Good-bye, September

September is at an end, and the weather is getting very warm. Exams are getting close, and I get to work out a way to study while dripping sweat. I hate being hot. :(

I went to the air-conditioned gym today and did an RPM class (on exercise bikes to music) and even though I was sweating and working hard, I actually felt cooler than when I was sitting at home studying in the heat.

Also, what is it about exams being close that makes me want to cook, even though it is very warm in the kitchen? Anyway, please excuse the post quality. The other thing about being hot is that I get quite vague and have difficulty concentrating.

Northern Hemisphere residents, right now I am jealous.

I'm excited!

Can you guess why?

I realised that I am almost 1/4 through medical school and becoming a doctor. Hooray! As an added and extra bonus (which makes me resemble the kitty in the picture) I am nearly half-way through completing PBHell in its current format.

For me this is a lot. Medical school has been tough at times, but as long as something is interesting and worthwhile I don't ever mind working hard at it. To be honest, while it has involved a fair amount of work, it is definitely a goal I can attain.

It also means that I am almost a second year medical student. While not much, I won't be as embarassed any more when I don't have to call myself a "first year" any more. It is very exciting. I would imagine that the next time I feel like this will be when I am approaching the end of my intern year. But right now, that feels like a million miles away.

Credit where it is due

I don't usually wax on about being older, married and so on, but I just wanted to add a quick post to say that I am damn lucky that I am going to medical school now and not ten years ago when I was single and had a slightly less balanced life.

Living with a supportive partner has been the best gift I could have ever asked for. If I come home wondering whether I am overreacting to something, being unfair or worrying too much, I have a wonderful sounding board who is not afraid of being honest with me.

My better half can turn me from a nervous wreck who is sitting on the couch in a panic to falling off the same couch with tears rolling down my face in the space of thirty minutes. Hugs are also nice.

I could go on but I won't. I'll just add that he rocks.

Sulky

Did I mention that today was the day that I was beginning my massive study period?

Of course I did. It is written directly below this.

Oh well.

Actually, revision is not so bad. I just hate the clotting cascade and everything in it. Stupid cascade. *grumblegrumble* Stupid finite brain.

Excuse me, I just have to go off to my corner to sulk and study simultaneously.

Tomorrow

Tomorrow I am going to get my head down, start to do some serious study and finish with all of this procrastination. Tomorrow.

Reading about other people doing all of their wonderful study is starting to send me into panic mode. They have clearly been doing more organised work than me. (Polly clearly rocks. ;) ) I've been spending time trying to understand concepts, so hopefully when it comes to doing the Big Revision I will actually learn it pretty easily. Part of me doubts that this is the case. We will see.

But for now, I'll go to bed scared and focus on tomorrow.

Sweet and deadly

Hospital morning teas can be deadly. Particularly when they spread out into lunch and afternoon tea because there is just so much wonderfully naughty food.

I always find it ironic that people who spend all of their day dealing with a lot of obesity-related illnesses will retire to the tea room and tuck into a second helping of cheesecake. :)

Off to the gym!

The confusing nature of modern medical courses

Sheepish (from The Paper Mask)posted a comment on the second-last post, and this entry started out as a reply to that, but ended up far too long. I turned it into a post instead (which will make my numbers for this month look far less slack ;) ).

There are many opinions out there that hold that the current nature of medical school teaching and learning in Australia is suboptimal. While I would argue that a keen, quality student from either the old system or the new is still going to make a good doctor (I'm sure nobody would argue with this), I definitely think that the current style of course is in dire need of some changes, at least at the level in which I have been involved.

The current medical courses which integrate PBL and lectures ARE extremely frustrating in that it is very difficult to work out what to learn. PBL seems almost too basic at times, but on the other hand, the lectures are delivered by scientists at a level that is so advanced that people whose undergraduate degrees were in these areas have trouble keeping up.

Perhaps the lecturer wants us to have a solid knowledge base in his or her area, but sadly we just get completely overwhelmed (well, I do!) and end up going back to good old Kumar and Clarke or other clinical textbooks to actually understand anything. The lectures don't tend to reflect what we need to know, or the depth at which we should learn it. As a result, we don't often get a lot out of the hours that we spend in them.

Most students end up relying on the advice of past students to get through exams. I would genuinely prefer to have a more guided course content, taught at the level that we need to know it. PLEASE bring back a more didactic teaching style in some fashion. We spend a week on a condition in PBL and almost never have a lecture on it. I LOVE when we have actual clinicians teaching us, but I think that this will happen more next year.

