Wassup PMC!

Taken from obsessedwithfilm.com

Next week, I think I'll finally have the time to pick a representative form the current batches to post any thoughts/events/nerdy stuff/etc that they want to share. Hopefully, whoever it is, they're the ones who actually want to do the job. If anyone wants to volunteer now, please contact us at putrammedicclub@gmail.com. Obviously, it's only open to med students from UPM.

Just a small reminder, if anyone is using the username and password, and are commenting/stating opinions please make yourself accountable to your own opinions by writing your name and batch/year/whatever below your comments. We don't want to have a case of lempar batu, sorok tangan here. Make your opinions accountable and please don't make statements speaking for the whole of us.

Another thing, remember to wish the 5th years good luck with their third professional exam in two weeks time!

Nazirah, 3rdyr 2010/2011

In the Medical Ward...

It has been a while since I wrote in proper English after my SPM exam until today. Seasoned by the experience of slightly more than half a year of clinical experience, I was asked to write an essay regarding internal medicine posting. The first thing that popped in my mind was just a repetition of three words- hectic, hectic and hectic. I wonder if there was anything rather more interesting than examining young female patients legally, with a yellow license clipped on my formal attire. Although it sounds interesting, I’m sure all medical students who were in my shoes will find it perplexing as most of the time, we are not sure what is exactly that we are examining.

Other than those “interesting” events in our clinical life, I can hardly scavenge fading memories regarding something particularly interesting that happened somewhere around October 2011. That was a fine day among hectic days, when all the year three medical students were so occupied with the preliminary tasks in their mind, mainly filling up their log books. My plan was to get at least 5 signatures of all the blood taking procedures from the hopefully kind MOs or HOs. And there is no free lunch here. I was prepared to be summoned here and there to help with this and that. The actual situation that happened that day surpassed my wildest dream. I haven’t enough cortisol or adrenaline to face the situation which has doomed to happen in this normal day. I was a medical student and today I deal with a real life!

It was 5 in the evening. This is always the time of day when we (some hard working student might disagree with me) doze off pretty easily. It was in Ward 7B, a ward with a number of acutely ill patients struggling to stay alive. During the day, most of my course mates were discussing what food to eat next and I wanted so much to join them. As always, I was not really feeling considerable to spare the patients with funny sounds in their lungs or hearts my time but I knew I had to do it anyway. My cold diaphragm of stethoscope was gently applied on their feverish chest. Of course, I asked for consent before I do so even though I realized that deep down in their heart they wish to left alone to breathe peacefully.  But what to do, I really wish to be a good doctor…

Initially I thought the few bizarre presentations from the patients would have made my day fantastic enough. When I was just about to happily leave the ward, I sensed something amiss at the corner. A few MOs and HOs were rushing towards a bed hastily with gloves and masks. It was not the first time to see situation in a medical ward. However, driven by curiosity, I approached the bed, trying to figure out what has actually gone wrong through the anxious expressions on those young doctors’ faces. From far away, the ringing of alarm from the machine seated at the bottom of the bed was clearly audible. Each wave of frantic alarm pervaded the atmosphere, stimulating adrenaline rush from everyone out there.

Slowly, some of the familiar faces started to appear in front of me. Then came Shafiq and Liyana (and also a few dudes I have forgotten who), who were still lingering around the hospital ward with unknown reasons (they are not ghost, they are good medical students…, just like me.). “Eh Pang, ape bende ni…” “Mane aku tau… Itu houseman macam tension gler…” “Nasib baik kita medical student je… Kita tengok je la…” We merely chuckled as we knew that was the only thing we managed to do at the moment.

Half an hour was gone, and we were still standing beside the bed. We realized that this patient was a TB patient. At first, we still could see the jerking of the leg of this patient whenever an intubation tube was inserted forcefully into his throat. “Ni mesti sakit gila…” Shafiq uttered this with chills and rigors. Then, a houseman started to surface mark the midinguinal point for femoral pulse. I assumed he wanted to dig some blood for ABG. He failed a few times to locate the arterial blood. Every time the large bore needle was pierced into the false area (I guess sometimes accidentally pierce the inguinal ligament, femoral vein or bla bla…), a clear brisk contraction of his quadriceps muscles was visible. After a few attempts, the houseman was happy. I could remember vividly Shafiq’s facial expression, as if he was the one lying on the bed.

Another half an hour was gone. This time, the MO in charge took a resuscitation bag and instructed the houseman to pump in air into the patient’s intubated throat. The resuscitation bag was blue in colour and looked soft to be pressed on. Therefore Shafiq was curious to ask me the following question, “Kenapa mereka mcam letih je tekan itu bag…” I could not answer him as I was having similar question mark in my heart. Therefore my answer to him was, “Pura-pura je mereka ni… Mau tukar shift awal kot…” My irresponsible answer was immediately replied with a bad karma, when the MO shouted at us. “Medical students right? Why are you guys standing there? Take a mask to come and help!!” That moment I knew my statement regarding the resuscitation bag is going to be justified as a FALSE statement.

