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.

SSRS from a good friend of mine...

So, here follows a report from one of my friends (yes, I did get their express permission!) for their involvement in the SSRS program.

"The aim of the study is to determine the impact of continuous positive airway pressure (CPAP) on chronic cough in patients with obstructive sleep apnoea (OSA). This is a single-blind, randomized, controlled and parallel group study of the effect of nasal CPAP on cough in patients with proven OSA and cough. Patients are recruited prior to their commencement of CPAP treatment and are allocated to either treatment group (CPAP with treatment pressure) or control group (CPAP with sham pressure). Cough data is collected 4 times during the study: at baseline, 1 week review, 1 month review and 2 month review respectively. This is achieved by using the 24 hours Ambulatory Cough Monitor and patients’ self assessment through completing the Leicester cough questionnaire. At the conclusion of the study cough results will be compared between the two groups to determine the effect of nasal CPAP on cough parameters including frequency, sensitivity, threshold and Quality of life in patients with proven OSA and chronic cough.

My main involvement and responsibility in this project was patient recruitment in the Concord and Liverpool hospital sleep lab. This involves presentation of the project, communication, negotiation with patient and answering patient queries. Relationship building and maintenance with Concord and Liverpool sleep lab staff was important, as frequent liaison with sleep lab scientific officers was required to follow up patient reports. My other responsibilities include data entry and maintenance of patient information in excel spreadsheet, as well as delivery and pick up of the cough monitor at the patient’s preferred time and location.

This project gave me an opportunity to gain a basic understanding of the clinical research process, the complexity in its set up and the difficulties that the researcher may encounter. A better understanding of sleep apnoea in the clinical setting was also attained. Patient recruitment was a challenge however it helped to improve my communication, presentation and negotiation skills in the process. Managing different aspect of this project helped me to further develop my organization skills."

Life is rosy...

My first week as a second-year ended quite well; but before I get to the end, I probably should take it from the top. First of all, it's always nice to see everyone back; many of them I have not met during the holidays for whatever reason (I would like to blame my research project, but in reality it didn't prevent me from doing much... thanks, awesome holidays-are-meant-to-be-holidays supervisor!*) This week was meant to be a "get right into it" week, but most of the lectures were short, or introductory/welcome lectures; so it seemed a really relaxed week overall. However, the attitude towards study certainly seemed to have shifted in our grade; noticed a bit more of a studious attitude, not just in myself but of those around me - and this was the first week back as well! On the flip side of seeing everyone back was the not-so-joyous realisation of how our cohort had changed a little; some good friends of mine weren't around, and some I knew suddenly appeared in our cohort's lists for practical classes and tutorial groups. I think that as a grade, however, we pulled through first year quite well, which was quite heartening. Our first anatomy tutorial went quite well, and even included a little radiology session, which we haven't had before; getting a kidney via ultrasound hurts a tiny bit though.

Which brings me to our system of study for our first few weeks; the renal system. Not exactly what I would vote as 'most stimulating subject of study'; I think I will struggle to keep focused on my studies for renal. I remember meeting one of my friends from high school who I hadn't spoken to in a year, and asking him: "how do you study stuff you're not interested in?"; and he answered "well, I just force myself... I persuade myself that if I don't learn this properly, or read this much, then I won't get a nice job and get paid well, and life would be s**t." (He's doing Comm/Law... I'm not saying anything about Commerce or Law by inserting that piece of information in; I think it's a wonderful double degree that gets you places and does, by all means, lead to excellent job prospects if you have no passion for anything in particular that any university offers). Unfortunately for myself, I have not that faculty that allows me to delude myself; I have tried to settle for "my patients will die if I don't know this" which, funnily enough, doesn't get me anywhere, because then I think "well, I do have 4 more years of med school, and another couple of Olympics in ward experience to learn this, so just chillax right now."

That isn't the reason why life is rosy, however. Why life is rosy is because two very awesome things happened to me, today. One: I have an awesomely witty ICM tutor. and Two: I can cycle to hospital and not fall asleep during ICM/PCS (8km one way). Score.

* In relation to the SSRS, I may be getting a writeup of one my friend's experiences on this blog. So stay tuned for some objective recounts :) Also, I forgot to mention what PCS is - Procedural Skills; lessons on the more clinical side of medicine such as cannulation, injections and hooking up IV drips. That, actually, should be my third reason for why life is rosy.

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!

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.

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.

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...

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.

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.

