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Hey Guy’s I know I haven’t provided many useful things to this site over the last 6 months at least, but time has kind of gotten away from me. Tomorrow I have an exam testing all of the knowledge that I have so far gained in Medicine, which is fine by me as long as they don’t ask stupidly detailed questions that current medical practitioners can’t answer. Well anyway this is just a short spill, I’m going to write more opinionated posts about the course and other things as they come to mind. I’d just like to wish people good luck with both exams past, present and future. Hopefully you get the questions that you are looking for.

listen past the beginning… awesome

Big Ideas (don’t get any) from James Houston on Vimeo.

Kudos to my good friend Michael Vasimalla who inspired me to write this, based on this comment:

Dr Corinne Van Heuvel (in a lecture): What do you think this is?

At this point, Michael decided, based on the shape, that this slide showed a picture of an inflammed brain. Just before he answered, Dr Van Heuvel decided that this specimen was not easy to identify, and gave an appropriate hint:

Dr Corinne Van Heuvel: Here’s a hint, girls don’t have these…

Michael Vasimalla: (following on from his train of thought) Brain…

The specimen, of course, was an enlarged prostate gland.

This will take on a slightly more (but only very slightly) serious tone to my last post. Resource is not assessable per se by the lecturers and helpers in the session but rather as an exam, which does matter significantly more than the PBL assessment because if you fail this, then good luck trying to convince the MLTU that you have compassionate reasons to sit a supplementary exam. Okay. Shall we begin?

How to get the most out of any given resource session:

1. Given that you have a one and a half hour session, go to all three hours of that one and a half hour session. Yes, you heard me right. If you don’t understand what I mean, go and figure out what this means before proceeding.

2. Tables have more than one side. Learning to read upside down is a skill easily learned, and sessions are usually cramped, because of recommendation #1. Being tall is another good option but it’s not one that I’ve been able to use.

3. If you ever get Professor Mounir Ghabriel, bring a pen and a notepad and seek him out. If you are successful, this will result in a very intricate study resource on your notepad. This you can sell on eBay for a profit, but it is usually used either to pass exams or as a dowry for a very attractive, kind, caring husband.

4. On the other hand, if you don’t want to get drilled, don’t ever ask Dr. Jaliya “What is this?” The standard response is “You tell me what you think it is.” Approach someone else. Like Melvin if he is there. However, bear in mind that it is good to be drilled if you actually know what the things are because then you can consolidate your information. However, in such cases, there isn’t really much point in asking Jaliya the aforementioned question without looking like a tool. Get someone else to ask Jaliya, and then all will be revealed.

5. Your coursemates are a good and reliable source of information. Without making it too obvious that you are leeching information off them, it is possible to leech vast amounts of information off them. Simply ask to “test” them on what the flags are on a particular pinned and flagged specimen without . If they refuse, don’t push it - because they won’t know what stuff is, so you won’t be able to learn. However, if they do name the flags, good, you now know what the flags are, so that when someone comes and asks you what the flags are, you can tell them, and then they can take your place.

6. CT scans and cross sections are things you will need to visualise in three-dee. Imagine the person in the cross section is standing up. Now, that’s the wrong orientation. Right is left, left is right, up is down, and down is up. And everything you know is wrong. Therefore, anything you write is wrong. Therefore you will fail resource. Quod Erat Demonstrandum. Unless of course, you have your orientation right. In which case, none of that has to happen. You should be able to name every big vessel or organ in the cross sections and every chamber. If you can’t, see Technique number five.

7. Approach to pathology pots: You need to be able to describe these as if you were showing your “extensive knowledge base” (see PBL 101). In other words, you need very little knowledge base. You do however need to be able to:
orient the specimen (this is a transverse section)
identify the specimen (this is a lung. inside joke.)
pick out things which are obviously not supposed to be there (there is a lesion right here)
describe what you see (this surprisingly takes close to no knowledge at all: this lesion is on the lateral surface of the specimen. It is bordered by connective scar tissue)
describe what you think happened to cause what you saw (I think the lesion was caused by an invading pathogen, which resulted in an inflammatory response in which macrophages and neutrophils infiltrated the area and phagocytosed damaged and infected tissue which resulted in the formation of an exudate which probably filled the lesion. Connective tissue then formed around the lesion as part of the healing process resulting in the visible scar tissue.) This is the hardest part, significantly. Fortunately, it’s also worth the same as the description usually. Fortunately, there are only so many specimens they can test you on, and usually it will be very obvious what it is, at least, in first year. You should be able to do this out of resource anyway in the pathology pot room. Go up there with a friend and describe to them the pathology you see in one pot and switch. Keep doing this until you can pull random descriptions out of your backside. Once you can, you will need to have a DRE to make sure there aren’t any residual descriptions, because they can cause rectal haemorrhage, which is not a very nice pathology to have.

