BrainGenie for a non-scientist

I'm struggling through some of the science disciplines in my medical degree.  This is most likely due to the fact I did not do any science past grade 9 in high school except for a tiny bit of intro to biology and physics in my first year of my paramedic degree, and my terrible attempt at self-study for the GAMSAT.

Seeing as I'm working on becoming a doctor, and the USMLE Step 1 has some of this stuff in it, I thought I better learn what DNA is etc. Scary thought, isn't it? A doctor that doesn't really understand much about DNA and genetics.  Luckily, I only need a fairly basic understanding of these things and I came across a gem of a website called BrainGenie.com . It seems to be for primary and secondary school students but it is FREE, and has good quality, clear lectures.  I'm currently going through some of them now, and I might even refresh on my long division while I'm here.

The BrainGenie lectures wont be enough to do well in the Step, but it's a good starting place before moving on ad adding more detail.  I believe one needs a good foundation to build on.

I also have a "5th-pass theory". I heard it somewhere and kind of butchered it a bit.  It might even be a real theory of learning.  But my theory goes something like that the "first-pass" or first time you see a new piece of information, your brain is thinking "I've never seen this before. It is completely foreign to me. Scary". The second-pass you brain says "I think I've seen this somewhere before, but I can't remember what it is exactly". The third-pass "Oh this again, what is it again?" Forth-pass "Yep, I know what this is" and finally the fifth-pass your brain says "Oh! This old thing! Yeh, that's easy!".

Sometimes the first-pass needs to be gentle...

Back to reality

I'm well-and-truely back to reality - I'm back home, back at work, and back into studying!

Today is the last day of 2011 so I'm having my last McDonald's breakfast hehehehe.

On today's agenda - at work, so normal work duties which are minimal, but I would like to clear out my locker ready for the new year. We have new Clinical Prctice Guidelines and I was waiting for my new copy to turn up but it might be weeks so I will look at the electronic version instead.  There's my Masters readings and I can even do the first two assignments for one subject if I wish, presuming they haven't changed (much) since my first attempt.  Then there's the molecular biology I threatened to learn about of before next term (which starts on the 9th of January) and my academic advisor keeps asking me about but that is going down like drinking nails. I hope to find some good YouTube videos on that subject because my textbook is about the most boring thing I've ever read in my life.

That's about it.  Oh yeh and making my home gym more gym-like and less laundry-like and getting good, healthy food ready for my New Year's resolution.

Samoa skips a day

My medical school is based in Apia, Samoa. Tomorrow, they will skip Friday altogether and jump straight to Saturday, therefore jumping into Australia and New Zealand's date/time line/zone thingy-me-bob.

Samoa changes time zones


The picture above crudely shows the line that separates today from yesterday.  It 's just "Samoa" Samoa (formeryl known as Western Samoa) jumping forward into the West towards New Zealand, not American Samoa which makes it a little confusing. 

I see the logic that Samoa does a lot more business with New Zealand than it does American Samoa, nevertheless it would make a confusing short journey from Pago in American Samoa to Apia in Samoa.

Whew.

Just two years ago Samoa changed to driving on the left sid eof the road instead of the right.

They are going through a lot of changes atm as they move forward into their development.

Flying home

Just at the lil' airport on my way towards home for a wedding tonight.

Vineyards

Tasting too many wines at theocal vineyards....it is definately the weather for it.
Can recommend Goaty Hill...

ATVing

Just had a lovely afternoon on Dad's ATV on my parents property. There are heaps of butterflies and wallabies....very nice indeed.

Gone on holidays...

This is the view from my Mum and Dad's house.

Today is beautiful weather. Yesterday was my xmas and I got to eat lots of yummy food and drink too much champagne!

My flight was delayed for four hours from Melbourne due to a nasty hail-storm but I managed to make it by 3am!

Time for an afternoon nap me thinks....

Xmas and work - wow

We had a massive 24-hours at work - there was so much work, and big jobs too, going on around the area and of course we got sucked into that vortex.

Very sad jobs too - sometimes this time of year can really suck.

Last night we got sucked into Melbourne and had trouble getting out due to, as per usual, there not being enough ambulances to meet the demands.  I did, however, get to do my first heroin overdose! We almost never see them out in the country.  We see pissed people that have hurt themselves.

It was such a stereotypical job too - at the top of public housing flats, many hands on-deck - police, fire, security, us.  Very different to what we're used to and quite a novelty.  Our patient was also stereotypically ungrateful for having his life saved.  It was just as it appears in the movies.

We were ramped (suck in the hospital triage with our patients on our stretchers waiting for a free bed) with our ungrateful OD and another crew brought in a drunk man in business attire who was virtually unconscious, and five weary ambos standing, waiting, and one ambo said around midnight: "It's Christmas now.  Merry Christmas......" and there was about five minutes of silence as we looked at where we were and who we were with.  This is our life.

---------------
Tonight when I finish my shift I get to get on a plane and fly to Tasmania to see my Mum and Dad. I cannot wait :D

Tight-ass home-maker tips

I just managed to score some curtains, railing, and rod from the local op-shop.  I'm so impressed.

The "good" op-shop (the big one with furniture) is only open 11am-1pm Fridays and Saturdays. If I'm passing by I often stop in to have a scout around.  I'm convinced that if you have a small wish-list in the back of your mind it's easier to wait for what is suitable/affordable than trying to find it straight away.  It's easier if you can accept that you can live without curtain netting until you find the right stuff.

All my windows came with blinds but I put up curtains in the bedrooms to block light creeping in through the cracks on the sides.  They were very cheap, light-weight ones from the cheapie shop ("The Warehouse"), in just simple charcol and gold.  In Cambodia, I picked up two matching massive king-size bed sized silk fabrics which I converted into curtains and look great. 

I've had my eye out for some netting for months. There are three windows in my house that could use netting for privacy but it seemed so expensive from the shops.  I found some that were acceptable in design/colour (not too old granny), were in good condition, and the right width and length.  Excellent.  There was also a good rail I got for $2, and I asked and they managed to find my a curtain rod tucked away in the back. Excellent.  Everything cost me a "donation" as they are moving locations - so I just gave them $8.

I'm currently washing the curtains and I look forward to putting them up when I have some time. I'll put up some photos when they're done.

----------
Edit: If you have trouble deciding what looks crappy old op-shop and what looks ok vintage, try looking at modern versions and think about what you like about them.  For example, my dear friend has top-of-the-range netting curtains at her house. I was checking what made them look modern and expensive, compared with the granny-flat ones I see at my patients houses. Some things to consider are:

• Colour - some colours look more tired than others, for example some cream colours can look like white that has yellowed with age, but some whites can look cheap too. Complimenting the rest of the room is a good way to have things fit well into a room.
• Texture - I'm really into the tweed-like textures atm. Consider whether a finer or coarser texture would look best to you in the different situations.
• Natural or synthetic - one of the best things I like about the bigger netting I just bought is it appears to be made from natural fibres, ie a wool/cotton blend.  This gives a sense of luxury and can be a real find in op-shops as it was the preferred material a few decades ago. Now it's all cheap nylon and synthetics.
• Pattern - a modern or classic pattern can be a world of difference from a daggy 1980's/90's one. I'm really into the deco era and shudder at the sight of anything I had in my house when I was growing up.
• Less is more - A few op-shop pieces, even curtains of furniture can looks good if they are maintained in a good condition. Having your whole place decked-out like students accommodation where you display everything you have every owned gives a slightly different feel. 
• Condition - as above, a well-maintained item is essential.
• Be brave - so what if your $4 curtain doesn't look so good when it's up? You only lost $4, not $240. Unless you're expecting a visit from Home Beautiful magazine this week, try again, get creative, express your artistic side, and try again.

Good luck.

Xmas to ambos

This is what Christmas looks like to ambos:

• Drunks
• Domestic and other violence
• Intervention orders
• Lonely old people
• Lonely people in general
• People awake causing trouble when they should be asleep
• Hoons
• Car accidents
• Emotional manipulation
• No time off/missing out on the festivities
• BBQ burns
• Food poisoning
• Alcohol poisoning

And that's just the ambulance staff!! hahahaha

When your life is not on hold

Wow. It feels so relaxing to only be working full-time on-call, without (mandatory) study.

