UTAS Medicine

Hey everyone.

I know when I started thinking about medicine, one thing that kept my interest, motivation and excitement going was textbooks.

Okay, I know, lame huh! But they are so good in the medical sciences because there is only so much you can absorb from lectures. So much of the learning in most of the medical schools in Australia is self-directed, and you’ve got to get the information from somewhere. So you use textbooks, which are designed to teach you, to help you, to comfort and encourage your learning pursuits!

Okay enough Hayden.

Textbooks for first semester were:

Prescribed:
Anatomy and Physiology, Seeley et al.
Histology and Cell Biology: An Introduction to Pathology, Kierszenbaum et al.
choice of
Rubin’s Pathology: Clinicopathologic Foundations of Medicine, Rubin et al.,
or,
Robbins and Cotran’s Pathologic Basis of Disease, Kumar et al. (I chose Robbins, who has become my learning god).
Pocket Atlas of Histology, Cytology and Microscopic Anatomy,Khunel et al.

Recommended:
Communication Skills for Medicine, Lloyed et al.
Skills for Communicating with Patients, Silverman et al.
and some others based on the Australian healthcare system.

Textbooks for next semester are:

Prescribed:
Gray’s Anatomy for Students, Drake et al.
Imaging Atlas of Human Anatomy, Weir et al.
Essential Anatomy Dissector, following Grant’s method, Hanson et al.
Clinical Examination, Talley & O’Connor.
Medical Microbiology, Murray et al.
Colour Atlas of Pathology, Riede et al.
Ethics and Law for the Health Professionals, Kerridge et al.
and one of the following anatomy atlases:
1. Atlas of Human Anatomy, Netter et al.
2. Grant’s Atlas of Anatomy, Agur et al.
3. Colour Atlas of Anatomy: A Photographic Study of the Human Body, Rohen et al.
4. Colour Atlas of Human Anatomy, McMinn et al.
Plus all Semester 1 texts.

Recommended:
Pharmacology for Health Professionals, Bryant et al.
Pharmacology, Rang et al.
Promoting Health: A Primary Health Care Approach, Talbot et al.
Evidence-Based Medicine: How to Practice and Teach EBM, Straus et al.

So as you can see, with each textbook averaging one hundred dollars plus, you have to take out a small housing loan to be able afford to study medicine.

The good news is, it gets better. Being such an integrated course, we essentially learn every medical science subject at once, necessitating a wide range of resources very early on. So, once first year is over, you already have the bulk of the textbooks you need. First Semester Year 2 just requires a couple of extra Cardiovascular and Respiratory textbooks (plus the Pharmacology ones if you hadn’t already acquired them); Second Semester Year 2 needs a couple of texts on Renal physiology and the digestive system; and First Semester Year 3 focuses on neuroscience, so a text on the nervous system will be needed.

After that, it’s pretty clear sailing, save for perhaps something like Harrison’s Principles of Internal Medicine or Davidson’s Principles and Practice of Medicine, and anything else that I don’t know about or don’t have enough information with which to make an educated guess.

If you’re really interested in the list I set out above, I suggest you jump over to www.amazon.com and check out some pictures and reviews. Some of the texts let you look at a few pages inside online, if you’re so inclined. Just remember, the prices are in US dollars, so don’t get too excited.

Have a great night everyone.

Hey all.

So I had my last exam on Thursday. I’ll quickly go through what each exam was like.

Theme 2-4 was nicely straightforward. Two hours, about 5 questions sections with three or four short-answer questions in each. It was a good exam to show what we know. The questions were fairly broad, but you could work out which theme you were supposed to focus on and answer accordingly. They were all case-based, where a description of a patient, the context of their meeting to you, and problems encountered, were all given before the questions were asked, so you needed to get that information in you head, and give your answer in the context of the cases. There was really only one question where we needed to know specificinformation, and that was to list Australia’s public health priorities and explain which one was relevant to the previous case question. The rest were really more opportunities to demonstrate our proficiency, rather than the facts we know.

Because of this, it’s a bit hard to judge how you went, but I know that my answers weren’t bad, so it’s just a question of how nice the examiners want to be

The practical Theme 1 exam was a bit of a mixed bag. I came out of it feeling very good, but a lot of other people said they had no clue about at least half of it. We didn’t know, going in to it, what proportions of questions would be based on what subject, but it ended up being half histology, half pathology.

Because it was a spot exam, we had two minutes on each station, and when the alarm went, we changed stations. There were 24 stations with two questions on each, and I started on number 13, which was the beginning of the pathology ones, which happened to be more difficult than the histology. Most of the stations were microscopes with slides in them, and the question was usually “What pathological process does this tissue feature?” and “Name three cells that would be present in this process”. So the tissue might feature (chronic) granulomatous inflammation, and three of the cells would be epithelioid histiocytes, lymphocytes and plasma cells.

I know, thinking back to it, that there are a few questions I got wrong, but there were many that I was sure I got right, and I put down something pretty reasonable for everything. So I’m pretty sure I got through it okay.

