Born This Way

The catchy dance-pop song by Lady Gaga has been stuck in my head for quite a while now. It's got a good verse, great bridge and and an awesome chorus - well, in my opinion anyway - my tastes are pretty broad but sometimes don't agree with many, heh.

I just want to reflect on the title of this song. The song is actually about being bold about not being born 'perfect' - specifically, in regards to homosexuality. I don't want to bring any discussion about religion and homosexuality, because I am Christian, but I don't believe in discrimination based on any reason outside of pure competence, and I don't support homophobia. But I digress; the main reason why I brought this up was actually about disability.

Over the past five weeks I had been attached to a disability service that caters primarily for school leavers (over 18 years old), providing them with a variety of programs that are mainly recreational in nature (such as team sports and reading) but also give an opportunity for these people to develop some important life skills. As far as is possible, the service's aim is to promote independence of it's users, through the development of a person-centred goals plan and the constant follow-up of the progress made in these goals. Goals could include learning how to make a cup of coffee, using the internet and learning financial skills.

For the majority, it is realistically unlikely that they will achieve full independence - but the progress they make is remarkable, and in some cases, independence is a reality.

What is interesting is that these users have profiles on them, with data and information about them collected through the years at the service, or if they are new, supplied through their parents or carers, as well as their previous school. These profiles begin with the user's name and date of birth, followed by their medical condition, then other details.

The medical condition means next to nothing.

Each individual is so different, and these 'labels' box them, in the common mind, into a stereotyped behaviour expected of them. An example is a young woman who has Prader-Willi Syndrome; they are known for their inability to resist eating anything and everything, but this woman displayed none of this behaviour, and through five weeks of observation, I saw no efforts whatsoever to obtain more food other than what was already prepared for her. Another is a young man with intellectual disability who nonetheless has a gift for drawing comics and loves Japanese anime - we had quite a lengthy discussion over several days about Naruto, which eventually tired me out as my suspension of belief and immersion was not as deep as his.

What is wonderful to see is that every single user at this service is happy and satisfied. Their quality of life is greater than what many 'normal' people experience. The day begins with everyone streaming into the centre, greeting fellow users and staff alike - and in the case of one young man, doing so with quite intricate handshake combinations - and heading into their programs, which are group activities of 3-10 other users. The rest of the day is spent in the above mentioned recreational activities and working towards their goals; and at the end, the day is over, people leave to go to their group homes or are picked up by parents, and everyone looks forward to coming back the next day. The goals plan helps to ensure that the users are not being stagnant and just 'going through the days' like many people may.

Kudos has to be given to the staff as well; it is an enjoyable job but it is tiring and at times difficult. I'm not one to romanticise everything, and this place has it's ups-and-downs - unpredictable behaviour leading to assault and abuse, as well as anger and absconding (leaving the program without letting staff know), and other unpredictable events - these are not common experiences but are nonetheless present, and strategies exist to deal with these because they happen. The staff there deal with this marvelously and are, like many sectors of the health sector, often understaffed in their programs, and do the best they can for the users.

For sure, this attachment has certainly broadened my horizons significantly. I've not really been in contact with people with a disability, so by the end of the five weeks I felt a lot more comfortable with those with a disability, as well as having obtained a wonderful learning experience about disability, the people it affects, the service and how it is accessed. It can be a bit intimidating at first - we had an orientation day when we started and were joined with several volunteers; by the end of our fifth week, I noticed that one of the volunteers was waiting outside, and so struck up a conversation; it turned out that he felt too overwhelmed with dealing with so many people with a disability, so instead of being on the programs he raised this with the staff and felt more comfortable in helping in an administrative capacity - and so was contributing to the service through this way. I think this is quite valid (well, perhaps not for us as we were there primarily to learn) and important to realise - that volunteer efforts in a service based around a single focus (such as Doctors Without Borders) often can work wonders in supportive areas of the organisation requiring just as much help as the frontline.

So it was with a sad note that my partner and I (two of us were at the centre) had our last day, bade our farewells and promised we'd do what we can to visit again. And so in our sixth week of the Medicine in Context rotation, we split up, get new partners, and spend another five weeks in another attachment - for me, a mental health service. I guess once I've finished up with that, I'll report back - but hey, it's pretty hard to top this :)

So, what did I learn...