It's amazing how many things in life can occupy your day when you have the space for it to do so. It's not all bad. Some of it is necessary in order to maintain a certain standard in my house and personal appearance, and to be able to help out friends, catch up on my Star Trek dvds (I'm going through the Enterprise series atm), and then there's that thing I really think is important called "sleep". I did a few things at work like organise my in-tray and catch up on some paramedic clinical stuff. I slugged on myself today also on some beauty products just for a treat.

I didn't study at all today. Tomorrow is Friday already. I've given myself until the end of tomorrow to sort out my house, as I'll have to pack on Saturday ready for Sunday's flight. Although I don't need all day to pack, I need to leave plenty of buffer-room due to my work. I am predicting this weekend might be busy due to the warm weather we're having and that it's a mega-long weekend and Christmas and all.

Today I probed my group manager about the possibility of part-time paramedic work and job-share in the region.  He was fairly optimistic about it which is a great reaction - quite polar from the attitude when I started.  I'm about two years off (in my conservative projection) from ceasing full-time work to complete my clinical placements in medicine, but I thought it might be nice to sow a few seeds early.  Two years can go fast in the paramedic world thanks to shift-work and people being on annual leave all the time, up-ward relieving, and so-forth.

Anyway, off to bed to try and keep this adequate-sleep habit going...for now.

Australian bureaucracy

ABC Radio Australia News:Stories:Australia blocks Pacific doctors from training programs

A Guide to Working Abroad for Australian Medical Students and Junior Doctors

A Guide to Working Abroad for Australian Medical Students and Junior Doctors

Masters

So I'm doing some reading for my Masters subject, which doesn't commence until late Feb, but as you may recall I dropped out of this subject about a year ago and I retained my hardcopies of the first 5 modules and their readings, and my first assignment.

I'm also looking at the new cool educatin portal work has put up. It has learning packages in the forms of videos and quizzes. Well, actually it only has two videos at the moment, but that is where it is growing to.  Our new Clinical Practice Guidelines have also been released and I can't wait to get my new hard copy soon.

This is my classroom

My study is all tidy and vacuumed ready for another round.

Another new med school in Aust

Rob Oakeshott delivers new medical school | The Australian

People just don't get it

I don't know how many times I've tried to explain my work situation to people. They just don't get it.

I love the look on people's faces when I describe my roster: utter disbelief.  Try explaining it to my university lecturers - the word "excuse" has been thrown at me a few times, and it happened again today, soI'll try and break it down again, as an example week - this week.

Monday - off during the day, overtime tonight 1830-0700
Tuesday - off during the day, perhaps sleeping depending on how busy Monday night was. Start on-call at 1830.

Tuesday 1830 - Sunday 1800
I'm on-duty 0700-1830, and on-call 1830-0700. That's 24 hours of the day, continuous for a week.  I go into the ambulance station during the day when there is one computer and Elluminate, Skype, and other programs essential to my study are blocked and cannot be un-blocked.

During the night I go home with the ambulance and pager. I can do what I want within an 8km radius of the ambulance station, providing I can be ready to respond from the station within 10 minutes of receiving a page. This means things like swimming, running distances greater than 3km, cooking a roast, having a glass of wine, dyeing my hair, etc are all very difficult to do whilst on-call.  There is very little within 8km of my station. No restaurants, no cinema, nothing except my house and a small supermarket open until 9am during Summer trading.

What happens if you work all day and then get paged all night? Generally we keep going. I have worked 24+ hour days before Not such a good idea when you're diagnosing and treating life-threatening emergencies without back-up, working in an unpredictable and sometimes dangerous environments, and, oh yeh, driving an emergency vehicle sometimes at high speeds in all sorts of traffic and weather conditions.

Fatigue breaks are a life-saver. Fatigue breaks are 10 hour breaks where we cannot be disturbed, paged, or contacted. This is the "bali" or "mercy"  signal. The "I cannot go on any longer" call. It's just enough time to go home, try and switch my adrenal glands from "stress" to "relax" maybe have a shower and something to eat, maybe feed my dog, and try and sleep for about 8 hours while they are building a house next-door, pray to God nothing happens int he town while I'm off, and then get up and find a new uniform and do it all again.  It's really great when I've been up to, say, 7am, tried to sleep during the day until about 3 or 4pm, go to work for a few hours, then come back home and try and sleep at night when my body clock is out.  I often can't sleep that following night for ages (I wonder why) then I still have to be up and at work on-duty at 7am. My circadian rhythm says: "Hey! You had me awake until 7am the day before and now you want to get up at 7am!? WTF!?" It can switch like that, back-and-forth, for the week.

All of this, and it's completely unpredictable which nights I'll work all night on call-outs, where and when my fatigue breaks will be, when my down time will be, which nights I'll finally get to eat a home-cooked meal etc.

So that is how my roster is. This is why my academic advisor can't understand why I can't give her an exact day and time to call her on Skype when I can choose anytime this week. This is my life.

-------------
Good things about my roster:

• We get paid well for having no life. Call-outs are at double time (double rolled-in rate, actually, which includes penalties etc) and even when we're on a fatigue break, we still get paid.
• Most times, we only do about 3 jobs a day. "Jobs" take about 3 hours each, with leaves us with 15 hours in the day of "down-time".  It is best when the down-time is during the day as we get paid single time for the day shift anyway, and nights are busy where we get our double rolled-in rate.
• There's always overtime going due to dropped shifts and fatigue breaks.
• I live <1km from my work. I often walk there when I can.
• I have a  work vehicle (the ambulance) when I take home. My private car does little kms.
• During my down-time I have few work duties. We have a cleaner, sometimes we put away stores, we clean the ambulances when needed  - the rest of the time I can study medicine.
• I get 10 weeks annual leave a year.
• I don't do actual "night shifts" so if I'm fatigued at 1am, I can stop working at 1am for example. 
• Rosters like mine are often in small rural towns where the work is much better quality, i.e. the cases are genuine - the patients are actually in need of our services and not wasting our time.

I love my job - there is no question about that. But my roster is sometimes a killer, and it's difficult to explain to people why I can't commit to a Skype session.

The aftermath

Trying to get my life back on-line.  I have half a day off now to organise the other areas of my life that got neglected and de-prioritised while I was studying.

Today's goals:

• Groceries shop
• House work
• Mow lawns (unlikely)
• Take a look at finances/tuition fees
• Print boarding passes for Tasmania

This week's goals:

• Finish off and print out final (post-exam) revision notes for endocrine system and store for final pre-clinical exam in 2013
• Clear cupboards in guest room and second bathroom for new house mate
• Hang newly framed picture of Potala Palace
• Make a study plan for Summer break (Masters, microbiol, PT, neuro)

Results

Well I've spoken to two other classmates and 75 seems to be the going mark for the exam. 75 is the new 85. I feel I deserved an 85 in my mind but it is some-what comforting knowing it was the exam and not me.

It's my work xmas party tonight which should be fun.

Endo over

I just did my two quizzes and final endo exam.  The two quizzes wen really well. I got 90% for each. Then I did the final endo exam. I thought I'd done ok, maybe my normal around 85% but I only got 75%. I don't know why.  I felt way more confident than that seeing as for my quizzes I averaged around 83% and had done heaps of revision and a lot of the questions were repeated except for, maximum, 5 questions on reproductive hormones I didn't know very well but think I got at least one or two of those right.

So, I've calculated my overall module score should be around the 80% mark which is, depressingly, my lowest grade yet.  Even lower than biochem.  I was thinking I'd get my highest grade.  In fact, I'm so shocked at how bad I went I've emailed the curriculum coordinator to double-check all my answers were recorded.  I can't believe it.

A little bit down now but glad it's over.

My dog is big but cute

My dog is doing this thing lately where he gets all cozy amoungst the cushions on the couch.

That's his "Why are you studying and not paying attention to me?" look.

Free Google books medical textbook list

If you haven't heard of Google books yet, it can be a little gem.  Not all books are available on there, and the ones that are are usually missing pages due to copyright restrictions and you usually can't print the pages, therefore you might have to supplement with borrowing from the library and/or photocopying the pages you need, before upgrading to a $1 secondhand >10 years old version, and then finally being able to afford the lastest edition (or at least one less than 5-10 years old).  It can be a real pain if your med school references specific pages in specific editions which is what my med school does, but you can still work around it if you're really tight on cash.

