What I'm up to now: the Common Rounds

It's been a while since I last sent my last post.
At this point in time I'm now a second year medical student. At the end of this year I'll be half way through my degree. How exciting.

Something new:
Some friends and I have worked on creating a podcast show for medical students. We provide medical educational podcast content covering different organ systems. Eventually we'll expand into having interviews with doctors talking about their training program. We'll also look into the possibility of accommodating to premed students who want to get into the course.

So if you have 30mins to spare, come listen to us and join us at the Common Rounds

Med Revue

Ever since orientation, I made up my mind that I wanted to be in the MedRevue. I wanted an acting role, and singing too! I wanted to shine like a star and be under the spot light. But when the time came for the audition, I was terrified.

The weeks leading up to the audition were oscillating feeling between confidence and regret, regretting that I put my name down to audition! I prepared an excerpt from How I met your Mother (Marshal Erikson’s burger speech), and the song Hallelujah. I sang and rehearsed in every night in the shower, until the big day came.

That Thursday afternoon, I sat in the auditorium with 20 other students ready to audition. I listed to audition after audition and I was deeply impressed with each student. They were all so talented! I heard my name being called and I walked to the front. I took a deep breath and let my practice do the rest of the work.

Passed my first med school exam

The end of first semester exam happened a few weeks ago over the span of two day on June 19 and 20th. We had 6 days off before the exam to learn 17 weeks of content. I was not used to such a tight schedule as in undergrad, we had at least 7 days at least PLUS any additional days before your scheduled exam time. To make matters worse, at ANU they only teach you one subject, so all the clinical content, med science content, population health content etc are crammed into one exam.

Due to this structure, some of my previous exam preparation strategies were not applicable, and the stress levels were high. By day 3, I could not stand studying anymore. Every slide I read just showed me information I didn't know. It wasn't until I compromised to just understand as much as I could, did I then find the motivation to sit back at the desk. By then, it was day 5...

When the exam came, I was apathetic and just went in to get it over and done with. I sat down at my table, got my pen ready, and started scribbling away once the clock struck 9:00am.

****

Today I got my results back. I heard rumors that they could be released tomorrow, but unexpectedly I got them in an email today. I wouldn't say I was dreading my results, but I was certain that the scores would be average at best.

When I read the email, I was surprised. Surely they got my exam mixed up with another person, because I did pretty well. With a class average of 68, I got 81. Huh... I was just 1 mark short of getting a high level pass.

I'm over the moon, but also feel that I don't deserve the score. Don't get me wrong, I'm deeply grateful for the marks, but how on earth did I get such a score when I just felt like I winged the exam? Maybe it's because I feel that my score doesn't reflect the amount of hard work I placed into it. Either way, I'm going to work even harder this semester to get a score I can proudly say that I earnt.

Note:

I realise this article may sound like a silent brag, and maybe it is :D

Good day!

Examining my grandfather

I was raised by my grandfather since I was a young child. He fed me, played with me and even changed my diapers. I was his joy and we were inseparable. Lately since highschool I’ve been studying in Australia, and he lived in Taiwan. We hardly get a chance to see each other. During the 2014 mid semester break in July, I’ve decided to fly back to Taiwan for the week and spend some time with my beloved grandfather.

The time I forgot I was a med student.

Since med school began in February, I have settled myself into a daily routine. I would wake up, go to class, come home, eat and study. Everyday I would see the same group of people, every hour of class would be packed full of new information, and every night I would try to decode the information and integrate it into my brain.

As you can tell dear reader, as a med student you are immersed in the culture of medicine and at times it can feels like it's become your life.

"Attention passengers, we need a doctor on board."

During my one week break from uni, I was on my way to a family reunion overseas. While flying from Sydney to Hong Kong, I heard the PA announce that a doctor or nurse was needed to help with a situation. Immediately I wanted to go up and help, but I also doubted my own abilities as I'm just a first year medical student that hardly learnt any pathologies/treatments.  I recalled the PBL session regarding medical attention on the plane and recalled a 'fact' that there is statistically a doctor on every plane and I thought I'd better leave it up to the doctor.

While I was battling between my urges, two pages have gone by. After the third page, I summed up the courage and told the staff that I am a medical student/pharmacist and I would like to help. I made sure I clarified that I was a first year medical student and was not capable of diagnosis or prescribing treatment.