One of the other problems in PBL is that if you have a more dominant member of the group who has an excessive amount of confidence, he or she can convince the group that whatever they say is right, even when this is only the case in their own head. I would much rather look something up in a book or in a journal than argue a point or wonder whether or not I can believe a single thing that another person at my own level has to say. I would also rather spend time sticking pins in my eyes than arguing with somebody who uses LOGIC to prove that what is wrong is actually right. My brain is too small to take up space learning incorrect information!

I would like the style of course to change, and the universities are apparently receiving a lot of feedback about this, from both students and doctors. It is another matter whether they will listen or are happy to send students through with the course as it is.

It is sad that doctors who give their time to teach in a hospital setting (because we all know how much spare time you have ;) ) get students who aren't interested, particularly when you are making an effort. It isn't fair to you, and it makes things worse for those of us who are keen.

Long before I even considered being a medical student (well, not that long!), I had groups of medical students come through my work area in the hospital to observe things. Mostly they just stood back and gossiped instead of paying much attention to an area in which junior doctors quite often make fools of themselves. In the end, I told them this (in slightly stronger words), but I don't think it sunk in.

There was one student in all of this time who actually paid attention, asked questions and was interested, and in the end she learned a LOT more than the others, as I organised for her to spend a good while learning from one of the medical consultants (who was one hell of a teacher and who students would normally not have known about or wouldn't have had access to). Being interested pays off.

Having spent a little bit of time in clinical areas with others in my year, I was a little dismayed to see the same kind of behaviour. They are genuinely intelligent, nice, and enthusiastic people, and I don't think that they realised what they were doing, but it was still disappointing.
It is hard being in first year and not knowing much, but that doesn't mean that it is too early to get in there, have a go, and start learning. Hell, if somebody is willing to teach me, I'll be in there like a shot!

Why?

Why is it that it is easier to accept the decision of a parent to not vaccinate their child if you aren't close to them, but when they are very close to you and they tell you about the alternative literature they are reading and believe, and have decided against vaccination, it is something that is very hard to accept?

Yes, I respect the right of the parent to not give their children "pointy kisses." (See The Underwear Drawer's comic on Paediatricians.) It is just difficult when they accept the word of complete strangers over the opinion of those closest to them.

Aaarrgghh

Sorry that the posts have been a little sparse lately.

I have exams coming up very soon, and I haven't been putting in enough study to feel comfortable about them. You know that feeling you have when your exams are getting closer and closer but Dr Phil suddenly looks far more interesting than metabolism diagrams?

It's that feeling.

Unfortunately it also seems to be the busiest time of the year socially, as I have family about to move away interstate and in-laws who like to drop in on a whim from interstate and expect everybody else to drop everything and spend time with them. I love them, but I'm expecting to see them a whole lot less when their only grandchildren (not mine) have moved more than a thousand kilometers away from us.

So, everything is coming to a head and quite franky, I will be happy to pass this year. I know I felt that before the mid-year, but I think I was slightly more organised and motivated then. Oh well.

Also, why do doctors who went through the old Australian 6-year undergraduate system feel obliged to trash-talk the new 4-year graduate medical courses? Most of our undergraduate medical courses are shortening to 5 years, anyway. Surely a 4-year graduate course after a science/health degree completed by more mature people compares favourably to a 5-year undergraduate course completed by somebody who could start the course as a 16-year-old?

Good luck!

Medical school interviews for next year in Australia are well and truly underway. To anybody who is about to go through them, good luck! I remember that it was a more stressful process for me than actually being in medical school.

Also, good luck to those of you in the other hemisphere who are about to start medical school. I'm excited for you - it is so much fun and you get to learn so many interesting things (as well as a lot of uninteresting things, but I don't pay much attention to them!).

A small word of advice - it appears that difficulty with aspects of organisation and administration in medical school is a vital part of our medical education no matter what part of the world you are learning in. Perhaps they wish to teach us patience. Maybe they are getting us ready for our jobs as doctors in the future. There is a distinct possibility that they just can't run any other way. Don't let it get to you. Ignore it, yell like hell when you need to, and just get on with the things that are more rewarding and infinitely more fun.

I might as well add a big fat GOOD LUCK to those of us preparing for our exams. If you are anything like me, you need it!

A fishy tale

The good news is that I am feeling much better than I was a few days ago. Welcome back, brain! Fortunately I managed to recover in spite of receiving almost no sleep at all on Saturday night. Here is a fishy tale of what occurred:

We had gone to visit my brother and his wife who life a few hundred kilometers away and so were staying the night. Our bed ended up being on the other side of a brick dividing wall to his aquarium. This dividing wall did not go all the way to the ceiling and the door was open anyway, so we could hear everything from the fish tank.