Here are a few links to books that are on my core textbooks list at my med school.

Lippincott's Biochemistry
Davidson's Principles and Practice of Medicine
Robbins Pathologic Basis of Disease
First Aid for the USMLE Step 1
Guyton and Hall Medical Physiology
Martin Neuroanatomy

There's quite a few more textbooks in my well-established library now, but that's just some examples of the ones I have in hard copy which are available in part online for free.

If I was Google books and book publishers I would make everything available and just charge per page or per view in a sort of iTunes format. They'd make money for sure!

-----------------
Study is going well but I'm sort of getting bored of it. Can't wait til it's over and I can start a new topic.

Revision day 9/10

Well darn work has gotten in the way again.  I was called out until 4.30am this morning so had to sleep until midday today.  Back at work again now.

I really can't be bothered with my revision notes anymore.  I'm seeing flaws in them everywhere and I'm getting really disheartened because of it.  I've been watching some Kaplan videos on endocrine physiology instead which is going well, but there are so many of them to watch and I'm afraid I'm not retaining much.

I found out I am doing neuro next term so I can look at that as soon as I've done my endo exam.  I also looked and I forgot I enrolled in two Masters subjects next term - I don't think I'll do both but I'll wait to access the course materials before I withdraw before census date (cannot miss the census date again!).

My house is an absolute disaster and it's starting to do my head in but I can't do anything about it until after the exam.  I hope none (else) drops in on me unexpectedly before then.

Big weekend planned of fun - can't wait!

Revision day 8/10

I'm back at work today and have done a little ambulance work and am now studying and trying to memorise my revision notes.

I'm making a few quick notes as I go through of things I feel I don't properly understand why the answer is the correct answer and a few physiol/biochem/pathology processes which haven't organised themselves in a meaningful way in my mind yet which I am worried I will therefore forget after the exam.

That is all. Must go read and re-read these notes now because I want them done by today so I can look at a few other things like the videos.

Revision day 4-7/10

Revision days 4-7 were spend not studying anything other than my lovely revision notes.  I had a work function in the big city and then public duty at Meredith Music Festival.  Today is presentation day and the last lecture for endocrine.  Woo-hoo!

So, revision days 8, 9 and 10 will be revising my notes and hopefully watching Kaplan and reading some other pathology notes at work during down-time.

All is going well and I can't wait to be done in a few days so I can start looking at other things.

Doctor in Training

This is me watching my Doctors in Training lecture at my desk. I <3 my new mac.

No matter what I do though, the pictures from my phone (Samsung Galaxy II) always upload sideways! I also don't know how to rotate it once it's in Blogger. Tilt head for now....

You know you've been studying too much med when....

...you start to describe butterfly wings as "lobes".

Revision day 3/10

I did very well yesterday, if I do say so myself, which, of course I do.  We didn't turn a wheel at work so I got cracking at 7am and kept going through to 5.30pm where I stopped studying and did a few branch duties before I went home.

My revision notes are looking friggin fantastic, if I do say so myself.

Keeping with tradition, I've banned myself from Facebook until I've done the exam which helps eliminate at least that distraction.

I studied so well that when my neighbour asked me to join her for a bbq at the park I was able to attend guilt-free!  The 3 drinks went straight to my head and I slept straight through from 10pm to 8.30 am so now I'm feeling pretty good this morning to keep going.  I've just accepted an overtime shift at work tonight from 5pm so my goal now is to get a lot done before then, despite the weather being so beautiful today.

It will probably take me from now until 5pm to finish making these revision notes as there are over 100 questions and quite a few are clinical vignettes which is a paragraph or so of writing. I have 14 pages so far (!) of just revision questions, so it's a lot to organise and I have to watch the end of a few lectures to get a few more questions.  I'm also sorting them into weeks which are themes, such as "the thyroid gland and hyperthyroidism" and "the adrenal gland and Addisons" and then under each week I've separated the questions into science disciplines, i.e. embryology, anatomy, physiology, pathology, pharmacology, etc. I'm hoping this will help my mind in gestalting.  If I had more time I might colour-code a bit more than just the headings and subheading, but given my schedule for the rest of this week that is unlikely.

And, no I haven't been able to start watching my Kaplan or Doctors in Training videos yet.  Next week maybe.

Overheard in the ambulance

OVERHEARD IN THE BACK OF THE AMBULANCE
After quite a lot of coaching and coaxing by the paramedic to try and get the elderly female patient to use the penthrane inhaler correctly (penthrane is an analgesic methoxyflurane which is inhaled through the mouth using an inhaler which is confusingly shaped like a whistle.  It can also have some neurological side effects similar to drinking alcohol...) the patient finally got enough pain relief on-board.

ELDERLY PATIENT

"Thank yooooooou"

PARAMEDIC

"That's alright.  All I want to do is make you feel better."

ELDERLY

 

"I looooove yoooooooou...."

Exam revision day 2/10

Yesterday we were so busy at work I only got about an hour of study done.  I used that time going through my practice quizzes from week 1.  Some of them are from my case study, some were given in the lecture, and some I jotted down after the weekly quiz that I could remember after each week.  That in itself was actually quite good revision.  I have about 20+ questions for each week which makes about 120 in total for the module. I think there's 100 questions on the final exam, so I reckon my revision notes are going to be a good asset to me.  Stay tuned and I'll let you know!

So now I'm going through all of the revision questions I have for endo and seeing how many I can get done today.  It's easier to motivate myself and concentrate on revision questions because I know I'm not wasting my time doing those, rather than reading some obscure chapter which may or may not be useful to me at this stage.

I also started watching some of the Kaplan DVDs yesterday but kept getting interrupted (how dare people call for an ambulance when I'm studying!) and then I put them on again last night and I fell asleep in the couch at 8.30pm I was so tired.

Ok back to the revision questions.  I'm retyping them all neat, underlying key words, making sure I understand why a correct answer is a correct answer and why the incorrect ones are incorrect. Some of it is pure rote learning but not much - those ones I'll cram before the exam.  As I'm retyping them I'm actively revising rather than just zoning-out.  I'll be sending my revision  notes to my friend in my class too, so that motivates me again to make sure all the answers are correct so I don't stuff her up.

Hopefully I'll finish these notes by today or early tomorrow so I can do the Kaplan videos, my Usmleworld Qbank, and I also bought a few Doctors in Training USMLE Step 1 videos for "Solid Pharmacology" and "Solid Internal Medicine" (Solid IM is new to DIT).  I've bought a few of the appropriate endocrine lectures.  They are usually $12 each for about an hour plus notes, but they often have sales where they are $9 each, so if you go on their mailing list you get notified of these.

Excuses

I get approached a lot by people, especially other paramedics, about the possibility of them studying med.  I must say, of all of them, only about half again would consider OUM.  It's just too alternative for most.  I've fielded a few phones calls over the past few weeks. It must be that time of year.  Only one I know is actually going through the application process now (power to you!) and one or two are studying for GAMSAT this Summer.


The amount of times I've been approached by people that have a bucket-load of excuses and never go through with it is incredible.  Most common excuses are "can't afford it" and "don't want to go back to study". The most honest reasons I (barely ever) hear are "I'm afraid of failure", "I don't want to be at the bottom of the pecking order again", and "it looks really hard".


I remember when I did the MedPrep course (and excuse me if I've already told this story before) and the lecturer said "If you don't give it your best and keep trying until you get in, one day you'll be sitting the in the GP waiting room with your children telling them the story of how you almost became a doctor".


I had an anatomy lecturer in my paramedic degree that told the class how he used to be a medical student.  This guy was about 55 and used to being a medical student was still his identity.  He had to go to work at that same university every day and teach medical students and he couldn't even hide his regret. Imagine that?


Blaming your children for not doing something is gold. I mean, how can I reply to the best excuse of all which is "I can't afford my mortgage if I got back to medical school".  It's so true.  You probably won't be able to afford that mortgage you have. And I know the feeling.  I mean, I did almost exactly the same thing - I chose OUM to retain my lifestyle over moving 3000km away with no money and the prospect of another 4 years of two-minute noodles.


My point is; we don't all have to act on our dreams of someday becoming a doctor (or an astrophysicist or whatever). But if you think you might be that person in the GP waiting room one day, sitting there in regret, which your children can read all over your face, then that might cost your soul more than your mortgage repayments.


