Trial OSCE

I had a trial-OSCE a couple of weekends ago. Three students were taking their final OSCEs, and three students were having their trial run.

I hate to admit this but I did not prepare. I was in complete denial about what I was going in to. I figured it was a trial run so learning from mistakes is ok. I relied entirely on my paramedic background.

My paramedic background served me well. There were one station in particular where I felt uncomfortable (it involved a CT image), and one I completely lost the plot due to a reason I know but won't go into now. That particular mistake won't happen again. I think I might try and do a separate post about it.

So, anyway, it was actually good. I saw that I can so accomplish this with effort. There are things I need to do to get nowhere I want to be but it is very achievable. It was probably the best outcome I could have gotten from the experience.

I have being avoiding med school and pretending I'm not a med student since returning to work. I was so tired of the stress of it all, and with moving house and a new baby and returning to work, and no placements to go to, and with OUM pausing the clinical exams until the new year: I had little to motivate me to care to study in my free time. The little that I have.

Anyway, I'm trying to get back on the horse. At work I go the extra mile to learn about the cases we attend but not much else is happening. I hope to start some IM placements locally soon but I wonder how many timesI can harass my contact for a spot.

Fingers crossed for the new year.

Raising my IQ experiment

Ok so here's something that may come off as, I dunno, strange or silly or egomaniacal. But I'm going to blog about it anyway.

I want to see if I can raise my IQ.

I believe I'm in the low 140's, and at least in the high 130's. I'm in Mensa so that's minimum of 132. Maybe I just scraped through, who knows. I've only ever done the online tests.

I joined Mensa before starting med school and having a baby, where I think my IQ went up a bit just from using my brain a bit more than normal. I just did an online test that claims to be within 4% accurate, under heavy influence of sauv blanc, and still scored a 139. I think I'm better when sober and well rested. Dehydration alone reportable decreases IQ by 10%.

So, anyway, I'm conducting an experiment to see if I can raise it and get into my goal of the Triple Nine Society.

TNS requires an IQ in the top 0.1% of the population, whites approximately 145. I think I can do this.

I need to sit a proctored exam to gain evidence of my IQ. They are generally expensive, however I have quickly Googled and there is something called an ACT and I think its for College admissions and is only $40. There is one nearby in April 2016.

What I really need is A GOAL. I am lacking something to strive for. I have med school, sure, but I need something new. My proposed regime for increasing IQ will surely benefit my studies.

I have one hard rule: no nootropics except caffeine. No messing with my brain chemistry and relying on stimulants. I even want to quit caffeine. When I was really clean with my diet I experienced heightened mental clarity and I want it again.

At the very least I want to know my IQ, my best possible effort, and hopefully it is enough to get into one of the Top !% societies. Mensa is the biggest, oldest, and most well-known high IQ societies but somehow I feel like Top 2% is setting the bar bit low. There is The High IQ Society whites easier to join online and is the Top 5%. I am with them as well. I joined them before Mensa as I was more confident.

I'm aiming for high 140's.

Here's my rough wine-induced plan:

• no alcohol
• eat clean
• train mean
• early nights
• meditation
• dual N-back training
• common IQ test question familiarisation
• more research this subject

No wine will be hard. I've become to rely on it due to having a toddler.

Wish me luck.

Two essential textbooks

Here are the two textbooks which I believe are essential (for Australian OUM students anyway):

1. General Practice by John Murtagh
2. First Aid for the USMLE Step 1

AMC MCQ prep

I am beginning to prep for the AMC MCQ exam. I said I wasn't going to start yet, but I am not feeling confident in my abilities of an almost-doctor that I want to have a focused kind of "revision" of actual "what to do" when treating patients so I figured AMC prep might help me have some sort of plan.

I've been looking around the net and I think I'll do the HEAL bridging course, but not yet. It's 6 weeks so that it a trouble in the first place as I only get annual leave in 4 week blocks.

