psych!

this afternoon, as part of our clinical coaching session we spent some time in the mental health ward of our hospital. it was a sneak peek into psychiatry. and to be honest it was exactly what i expected... fascinating but also quite scary.

we started off in our coach's office. it was a huge corner office, i was impressed to see that patient charts and folders overflowing with sheets of paper didn't cover every square inch of his desk or his floor or his chairs. our coach was probably mid-50s, well-dressed and like many in the medical profession, a blackberry addict. his crackberry must've went off about 3 or 4 times within the first 1/2 hour.

although very nice and clearly very well educated there was something about him that made me slightly uncomfortable. for starters, he spoke REALLY fast. he also kept saying "you know..." think of alicia silverstone in "clueless" from back in the day. now replace all the "like" with the words "you know". that was our coach. lastly, he just seemed a little... anxious. he didn't have any characteristic tics but he just couldn't sit/stand still. he kept fidgeting with his marker or the chair or whatever he could get his hands on.
i can't help but think that maybe his patients have rubbed off on him JUST a little bit.

after running through how to take a history on a psychiatric patient, we actually went to go see one. i'll be completely honest, i was nervous. and it didn't help with my coach saying as we started walking out of his office... "let's go see if we can chat with a few patients. should be fine. you guys will be safe." SAFE?!?!?! nobody mentioned anything about being UNSAFE! i was worried.

once on the ward it didn't get much better.  i'm sure we reeked of fear. all the patients stared at us as we walked by.  some of the patients were curious (?) audacious (?) enough to come over to where we were standing and strike a little conversation with us.  when we introduced ourselves to the patients i didn't even give them my real name despite my ID badge hanging conspicuously from my belt loop.  what a douche!  (in my defense, i was the last to introduce myself and no one before me gave their real names!)

the patient we interviewed was quite interesting.  he left home at a young age and has split time living on the streets, shelters or mental health wards like this one.  without going into too much detail, he suffers from schizophrenia and believes that he is a messiah. some of the things he told us: he used to speak with bill gates, stephen hawkin, bill clinton and many others on a regular basis on an internet forum.  he had powers of exorcism but these powers - along with his musical talents, have dissipated since he's been on his anti-psychotic meds.

i've always thought psychiatry to be incredibly engaging and interesting but i never really could see myself specializing in it. not to be crude but don't think i could work with crazy people all the time.  having said that though, i can't seem to strike psych off my "potential specialties list". there's something about it that i like which i can't quite put my finger on.

well, we get a 8 week block in mental health next year.  i definitely look forward to it - but with a healthy dose of apprehension of course. :)

hotel sisley open for 2009.

so we finally found out today our clinical schools/hospitals for 2009. to my great relief i got RBH, the school that I wanted. yay! YAY! YAY!!! this means that i get to stay in this great big old house with my great big old roommates (seriously, some of my roommates are great, some are big and some are old... kekeke) and our great big-portioned meals!

but what does this mean to you? well it means that you'll have a place to rest your head if you ever want to come and visit! we've had a LOT of people call our house home over the last year... i think about 15 or so... let's see, there is of course matt, susan, laura, alan and myself. we've had friends over: yi, angela, mike, jenn, judy, melissa. we've had boyfriends - well not MY boyfriends... sean and bryan. we've also had some family over... my brother pat, alan's brother arthur and susan's cousin maggie & her mom. tally that all up and that's... 17!

whether you decide to visit or not next year, i'm just happy i get to stay another year here at the sisley house.
:)

3rd year choices...

so i've put in my preferences for my clinical school for next year. you see, years 3 and 4 are "clinically oriented" meaning that although we still have some lectures and tutorials with a few PBL sessions, for the most part all of our learning happens in the "real world" - in the hospital wards. our clinical school is where we do most of our rotations - everything except the rural rotation.

3rd and 4th year consist of five, 8-week rotations in various fields. so for example... in 3rd year, you do 8 weeks in surgery, 8 weeks in mental health, 8 weeks with a GP, 8 weeks in general/internal medicine and 8 weeks in a rural location studying (duh!) rural medicine.

my first choice for clinical school would be RBH (royal brisbane hospital) which i'm at right now but who knows. if RBH is over subscribed then i could be bumped down to my second choice (Mater Hospital), or even my third choice (Princess Alexandra Hospital). worse case scenario would be that i don't get any of my 3 choices and i get balloted out to a hospital in the 'burbs. that would suck. i'm not hating on the suburbs - but everyone knows i'm a city boy. ;) it's just that with such a placement i would have to consider commuting from where i am or even moving to avoid this commute. this could get really messy really quickly. i think i speak for the house when i say we're quite happy with our current living arrangements. i don't want to have to find another place to live next january. on that note... i was planning to write my USMLEs in late-January. but if i have to find a new pad before school starts, USMLE might have to be re-planned and pulled earlier to december (not ideal) or pushed back to sometime during the school year (also not ideal). plus, if i get shafted out of the city and end up moving... i might have to find a new church too... :(

at this point there isn't much i can do about it though. just hope and pray that i get a little lucky...