All of us (the innocent medical students) bravely took a mask and a pair of rubber gloves, put them on, and tried to aid the resuscitation. At this point of time, we were all consuming glycogen store in the liver as all the glucose available in blood stream was all used up in the afternoon to examine patients. Perhaps God was trying to let me understand how hard resuscitation was. The first thing I was asked to do after fixing the patient’s leg immobile is to pump the air to supply oxygen to the patient. Oh god… I’ll bet you’ve never pressed such a hard rock stony dull bag in your life before. The perspiration drenched my formal shirt, my tie, my long pants, and my underwear, my everything… Now I realized the houseman was not hoping to end their shift earlier…  Shafiq was very clever. He stood beside the patient at the end of the bed, never wanted to approach the patient’s head… His duty was pretty easy, to hold the patient’s leg. I looked at him with an eye expressing vengeance. However, he dodged my eye. I can see his smiling mouth under the mask.

The patient SaO2 gradually fell. Then we have reached a moment to perform CPR on his chest. Again, I started the task as instructed. Now Shafiq has to take over my job. Once a while I look at him and I was happy to see him suffering now. Out of the blue, the patient vomited his blood. The blood spilled all over and onto his, her, their, your and not to forget, my face (here I exaggerate a bit to make it fantastic). The houseman was grateful that she was wearing an apron. I was pissed off that I was not wearing an apron. Shafiq was pissed off that he was not wearing an apron. Everyone there basically, was pissed off that they were not wearing an apron…

Now it was 7 pm. Oh god, I really could not stand this anymore and hence my question to Shafiq and subsequently to the houseman (after getting no answer from Shafiq), “We need to do this till bila ah Doctor?” The houseman, unsure with his answer, replied me “Until the ventilation machine arrives.” Then my next question will be “Bila itu machine boleh sampai?”… But before I throw my question, the houseman ran away to get some stuffs from the counter, probably he also did not know BILA.

Now it was 7.45 pm. An angel arrived (as if from the sky) in front of us and started plugging all the colourful wires to awaken the machine. Shafiq, with a BIG SMILE on his face, announced to me that we have rescued the patient successfully! WOOHOO… (I will skip this part for some reasons you will understand in the next paragraph.)

ENT posting (aka Easy No Tension posting).

Now, one of the things I never thought of would be this. I mean really people? Who would have thought I’d be writing an article on any posting. Then again, I suppose wonders or in this case, surprises never cease to exist. In either way, this is supposed to be an article about ENT posting.

Taken from Google Images

So, now, the question is where to start. The general consensus would say that that would be at the beginning itself. And I must warn you, I am a bit tedious when it comes to details and descriptions. Just kidding. It merits to be mentioned here that I literally did not know what posting I was going into the first day. All I knew was that the day before, we (Jay, Julia and I) had decided that we might as well go to the faculty at 8 in the morning and see what happens. So, the next morning, we had Julia coming into our room and telling me and Jay that she and I were in ENT while Jay got ophthalmology. It was a shocker and believe me when I say that I was whining in my heart.

Now, enough on all that personal stuff. It’s time to become professional. Again, just kidding! Not entirely. So, there we were at the tutorial room waiting for Mr. Yap and our briefing, which by the by was very informative and hilarious (you guys will experience it firsthand, and trust me, you will be glad I didn’t give you any spoilers) He managed to successfully make us look forward to the entire posting, despite the other shocker that we had to travel to HKL three days a week (that would be Tuesdays, Wednesdays and Thursdays). I suppose that you might want to know what made up the silver lining of that particular cloud. Truth be told, we realized it when he said the most important thing in that briefing; ‘WARDWORK = TIMES SQUARE TIME’. Not that we ever did it. Truly! Another thing about ENT is that the lectures are divided into 5 modules namely Laryngology (Dr. Subha), Otology (Dr. Khairul Shaharuddin), Rhinology (Ms. Narizan, who is actually an invited lecturer from HKL), Head and neck (Mr. Vincent, who is a new lecturer) and Allergy  with Mr. Yap himself). We also have another lecturer, Ms. Saraiza, who is an invited lecturer from HS. Okay, I see that I have handled the introductions to our doctors, I would believe now, I should give the limelight to our constant companions. And by that, I am in fact referring to our books.