RACGPs has a 10-week fully online course but it's really only a MCQ question bank and I resent having to pay $2000 for 400 questions. Maybe I'll do it once I graduate. For now there are plenty of free resources around to keep me occupied.

This is my current strategy:

I have John Murtagh's General Practice text book that I'm using as my core text. There are 141 topic it! Too many to tackle cover-to-cover.

I have the RACGP list of top 30 conditions treated by GPs. I will list them for you:

1. hypertension
2. immunisation
3. acute URTI
4. depression
5. diabetes
6. lipid disorders
7. general check-up
8. osteoarthritis
9. back complaint
10. prescription
11. oesophageal disease
12. female genital check-up
13. acute bronchitis/bronchiolitis
14. asthma
15. anxiety
16. test results
17. UTI
18. dermatitis
19. pregnancy
20. sleep disturbance
21. sinusitis
22. gastroenteritis
23. vitamin/nutritional deficiency
24. malignant neoplasm of the skin
25. abnormal test results
26. atrial fibrillation/flutter
27. oral contraception
28. solar ketosis/sunburn
29. ischaemic heart disease
30. virus

So, I think knowing the top 30 conditions is essential, but also are the rare but life-threatening conditions.

Murtagh's has clinical boxes with an asclepius listing medical conditions which are important to know so I hope to go through those too.

On Facebook, I've liked the https://www.facebook.com/AMCprep page. They put up free AMC MCQs, only one every few weeks, but if you go to their page all the old ones are listed so you can work your way through those before you pay the $100 a month or whatever it is on their website.

So I'm beginning with that and hope to complete by the end of the year.

There's also a few things on YouTube if you hunt around.

I also have to hunt around for my next lot of placements.

Stress and motherhood and placements: the update

I wanted to quickly update on where I am right now with my stress, motherhood, and my clinical placements.

Stress: much, much better. So it turns out that after 8 years as a paramedic I do have some PTSD which motherhood and an unfortunate incident triggered. I was also living in a place where I felt unsafe. I will NEVER put myself or my children in that situation again. I have returned back to work and MY house now and things are so much better. The stress at work is completely manageable, but if something happens that makes me feel the personal security of my child is threatened, I have a strong, physiological response (shaking, racing heartbeat). I know I have some work to do on this because I'd like to do some travel etc and I can't always control my environment. It has been a horrible time in my life and it has made me realise the safety of my nest is paramount.

Motherhood: It's getting easier now Bubby is 13 months. She's a bit easier to manage these days. Being back at work has helped me feel more "normal", and I schedule one day a month for myself where she goes to daycare and I do my own thing. She's in daycare 2-3 days per week which is perfect for all of us. This won't be the case when I do my next clinical placement, which I'm a bit worried about. Today, for example, I took the day off work sick (I was really crook yesterday and a bit better today but still sent her to daycare). I am getting everything done in one day lol. I also get everything done at work in my downtime between jobs.

Placements: I have 32 weeks to go. I need: O+G (8 weeks), surgery (4 weeks), IM (12 weeks), and 8 weeks of electives. I am currently speaking to four local hospitals that all sound promising. I have until March 2017 to complete all these plus my final MCQ exam and OSCE. Then I'm done! I am hoping to be done next year though and then look at internships.

Internships: so, if I do my AMC in time I can apply to Australian hospitals for internship. If not, I have to wait until the following year. I am HAPPY to take an extra year to prep for AMC and get a good score, also to work a bit longer as an ambo and maybe save some money before I drop down from senior paramedic to junior doctor. I'm looking at internship in Australia, Samoa, or NZ at this stage.