8. Approach to histological slides that you don’t yet know or have never seen: Purple is acid (importantly, DNA or RNA, the A stands for Acid), pink is base (importantly, proteins, because polypeptide chains have lots of N termini which accept H+), and white is lipid or empty space. Red is usually Hb which is usually in erythrocytes which can be found in capillaries in most histological slides. Got that? Good. Because it’s not enough by any standards. Other very simple stuff that might make you pass:
Layers on the outside or inside of something = epithelium. You probably should remember the different types of epithelium - simple (one layer) vs. stratified (many layers) vs. pseudostratified (kind of layered), columnar (tall) vs cuboidal (about the same width as length) vs squamous (flat). Any combination of the first three and the last three should cover almost everything in terms of identification of epithelia. Also, structure begets function. Why this type of epithelium here?
Infiltration of neutrophils usually means inflammation. What happened to cause the inflammation? And what do you think the neutrophils are doing? (the answer to the second question is usually “phagocytosis”.) You will see this in many histological slides throughout the year.

9. Name (often) begets attachment or location or shape or function or some other quality of the structure. Especially for muscles. Muscles are often named by what they attach to (sternocleidomastoid), what they do (adductor magnus) or where they are (supraspinatus) or some combination of the above (flexor digitorum profundus). And sometimes they have some other quality (semimembranosus) and sometimes the anatomist wanted to be really annoying by not making it easy to remember, in which case, too bad (sartorius). Fortunately, muscles tend not to be named after people. Other structures do. Ask yourself whether it is so efficient to learn those names. If not, move on.

10. Gravitate towards any lecturer which is having a discussion with students. This is usually due to someone else using technique number 3 (wise), the opposite of technique number 4 (not so wise), or the equivalent. Either way, there is much to be learnt. Jaliya or Ghabriel seem to be the most knowledgable regarding anatomy while Dr Van Heuvel is always approachable about path pots without a resulting long boring conversation.

What actually happens in the resource exam:
You’ll have to come in either just before or too early for your exam (based on the fact that there isn’t enough room and there needs to be more) and be placed in a waiting room (room being the Florey Lecture Theatre) prior to your exam. From there you will be led either downstairs to the sterile white hell or upstairs to level four, where you will sit down and panic. Don’t panic. Sit at a station (preferably the hardest one you can see) and write your student number on the paper at the station. You will be given about six minutes at each station to answer the questions at that particular station once the exam starts (the starting station is the one you will spend the most time on and therefore you should sit at the hardest one first). Once that is done, you will move on to the next station and answer the next set of relevant (or not so relevant) questions in your exam paper. After all stations are completed, you will find yourself magically teleported back to where you started from to spend another six minutes reviewing the exam paper (and catching up on the hardest question, which is why you should sit at the hardest station you can see to start.) Save here. You will then be lead to the other place (either the sterile white hell or level four, whichever one you didn’t go to) to repeat the exercise - again, sit at whichever one seems to be the hardest station.
N.B. The hardest upstairs question will usually be the one that has the least stimuli, while the hardest downstairs question will usually be the one with the most pins.

11. Find a good group of friends and study resource out of resource - this of course depends very much on the way that you learn best. For some, myself included, this is the most invaluable thing. For others, this will be a massive waste of time except that you will get to spend some quality time with your friends.

12. Melvin does private tutes. For free, provided that you are his friend Given that, I’m pretty sure he isn’t the only one that does. In fact anyone who has made it to clinical years is bound to have some residual knowledge they can impart. Even (and especially) your p2p tutors.

13. If all else fails, and even if it doesn’t, go and read through the SMSUA student papers (available for $30 or less from your SMSUA rep). Learn what the answers meant (given that they were given an S.) It’s last resort resource; this should be saved to a time close to exams, like about now.

