Last 4 weeks of medical school – Orthopaedic Surgery

October 20 – November 13, 2014

Ending medical school with a specialty I had been dreading… Orthopaedic surgery. Crazy hours, macho surgeons, and an intense knowledge of anatomy required were only some of the things I had been warned about.

Needless to say, I found none of the above true and in fact, extremely enjoyed my ortho term. There were 5 other students in my group and we were based at a smaller hospital especially known for elective hip and knee replacements. We were split into smaller groups of 1-2 students and assigned to an ortho surgery team. There were 3 doctors on my team, a consultant, a senior registrar and an intern – and I was very appreciative of each person, in particular, our consultant.

He started every face to face encounter throughout the day (even after coming back from lunch) with a smile on his face and the words, “So, did you do any reading? What did you learn? Why don’t you tell me all about it?” In response to our answers, he would ask us questions and provide us with more teaching. He was always kind and non judgmental, even if you didn’t know the easiest answers. His continuous interest and support in our learning was the push students (like myself) sometimes needed to really become interested in what we learning. Although the registrar had a different style of teaching, he was the same. There was never any time we spent with our team, whether that be in clinic, in theatre, or even on coffee break, that we didn’t gain more knowledge.

Even though I am not interested in pursuing surgery, for the first time in a long time, I felt useful and wanted in theatre. The team would encourage us to come to theatre and rather than leave us to watch silently and awkwardly in a corner (the bane of medical students’ existence sometimes), we were always asked to scrub in and assist. Even if we weren’t assisting, the team would continuously ask questions and teach during the surgeries, which was great.

I really thought Orthopaedic surgery would be my least favourite rotation, especially with less interest in surgery and my subpar anatomy – but I have to say, these last 4 weeks of medical school have only bettered the two. I’m looking forward to my surgical terms next year when I’m finally working and I have to say my anatomy is heaps better now!

My last rotation ended with 2 MCQ exams on Nov 13 (a day earlier due to the G20 public holiday) – one 50 question ophthalmology exam and another 50 question Orthopaedic exam. Despite walking out of the exam with the trembling thought of, “Oh my god, that was so much harder than I anticipated,” I’m happy to say that our results have seen been released and I got an excellent mark – so stoked!

We didn’t have time to lament awaiting our surg exam results though, as we had OSCEs to study for, which I will talk about in my next post 🙂

Obstetrics & Gynaecology: The wrap up

It’s only been 2 weeks since my O&G rotation ended but it already feels like ages ago.

Overall, I really enjoyed my time on Obstetrics & Gynaecology. I have to say thank you to the other 4, lovely students on my team: Darice, Sam, Roger and Michael (not my partner) – for your support and for being so fun to work with. There was always a joke to share or something to laugh about. And more importantly, we shared knowledge and learned heaps from each other. Thank you especially to Darice for driving me all the way home so many times in the evening! You are such wonderful company and I hope you are enjoying your time back in Singapore!

So, final exams…

O&G had 3 consecutive days of exams, how did they go?

(Note: Sorry, this might turn out to be a little long. I’m trying to put everything down to look back on in the future!)

Wednesday, May 07

A written multiple choice question (MCQ) exam. 60 questions, 30 gynae and 30 obstetric. I think there was a collective ‘what the hell happened feeling’ after finishing that exam. So much so that the cohort got together and reproduced most, if not all, questions from memory in order to further discuss them. Very dissimilar to the example of a previous exam they provided us, I think many of us felt this MCQ exam did not test fundamental knowledge required for an O&G rotation. In addition, there was unequal weighting of topics tested. For example, out of 30 obstetric questions, 3 of them (10%) asked about oxytocin – a drug used in active management of third stage labour.

Thursday, May 08

3 Obstetric OSCE stations. Each 8 minutes long and without perusal time. Talk about anxiety!

Station 1: An older lady who is obese, with hypertension on an ACE inhibitor and a previous history of 2 large babies has come in to see you (the GP) because she’s 8 weeks pregnant. The point of this station is to not only address the standard steps of care (confirm pregnancy, blood tests for type + antibodies, Hb, syphilis, Hep B/C, Rubella status, etc, dating scan, folate, diet…) but also to address her specific risk factors (age, obese, previous large babies, all risk factors for gestational diabetes and pre eclampsia, take her off her ACE inhibitor as it is a category D drug, etc).

Station 2: A lady in her late 3rd trimester has come into see you in the Antenatal Clinic with vaginal bleeding and a diffusely tender abdomen/uterus. Morphology scan at 20 weeks showed a fundal placenta – effectively ruling out placenta previa and leaving the likely diagnosis of placental abruption. Important points of this station was to identify the likely cause of bleeding, to admit her for further testing and monitoring of baby, inform theatre and anesthesia of potential need for emergency c-section, etc.