SQUUEEEEEE

And so begins my long-awaited holiday for the year :) Exams overall were fairly solid; we had four written exams and one anatomy spot test; the four writtens included an MEQ (mini-essay question 10-20 marks/question), SAQ (short-answer question anywhere from 2-10 marks) and 2x MCQs (multiple choice question, 1 mark each) tests; they were pretty difficult compared to first semester, and I'd say a fair bit more difficult than HSC exams (speaking of which, everyone finishing up secondary education in NSW this year should be done with exams - hoorah!). There was a significantly increased clinical/diagnostic focus in the written exams this semester, which may or may not have caught people off guard, but I was happy with the general gist of them. What was disappointing was the reuse of questions from multiple choice - leakage of questions to some students and not others by means of connections meant that some were aware of a few questions (and answers) that were in the exam, and some were not. I doubt it can be avoided, since it's only natural for upper years to leak exams to lower years, but nonetheless.
The anatomy spot test was, in my opinion, fairly difficult - not particularly because of the level of detail required, but more because of the rather... disfigured cadavers/specimens being used in the exam. I struggled to identify a pancreas that looked like it was cut in half and strewn across the tray; only by looking at the only organ attached next to it (a spleen) and the texture of the organ was I able to realise what it was. Ambiguity regarding the level of detail was another hallmark of the test, although not entirely foreign to us thanks to a formative anatomy test prior; a label would indicate a heart valve, but may be closer to a particular cusp of a valve; what to write down was an internal debate in itself. Despite this, the use of models did help those who had little experience looking at cadavers (i.e. most of the cohort) and more experience looking at diagrams and illustrative atlases - and apparently the pass mark for the spot test is going to be below 50%. Hmmm.
A post-exam party/bash at either the city or the beach concluded the final day of exams; and goodbyes were said as we looked back at our first year of medicine; and look forward (hopefully) to our second. And by look forward, I don't mean, 'be eager to undertake' - thanks to warnings from a notable third year, half our grade is now planning to study in our holidays, including myself. *sigh*
Farewell, first year. May I never be associated with you again.

Sorry for no update

Hey guys, I'm taking a little siesta from blogging, as my exams start on the 9th, and I find that anything on the net causes me to lose concentration - in fact, almost anything related to a computer. See, I may do a blog post, which might take 10 minutes, and that's fine. But then I'd feel restless, and go check forums. And then check other blogs. And check my mail. And waste a good ol' hour or so laughing at the wittiness of several blog writers. And then go to all my random sites, and check my mail, go to facebook, laugh and comment at a few things, go check my mail, go to more random sites, check my mail....

And in the end I've lost most of the day. So I'll be back on the 20th, which is when my exams finish. Also, congrats to all those Year 12s/13s/Final Secondary School Year People for finishing your last year of secondary education - and for most of you, all your tests as well; if you still have them, good luck :) And good luck to everyone else who may have tests (or interviews) during this period.

Peace,

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!

What a day

I think people were kind of looking at me oddly on the train today. Thanks to the hot sun and my forgetfulness, a melted chocolate in my right pocket spelled disaster for the earphones, ipod shuffle, mobile phone and parker pen (No, my pockets are not abnormally large) nearby. Thanks to my amazing foresight and provision, I also did not carry tissues or a bottle of water with me that day. So lets see. Brilliant genius medical student is confronted with messy electronic goods, and *almost* nothing to clean it with. What to do? Well, use the closest replacement to tissues - good old-fashioned paper from a notepad! How I managed to clean my earphones with pieces of paper, you can figure out for yourself, heh.
Anywho. Today was also a notable day because it was the last day of ICM. This means that I will not be seeing Blacktown Hospital for the next 4 months (until February at least), but more importantly (of course, what could possibly be worse than not seeing a hospital for months?) a new ICM group and tutor. My group and tutor are...LEGEN (wait for it, wait for it, wait for it - and I hope you're not lactose intolerant, because the next word is)DARY. I can't really rate one over the other - I think the group is so important in terms of your experience in ICM; whilst our tutor is a brilliant physician who has such a great love for people and for teaching us young whipper-snappers. I will miss them. Of course, the aforementioned chocolate was the result of a farewell gift thoughtfully thought of by one of us in the group (the rest of us all forgot, or didn't even know that this was the last week of ICM).
Anyway, the reason why I was on the train was not because I was going home, but because I was doing part of another PPD assignment (talking to a health professional). I went to Hornsby where I met my cousin (a registrar), and we and my friend who's also in first-year had a nice long chat about what we should expect in the future, and tips to manage stress and adverse situations. That was cool - I've just finished typing up my notes taken during the session; we'll have to present it at a time and date I'm not sure of. Thus, one would assume I am quite free for the rest of tonight - not so, too much work to catch up. Should get cracking, then.

Panic! At The Med School

So, uh, only 4 weeks until final exams. AHHHHHHHHHHHH
Well it seems everyone else is coping pretty well, no outward signs of panic yet - at least, from what I can tell (which isn't much). I've started to go head-down, doing summaries and generally trying to be constructive whilst avoiding the unconstructive-but-is-still-med things...like...House...and some flash game where you try to kill the whole world via a mutating disease. Yep, unconstructive they certainly are, heh.
This week seemed to be a real bludge; I'm sure many of us tried to use it for good though. Friday was a pain though - a day that was scheduled to end at4pm actually ended at 10am after two lectures; we had a practical that was cancelled (spanning 5 hours since there were 2 groups and an hour break inbetween), and half an hour before the last lecture was to start, we were notified it was cancelled (most probably due to the majority of students not being bothered to stay at uni for one lecture), and so we went home at about 3pm.
This week was also EBM week - Evidence Based Medicine (looking at types of studies, critical analysis of those studies); mainly because the EBM group assignment was due on Friday. Group assignments simply do not work, especially in as large groups as PBL groups (10-11 people). Thankfully, I'm in a PBL that was well organised and where everyone pitched in, but the story was not so rosy for a few other groups, as you would predict. Perhaps an issue for our new Dean to address?
Speaking of our new Dean, we first-years were treated to the Dean crashing half of a PPD lecture. I had never, ever heard the lecture hall so enthralled by our PPD lecturer (who is super awesome anyway, but students will talk when given the chance to) - and on a lecture about the Medical Practice Act, no less. Of course, that façade vanished once our Dean left the building; but, still.
3 more PBL cases to go, 3 weeks until the end of first year. Boy has this year passed - just like that *snaps fingers*