Results for Semester 1 exams came out today, amid much anticipation, following the non-graded Y (which stands for 'Yes') grade I received previously, which meant that I would be continuing to next semester. This anticipation quickly turned into a more sombre emotion as I scrolled through my results and found that I failed half my exams - two out of four; one by less than half a percent, but a fail nonetheless. In UWS, you can only fail three exams in the entire year, even if your average score is over 50%, which I admit sounds fairly reasonable. But right now I think I'll need all of this leeway to get myself through this year and start clinicals.
I came into Year 2, Semester 1 with optimism; although previous years warned that this semester was difficult, I was, or so I thought, prepared for this difficulty; I saw it as simply a slightly larger obstacle to overcome. So naturally, I am sure I spent more time studying this semester than last year, and so expected a slightly better result than what faced me today. Thinking about this in a more rational manner, it is obvious that I must have underestimated the difficulty of the exams, overestimated my effort, and should have done a few things differently.

First, I can hardly blame the school for marking too hard, as the cohort statistics were published and, although, as an entire cohort, we slipped (a fair bit), my personal results slipped significantly further. This indicates that my result was personal and so must have reflected personal achievement.
Second, I didn't attend as many lectures as I did last year, and also paid less attention in labs and in PBLs. Anecdotes are given of hero students who cram in two weeks before exams and pull off Credits, but I'm of the opinion that these hero students could have been right at the top of their grade, had they bothered to put in the effort. And for a more average student like myself, not attending all the lectures really does make a difference. Something to correct for this semester. As an observation, overall attendance rates for lectures seemed to dip quite a bit this semester as well.
Third, I must find a more efficient way to study. I doubt this will come easily, but I think going back to handwriting may prove more effective, to reduce any distractions and to help retain memory.
Fourth, exam technique still applies in Medicine. I chalked my relative success in anatomy last year to online quizzes with photographic images and familiarisation with cavaders; yet for some reason, this semester I went back to learning straight off anatomy textbooks, which covers basics but isn't a good way to prepare for exams such as anatomy spot-tests; rapid-fire tests that you only succeed in when you are an expert in real-life anatomy. This probably traces back to studying earlier and more consistently, since I found myself still learning a couple of days before exams, which caused loss of quick recall of the anatomy learnt months ago, as well as inability to quickly recall the newly-crammed material due to a sense of overwhelming doom accompanying the names of hundreds of different structures.

This year, I'm still aiming for an overall Credit; which means I will most probably need to hit a Distinction average next semester. This nearly happened last year, but on reflection, I think I can do better without trying to suddenly become a hermit. Second semester starts in three days, and I'm actually quite excited to get back into it. Nothing beats crappy results better than a dose of optimism, a sprinkle of hindsight, a tablespoon of objectivity and a generous helping of get-back-into-it.

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?

Life is moving at a fast pace...

As we reach the half-way point of the first semester of year two, I'm starting to feel a little overwhelmed by the amount of effort required to do well in Medicine. I know that the upcoming years will be tougher than this year, with a full-time 9-5, 5 days a week attachment and intense Conference weeks filled with lectures, I can't help but feel a bit apprehensive that if I'm lagging behind now, I will be lagging behind in future years. In the space of eight rather short weeks (in my opinion, they flew by pretty fast), we have covered both renal and musculoskeletal systems. At the moment, my knowledge on musculoskeletal is close to nil, and I'm brushing up on my renal block now; and to help things, we just started neurology. I guess it's just a tiny worry, but it's a worry nonetheless, and I guess I've just got to keep at it. Good thing I'm finding all of this interesting (well, maybe not the renal), but still, it's a heck of a lot to keep track of - indeed, I didn't expect musculoskeletal being only three weeks in length; there's so many tendons, muscles, parts of the bone and functions of the whole system to learn! I'm glad we have mid-sem breaks not combined with Easter (that gives us, effectively, an extra day), and we don't have any mid-sem exams (definitely felt good last week walking around the university and seeing everyone heads-down).

I think that me and my mates playing Starcraft at every break is hardly helping the issue either. Or that we now have a Starcraft club. Oh what have I got into...