Station 3: A lady has active post partum hemorrhaging. Important points included resuscitation if necessary, discussion of possible causes (atony, retained tissue, trauma, bleeding disorder) and their management options, consenting for theatre and the need to inform the patient of the possibility she might need a hysterectomy.

I found the content of each station to be very fair and expected. However, what really disappointed me, as well as every other student I spoke with, is the lack of standardisation across examiners. For myself, the examiner at Station 1 did not let me speak freely, he only wanted me to specifically answer his questions – some of which did not even relate to a first antenatal visit. As a result, with such time constraints, I did not get a chance to say most of what is expected at such an appointment. When I proceeded to Station 2, every time I paused to think or see if the examiner had any questions, she would loudly say to me, “Don’t let me prompt you! What else do you want to say? Keep going!” She never actually prompted me with anything and I felt her constant berating very distracting and disruptive. Finally at Station 3, the examiner sat in complete silence and let me talk through anything I wanted until I stopped, only then did he ask further questions.

Overall, I think it went okay. I never know how I’ve performed at these types of exams because you are always your biggest critic. I can still think of things I should’ve said or things I could’ve left out.

Friday, May 09

3 Gynaecology OSCE stations. Each 8 minutes long and without perusal.

Station 1: Young lady is referred by GP to you in ED with few weeks history of iliac fossa pain. Ultimately supposed to rule out an ectopic pregnancy and come to the conclusion that likely ruptured ovarian cyst and/or ovarian torsion through discussion of investigations you would order and being given the results.

Station 2: Young woman presents to ED with symptoms of PID, confirmed with investigations. Incidentally, she has acute Hepatitis B. Needed to discuss her medical management including the need for hospital admission, contact tracing, contraception counselling, medical consult for the hepatitis.

Station 3: Vaginal bleeding in an older woman post hysterectomy on the ward. Management including resuscitation, discussion of consent, likely source of bleeding, etc.

Again, similar to the Obstetric cases, the cases presented to us were very fair, however, different standards of examiners across the board again. My examiners at Station 1 and 3 carried a discussion with me, letting me speak but also asking questions and pushing my knowledge, which was very good. My examiner at Station 2 was completely silent and cold, making me even more nervous. We were told multiple times that if we were struggling, not to worry, the examiners will provide prompts or attempt to put you back on track, but that certainly did not happen for me with Station 2.

I felt this was my hardest set of exams so far, mainly because of the quantity of OSCEs we had to perform and the uncertainty of whether I passed or not. I think I excelled at some stations and got a little stumped at a couple others. Marking is also very subjective, so all I can do now is cross my fingers and hope that everything went okay!

After this O&G rotation and as someone who is interested in General Practice/Family Medicine, I definitely think I will love the aspect of women’s health and antenatal care within that career pathway, yay!

And if you’re still here, a toast! To the end of second rotation! With Yoni and Christine 🙂

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Year 4 Medical School: What’s going on!?

Hello friends!

It seems I’ve gotten into the habit of not regularly blogging – arg! I’ll try really hard to fix that, I promise. 🙂

As some of you may know, I’m now in my 2nd week of 4th (and final) year of medical school! My first rotation is Paediatric Medicine, which I’m absolutely loving. I feel quite lucky that all the doctors and staff we have come across have been kind and more than willing to share their time and teach us. More importantly, parents and their children have been very receptive of students, which makes all the difference in the world, because that’s the only way we learn – on real patients!

Also, babies are so freaking adorable, I can’t get over it. 

With that being said, I’ve also been quite busy and stressed out. 

During the day, I’m in the hospital on my rotation. When I get home, I have to put all my focus into studying for the Medical Council of Canada Evaluating Examination (MCCEE), which Mike and I will be writing on February 28th in Melbourne. That’s less than 6 weeks away! 😦 

The MCCEE is the first big step that we Canadians Studying Abroad (CSA) or International Medical Graduates (IMG) need to take in order to be eligible to apply for a training/residency program in Canada once we graduate. It is a daunting 180 multiple choice question exam that covers 5 broad topics: Child Health, Maternal Health, Adult Health, Mental Health, and Population Health and Ethics. 

Needless to say, we are freaking out. There’s so much to know, in so little time. The most challenging part is studying for Maternal Health when we won’t have actually started, let alone complete, our Obstetrics and Gynaecology rotation yet. 

The good news is, our leave from Feb 26-28 has been approved! That means we will be flying down to Melbourne on the 26th and have 2 dedicated days to study before our exam on the 28th. And then we will have a weekend to explore and see Melbourne, yay! 

Until then, study! 🙂 

Mental Health: What’s the deal?

Wow,

I am terribly behind with my regular blogging! 😦 There’s no excuse, but it’s been busy and blogging about our recent vacation took a lot longer than usual.