Taken from shawnfeeney.com

For those who are going into ENT, the preferred reading material would be Lecture Notes on Otolaryngology by P.D Bull (not PItbull, as I initially thought. And I must admit, his name was one of the reasons I finished reading this particular book). Mr. Yap would tell us to finish this book by the first week (fret not, it is possible, even with a packed social calendar like ours) and then to move on to heavier materials such as P.L Dhingra’s Diseases of the Ear, Nose and Throat or even Logan Turner’s textbook who’s name escapes my memory at this point of time. But remember, whatever books you might read, it all tells us the same thing. Only difference is whether it is simple or convoluted.

After his briefing, we had the pleasure of meeting Ms. Subha in lecture. Later, we went to her clinic and learnt many things, the first one being that we did not know a lot of things. Hilarious isn’t it? Nonetheless, we had loads of fun in both clinic and her lectures. The next day off we went to HKL in the 6.30 am bus. I know it sounds not so fun but when you’re sleeping in the bus, all the animosity towards traffic jams for making us wake up so early to avoid it melts away in your dreams. In HKL, within the next few days, we would come to establish a routine, namely consisting of lectures, clinics and speech/audiology sessions (this is where we have to observe how audio testing is done by the audiologist and also speech therapy). Don’t get me wrong guys, these sessions are also available in HS but with fewer patients. An important note here would be regarding the BERA (Brainstem Evoked Response Audiometry) and also the allergy testing (which is done on Mondays and Thursdays in HKL and on Wednesdays in HS). BERA usually involves babies and requires them to fall asleep, so it is as you might be able to imagine, rather boring. So, when you go for that make sure you guys alternate. As for the allergy clinic, try to get it settled fo as soon as possible in the mornings because they usually finish up by 11 am. Then, we would also have bedside teachings in HKL, whereby each group gets two turns each, once with Mr. Vincent and another with Mr. Khairul. During our time there, Mr. Yap was away, so we didn’t get him for bedside or the opportunity to join his NPC clinic at the oncology clinic on Tuesdays. Hopefully, you guys will have better luck with that than we did. So, basically these are what you will be doing in the 3 weeks that you are here and in HKL.

Taken from geekologie.com

OW! Before I forget, we also had skills lab, where we got to play with all the ‘tools of the trade’, namely the otoscope, Thudicum (nasal) speculum and also mirrors that let us see your larynx. So, yea it was fun. Loads of it. Now, I can't imagine to tell you all that we experienced or learnt in ENT but I can endeavor to give u a sketchy idea of what it was like to be in this particular posting. Truth be told, it is actually a jam packed ride that is fun and scary at the same time.

Taken from onthebrinkofanewera.blogspot.com

Now, in a nutshell I believe I have told you as much as I can about what to expect in ENT posting, but truth be told, I feel like a spoiler already. Hopefully you guys would find this an interesting article that was helpful and funny (now, that’s the narcissist in me talking!) Now, for those who will be going into ENT, cherish every moment you get to spend in this posting. The main reason I am saying this is because 3 weeks has the tendency to just pass within a blink of an eye (I think that is the ophthalmology posting speaking). Anyways, have fun guys and hope you guys enjoyed this article.

P/S: There were no suicidal tendencies experienced!

Durga, 3rdyr 2010/2011

No WORRY-Lah, Be HAPPY - A Medical Student's Motivational & Inspirational Guide

So here's a link of an e-book that one of the very first pioneer batch of the UPM MD course wrote for medical students:

http://www.scribd.com/doc/31391411/No-WORRY-Lah-Be-HAPPY-A-Medical-Student-s-Motivational-Inspirational-Guide-4th-Edition

It's pretty good too! I remember being depressed and then reading it before the second pro exam, I felt positively good (for a while, anyways.) Check it out!

Nazirah, 3rdyr 2010/2011

Geriatric Posting

Geriatric, based on Wikipedia is a sub-specialty in internal medicine that focuses on health care of the elderly.

So, in Malaysia. UPM je yang ade posting geriatric untuk medical students setakat ni. Jadi, kami yang third year ni kena la ikut sajaaa~ Sepatutnya dorang letak kat fourth year, tahun ni dorang pindahkan ke third year. Tapi bagus jugak, fourth year nanti kan dah major posting susah2 je semuanya, cam tak kena plak tetibe ade geriatric. Sebab geriatric ni, bagi aku minor posting je. Best je! Even though kena pegi HKL 3 minggu, awal-awal pagi. 6.30 bus dah jalan. Tapi, best!

Sebab posting ni je tak payah study banyak. Sebab kebanyakannya benda-benda yg dah study kat posting medicine mase 5th sem. :))

Basically, kitorang banyak jumpe case stroke la. Since ward 16 tu banyak accept elderly patient untuk rehab kan, jadi ramai patient yang dah kena stroke, and dorang admit sebab nak rehab. Rehab dari segi emotional and physical.