to complicate things/make things interesting... there are options/potential opportunities to do some of these rotations outside of brisbane. i'd LOVE to do these whenever/wherever possible. so for example, the surgical rotation can be done in Brunei. that's cool. the school also has an engagement - not quite a marriage ;-) with the Ochsner Health System in New Orleans which normally houses med students from Tulane University and Louisiana State University. this isn't up and running yet, but we've been told it should be by the time we're done the first 2 rotations or so. this would be sweet too. and lastly... although VERY preliminary and unfortunately unlikely to occur in time for us, it has been mentioned by the school that a relationship with NOSM (Northern Ontario School of Medicine) is in the works to let us do our rural rotation in Sudbury, Thunder Bay or the like. this would be... would be... da bomb man!!! i am keeping my fingers crossed, but i'm not holding my breath.

*****
study totals - where did these tallies go??? :)
week ending on sept 13: 16 hours.
week ending on sept 20: 20 hours.
week ending on sept 27: 16 hours.
like the canadian goose that flies south during the winter months, it is now time for me migrate out into the living room to study. ugh..,

shooting my own foot.

last night we had a CaRMS information seminar put on by the SOM. our speaker was Sandra Banner who is the executive director and CEO of CaRMS. she basically talked about the process of matching and going back to canada once we're done, and what our chances were according to the stats.
i found it to be quite useful.
between this and the international students night a few weeks back, i'm feeling the love from UQ. it actually seems like they care!

now i know i shouldn't be complaining but... sandra had mentioned that the results on the MCCEE (medical council of canada evaluating exam) - the exam that all doctors who studied outside of canada have to write, is not always indicative of getting a residency spot. as a matter of fact, canadians studying abroad (CSA), tend to do worse on the MCCEE than say foreign doctors looking to immigrate to canada. however CSA, statistically speaking tend to have a better chance at matching. off the record, sandra went as far as to suggest that there may be some bias in favour of CSAs. yes. this is a good thing for me. BUT, if we're going to use the MCCEE as a measuring stick, shouldn't we stick by it?
there could be other legitimate reasons as to why CSAs have a better chance. these might be less quantifiable. for example, perhaps (in general) our english is better. perhaps we're younger & less likely to have families and hence have more flexibility in terms of where we go and what we do. or maybe we're able to connect with the interviewers better through common topics like... how much the leafs suck, how bloody cold it is in january or how there's nothing to do in the prairies (yes. that includes alberta). ;p
overall, the seminar was informative and fairly positive.

the only sore spot on the night was this complete tool that was sitting in the back asking questions. it wasn't the questions that he asked, but the way he asked them. he was bordering on belligerent. i thought sandra gave us a great talk and was incredibly helpful. he was just being ultra aggressive and unnecessarily defensive. i blame his faults on his parents. tsk tsk. it's unfortunate because it's idiots like him that are the most vocal and in the end he's a reflection of the canadians at UQ. worse part is that he introduces himself as being from toronto when he's actually from BRAMPTON. for all of you aussies out there, i assure you that he is not representative of canadians. nor of torontonians. he MAY be a correct reflection of bramptonians. i'm afraid i don't know enough people from brampton to confidently comment though. ;)

*****
slightly related, i have a friend in 4th year from toronto who has decided that he's going to stay here. he's been offered an internship spot in wollongong in new south wales (about an hour outside of sydney). this doesn't seem like such a bad option. although his circumstances are slightly different from mine, i can see where he's coming from.

*****
let's bash on surgeons some more. my third year peer tutor told me these two:
how do you hide $50 from an orthopedic surgeon?
you put it in the patient's chart.

how do you hide $50 from a plastic surgeon?
you can't.

strike pathology off my "potential specialties" list.

had the opportunity to watch a real autopsy being performed today. needless to say, it was quite the learning experience. i won't go into all the gory details here but i will tell you that it was a much different from the cadavers in our anatomy labs. this patient... this body... this PERSON was still... fresh. the blood was still red and her skin was still plump. sure the rigor mortis was starting to set in, but she still looked like a REAL person. like someone who's just asleep.

i'm glad for the experience. but forensic pathology is just not my cup of tea.

5 year, 10 year, 25 year plan?

i've been sitting on this post for a few days. don't feel like i'm getting my ideas out coherently but i thought i'd just go ahead and post it.