Enjoying my holiday!

I went into med school expecting to be overloaded with school work and things to learn. However I was still surprised to see only 3 one week holiday breaks scheduled on our timetable for the entire year.

No more one and a half month July holidays. Now each week is more precious than ever!

Quick! Rest and play as much as you can. School is starting again next week.

Good morning block 2

In the blink of an eye half an year has passed and I've already sat my first end of semester med school exams. After a 2 day break (ie the weekend) teaching for block 2 (- cardiovascular) is about to begin.

BRING IT ON!

2014 GAMSAT result release!

Congratulations to all those who sat the GAMSAT this year!

Hope you all were happy with your results this year. Best of luck to those who will be applying for med school this year!

For those who weren't satisfied, rest well and sharpen up for the next try!

First med school exam! My initial med school experience!

I had my first med school exam today. It is definitely a funny feeling to go to the exam feeling like you are going to fail, and then come out of the test feeling fine!

It has already been 6 weeks since med school started, and although I knew med school wasn't going to be easy, the amount of content they cram into the lecture is takes a little to get used to. 

So far, the first six weeks of 1st year med school has been the 'foundation' block. This block focuses on getting non-science background students up to scratch with medical science content. So for the past 6 weeks we've been taught intensely on:

• Anatomy
• Microbiology
• Cell biology
• Histology
• Physiology
• Social Foundations of Medicine

My General Registration has finally arrived

I’ve finally received my General Registration as a pharmacist today. I lodged my application since November 8th, it finally arrived on December 31st.

During these 9 weeks, I’ve gone through excitement, annoyance, frustration ,out rage and indifference. I’ve called AHPRA at least 10 times, and by the end I’ve come to accept the thought that ‘it’s not going to happen any time soon’.

It wasn’t until my friend texted me that I realise the registration came through. Too bad that it had to come through the day after my last shift. I guess I'll get to experience being a full pharmacist at my next job.

Oh well, now it’s time to look for a job next year! It’s really scary… hope it all goes well!

Happy New Year People!

Waiting for general registration

Back in November 6th I've submitted my registration paperworks to AHPRA (Australian Health Practitioner Registration Agency) to change my registration from a provisional pharmacist to a general pharmacist.

Their website indicates that the process from provisional to general takes up to 10 days, but can also be between 4-6 weeks.

It has now been 6 weeks and I'm still waiting for news. I must admit that this has driven me crazy, especially when I see my friends obtain their general registration even though they submitted their application later than I did.

Oh well, I've called them up at lease 10 times over the last month or so. I don't think there is any more I can do. I think this is a test of my patience, and I am failing miserably.

Probably the moment I stop caring and checking my application progress, they'll give me the good news.

FORXIGA - Completely new class of diabetes medicine

AstraZeneca are releasing a new drug called Forxiga (for-zee-ga) or dapagliflozin (da-pa-glee-flo-sin). It is marketed as a medicine to treat type 2 diabetes. The difference that sets this medicine apart from current diabetes medicines is that it it's mechanism is insulin-independent.

While current diabetes medicines either augment insulin production, increase insulin sensitivity or supplement insulin directly into the body, this completely new class of diabetes medicine does not rely on the insulin pathway.

How it works:

Dapagliflozin works in the kidneys. It stops glucose from being re-absorbed and thus increasing glucose elimination. In short, it makes your urine sweet.

MOA of Forxiga

Side effects:

1. As the glucose content of the urine increases, so does the patient's chances of getting a UTI. Patient's are likely to get UTIs or other infections within 1 week of treatment. However studies showed that 1 course of appropriate treatment successfully eliminate the infection without future recurrence. However, be cautious in patients already having recurring UTIs.
2. Dapagliflozin's effect is completely renally dependant. Monitor renal function and be careful in patients with CrCl less than 60ml/min.
3. It can cause weight loss. Although unproven, the theory is that it increases sodium excretion that leads to accompanied loss of water.
   

Role in therapy: 

Dapagliflozin is designed to be used in combination with
current diabetes medicines. However not recommended with pioglitazone. 

Dosage:

10mg tablet once daily. No dose adjustments required for any demographic. One dose fits all.

When will it come out?

December 1st 2013. It will be on the PBS, but will require an Authority.