A few months ago, my brother bought a red devil cichlid to go in his tank. This fish is huge (about 25cm), and much larger than any of the other fish he has (or had) in his tank. It looks very similar to the fish above. The rule of fish often states that a fish will eat anything that can fit in its mouth. Some people who have these huge cichlids feed them so-called "feeder" goldfish as part of their diet. Nice.

In spite of there being a fair bit of shelter in the tank, within a couple of months, the only things left in the tank were some small crayfish, a slighly smaller red devil (who is around a quarter of the size of the bigger fish) and a couple of catfish who somehow swim fast enough or don't attract the wrath of the killer red devil. I won't go into what I think about this. He already knows.

When we went to visit my brother, he had installed a mesh divider across one quarter of his tank and (God only knows why) had put in two baby barramundi. The divider and the fish had been in the tank for a few weeks, so I assumed everything was as it should be.

For those of you who either aren't Australian or who aren't interested in fish, a barramundi is an Australian fish found in the Northern Territory rivers. They grow to be quite huge, but when they are small they are very cute (and bite-sized to larger fish). Their legal take-home size if you are fishing and happen to catch one is a minimum of 58cm and a maximum of 120cm. Big fish.

Although I may be destroying the suspense of the story by sharing this, I can also say that they are very agile little critters and can dart around like lightening when the need arises.

I had been asleep for no more than an hour when I heard really loud splashes coming from the tank. Having a big tank myself (full of fish who don't eat each other due to equal size and temperament) I know that the occasional splash is normal. However, these just kept coming. I snuck around the corner and sat in the shadows to watch what was happening.

This red devil was having a hell of a night. The mesh barrier was dented in several places and was sitting at an angle, but was still holding. The splashes were coming from the smaller red devil who was alternating between trying to hide in the log shelter, into which the larger fish was trying to force itself, and above a large solid plastic plant near the surface, where the bigger fish had a lot of trouble fitting. The bigger fish was being very territorial and trying to either chase the smaller fish out of its tank, or kill it. Not nice. Considering that they had been living in the same tank for months, the smaller fish had been quite good at not getting itself killed. I wasn't comfortable with this, however there wasn't anything that I could do for this poor fish, apart from try to convince my brother to do something about the situation in the morning.

Lying there listening to the splashes was horrible. But then, after a little while, there weren't any more splashes. Which in a way, was much worse. I stuck my head around the corner, and saw that the big fish had actually knocked down the mesh barrier, and was now in the half of the tank where the smaller fish should have been. There was no sign of them, and the only other thing in the tank was one very angry-looking little crayfish.

I went to my brother's room, knocked on the door, and told him what had happened. He swore, told me to just turn the light off in the tank, and went back to sleep. I now doubt that he was actually fully awake, as in the morning he had no idea of what had transpired.

Thankfully my husband was also there. We spotted the two little barramundi, who had escaped to the other side of the barrier. We tried to fix the barrier back into place as best we could, and turned the light off. Once again, without a second tank or any other equipment, there was nothing we could do.

It was so hard trying to fall asleep. I had no idea whether this big fish had broken out and was doing his best to eat the baby fish. Occasionally I heard a small splash. Then I went back to sleep.

When the morning came, the barrier was still in place, and the barramundi had avoided being eaten by the smaller red devil who looked well-rested after having had the rest of the night on the other side of the tank to his nemesis. The big red devil was still on the smaller side of the barrier. Later that day, my brother rearranged his tank and organised to trade his two larger fish. So now, the little barramundi are free to grow huge and eat the next lot of smaller fish that my brother decides to put into his tank.

Rant: If you have fish, PLEASE research the composition of your tank before you set it up. In the wild, smaller fish have somewhere to run, but in a tank, they are trapped and will die an awful death if you put them in an area with something that will eat them as a snack.

Coldsville

At the start of the week I had all of these profound thoughts and comments to post but alas, Blogger took forever to load so I let both the deep and meaningful thoughts and the potential for posting them fly away in to the dark, breezy depths of my mind. (I'm not sure if it was blogger or my ISP. At the moment, I don't really care.)

Right now I am in the grip of a cold and my brain is on hiatus, so any thoughts I share would be at the level of a person who asks the same person the same question several times in the one day, albeit in slightly different forms. Not good.

I set the digital set-top box to record my favourite show, went back to watch it the next day, and found that I had programmed the wrong channel. Sometimes my brain frightens me.

I am really not on the ball, and we are also studying quite a difficult topic which I have half the energy to study, but need double the usual time. I would work out how I am supposed to study but my brain won't let me.

Now I have been thinking too much, and need a nap.