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.

What an exciting time!

Congratulations to everyone who made it into medicine this year; specifically those coming to UWS - your combination of smarts, effort and good looks probably helped your odds ;) On a more serious note, commiserations to those who did not make it in yet. I always looked at entry into medicine as a when, not an if question; and this seems to be the correct attitude time and time again for those who continue to pursue their goal. The 'when' question could be answered as soon as in a few weeks time; late round offers are abound in medicine, with so many offers going to so many interstaters, as well as those who decide to move out of their home state, and those who decide that medicine is not for them anymore. There may be a few key questions that you would like to ask:

Q) What other options are there?
A) The first one to think about is graduate entry into medicine. This is not necessarily a bad thing; the whole process of finishing graduate entry could only take a year more than some undergraduate courses - in addition, it gives you an extra degree, and it gives you both time and the practical option to consider going into medicine - you may discover the career that makes your heart beat and your brain tick, or your passion for medicine may glow even brighter. The second one to think about is alternate pathways into medicine; UNSW has such a stream for Med Science students (not recommended if you want to do Med Science explicitly for that stream), UWS also has a stream via a B Science(Advanced). Details are in my first post. You may also want to consider taking a gap year - whilst some may consider it an utter waste of time, a gap year may give you time and space to think, perhaps concentrate on the UMAT if it was your hurdle, allow you to travel or to work full-time to save up money for possible admission to an interstate uni (if money is your hurdle). So, no, it's not the end of the world.

Q) I'm thinking of repeating Year 12 next year, since my HSC/Final year results was the one that let me down.
A) In theory, this may sound like a good idea, since you *only* sacrifice a year, and may well stand to do great, especially if you thought you didn't put enough effort. From my observations though, it would be infinitely better in practice to go to university. Science, Med Science, and allied health degrees all have a fair bit of overlap with medicine, especially in first year. In many universities, the difference between med science and medicine in first year is the rather cursory clinical experience. If you start university, you're not even sacrificing a year; you will have more options open to you, such as graduate entry (which you would only be two years away from if you completed a year of university, provided you do a 3-year degree), you are working towards a degree, you get to experience university life, and you get a taste of the style of study university requires. In addition, a year of a related degree would most probably help you in your medicine course when you get in; from a personal point of view, our strongest academic students generally already have university experience.

Q) I should give up, I wasn't meant to do medicine anyway.
A) That's what I felt like when main round came and I didn't make it. This may give you a chance to reassess your own motives for doing medicine, and whether they are enough to make you want to keep going for it. As many would say, getting into the course is the hardest part of medicine. Also, if you hadn't applied for interstate universities or investigated many alternate options (including not applying for universities inside your own state...and yes that happens), you should look into them now and apply for them next year.

Now, possible questions that first years may want to know about! Most and many, are and have been answered numerous times in the forum Med Students Online, but I guess I'll dish out my own personal point of view:

Q) Should I buy textbooks/stethoscope/sphygmomanometer/tendon hammer/penlight/labcoat/etcetcetc now?
A) This depends on your university - generally though, there isn't much of a reason to get things early. There seems to be very low competition amongst medical suppliers, so as a result, sales are often rare and may not really represent great value at all. Also, allowing yourself to attend university for the first few weeks will help you in your textbook-buying decision making, since you start to see which textbooks are favoured by professors. You also get a chance to trial run textbooks if you use the uni library. I have a post on buying cheap textbooks if you're short of cash, use the tags on the side of this blog to find it. There are some textbooks that seem to be the standard for pretty much all universities though, so buying them early (say, if you were leaving soon to go to another country) probably wouldn't hurt - Talley and O'Connor's Clinical Examinations, Gray's Anatomy for Students, Guyton's Medical Physiology seem to be fairly standard texts, especially the first one. For steths, a Littmann at the $100 mark will be suffice for med school and even beyond; if you want, there are more pricey scopes around. Almost everything else can wait; in fact, stethoscopes can wait for a while too, especially if your university isn't very heavily focused on the clinical side in first year. For UWS students, your first semester's clinical experience consists of history taking, which does not require anything other than your brain and your mouth (although it would probably be best if you had a body).

