The tension is palpable

Holidays have arrived, yay! And, for the first time in quite a long time, our break is actually longer than everyone else - since we started more than a month earlier, whilst everyone enjoys their mid-sem break, for us it's actually our end-of-sem break.

The last couple of weeks of MiC have crawled by rather slowly, as the promise of our hospital attachments drew nearer. The last weeks of an MiC attachment are a bit dreary - the excitement of change between the last attachment and the current one has dissipated, many of the tasks you set out to do may have already been accomplished, and generally there's a sense of staleness that you want to be rid of. It's not really dependent on the quality of the attachment either - it's just the nature of community attachments. One of our professors commented: "the things you do in MiC - it's not until 10,15 years down the track where you go 'oh...so that's what it was all about'". That's exactly the sentiment you get when you do MiC, especially if you come out from hospital attachments when MiC is second or last; the amount you learn in practical skills at hospital seems to dwarf what you absorb in MiC; learning about service provision is just not as exciting as doing a cannula, no matter how badly our School wants it to be.

To wrap up the term, we had a Reflection-week, which consisted of a couple of lectures and tutorials about MiC - most of it, naturally, regarding reflection.

As I write this, I'm reviewing this draft post that I was meant to publish at the start of the holidays, but it's now the end. The holidays flew by quickly, in part because of my various commitments outside medicine such as the clubs and societies at UWS, and personal ones dealing with family and things I hadn't done much in a long time (piano, poker, learning Mandarin). And now I need to fulfill my role as the family's chauffeur. Sigh... anyway, till another time!

The starting gun is loaded

I'm now only 6 days away from heading into third year, and am definitely excited about what's coming up ahead! Bought Oxford Handbook of Clinical Medicine (OHCM) after finding it at the cheapest place possible (on Abebooks.com for $33) and am voraciously reading it whilst waiting for mum to finish grocery shopping. The only downside of getting your P's (driving licence) for me was suddenly becoming my mum's chauffeur, and considering it's the holidays, she believes my main priority is to make up for the past 10 months of not contributing to the house - i.e. driving her around. So OHCM is my way to whittle away the wait... also got an ipod shuffle for Christmas, which I've loaded some New England Journal of Medicine (NEJM) audio summaries on for some bedtime listening (or alternatively whilst jogging).

Turns out that that was pretty much the extent of my study this holidays. I finished reading a book on clinical decision making, but only because it was interesting and only a couple of hundred pages; borrowed a few other books and haven't really made much headway. So I guess I've had a pretty relaxed holiday, which is good - considering how rare holidays are going to become. Took up some more exercising, as well as piano (after practicing for a month, I still can't quite get the Pirates of the Caribbean theme 100% correct yet), which I've neglected for a long time - presumably, due to studies (...not really).

I probably haven't discussed third year in much detail before, so I'll just give a little bit of a rundown as to what I'll be spending 90% of my waking hours on this year (psh, actually more like 50%, need to account for time spent doing very unrelated-to-med things). The year is essentially split into three 'semesters', which are each split furthermore into halves (hence, six 'terms'). The semesters are known as Medicine in Context, Medicine, and Surgery.

Medicine and Surgery are pretty self-explanatory; they are both hospital-based, and as you would expect, in Medicine you would be joining a medical team (e.g. gastroenterology, neurology, geriatrics, other fields of medicine besides surgery or general practice) and expected to both learn and pull your weight as part of the team; whilst in Surgery, you would be joining a surgical team (in third-year, this is mainly general surgery, but depending on what you were allocated, you may be joining a vascular, maxillofacial, orthopedics or other more specialised teams in addition to general surgery) and expected to be on time to scrub in (get ready for the surgery by taking surgical sterilisation precautions) and to learn.