So what’s the deal with school now?

Well, I’m 5 weeks into my Mental Health rotation, and yes, I’m quite enjoying it! By random luck (or is it bad luck? Haha), both Mike and I got placed as the only 2 students at a private mental health hospital in Brisbane.

The experience so far has been very enlightening. We found it initially daunting and awkward learning to take a psychiatric history from patients and formulating our thoughts. The feeling is quite similar to being in first year again, learning how to take a medical history and talk to patients. Fortunately, we’ve gained a lot more confidence in the last few weeks. Taking a medical history is like second nature to us now, hopefully taking a psychiatric history will, in time, feel the same.

We are humbled and grateful every time a patient agrees to talk to us or allows us to sit in during a consultation. If you think about it, these people are sharing with us, complete (not yet qualified) strangers, the most personal aspects of their lives. Some people have been victims of sexual and/or physical abuse, others have gone through great losses, some struggle with their spouses having affairs, while others have thoughts of self harm and have even tried to kill themselves. Every single patient we’ve met has taught us something, in some way, that we could never learn from a textbook.

Every patient we’ve met has a different story and is fighting a different battle. One of the first and biggest challenges for us has been, “How do we talk to these patients? How do we approach sensitive topics in a way that will not be upsetting?” We quickly learned that despite all the differences, these patients are all still the same in one way: Like you and I, they are people too.

Talking to patients with mental illness or a difficult life/past can be hard. But it’s not necessary to over-think how to talk to them. As long as you are patient, empathic and a listener, most people will be more than happy to talk to you and share their stories with you.

We also get scheduled teaching time with 3-4 consultants every week, which has been great. They have all been great teachers and we’ve learned so much already! Not just in terms of knowledge aspect, but also plenty of real life stories and experiences – something you can never learn from reading a book.

Have I mentioned we have a great Registrar? Yes, thank goodness! Most of our day is spent with him and the patients. He’s pretty awesome with them and definitely a good role model to try and emulate. As one of our profs said, “Shamelessly steal!” Adapt the styles, sayings and techniques from your seniors and colleagues that can make you a better doctor!

The most scary aspect of Mental Health at this moment? The fact that we are approaching the end of Week 5… only 2 more weeks until final exams. Absolutely crazy. It’s insane how quickly time has gone by!

Post-Surgery… Vacation!

Surgery is officially over, woo hoo!

Our final written exam (worth 70%) was yesterday… 2.5 hours of looong testing-of-knowledge. The exam was certainly challenging, as many of my friends have agreed, but now we just have to sit and wait for our results!

More importantly – on to a one week vacation!

Mike and I were able to score really cheap plane tickets, so we are going overseas for the holiday!

Today, we are going down to Gold Coast.

Tomorrow morning, we are flying out to… Singapore!

Yep, again.

Our super basic itinerary:

  • July 12 – Gold Coast
  • July 13 – Singapore
  • July 14-17 – Bangkok
  • July 17-20 – Singapore

All our flights added up to less than $500, which we thought was a steal! We have already booked all our accommodation but haven’t really finalized our plans of where we want to go and what we want to do yet.

Like usual, I will try to blog whenever I can! If not, there will be tons of photos and posts after we come back 🙂

Have a great weekend everyone! And for those on a holiday like me, have a lovely vacation!

Visiting Fi in Toowoomba!

Kristen, Christine and I went to visit Fiona in Toowoomba last Sunday! What a lovely opportunity to catch up with the girls, how I’ve missed them!

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Fi, our very lovely (and free!) tour guide, took us on a ride around town and we eventually drove up to Preston Peak Wines for lunch. Fun and friendly wine tasting but a limited lunch menu. The location was beautiful and peaceful, it’s too bad the sun wasn’t out for very long!

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The day was short and soon we were on our way back to Brisbane. With exams coming up, we left with the promise to be back for a hiking and boardgames day – looking forward to it!

Until then, surgery study time!

The “REALLY COOL” car we saw during the drive home:

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Picked up a little something for Michael, a bottle of fortified wine. Golden Gleam – Fortified pristine White Muscat juice. Lychee and marmalade characteristics; a very fruity wine. 🙂

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My Ways of Being a Better Medical Student

I believe trying to observe the following makes me a better student doctor.

Here are My Ways of Being a Better Medical Student:

(Didn’t realize this post would be so long, so I added some pictures from the internet. Photos are linked to their sources!)

Always introduce yourself – to patients and to other staff members. You’ll be meeting people all the time, under a variety of circumstances, at all times of the day. It is only polite and respectful to let everyone know who you are – even just in case you’re not even wanted! It has happened to me a number of times, sometimes patients just want medical students to sit out from consults. It can definitely be awkward, even scary, to find the opportunity to introduce yourself but you just have to man up, find an opening, and do it! Trust me, I know first hand how awkward it feels, especially when it’s one of your registrars or consultants you’re finally seeing for the first time (maybe during rounds) but completely ignoring you. But, more often than not after introducing myself, people will treat me differently – I’m no longer invisible and even addressed by name, who would’ve thought! 😉

Say hello when passing others, and smile. It takes no effort from you and can brighten someone’s day. Win win.

