Sunday, March 27, 2011

GAMSAT Version 2.0 and "meh" talk

Weekends always go so quickly. What's with that..?! I had a very bizarre experience this weekend. I did St John First Aid duty for the GAMSAT exam (Sydney Venue). It was so weird right. Last time I was there was four years ago when I was sitting the exam myself. It's funny how even the memory of a high-stress situation can provoke the same sympathetic response as the original event. I so vividly remember not being able to sleep the night before the GAMSAT - I kept dipping in and out of consciousness, checking the time on my mobile phone next to me every half an hour for fear of sleeping-in and missing the damn thing. Not to mention the drum-roll palpitations on entering the exam hall. It's such a b*tch of an exam and I honestly see no correlation between passing the exam and success in medical school. It really is just a high-attrition tactic to wipe out > half the med-school hopefuls so that the bureaucrats and admin people don't have to deal with the effort and paper-work of going through all the potential applications that would come through. Meh. Anyway, thing of the past, can comfortably put it behind me and was oh-so-very relieved to be there as a spectator at the Australian Technology Park in Redfern (venue where the exam is held) this time.

On the med-school front, I finished my rotation in Neurology last week. It was a really good rotation; made all the better by the team I was with and my supervisor. I definitely could have been more pro-active and involved, but I seemed to always find the temptation to go home after lunch too strong to resist. So basically I'd attend ward rounds in the morning; then tag along with the registrars on their consults (usually in ED); there would always be a meeting of some sort that was worth attending (especially the radiology ones where they go through scans of patients on the wards); some days there would be a clinic on in the morning or afternoon; and the rest of the time was spent seeing patients on my own or with another student. I tried to see at least one patient a day and do a long-case type assessment of them. Sometimes the interns would ask us to take bloods or put in cannulas which I'm a bit over doing now because the novelty has worn off, from doing so many last year. Anyway, there were four medical students on the team - one of whom was a bit annoying because she would always hang around until really late into the evening with the team. She's interested in pursuing Neurology as a speciality, so I understand that she wanted to get as much out of the placement as possible; but still, it made us all look unmotivated and less-than-keen. It was a bit frustrating too because she would never explicitly answer my questions on what she would get up to in the afternoon/evenings when we weren't there; so it was hard to gauge whether it was worthwhile staying behind or not. Of course we could've just stayed behind ourselves and found out, but I don't know that it would have really been useful as most of the activity seemed to happen during the day, and she would always slip off and do her own thing anyway. Meh. I'm sounding a bit like sour grapes now, so I'll stop. I am actually happy that she's thrown herself into Neurology. Two reasons: (1) every speciality and its patients deserves to have a keen-bean enthusiast who will throw themself into their work - these people turn out to be the movers and shakers of the specialy; (2) last year she was set on pursing O&G, so she would have made some very stiff competition if we were going for the same registrar-level training position. Okay, official freak of sour-grape I am today - will stop! So, um, yeah.. I always assumed I'd fall into a career Neurology myself, because I have a degree in neuroscience - so it seemed like a natural progression. I have to say though, the fascination and general awesomeness that drew me to the theory of neuroscience back in my undergrad days; is numbed by a sobering overtone of helplessness when it comes to the actual clinical practice of Neurology. There really isn't much that can be done for a lot of patients under the Neuro or Stroke-Unit teams, curatively - with the majority of management aimed at stopping disease progression or rehabilitating the body back to a functional state, post-event. The true hero(es) in my eyes, are the clinical research teams that are working on preventing and/or curing neurological diseases. I hope that I can see their effect of their studies in my life-time. It really would be an amazing contribution to society.

Tomorrow I start the last of my medical/surgical "selective" terms - Gynae Surgery. I had initially been timetabled for Haem Oncology, but I heard it was a fairly average term to do as a med student, so I swapped out of it. The person who was assigned to Gynae Surg has no interest in this area at all, so she was happy to take anything else. I'm thinking again about going into O&G, so I guess it was a win-win situation. I've heard the supervisor for this term is really nice, but he grills his students on their knowledge of the anatomy of female reproductive organs. So I spent like maybe half an hour (if that) trying to memorise the ligaments that hold various different things up and stop them from falling, if you get my drift. I think I'm okay getting grilled for the first week, and then getting the swing of things by the second week, because I'm honestly finding it too hard to just stare at diagrams of the uterus and ovaries without a clinical situation to slot things into context.

Anyway, it's now midnight and I'm wishing I had more weekend time to catch up on sleep, chillax, watch some DVDs and do some uni work. Meh.


  1. Oh! I know I'm a bit guilty of being the 'keen bean' student. Oh no - I know it annoys some of my buddies, but I do get something out of it - if only because it's quieter after hours and patients aren't getting whisked away for whatever. You've got time.

    Perhaps the novelty will wear off for me soon?! Probably - I'm home sick right now - if I really were so keen, I'd probably be coughing and spluttering over patients at this very moment!

  2. Oh I was totally just being sour grapes, there's nothing wrong with what you or said person in my little story are doing - in fact, you're probably doing the right thing. The novelty might wear off, but hopefully it doesn't do so anytime soon; otherwise, you risk becoming cynical and jaded.

    Enjoy it while you still can/do!

  3. I just started reading your posts and I find them fascinating. It's interesting what students think of their colleagues who insist on starting early and finishing late. There must be some level of anger or frustration toward me as well.

    Now this might be a longer-than-short comment, but I do really want to speak to someone, anyone about this. I look at the hospital from the perspective of the clinical attachment I am assigned and wonder how short-staffed we are. I see the registrar slamming the intern and the intern already has enough problems keeping up with their list. They need help... they really do. So I'm standing there, eager to help them so that their workload is lighter, freer, so that all of our patients are cared for quicker and management plans are modified in shorter periods of time.

    We do become insensitive to the routines of clinical practice but we must never forget that for every patient, that may be a new experience or a different one from the others. Our attitudes dictate outcome, especially in the future.

    My friends tell me about the concept of not being paid, or not learning enough in hospitals. The truth is, medical education adheres to principles and protocols of teaching that are long outdated as effective. So we are stuck with a system with no formal teaching in the clinical setting - we learn in a self-directed fashion. We must remember that we are using the patients of today to learn in order to manage the patients of tomorrow. We must never forget to remember the current patient's state of health and that we have an active role in their outcome also.

    My esteemed colleague, please hang in there. Humanity needs you.

  4. Aw thanks for reading my post Endless, and for your very thoughtful comment too. I completely agree that time spent on the ward is never really "time-wasted" (even if I may have referred to it casually as such). I think there was definitely an element of physical/mental exhaustion (and frustration at myself) for not being able to keep up with the seemingly endless energy of my colleague. Some rotations are better than others too, when it comes to finding inspiration - and often the factors are purely internal and regardless of the quality of teaching. So I guess you take the good ones and milk them for all they're worth... as for the less inspiring ones, I tend to mope and sulk, hoping for a better day.

    Cheers :-D

  5. You are absolutely right Miss Purple Stethoscope - inspiration is sometimes difficult to find and it really does feel like I don't want to find it. Some rotations have driven me crazy as well!

    Physical and mental exhaustion really does bring us back to facing the reality that we are not robots. I don't think you should feel frustrated about your Energiser Bunny colleague. They may persist more than the average medical student, but I promise that they will eventually decompensate and burn out. Sometimes, they probably ache for someone to ask them how they are really coping. I know I do sometimes.

    I really like your posts. I will continue reading them and commenting as time flows forward.

    Until then, keep smiling.