Dichotomy of knowledge

I've been using USMLEWorld QBank as an additional resource to help me prepare for my weekly quizzes, and I found http://usmle-score-correlation.blogspot.com.au website to see what my QBank score would mean on the USMLEs.

It goes like this: The stuff I'm good at, from being a paramedic, ie cardiovascular/respiratory anatomy/physiology/pathology etc, I do really well in. Enough to get into what I want to get into. The stuff I don't have a background in, ie renal, isn't even good enough to pass. I haven't dared looked at my biochem scores for a long while.

Right now, what I'm not good in is outweighing what I am - too much.

I have a lot of work to do.

I'm gonna go read the renal sections of some of the books I have on my shelf now I've completed the allocated readings. It's a Sunday afternoon and I haven't left the house for days. I take no more than an hour off a day plus meal breaks.

Oh, and PS: my academic advisor doesn't count doing the readings as "study". Apparently I'm to read 100-200 pages per week, do all the lectures and meetings, and THEN do 40 hours of extra study on top. This could be where I've been going wrong. I've been doing 40 hours total, you know, a mere 7 hours, 6 days per week.

Back at med school

I'm back studying at med school. Things are going ok so far, but my initial thoughts of having a more balanced life seem impossible now only a few weeks back. I'm beginning to wonder how other people do it.

I guess I'm already a little disheartened by my grades so far. Mostly, because I thought I was doing really good. In my mentor meetings I feel confident, like I know what I'm talking about. I read about the diseases and think "Oh yeh, I know this" and cross read other references and it all looks familiar, I actually complete the allocated readings, then all of a sudden it's quiz time and one week I do amazing, and then next really poorly. I can't make heads or tails of it.

I suppose all I can do is hope they will take me back into the MBBS program if the MD thing doesn't work out. I can't believe how negative I sound already. I guess this is a good warning to potential med students that it can be a real hit on the self esteem.

My parents are coming over from interstate to visit and I've basically had to tell them that I don't have time to spend with them. They're all like "Just one day together will be fine" and I'm seriously thinking "No, I don't even have one day". I have a really good mate's baby shower on the weekend, I promised my best friend I'd help her prepare for it by making the vegan food, and another party back in my bf's hometown and I'm basically cancelling on everyone. I feel dreadful.

To make matters worse, I feel I can't train and I'm still off work with a broken toe. Talk about feeling completely useless right now. At least I don't have major anxiety like last time or chronic fatigue.

To sum things up, I suppose things are not going well for me back at med school after all. They were last week and I didn't feel like blogging so excuse me while I vent now. I guess this is how I got into this blogging in the first place! If things keep going bad for me, then expect more posts. If you don't see any, then assume things are going well.

One positive thing is, I do have a really good academic advisor this time. She is very friendly, helpful, and supportive. Do you remember that the last one laughed at me (literally in my Skype-face) because I didn't have a solid microbio background? My new ones is all like: "Med students always put too much pressure on themselves. You can't know everything. It's ok not to do well in everything - you're still learning." I know some people prefer tough love, but I like the softer approach and gentle reassurance. I also like the fact she sounds like Oprah, although I haven't been exposed to many people with that type of accent in rural Australia.

Perhaps, one of the worst things is, I feel like I would make a really good doctor. I feel like I "get" things quickly and can work my way through diagnoses no problems. It's frustrating me that I'm stuck in the purgatory of pre-clinical.

That is all. Excuse my complaining. I'll try and end on a positive note, perhaps some sort of positive affirmation, each time to avoid the bad mental state I got myself in last time I was studying at med school. I don't want to get those grey hairs back again. It may not be original, as I need practice, but here goes:

I can do this. Whatever it takes, I have the ability.

Edit: My former mentor is mentoring me again, I've been told I have to repeat neuro at 50% tuition if I want to complete an MD (MD>75% vs MBBS>60% as I got 60) although they didn't offer it this term so I'm doing renal and seeing how I go (if I get 60-75 then I'd seriously consider changing back to MBBS if they will allow me - I haven't asked - and not worry about the USMLEs for now), and my tax return pretty much covered my tuition fees but I wasn't able to do a 12-month tuition plan until January so I have had to pay a whole module. Oh, and I broke my big toe during my taekwon-do tournament and have had the past 6 weeks off work!

Meh

So, today I'm back at work. So far I've revised my revision from yesterday and I will be continuing to look at my CM Literacy stuff and Foundations stuff.

I also have to cook my 12wbt food and so a workout, although my motivation for this is low despite me reading my "Commitment" that I wrote to myself in the pre-season.

I'm also trying to sort out my application to IUHS that I've sort of put on the back-burner for a bit but now I need to get stuck into it.