*****
been thinking about my future quite a bit lately.
not just about what i want to specialize in or what my first car is going to be (i'm thinking something on par with a mini cooper s???). been thinking about marriage, kids, career...

well the marriage & kids part usually requires another consenting female. put that on my need-to-obtain list. the dilemma boils down to all the things that i WANT to do & all the things that i feel i NEED to do.

so what do i NEED to do?

• pay off my ever increasing debt.
  
• get married early enough to have 4 kids without the repercussions and the associated health risks with having kids at an old age.  (yes i said FOUR kids.  and yes, i will find someone agreeable to this! :p)

and my WANTs...

• Canadian Forces. i started looking into the canadian forces in an attempt to find a way into med school. then i started looking at it as a way for me to pay off my tuition in a hurry (there is a decent sized signing bonus). but the more i think about it, i think i WANT to do. for lack of a better word, i think it'd be... cool. ok, i won't lie. i think it'd be pretty cool to fire a live weapon. what can i say? i'm just a little boy at heart. plus you get to see parts of the world you'd never get to see otherwise! i'm not saying i want to be an army guy for the rest of my life. just for a few years.
  
• i also want to do something like MSF for a year or two. ideally it'd be with a organization that has no political or religious agenda.
  
• start the next phase of my life. i want my own family. my own wife, my own kids, my own dog, my own house & my own porsche sitting in the driveway.

as you can see there is no order in my wants and needs. some of the things i want can't go with some of the things i need - how am i possibly going to pay off my tuition when VOLUNTEERING for a group like MSF??? heck, some of the things of the same list aren't even compatible with each other! i don't want to be in somewhere in afghanistan when i have a family with kids!

i think this guy sums up what i'm feeling deep down. (thanks mike for the heads up). hopefully i can look back in 5,10 or even 25 years and think, yes it was worth every night-in. every stress-induced freak out. worth every single sacrifice.

don't know why i feel like my head clock is ticking louder than ever. can't you hear that? it's going TICK! TOCK! TICK!! TOCK!!
i know i'm getting WAY ahead of myself and that i just need to take things step-by-step. my dad used to tell us this all the time...

i stole this photo shamelessly & without permission from my friend julie's facebook profile pic. it translates into something along the lines of... let's be happy. and... do when you do. as in play when you're supposed to play, and work when you're supposed to work. i'm pretty sure i'm supposed to work right now.

10 year moratorium.

yesterday the UQMS (UQ medical society) held an international students seminar/info night. with the increasing number of international students (mostly from canadia) they were kind enough to have some upper years and representatives from the school come and talk to us.

i found it really useful - yet slightly frustrating.
some upper years who recently wrote the USMLEs talked to us about the steps involved in arranging for the exam - which some would argue is a challenge in itself! we also got a timeline for writing the MCCEE (canadian boards) and perhaps even staying here in australia.

the frustrating part is that are there no hard & concrete answers. even the reps from the school of medicine couldn't give us straight answers. everything is fuzzy and all the information/rules are constantly changing. but from my glass-is-half-full perspective, this is what i got from the lecture. there are no guarantees with regards to internship/residency spots in australia, canada or the US. however like the adidas slogan, nothing is impossible. it may not be easy but NOTHING IS IMPOSSIBLE.

i can work with "not easy". heck, getting into med wasn't easy. and from what i've done so far, med school isn't easy. why should getting a job be. right?

*****
i've made up my mind. i'm writing the USMLEs this winter.

*****
when i first came to australia, i had full intentions of returning to canada. however, i was also open to the idea that if i really liked brisbane/australia, or opportunities unavailable in canada came up, or whatever, i would consider perhaps even staying in australia. but after friday's seminar this doesn't seem like such a great option. in australia, there is something called a "10-year moratorium" for people like me. people with a medical degree from australia (or hopefully will have one in 2010) but don't have PR status. this means that in exchange for a internship spot, they can control (to a degree) where you work for the next TEN years! in a nutshell, for 10 years after either obtaining my PR status or becoming a fully licensed physician (whatever comes last), i will be forced to work in an under-serviced region/placement. this general concept is not unusual per se. most places enforce a "return-of-service" or a "moratorium" on international graduates/non-citizens. this is done in an attempt to offset the huge demand for doctors in rural areas. what's unusual or RIDICULOUS is the length. for example, i believe the return-of-service scheme in ontario is only 4 or 5 years or so.

TEN years? i'll be in my mid-30s by that point! gosh that sounds old!!!

weird.

yesterday we got an e-mail from the head of our year telling us that the board would be discussing our exam today and that our exam results would be released by early next week.
this simple little e-mail seem to put me into a bit of stress. subconsciously anyway. this morning i woke up after dreaming that i had just completely bombed the exam. i was glad when i woke up and realized it was just a dream. weird eh? i didn't think too much of it cause the results weren't going to be released until monday at the earliest and i would have at least 3 more sleeps to "undo" that bad dream.