Post #1 of October

Ah. Next week will be a PBL-free week, due to Labour Day. This is good; not because I have less work to do, but because I have more time to catch up. Oh, how perspectives change...
This week was pretty unremarkable - I guess that after 25 or so weeks of uni, things seem kind of like the same. We had another respiratory case this week, but an even more complex multi-factorial one; and we started on basics of the neck and breathing anatomy. Then we had various lectures on respiratory control and drive, and finally, to wrap up this wonderful week, we had our formative anatomy spot test, which went by very quick (10 minutes - essentially identifying various structures) and an Evidence-Based Medicine lecture (on the difference between causality and simple association/link between two things - say, smoking and lung cancer), which, I admit, was pretty good - lecturer was well-spoken, well-dressed, well-prepared; which made for a very easy lecture to understand and take notes from. So, after reading this recall, you're probably just as bored as I was during this week - and for no reason; I mean, hey! Medicine! Prestige! Wealth! Awesomeness! Around the corner! Should I not be excited at every twist and turn, every avenue of discovery that awaits? Well... sort of, but it doesn't really lend itself well to being interesting reading.

I, however, was firmly reminded of a very important concept in medicine, this week - the concept of "medicine-is-not-static" (for lack of a better concept name). One of the more popular physiology books (although we're lead to believe there are only two that ever exist), Guyton's Medical Physiology 11th Edition, was published in 2006; fairly recent, one would assume. This is the latest version of Guyton - and since it is fairly readable and in general quite a good text, many in the course often refer to that, and nothing more, treating it as the authoritative textbook on physiology. However, during our PBL we had found that:
1) one area of the brain stem that was apparently very important in inspiration (in breathing) is now not very important at all
2) another area of the brain stem that seemingly only dealt with expiration, dealt with both
3) there was utterly no mention of the current leading thinking regarding a very important specific part of that area of brain stem.
In short, if someone were to use this textbook, and this textbook only, they would be out of step in regards to how we breathe. It's the first time that this has actually happened to me; reading a textbook and finding that there are contradictions from lectures and other texts - but I have a feeling I'll be expecting a lot more. This is not to knock Guyton (which I again emphasise is an excellent textbook); just that 3 years can already be considered outdated in physiology. I've been told that this 'outdated-ness' varies wildly with various parts of medicine though.

Well, the long weekend awaits. To be productive, or not to be... I'll see.

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...

Out of Breath

The first time I've ever wanted to really be over 18 was yesterday, when I was in the city meeting up with some friends from other uni's. Until then, I saw no reason to be over 18 - I have a debit card, eBay account and Paypal account all *supported* by my father, and voting isn't too big a deal for me (although I do pay attention to politics, ironically). But when there was only me and my friend who came from Perth left, we went to look for dinner, and saw "$10 Buffet!" which, you know, was kind of enticing. Until we saw the bouncers.
Who directed us to another bar (which also mentioned "$10 meals") which apparently allowed under-18s...
Which rejected us again.
And so forth and so on ($6 steaks) until we couldn't take it (well, I couldn't) and we went to eat something else.

Anyway.
Formative exam was a massive screw-up; unlike last semester's formative which was a breeze, this formative was a lot closer to the difficulty of mid-semester exams - and since I winged this one, chances that I pass are not good. PBL was interesting - we just started the respiratory system and will finish it off by the end of this semester (surprisingly close - I can't believe the academic year is nearly over!)
We had updates on our anatomy spot test (where you identify various parts of a cadaver) which was to be summative (i.e. counted) and our OSCEs, which are formative (i.e. not counted). Apparently we'll be getting a practice run for the spot test, but not for the OSCEs - fair enough.
We have a one-week break now though - time to do some revision and catch-up, so I don't fail the end-of-sem exams. Aren't I lucky.

The Ironman

Well, clearly that was what our PBL guy thought he was. Some super tough guy, who doesn't need to listen to doctors, or attend any appointments with healthcare professionals. No, after staying in Emergency Ward for nearly a week, he thought his health was totally unimportant, and after all, whilst he was in hospital he's behind on his work - yeh, I mean, that is so much more important than your health. Our PBL case today, was a numbnut middle aged man who clearly thought that taking your medication regularly and not neglecting doctor appointments was the golden path to living long and prospering.

*achem*
Sorry about the heavy dose of sarcasm. This patient, real or not real, died because he did not listen to someone who knows more about his health and how to keep it, than he does. He walked out of Emergency Ward because he was treated correctly and was deemed to be reasonable human being that wanted to live. 4 days later, he comes straight back to Emergency Ward courtesy of the paramedics, and they can't save him anymore. Well done, I say! Well done! It ticks me off that the first patient that died in PBL, died because of his own stupidity, non-compliance and despite the health system's best efforts. We spent 10 minutes as a group, discussing ways to solve non-compliance - I think that a story like this might be able to shock all these people who think asymptomatic means you're fit as a fiddle and ready to go.