I'm also dealing with buyers remorse after a stupid internet impulse purchase last night, but oh well. I'll have to suck it up.

PS I have a new label "med school". Before I was just using "study" but now I need the new label to differentiate between TCM school, the Masters, Western med school, and all the other things I'm doing.

Bloody tonisilitis

I get up early one morning on my fatigue break and I get run down enough to get bloody tonisilitis again. Or according to my TCM doctor, I have a Blood deficiency. Great. Anyway I'm really upset. I have been working hard at getting myself well and motivating myself with running and I get so sick. It's really bad this time, my right side gums and neck is so painful. Ugh. I don't even have any spare time to get acupuncture so I don't know what I'm gonna do. Feeling quite glum.

Still over it.

That is all.

Over it.

Had a lovely morning being Valentine's Day - it is all about who you spend it with for sure. As the BF and I are saving to build our new house and want to do a bit of travel soon and we don't want reject materialism/consumerism, we tend to do "quality time" activities instead of buying gifts. This morning was breakfast in bed and a nice massage for me before work. Lovely.

We also did some cool stuff in the city as our sort-of V-day-weekend. We went to the National Gallery of Victoria (free!) and walked the city streets on the warm Summer's night to a short-film festival put on by the United National Association about sustainability and transitioning to a greener world. We then went down Chinatown and had an interesting(!) cheap meal there, which my positive spin was something like "Well this mutton stew will be good practice for us when we go to Mongolia!" lol

Ever since one of the BF's horses bit him really hard on the arm, I've been scared of them. I'm scared of his cows too. I can handle the Shetland pony mostly. When we walk around his property I just anxious if I realise I'm in the same paddock as them and if they start walking or running towards us I freak out. When I hear jobs on the work radio about people being injured and even killed by their livestock I shudder. I have no idea how I'm going to handle living on a farm.

Veganism - I have been caught a few times "forgetting" that I'm vegan. I even nearly ate meat on the weekend - the chicken sandwiches looked so tasty! I managed to get a vegetable sushi roll but as I got halfway through it I realised there was mayonnaise in it. Darn. I'm back at home now so it should be easier again.

And my study - well, my motivation and enthusiasm is at an all-time low. I have 3 weeks left and I really can't be bothered. I am at risk of failing if I don't get my act together. I'm just so annoyed all the time at the remote proctor not working and the issues I have with trying to communicate with the faculty staff. I'm annoyed at the lectures being compulsory and my internet being unreliable and stressing about losing grades. I'm annoyed that the lectures are mostly the students talking and the stress of being put on the spot to answer questions I may not have read about as yet. I'm really annoyed that the quiz questions are commonly poorly written and so dis-jointed and often don't reflect the learning objectives of the week making me suffer losing valuable marks. 

Yeh, I'm over it.

Better but nauseated

Well I am feeling a bit better today after deciding not to go too hard on myself or dwell in the past and to get my bum into gear and do some hard-core study this week. I also remembered that since we only have 6 case studies per 8 week term now (instead of the previous 8) that I actually have 2 whole weeks for revision before the final exam.

I have actually enjoyed, as usual, my studies today and yesterday. I am not enjoying the constant pressure of the lectures, quizzes, mentor meeting etc. I guess I can compare it a lot to when I was a paramedic student and graduate paramedic, and geez I really feel like I need a break. Holidays are in about 6 weeks so I can't friggin wait (not that I'm going anywhere).

After studying all day at work (I read about the different types of dementia and about the limbic system) and having some interesting patients, my plans for tonight at home are (if I don't get any call-outs) to do a quick work-out and vacuum, and then attempt this quiz even though the thought of it makes me feel nauseated.

I might even do some QBank if I feel as good as I do now (and the ongoing issues with the remote proctor doesn't suck the life out of me)...

FML

Well I did end up doing a workout last night as well. I also watched tv (Fashion Police) and didn't do any study at all.  I tried to do my quiz this morning but my internet wouldn't work. I still have it hooked up to the LAN (that works) and I haven't figured out the wireless router as yet as it works on my phone and iPad. I run a diagnostic and it asks for a PPoP address or something like that - I have no idea what it is asking for. Ugh...

I had my mentor meeting and I felt slightly more prepared than last time but still feel like I don't know anything at all and like the biggest dumbass medical student she has ever come across. My motivation in waning and I'm day-dreaming of the end of this term.