Q) Can I start studying?
A) Yes you can; whether you should, I would say, emphatically, no. Cmon, enjoy your break! You just made it into med! You are awesome and study is not awesome - awesome and not awesome don't mix, so don't study!

Q) But I really want to!
A) Umm...ok. In that case, you start reading Wikipedia (read anything medical related I guess?). Get used to using it; even if you hate it, chances are you will eventually search up wikipedia when you get stuck on something. Wikipedia is a great place to collect random tidbits of knowledge, so go ahead and be a study nerd!

Q) Are grades important in medical school?
A) Grades for the sake of grades, I would say, are unimportant. However, depending on your uni, and whether you got a scholarship, it may well be very important for you (if you want to do Honours, or have to maintain a scholarship, for example). Personally, I think grades are also important as kind of a guideline as to how much you're learning (maybe not the best, but still). If you're aiming for a pass, and a pass only, chances are that you'll end up not doing very much study at all. And in courses where the contact hours can be quite low (such as UWS, maybe other universities as well), that frame of mind can set you quite close onto the road to failing. They do not, however, carry much weight directly after university though - otherwise universities which implement a pass/fail grading system would disadvantage their high achievers, and I can't see that happening.

Q) How much work should I be expecting to do?
A) In first year, to be honest, not a lot. When relatives/friends ask you the cursory questions, and then ask "So, is med hard?", you will probably disappoint them. You could probably easily get by with an hour or two a day, and some solid study in the time leading up to exams. If you've done a year of related university work prior, it may be even better. So, put on your party hats and expect to get inducted hard-style into university life ;)

Ok, so, t-t-t-t-that's all, folks!

Happy New Year!

So, with the start of a new year, there begins fresh aspirations, old wishes and another chance to do something interesting with the life you live. For me, this meant a new list of resolutions (I am proud to say that almost half of my resolutions for 2009 were met), which included some old ones (the ones from 2009 that weren't met), and, as for the something interesting...well...I went back to research today.
Yes, it is January 4th, the first Monday of the new year and I already logged a day at the labs, albeit another relaxed one. I have a feeling my progress in terms of attendance would be severely hindered though, thanks to two events: 1) Cityrail trackwork...on WEEKDAYS! Forcing me to take a train to the city, before coming down to Macarthur; and thus lengthening the travel time to a hint under two hours... and 2) Ramp trackwork. There is a single ramp connecting the station to the UWS campus; the alternative is walking around the other side to the shopping centre, across a large bridge and into the other entrance of our uni. Methinks a car would solve this, but alas, still, I am more than three score hours away from that lofty 120 hour L's requirement...
So, these two will continue for the next two weeks, and I hope I won't have to travel too many times to the campus. Else, I will be trying my best to pass off driving to uni with my dad as 'L's driving practise'.

Edit: Well, it's actually the 5th now. Dang it, failed blog post.

UWS LOVE

So, today was examination results day. A state holiday observed in respect for the stressed out students of UWS. Naww, I wish...
Anyway, I'm on a super-high; my end-of-year marks were enough to cover for my so-so pass score in the first semester, and as a result I'm sitting on a comfortable credit average :) And so far, the news from the rest of my cohort has been quite positive - unfortunately, it seems we had a drought of HDs...
So, in the UWS faculty, there's been talk of implementing an Honours system (you know, those ppl with MBBS(Hon.)) which involves a fairly relaxed (200 hours spread over two years) research project, and doing well academically. There's also been talk of a combined MBBS/PhD program - we have a sole student who did the Bachelor of Medical Research, who's also been funded for a PhD; kudos to her for being a trailblazer :) The PhD would add an extra 3 years; I don't think it will come under the 7-years-at-uni rule (the maximum amount of time you can stay in uni, being funded as a CSP place, is 7 years, if you're not over 25) though - otherwise I don't know what would happen. Also, it seems to be a pathway from the Bachelor of Medical Research. All of this interests me, since I'm considering clinical research in the future, and I guess it bodes well for UWS, offering these additional degrees/letters in your degree.
Today in the labs, we set up another experiment; although on paper it appears as if there were 3 separate projects with 3 different students, we seem to work together. Which is cool, which is cool. In fact, there hasn't been much time 1-on-1, excepting the early (for the holidays) mornings when there's no-one else but researchers and receptionists (who are rather friendly, I must add). We also got a pretty hefty insight into why lecturers sometimes can't make lectures or don't prepare them to as high a standard as we'd like (page numbers, nice Powerpoint design) - our Year 1 co-ordinator was running an experiment for about 30 hours straight, with monitoring around the clock. When this type of experiment is done regularly, rather than as a one-off stint, I could see how it would eat up your time - not to mention, keeping up to date with what everyone else is doing in their labs, analysing data, and writing up goodness knows what (A thesis? An outline?)
I've also found that research is very techy. Why am I surprised, I'm not sure (I should've expected it...) but the amount of software, hardware and even the presence of programming/coding scripts was bewildering. Right up my alley, then.