Hope to see you all in resource soon without notes.

Hello and welcome back to Mana’s series of blogposts on how to do well in parts of medical school with the least work possible. I’m Mana, and today we will be learning how to pass Communicology with literally 400% activity and literally 1% effort. Communicology provides a Handy How to Fail guide, so I guess I had to rectify the situation.

Last year, I found a loophole in the Communicology system which to date has not been fixed. Naturally, I used it. The loophole is that Activity and Time are related to time spent logged in, not time spent actually typing or listening to Lucy and Max explaining things. Basically, the more time you spend logged in, the higher your time will be under the myActivity tab up the top. So, naturally, I logged in and left it logged in. Then I went to uni, came back, had dinner, took a bit of a nap, and then went back on my computer and logged out. Result: under “Time” - 400%. Automatically turns the icon green meaning (according to the description given by them) “You almost certainly have engaged well with this module. Now, if that page i had left it logged in on was the “Notes” page, guess what? Activity was also 400%. Regardless of the fact that for several hours I had not even been at my computer. Simply do this for each module and your activity and time spent will skyrocket. Hence, 400% activity, 1% effort.

Sadly, this does precious little for the notes and for “completing” activities in Communicology. No biggie. I’ve been asked by a few people already how to actually answer the things in communicology. As I like to teach by example, I will do some questions out of various modules of communicology. The “Notes words” number under the myActivity tab is based on the number of words you have in the boxes. Aim for exactly the limit of words they set. The first one, Safety, seems pretty straightforward:

1. Where might a health-care worker be at risk from patients or clients?… (Limit: 100 words)
Sample answer (Note there are lots of words but I actually say precious little):

A health care worker is always at risk from patients or clients, especially those they interact with on a regular basis. Whether in the hospital or at home out of work hours the health care worker could potentially be harmed.
(Good, two sentences that don’t say anything = 40 words.)
Whether through infection either through infectious patients or through poor hygiene practice by other staff members or the ever present threat of bodily harm from psychotic, emotionally stressed, or otherwise unsatisfied patients, it is important that the health care worker is fully aware of this threat at all times and takes measures to ensure the wellbeing of his or herself.
(Good, another one sentence that says very little = the other 60 words.)

Take note that nowhere in this sample answer do I impinge on what I might say in a following question. In fact, I could compress that entire thing into:
Everywhere, from infection, psychosis, emotions and unsatisfied patients. (= 8 words.)

Okay. So, how about the questions that follow an activity? Lets go to the Seven Seconds module for such an example question:

2. Observations - what events I noticed in the animation… (100 words)

Before answering this question, I think I might point out that this is the dominant question type in Communicology. A statement. No biggie, just imagine it’s the title for a nice long paragraph you are about to write about nothing.
Sample answer:
I observed at the beginning of the animation a character, possibly male and of low socioeconomic background, sitting on a structure, possibly a bench from a park. This character is holding what appears to be a bottle which one could infer contained a drink of sorts, and there are things identifiable as flies or other winged insects in the air nearby to this character. This character then consumes the brown fluid from the bottle such that it is empty. The character is then seen on the structure once again, clutching an apparently full bottle. The character’s lips then ripple inaudibly. (100 words)

Okay. So now what i’ve basically said using 100 words, is what i could have said in 8 (again) words:
I saw a bum on a bench drinking alcohol.

Learn how to do this. Once you can, repeat for every single activity or notes module in communicology, and you should be well on your way to getting that 400% activity, time and notes in your myActivity section. Which is all that matters in communicology anyway. I mean, the myDiary isn’t even required. I had a grand total of zero words in my myDiary last year and passed.

Join me next time when I write about how to pass resource without printing any handouts. Ever.

This is bound to be controversial because regardless of what I write here, someone is going to disagree and with very good reason. Oh well, so be it. I guess I could also write this as “How to be a complete jerk in PBL and still have the tutor like you.” In fact I take no responsibility whatsoever for the contents of this post, though I did come up with it, and I did type it. For any staff members out there that might want to fail me: This is a joke. Obviously. Take it at face value, I’m a very stressed medical student with a bit of a sadistic sense of humour and please don’t fail me thanks.