I also had my first time of going out for food as a vegan. I had called ahead, but it turns out the gnocchi has egg in it, so I had to have a change of plans. The beef salad without the beef or dressing sounded so incredibly boring after I had planned for the extra calories for the week. I ended up going with a vege coconut curry and rice which was delicious. I used my new My Diet Coach app and nearly fell off my chair when I calculated the calories. Holey-moley. That, with a glass of Coke, means I am over my daily calorie budget. Great. I can workout for an hour and not eat for the rest of the day and get back to 0 balance.

Kitty managed to get her arm (yes, I do refer to the front legs of quadrupeds as "arms") stuck through her collar which terrified me into thinking she might do this and get stuck somewhere never to be seen from again. I will try making another smaller hole to tighten the collar a bit more. Poor Kitty.

Well, that is all. I guess I better stop complaining and get back into trying to study. FML.

Access

Internet access is obviously very important when studying a medical degree by distance. I am trying to figure out how I can access my mandatory lectures online when my work computer wont let me download Java, which is essential. And my iPad doesn't allow Java either, which I think is the worst idea Apple ever had.

My mobile phone allows a "hotspot" but I have to figure out how much data and speed I'll need to use Elluminate, and then I'll friggin have to dust off the old laptop which annoys me as my desktop and ipad are brand new.

Sigh.

Well at least my old laptop still works.

Readings

I just counted up all the pages I was expected to read this week:  451! Four-hundred and fifty-one pages of information-dense medical textbooks in one week PLUS a three hour lecture, one-hour journal club and accompanying journal article (add another 5 pages), a weekly mentor meeting, and a weekly academic advisor meeting AND the 27 page case study... Ok so now that's 483 pages!

Not. Gonna. Happen.

If I studied 7 days a week for 8 hours a day that's 9 pages an hour (or the recommend minimum 40 hours would be 12 pages an hour, plus the lectures and meetings).

Faark - I better stop blogging.....

Stealing

The contractors building next door firstly asked to use my power one day (I only allowed them to for a few minutes) and now another group is stealing water from the house across the road (which was repossessed by the bank). I highly doubt they have permission.

My friend said she allowed the builders next to her to use her power when she was at home which she billed them for but one day she came home and found them stealing her power without asking!

I'm glad I told these builders I had no external powerpoint, and that my dog is big and scary, and that I'm home 7 days a fortnight.

Where are the morals? I might have to padlock my taps and powerpoints!

Get the services connected already!

Ramped

I'm currently "ramped" at the hospital, which means my patient is stuck on our ambulance stretcher at triage because there are no hospital beds available.

Not good at after midnight. Not good out of our catchment area. Not good when I haven't been able to complete an 8-hour rest break in over 24 hours now. Not good that I've now been up for 18 hours and am probably going to be past the 20 hour mark by the time we make it back.

But it's all ok because tomorrow is my last day for the week.

School fee blues

My massive med school tuition fees are starting to get me down.  I know I'm really lucky to be able to travel and afford things like a new fence when I need them, but it's frustrating to work my ass off and not get ahead at all.  I really noticed it when I just took two weeks off work sick and only got paid my base wage (no overtime or call-out allowances).  Another 4 years of this it going to hurt.  I'm going through a phase of doubt while sitting here going through my miniature bank accounts. 

Ugh.

Well only 4 1/2 weeks until I go away. Geebus!!!  That is totally scary.

Well I haven't done my workout today yet, despite sitting here in my trackies.  I think I'll go do that now to try and lift my mood.  Maybe I'll have an epiphany or at least more optimism in regards to the financial situation.

C'est la vie

Apparently I've been working and studying too hard and that's why I got sick.  I dunno.  Maybe. When I got sick in March I was on annual leave, so that theory doesn't really work.  Maybe I should have a good look at my diet and try and boost my immune system with juices again.  Maybe I should stop working with sick people all the time.

Anyway I'm happy because I'm starting to feel better.  I've lost about a week or pre-exam revision, but I'm happy I think I'll have about two good days before the exam to cram.  What can you do?  That is life.

C'est la vie.

Med school annoyances

Sometimes my med school really annoys me.  Not because of the learning material or lecturers, but because of stupid administrative errors. 

I get that there are a million different time zones for different students - but get your act together.  Med school is confusing enough without constantly moving the goal posts, giving conflicting information, restricting flexibility in a distance education unit, and then accusing the students of being stupid for raising issues of merit instead of admitting you stuffed up.

Really annoyed right now.

Here is an exact example:

".....final exams will be administered following completion of the module (i.e., "week 9"). The exam will be open from 1 am - 11 pm Pacific Time."