Kalau emotional, mcm dorang assess tahap depression orang-orang tua tu la. Mental state semua, nutritional pun ada. And for physical, dorg assess mcm mane orang-orang tua ni nak be independent after their traumatic event. Kan selalunya orang stroke, dorang ade weakness on either side kan? So, kat ward ni, physiotherapist, occupational therapist, the doctors and nurses akan berganding bahu untuk improvekan functional ability dorang. Kira yang tak boleh jalan tu, mula-mula pakai wheelchair, pastu walking frame, pastu quadropod then last-last pakai walking stick je! Lek je, dah bleh jalan. So bagus la. Lagi satu, kalau yg tak boleh uruskan diri sendiri, dorang akan ajar balik la care untuk jage diri. So, penjaga takde la susah sangat nak jage dorang kan.

Masalahnya, geriatrician kat Malaysia ni, sikit gilaaaa. Compared to geriatricians kat Singapore, memang boleh gelak je la. Kat sana berpuluh-puluh, sini tak sampai belas-belas pun. Aku pun tak tau, bila ikut posting ni, ade jugak tergerak nak jadi one of them kan. Tapi tak tau la, jauh lagi perjalanan untuk decide skang ni.

Mase posting geriatric tu, macam-macam belajar. Pasal healthy aging; and others;

• Balanced diet (same je ngan orang-orang muda punya, less salt, vegetables, 6-8 glasses of water, reduce white rice and pasta intake, better ambek brown rice. dairy products are important to avoid osteoporosis. And banyak lagi) cuma org tua selalunya takde selera nak makan, jadi dorang senang malnourished. Kitorang punya group project pun dapat identify more than 50% elderly are malnourished. Haih.
• Proper exercise for elderly is not jogging. Jogging akan cause problems to their knees. (Osteoarthritis) So, elderly harus practise safer exercise, macam walking and tai chi.
• Boleh retire, tapi jangan stop everything all of a sudden. nanti bole depressed. So, galakkan orang-orang tua buat keje, jangn bagi dorang boring kat rumah. Bagi otak dorg active walaupun dah retired. To avoid dementia too.
• Jangan neglect orang tua. Caregiver kene responsible.
• Avoid FALLS. And macam2 lagi

Senang cerita, posting ni banyak mengajar pasal life. And banyak jugak la aku terinfluence dgn lecture geriatricians pasal healthy aging. Harap-harap boleh praktikkan sampai mati. Pastu banyak jumpa orang-orang tua yang comel. Iaitu Aunty Maria yang pernah sama sekolah ngan aku. Sangat friendly and loving. Lebih 5 kali kena peluk ngan die, siap kena ciom2 lagi. :) Bagusnya orang tua mcm tu, sampai tak jumpa satu hari pun dah rase bersalah.

p/s: Nak avoid wrinkles, silalah pakai sunscreen SPF > 30 dan moisturizer yang secukupnya SETIAP HARI even though you claim that you don't get exposed to sunlight, just use it anyway. Saya syorkan Loreal UV perfect ya, dah gune lame and sgt bagosss. ;)

XOXO*, 3rdyr 2010/2011

---

*bukan nama sebenar

A more academic approach

After much fruitful discussion with A* (also currently a third year) about the kind of thing us UPM medical students might want to see in the blog, I have came up with a variety of things I'd like to do to breathe life to this site.

Us seniors must have our moments when we get really perplexed as to how to answer when a junior first year asks, "Camne nak study embryology eh?" I mean, I don't even remember half about what I should about the germ layers, therefore it's going to be quite a task explaining how the heart develops in the first 7 weeks of life. It's not that I don't want to, because I tried to the other day when this girl asked me, and I had quite a hard time explaining with my vague memory of how ASD and VSD occurs. Maybe this will be important in my Paeds posting someday, I dunno.

What we realised in our discussion was, those things are what we'd like from seniors, but we're not necessarily the best seniors to explain that stuff because it's not fresh in our heads. Ask me tips about the second Proffesional Exam, and I'll tell you all the shortcuts and tricks I have under my sleeve, but ask me about the first Proffesional Exam, I'll probably tell you half the things you ask me aren't important. Second years would have a better time explaining this stuff than me.

SO, this is where YOU come in. Yes, you, medical student. I know you're reading this, and you're wondering why this site has nothing interesting up. Well, this is how YOU can contribute:

Write to us. Tell us things about a subpackage or posting that you wished you would've known before you started the learning the package/posting. It doesn't even have to be in one part, it can be in several if you're ambitious enough.