I don't want to put even more guilt on parents, especially seeing as I'm currently childless.  I just want to say there's lots of people who are "want to's", who are "gonna be's". I ask those people to really think what's stopping them. Is it the lifestyle change, or is it fear of something else?  It is a hard thing to do, I know.  And even if you can admit to yourself it's fear of failure, acting despite of that fear can be almost impossible.  I know it.  Because I'm the opposite.  I just have to act - I can barely contain myself!

Studying for final exam

Today is the first day of study for my final endocrine exam in 10 days..... and  I don't know where to start.

I'm at work so I need to get myself sorted out asap because I never know how my day, or week, will end up.

Ok, off to start looking back through the case studied and practice questions.

In your end-o

Today we did the first half of the student presentations.... and I'm going next week!  I've finished my presentation this morning in case I was first up and to get it out of the way before revision week next week.

It's nearly the end-o of the endo-crine module and I really like endocrinology.  I also really liked biochem, cardiac and respiratory so far (not so much musculoskeletal).

My lecturer said she's doing neuro next term, so I guess neuro is on the list of possibilities for me.  In fact I think she said she was going to request that I be in her class because she is also my academic advisor right now (I'm supposed to have one in Australia but there is none currently in that position) and she wants to tutor me in molecular biology and other basic sciences to help me for the USMLE.  It is such an amazingly generous offer, but half of me is thinking "oh no, not MORE study!  i have bought the textbook to do the MITOpenCourseWare free online course in mol bio, so I hope to do that over my 4 week break.

I have been concerned about my finances for enrolling into next term, but I've decided I will find that $3000 somewhere, even if it means borrowing it, which I really don't want to because of the high interest of repayments and my budget is already stretched - so repayments with interest is not exactly ideal.  Plus, I have those clinical modules coming up for which I need to SAVE money, not borrow it.  That is why I was hesitant to borrow, but I've decided to do so anyway (if I need to - I have a few pay cheques coming up before then) to get these preclinical modes out of the way.

I just got sent a Google-alert for the following article which is talking about the numbers of females in medical schools has now passed the number of males and they are predicting soon there will more female doctors than male doctors in Australia, especially in certain specialties - no points for guessing that those specialities are the "family-friendly" ones some of the female medicine specialties.

Rise of women doctor numbers in Australia

(PS the title of this post is a quote from Scrubs)

Meerkats

I got home from taking a patient to the new Royal Children's Hospital in Melbourne last night at about 2.45am.  It has a giant two-story round fish tank in the emergency waiting room, and a meerkat enclosure! It also meant my day was 21-hours long!  It hurt.

In the ambulance on the way to pick up the patient (it was an inter hospital transfer) I was on my iPad working on my presentation for med school.

When I got home I stayed up finishing it off so I could submit it before the 9am deadline.  Now I'm back at work again and trying to write down some notes to make it sound good when I present it.

Wish me luck.

Oscar's Law

Today I got to meet the Oscar from Oscar's Law.  Oscar's Law is a campaign to help all the "Oscars" by abolishing puppy factories.  Oscar is a dog that was rescued from a puppy factory.

A personal appeal from Untitled founder CJ

Is Wikipedia or Google the best website on the internet today?  Hmmm... tough question.

Anyway I just made my donation to Wikipedia's annual appeal.  It's ad-free, for crying out loud!  And I use it ALL the time.  I got told once by a reliable source that they did research and found Wikipedia to be more accurate than Encyclopaedia Britannica (or one of those big ones) - edit: I just researched Wikipedia's accuracy on Wikipedia and it says "as accurate" as Britannica, but I'm unsure of how accurate that article is.

Untitled will always be ad free also.  Firstly, I find ad annoying and especially on personal blogs.  Secondly, I did the AdSense once and didn't even make 1c.  So, I promise here today on this post, this blog will always be ad free (links to my own personal wish list is excluded if I can finally one day figure out how to have a link to my wish list on here and allow things to be sent to me without my home address being revealed).

Anyway, random.

Update on proctor

So.... I rang my internet provider again, just to see if anything had changed, and they told me I had gone over my limit and was being shaped.  I thought this was strange because I had just changed my plan as I analysed my usage over the last few months and I was under 5GB per month.  He couldn't tell me what I was downloading due to privacy (but I was like - it's my internet!) but he told me the day I used the most.  I looked through my history without any luck.  And then I looked at my credit card bill - I paid for and subsequently downloaded the Usmleworld QBank that day which cost me 1GB!  Well, I dunno if it was all Usmleworld but it was on that same day.  Geez.

So I changed my plan up again to 10GB and at the fastest speed but still no luck with the Securexam software.  Then I got out my LAN cable (ethernet) and I tried and tried, I turned on and off my internet router, and I restarted my mac, then I shutdown and then started up my mac again, and then finally I could get enough speed to get into the friggin quiz.  Geez.

I read in the local paper that the National Broadband Network (NBN) is starting to be rolled-out in the next town to me.  Maybe by the end of my degree my internet speed will be fast enough to use software from the US.

Ugh.  Sigh.  Whatever. As long as I can do my final end of term exam without stress.

Now to do my presentation while on-call.  Can't wait for this term to be over.

Remote proctor hell

In case anyone was wondering if I've completely lost my marbles due to all the cooking and de-cluttering and little studying... the answer is most definitely yes!

Kidding.

I tried to take my weekly quiz for med school this morning and my "bandwidth test" failed.  Repeatedly.  It says my internet is too slow.  WTF?  Geez.  I can't win.  I'll try later while on-call until my time runs out and then I'll email the coordinator once again.  I'm sure I'm off his Christmas card list.

I was on the phone to North America somewhere yesterday morning, way too early for me anyhow, and we went through a few diagnostics.  I'm starting to think upgrading my iMac to the OS Lion wasn't such a hot idea.  I also couldn't take the practice test on the OUM website because it isn't there.  WTF?

So after studying and avoiding studying yesterday and today for this quiz, I have been called into do some OT at work and I'm gonna take it in the vain hope I can scrape together enough funds to allow me to study next term.  Very vain hope indeed.

The good thing is my study mojo is back, and not soon enough.  I have my presentation to finish in the next 36 hours and I also have to try and get it from Keynote format to Powerpoint which I haven't done before.  Hopefully that will work without a hitch.

And then there's next week - revision week! (Add sound effects suggesting doom here).  Eek!

Well, I must go get back into the uniform and check my life at the door on the way through because herein starts another cycle of day-shifts spaced with on-call shifts until..... Tuesday 1830h.  Sigh.

Home-made marmalade

Before I moved out to this little town you could say my motto was something like "Can't cook, won't cook".  I even considered doing one of those bachelor's cooking night courses at the uni. Out of shear necessity of needing to eat more than just 2-minute noodles I started cooking (occasionally).  Cookbooks drive me mad.  I don't like to stick to set volumes and times, but I do draw inspiration from recipes I find online or wherever.  I prefer to improvise and get creative.  I think that's what I like about rural and remote medicine - you don't always have every latest and greatest test or piece of equipment at your disposal.  But I digress.....

Here is my recipe for home-made candied burnt-orange marmalade I made (made-up) yesterday instead of studying.  A lot of the recipes I saw add pectin, but I did not.  I used citric acid as a preservative, and lemons, but I have no idea how long they will store for.  I'll be keeping mine in the fridge until my preservative skills improve.

Candied burnt-orange marmalade
Ingredients:
10 oranges
2 lemons
1 cup of water
4 teaspoons of citric acid
1 cup of castor sugar
Saucepan
Jars for storing - wash well in hot water to minimise bacteria and allow longer storage
Labels
Makes only about 500mg - 4 tiny baby-food jars.  Double recipe as required.


Thinly slice four oranges and two lemons with their rind still on.

Cut up the remaining six oranges but discard the rinds.  Cut the flesh into chunks about 1-2cm cubed.

Places the oranges and lemons into a non-stick saucepan.

Begin to cook on a moderately high heat and begin adding some water so they don't stick.  Continue adding the water so the oranges and lemons reduce but don't dry out too much.  Stir as necessary.

Add the citric acid and stir-in well.

Add the castor sugar and continue reducing the juice and water on low heat and mix in well.