Personal comment:

Exciting and novel mechanism to treat diabetes. This opens up a new option for patients that have problems with their insulin. I'm looking forward to seeing it in practice.

I got into med school!

After peeping at my phone throughout work the whole day I finally received the email I was waiting for!

ANU has offered me a CSP position. 

I am so happy and grateful of the outcome. Just like Oscar winners I want to thank everybody that has helped me through this journey! My friends and family that cheered me along the way, my boss who allowed me to take time off for the interview, my girlfriend who prepared me every step of the way etc.

Now that I'm here, it is officially time to look for next year's accommodations! Bye bye Brisbane, and hello Canberra!

Waiting for news

Apparently today is the day med offers are being released.

According to Catherine from GEMSAS, all rejection emails have been sent out.

As I sit here email-less, I think it means good news.

Oh lunch break.

Ah! I see an email!... and it's a false alarm.

Transition from provisional to general registration

So far I am at the stage of transitioning from my provisional pharmacist registration to general registration.

Requirements to become a pharmacists are as follows:

• Complete an Intern Training Portfolio (from either Guild, PSA or UQ)
• Pass the Intern Written Exam
• Pass the Intern Oral exam 
• Complete 1824 hours of supervised practice.

I have already completed the first two requirements. I'll find out my oral exam results on the 4th Nov and my 1824 hours should tick on the 7th of November. 

According to the Australian Health Practitioner Regulation Agency (AHPRA), I could apply for general registration now because my provisional license is expiring at the end of November and I am expected to finish all requirements within the next 60 days. 

So I followed the online form and paid $477 ($160 application fee and $317 registration fee) to get my general registration. Once I paid for the application, I was sent a check list of supporting documents to send the registration agency to complete the paperwork. I have 60 days to lodge my supporting documents. If all goes well, I'll be sending them on their way on the 11th of November once I've completed all four criteria and got my paperwork certified. 

5 days left!

Assuming the medicine offers to be released on Nov 1st, there is only 5 days left!

My self-confidence has been constantly fluctuating for the past few weeks. Oscillating between 'I did awesome' to 'Something must have gone wrong'. In other words, I'd like to think that I'd definitely get in but another part of my self is telling me that I am being too cocky. **Stupid brain, pick a side and stay that way!!**

At this stage I have finished all necessary assessments, so I have some extra time to myself. It is really tempting to look up potential rental options for next year, but both my girlfriend and my other conscience would slap me on the wrist and tell me 'it's too early to look!'

WELL... it's only 5 days left!

Kenacomb vs Otodex

When treating ear infections, doctors commonly prescribe either kenacomb or otodex.

Recently there has been a shortage of otodex from suppliers, I have been told it won't be back until December. Today I have had to make phone calls to local doctors to ask them to substitute their otodex scripts to kenacomb.

What is the difference between the two products?

Both products are corticosteroids with anti-infective ingredients, and are both indicated to treat otitis externa.

The difference lies between the ingredients.

Kenacomb:

• Corticosteroid: Triamcinolone 0.1%
• Antibiotic: Neomycin 0.25%
• Antibiotic: Gramicidin 0.025%
• Anti-fungal: Nystatin 100 000 units/mL

     Dose: 3 drops 2-3 times a day.


Otodex:

• Corticosteroid: Dexamethasone 0.05%
• Antibiotic: Framycetin 0.5% 
• Antibiotic: Gramicidin 0.005%

     Dose: 3 drops 3-4 times a day

Voi la, similar but different. Confusing to remember either way.

Wind pain

Part of my job is to help patient's with their medical problems. I am to help identify minor ailments and provide appropriate treatment. This saves GPs from needing to deal with simple headaches, sprains, diarrhoea, constipation cases.

Today a lady approached me and told me she had 'wind pain'. What the hell is wind pain? When I asked her what the symptoms felt like, she told me she doesn't have diarrhoea, constipation but just stomach aches from gas buildup. I guess she meant she felt bloated. I could not identify what was causing this, and she told me the pain was severe and debilitating. She has tried products such as buscopan and degas, with no success. Well... there goes the products I would have recommended. I suggested for her to take general pain killers for the time being and book an appointment with a doctor to further investigate the issue.

When the patient was on her way I thought to myself "Gees... wind pain, where on earth did she come by such a term?"

30 mins before my oral

This is the last assessment for the year!
In 3 hours I will be done!