Here's a format if you're not sure where to begin:
1) how to study/tips in the subpackage/postings
2) reference books you think are useful
3) your experience in the subpackage/posting, any suicidal tendencies for example
4) Lecturers (the best ones/the not so great ones/styles of teaching)
5) Exams/OSCEs/CFUs in that subpackage/posting

So the pre-clinical subpackages are:
1st year:
1 C&ET (The Cell & Excitable Tissues)
2 GA&E (General Anatomy & Embryology)
3 BIOCHEM (Molecular Basis of Medicine)
4 PHARMACO (General & Biochemical Pharmacology)
5 PATHO (Pathology)
6 IMMUNO (Immunology)
7 HAEM (Haematology)
8 MICROBES (Medical Microbiology)
9 PARASIT (Medical Parasitology & Entomology)
10 CVS (Cardiovascular System)
11 RS (Respiratory System)
12 US (Urinary System)
13 AS (Alimentary System)
14 NM (Nutritional System)

2nd year:

Gambar sekadar hiasan

1 REPRO (Reproductive System)
2 ENDO (Endocrine System)
3 CNS (Central Nervous System)
4 MSS (Musculoskeletal System)
5 Public Health/ Epidemiology/ Biostatistics
6 Professional Exam 1
7 RESEARCH

Clinical postings/topics are:
3rd year:
1 Medicine
2 Surgery
3 Professional Exam 2
4 ENT
5 Opthalmology
6 Geriatrics
7 Sports Medicine
8 Radiology
9 Rheumatology
10 End of sem exam

4th year:
1 Psychiatry
2 Introductory Orthopaedics
3 Family Medicine
4 Community Medicine
5 Obstetrics & Gynaecology
6 Paediatrics
7 Electives

5th year:
1 Senior Medicine
2 Senior Psychiatry
3 Senior Surgery
4 Dermatology
5 Senior Orthopaedics
6 Anaesthesiology
7 Accident & Emergency
8 Senior Obstetrics & Gynaecology
9 Senior Paediatrics
10 Forensic Medicine
11 Profesional Exam 3

So that's pretty much the UPM syllabus for you. That's 49 topics... Wow. I'll start hunting down some juniors and seniors for their two cents and hopefully, it'll get a lot more vocal in here, and people can actually start using this space to voice out their opinion.

I've surveyed and asked around, and apparently some students would also be interested in reading articles along the lines of these topics:

• The necessity of co-curriculum activities
• Compulsory university subjects
• Being a class rep- why you should volunteer
• HSDG vs HKL
• Volunteering in the community
• Electives: 3rd world vs 1st world placement
• Being a houseman/MO
• Being a specialist/masters student
• Foreign vs local medical education
• Learning a third language

If you do want to volunteer, ANYONE from the course or any medical proffesionals are welcome. We're not looking for the Pulitzer Prize in writing here, just a relatable voice that can reach out to the common medical student. Don't worry too much about grammar since we'll edit it so it looks alright. If you're interested in helping us out, please do and send us over an article. More than one article on a subject is more than welcome. We'll have a debate, it'll be interesting. Tak payah la rasa malu ke orang baca, whatever it is, just believe in yourself and believe that it's good enough.

This not only helps future students taking your subjects/postings (as well as senior students having amnesia) but it could probably help some people who've applied to medschool to have an idea what medschool is like.

Looking forward to filling up this site!

Nazirah, 3rdyr 2010/2011

--
*anonymous who wishes to be kept unidentified

Random Articles in the Internet: Tips for Surviving Medical School

Remember when you were a premedical student in college? It seems like a century ago for many of us who have just completed the first year of medical school. It feels that way because our lives have changed dramatically. Normal life seems to have vanished, and suddenly, 24 hours in a day are not enough to get through the enormous volumes of information that we are expected to learn for every exam. It seems virtually impossible. We barely have time to eat or sleep.

Medical school is not the end of the world. Take it from us, 2 students who have been there, when we say that medical school is what you make of it. Do not let medicine define you; instead, you should tailor medicine to your lifestyle. Otherwise, you might become overwhelmed by the demands of your new life and lose the sense of why you chose medicine in the first place.

How do you survive medical school? From the beginning, time management must be a major priority. If you can manage your time successfully, you can still enjoy your life to a certain extent. Studying in med school is not the same as it was in college; this is a new world where you have to explore different techniques and find what works best for you. In medical school, it is all about studying smart, not studying hard. If you don't know this at the beginning, you will learn it the hard way.