Keep a good eye on it now as it will start to candy and burn.  I've got no idea how long this takes - maybe 15-20 minutes.

Once everything looks jam-like and there is no runny juice or water allow some of the rinds to just burn a little on the pan and then remove from heat.

Put into jars.

Can be used as marmalade on English muffins, or as I prefer in cocktails or ice-cream.

Burnt-orange cosmo
30mL vodka - any, seriously.  The cheap stuff is fine.
30mL Cointreau (or Chambord for a bit more berriness)
Cranberry juice (or pomegrante juice, or even ginger beer for the "mule" version)
Candied burnt-orange marmalade
Chilled martini glass

Mix together and enjoy responsibly!

Keeping it simple

Having a simple-life, a relaxed home-life, down-shifting, living frugally, living green, and living ethically can sometimes all share a similar thread.  One of the most important things to do, in my opinion, is to de-clutter.

When you de-clutter your home you begin to know exactly what you have and where everything is.  The things you already have you can take more time to look after and repair rather than replace.  You can enjoy and actually read the five novels you have instead of the five-hundred, for example.

I find the food in my pantry is much more likely to get eaten before it expires if I know exactly what I have in there, can see it all, and it is kept nicely in their packets or those plastic containers.  The same goes for the fridge, the wardrobe, the sewing cupboard, etc.  For some reason I buy less new stuff when I am more aware of the stuff I already have.

I'm not a de-cluttering expert, but this is how I do it;

Rubbish - junk that is no good to anybody

• Finally get to use those plastic shopping bags in the kitchen draw.  Take one (or two - for some reasons all mine have holes in the bottom, so I double-line) into each room in your house and don't leave that room until it is full.  I'm forever filling mine with paper and mostly empty tubes and containers of stuff which is well-and-truely past it's use-by date and I'm continually asking myself "Where did all this crap come from?"  The normal answer is that is accumulates over time somehow.
• Take bags straight to your bins and sort into recycling and rubbish, thereby full-filling the minimum green obligations.  If you don't have a recycling service for some reason, dispose of the rubbish in the best way you can.
• Repeat the top two steps as frequently as necessary.

Junk - junk that may be useful to somebody

• Boxes would be handy here. I collect and save cardboard boxes that stuff gets delivered in at work.  The other option is the local supermarket.
• Get those old books you are seriously never going to read because you've had them for 10 years and haven't even read the blurb and put them into boxes and take them to the local op-shop.  
• I tend to keep reference books, like "Vegetarian Nutrition for Athletes" and "What Flower is That?".  These have their own small bookcase.
• Other junk, like crappy old crockery when you already have 20 dinner plates.  Exceptions - keep old cutlery for picnics, keep jars for homemade chutney.  These will be coming posts!  Old bottles can also be handy too. If you do decide to hang onto bottles and jars, it's best to put them in their own box out of the way yet where they can be found when the time comes.  The garage or laundry are good places.
• Childrens' toys - as much as I love my Hello Kitty manicure set, it might be time to give that to the op-shop.  If the toys are too dirty and embarrassing to give to friends/relatives, don't under-estimate the op-shop.  I forever see children leaving there with a new toy.
• Things in this category also might go well at the local trash 'n' treasure market.  I've done a few, but the goal is to get rid of everything, even if someone offers 20c for it.  It's junk to you, remember!

eBayable - junk that probably has some value to somebody on eBay

• Have a look at what stuff you have and never use and ask yourself if you'd rather have it cluttering up your home or $5.
• Things I have found that eBay really well are textbooks (medical and scientific go well for me), Nintendo games (Wii and DS) and some DVDs especially TV series.  I'm guessing other textbooks or well-known books might do well, as would other video games and some DVDs.  I had the Grey's Anatomy series and they sold very well.
• Anything with a brand-name that is normally expensive to buy new seems to do well. I got rid of all my genuine Pandora charms in a flash!
• Things that I find don't sell well are old clothes (unless they have a designer label) and other things that should really be in the above category and taken to the op-shop.
• Remember that eBay charges a small fee (unless you list it without a gallery photo for 99c reserve price) and there is time involved in putting up an item for auction and then organising posting it.  Also, some buyers can be really annoying.  Overall, I've had a good experience on eBay.

Valuable items - things that definitely have an intrinsic value

• Valuable items don't normally fall into the clutter group, but if you find yourself with something that definitely has value, such as gold jewellery or a very nice antique, either display them, store them appropriately, or sell them at the right place such as a jeweller or antique store.  eBay may be appropriate in some instances.
• Taking the time to display something nicely shouldn't clutter your home.
• If you decide to store something should only be for certain special circumstances such as heirlooms.  If you do decide to stare a few things then pack the item appropriately and label the box clearly.  Don't forget you have it!

By now you should be feeling much better.  You might be surprised at how often you have to repeat this process!

Things I like to keep in mind while I'm de-cluttering;

• When did I last use this?
• If this got stolen from my home, would I even notice it was gone?
• If I had to move overseas, would I bother paying to ship this with me or to put it in storage?
• Does this thing enhance my life, or make it more cluttered?

There are some exceptions to the rule, but try not to get trapped here.  For example, I like to reuse sewing fabrics, buttons, and bits and bobs.  I have a sewing/crafting section of my cupboard.  I keep it fairly organised.  I also like to re-use envelopes (I keep the ones banks forever send me junk in and re-use them for my mail - just takes a bit of sticky-tape and white-out) and scrap paper.  I also keep these very organised in their own draws in my study.  I have a friend that is a farmer and keeps old motor parts in his shed, just in case, because he generally uses them eventually.  If you do some of these practices then you need to keep this sort of junk organised or risk getting cluttered. It might be best to set yourself limits such as one draw, one cupboard, or one shed!

You might want to de-clutter a room a week, or I like to do a plastic bag in each room and a box on one of my days off before I start the housework.  The important thing is to start.

Once everything is de-cluttered you can start to organise your remaining stuff!

Good luck!

Glycosylated

This was the word in my brain when I woke up this morning.

Grounded

I'm grounding myself for the next two weeks.  Well, at least for this week.  I am waaaay off track with my study.  Apart from my normal 80-hour fortnight, I did 43 hours of call-outs over night and 12 hours of an overtime night shift.  I also went away on my days off twice.  Yeh, I'm so behind.

I'm only at Code Yellow though, because I think I will be ok if I pretty much just study and do nothing else.  This time of year gets increasingly difficult, though, as I have two work Christmas parties to attend, another social function which I promised my friends I'd go to months ago (they get a little cranky that I can never make anything and booked me in advance) and I've put myself down to work an extra shift at a music festival coming up in my area.

My final exam (for this module) is on the 15th of December, so, yeh, I've got 18 days, 6 of which I'm free of work or social commitments.

Standby to find out how this all ends!  I'm off to finish my presentation....

I've got a long way, Baby...

Here is my list of what I need to complete before I graduate (minus a few USMLE exams!).  I still have so much more to do :(

I've highlighted the pre-clinical modules I've already completed (and endo which I'm nearly finished).  It's a little bit disheartening.  So much work for so little gain!

Good grief.

Back to it.

Plan

I can't log into my quiz yet again and I've run out of ideas.  The help desk number is in the USA and I don't want to make an international phone call.  Frustrated.

It's Thursday afternoon, I have a double case-study I've barely started, and I'm feeling so behind.

It's times like these I like to make a plan.

Here's mine;

Today 
1. Give up on attempting quiz.  There is nothing I can do so I need to let it go  What ever will be will be.
2. Whatever happens - read half of my case study by end of working day.  Get to page 52 (in 3 hours).
3. Do the dishes and hang out laundry.
4. Wash hair as soon as I can tonight between call-outs.


Tomorrow
1. Whatever happen finish case study by end of working day. 104 pages.
2. Vacuum as soon as I get home between call-outs.
3. Watch Kaplan at home on-call between call-outs.

Saturday
1. At least scan all readings for this case study by end of working day.
2. Prepare for tomorrow's lecture.
3. Put away clothes in wardrobe.

Sunday
1.  Do lecture and academic advisor meeting
2.  Write down possible exam questions from lecture.
3.  Do tidy-up of house before friends come over Monday.
4.  Night off - watch some tv or mow lawns.