Medicine in Context, which is the semester I'll be doing first (in order to spread out resources evenly, a third of students will be starting with MiC, a third with Med, a third with Surgery, and then rotate), the week is divided into a one-day-a-week General Practice (GP) attachment, a three-day-a-week Community Organisation attachment, and a "reflective/presentation" day (Fridays) which seems to be either a go-back-to-campus day or "free" (read: they want you to study) day. In regards to the Community Organisation, this is an organisation which deals with the related elective or subject that you have been allocated (although I say allocations, you are given a preferences list to fill out), which for me will be Disability and Mental Health, my first and second terms respectively. Each term is six weeks in length, and each semester begins with a conference week, which as mentioned before, is essentially a week filled with lectures.

The GP I'm going to be attached to is very close to my house (about 3-4km) so I'll be looking to cycle there and back; my Disability organisation is also fairly close (about 8km) so that might be possible to cycle there as well. This is probably one of the big changes between pre-clinical (first and second years) and clinical years for me, as the return trip has literally dropped by >80% from 3 hours to 30 minutes - which is nothing to sneeze at. However, an equally big change is going to be the largely reduced amount of time with the rest of my cohort, as conference week is the only scheduled time for the whole cohort to meet; half of the cohort is in the south-west whilst the other is in the west/north-west; and a third of the cohort will be not in hospital the majority of the time (the third that will be doing the Medicine in Context rotation). Also, I don't get much time to get to know the Malaysian students, since they'll be at Campbelltown whilst I'll be an hour-and-a-half's commute away - which is kind of sad; in addition to the people from my cohort last year who won't be in my cohort this year (Medical Research degree, deferring, repeating). On the upside, I'll be spending a lot of time with a few people, which hopefully means I'll get to know them a lot better - my main partner for this year I barely know, so there'll be plenty to cover in the downtime.

So, it's time to ring up my allocated organisations, get ready those notebooks and prep my bag for what should be a very interesting year! As always, I'll try my best to keep posting during the year - still amazed that it's still here after two years, my longest blog effort ever haha...

Conference - Where kids can come to act smart

Only a couple of days out from finishing with the last of exams for this year, I was celebrating hard-stylez by attending the wonderful Victor Chang Cardiac Research Institute conference titled "Charting the depths of RNA". I must've been off my head or something, but I was really quite keen to attend this, listen to some awesome international speakers and generally learn something new. Once again, the experience of this conference was quite similar to the ISAN experience I blogged about more than a year ago; this time, without the good night's sleep, thanks to several friends (who don't do med) kindly playing Trivial Pursuit at my place till 1:30am - although I should be also to blame, I didn't have the heart to kick them out earlier...
At any rate, the conference was quite interesting, if you were a researcher in all the new and wonderful types of RNA around - microRNA, snRNA, and some other RNA's with small-letter prefixes that I couldn't remember. For the average medical student (and I didn't spot many, most seemed to be science students), it was next to useless, with perhaps the very interesting exception about novel therapies for Duchenne's Muscular Dystrophy (one to look up if you don't know what it is) and other clinical applications of microRNA. This was more focused on the variants of RNA rather than the old regular RNA that you read in the textbooks - it seems that, for the last few decades, we've getting it rather wrong and have not realised the importance of these microRNA things, which do not contain genetic code to translate into proteins, per se, but instead modify expression of regular DNA. A prime example of why this was important was given in the introductory speech by a Head of Science in UNSW, whereby it was noted that the number of DNA genes that coded for proteins (what we focus on in med school) did not necessarily correlate with complexity, but the number of genes not coding for proteins and instead doing something else, DID correlate with complexity - i.e. humans had more than, say, the fruit fly. This, I thought, was a rather succinct point which helped me concentrate through the first couple of talks, then fall asleep at some of the others and generally lose focus. The technical detail in the conference was enormous, and most of it went right over our heads (went with a friend, who was equally keen on this), but it was an interesting experience nonetheless.
The food was of average standard; to me, a rather undistinguished eater, the party meat pies were the most delectable, followed (by a long way) by this random ball of what tasted like cooked self-raising flour (with no eggs or milk), and then some rather unsavoury sandwiches. But hey, we didn't come for the food. Another aspect of the conference were the sponsors, which were very nice people - they handed me pens (they should upgrade to BIC promotional pens or something, pens aren't much good if they can't write), much needed Post-it notes, and even a thing that blocks out light from your eyes when you sleep - can't remember what it's called, unfortunately. That was a fun part of the conference.
In all fairness, as I stated above, I thought it was a great conference for those involved in the field. For us, the relevance is still there, but the clinical talks were few and far in between, it was very clearly pitched to scientists, as they were revising how the heart worked in one of the talks on Atrial Fibrillation. In contrast, they glossed over the basics of microRNA and did not mention the basics on the techniques used to extract RNA and assess it. Overall, I thought it was a good day out, a nice way to celebrate the end of exams, and a great way to give you a headache were you unfortunate enough to try to pay attention whilst not knowing what in the world microRNA was.

