Medical Intern 2019

Woweee..... What a couple of weeks!

The moral of the story is to be prepared for when an opportunity comes along so you can grab it with both hands!

In the end I was offered two internships and a third interview (which I declined when I accepted the second offer).

I actually now start January 7th 2019 which is three weeks from now! :O

It's also interstate so I need to pack up the whole house and move my entire life and family as well as prepare myself mentally and clinically for the year ahead of me which by all past accounts will be challenging.

At this point in time I feel really grateful for all the help I received along the way from my mentors, work colleagues, and especially my husband and children. My parents have been great and my friends. My paramedic boss was so good about it when I gave him under the minimum notice to resign. I'm actually going to remain as casual paramedic and see how the year transpires.

I'm also really proud of myself. I was reflecting back on all the crazy stuff I've done to get to this point. I drove past the McDonalds I studied in on Easter Weekend because the library was shut. I remember the guy next to me saying I'd be better off studying at the casino, given the incredible noise and busyness of the restaurant that particular day. He was probably right!

All the double-shifts, driving hundreds of kilometres, staying up late and getting up early to study around the kids, how my first was born the week after. my final pre-clinical exam and my second the morning before I received my diploma. I'm really proud of my stoicism during this time. And its no wonder I feel burnt out right now.

But there is no time to rest now!

I'm on might shift tonight on the ambulance but I have a million things to do today. Grocery shopping for one because I still have two children that need heathy, or any, food in the house. I also have to declutter my possession s as I don't want to be transporting interstate junk that I don't need or want.

Then there is the clinical revision I really want to do. I've submitted all my AHPRA paperwork which took about 5 hours to complete. I want to print some "cheat sheet" cards covering common meds and common physical exam points (especially neuro).

I also need some doctor clothes. What I currently have won't cover me on a full-time roster. I was my own version of a uniform which consists of opaque black stockings, black knee length pencil skirt (not tight), house, and cardigan with pockets. Hopefully I won't start in ED because that required green scrubs and I only have one set.

Ok that is my very exciting update for now! What a journey it's been to get to this point!

No longer a med student!

Internship offer!

I just got my first offical internship offer! I start Jan 14th 2019.

I'm so excited about my future in medicine.

Not much

Not much has happened since my last post. We have been away on a family holiday before I commence back at work (ambulance) next week.

Australian internship prospects have not changed.

Being away on holiday helps to find the time to sit back and reflect on what you truely want, and to find the adventurous spirit to brave through the tougher times (such as these).

I have been researching possible alternative locations of internship and I hope to have something sorted out in the coming months. Until then its just getting back on road as an ambo, preparing for AMC2, preparing for internship, and saving in case we have to relocate (yet again).

AMC1 pass!

So, so, so happy to report I passed the AMC part 1 on first attempt in May.

The 6 weeks had off to study was all I had really. And we moved in the first week and holidayed in Tasmania for a week as well so it wasn't exactly 6 weeks full-time. I ask had the kids to think about so my days wherefore like 6 hours of study, not 12-14 hours or anything crazy like that.

I think my ambulance experience, my clinical placements and med school course work, and then my study strategy is what got me a passing score on the AMC. I also recommend AMCQBank.com (no affiliation) as that really prepared my mind for the skill of the test taking. I also learned some clinical knowledge along the way, although I'm sure its not the most reliable or authoritative source available! However, it helped me gauge where I was in terms of readiness for the exam. I recommend scoring at least 50% in the AMCQBank.com practice exams before attempting the real exam.

It also helped me realise that I can study for and pass standardised Australian medical exams. Even if in the beginning things seems tough, or I don't know everything, I can still be "good enough" to continue wiht my career. I'd love to know more and be more comfortable as a junior doctor so now I begin the processor preparing for internship.

I have applied for internships in Australia for 2019 and am waiting to see what happens. We are also considering Samoa 2019 to be able to give us a sense of predictability for the next few years, rather than just waiting another 12m months to see what happens. I'm not sure on that one.