Next week (Week 7)
1.  Do a bit on presentation each day (break into daily chunks - TBA).  Submit by Friday.
2.  Prepare revision study plan during breaks from putting together the presentation.
3.  Start throwing out junk from cupboards during study breaks and keep on top of house work.

Week 8
1.  Make revision study plan
2.  Revise for end of term exam as per plan
3.  Use study breaks for house work and continue throwing out junk from cupboards.

I feel a little bit better now.  Now to go read that case study....

Down-shifting

I've just started reading a new blog - Notes from the Frugal Trenches, amoungst others from Simple, Green, Frugal Co-op blog.  I was reading about "downshifting", as the thought of it pretty much dominates my mind atm.  I thought I'd just reflect on my own downshifting journey over the past few years.

(YA = years ago, MA = months ago, ie in the past from where I am now).  I've tried for chronological order;

10YA - Lived on a 33ft yacht for about a year.  Realised how many more stars there are in the night sky away from cities, pollution, lights etc.  Got nostalgic for the days when I used to be able to see the Milky Way from my suburban home as a child.  Realised I hadn't seen many stars at all in the city for years.  Quite a shock.

9YA - Did my Army preventive medicine (environmental health) training living on-base for a few months out in the sticks.  Really enjoyed my lifestyle there and how good I felt, particularly my afternoon 5km run around the base through the trees on a dirt track and some grass, the fresh air, and the lack of traffic.  Decided at this time I wanted to move out of the city but would still want a good career, which I didn't have on the yacht.  Looked at the Army full-time, decided on becoming a paramedic.

7YA - Began becoming a paramedic.  This included some clinical placements in rural locations which I really enjoyed.  Started narrowing down where I would want to move to. 

4YA - Got my first full-time ALS paramedic job in a rural city.  Had quite a culture shock as my normal forms of entertainment were either not available at all, not readily available, or not of the same standard.  At that time these were fancy dinners at restaurants, cocktail bars, Gold Class cinemas, and live shows/gigs, as well as a membership at a nice fancy gym with a eucalyptus steam room and aromatherapy room to name just a few.

3YA - Transferred my job and my life to a small rural town.  Another culture shock again. No shops except the op-shop and a small supermarket which didn't contain any fancy products. Searched the supermarket shelves and couldn't find rice milk or tofu (they are now available). No free-range chicken, no fresh organic food.  No takeaway food and the one and only restaurant at the pub was terrible.  No gym at all.  And my roster involved being on-call a lot.  Had to begin shopping on-line which helped me decide what I really wanted and less impulse (still some impulse buying).  Had to learn how to cook and how to use more staple ingredients. Bought a Nintendo Wii and set-up home gym and bought Tracy Anderson workout DVDs.  Go for an occasional run in the fresh air around the paddocks - reminds me of the good ol' times on the Army base.

1.5YA - Bought my house so I could finally do things like install solar panels, put in a vege patch, plant some fruit trees, and get my non-existent gardens in existence.  Already had some nifty devices like those standby power switches.  Water tank already insitu.  Grey-water hose from washing machine to vege patch in place since renting as we were ina serious drought then.

8MA - Decided I was going to go frugal. Rearranged my budget as much as possible (with more help from My Budget with who I have been with for a few years now). Reduced as much as possible.  Shopped around for cheapest insurance, internet, phone etc.  Simplified.  Convinced myself to only travel overseas once per year instead of up to 4 times at one stage!

6MA - Found myself the perfect house-mate to take up some of the ridiculously large amount of space I have in my house and to contribute rent.

4MA - Started reducing the amount of overtime I work.  Enjoy my days off.

2MA - Finally getting my feed-in sorted for my solar (so the electricity company buys-back any excess I generate thoughout the day).

1MA - Started seriously looking at rural acreage for my (hopefully) final transition to as rural as I want to go.  Planning to rent my rural township house out (I wont sell it as I need a city or town house as an asset as my acreage house will firstly be my forever-home so I can freely design and do with it what I wish without worrying about resale, and secondly it will not increase in capital as dramatically as my township house, and thirdly my plan is to have a number of small-mortgage houses with people renting them off me and to never have a large mortgage to which I am chained to as per the advice from a few of the older people I'm friends with).  Am still currently in the planning phase or the acreage house.  Projected period of planning is 12 months, projected period of construction/moving is another 12-24 months after that. V. excited.

Recently - Bought my first few shares! They were in a co-operative wind farm!  V. cool.  Hoping to receive my first few small dividends in the next year.  Joining some local sustainability groups.

So now I've started a new post category - the "simple life" which I hope share the more time I intend to spend on my down-shifted, frugal, green, simple life. 

---------------
I'm hoping to still keep up with modernity, though.  I love technology and I have no intention on rejecting modern life and living like the colonials.  I'm just trying to cultivate that part in my bio that says "find the time to stop and smell the roses....."

Update

I haven't blogged for a few days because I was away from home enjoying myself for a bit of a long-weekend away.  Very nice indeed.  I went away visiting friends in another part of the state in the country-side.  It turned out to be like a mini-holiday and I found it very refreshing for the soul, despite there being a horse-biting incident!  Ouch!  Apart from the minor dramas, it makes me want to work part-time for the rest of my life and just chill on my property somewhere.....  I'm a long way from that being a reality.

When I got home my dog had been home alone for a number of hours as my baby-sitter (and soon to be roomie) had gone to work.  My dog was fine.  I then had to go drop into work and pick up the pager to start call.  I was gone for about 15 minutes and when I got home my dog had emptied the rubish bin all over the floor!  He really told me how impressed he was that I had left again so quickly after returning!

Being away from the weekend, I unfortunately missed another lecture, which is now a total of 1% minimum down the drain from my module grade.  I didn't intend to - I was all ready to use a foreign computer again, but it was all a bit too hard at 8am on a Sunday morning.  Now I'm not sure I'm going to be able to beat my PB of 87%.  Pituitary diseases and Cushings syndrome were basically a blur to me....

But, there is hope for now we start something that all paramedics know at least a thing or two about - diabetes!  Diabetes mellitus to be precise.  It's a double case-study this week, so I better get to it.  It's already Wednesday and I haven't began my study week yet!  Eek!

Glucocorticoids

Well I'm studying the glucocorticoid axis right now and it's starting to sink in. I think I've gotten used to being able to read something only once or twice and understanding it, but with the last two case studies it's taken a lot more work. Well, at least it has seemed to.

I read a few of first paragraphs on cell biology and molecular biology of my Kumar and Clark's Clinical Medicine text before starting back in the adrenals this morning. I'm not sure how much will sink in.

I have my Cushings lecture on my iPod all ready for my long drive this afternoon. I hope it doesn't send me to sleep at the wheel.

Now I'm going to go try and watch some adrenal/molecular bio videos online to spice things up a bit.

Tonight I have a social event to attend which will be a nice change, shut to be honest I'm kind of back in the study groove now. Typical.

Dawwww

A cute photo of my neighbour's kitten who is very adventurous.

Survival stroke

Survival stroke was a swimming style we got taught in school as kids - ie how to not drown.  That is what I feel like I'm doing this week in med school.

We were busy at work, and because I feel like I totally stuffed up last week and I have a few extra pressures coming up this week, I sit down, look at what I have to do, have a mini-meltdown, and the completely freeze-up.....

Ah, that reminds me of a story.....

I have been mentally collecting stories of the best (ie worst) excuses for calling an ambulance and getting despatched to.  Out in my rural area, these types of incidents are few and far between.  The best one I have personally got despatched to was a cut finger while cooking.  A few nights ago I topped my previous personal best of "hungry" and "scared of thunder" when I heard a city crew got despatched to a "brain freeze" - yep, the kind you get after drinking a slurpee too quickly.  Seriously.  How does that even make its way past the call-taker to the despatcher.  I'd love to know what the paramedics had to say to the caller.

But I digress....

I'm in brain-freeze myself, but the other kind.  The kind that makes you go completely mentally blank.  If I was trying to write a novel it might be called writers block perhaps?  Or is it pure procrastination?  Overwhelment (yet again)?

I'm in damage control. Again.

In good news, my fitness regime has been going surprisingly well!  I hope I can keep it up.  I've decided to workout every day on my days off, and to not worry on my days I'm working.  That's still 7 days a fortnight which is pretty good and includes cardio and muscle workouts - TAM of course.  I caught a quick glimpse of some surprising muscle definition this morning and I am again a converted follower of Ms Anderson.