Hip hip hooray

You could treat this title both literally and sarcastically.
In a literal sense (always good to break the good news first, right?), my summer holidays have just been planned out for me! UWS sent out letters for acceptance into their SSRS (Student Summer Research Scholarship - 6-8 weeks full-time on a research project) and I received one in the mail a few days ago. So it looks like I'll at least be doing something constructive this summer. I also turned 18 recently (kind of hard to perpetuate the med-students-are-drinkers culture if you can't legally drink) but I haven't exploited any of my newly-found (for me) privileges yet. Might see whether I can get a credit card (I am a very, very responsible spender) or my personal Paypal account (Once again, very responsible). I think 18 seems quite young to be given all these privileges though - but meh, who am I to complain, hehe. I've also managed to resurrect my PDA from the dead, thanks to a factory settings hard reset (basically an entire wipe-down of the PDA) - so I'm hopefully going to be using that as a learning(read: procrastination) device for times when a netbook is inappropriate (whipping out a netbook during ward rounds? hmmm....)
PPD today, our last session for this year, was pretty good; we did our health professionals informal speech presentation thing, and had some really interesting insights; for example, the differing viewpoints of consultants, trainee doctors, and patients.
Sarcastically, it is drawing ever so closer to the final exams - only two and a bit weeks left. We received our practice anatomy test results back, and suffice to say, my mark was hardly amazing. We also have our formative OSCEs tomorrow (clinical examinations), for which the majority of our grade are panicking about (including yours truly). So.... in essence, HSC students, do not worry about nearing the end of exams and stress; there's plenty more awaiting you!

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...

A Small Update

Thought I might write a bit more, since some time has passed. I got my stethoscope, but my books haven't arrived yet. It came with soft ear-tips, a back-up pair of soft ear-tips, a pair of hard ear-tips (haven't used them, and hopefully never will), a name tag, and two paediatric attachments - the bell and diaphragm. I quite liked the smaller diaphragm, and am yet to see why a larger diaphragm is more useful than the smaller one - the adult-sized diaphragm is not changeable though, probably because of my engraving. Speaking of which, I thought the engraving was done well, quite happy with it :)
One thing the Medshop description fails to include of the C&R Trikoph, is that the rims are non-chill. I was pretty worried about this actually, since every stethoscope except this one had "non-chill rims" in its description, but yep, rest assured.
I'm yet to have any other stethoscopes to compare the steth directly with, so I don't think I'm quite qualified to make a recommendation for this based on acoustics. From what I can hear, the acoustics seem pretty good; nice differentiation between parts of the sound, and it seems quite loud. I'll comment about this once I get another yardstick to compare it with. Also, if you ever come around to purchasing your first stethoscope (like I was), don't worry if the ends of the steth seem to put a lot of pressure on your ears, and even if it hurts to use it at first. After about an hour (cumulative) of usage, my ears seem to be getting used to it, and it's not really painful now, but merely slightly uncomfortable (which I hope will subside very soon as well).

I had my first abdomen physical examination for ICM this week, on a patient who could barely speak English (thankfully, our tutor spoke whatever language he was able to speak), which hindered communication somewhat. He was really nice though, very compliant and happy to sit through whatever I was doing. Other than that, nothing really remarkable occurred this week... except for today, when 2(!) lectures were suddenly cancelled. That was a bit of an eyebrow-raiser. Oh, and only one more week till UMATo9! The tension is palpable (get it? get it? naww yeh k that was lame) Signing out,

Ah, no uni today...