Don’t gossip. And if you must, do it outside the professional environment and out of earshot from everyone else. It makes you look unprofessional and you never know who might be listening. The medical world is small and word can travel fast – don’t sink yourself! You never know who you will cross paths with again and that one person you bad-mouthed could end up being your preceptor, your examiner, etc. If there’s someone I particularly don’t like, I always try to find someone else more constructive to my learning and morale and spend my time with them instead.

Never be afraid to ask questions. It shows you are listening, processing information and are willing to learn. Some people are great teachers and love the opportunity to share their knowledge – they’re just waiting for you to take initiative. Of course, with that being said, there’s always a proper time and place for questions. If someone is having a heart attack, no one wants to hear, “Could you show me how to read the ECG?” And you should really have enough common sense not to ask “stupid” questions that will only make you look bad. If you’re a 3rd year medical student asking, “What’s aortic stenosis again?” you are going to be in big trouble and look ridiculous!

Never be afraid to say “I don’t know.” I have no problems saying, “I’m sorry I don’t know, could you show/tell me?” when I really don’t have a clue how to answer a question I’ve been asked. If I can give an educated guess, I do, but otherwise, there is also nothing wrong with, “I’m sorry, I’ve forgotten, could you remind me?” Sure it’s embarrassing for you, but you will learn on the spot and/or never forget that information again. I’ve lost count how many times I’ve heard, “That’s okay, this way you learn and won’t forget again!” For example, the other week, my surg team was commenting on the long half life of the drug Rutiximab (21 days). The registrar then says, “At least it’s not as bad as Amiodorone! Sandra, what’s the half life of Amiodorone?” I laughed (as if I would know this) and replied, “I know it’s more than 21 days!” Now I will never forget Amiodorone has an extremely long and varied half life of 25-100 days. However, not knowing the answer should happen much less than 50% of the time you are asked questions, otherwise, you don’t know enough and you should go study!

Learn as much as you can on the spot. At this point in our lives, we’re not going to have our hands held and be told what to study. Pay attention on the wards and learn as much as you can – that’s often the useful stuff that you can’t learn as easily from textbooks. Bring paper or a notebook and jot down all the things you learn throughout the day. Write down topics that come up which you need to go home and read up about – follow through with it. Interns are a wealth of knowledge, it wasn’t too long ago they were in the same position as you, ask them questions and listen to their suggestions.

Be keen and willing to learn. Someone who shows they want to learn will be taught more and given more responsibilities. Put in the time and effort you think is necessary for you to reach your learning goals. Ask to participate and ask for opportunities to practice your clinical skills or to broaden your knowledge. Try not to decline a learning opportunity that comes up.

Be that medical student you would want to be partnered with. It’s great when you’re paired with another student who’s friendly, encouraging and easy to get along with, who’s knowledgeable but not cocky, who helps you learn without stealing your thunder, who can shine without throwing you under the bus, who’s not the super keener but not a lazy bum, who’s respectful of patients and confidentiality, etc. But it’s even more important to try and be that person for others. You surround yourself with the people you deserve, so be deserving! 🙂

Bake. Everybody loves home baked goods. If you can bake, you should share that deliciousness. No one will fault you, people will love you.

Keep up with your studying. Cramming doesn’t work anymore. Unfortunately, you have to remember everything you learn and build upon it. It’s hard, I know, I’m continuously working on this point.

Eating is important. But don’t just eat, eat healthy – your body will thank you. Also keep snacks on you – granola bars, nuts, chocolate, etc. They will save your life when you are too busy to take a break.

Get enough sleep. If you function well with 5 hours of sleep, that’s great. If you need 7 hours – make sure you get it. That also means you need to time manage well. Don’t sacrifice your studying or your eating time to make more room for sleep. You really need a balance.

Do things that make you happy. Keep up with your hobbies, take up new ones, see your friends, have quality time with your partner, take time for yourself to rest and relax. Otherwise, you will be lonely, stressed, and crazy.

I’m sure there are lots more that I can’t think of at the moment! 🙂

What about you? Do you have any tips?

The end of GP and 1 week holiday

GP Rotation is finally over after a multiple choice exam last Wednesday and 2 oral exams on Friday.

How did I do? Only time will tell. I always find it hard to gauge my performance, especially during oral exams because I can always think of things I could’ve said or things I could’ve managed better. All I can say is I hope I didn’t fail!

Ended my GP rotation performing a wedge resection of an ingrown toenail – sounds gross but I was pretty excited!