So, anyway, the rest of my week was good. Productive week, and Formative (yes, I know it doesn't count, but it's good to know where you're at) Exam #2 is coming up, this Friday. So yep, good time to go heads down. Also, hope all you UNSW first-year meddies snapped your exams :)

School's Out

Hmm. I was struggling to find an appropriate title for this post, but I guess this one suits, since the day is *sort of* over.
Alright. ISAN09! Some stats: 2 day conference, 8 Symposiums (lecture sessions) running through the two days, 2 Symposiums running in either of our 2 lecture halls at any one time, 30 presentations (one presenter unfortunately was not feeling well), and a cumulative 9 hours of total hard-core concentration. Phew.
The symposiums I attended were Microneurography I (Chaired or introduced by our own Vaughan Macefield, UWS Represent!), Gravitational Stress, Imaging Central Autonomic Control in Awake Humans, and Clinical Applications of Neurotransmitters. Impressed? Yes, I was blown away by the average IQ in the conference as well :)
First one; Microneurography is a method of measuring electrical impulses in nerves all around the body (but mostly in the arm and leg since they are the easiest to access). That symposium was all about refinement of techniques in using this to record activity in nerves - actually quite difficult to concentrate in, but I managed to get most of it down in notes.
Second one; Gravitational Stress - this was all about research regarding nerve activity in Space and microgravity (i.e. zero gravity). Sounds exciting, yeh? Unfortunately, the presenters from Japan and France were difficult to understand, and the material was (in my opinion, anyway) rather in-depth and specific. It was still interesting to find out how they simulated microgravity on Earth though; and some of the gadgets they used in space to record vitals.
The third and fourth were just yesterday; the Imaging symposium was pretty full-on, whilst the Clinical Applications of Neurotransmitters was more interesting for me since it had some clinically relevant stuff - such as reducing High Blood Pressure in individuals by de-activating the nerves in the kidneys, with some pretty dramatic results. So I thought that was really worth looking into; and in reality all of the research presented at this conference was pretty cutting-edge; we had information from studies which had not even been published yet, and was still in the process of submission. So yep, chance of a lifetime.
Meeting some of the researchers was interesting too; I met this person from Canada who actually held an Engineering degree, and was applying mathematics to the waveform model of nerve activity! Since this conference wasn't strictly medical, it was great to see the mixture of scientists and clinicians from all around the world, sharing information but also quite enjoying themselves in Sydney :)
The conference ended with a brilliant idea from one of my friends who suggested to Vaughan to take a picture of all the delegates. They were all quite game to take a few (ok, many, since there were numerous cameras) happy snaps, and nothing completes a meeting quite like a happy group photo with one particular scientist's taste of The Beegees playing on his iPhone. Nothing. Well, almost - Vaughan then introduced his iPhone (or iTouch?) and played The Presets, then suggested a breakdance party. Professor Macefield Rules :D
Today, in comparison, was not as exciting. Our PBL group assigned EBM roles, discussed a little bit, and went off on our merry way; PBL this week was quite interesting though - for once we didn't have a concrete diagnosis by Monday - which means some sleuthing around for the week! Aweeeeesome.

It's Never Happened Before

What hasn't happened before? Well, me winning in Minesweeper on Expert was what hasn't happened before. Minesweeper Expert was a constant source of rage and bereavement for me - I have this print screen titled "THISISWHYIDONTPLAYMINESWEEPEREXPERT.png" which highlights how I had nearly finished the entire board, and it all came down to one coin flip, which, by Murphy's Law, meant that I lost. This happened a multitude of times, and even today, until finally, I outwitted the probability table and finished in 542 seconds. Granted, I'm not going to break any records anytime soon, but the satisfaction is really keeping me on a high right now :)
Another thing that hasn't happened before was me speaking for 15 minutes straight. I've never, ever been able to do that. Ever. But the opportunity presented itself in the form of PPD's Reflections statement sessions; 2 hour sessions with your PBL group, talking about your life story. Multiplied by 11. Heh. It's actually quite fun, learning about where people come from; I quite liked it, and I think most of us did as well; the saying "I don't want to hear your life story" definitely didn't apply here.
Yet another first was me not sleeping through a particular (though excellent) lecturer for the first time. He is absolutely brilliant, but his voice...is...rather.....calm...and....mellow..........zzzzzzzzzzzzzzZZZZZ
BUT. Not today. Hah.

On top of all of this, ISAN09 is coming up in just 2 days time! Whoopee! This must be the greatest week ever. Winning Minesweeper, interesting PPD and ISAN. Oh, except on Friday it's PBL again. Akk. I would look forward to it if I did work this week, but alas. Various priorities popped up ahead of PBL (such as learning a song - Superchic[k]''s "Stand in the Rain"). Just goes to show how you can have a life outside of Medicine. :)

I'm Trying Hard

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

So Tired...

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

Fun fun fun

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

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

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

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

ISAN09! Rawwwrrrrrr

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

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

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

Time passed so quickly...

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

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

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

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

The leg bone's connected to the thigh bone...

A 2-hour anatomy practical really doesn't get you into the mood for a 2-hour statistics lesson (Yes, Statistics, you may be thinking wtf? in Medicine, but believe me it has it's purposes) straight afterwards. Add to that a lecture in the afternoon (which half the grade dozed off in) and I think Wednesday was a pretty long day...