Next month I am returning to ambulance work at a new branch. I am very excited to be back doing the job I love, getting my clinical game back on after 18 months of not seeing a single patient since having my son, and regaining my Authority to Practice. We are also a registered profession now so I look forward to paying $500 for that honour lol

So for now I'm studying my ambulance stuff, preparing and applying for internship, and just figuring out a good routine as a mum so the kids grow up happy and healthy.

AMC Prep Week 5/6 - on the road

I am in Week 5 of 6 weeks AMC prep and I am away from home visiting my parents in Tasmania. So far they have been very supportive of my study including looking after the children and cooking meals etc. I wish I had this much support all the time.

This week I have dedicated to the AMC Anthology of Medical Conditions book, specifically the images within the book as I hear they appear on the exam, and AMCQBank. There is probably about 100-150 pictures in Anthology so I think it's reasonable to at least learn the conditions/diseases presented.

I have also been told the images in Tjandra Surgery textbook are worth knowing, however that is a much larger textbook. I will have a flick through when back at the hospital library. My colleague also said each topic that appears in AMC Handbook to look up the answers online in the RACGP guidelines. That makes total sense. And is probably a better way for me to study than using Murtagh's.

I am really enjoying QBank. I was around 70% average but I've dropped to 60% since doing the normal distribution of questions, that is more adult medicine, whereas before I was focusing on obstetrics and gynaecology and psychiatry questions to supplement my study last week for which I seem to do better on exam questions. I have done about 400 questions out of 1795 so far. Actually, I think part of my drop in percentage is doing the questions at home and on holidays because the distraction level is extreme. I find I lose A LOT of marks because of simple errors such as reading the question or answer choices incorrectly. I will have to take my time on the day.

My colleague just informed me she passed the AMC with a 60-65% average on QBank so that is a little reassuring, however I would like to improve my scores over the next few weeks before I sit the exam. Of course, I'd like to do really well on the exam, and not just pass it, but I need to sit it next month as I don't have any more full-time study time available to me, plus hoping to have some results for internship applications mid-year.

I have now booked my exam for Saturday the 19th of May. I will be staying in the city (without the kids) the night before so I don't have to travel as far to the testing centre. I need to be there at 8:30am.

My current level of confidence has improved to where I can see I can possibly do this (hence I booked the exam) but I am not very confident at all. And it feels shit.

Overall, though, this prep has made me feel much more confident about possibly being an intern soon. As a supervising doctor once said to me: "You don't have to be the best, you just have to be average." Love it.

If I pass AMC then I will feel the right to feel average :)

Improving

I have been intermittently taking practice exams to see where I'm at and I'm happy to report my confident and marks are improving.

I think a lot of it is just activating my brain in this way again after such a lengthy break with the kids, not thinking about much else except nappies, formula, and whether Iggle Piggle is an appropriate role model for the past year.

I started out with an embarrassing 45% correct average, now it's around 70%. I would like to be hitting 75% consistently (or even greater) before I attempt the real exam.

So I've almost completed 4 weeks of full-time study prep, but in that time I did miss some days due to moving, Easter, illness etc. I plan to have another 4 weeks of part-time prep when hubby goes back to work but I would absolutely love another 6 weeks full-time study (to make 3 months total) but I simply do not have that option due to childcare.

Anyway, no time to lose worrying. Back to the books.

I'm currently doing AMC QBank as well.

Week 4/6 of AMC1 prep

Today I start week 4 of my 6-week Australian Medical Council exam for International Medical Graduates prep. I can't believe I'm already half-way.

Week 2 was a write-off due to moving. Last week I had a massive migraine with neurological signs that landed my in the Emergency Department with a CT Brain. I'm all fine but it took the wind out of my sails.

Weeks 3 and 4 have been a much reduced study load than what I set for myself in weeks 1 and 2. I really should've given myself an extra week for adult medicine at least.

This week is Obstetrics and Gynaecology. I am doing the O&G questions from AMC Handbook of MCQs, and cross-referencing them with Llewellyn-Jones Fundamentals of O&G. Some of the gynaecology questions from AMC Handbook are in the adult medicine section so I saved them for this week when I came across them in week 2 as there are only about 28 obstetric questions.