My diet has been going well.  My sugar cravings have diminished quite a lot which is good.  My brain is getting used to functioning on slow-release carbs and fruit instead of lollies and Coke.  This has to be a good thing.  I'm still into my tofu and veges.  I craved a cheeseburger last night, got one, ate about two bites and  seriously couldn't stomach it.  My dog was happy about that.  I'm not sure what has happened to me - this doesn't usually happen.  I can still usually have my cheat food day, but this week I struggled to eat a Cheery Ripe.  I had to eat half, take a break, and eat the other half later on.  Well, I think I know what's happened - I started drinking this meal replacement called Rapid Loss.  I got sucked into the infomercials and I'm kind of glad I did.  It's working well for me.

So this morning I had a meeting online with my academic advisor and we started going through molecular biology and the basics of pathology, you know, just to add more study on top of my endocrine case studies, the intergrated learning series, etc.  Ugh.  So I looked at the MIT free online courses (Open Courseware) and I've ordered the molecular biol text to do their course.  WTF?  When will  Ido this?  Ugh. 

Overwhelment.

Damage control.

Survival stroke.

Proctor troubles

Im having trouble with my remote proctor once again. And the proctor troubles not only stops me from doing my quiz, it slows down my whole Mac. And.... I couldn't connect at all until I unplugged the darn thing. Ugh. Technology, eh?

So I'll do my quiz tomorrow some time.

I finally have a night off tonight. I studied for a while this afternoon, then I watched a movie - Something Borrowed - a total chick-flick. I needed a real night off from everything. Feeling better.

I feel like I haven't absorbed much from last week, which was on the pituitary gland. I guess it's lucky the diseases are fairly rare, but I think the endocrine system is highly testable on the USMLE. I will have to look at it in revision week.

So this week is adrenal, which I'm finding difficult as well. It's just all so new to me and there is a fair bit of biochemistry in it. The case study was dense and I had to just basically skim it and delve straight into the readings to make any sense of it all. So, that is what I'll be spending tomorrow doing for sure. More adrenal.

I ordered a Doctors in Training lecture on Endocrine from their new Internal Medicince course, but the streaming stuffed up. I think my Internet connection is a little slow ATM and I don't know why. I hope to get to watch it tomorrow some time and maybe the adrenal one too, and the associated pharm lectures. I'm missing the appropriate Kaplan lectures for these two weeks, so DIT it is.... I'm so glad I can purchase some of the lectures individually.

That's about it. Worked a lot at night this week which is good for money but bad for study time.

Such is life.

Big yard

Lots of mowing.


One of my main goals is to get one of those beautiful lawns you can walk on bare foot and not experience pain.  From where I've had it, to where it is now is quite a dramatic improvement, but I still have a fair way to go.

I finally have a mower with a motor in it, but I still like my push-mower and it gives me a good workout.  I like to get out in the garden for about 30mins to an hour after work each day, get some vitamin D and a large dose of allergy-inducing pollen to go with it at this time of year.

We worked past 4am this morning (actually it was quite funny because I attended the same patient at 11am and then 14-hours later at 1am and she was confused as to what sort of shift I was on - I just love explaining that I work 24 hours for 5 days straight.  It gets a great reaction). I got up at 12noon, had a relaxed break, vacuumed a little, and went back into work at 2.30pm.  There I started studying the physiology of the adrenal hormones while simultaneously sorting out my solar power feed-in contract and cancelling my pay TV (seeing as I'm trying to be green and frugal into my future life).  I also got to order a cheap international edition of Guyton and Hall physiology so I finally have pretty much every textbook I need.

At 4.30pm we got paged and I just got back now.

I got home and my neighbour brought me over a plate of dinner - how lovely a surprise!  Very nice indeed.

Now I just want to read more of this physiol chapter before going to bed/getting paged again.

Stress level is about a Code Orange.  Only because I think I can make up ground in revision week as I have a few days off and no other commitments, and apart from last week, I've been keeping up ok.

I read on Gwenyth's GOOP an article by her holistic osteopath about spine pain and it's life "meaning".  Neck pain can be either physical (osteoporosis) or emotional (life overload).  I have neck pain now.  I always attributed it to studying too much, but some times I can study for days on send and get no pain, and other times just an hour will make the pain incredible.  Food for thought, me thinks.  I don;t know how I got onto Goop - it never tends to hold my attention much, but I think a blog directed me back there again.  I don;t mind Gwenny, and she discovered Tracey Anderson which I thank her for greatly, but the Goop articles I normally find a bit dull.

Ok, back to the books.

Sugar

Trying to keep up my schedule, utilise maximal brain power, and keep my good humour are all very difficult to do on a calorie-restricted diet.  But seeing as my weight ballooned to an all new high last week, and new research is strongly suggesting what most intuitively know that it is much  better to never gain the weight in the first place, I decided I needed to take action asap.

I'm happy to report I'm back down under the previous personal record of top weight to my "comfortable" weight, but I'm going to try and get down a bit more towards my "happy" weight.

Studying is much easier for me under the fuel of lollies, but as I've said time and time before, my medical studies are not going to come at the cost of everything else which is important in my life.

Speaking of studies - we've been really busy at work.  This is good in one respect because the call-outs over night are earning me enough money so as I don't need to do any over time atm, which is doubley as good because I have stuff to do on my days off  including study and more study.

Today I was sleeping util noon (we were working until past 2am) and I started studying the adrenal glands in Robbins for an hour before having to work again.  It's now nearly 5pm.

So, again, I must go back to it.  I'm hoping to get an hour and a half done before going on-call and then I'm hoping to do a TAM workout as I just got my latest Metamorphosis dvds in the mail this morning.

Code Red

I'm at Code Red, or at least reddish-orange.  I'm having internet issues, time management issues, and life-getting-in-the-way-of-study issues.

It's Monday and I just want to start my next case all fresh and leave Pituitary behind.  I'll have to catch up on that in revision week.  I just don't have time to back pedal now.  Pituitary is a blackhole of my term in which I cannot afford to get sucked into right now!

This week is Adrenal, which is quite fitting as my adrenals are continuously working overtime.  I guess it's not too much of a surprise as I am a paramedic.  I'm also doing Adrenal Tumours as my presentation so I hope to cross-study for both.

Gotta go look at my new case...... No time to waste when you're at Code Reddish-Orange.....

Waiting

Well I stayed up late last night trying to figure out this foreign computer I'm using for today's lecture (i did bring my old laptop but then I had trouble with the wifi password, which I now have, but I already set this computer up....agh) and my new headset - which I realise I just spent $45 on the wrong kind (it has a usb and i need the audio/mic jacks), annnddddd the lecture starts an hour later this week.  Noone told me that.

The only other student I can see logged into the uni site is from NZ, and all the other students are Yanks including the lecturer - so I'm right now presuming that the US had a timezone change over the week.  Would have been nice to know.

I've had an absolutely lovely weekend away - it is so beautiful here and very refreshing for the soul and adrenal glands.  Unfortunately my study has suffered and next weekend will be the same deal.

Those podcasts I downloaded from iTunes didn't sync onto my iPod. I was so annoyed when I got in my car and found out.  However I found some old OUM lectures from before they took them off  iTunes so i listened to last year's version of my lecture today - I hope it helps me prepare as I am so under-prepared.

Must go now and make use of this extra hour before class.

Podcasts

So, where are we at? I got to review for my quiz quite comprehensively yesterday but I almost went into a cardiac arrhythmia when I realised how I stupidly messed up two questions.  Geez.  Insert palm of hand to forehead move here. Oh well. I won't miss them on the final exam.  At least I still got 80%.

These quizzes account for 30% of the total unit mark, and a quick predictive calculation of what I'm expecting for the other 70% puts me on target for another ~85% module.  That is ok, but I was hoping to get up closer to that 90%+ mark.  Frustrating.

I have a few days off and I'm going visiting - I have a 3-4 hours drive ahead of me today so I'm quickly downloading some medical podcasts onto my iPod. OUM used to have podcasts of their lectures but I can't seem to locate them - there is something right down deep in the back of my memory that makes me think they sent an email saying they were ceasing that. Hmmm...