Last year I managed to survive through PBL with a lot of study. This does work, but I think this year I’ve found a much easier way to do PBL, such that my tutor thinks I have reached “above expected competency” when I really haven’t done that much. In fact, I have brought no notes whatsoever to PBL this year, a habit continued from semester two of last year. Apologies in advance to my PBL buddies, who I am sure have borne the brunt of this. More this year.

This is how - I’ve split this into two sections, the first being how to show you are competent without having the necessary knowledge base, and secondly, how to not contribute without making it completely apparent that you do not have the knowledge base:

How to show your competency:

1. Speak up. Nothing says “partially demonstrated” (i.e. fail) like a person who just sits in PBL and stares at their notes (if they have them). Even if it’s just asking the person who is speaking about something they just said, which requires close to no knowledge base at all on your part, and yet gets the tutor noticing that you are “analysing the information” given to you = gold star.

2. Know the PBL process. Lucky for me, this got drilled into me last year. I am under the impression that everyone has access to a PBL handbook available on the MLTU. Make sure your group sticks to this somewhat - one of the things i’m really specific about in PBL is the difference between a hypothesis and a significance (you know, in that table that has “data points -> significance -> hypotheses) - basically, if something “could” be (as opposed to “definitely is”) something, it’s a hypothesis. A significance is the reason why you are putting the data point on the board in the first place. Any questions/investigations from then on in should test a hypothesis.

Again, minimal knowledge base - yet, you can get up and be the board scribe more often (often = brownie points) and sometimes direct the group too. It’s also really difficult to be the board scribe and not look like you are interacting. Interaction is good.

3. Be picky. This is yet another reason to talk, it’s also good evidence of “good comprehension” and “good reasoning” even if it isn’t really as relevant as you might think. Stuff like missed relevant information or very unlikely hypotheses are things you can be really picky about. Systemic lupus erythematosus is very rare. It’s even rarer in men. On the other hand, it can cause a vast array of symptoms. Never miss an opportunity to give a random differential that something could be. Like lupus. Pain? Lupus. Fever? Lupus. Or it could just be influenza.

How to hide your incompetency:

4. Bring food. And be the first to open it in a moment of awkward (read: everyone is stumped or doesn’t know what to say) silence. This almost certainly guarantees that you will not have to be the next person to talk, because you have food and you are about to put it in your mouth, and it’s rude to talk with food in your mouth. This can work very well if it is something you can share too, because then you can offer it to someone else and they won’t have to talk either. Or, brownie points if you offer it to your tutor.

5. Take toilet breaks. I usually go once in that two hour session of PBL. Never twice unless you have an inflammatory bowel disease (which I suspect I do but knowing me, I probably don’t, because I also suspected that I had ADD and depression and angina and diabetes mellitus at some point too. Who knows, maybe I have lupus?) Take these opportunistically. Especially when someone has started on a mechanism on the board which you know nothing about. (If you do know something about it, take the opportunity to contribute and show the tutor that you have the knowledge base that you don’t necessarily have.) The mechanism will be done by the time you come back. Usually.

6. Make sure you get your fair share of paper scribing. If you are a guy and have artistic legible flowing handwriting, or, if you are a girl, all the better for the group, because then the notes will actually be readable. Even better if you can spell hepaticocholangiocholecystenterostomy when it’s been written on the board as hepat——–c——–omy (usually by a male board scribe writing fast). It means a whole session of just copying down what is on the board, which requires no thinking and no knowledge base. Never do this in consecutive sessions without a reason (yes, I have actually found a “reason” to do this which did work and was logical).

7. Shoot people down with a bit of reasoning. This requires a bit of knowledge actually, but done well, it can make you seem like you know a lot more. Like: “hmmm, I think it’s not lupus…! This is supposed to be, like a respiratory case? Plus the patient is a man in his late 50’s…”
close to no knowledge whatsoever except that which you have off the sheet and the common sense that what you are doing in lectures is *probably* related somehow.
N.B. Be nice though. “Good differential though I guess, lupus, though unlikely, could present like this. Where do you know this stuff from?”

I hope you never actually need to do this to do well in PBL. You should actually do work and learn stuff for exams. But, if the MLTU gives us lemons, we can grow a lemon plantation and make batteries to power electric typewriters for monkeys, and given enough typewriters and enough monkeys, we can come up to the answer to everything, which has to be worth at least an Non Graded Pass for PBL.