A lot I know from just having a baby myself. Some I learned at med school and from my in-hospital clinical obstetrics placement, but seeing as I was pregnant with my first during the reproductive system module and then with my second during my O&G placement, I can't say I was really on the ball during those times at med school. I definitely learned more by simply being pregnant myself. Of course its very much augmented by the fact I read O&G textbooks to supplement my own experience as a patient. I always say that its easier to remember things when your brain deems them important. What is more important than the health of your unborn baby?

Part of the issue I had such a terrible migraine, I think, was from studying at the library. The public library has only one study room and it is often booked by group of old ladies chatting about knitting or baking or some crap that really infuriates me. The other "study" section of the library has been so unbelievably noisey and distracting lately. I am a mum and a paramedic so I can work under pretty awful noise conditions but this library situation has been horrible.

Then I realised I really needed a particular textbook that I really didn't want to have to purchase so I rang the local hospital library to see if they would allow me an outsider membership. It took a week to organise and $135 for an annual membership but I am so happy to be able to borrow at the hospital library AND study in a lovely quiet space. So stoked.

Its been the Easter long weekend so neither library has been available to me and my husband had arranged some (urgent) landscaping to occur at our new house and our babysitter kind of feel through so I was unable to study which really sucked. Always, always obstacles for me. But...I just have to push through.

So far I am sticking MOSTLY to my plan of completing AMC Handbook cover-to-cover and referencing topics in Murtaghs, as well as Llewellyn-Jones O&G, Practical Paediatrics by South and Iaasacs, and I think I'll also use Foundations of Clinical Psychiatry by Bloch. A few other clinical guidelines online, and I'm really going to try and go through the photos in AMC Anthology of Medical Conditions because that's where I heard a lot of the images in the exam come from.

Ok back to the books because I have no time to waste.

The AMC prep continues

I'm in week 2 of my 6 weeks full-time AMC study prep.

We moved house last week which threw a massive spanner in the works. I sacrificed my study time to unpack and set up furniture to be able to live. It's so much more time consuming with kids, plus our new place needed a number of immediate renos. I love it though, so much character and oh boy was it a bargain for where it is. All I see is the potential. I just want to stay there but who knows where I'll get my internship next year.

I'm still studying AMC Handbook of MCQs against Murtaghs as my primary focus, then looking at some other topics that are known to come up in the AMC part 1.

My colleagues have been doing well passing their exams which makes me more optimistic, although they are a lot smarter than I am!

That's all I have to update, I have to reach my set daily study questions quota in the library before I go home. Luckily I moved just around the corner so I can go home for lunch break. Today I want to do 20 questions which should take 8-10 hours.

AMC prep

My AMC prep is now in full-swing.

My 3yo has started kinder two days a week from 9-2 and I put the baby in daycare the same times. Then I go to the library and study.

I was also doing Sundays at the library (6 hours) which was fantastic but hubby was feeling the exhaustion a little too much so I decided to drop the Sundays and hope and pray the kinder hours are enough.

Hubs has 6 weeks off starting week after next. I will be studying full-time during that time. I have broken the AMC handbook down into 6 weeks and will complete all the questions and do the necessary back-reading in Murtaghs etc. This will be the bulk of my prep.

I am still intending on taking AMC1 mid-year. I would LOVE to postpone it to end of year but I'm not sure how much more benefit I would get as I'm wanting to return to work part-time as well as my long service leave pay is about to finish.

Happily, my brain is finally able to switch into student/doctor-mode the times the kids are in care, which is fantastic. I finally feel like myself again. I'd personally prefer twice as many hours to study but that is not my current reality. I'd love to stay up at night an study when they go to bed but to behest, I am exhausted by then and bubs is still waking twice a night. I don't think I can do it. Maybe closer to the exam I'll caffeinate myself eve further.