I actually enjoy anatomy, to be honest; it's wonderful to know where everything's connected (actually we were looking at the abdomen this week, not the leg as the title so subtly implied), and wonderful to have some really great teachers of anatomy (we have this fairly old surgeon who's awesome at teaching, I think everything he taught went right into my head and displaced something else), and the cadavers themselves were (today, at least) far from obese, which was nice. It's just that learning anatomy, for me at least, requires intense concentration, somewhat alike to playing chess. Although I've played a four-hour chess game, a 2-hour anatomy prac seems just that much more tiring and satisfactory. So all that intense concentration took me right out of the zone when we started on database analysis in Statistics. *zzzz*

And oh dear, my computer just restarted after Automatic Updates. Thank heavens for Blogger's autosaving of drafts ^^

We were also meant to do our 'Interviewing of a Patient' (not official name) assignment, our first one so far (Yes, come to UWS if you don't like assignments!) yesterday. This is part of our PPD segment in the course, and the aim of this particular assignment is to interview a patient and give a recount of his/her experience, and empathise with the patient via means of a written response and a presentation. Our patient had his son come over to visit him, so he was busy, and as such we decided to reschedule the meeting, probably to next Wednesday. It's quite nice to have friends that can drive; Camden isn't exactly the most accessible place via public transport.
We were about to skip our last lecture so we could interview our patient, but since that didn't go to plan, we had the enormous privilege of dozing off through our lecture; I think I should go and look at the lecture notes/synopsis now. And probably revise anatomy... and probably write up my clinical ICM notes...and probably revise the statistics stuff as well... arggh.

Awesome-ness

My textbooks arrived! Actually it arrived yesterday, but no-one was home so they re-attempted today. So I purchased 3 books from an Indian distributor on AbeBooks.com, at the cost of AU$160 including shipping, via FedEx. They were Rang & Dales Pharmacology 6th, Netter's Atlas of Anatomy 4th, and Boron & Boulpaep's Medical Physiology 2nd Ed - two softcovers and one (the Boron) hardcover. Being the hardcover, Boron's cost about half of the total bill, but there appears to be no softcover version of the textbook.
On first inspection, it appears that I got the cosmetic-damaged goods. The corners are either bent (on the Boron hardcover) or slightly damaged (softcovers); the softcover spines are a bit damaged on the bottom. I'm not very sure whether this is the case for all retailers, and when I purchase more books in the future, I'll be sure to compare experiences.
One thing I noted was that although the Netters and Boron were labelled "International Edition", the Rang and Dales wasn't. As a result, the Rang and Dales also came with a StudentConsult code, which was surprising - I wonder whether it was a mistake or if the Rang and Dales doesn't have an international edition...
The paper is of excellent quality, and in full-colour. So I think they're quite genuine (the Boron is printed in Canada), just subsidised for their target market (desperate med students from developed countries trying to save as much moolah as possible). Netter's atlas looks brilliantly vibrant, and from this, I'm generally quite happy with this purchase. The local editions of these books would be about AU$400, so there's a saving of about 2.5 times (after considering postage); the drawbacks are the cosmetic dings and the International Edition labelling.

In other news, I think HP6 doesn't deserve the bad beating its getting from some members of the public. It's a bold move to not contain an epic battle scene; certainly a departure from the norm. I was chuckling a fair bit during the movie too, twas nice to escape the general darkness of the film. But in short, yes it does depart from the book, no you shouldn't avoid it at all costs, but yes you may want to consider your expectations before watching.

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,

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 :)

Back to School...

Well it's been a relatively uneventful but (as usual) very quick holiday, even though this one lasted a whole month. My call for extra temporary students for my little part-time tutoring thing pretty much failed, helped by my site's web server downtime (a week or so), and managing to hit one interested person, but not having his message until a few days ago (and thus pointless, because by then I had things arranged for the last few days of the holidays). I spent most of my holidays away from medicine, trying movies (a korean mystery named Mother), music (Adele's 19 album) and even going back to some books (John Marsden's Letters from the Inside is, in my opinion, worth a mention). One thing I did not stray away from was stethoscopes. Worrying about which stethoscope to get is probably equivalent, in med school, to worrying about which pens to buy for the HSC. But, frivolous as it was, I spent hours upon hours doing as much research as possible into the little pet topic of interest amongst med students. And finally, after all the blood, sweat, toil and tears, I made a decision: the Australian company 'Cumpers & Robbins' Trikoph (??) Cardiology (!) Stethoscope (a very important point to note) in Navy blue colour (an important decision, or so I heard, which I made in about 10 seconds). At $160, it certainly wasn't cheap (found a 10% discount voucher - 'Supporter5' for the store, Medshop Australia, which dropped the total cost plus shipping to $151) but it was certainly within my price range. Amongst others, I had the Littmann Master Classic II (single-head, single-lumen, standard diaphragm), Spirit Cardiology (single-lumen and standard diaphragm) and the good old Littmann Classic II SE, for which I was particularly enticed when I saw the 'FREE PENLIGHT' offer at Medisave.

Some key pointers from people I asked (doctors, cardiologist registrars and a few others) and what I gathered online about stethoscopes:
- Soft ear-tips apparently make a world of difference.
- They last a while. A long while. But they often 'grow legs' when unsupervised.
- One of my cousins is doing well as a doc with a Littmann Classic II.
- Brand-name appears to have minimal effect on steths, but Littmanns are far and away the most popular (by which reasons, I have not found out)
- The cheapest cardiology steths (from a decent brand) are better-sounding than the most expensive classic steths. I'm not too sure about this, and it will be one of the key things I'll be testing for with my steth.
- Single lumen vs double lumen tubing - contradictory anecdotes about this, but double lumens are quite standard in cardiology stethoscopes (although mine doesn't.....)
- Floating Diaphragm, Tunable Diaphragm, Floating Tunable Diaphragms, Bells, Paediatrics Diaphragms and Bells, etc etc. - Apparently, only C&R and Littmann have floating diaphragm factories. Hmm... this allows you to vary the frequencies of sounds you hear depending on the effort you push on the head of the steth. Once again, contradictory anecdotes found on the net regarding whether this is a good or a bad thing (having zilch experience, I'm sitting on the fence in regards to this)
- Length of tubing - Once again, contradictory anecdotes, some say longer allows you to not invade the patient's 'private space', whilst others say shorter allows you to hear better - I would side with the shorter team, since 22 inches (relatively short amongst all the 27 inch ones) is pretty much the length from your ears to the slightly bent arm anyway. Having said that however, I don't think it is a crucial difference - its hard enough to find 22 inches as it is.