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!

A well-deserved break

Well, my exams have finished, so I'm back. And what a better way to welcome me back to Blogger than the announcement that I have 4 spam comments to be moderated! Such a comforting thought, to know that these people are bothering to attempt to spam this blog with advertisements for chinese webcam sites and whatnot. But anyway...
My mid-year semester examinations were comprised of four papers; a MEQ (Multiple-Mini Essay paper), SAQ (Short-answer), MCQ (Multiple-choice) and an Anatomy Spot Test (the second one so far, we had one in semester two, last year). Suffice to say, I believe that this time around, my marks compared to last years will be lower, despite putting more effort into studying; the role with the student union has actually made me more inspired to study harder, paradoxically. The exams were quite a mixed bag in my opinion; the MEQ and Spot Test were filled with things I managed to only gloss over in my study (although entirely my fault, an example of this was not covering Chronic Renal Failure enough whilst covering every other pathology of renal disease possible; and knowing in great detail the structure of bones for the spot test which was never utilised), but to balance things out, the SAQ and MCQ had quite familiar questions which were answerable. The MCQ was a special test to note, since we had two sessions that were essentially filled with practice MCQs that could come up; once again, the number of MCQs repeated from previous years was a significant number; to the extent that I would confident in saying I would expect no more than single-digit numbers of people failing that exam. Essentially, if you were to memorise all the practice MCQs given out, and guessed the remainder, then assuming you have a 1 in 4 chance of getting those guessed questions right, you would be very, very, very close to passing.

I don't think that's necessarily a bad thing; in fact, I don't think failing future doctors on whether they can recall every detail of a cellular mechanism so they can find the answer that is INCORRECT, is essential, in this stage. Yes, doctors are responsible for people's lives, but at this stage, we're still medical students in pre-clinical years, and performances in OSCEs and the results of clinical years are more important. Regardless, it is one exam and shouldn't make much of a difference in the overall scheme of things.

Post-exam period mood: Nonchalant. Once again, the post-exam feeling of "I feel like I should be studying but I don't have to" has settled, and I'm inclined to start studying for next semester, although I feel like I may want to wrap up last semester with a nice concise book of notes. These holidays are going to be a bit different from the last ones though - now that there aren't any exams, it's full throttle to student union and general university affairs, as well as more personal ones like preparing to take my P's test (provisional driving license - i.e. license to drive unsupervised, for all those non-Australian/non-NSWers reading) and finishing Big Bang Theory. Also on the agenda is sleeping more, eating more, and exercising more; very important things that I didn't get as much of as I would've liked to during the exam period... speaking of which, a siesta sounds mighty alluring right now. Time to nod off..

A finger in all the pies...

So as I'm beginning to reach the end of my student summer research scholarship (SSRS), with about 3 weeks remaining, it appears that the most of my time has actually not been dedicated to a single project, but rather to a variety of projects running at the same time, by different researchers, in the same laboratories. It's been a great learning experience in terms of what is happening at the university's labs, and was not only observational but also included some hands-on experience such as the preparation of a salt solution, miniaturisation of pipette diameters, and taking part in experiments both as subjects and being involved in the running of them. The one thing that I want to see before I finish up is what actually happens when there are no SSRS students around, and I've yet to see the boring side of research - except the rather long waits during experiments when either waiting for something to happen, or trying to find a nerve and patiently moving around a recording needle in the vicinity of that aforementioned nerve. Ok, which can get a bit tedious. I've remarked to my supervisor that it seems the interesting side of research is presented in the scholarship, and he agreed; which is fair enough, and great for the students on this scholarship :)

As an aside, I've started to at least try to prepare for this upcoming semester's work. Promises of a long hard grind for this year have shaken me to start studying near the end of the holidays - a good thing or a bad thing, I am not sure. Surprisingly though, I've found that I've gone out with my friends a lot more than during the break between high school and university, despite the SSRS. It's great to catch up with high school friends after a few months; it does make me miss them. Although I do not miss the hidden pencil case/calculator/bottle/bag/anything that belongs to me. Or the 'friendly' punches.