BUT...
after lectures today, to my surprise i found out via a text msg from a friend that the exam results were posted already. i freaked just a little thinking that the dream i had might be real.

the overall pass mark was 58.
the average was 69.
with a standard deviation of 7.
me? just at right about average.
i think i'm content with the mark. not ecstatic cause OBVIOUSLY i can definitely do better. but feeling also slightly relieved because the more i thought about the exam, the more i felt uneasy about it.
but i can be better than average. i know i'm better than average...

*****
ps. i'm leaning toward writing my USMLEs this winter.

pps. kudos to the school of medicine for getting our marks out so quickly.

hit a wall.

got some good study in this week. right up until about friday. between sunday and thursday i was at about 43 hours and on pace for 60+ hours.
then friday hit. i woke up late and i just hit a wall. i managed to get a couple of hours of study in but otherwise spent the day cooling my brain. did some laundry, went out for dinner & ice cream for matt's birthday and hit the sack early.
got back on the horse today though. still got 4 good study days left until the exam. sunday, monday, tuesday, wednesday. 4.

*****
hm... pat should be in the air somewhere over southern ontario by now.

*****
found this in the toronto star this morning. it's an article about plans to make it easier for foreign trained doctors to practice in ontario. sweet. but i'll believe it when it happens. it's quite amazing though... 850,000 people in ontario alone don't have a family doctor. the province is short 2,500 doctors and another 2,600 are over the age of 65+ (& hopefully retiring soon!).

speaking of doctors in ontario... a friend recently told me about some lousy GPs that she has had. and then by coinky-dink, one of my roommates brought up this site where you can rate your doctors. it's called ratemds.com. check it out. i looked for my doctor and dentist but neither of them were there. but i did find some of the doctors that i worked with during my first year elective and they were rated quite well. that's always good to know.

week's total: 52 hours.
alright i'm tired. i'm going to bed. good night.

USMLEs???

to write or not to write. that is the question. 
i've been thinking for the last couple of weeks whether or not i should write the USMLE Step 1 at the end of this year.
i can't seem to make up my mind so i've come up with a list of reasons why i should/should not write them.

why i SHOULD:

• it keeps my options open, I don't want to close the door of going to the States for my internship/residency.
• it would suck if I didn't match with a Canadian residency program & had to wait and reapply the year after that.
• Step 1 primarily consists of material that I will have covered in the first 2 years medical school - that means the material is going to be fresh in my head NOW.  not after i graduate.
• more knowledge is always good.  You can't argue with that.
• if i want to specialize in something, it'll be easier to do so in the States than in Canada.
• there is potential that our cohort is going to be screwed.  there are more and more Canadians that are studying medicine outside of Canada each year.  no one really knows what the matching process is going to be like come 2011.

why i SHOULDN'T:

• the idea of studying in the US even if it's just for a few years does not seem very appetizing.  i'd much rather spend a few years up in Sudbury, Timmins, heck even Thunder Bay! than go down to the states.  or would i?
• lack of time/memory space.  there is plenty of work to do as it is.  Do I really want more?  sure i can better manage my time but what about the brain space?  how do i get more of that???
• i haven't decided what kind of doctor i want to be, but GP is still very high up on my list.  things might change but from my current understanding, it is not and won't be impossible to match into a GP program.
• worse case scenario might be that I don't match & need to take a year off to reapply.  i could study for my USMLEs at that point.  in the big picture, would that be so bad?
• perhaps the biggest question of all - and no one really knows the answer to this one.  if you do, then you are a god in my eyes - is will I NEED it???  i don't want to study and sweat for something that I'm not going to use.  it's not like buying an extra loaf of bread because you're not sure how much bread you're going to consume over the week.  that's easy.  just buy an extra loaf, you could freeze it before it goes bad.  worse case scenario, it grows some mold, you throw it out and your down $2.49.  big whoop.  

some help please???

tough choice

it's not like i have to decide tomorrow.
but i think i've narrowed it down to 3 possibilities.
1. GP
2. emergency med
3. paeds
probably in that order.
pretty random i know. meh.

still in transit

after 28+ hours, i am still in transit.
i will save you the details for another time but i am stitting in the airport at sydney waiting for my connecting flight to brisbane. (i missed my scheduled connection!!!)

after all that time at 36,000 feet, the weight of my choices are starting to finally dawn on me. when will i see everyone again? what am i going to eat tonight? what if my roommates are smelly and dirty? did i pack my sunscreen?

oh! they're calling my flight! gotta run. will put up some pictures when i get a chance!