This medicine degree, in terms of contact hours (i.e. hours spent at uni or hospital), is pretty easy-going, when I think about it. Contrary to popular belief, we have close to 1 and a half days off - Tuesday is my clinical day (1.5 hours, so that counts as half), and Thursday is my 'off' day. It's kind of pleasant to have all this time to manage yourself, although it presents a great danger in that I more-or-less don't fully utilise this time off. Although I love this self-directed style of learning, because I never really was the kind that did well with 'spoon-feeding' (I think that's a pretty derogatory name for rote-learning, but anyhow), the week always ends up with Thursday being used for half-playing and half-studying, whilst the rest of the week was mostly unremarkable in terms of productivity. From my fellow cohorts collective responses, it seems like this is the case with more than just a few people as well, so I wonder how our time could be best utilised...
So this week we're dealing with starvation (more specifically, a 40 day fast due to being caught in a blizzard 4000m above sea level in Nepal) and I've got a heck of a lot to do, hence I'll be off now.

Mid-Year Exams

So our mid-year exam timetables were released today.
And as of today, I have exactly 1 month and 5 days to both catch up on everything I've done previously, and keep up to date with the next 4 PBL cases, including this one. Looks like I've got to buckle up a bit and stop major procrastination.
I was actually fairly excited about exam timetables, because I felt pretty ok about my position in terms of lectures and PBL cases; but the fact that it is barely over a month away has really hammered into my mind right now, and it's kind of frightening. We haven't received our Formative Test results back yet, so I'm not sure how much I already know and thus how far the bridge is between simply keeping up, and starting to put in maximum effort from today. It's annoying that I know I will inevitably lose an hour or two PER DAY to gaming, or MSN, or facebook, or some random crap that isn't at all related to my future - but hopefully I'll still remain productive.
These medicine exams feel a little different to high school exams; I know that this forms my education towards a career, and most especially, towards dealing with patients, instead of a competitive Maths test or English speech, working towards a number. All the same, i think a little bit of healthy competition is strengthening me; I've found a really smart colleague (our PBL tutor called us this; colleagues. I was amused, as was everyone else) who is keeping on top of things, so my aim, childish as it is, is to do better than him. I know that if I do, I've kept on top of things; but even if I don't, I've done my best for the best cause I can possibly think of at this stage: my own life.

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 ;)

Entrance into Undergraduate Medicine in NSW

My main knowledge base, due to having trodden that path, is undergraduate (UG) entry into medicine in New South Wales. So if you'd like more information about Graduate (GD) Medicine entry, UG entry in other states, or pretty much anything else, I'd like to point you to an excellent forum: Medical Students Online (MSO)

So there are currently (as of 2009), four universities that offer entry straight from high school, or not having completed a degree yet. I'll go through them in order of how much knowledge I know about them, from least to most.

~ University of Sydney - USyd doesn't actually offer an UG Medicine degree, but they do offer Provisional entry (with a total length of 7 years spent in university) into their Graduate program for school-leavers. What this means is that they offer you guaranteed entry into their Graduate Medical program provided that you:
(a) Do extremely well in your final year exams. For NSW/ACT students, USyd generally only considers those who score 99.95 ATAR. This means you need to beat pretty much everyone in your state that year to even be considered entry. The only exception to this is the combined Music/MBBS program, which requires 99.5 ATAR but also a stellar performance in Music.
(b) Do well enough in their interview process (an MMI); anecdotally, the interview doesn't count for much and is a formality, but it still needs to be cleared. MMI - Multiple Mini Interviews - are essentially, multiple mini interviews (who would've guessed); anywhere from 8-10 stations consisting of a particular scenario or theme (e.g. testing empathy), in which you are given ~8-10 minutes of time to answer. They are generally quite hard to prepare for, or at least, harder than the traditional interview style; probably because they can test a large range of scenarios/themes. Don't worry though; your ability to talk for 8 minutes continuously is not tested - if you haven't answered a part of the scenario that they want you to answer, usually they provide you with prompts in the form of additional questions. Also, using all your time is not necessarily a good indicator of how well you did; conversely, finishing early isn't one, either.
(c) Be ready to do another degree other than Medicine for the first 3 years such as Arts/Sciences, and do well enough (credit average), to enter the actual Medicine course (which is 4 years in length).
They do not accept UMAT, although they do accept GAMSAT for entry into medicine the 'normal' way (Graduate entry).