I found that there was virtually no information for brands other than Littmann or Welch-Allyn, so, in the spirit of the medical student guinea pig, I will be reporting the results of my Trikoph stethoscope, and see whether it measures up to others (via the help of some colleagues).

You may ask 'why a stethoscope in the middle of the year?' to which I would reply 'because I didn't need it in the first semester', to which you may reply 'you don't need it in the second semester either' to which I would reply 'my friend said we did, and I want to get one soon anyway'. I was also shopping for books and might get a penlight - not just for med, but for computer repairs and upgrades (quite handy to see where jumpers are without taking out the disk drive - if you don't know what jumpers are, ignore this whole thing). But for now, am looking forward to another exciting semester of hard-core medicine, so sayonara holidays!

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.

Tension

Less than...18 hours until exams start! Wooo............
By the time yesterday rolled into view, and I was thoroughly sick of studying, having crammed my brains out. So I decided to go on a word-count spree, just to make myself feel good.
Turns out that over the week I had accumulated 20,000 words of personal, self-typed summaries. I felt proud that my notes over a week were approaching a PhD thesis length, and also made me realise that the length of a PhD thesis had nothing to do with the actual amount of work done over the three or so years to reach it.
So today was supposed to be the ultimate final revision day. And it sort of was. A small group excursion to Parramatta Library for study purposes revealed a few very important points:

1) All local libraries are closed on public holidays. Including the State Libraries, but excluding University Libraries (as of 1st July 2009).
2) One small coffee (between the 5 of us) was not enough to stay in Gloria Jeans for very long.
3) Parramatta Library, however, has a very useful outdoor table which we did use for study.
4) Despite the best intentions of the group, and despite one person trying vainly to stay on track, and despite everyone participating, half the study time was lost talking about games, what we were to do in the holidays, and miscellaneous topics of discussion (such as Twilight)

So remains the last few hours available for intense exam cramming; I'll be back on Thursday to debrief the exam. But for now, PPD, Statistics, Immunology, Diabetes Mellitus and other Lecture revisions beckon. Toodles.

Down, but not out

First post of the month, yippee!
That's probably about the most joyous statement I can muster today; I'm smack bang in the middle of my StuVac, and let me tell you, Uni cramming is NOTHING like HSC cramming. I've managed to write up 10 000 words of concise PBL summaries so far (up to my 6th PBL out of 11) in the past 4 days, and I'm behind by one PBL, by my schedule. So not really feeling happy about my progress so far... on top of that I still haven't finished my Week 12 (i.e. last week) contribution - the writing up of the final learning objectives, so I really hope I'm not delaying 10 other people's study - I'm about halfway through.
So I've realised that despite being relatively more prepared than I was for the HSC (I started cramming for HSC trials a few days in advance, whereas this time I started a week and a half away), and despite this being the very first Semester of the very first year, I'm still managing to be behind. *sigh*
Oh, and I got snapped for my JFPP interview. Self-prophecy much, but I knew I didn't have that much of a chance; I know the people who did apply for it are really keen on the program, so kudos to them; at least next year I'll have a fair idea of what to expect (and make sure not to forget my citizenship documents, heh...). That leaves me with an empty schedule for the summer holidays (so far away, I know) so I'll be looking to fill it up with the newly announced UWS Summer Research Scholarship deal; or perhaps USyd's research program; or perhaps just go into the hospital system and see what I can scrape.
And finally, my external monitor for my eeePC is starting to die (15" monitor, second-hand when bought). At 1am yesterday it started flickering all shades of orange; so I'll be looking to replace it with a new monitor ([!] that's kind of a good thing! Big 23" LCD monitor, here I come!).

So yeah. I think the best thing to happen to me now is to manage to finish my exam preparation in time, and snap the exams so I can look at ways to solve all these problems, and then break out a new resolve to continuously stay on top of stuff for the much, much, much more arduous (but hopefully also much more interesting) second semester. I do realise though these are relatively miniscule worries in the big scheme of things. But for the moment... "I can't wait.....for the weekend to beginnnnnnn"

Surveys, Tiredness and Yummy.

