethoscope had been sent via Aus Post today, and my order for textbooks from India (about $50/textbook inc shipping) got processed. Also got my Talley and O'Connor clinical examination book yesterday, and found out that I really did not have any book-contacting skill anymore :\ Lots of bubbles and even a few jagged edges. Bleh. So yeh, exciting couple of days :)

A review of the first half of Semester 1, Year 1

This should actually be a much larger post, since the beginning is pretty memorable, but I'll condense it since I'm posting this at the end of Week 1 of the second half of semester 1 (wow what a mouthful).

So our first week begins with a whizbang (or perhaps not) introductory lecture by UWS Medical School's Dean, Neville Yeomans, to which our parents were invited. Made new friends, found some old ones, and the rest of that. We then had an introduction into the PBL style of teaching, which I had much forewarning about and so wasn't really that revolutionary; and then a series of lectures on what it means to be a doctor, ethics, morals, and all the rest of it.

The rest of the first half of Sem 1 was pretty much an introduction to all things medicine. Our lectures were mostly named 'Introduction to MRI', 'Introduction to Pharmacology', 'Introduction to Communication Systems in the body', etc. The UWS Course has two main components; Foundations of Medicine, which you could call the science side, and Personal and Professional Development (PPD), which you could call the humanities side.

Those components are covered by a week-long Problem Based Learning (PBL) case study (Monday being the introduction to the new case of the week, and Friday being the debriefing of that case), as well as lectures, practical sessions which were all in the computer lab for this first half, our ICMs (Introduction to Clinical Medicine - one 1.5hr session per week at a hospital as part of our clinical experience) and later on, dedicated PPD sessions.

So the PBL style of learning is essentially studying a fictional case of a patient who presents (or comes in with) a certain symptom, upon which we would hypothesise over reasons for the symptom (i.e. diagnose), note down anything we didn't know about the case that we should need to know (Learning Issues, or Objectives), and going away for the week to research by ourselves on the case. Lectures were generally related to the case of that week, which provided a little oddity in that we could predict what the problem with the patient was by deducing information from lecture names, hah! Then on Friday we would gather back and report on what we've learnt, and find out (a) what the actual diagnosis was (which is usually not a surprise by Friday), (b) what the official Learning Issues that UWS wants us to know are. PBL Groups are groups of around 10 people, with 1 tutor who is not a 'content expert' - i.e. we aren't meant to ask him/her about details of the information in the case (such as: "Is this really a myocardial infarction?") because he/she will reply with "I don't know, maybe you should put that up as a Learning Issue", heh..

Over the cases we had in that 1st term, we covered a host of things such as epilepsy, spinal injury, myasthenia gravis, anaemia, heat stroke, and sunburn, along with many others due to the broad hypothesising that we were meant to do as part of the PBL process. So it's been an interesting first half of the semester :)

We also had a Formative Test (read: a test used exclusively for your own standards to see how well you would do, andd it does not count towards final year marks) which we haven't received the results of back yet; I'm not too sure we were taking it seriously, but I certainly saw that there was much that I had not covered or had forgot due to lack of revision. Which brings me to...

...how much effort I put into this first half of Sem 1, Year 1 of Medicine, versus the HSC. I must say that I've done exceedingly more than I ever did in the HSC, and I probably would have done much better, were I to have put that same amount into last year. I didn't though, and it's a regret but I've learnt from it, so I've decided to just do as well as I possibly can, in the knowledge that this is part of my career, and not working towards a certain number. So yep, that about wraps it up :)

Oh, and I spent my holidays semi-productively, revising most lectures, but also visiting old school friends and things. So I thought that was a very good start to a non-procrastination filled life ;)