Here's the thing: I'm 8 years in my job. We get 4 months long service leave at 10 years, which you may take early (from 8.5 years) if you intend to stay until 10 years. I am thinking about potentially doing my internship in Samoa (or elsewhere) while on LSL (8 months half-pay, plus accrued annual leave). That's the game plan atm. I will also see what is around in Australia and what is best for the family. My partner loves the idea of living overseas for a year. I, however, "like" the idea of a sibling for my daughter and there's no way I'm going to be pregnant or have a baby as a medical student (again) or in Samoa. And as I'm 37, I'm running out of time (and for anyone who says I can have a baby at 42, I think they're mad).

Goals: visualise with me here please! (Hey, I wanted to add you really need to write down your goals so you can work towards them, otherwise who do you know here you're going...?)

• Graduate from med school mid-2016
• AMC exam early 2017
• Apply for internships in 2017 for 2018 start
• 2018 first year as a doctor, Bubby will be 3-4 years old and in kinder. I will be 40!!!
• I will be 40, but look and feel 30! 
• Internship local and do a year as dr overseas after, or the inverse

OUM - my thoughts now from this perspective

Hi Guys,

Well, here are my thoughts on OUM now I'm in my final year.

I'm actually a LOT more positive about the course than in previous years. Probably because I'm not as stressed, isolated, and full of self-doubt as in the beginning. Those were all things only I could control, but I believe there are steps current and future students can take to help alleviate some of the symptoms of being a distance student in a non-traditional med school. Her are some quick tips:

• meet a least one other student face-to-face and become their "buddy/wingman" during the course
• phone other students to chat (vent) privately one-on-one
• participate in the student union and fb groups
• don't get sucked into the negativity - its all too easy when you're stressed
• remember why you started the degree in the first place
• remember no medical degree is perfect: if in doubt, find someone from another, traditional med school and ask
• remember why you chose OUM in the first place (and own it)
• keep your eye on the prize

It also helps to be able to talk to faculty members to get word straight from the horse's mouth. 

To recap, these were my reasons for studying at OUM:

• I didn't want to relocate to another state and my grades were never going to be good enough for the local university
• When I did the cold, hard maths, OUM was cheaper than the place I was offered interstate
• I was a brand-new paramedic and wanted on-road experience before changing career trajectory
• I wasn't really sure I wanted to become a doctor as I loved paramedicine so much. This way, I could keep my job and simply drop-out of med school if I changed my mind
• I didn't want to stop working full-time and go back to living off two-minute noodles and share housing. I REALLY didn't want to do that for another 4 years
• Getting medical degree was more about learning medicine and challenging myself than it was about where I got my degree from
• My intentions were to work as a doctor overseas in areas of extreme poverty, thus where I went to medical school was relatively irrelevant 
• My studying-style is more suited to distance learning. I can read a textbook and retain the information MUCH faster than I can sitting in lectures
• I like to be different

Hope this helps some of you xxx

Stress Management and clinical placement after-hours

Stress
In an almost ironic fashion when contrasted against my last post, this post is about Stress Management.

It turns out, from a DASS assessment, I have severe stress. Funny about that, because I don't feel stressed. Even though I have good reason to be stressed. I have been feeling irritable and frustrated. Mental health can be funny like that and irritability can be a symptom of chronic depression and/or anxiety.

Exercising regularly has some good evidence for its effects on stress. This morning I began my now daily goal of 20-30 minutes of exercise each morning. This sounds like a massive commitment to me, but I think I just needed a really good reason to prioritise my fitness. One of the problems is obviously I'm quite time-poor, but the other one is that I actually feel really good. I don't feel unfit or unwell or any need to do exercise (other than stress management).

Clinical placement after-hours
I am currently at the hospital after-hours (after 5pm) doing my clinical placement in paediatrics. Tonight, we have no patients admitted to the ward, There are 4 in special care nursery, all doing fine. The ED has my number, and so does the Paeds Reg. So, I'm up on the ward just getting some study in. I'm behind. As usual.

I have one topic a day to cover during my rotations (5 a week). So, for example, tonight I'm covering asthma which has a 30 minute lecture to watch, and the entire chapter of childhood asthma in Nelsons Textbook of Paediatrics, which is pretty substantial. That on top of your day on the ward, and, oh yeh, that little thing called "a life" outside of medicine.