The final exam, on Thursday, was the OSCE (Objective, Structured, Clinical Examination). This was supposed to be very straightforward. But oh dear, what a nightmare.

We were given our marking sheet in advance, a few weeks ago. We had to enter a room with a patient inside, introduce ourselves, explain our role, obtain consent, confirm their name, make them feel comfortable, let them explain their problem, close the interview, and leave. Pretty straightforward, right?

Well, mine was a nightmare. I went in the room, and went through my paces, said hello, obtained consent, did all that other stuff, pretty quickly but that’s okay, and closed by asking the patient if she had any questions for me, she said no, so I said okay we’ll stop there. The examiner then asked “Hayden are you sure you don’t want to ask anything else? Anything at all?” and I was thrown, I froze, I sat there for thirty seconds and said I’ve drawn a blank, so she said “How will you close this interview?” and I thought I had, so I just repeated myself again. And again. Oh dear. The poor patient must have thought I’d gone crazy.

Thankfully the examiner said “Okay Hayden, thank you” and I could leave, but I was devastated when I left, because I thought I was good at this communication stuff (Theme 2). Little did I know how much pressure could affect me! I’m definitely going to have to work on it more before the next OSCE. Thank GOODNESS, this exam didn’t need to be passed, so long as I did well enough on my other ones to make up for it.

To those just finishing exams, congratulations, and to those preparing for the UMAT, good luck, work hard, it will pay off. Leave a comment! Talk to you later

Hi all, just a quick one to tell you how todays Theme 1 exam went.

I think the exam was fair, there was a lot more pathology than I would have expected, and a lot of the questions weren’t straight out, we had to discern what would “most likely” have been present in a chronic leg ulcer of a diabetic patient. You would have to know that it is most likely coagulative necrosis due to ischemia (because of the patient’s diabetes) and be pretty sure that you’re right, and then write a whole lot about describing it. A fair bit of the exam was like that; about a third of it was multiple-choice questions (which started out very very difficult but got easier), and the final third was normal “what is the chemical structure of dietary fibre”, “compare and contrast the histology of cilia and microvilli”.

I felt pretty confident when I finished, but a lot of other students looked pretty pale and left very quickly afterwards, so maybe I overestimated how it went… oh well. On to the next one!

Hi all,

Just a quick update. I’ve started SWOTVAC study, focussing on neoplasia first because that’s my rustiest topic.

The exams are as follows:

Theme 1: 2 hours, 11th June
Themes 2-4: 2 hours, 15th June
Theme 1 Practical: 30mins, 19th June
Objective Structured Clinical Examination: 5mins, 21st June

I have no idea how they’re going to fit all the material we have covered in Theme 1 into a two-hour exam. Either it’s going to be impossible to finish or they’re severely truncating it which makes me tempted to skip a few topics in my study (DANGEROUS). The OSCE is pretty interesting, it shouldn’t be too difficult this semester, we just have to successfully open an interview and establish a rapport with a patient, and in doing so, get the examiner to tick off certain criteria boxes. Pretty straightforward, but it is easy to stuff up if you’re nervous so we’ll see how it goes.

A few weeks ago we had a Clinical Skills Night.

We rocked up to the hospital and signed up for a range of activities to practice: venepuncture, wound care, intubation and suturing. I did everything except intubation (you could only pick three).

The venepuncture was great, we got to do it on our friends. I have the vacutainer with my friend Liz’s blood in it in my room. Suturing was really good too, we did it on pig trotters (very similar to human skin). It’s so much harder than it looks! Wound care was a bit like a lecture and it went over my head because they talked about a lot of different brands of dressings and I really had no idea about any of them.

Ciao for now!

I thought I’d tell you a bit about the long-term parts of the course, in case you wanted to know.

I told you before how we now have an integrated curriculum, where we learn all the basic sciences (anat, phys, pharm, path etc.) at the same time? Well we do that for a different system or set of systems every semester for the first two years. This is how it goes:

Year 1:
Semester 1: Integumentary system (skin)
Semester 2: Musculoskeletal system
Year 2:
Semester 1: Cardiovascular system and respiratory system
Semester 2: Digestive system, renal system and reproductive system

Other systems (like the endocrine system) are encompassed within the other systems. Year 3 is known as the transition year, where we consolidate our basic sciences learning into a wholly clinically-led curriculum.

Years 4 and 5 are a series of clinical rotations, where we spend a year each at two of the following hospitals: Royal Hobart, Launceston General, and the Rural Clinical School in Burnie. I’m planning on going to the Rural Clinical School in Burnie for Year 4 (not because I want to go into Rural Medicine, more so because the class sizes are smaller and there is more opportunity for a hands-on medical education), and the Launceston General Hospital (the reason being that we have our Year 3 mainly in the Royal Hobart Hospital, so I want a go at all three of the major Tasmanian hospitals).

Something we start next Semester is the Kids and Families Programs. We are paired with another student and allocated a family somewhere around Hobart who is about to have a baby. Then we visit them a couple of times a semester to get a hands-on view of their baby’s development, and we have an opportunity to learn about the dynamics of a family while they are bringing up a child. This is a major part of Theme 3.