On a somewhat unrelated note...

HSC exam results came out today. No joy for my five students that I tutored - no band 6's or even band 5's in my subject, which was really disappointing. It feels so crap when you know that their parents have paid you so much in tutoring, and both you and your student tried so hard, but in the end, the result was so much lower than we worked for. One of the things I dislike about tutoring is this responsibility for marks - today, it felt like I was the one who did those exams, and got those results. Ironically, it was my students who were trying to cheer me up - but really, it's this feeling that you've just taken someone's money and seem to haven't had done much to help, that's killing me. Anyway, I've recently got two days off the SSRS, thanks to my awesome supervisor. Just used one to go to the beach today, and will use tomorrow (actually, today) to read up on latest news and catch up with some old friends. Reminiscing about how, just one year ago, we too had stayed awake at 6am to log onto one particular website...

And in the lab...

The first proper day of the SSRS, last Wednesday, ended up not being very proper at all. The day started at a very, very lazy 11am (Holidays really do not spur me to wake up early), where I first met another researcher, who introduced me to the neuroscience labs. Hehe, should've seen my face light up, as if Christmas came early! We proceeded through the first pair of glass doors (guarded by swipe key access; my student card, however, didn't work)... then a second pair of white doors (guarded by fingerprint security)... then a fairly long white corridor (CIA-style) with lots of glass-walled rooms, lots of white cupboards, and lots of Macs. *blink* I had never, in my life, seen so many Apple computers - they were everywhere, arggh! Finally, we entered a room where there were actually people inside; which opened to the vast, expansive view of Macarthur Station, the fields, and the nearby shopping centre (unlike CIA-style). The view probably would be better if it was at, say, a beach, but still, I don't think I'm going to mind working here for the next couple of months :)
So far, I had yet to see my supervisor, but I met two of my fellow SSRS students (both second-years; outclassed much - first years haven't even done neurology), fellow researchers, and a third-year who volunteered to be the human component of a most interesting setup - cables and equipment were set up everywhere, measuring blood pressure, respiratory rate, ECG and nerve activity (via microneurography - essentially sticking a small needle into a nerve to measure activity, as the name implies), whilst a saline drip entered a muscle in his lower thigh, and a pain dial for this brave volunteer to gauge the pain caused by the saline drip. Consensual form of pain torture? Hmmm - well at least he was remunerated for his efforts :)
About half an hour in, my supervisor strolls in.
...

After witnessing the experiment's conclusion (and remuneration of that rather sore volunteer), the three SSRS students and the supervisor removed themselves from the laboratories, and discussed how best to organise the week ahead. This was followed by some rather quiet study by myself (since I was quite lazy in reading up on migraines during the week preceding), and witnessing of a repeat of the morning's experiment, with a different volunteer; made all the more interesting, since in the morning everything was already set up, whilst in the afternoon, everything had to be poked back into the new specimen :)
And so concluded the first proper day of the SSRS project, involving about 5 minutes of actual discussion on my project. Right on track to making a big discovery.

And back to work again...?