We have this week off before starting our Surgery Rotation next week. No plans to go anywhere or do anything in particular but time is flying. It’s already Monday!

I miss the GP Clinic already, it was such a wonderful place to learn. Thinking of starting a new rotation next week makes me nervous already…

Sandra & Sandor

One of our favourite places to study is at The Edge, right beside the State Library of Queensland.

Window bays overlooking the Brisbane River with comfy benches, free wifi, projectors, etc – everything you could possibly need for a good study session. Did I mention there’s also a little shop to buy drinks and snacks? What more do you need?

You can book a maximum of 2 sessions (2 hours each) per day. Laughed when we came in and saw this sign, thought someone couldn’t write my name down twice. Turns out, just a coincidence that a Sandor was using the bay after us!

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Michael hard at work

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Mike, Christine Q, and I had a good 4 hour study session. On the way out the bus stop, we realized Buddha Birth Day Birthday Festival (largest annual Buddhist Birth Day Festival in the world) was going on in South Bank and decided to drop by and have a look. We didn’t stay for long (too much studying to do!), decided to only browse the food kiosks. Lots of food being sold, although I was disappointed there wasn’t any “mon an chay” (vegetarian dishes) that are normally sold at pagodas during special occassions – oh well! 🙂

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GP: Coming to an end

Friday will be my very last session at the clinic for my GP rotation. How quickly 6 weeks have gone by!

We will having our final exams next week:

A multiple choice question exam on Wednesday and 2 oral exams on Friday. These are 13 minute stations (with an additional 5 minutes perusal) where we will have to perform a diagnostic case and a management case.

For the diagnostic case, we will have a patient come in with a presentation where we will have to take a history, talk through the physical examinations, provide our probability and differential diagnoses and lastly, provide a list of problems that should also be addressed.

For the management case, we will be giving a patient the diagnosis of their illness and will be working with the patient to manage their health. This will include assessing the patient’s knowledge, educating them on the diagnosis, coming up with short and long term management plans, taking the opportunity to discuss preventative health issues, providing resources, planning to follow up and safety netting.

Am I scared? Extremely!

There’s lots of time to study from now until then. I will definitely continue to practice cases and make sure I actually know how to manage diseases! I think the worst thing that could happen is to walk into a scenario where you have no idea what the disease is, let alone how to manage it!

And after next Friday – ONE WEEK HOLIDAY – YAY!

Note to self: Buy a stop watch for exams. Managing your allotted 13 minutes for oral exams is impossible if you have no idea how much time you have left.

Rotation 1 complete!

Today I completed my first exam, and thus my first rotation of Year 3 – hurray!

Our Medicine in Society – Geriatric Medicine exam was 1.5 hours with 40 multiple choice questions worth 80 marks, and 1 short answer radiology question worth 20 marks.

The exam was overall fair and representative of what I learned this rotation in geriatric wards. With that being said there were still a number of tricky questions, so hopefully I did well!

Now that that’s over, do I have vacation?

Why yes indeed!

I’m off until March 18, which will be our first week into Rotation 2 – General Practice.

Mike and I are actually at the international airport right now, 3 hours after exam! Heading to Vietnam until next Sunday and stopping over in Singapore tonight. My mom is currently in Vietnam, so we are meeting up with her to visit some family and do some quality relaxing on the beach! 🙂

Plans tonight in Singapore: Chocolate Buffet on the top level of the famous Marina Bay Sands! Mmm, is your mouth watering? Because mine is! We plan to try all 57 chocolate varieties they serve, wish us luck! And of course, we definitely have to check out Gardens by the Bay and photograph the supertree groves! So excited!

We are also flying with Singapore Airlines, so looking forward to a nice and relaxing flight, especially after the exam!

Plan to blog whenever I can during vacation, come back and visit!

Have a lovely day everyone! 😀

Home: Comforts and responsibilities

Like many people say, home is where the heart is. But after being away this year, I felt a little estranged walking in. I guess it’s simply because certain things changed and I wasn’t around to witness the process. Even little things like a replaced mat, a new appliance and small cracks in the old paint are taking me by surprise. I’m actually spending time staring at them!

I’ve also almost forgotten how much busier you can be when living in a family household, especially as the older sibling/eldest child. Someone can always use a hand, something here or there can always be done, and there is so much catching up to do when you’ve been away for so long!

I’ve come back right in the middle of home renovations, which are always such a joy! (Note: Sarcasm) Completing renovations is always very satisfying, but the potential long journey to that point is often tiring and can really test your patience. However, there are still good aspects of undertaking such projects, such as hanging out with family and using my non-existant muscles – which are already feeling the burn. We’ve barely made a dent in anything so I can’t wait to see how happy my body will be by the time we’re done. (Note: Very serious, no sarcasm meant. I really need move my butt)

The current state of our study. Hopefully the next time you see it, there will be no messes!