Yeh, wow random blog title, heh.
First off I'm surprised this has lasted a month. Hoorah! I'm so happy I could hug you right...now :)
Mmmm kay first on the agenda was a survey...
We had an anonymous survey today for constructive criticism of a lecturer. I won't name him, but I thought he was just average. Problem was that I thought it was a survey about the PBL experience, since it was our last PBL for the Semester today. So I started the survey off *very* positively, then saw the name of our lecturer at the top of the survey (my friend nearby had to remind me too...), and after that I aligned my marks more towards what I would actually give the guy. Tried to give some constructive criticism though - get your lecture notes on time, be a bit less boring, try to encourage some discussion - but I thought it was a rather poor effort on my part. I had an excuse though, which leads me to the next situation:
Tiredness. I have no idea why I felt tired today - I slept a grand total of 10 hours yesterday, after promising myself I'd "just take a 15-minute power nap". Problem was that I took this "power nap" in my bed, and my bed felt so comfortable...so I just slept early. So you'd think I would be wide awake in the morning, and to an extent that was quite true. Until I had my first lecture. Metabolism.... zzzzzZZZZZZZZZZZZZ
Woke up 10 minutes before the end of the lecture, and that set the mood for the rest of the day. Oh wells.
On a brighter note, I ate my first ever brownie today at our last PBL session of the Semester! And it was super delicious, haha. And I'll leave on that happy note whilst I start my intense cramming for my end-sems (only possible in Semester 1).

Work Balance, as our first semester in med draws to a close...

I tutor 3 (temporarily 4) students on the weekend, one-on-one, for a cumulative total of 7 (temporarily 9) hours per week. So far it's been working out perfectly, but as exams draw closer, I'm wondering whether I should cut down on my sessions, even if just for a week. Then I think, if I had more time-management skills, I shouldn't need to at all. Which gives me a challenge; to continue tutoring during the exam period.

Since it is Semester 1, Year 1, and my formative exam result was a pass (even if barely), I'm going to take up this challenge and see whether it would have any negative contributions to my exam performance and studying for it. I've already noticed that I finish Friday pretty drained, but I seem to rebound back on Saturday, in time for tutoring, in essence, from 10am - 6pm. Then I have a temporary student on Sunday afternoon, and I also have church, which means that both Saturday and Sunday's mornings and afternoons are occupied.

At the moment (Friday night), I'm very drained, and kind of fell asleep in the last lecture (Pathology of Diabetes), which means I'm feeling pessimistic about this challenge and whether I'll pull through. Even though I have a big aim (First in my course, I know, laughable) and bigger competitors (great thing about med: everyone's a nerd, so everytime you go anywhere in the med building, there's a big group studying), I have a feeling it won't be enough to pull me through this stuvac block. But who knows...

Not to mention, I haven't even met everyone in my course yet, and its nearly the end of Semester 1. Haha... the groups I haven't met yet are the ones I have not had much to deal with yet; Indian girls, and caucasian guys and girls. It's an improvement from high school though - I think I could name a few people who I had never spoken to, in all of the 6 years we had; mainly because I would not be in their classes and my group would be very, very far away from theirs (both geographically across the school, and in terms of common interests). So yes, indeed.

I also found it ironic that we're so nostalgic, at the median ages of 18. Many of our conversations drift to high school, although I know that's all we've really experienced. But yes, interesting. Currently I'm in a nostalgic mood myself - listening to 1 Litre of Tears' Main Theme song (which by the way, is a very moving Japanese drama series. Very, moving. I was bawling by 5th episode, 11 episodes in all.) which summons back all the memories of Year 12 - the series, in fact, has a very strong nostalgia element, and all this classical music really accompanies this mood well. So I'll leave on this note - our first ever semester in med is drawing to a close, and I will miss it :)

2nd Last Week of ICM for the Semester...

Today our ICM, and next week's ICM, was a review session. In essence, we didn't watch the videos of actors portraying medical students doing interviews, but instead went straight to the wards for some friendly non-assessable assessment of our History taking skills and bedside manner. We managed to fit three histories into one session, and I just so happened to be the last, which caught me unaware - nonetheless I did my history without any real fuss, but wasn't really thinking quite as optimally as I would have liked. Today was also special because:

1) We introduced our tutor, Dr Zelas (a middle-aged male surgeon) to Twilight via a patient who was reading New Moon (one of the novels in the Twilight series), and;
2) We spent a good fifteen minutes after the session planning what to get for Dr Zelas as a thank-you present for this semester's ICM; apparently we will be switching ICM tutors next semester(but not our group, yay), and may be thinking of including said novel in the present package. Hah! It would be amusing if he finds he quite likes Edward and Bella; perhaps he's an old-faashioned romantic, in which case he should take quite a liking to this novel aimed at the teenage female demographic! I have male friends who enjoyed the series; and I certainly enjoyed it (stayed up to 4am reading Twilight, and yes I'm quite straight) so the scenario of Dr Zelas sitting on a sofa reading Twilight until...twilight, might perhaps be not very farfetched at all, haha...

Apparently, we also switch PBL tutors this semester too. So we'll be looking to get something for our PBL tutor as well; although my absolutely shocking PBL assessment mark of 14/20 doesn't quite encourage me (though on second thoughts I was a bit quiet...) I will look forward to writing the cards. I get the impression that Dr Zelas has no clue what our names are, and that we might be quite forgotten in a few years time, but I hope the gifts might help jog his memory when we become colleagues, hah.

So it appears that each semester, we switch PBL and ICM tutors, have no idea in regards to switching PBL groups (although that may be quite possible), stay in our ICM groups, and stay at our chosen hospital (Blacktown, woo!) but also stay on the same day. It's unfortunate abotu switching PBL groups but I guess I look forward to working with other people and see what dynamics will appear in the new group :)

John Flynn Placement Program

I nearly failed the JFPP interview on Wednesday immediately, when I forgot to bring my proof of citizenship/permanent residence on the day; and not only that, but not realise that our med building had an almost hidden 4th floor which was were the JFPP interviews were held; so at 1:30pm (interview scheduled at 1:40pm) I was running around like a chicken without a head around our med building, trying to find the interview. So yes, not a good start at all.