On Tuesday I had my first meeting with my SSRS project co-ordinator/supervisor; I finally found out what my project was actually about (although the title "Perivascular Pain" was, in the end, a surprisingly good summary for the project) - essentially investigating a cause for migraine, more specifically a hypothesis regarding how nerves suddenly activate themselves to send pain signals during a migraine attack. It got me pretty fired up - I was reading a few papers he gave me, and it seems that there hasn't really been a breakthrough in understanding migraines for the last...15 or so years (papers dated from 1994-2004, no difference). I'm supposed to do some 'light' reading so that I can understand the project better, and I really want to, but once again, procrastination calls, especially since it's the holidays and (rightfully) I feel like doing absolutely nothing (constructive). Had quite a few friends come over since the start of the hols, they're all from high school so I haven't seen them for a while. For some reason though, my parents are still annoyed at me playing computer games. During. The. Holidays. WHY? WHYYYYY....
Anyway, MedBALL is tomorrow! It's a ball (i.e. formal/dance thing, not a round thing you kick) organised by our awesome UWS Med Society, with the theme 'masquerade'. I went to Lincraft (craft store) of my own accord for the first time ever; bought some cloth, and devoted yesterday night to stitching, and periodically poking myself with the needle. I think I'm getting quite good at threading the eye (of the needle) - a very useful skill to please elderly people :) Now all I need is a way to get to the venue...and what to eat for dinner. Big thoughts.

How a week without uni flies by...

First of all, I couldn't think of any more PBL case names that would fit this post, so I've stopped.
The one week mid-semester break is about to end tomorrow - between meeting with old friends, playing some Starcraft (old geezers, I know) with said old friends, and doing tidbits of study, the entire week has vanished into the depths of time and space immemorial.
I have a real knack for starting workbooks. Writing the name...and the subject; and then the year; then doing a nice title line (I don't do title pages, way too time consuming) for the broad subject (lets say; Physiology).. and then a subtitle for the particular section (let's say, Chapter 1), and then about a page of work. Of course, when I start workbooks, I'm always in the organisational, neat and tidy mode, so I can't write stuff about, say, the heart, where I have the cells. So I start another one. Repeat endlessly for as many books as I have in the house, and as many subjects as I feel like covering that day.
This used to be my procedure for high school studies - it made me feel good that I was starting a brand new book, turning over a brand new leaf, starting afresh and ready to summarise and/or take notes of something or other. Thankfully, during this week, my brand new workbooks were slightly more used - I think one of them has a dozen or so pages of notes *yay*. And therein was the limit of my study during this week.

Of course, now that I really feel like studying (on a Saturday; wow I have no life), vUWS (WebCT/internet portal of the uni) so happens to be on a maintenance weekend - so I have no access to Learning Objectives. So I guess I shall slip into watching another few episodes of Family Guy...or South Park...or the countless gigabytes of series donated by my ever-considerate old friends...

De-Brief

In hindsight, the fact that our three exams were one after another (Tues/Wed/Thurs) really didn't impact on how I would have went. Because really, I think I wouldn't have done any better with any extra time in-between. So here goes:
Exam (1) was Short-Answer; this was a huge shock. First off, the first question had nothing to do with any sort of science and was 4 marks. The next question had nothing to do with science, and was 5 marks. Thereby followed a string of 4, 5, 6, and even 8 and 10 mark questions. I was *utterly shocked*. With only high school exam experience to fall back on, exam (1) felt really hard simply due to the number of marks allocated to each question; the pressure was on to do well in each and every question, and it was pretty intense. Another big thing was that I forgot to write fast. This time, although all the lecture note-taking via my netbook didn't impact on my writing speed, I was just unprepared for the pace of the exam, and especially forgot how long it took to write answers. Silly me, heh...
Exam (2) and (3) were Multiple-Choice. Exam 2 was the hardest multiple choice paper I had ever sat, followed by Exam 1, which was still hard but definitely a step lower. I found that, unlike the Short Answer paper, I had bucketloads of time (filling in a bubble is certainly faster than writing lines and lines) so time was certainly not an issue; just simply my gaps in knowledge and the rather lack of emphasis on PBL-exclusive stuff (e.g. mechanisms). I ended up tallying questions I was sure of and wasn't sure of; in both exams it turned out to be about half-half, so I'm hoping at least 10 of those unsure ones will pull through - aiming for a 60+ :)

And then we went bowling to destress.
Highlight of my bowling today: got a strike (!)
Lowlight of my bowling today: 5 gutter-balls in a row.