In the past I'd watch a doctor show like ER to get me motivated when I'm feeling like a professional student and not a doctor but seeing as I haven't really watched TV since the kids were born, now when I do-so it just seems so lame. BUT, someone did recommend I read When Breath Becomes Air and that definitely sparked some motivation within me. I think I should try and get another medical memoir to read.

Having kids...it's just such a huge obstacle for mothers wanting to do anything else than be a mother. I am so thankful to have this current balance. The kids are loving kinder/daycare so mum-guilt is not very strong right now. Baby smiles and waves when he sees the educators at daycare. He happily plays with their toys and naps better than at home. I think he is benefitting from the daycare as much as I am.

In my vast experience as a mother (lol), I believe that finding the right balance is unique to each family, takes trial and error to find, and is immensely dynamic require readjusting the sails as you voyage.

I am very, very nervous about AMC, but each day I study my optimism grows a fraction. The honest truth is, I am not confident because I am simply not ready, I haven't studied enough and my knowledge is not where it is expected to be. I will overcome this by studying more and improving my knowledge as preparation is the best cure for nervousness.

AMC prep and worry, worry, worry

Hi,

I'm back!

So...what has happened since my last post...

I had my second baby. A gorgeous baby boy. He's just so sweet and handsome, calm and very very strong! Wow! We call him Hulk Baby or Bam Bam. He's just perfection. I received my medical school diploma the day after he was born. It was a strange and amazing week!

He has only just started sleeping well at 6 months old, and with having a 3-year-old on top, it means I've been the perfect example of exhausted. Complete baby-brain has prevented me from attempting any form of study, revision, AMC or internship prep, until now. Given this situation, I have deferred my internship until 2019. I hope I get something next year.

So I will be focusing on AMC prep now. I hope to sit AMC Part 1 before May/June in case any mid-year offers become available (unlikely). I think I might need longer to pass it. I'm now dealing with the consequences of only putting in minimal effort at medical school basically since my first child was born. I had a feeling I'd need a catch-up year but having a baby on top means I'm practically having two catch-up years. I worry this won't be good when I apply for a job. I plan to try and do some observer shifts in the second-half of the year to accomodate for this. I worry I won't be able to fit everything in as I also want to go back to work casually for some extra money.

My daughter commences 3-year-old kinder next month, just two days a week, 9-2. We have arranged for our infant son to attend daycare on the same days to allow me time to study. Currently, I get not more than an hour or two per day, and that is highly interrupted and unproductive. My kids sleeping patterns overlap in the middle but it means at least one is awake for 16-18 hours a day. You don't need a PhD in mathematics to figure out I'm already running on empty and can't stay up to study when they are asleep. I'm ok to live day-to-day as a mum like this, but as a doctor preparing for registration exams and needing my brain to fire on all cylinders, this is less than ideal.

My husband will take care of the kids solo on the weekends this year so I can go to the library but the opening hours are limited at only 9 hours for the entire weekend. So, to do the maths, if all goes to plan, I will have 19 hours per week allocated to study. Most people study full-time, as in 40-50 hours, for 3-6 months to pass AMC. This makes me even more worried.

So I'm worried. In a nutshell. In a worried nutshell.

Then add on top of that "mum guilt." The fighting of the biological desire to be there for my babies 24/7. The wanting to play Lego and make snacks above medicine is a strong force. Intellectually I know better. I know they can thrive on two days paid care a week, I know they can thrive on hubby being the stay at home parent while I kick-start my medical career. I know this because I've done it already with thee lest child and she is just a fantastic kid.

I know they kids will have amazing opportunities as they grow with my income that medicine can provide.

My daughter's kinder is also the school both children will attend until they are 18 (graduated secondary school). It is a very good (read: expensive) school. It makes the worry about everything worth it. I follow the school on social media and when I see the older students are in Spain or France on exchange, participate in sports such as equestrian or cross-country skiing, travel to Ireland to learn traditional dance, and that half of the students graduate with scores in the top 20% of the country (i.e. admissions access to the majority of university courses), I know it is all worth it.