Besides family (and friends whom I have no time for yet) and the bed, there are many other comforts of home I often take for granted, primarily FOOD.

Things like, Cinnamon Toast Crunch cereal… the taste you can see!

Vietnamese dishes I would never make myself like warm Soy Bean Pudding with ginger syrup, perfect for the cold weather!

Additionally, I’ve forgotten how many delights a fridge stocked by my mom can contain! 😛

My sister still has her claim on my old bed. She’s joined both our twins to make a massive… king sized? So she’s stuck with me in ‘her bed’ along with her life-sized teddy. I sometimes worry he might come to life and kill me in my sleep.

She’s also bought a new pet – a 5 month old yellow bellied slider turtle, which she named Franklin. Very original name, I know 😛 As you might see, his shell looks pretty unhealthy. Franklin’s previous owner didn’t take the best of care (provided no proper heat/UV-B lamp… the poor turtle) so my sister is making sure he’s getting a lot of love.

I’m also still debating on whether or not I will write the USMLE Step 1 and if so, when I will be writing it. In the meantime, I’m still going to study over the break. Pocket medicine was the only physical book I brought back with me, but everything is on my iPad, so should be fine! I’ve decided to begin studying by going over Pathoma lectures, starting with Chapter 1 today. We’ll see how that goes before I plan anything further! 😛

And while you’re here, I wanted to share with my year book profile – written by Roger and Christine with a few things added by Michael and Yoni (yes, we were supposed to get our friends to write one for us). After reading the profiles of many other classmates, I’m quite thankful my friends are nice and don’t have a cruel sense of humour! 😉

Nov 8: Last exam = Halfway through medical school!

At around 11:30am on November 8th – we all completed our final exam of the year: Ethics and Professional Practice.

We’re now half doctors!

If we passed all our exams that is! Haha, we’ll find out soon enough 😉

A few happy things occurred that day:

1) I wrote my last exam – duh! It was only an hour long but the exam itself was lengthy and most people were scribbling until the very end.

2) I promised friends and family that if they helped me raise $100 for Movember by Nov 8th, I would wear a moustache to my final exam. And those wonderful people made sure it happened! It was quite embarrassing up until the point I stepped out the door. Then it became fierce proudness. Look at me world! I’m proud to support a great cause!

Yes, of course I got looks as soon as I left the house, but most people knew what it was for and gave me friendly smiles. Some people burst out laughing – which I thoroughly enjoyed. I didn’t have time to go buy a fake ‘stache so I drew one on with eyeshadow and eyeliner, praying that it wouldn’t melt off my face by the time I made it to campus.


(Josiah and I)

And, feel proud because I didn’t wash it off until after we had taken our class picture! Christine was also the only other person who wore a ‘stache with me – props to her! 😉

[If you would like to donate to me (and my team, UQ Med), please visit http://mosista.co/sandranguy]

3) We took a new class photo. Thanks again to Zac R for organizing it for us and being the phtoographer!

4) We could finally reeeelax! Had a super chill evening at Fi’s place with the gang and then headed into the city for the Oschner send off party. Most of our American students go back to the states and complete 3rd and 4th year in New Orleans. Additionally, many of them are preparing to write their USMLE so it was a last opportunity to see them and wish them luck 🙂

A few photos from the send off party at Birdees. Photo credit again goes to Zac R.

Yay! Done 2nd year!

Photo #254: We’re Half Doctors!

November 08, 2012

Around 11:30am today, we finished our Ethics and Professional Practice exam – the last one of second year, woo hoo! We are now halfway through medical school – if we pass our exams that is! 😉

Huge thanks to Zac R. who organized and took this class photo for all of us!

(You won’t be able to find me, but I am standing on the left ledge)

(Photo cred: Zac R, 2012)

OSCEs over and now the wait starts

3 weeks ago, I mentioned my year 2 clinical exams (OSCEs) coming up.

Well, I’m happy to say they are finally over! As part of the first batch of students taking the tests, we were scheduled to be at the hospital by 8am today. I was so nervous and worried that I woke up at 5am to read through everything again… 5am! Very rarely would I wake up that early because I’m so stressed!

At 8am, we were ushered in a conference room in the Outpatient Clinic at RBWH. We were signed in, divided into groups of five and were notified of the station we would be starting with. After being given a lovely speech of encouragement from our program director Dr Schafer and once everyone was ready to go, we were directed to our respective hallway and proceeded to sit down at our first station.

There were a series of 5 stations. At each, we had 2 minutes to peruse (and make our way from the previous station), followed by 8 minutes to carry out the specified task. 10 minutes total per station.

I started with Station #3: Clinical Reasoning.