~University of Newcastle/New England - Joint Medical Program (JMP) - This is a new program with a medically new university (UNE, or University of New England) partnered with a more established one (UNCLE, or University of Newcastle), which has been around, teaching medicine, for decades. The JMP has about 160 places, 60 in New England and 100 in Newcastle, and has a unique admissions process, by which they:
(a) Generally ignore final year high school results; they do require over 93.8 for urban applicants, but afterwards do not use it in their criteria,
(b) Use the UMAT result as a threshold value, not to be counted in admissions criteria; so UMAT is used by itself to rank applicants, and the top 800 or so applicants are offered an interview. After this, there is no discrimination in UMAT scores. Which leads to:
(c) The interview. With an approximately 1-in-6 or so chance at this stage, entry into JMP is especially unique because ONLY the interview score counts towards entrance. The interview is 100% weighted in the admissions criteria, and thus, it's a make-it-or-break-it situation.
Due to this, it's highly recommended that you should apply elsewhere in addition to the JMP scheme, although its generally advised to apply to as many universities as you possibly can. The JMP takes 5 years to graduate from.

~University of New South Wales - The University of NSW (UNSW) is the major established university for undergraduate medicine in Sydney, as USyd's program is Graduate Entry, whilst the JMP is outside Sydney. Their course was revamped in 2005, and they offer the most balanced of entry criteria, versus the other universities. Admission consists of:
(a) Even weighting of final year secondary school marks (ATAR), UMAT score and Interview (two interviewers to an interviewee, generally lasting from half-hour to an hour) process - i.e. each one contributes to a third of your selection score. However, UNSW is generally the most competitive university for UG medicine in NSW since it is the only one in Sydney that is well-established, whilst not being entirely exclusive to the elite of the elite (USyd's Provisional Entry program).
(b) They have an alternate entry scheme via their own Medical Science degree; essentially, those who do not make it into Medicine can take a year of Medical Science at UNSW, and the top nth percent (places reserved are in the single digits) enter the Medicine course with Advanced Standing (i.e. You don't start at Year 1). Forewarning: Medical Science is generally regarded as a degree with no real post-graduate future, apart from entering Medicine. In addition, Medical Science at UNSW is extremely competitive due to the amount of candidates wishing to enter Medicine through this stream.
(c) The cohorts at University of NSW are, in general, extremely academically gifted. Median UAIs, due to the counting of ATAR in the selection process, are firmly in the 99+ range. UNSW does offer EAS and rural consideration; so apply for those if they apply to you.
(d) The UNSW course is 6 years in length, though this includes a Research Project which is completed in one year. Depending on the situation, you can also negotiate for a combined degree at UNSW, such as Arts/Medicine, for 7 years.

~University of Western Sydney - UWS' Medical School is the newest of all medical schools in New South Wales; the first cohort was accepted in 2007, which is a year before the JMP scheme's first cohort. Admissions into UWS's Medical program is as follows:
(a) A minimum ATAR of 95, which is used as a threshold, much like the JMP process; there is no further discrimination of ATAR scores. Despite this, the median ATAR hovers around the 99 mark.
(b) A UMAT score which contributes to a third of the admissions criteria; it is currently speculated that UWS has placed a weighting on Sections 1 and 2 of the UMAT. Because UWS is the other university in Sydney that offers Medicine, in addition to not counting the ATAR of students, the UMAT score required for entry is generally amongst the highest compared to the JMP and UNSW (UNSW's minimum UMAT depends on your UAI, but median statistics generally point towards an even UMAT score for entrance into either university).
(c) An interview (MMI style, approximately 10 stations) that counts for two-thirds of the selection criteria.
(d) UWS places an emphasis on attracting local students, and as such, students living in the Greater Western Sydney region require 93 ATAR and a lowered UMAT score to receive an interview offer. However, there is no advantage given at the interview stage. UWS also considers Indigenous applicants separately.
(e) UWS has an alternate entry scheme, much like UNSW; entry into Medicine can be achieved by first completing a year of Advanced Science, ranking in the top nth or so positions (again, places reserved are in the single digits), scoring over 50% percentile in the UMAT, and sitting the interview process. Those who enter via this method are given no preference in the interview process, and do not enter the Medicine degree with Advanced Standing.
(f) UWS reserves about 30 places out of the ~120 local spots offered for the Late Round in UAC Offer rounds. The given reason is that those who take 2nd round interviews have to be reserved places so as to not disadvantage them. This however, means that the chance for entry into UWS in the Late and other rounds are substantial, and this, to a certain extent, can be applied to all universities.