Studying medicine is a long process and demands a great amount of discipline and sacrifice. But the reward is priceless. We hope that you chose medicine for the amazing field it is: the rich opportunities it provides for helping humans and the avenues it opens for making a difference in the world. The following are some of the most common pieces of advice we have collected:

1. Take care of yourself. You may face long-term negative consequences to your health if you adopt negative behaviors. Do not deprive yourself of healthy, fresh food. Do not ruin your health by eating fast food and avoiding exercise. Do not pull all-nighters and deprive your body and brain of sleep; the consequences are too severe for what may be only 15 minutes of productive studying. Your brain needs fresh food, water, fruits, and vegetables. Your body needs exercise and sleep.
2. Do not compete with your classmates or compare your grades with others. We all had to be competitive to get into medical school. But once you are accepted, it becomes a level playing field. Although many students still compete with their classmates, it will not make them better physicians. Getting a 95% on your pathology exam does not mean you will be a great pathologist or clinician. As soon as you walk out of your first exam, look around, and you will see people obsessing about what the right answer was for Question 13. It is easy to spot them. They will come to you and ask you if you put "C" for Question 84. Seriously! Avoid everyone after the exam, and make friends with those who share your philosophy.
3. Answer practice questions while you study. "Studying my notes 10 times is probably the best way to prepare for exams." Wrong! The only way to test your learning is to do practice questions. For example, after studying your Board Review Series physiology textbook, make sure you complete the questions at the end of each chapter. This will help solidify the concepts you just read. Studying the same thing repeatedly does not make you smarter, but getting a question wrong will teach you quite a bit. Professional educators will tell you that it is statistically proven that students who do more questions perform better on boards, and that the only time you should go back to the big books is when you consistently miss questions on a certain topic and the answer explanations are insufficient.
4. Learn the big picture. You will likely start your first day in school delving into biochemistry, anatomy, physiology, or histology. From the start, instructors talk about columnar cells, impulse transmission, and glycolysis in fine detail. The next day, you are learning about brachial plexus and cardiac output. This is an enormous amount of information overload and students are often not prepared. As you memorize, learn the big picture
5. Study with groups. "I am going to study on my own because I don't need anyone's help." Wrong! Medicine is all about teamwork and sharing information. You have to be able to cooperate with others. Even when you apply for residency, it is important to keep this concept in mind. The moment the residency directors feel you will not be a good team player or that you might have "issues" with your colleagues, your application goes in the shredder. Find a small group of people who share the same healthy habits as you, meaning they like to exercise, they do not like to discuss grades, and they have a positive attitude. Once you find the right group, arrange to meet weekly for several hours to ask each other questions about concepts you do not understand. Even better, ask each other questions on little details you think your friends might have understood. Arrange for a review session the night before the exam for last-minute tweaking of your knowledge.
6. Take time to engage in stress-relieving activities. Everyone in your class is facing the same amount of stress, some people more than others. You might notice some students walk around with a frown, whereas others wear huge smiles. How is that possible if they are all facing the same pressure? Again, it is time management. If you have extra time, you are able to reduce stress. Spend time with friends, or do something on your own that makes you feel better. Activities like exercise, yoga, listening to calm music, talking to your parents or praying -- there is something out there that makes you feel better. Find it and do it. Do not let the stress affect your studies, relationships and, most importantly, health.

Finally, and we cannot emphasize this enough, remember that we are joining a great profession. Be passionate about what you are learning! Medicine is a treasure and an art. As Henri Amiel said, "To me, the ideal doctor would be a man endowed with profound knowledge of life and of the soul, intuitively divining any suffering or disorder of whatever kind, and restoring peace by his mere presence."

Note: This was adapted from a book manuscript in the publication process, How to Prepare for the Medical Boards – Secrets for Success on USMLE Step 1 & COMLEX Level 1, by Adeleke T. Adesina and Farook W. Taha.

Article taken at 11/03/11 from http://www.medscape.com/viewarticle/736773

Random Articles in the Internet: How Should I Deal With Gunners?

Question:

How do you deal with a classmate who is a gunner? Is it something that I even need to worry about?

Response from Sara Cohen, MD Fellow, Department of Physical Medicine and Rehabilitation, Harvard University, Boston, Massachusetts; Fellow, Department of Physical Medicine and Rehabilitation, VA Boston Healthcare System, Boston, Massachusetts

During one of the first anatomy labs in medical school, I was approached by the professor. After he examined our dissection of the abdominal cavity, he reached his gloved hand deep into the cadaver and spoke to me for the very first time as he pointed at a blood vessel. "Sara," he said, "can you tell me the name of this artery?"

I was pleased because I knew this one. I opened my mouth to answer the question, but before I could get a word out, my lab partner piped up, "The gastroepiploic artery."

I was shocked. The professor had clearly addressed the question to me. He used my name and he was looking right at me. There was no way that could have been misunderstood. Why would my lab partner yell out the answer to a question that was obviously not directed at her before I even had a chance to speak up?
It turned out that this was my first experience with a "gunner."

The definition of "gunner" varies depending on who you talk to, but it generally refers to an especially competitive medical student. Every medical school class has at least 1 gunner, and usually many more than that. Some people use the term to refer to students who study much more than average and are especially concerned with grades. However, the term may also be used to refer to medical students who exhibit behavior that is either borderline unethical or even blatant cheating.