The blaring horn went off to signal the beginning of 2 minutes perusal. At this station, the patient presented with abdominal pain. I had to read through the complete history and come up with 3 likely diagnoses and support them with positive and negative findings. Two minutes flew by so quickly, I had barely read through the entire history and only had just written down my diagnoses. The annoying horn went off to let us know 2 minutes was up and it was time to proceed into the room. For this station, I get an additional 2 minutes to collect my thoughts before speaking. Before I knew it, it was time to start. This station overall went well for me, although it wasn’t until I stepped out the door that I realized my 2nd diagnoses should’ve been my first!

Next was Station #4: Clinical Communication Skills

Two minutes to peruse how I would facilitate a ‘behavioural change’ discussion with a cardiac patient who needed to quit smoking. Prior to today, this was the station I was most worried about but I think I did fine. Hopefully I addressed the patient’s concerns appropriately and explored the necessary details. I said the patient was in a contemplative stage but unfortunately, didn’t have time to completely wrap up the interview.

Station #5: Procedural Skills

A sigh of relief. I looked down at my sheet during perusal to see the choice of skill to be tested was a less complicated one. I didn’t have to do venepuncture or cannulation. All I had to do was take BP, RR, HR, and measure peak expiratory flow. This was the only station which I finished (comfortably) within 8 minutes. Thank goodness.

Station #1: History Taking

A woman presenting with fatigue and weight gain. It was a classic hypothyroidism case. At one point during history taking, my mind blanked and I had a long awkward pause followed by putting my hands over my face and mumbling, “Ah, I’m sorry!” However, I did pull it together and thought I took a decent history, even though I forgot a few specific hypothyroidism questions (ie. nail changes and thickened skin) I also ran out of time, so had to blurt out that I would also want to address the patient’s family/social history.

And lastly… Station #2: Clinical Examination

I was asked to do an examination on a patient with a suspected diagnosis of lung cancer. This was the station I was most prepared for but I don’t think practice can ever prepare you for an intimidating (almost rude) examiner. I felt he was really aggressive and didn’t let me finish anything I wanted to say. I started with asking the patient his age (check if hes oriented to person/place/time) but before the patient could answer, the examiner yelled, “Why would you ask that? You were told his age on the paper! It says he’s 48! … Oh, well his mental state is fine!” Every time I mentioned that I would be looking for ‘so and so’ and before I could actually touch the patient, he would cut me off and loudly say, “Normal!” … every time! As a result, I could barely ‘examine’ the patient. I was also told to move on to other parts of the body when I knew there were things I needed to mention but didn’t get the chance. By the end of the examination, I had only been allowed to do a few percussions and feel a few lymph nodes. One stupid mistake I made: not realizing I had said ‘hypertrophic pulmonary osteoarthritis’ rather than ‘-arthropathy’ and not cluing in when he repeated ‘arthritis?’ I am genuinely worried about failing this station because I felt like the examiner did not judge my ‘examination skills’. Instead I had to verbally stutter my way through the station because I wasn’t really given the chance to fully talk or examine the patient.

Even though we were told not to fuss if we didn’t finish a station, I can’t help it! Oh well, I guess all we can do now, is wait and see!

Things I enjoyed:

  • It’s nice to have the skills I’ve learned these past 2 years be tested. It’s obviously necessary if we want to perform well next year on the wards!
  • Very well organized and very grateful to all everyone (staff, examiners, patients) who made the day possible.

Things I wish could’ve been better:

  • 2 minutes perusal time includes leaving the previous room and settling into the next station. Then 8 minutes at the station includes entering a room and having a brief introduction with the examiner. The seconds are so precious and add up quickly… I would have liked to see more time allotted per station.
  • Perusal during clinical reasoning was quite distracting when you could hear the other stations through the walls!
  • I had mostly good experiences with examiners but also one particularly bad one. From comments on our FB page, it seems many other students felt the same way. Just as our patients are standardized, I wish our examiners were as well. I wish they had been specifically instructed on how to evaluate us. Discrepancy with examiners can lead to an experience like mine or like others who were able to perform (while verbalizing) an actual examination on the patient.
  • The alarm/horn was so nerve wracking! Please use a nicer sounding chime (like Westminster) next time, and NOT THIS – gives us mini heart attacks each time.
  • As examiners pass or fail us on the spot, it would be great if we could get our final P/F grade at the end of the OSCEs. But logistics makes it understandable.

The wait begins…

5 more weeks of school

I cannot believe there are only a few more weeks of second year medicine remaining… how time has flown!

I’m starting to feel a little stressed as there is still a lot to do before the year is over! In just 2 weeks, I will have my Objective Structured Clinical Examinations, more commonly known as OSCEs. I must pass this practical exam, as well as my written final exams, in order to move onto third year.