Normally, I have no need for podcasts on my iPod as my place of work is, oh, about 500m from my house.  I don't travel much.  And I wouldn't subject my co-workers to an audio book about the USMLE in the ambulance.  I have so far gone through TWO of those thingies that put your iPod through your car's radio - but the sound quality is terrible.  I could get an iPod jack for my car, but that's an expense I'm trying to avoid seeing as I really could do with a couple of new tyres sometime soon.

Ah that's about it.  Stress at about a Code Orange today as I'm going away for the weekend and I doubt I'll get any study done before my Sunday morning lecture.

PS  I also have to take my old laptop with me as my friggin iPad doesn't do Java and therefore doesn't do my lecture. Sheesh.  Maybe I should have got myself another laptop instead of my desktop.  But I do love my desktop.

Ah, back to a quick clean of the house before I head off.

Unpredictable

Just about as soon as I finished my post yesterday we got paged and were out of the branch working until about 5pm, ie I got nothing done on my study or anything else.

I went to beD at 7pm. Another early night. A mega-storm which we had been warned about all day on the radio started at about that time and I couldn't tell you what the intensity was because I slept like I was dead all night. I woke at 6am feeling almost normal and here we are today back at work for my last shift of the week.

Today I've just been reviewing last week's material for my quiz today. I used to find it annoying to have to go back to the previous week in the middle of a new week, but now I'm starting to think it's good because it really does help solidify that long-term memory. I also, as you may recall, didn't have much time to study last week so I'm catching up on those readings now. I'll go back to this weeks pituitary adenoma later today. Juggle, juggle, juggle.

That's about all. Although I disappointingly haven't been able to exercise as much as I wanted to this week, I have got my diet going really well - lots and lots of healthy food. I've now begun the process of reducing portion sizes and eating more frequently. I've caught up on sleep so I'm hoping to introduce exercise back tonight when I'm off work! Hoorah!

Links and yikes

Yesterday I got to almost finish my case study - that wont take long this morning to complete.  I also got to read a little in the Anatomy and Physiology book which we have here at work in our mini-library which the staff have just formed over time with book donations. They are all very old and probably a little out-dated, but never-the-less.  The readings this case aren't too massive so I'm staying optimistic that i might get them done this week.

I also did another section for my PT course and have seen I really need to do more on that to get it done in the allocated 12 months, seeing as I'm half-way through! Yikes!

I've added a few links to interesting articles.  I will try and do this regularly.  The first one is about a fellow OUM student. 

Student on a mission
Intern squeeze could hurt reputation
Rural doctors say scholarships are key

Off to go read/learn.

The current international med students and IMGs in Australia issue

I've been watching the whole med student tsunami, lack of internship places for full-fee and international med students (students from overseas that study med in Australian universities) and IMG situation in Australia since before I started at OUM, and more intensely now as the debate grows.

Here are a few links to some interesting articles today;

Medical students to take expertise offshore

Lack of internships may send Australian trained doctors elsewhere

These articles are focused on international students, but the incentive for universities to not lose those precious dollars from the international students will help open internship positions, and hopefully PGY-2+, making more room for....ME!!!

Time, wellness, and balance

Today is the first day of my new fitness routine. Right now I weigh more than ever before in my life. I have no multiple pregnancies or chronic hormonal imbalances to blame, well unless you count my chronic stress.

I think it went off the rails about in Tibet. Going on a big adventure like that was probably not such a good idea given the amount of stress I endure at home with work and study. Bali is looking good for next time (although I have been pricing up Mongolia).

I went to bed at 7.30pm last night. I was just exhausted from my normal life of work, call-outs, and med. I constantly crave junk food and sleep, but unless the Earth's gravity has increased by 10% in the past month I need to put the brakes on these bad habits ASAP.

I was talking to my dear friend about how we as girls can take care of our looks (figures/hair/makeup etc) without being superficial. In the same way I used to think only greedy people had money, I'm finding it difficult to psychologically make sense of how I can take care of my looks without being shallow. It's difficult, because to find the time to exercise and eat right requires prioritisation. Only shallow people would put how they look above study, right? I think this where a lot of women get caught when they have families - by always putting their families first. But I can tell you as a single female, I have the same guilt trips just in different forms.

Today we were so flat-out at work I did less than an hour's study. I finally got home at night and I did my TAM workout. I'm so glad I did. I watched a little Kaplan before deciding to eat dinner and post this before going to bed early again. I am also glad I found a way today to make tofu tasty (slice thinly, marinate the hell out of it, and stir-fry/grill until a little charcoal) and I have started the process of sugar detox.

Day One down and I feel fine.....

Now for an early night's bed. Let's hope tomorrow I can fit in more study too.


- Posted using BlogPress from my iPad

Money (and other things I like)

I'm getting quite used to the idea of going to Samoa for a year to do my internship, although I will definitely do the USMLE.  One thing, though, well two things that are kind of the same thing - finances.  The money I need to finish my clinical rotation, and the financial set-up I need at home to go and earn <not enough to pay my mortgage back home>. 

So anyway, it always feels awkward talking about money but it's a really important subject.  I think the whole GFC drew a spotlight onto our spending habits.  It's now becoming cool to be frugal.  I'm not cool.

For me saving money has always fallen in the same heap as dieting - good intentions, great plans, but doesn't last very long and only serves to make me feel (more) like a failure. 

I'm setting myself some goals - and I think they are more "real" if I put them here on my blog so here goes;

• Pay off my mortgage and any other remaining debts by the time I'm 40

Ok, so it was really only one goal.

I'd also like a sustainable house.  I'm kinda in the process of making it happen right now.  My current house is in my township and I want to go more rural onto acreage.  That's where I want to live sustainable and off-the-grid.  I can't buy the land yet until I get my first doctor job in Australia.  But I can plan/save/research for ideas.

• geothermal heating/cooling

My dearest friend Dr Donald Payne PhD is a director Direct Energy where they are really leading the way with this technology in Australia.  In a basic nutshell, you drill into the ground where the temperature remains relatively constant all year round, then the air you use to heat/cool your home is cycled through the underground pipes where they adjust to the underground temperature (for example 22oC in Summer) and then you use this air which you only have to cool by 2oC to cool your home for thus using much less energy.

• wind turbines

Harnessing wind for residential power is one of the best ways to generate energy in areas that don't have great sun all year round but are not in built-up areas; like where I live/want to live.  This things go nuts on what might seem like a still day down at ground level, but up there (20m) it's windy!

• solar power and hot water heating

I think this category almost speaks for itself.  I like the almost "passive" use of coiled black pipes on your roof to get some initial warmth, and then using a solar hot water system.  I have solar power on my current home but I do not store the excess power in batteries at the moment because I cannot afford them. 

Some others are;

• self-composting toilet
• vegetable garden
• rainwater tanks
• bore water
• grey-water/black-water systems
• other energy saving devices (I have some already) including the remote switches to turn off standby mode on appliances
• top-opening fridge

Well, that is all I have off the top of my head for now.

Times

Yep I'm struggling to be able to keep up with daily posts.  Things are a little hectic with work and study.

I feel strangly calm this week.  I feel like I haven't done much study but I think I've covered all the important stuff so I'm sure I'll get a nice shock in the lecture tomorrow when I realise I actually know nothing at all.  I don't know what I don't know yet.

We (Australian OUM students) just got sent an email today explaining how the Australian Medical Council and Australian Medical Board (I still haven't figured out the difference) have stated that IMGs must do their intern year in the coutry of their medical school, ie it looks like I'll have to do my intership in Samoa.  This is not a bad thing - I like Samoa and I want to do international health.  I also may be able to do it in the US or NZ and then transfer across.  Interesting times. 

The email also outlined some good things - the AMC exam part 1 can be done online.  This is great if I'm going to be in Samoa/US/NZ.  And I can be employed on just Part 1, and then do Part 2 to get full registration.  If it's online it might be more flexible with the dates etc.

The Samoan government has agreed to allow Australian OUM students to do their internship in Samoa.  This is a very good thing as I was a little concerned there might not be enough intership positions in the small island nation of Samoa when they have 25 of their own locals graduating as well.  Let's hope this is still the case when my time comes.

So that is all.  For me nothing much has changed - I'm still preparing myself for the USMLEs, to move to Samoa for a period of time, and to have a hard time trying to break back into Australia.