I really wish I had decided to have a life before I decided to get this far into medicine.

Mothers in Medical School

Have you checked out the blog Mothers in Medicine? (Good for Fathers in Careers too.)

I started reading it when I was thinking about going into medicine (and medical school) and how that might fit with my future desire to have children.

Well, now I'm living it. The MiM website is very US-based, and I think the general conditions for medical students and junior doctors in Australia isn't quite so tough.

The other things is that I tend to do most of my hospital rotations in rural areas. The workload is much less and therefore the demands and expectations for staff/students to live every waking moment in the hospital is also less.

I also study my degree by distance, so that makes "class" time flexible to suit my family schedule.

I also set boundaries. I say: "Sorry, but I am only available during these times" or "I need to know my roster in advance to work around daycare". I am unapologetic about being a mother and child/childcare commitments and the importance of these in my life and that they are second to my medical career (I realise I said: "sorry" and "unapologetic" in the same thought, but I think you get my point).

Does this mean I can still become a world-class cardiologist? I'm really not sure about that. Perhaps. But I'm not interested that. What I want out of this degree and career is something more lifestyle- and family-friendly. I'm thinking GP-land as it's much more flexible and shorter training (you can do it part-time, for example) and is more likely to fit around childcare hours, although if I decide I REALLY want to do Emergency Medicine then I'm sure I'll figure it out (nanny/au pair/baby sitter etc).

Anyway, there are a few positives for juggling both a baby and a career, and here are some of mine. It makes you:

• More motivated. You do it for them as well as yourself.
• More time efficient. No time to spare procrastinating.
• Focus on the essentials (see above).
• Appreciate the time you have both with and away from baby.
• Forget the woes of the hospital when you get home, and vice-versa.
• Put the important things into perspective more easily.
• Work harder to be a better role model.
• Better at multi-tasking.
• More creative with how you get stuff done (phone calls in the car, for example).

I'm back!

For now.

And so much had changed since I last blogged.

Exciting news:

I completed my pre-clinical studies and am now doing my clinical rotations!

Yay for me!

I'm about a third of the way through my clinical rotations so I am really happy to be on the downward slope of this medical degree.

I found out I can take a little longer to complete my degree than I initially thought, so this has taken a lot of pressure off as I thought I was running out of time.

Also... I've had a baby! Yay! I have a beautiful baby girl. She is doing great. It has been "interesting" juggling a baby, being a new mum, and medical school. Somehow I've found a pretty great balance. I've had a year off work on maternity leave so that has helped the time logistics so far but I'm planning on returning in the next few weeks to my old paramedic job so I just have to have a bit of faith that everything in my life with fit into a 24-hour day.

I'm currently typing this as my baby naps and in-between Emergency Medicine lectures. Sadly, I have to keep sitting exams during my clinical modules but I'm finding everything far more easier now I'm out of pre-clinical years.

One good thing about having a baby is that I find it a lot easier to re-prioritise things to suit her. I mean, I find it easier to just get things done when I need to in the small amount of times that I have, I go to bed earlier (out of necessity as she gets up so early), I eat better as she is modelling my behaviour, and I generally don't place my entire happiness and success on whether I do well in this course or not. For me, now, I'm more relaxed into it. I'll be happy to graduate. Whatever happens after that is a bonus. I'm a mum first now, and medicine, I'm sorry, will just have to be happy taking a back seat.

I'm still a vegan. Baby is too apart from her formula (you can't purchase commercially available formula in Australia). My pregnancy went really well. Baby was due the week of my final pre-clinical exam! I took the exam early and she came late. I'm so glad I ate healthy during pregnancy as she is just perfect.

Baby is awake so I hope to be brave enough to blog more.

Good luck everyone pursuing their dreams x