Gunner behavior in the preclinical years that is borderline unethical includes (to name a few) hoarding study materials, making comments in front of professors that are meant to make the gunner look smarter and other classmates look unprepared, and dominating small group discussions. More malignant gunner behavior includes ripping pages out of textbooks in the library, sending out erroneous study materials to the class, or even cheating on examinations.

As a medical student, you will almost certainly encounter a gunner classmate at some point. (If you don't, the gunner might be you!) Many specialties have become very competitive, which puts pressure on students who want to match in these specialties to be at the top of the class. If a gunner is making you feel unprepared or making it difficult for you to learn, the easiest approach is to avoid him or her in an academic setting. If you have a study group, make sure it only includes classmates who are conducive to your learning, rather than people who are trying to top you or make you feel insecure. Just because a classmate is your friend, that doesn't obligate you to study with that person as well.

Another strategy is to set a good example. If you share your study materials with the class, it will encourage others to do the same. This is a subtle way to let gunners know that information should not be hoarded, and it is best for everyone to learn the material.

If a gunner is making class very unpleasant by dominating the lecturers' time, and the subtle hints aren't working, the only option might be to approach him or her and explain your concerns. Most students don't want to be perceived as gunners, so pointing this out to the student might make him or her change. When you speak to your classmate, be nice and respectful when you address this issue -- after all, this is someone you're going to be working with for the next several years and you don't want to make an enemy.

Finally, if the gunner is outright cheating, it is your responsibility to report this to the appropriate authorities.
Unfortunately, during the clinical years, gunner behavior often escalates, because grades are largely based on evaluations from the attending physicians who are observing you. A gunner may try to be the first person at work every day and the last to leave. He or she may try to leap in and do every available procedure or surgery, even on a patient who belongs to another student. I've heard of students who looked up the laboratory results on their co-student's patients to be ready if the other student dropped the ball.

The best thing you can do in that situation is try to ignore the gunner's behavior and do the best job you can on your own patients. If you are very diligent and knowledgeable, that will be apparent to your attendings and residents. However, if the gunner's behavior is very disruptive, the best recourse may be to confront him or her.

Keep in mind that all attendings and residents were once medical students, and they're often able to recognize gunner behavior. Although the gunner may impress some attendings, others will be turned off by attempts at showing off. You may be gratified to discover that your attending dislikes your gunner co-student as much as you do.

Although gunners are a common occurrence in medical school, there's no reason for them to make your life miserable unless you let them. Work hard and learn as much as you can and take gunners for what they are: harmless distractions.

Article taken at 10/03/11 from http://www.medscape.com/viewarticle/732051

Random Articles in the Internet: Saifuddin bincang dengan dua kumpulan mahasiswa UPM

Most of us at the clinical posting stuck wherever in Malaysia might not know this has happened although it happened some while ago. Just updating. For the details of the politics behind this incident, this site shall refrain from commenting. But I will admit I have tons of respect for him.

Nazirah, 3rdyr 2010/2011

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February 24, 2011 PETALING JAYA: Timbalan Menteri Pengajian Tinggi Datuk Saifuddin Abdullah telah mengadakan pertemuan dengan dua kumpulan mahasiswa dari Universiti Putra Malaysia (UPM) bagi membincangkan mengenai pilihan raya kampus (PRK).

Kedua-dua kumpulan mahasiswa yang ditemui beliau secara berasingan itu ialah Kumpulan Pro-Aspirasi dan Persatuan Mahasiswa Islam universiti itu.

Menurut Saifuddin, berhubung PRK, Kementerian Pengajian Tinggi (KPT) bersikap berkecuali dan tidak memihak kepada mana-mana kumpulan mahasiswa mahupun individu yang bertanding.
“KPT juga mahu PRK menjadi gelanggang politik yang sihat dan menyuburkan idealisme mahasiswa, dijalankan dengan licin, telus dan adil serta meningkatkan penyertaan mahasiswa dalam proses tersebut.
“Saya ingin tekankan bahawa PRK ini seharusnya dijadikan medan terbaik memberikan pendidikan politik dan demokrasi kepada mahasiswa,” katanya dalam satu kenyataan media hari ini.

Alasan tidak munasabah

Merujuk kepada isu pilihan raya UPM, beliau menghubungi Naib Canselor, Prof Datuk Ir Dr Radin Umar Radin Sohadi pagi semalam dan dimaklumkan bahawa kemenangan sekumpulan mahasiswa pada 22 Februari lalu dibatalkan oleh pihak universiti atas alasan yang tidak munasabah.
Menurut Saifuddin, beliau “tidak mengarahkan” Naib Canselor, sebaliknya “memberi pandangan” kepada pihak universiti tentang cara terbaik mengatasi isu tersebut.