The OSCE will be a series of 5 stations and I’ll have to pass each one. We’ll have 2 minutes for perusal at each station followed by 8 minutes to complete the task.

The stations will be:

  1. Taking patient history
  2. Performing a patient examination. This might be focused on a specific symptom/joint or it can be generalized to any given system.
  3. Clinical reasoning. Given a patient’s history, examination and investigation results, I will have to give a series of potential diagnoses with relevant positive and negative findings of each.
  4. Procedural skills. A number of skills could be tested, including venepuncture, cannulation, blood pressure, BLS, etc
  5. Communication skills. Could be facilitating behaviour change, breaking bad news, etc

Am I worried? Yes, definitely! Will be practicing every day from now until then. I am also part of the first batch of students to have their OSCE… scary!

And the rest of the year:

  • Oct 20 – a 10 minute group presentation in front of our peers for Global and Community Medicine. The topic our group chose is “Schistosomiasis in China” – should be interesting!
  • Nov 5 – Clinical Science imaging exam
  • Nov 7 – Clinical Science exam
  • Nov 8 – Ethics and Professional Practice exam
  • DONE EXAMS! Woo hoo!
  • Nov 10 – Halfway Dinner!
  • Nov 18 – On the plane home!

There’s a lot more to do before the holidays, but oh so close! 🙂

 

 

Procrastinating… as usual -_-‘

I have 2 exams this Saturday: Clinical Science and Ethics & Professional Practice.

Am I ready yet? No.

Will I be ready? Maybe!

But as usual, I’m taking many breaks to go on (what Michael likes to call) YouTube Adventures!

Join me for a smile as I procrastinate!

Medical Terminology Concerto
(Not everyone will find this amusing as I do…)

2 Hamsters 1 Wheel
(Mike laughed so hard, he cried – for real)

Sugar Painting: Chinese Dragon
(Such a low cost business and so good! I wish I had such a talent!)

and because one video is never enough

Painting on Water
(Reminds me of doing marble nails if anyone has ever done that before)

Flexipan Small Cakes
(I really really want these pans now…)

Funny Japanese Pranks
(Because they never fail to make me laugh)

Gangnam Style!
(Come on… don’t tell me you haven’t seen this yet? :P)

The world’s first tuition-free online university

An old professor of mine recently shared this link: http://www.uopeople.org/

It is the University of the People‘s website, “the world’s first tuition-free online university dedicated to the global advancement and democratization of higher education.”

From their website:

The University embraces the worldwide presence of the Internet and dropping technology costs to bring tuition-free undergraduate degree programs to qualified high school graduates around the world. UoPeople offers Associates and Bachelors degree programs in Business Administration and Computer Science.

With the support of academic leadership from top universities and having accepted more than 1500 students from over 130 countries to date, UoPeople is well on its way to becoming a global higher education leader.

As you can see, there are currently only 4 programs up and running, hopefully more will be available in the future. And as of now, the University of the People is not an accredited university but they are in “the process of applying for accreditation from an agency recognized by the U.S. Department of Education.”

Initially, the course itself was completely free except for an application fee. Otherwise, there were no costs associated with materials and exams. However, starting next application cycle, the university is asking students to pay a $100 per end-of-course exam fee, if they can. Students who cannot afford the fee are referred to a “Micro-Scholarship Portal to enable donors to contribute directly to students in need of assistance. Additionally, students may apply for a UoPeople scholarship to cover up to the full cost of the Exam Processing Fees.”

This university is the first of its kind and I hope to see it flourish. Hopefully they will soon become accredited and be a stepping stone towards opportunities otherwise not available to many people around the world. 🙂

Last week of Semester 1!

Hello everyone,

Hope you are all having a fantastic day 🙂

I have exciting news to share – I’m almost done first semester of second year med, woo hoo! What a great year so far – some downs but definitely lots of ups!

This is my last week of school and then we have next week off to study for exams. I have 4 final exams this semester, spread over 4 days – June 12-15. They’re coming up soon!

I’m feeling confident. Not because I’ve studied and know my material but simply because I have to succeed! There’s too much at stake to be lazy and fail. So much stuff to go through but there’s still lots of time to get everything done.

We do not start Semester 2 until June 25 so guess what I’m doing for the holidays?

Singapore!

Mike and I have bought tickets to visit Singapore from June 18-22 – very excited. It’s a place we’ve been wanting to visit and didn’t get the chance to while we were on elective in Vietnam.

You know what makes it even better? There was a sale and our tickets cost only $200/person for a return trip – how could we pass up that opportunity? In addition, a couple of our Singaporean friends are also going home and have offered to take us around and show us the little gems of Singapore 🙂 I’m so excited! I will finally be able to experience epic food adventures I keep hearing about!

So great to have this little opportunity to look forward to but until then… study study!

Are you preparing for exam too? Good luck!