Um, hello.  What day of the week of week 9?  And isn't that part of the USA now in Pacific Daylight Time (I only know that from Googling Pacific Time as stupid me thought it might be the time Samoa is on seeing as Samoa is in the Pacific and where my med school is located)?  And when did I have to start converting time from USA to my time when everything else is in Apia time (where the school is based in Samoa, rather than the curriculum coordinator in the US) or what about UTC on Greenwich meantime?  There is only one US student in my class, one Kiwi, two Aussies, and four Samoans.  But, no, we'll work off YOUR time seeing as you are in the centre of the known universe.

So after a bit of Sherlock Holmes work I believe I've deduced that (I think) my final term exam will be on Monday the 25th July from 6pm to 4pm the next day.  Luckily, I have that day off.  In the past terms we've had two weeks to book a session at the testing centre in the big (capital) city closest to our homes.  Now it's to be online at home.  Can anyone spell "loop-hole"?

When my presentation is is another story..... I thought it was next week (Week 7) but the website where everything is listed says it's Week 8.  I'm going with week 7.  I'm now reduced to relying on gut instinct.

Maybe from their point-of-view it's simple.  But when you're thousands of miles (or should I say kilometres) apart from everyone else, information needs to be accurate, timely, and reliable.

Too much to ask?

Most probably.

Epic fail

So I just did my weekly mini-quiz and totally stuffed the whole thing up.  I'm so unimpressed with myself.  Feeling really down now.  But there is nothing I can do now, I just have to keep moving forward.  The only thing that is reassuring is that I was doing bad in the other modules in the beginning but pulled it all together by the end.

My next case study is "Fractured humerous".  It's the 4th out of 7 for the term.  Our learning issues surrounding this case are;

• Anatomy of the upper limb (skeletal, muscular, vascular, innervation) - here comes the brachial plexus
• Mechanisms of pain (physiology, biochemistry, pharmacology)
• Pathophysiology of hand weakness
• Consequences of vitamin D deficiency
• Pathology of fractures
• Clinical features and management of fractures.

So, yes, starting afresh tomorrow.  Too bad I have a mini-quiz for last week's case still to come. 

Oh well.  Hopefully I'll feel better tomorrow.

I think I'll try and finish a section of the PT assignment and sent it off to feel like I've achieved something.

5am lectures

The 5am lectures on Thursday mornings are very difficult for me and my terrible habit of needing to sleep occasionally.  At least they are not interrupted by inconsiderate patients having emergencies.

Well, I have seemed to have lost a good portion of today so I must stop blogging and start learning about calcium homeostasis, microbes involved in osteomyelitis, and other such areas of this week's learning objectives which I seem to be deficient in.

Oh, before I go, a quick mention that today we were talking about imaging and MRIs and I asked "What if you don't have access to MRI?" and I found myself thinking about working in Samoa.  If not Samoa, then Cambodia, or Rwanda, or somewhere exotic and remote where you need to improvise and rely on your clinical judgement.  I'm so excited, I seem to have gotten an extra boost of motivation lately thinking that I might actually one day do this big dream I have for working for Medecines Sans Frontiers (or similar organisation).  You know that nice feeling that rarely happens when a dream starts to morph into a future possibility?  I'm there right now.

Work - agh!

So work has been trying to kill me again.  The last 3 days have virtually been stolen from me due to just working and sleeping.  This all goes back to that stupid 5am lecture Thursday morning when I only had 2 hours sleep then no time to make up for it until today.  So just been an unproductive zombie.  Well, actually I was pretty tired before that morning.

I jut got up and have 3 hours before I go back to work.  I need to decide whether to workout, do dishes or study.  I think I'll do the first two and then study tonight before bed  That's the plan.

Ooh - and I wouldn't mind doing the first section of my PT assignment.  I'll have to do a quick section a day or it will never get done.

PT course

I just received my first assignment for the PT course and it is a big one!  They say it takes 20-40 hours and I believe them!  Although the 20% on anatomy is easy for me, the rest is foreign territory.  However, every question has a reference to it, so it wont be hard to go through and find the answers.  The part where there's a case study and you have to devise a workout plan for the client looks time consuming.  I expect it will take me about 2-3 weeks to find the time to fill the whole assignment out and at that pace I should have the whole Cert IV done in 8 months I think, so about Jan/Feb next year.

I had my first lecture for the term today.  It was good having it at 1pm and not 6am.  I feel pretty good and like I'm on-the-ball a bit more this term, so I better not get too complacent.

I also managed to log a workout this am, so that was nice.  In my new gym.  Works well, despite the TV being so tiny.  I still have to beautify the room a bit more and make it even more appealing to be in there - almost zen-like.  It's good I don't have to shut the blinds anymore (or move the couch) in fear of my neighbours seeing me!  I just have a semi-fernery (which I'm working on improving) to gawk at me.

AN Abrams