Beliau berpendapat pembatalan kemenangan itu tidak wajar atas alasan kumpulan terbabit berkempen secara berkumpulan.

“Saya anggap alasan ini tidak munasabah kerana umum tahu bahawa pihak yang membuat bantahan itu sendiri adalah sebuah kumpulan juga. Ini diakui sendiri oleh seorang daripada mereka dalam perbincangan dengan saya hari ini.

“Pembatalan itu dibuat tanpa memberi peluang kepada pihak yang dibatalkan itu untuk membela diri,” katanya.

“Jika berlaku pembatalan atas alasan yang tidak munasabah ini, saya bimbang kita akan dilabelkan sama seperti Myanmar yang tidak mengiktiraf kemenangan Parti Liga Demokrasi Kebangsaan pimpinan Aun San Su Kyi dalam pilihan raya pada 1990.

“Atau Amerika Syarikat, Kesatuan Eropah dan Israel yang tidak mengiktiraf kemenangan Hamas dalam pilihan raya Palestin pada 2006,” katanya.

Beliau turut memuji sikap keterbukaan Naib Canselor UPM yang bertemu dan mendengar aduan kumpulan mahasiswa itu.

“Sikap keterbukaan beliau telah berjaya menyelesaikan isu tersebut dengan baik. Namun, saya kesal kerana terdapat juga sesuatu permintaan daripada sekumpulan mahasiswa tidak dilayan oleh pegawai tertentu sehingga menyebabkan insiden yang tidak diingini berlaku.

“Saya bukan menyokong permintaan mahasiswa itu, saya cuma kesal ia tidak dilayan. Saya juga kesal dan tidak bersetuju dengan tindakan sekumpulan mahasiswa yang menyebabkan kerosakan harta benda awam.
“Pun begitu, saya percaya jika permintaan kumpulan tersebut dilayan, maka insiden tersebut mungkin tidak akan berlaku,” katanya.

Article taken at 8/3/11 from http://www.freemalaysiatoday.com/2011/02/24/saifuddin-bincang-dengan-dua-kumpulan-mahasiswa-upm/

Random Things in the Internet: "Bad" Medical Students

by Kendra Campbell, MD, Psychiatry/Mental Health, 07:57PM Feb 24, 2011 from http://blogs.medscape.com/kendracampbell

Taken from Google Image

I've written some posts in the past about how to shine during your clinical rotations. But an experience today inspired me to write about "bad" medical students. We were having a resident lecture by one of our psychiatry attendings, and he invited his medical students to join us. I couldn't help but stare in disbelief at one of the med students, in particular (and keep in mind that this was a small room with less than 20 people in it). One of the students clearly had his phone in his hand, although he was attempting to cover it up (but doing a rather dreadful job). For about 95% of the lecture, he stared at his phone, occasionally typing things or apparently reading stuff from the screen. He looked away from his phone only once that I observed, and never looked at the lecturer. It was really quite incredible, actually.

During my psychiatry program, we had an entire course on "how to teach medical students." We were taught tips and tricks on providing quality education to our students. In addition, we had lectures on how to deal with "bad students." We were introduced to various situations that we might encounter, and were taught ways to handle them. For some reason, psychiatry seems to be one of those fields that some future doctors believe that they'll "never need in the future," and as such, it can bring out the worst in students. 

I thought I would list examples of some of the "bad" medical students, whom I encountered as a resident, as a "don't do" list for med students:

1. The disinterested medical student. See above example. As an aside, let me say that although you may think that you will NEVER need to know psychiatry as a surgeon, you are wrong. Trust me on this one. So, even if you could care less about a particular specialty, it's really important to "fake it 'til you make it." It really doesn't take that much extra energy to act interested. And yes, residents and attendings DO notice when you take absolutely no interest in learning.

2. The "no" medical student. I was actually quite shocked the first time I asked a medical student to take a history from a patient when she responded "no." While it's entirely reasonable to refuse to do something you are uncomfortable with, refusing to perform required duties is certainly not a good way to get a good evaluation (or learn!).

3. The late medical student. While there are always excusable reasons to be late on occasion, chronic tardiness is very unprofessional, and is definitely noticed by your resident and attending.

4. The medical student without a clue. No one expects med students to know everything, or to be able to answer all questions. But when a student is obviously not taking the time to learn about a particular specialty or topic, it really shows. We all understand that you don't have the luxury of studying all day long, but reading for even 20 minutes a day will show that you at least have the motivation to learn.

5. The distracted medical student. We all have lives outside of med school and residency, and emergencies arise. But constantly texting or being pre-occupied with things other than the rotation looks unprofessional, and does not go unnoticed.

I hope this list is helpful to some of you out there. Please do provide examples from your own experience or add to the list!

Kendra Campbell, of http://www.doctorpsychobabble.com/