The nature of the competitiveness of entry into Medicine means that many who are extremely keen apply interstate to as many universities as possible; and many successful applicants do also receive multiple offers from other universities, to which they must turn down. This leads to the extremely convoluted entrance sequence, whereby offers can be made independently of offer rounds and after the Final Rounds have been announced. Anecdotally, there have been students offered a place in the days before the course was to begin, and this is the case for all universities in Australia.

Post Edited: 03/09/09 - Changed to reflect UAI/TER/ENTER -> ATAR, USyd information
Post Edited: 08/12/09 - Changed a mistake in the JMP briefing, referring to final year "university" results, which should be "high school". Added a brief description of MMI in USyd's section (since it's the first one)

Entrance in Medical School in Australia and NSW

Being a rather excited Year 12, I had researched most of the pathways to enter medical school in Australia. However, most of my research was limited when I realised that jetting all around Australia to attend interviews was a rather costly enterprise to undertake, so I focused on my home state, New South Wales.
As an aside, New Zealand medical schools are also considered Australian in terms of Australians being treated as locals, and vice versa.

So there are two types of medical degrees, undergraduate (does not require a previous degree) and graduate (does require a previous completed degree). I'll abbreviate undergraduate as UG, and graduate as GD from now on.

UG Medical degrees are starting to die out in Australia, which could be influenced by the American style of medical school entry, which is similar to GD Medical degrees - doing a degree first (in America you can enter Pre-Med which provides the scientific basis of Medicine in a degree). UG degrees are either 5 or 6 years in length, and most in Australia now incorporate clinical or hospital exposure from very early on (first few weeks).
GD Medical degrees are generally 4 years in length, and the degree you must do prior to entry into GD Medicine can be completely unrelated to Medicine.

There are 3 main obstacles you have to overcome for entry into a medical degree:

~ University Entrance score (UAI/ENTER/TER/etc.) from final year secondary school exams for UG Medicine, or GPA/WAM/University degree score from your previous degree, for GD Medicine. Take note that many UG Medical Schools will consider your GPA/WAM if you have done a year of tertiary study, generally in combination with your final secondary school score.

~ UMAT (Undergraduate Medicine Admissions Test) is a prerequisite into entry in all UG Medical degrees in Australia, with the exception of James Cook University in Queensland, and University of Sydney's Provisional Entry into their GD program. The UMAT can be likened to an IQ and EQ (Emotional Quotient) test; which test, in 3 separate sections, your ability in reasoning, empathy, and spatial pattern/shape recognising. The graduate version of this is the GAMSAT, which is, anecdotally, more difficult than the UMAT.

~ The interview process vastly differs across all universities. The one university that does not use interviews in their selection process is the University of Queensland for their Combined medicine degree. The interview is generally conducted in one of two formats; MMI (Multiple Mini Interviews), in which you take multiple separate interviews with a different interviewer each time, or a standard interview with either a panel or a person.

In New South Wales, the current universities (as of 2009) that have a Medical School are:
UG: University of NSW, University of Western Sydney, University of Newcastle/New England (Joint Medical Program), University of Sydney (Provisional Entry into their GD program)
GD: University of Sydney, University of Woollongong, Australian National University (actually in the Australian Capital Territory (ACT))
Edit: University of Notre Dame has a GD program at it's Sydney campus (the university was originally based in WA)

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!