Found the 4th floor (which can only be accessed either by lift or through a stairwell inside the 3rd floor's administrative staff room) at 1:35pm, thinking that I'm probably not going to get a spot now that I'm all flustered. There were 3 people who were at the actual interview, and one came out to invite me in (I immediately raised the issue of the missing documents, and he brushed it off and said I could bring it in tomorrow, which was rather nice, as that would've been an easy way to cull down the numbers...); it appeared that of those 3 people, one was the actual marker, one a previous/current JFPP scholar, and one a community contact, such as a rural/remote practicing GP, or the like.

The interview went alright, I spent 20 minutes which was a fairly long time (reports were an aaverage of 15min for an interview) for a JFPP interview. My odds were given to me straight uup - 15 candidates, 11 spots. Not a bad chance, I'd say; knowing me though, my chances are always much less than that. I tend to fail pretty hard at interviews for some reason, not sure why. Anyhow, I answered most questions, got stumped for one of them which I won't reveal, and so now I'm waiting for 4 weeks for ACRRM to process the interview results and see what the outcome is. So watch this space in 4 weeks, I guess.

Expectations and Deep Breathing

We received our Formative exam result back yesterday.
To recap, we didn't have mid-semester exams, unlike other courses at other universities. So to replace it, we had an exam that did not count - i.e. meant to be used as a measuring tool to see how large your knowledge base was.
I got back my exam results, and, on counting, I scored 54%. Which was a pass. It's about this stage that I see that there is no comparison with high school results; with the kind of work I was doing, I could easily expect 80% or more (I didn't do any revision for the exam, but did do continuous work during the mid-semester), but I'm wondering how to broach this result to my over-expecting parents. I can envision the scenario:
"Mum, dad, I passed my first medical exam!"
"How did you go?"
"Umm 54 percent. I beat heaps of people though..."
"What was the top mark?"
"Oh it was horrible. Really hard test. I think it was 65% or something"
"You must study harder. Your grade is not smart. You should have got much better."
"But it was a really hard test."
"Nothing is impossible. I told you those games are a distraction. Maybe you should stop tutoring as well."
"But........."
I was pretty content with my result, relative to our cohort, because marks are fairly meaningless when you don't have comparison results. Looking at the bigger picture though, this mark doesn't make me feel like I'd be a competent doctor in the future, and that really worries me. So study I shall, now. Or tomorrow. Maybe next week.

On another note, we had ICMs today, and this week we focused on respiratory problems, mainly coughing/shortness of breath. For ICM tutorials, we usually get a booklet for the specific tutorial on vUWS (virtual uws, or our online resources/lecture notes hub) to print out - however my group fell out of practice of printing those booklets due to lack of usage. Next week, however, we might change, since we never touched on respiratory symptoms before. I came to realise that most symptoms had many basic questions overlapping, such as when did it start, describe the symptom, and things that made it worse and/or better. Our patient today was a picture of many elderly people in the Greater Western Sydney region; a frail old lady living on a pension with barely any savings. We seem to encounter many smokers in Blacktown hospital (my allocated hospital for clinicals) and she was another one, who suffered from emphysema, most likely due to smoking but also a pre-existing tendency towards it. It was sad to see that although she stopped smoking more than a decade ago due to her parents suffering from the same problem she has now, her daughter hasn't. Whether that is a case of young people feeling invincible or that the addictive nature of smoking is such that it can defeat something as powerful as your mother suffering from emphysema, I'm not sure; but I do know that smoking is a massive plague on health resources, and especially in the GWS area, for some reason. At any rate, tomorrow I'll be facing another interview of a different sort - a John Flynn Placement Program (JFPP) interview, to be precise. So I'm off for the day, to just do a little bit of preparation for that and try to do some study.

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.

Hospitals are not cheery places.

I keep hearing that ICM (Introduction to Clinical Medicine, or hospital visits) are the best part of *insert students name here*'s Medicine experience. While I think it certainly is necessary and is useful to build up communication and clinical skills (later on), I don't always agree that ICMs are the best part. Today was a rather shell-shocking day; an elderly man was gaunt and straining to exhale due to progressed emphysema, hard of hearing and generally in a poor state. In the next few minutes of our interview we were introduced to his life as a result of decades of smoking. It's not like we aren't aware of the dangers of smoking, or the possible consequences and risks; but more the fact that it confronted us here, right then and now when we were just expecting to practice our history-taking and interview skills. His condition was such that he could not work, mow the lawn, do most housework, and look after his wife; confined to sedentary activity and struggling with every breath, he remarked that he felt suicidal. When he said that, we were all stunned; 6 first year medical students meeting a man in whom hope did not exist and despair reigned. And this reminded me of what we were here to do, but also, it reminded me of what we couldn't do; when all we can do is really give painkillers and pretty much pray for a painless death. In PBLs and other ICM interviews we have encountered a few chronic diseases, and its nice to be a doctor and be able to make someone get better, but with specialities like Pallative Care I wonder how they get through every day intact. Our patient re-iterated "don't smoke" and its a fair warning, considering his personal testimony, and all I can think of is how he hopes to stop others from going through what he is right now. Whilst cases generally make me motivated to study harder (in light of an application for that knowledge later on), this one just hit me and hasn't had any positive effect so far, except for this reflection. Much food for thought.