Hope this is informative for some of you. Ask any questions by making a comment.

Hey everybody, sorry it’s been so long since we have posted.

I wanted to write a post about what the new course is like. Michelle has posted on this a bit already, but the coursework for the semester is over now (we’ve just got review sessions next week, then SWOT-VAC, then exams). At this stage, I can tell you that Semester 1 of Year 1 is relatively light-on. Between 15-20 contact hours is pretty much the average.

To put this into context, in the Bachelor of Medical Research (which as I mentioned before, is the same as the first year as the old Medicine course) we had the following a week:

3 Lectures per subject x 4 subjects = 12
1 3h practical per subject x 4 subjects = 12
1 tutorial per subject x 4 subjects = 4

So that makes around 24 hours contact time per week. This was manageable and we got used to it. Three days a week were 8am starts so at least we were up and about, getting stuff done, ya know.

The MBBS this semester has a very weird timetable. None of it is set in concrete. Each Thursday they release the timetable for the following week, in a document called “Weekly Detail”. The Weekly Detail consists of:

- The week’s case: usually correlating somehow to the material being covered in the week.
- The timetable
- Case questions (explored in a tutorial on Monday and answered in a tutorial on Friday)
- Case tasks

The whole cohort is divided up into groups, called CBL (Case-Based Learning) Groups. Our CBL groups meet with a tutor (who is always a General Practitioner) every Monday and Friday. On Monday we introduce the case together, discuss the material that needs to be learned, and start to plan the Case Tasks. There is a Case Task for each CBL group each week.

We do one whopping integrated subject per semester (instead of the normal four), but in terms of the delivery and assessment of material, it is divided up into 5 Themes.

Theme 1: Human Health and Disease (all the anatomy, physiology, pathology, pharmacology and other science topics)
Theme 2: Communication and Collaboration (dealing with patients, being effective in a non-scientific situation, and all our clinical work like physical examinations and clinical skills)
Theme 3: Community Health and Disease (public health, community health, epidemiology)
Theme 4: Personal and Professional Development (self-reflective practice, ethics)
Theme 5: Integration (education and assessment that ties Themes 1-4 together)

So on a Monday, we typically have CBL tutes from 9-12 depending on which group you are in. Then at 12 we usually have a Theme 1 lecture, maybe on the histology of the integumentary system or something, and then a Theme 4 seminar on the ethics of, say, funding for disability services, or the analysis of the concept of dignity, then often a Theme 3 lecture on what Public Health is.

Tuesday and Wednesday are usually lots of lectures and seminars. Thursday is prac day. We have a Theme 2 seminar/practical each week where we discuss, explore and develop communication skills. The second prac is lab work. This semester we did some histology labs and some pathology labs, and one microbiology lab.

Friday is Case Report day. We have another tutorial in the morning in our CBL groups with a GP. And then we present out Case tasks, usually in the form of a powerpoint presentation, to the rest of the class.

This semester we covered the following very general Theme 1 topics:
1. Very very general and basic anatomy (we start gross anatomy hardcore next semester)
2. Cell biology
3. Basic histology of the four adult tissues, and of the integumentary system
4. Introduction to pharmacology
5. Inflammation, regeneration and repair of tissue
6. Neoplasia
7. Biochemistry - nutrition and glucose metabolism, and a DNA component

Assessment has been light. We have had two multiple choice question tests (do not be fooled, med schools know how to make MCQs hard; I usually perform better in short or long answer exams than in MCQs); two “reflective pieces” (where we are given a general medical ethical topic and take a reflective practice approach to writing a piece on it), and a formative practical exam. The majority of our assessment this semester will be external (examinations).

That’s all I can think of at the moment. Leave a comment if you want me to explain anything else. Ciao for now!

In my previous post I talked about the beginnings of the obsession. Today I’m going to talk about the process by which I got into medical school.

First came a lot of questions. Where would I like to study? For my personal situation, I would be able to move away from my home city if absolutely necessary, but financial issues were prevalent and my first and utmost choice was to study in Hobart. But, I would apply everywhere in case I don’t get in at UTAS.

Now for someone who has already got a tertiary record, some universities automatically don’t like you when it comes to medicine. Monash and Melbourne have this attitude, and Adelaide only liked internal applicants. I also didn’t have the opportunity to apply for graduate medicine because I hadn’t actually finished a degree, and I wanted to start medicine ASAP (remember the obsession?).

So that left: UNCLE (University of Newcastle), UNSW (University of NSW), UWS (University of Western Sydney), UWA (University of Western Australia), Bond University and James Cook University. Bond was out because I could never, ever afford to study there. JCU was also out because it was simply too far (I would have to visit my family and the expense, I found, would be too much). I also wasn’t keen on the focus on tropical medicine.

But there was something else to consider when I was planning this major career move: what if I didn’t get in?

To be perfectly honest with you, about 80% of the time this is exactly what I had in the back of mind. I was pretty much convinced that I wasn’t going to ever be studying medicine, and that I am doing this whole process so that I don’t look back 20 years time from now and regret what might have been.

So I researched the application process in early 2006. I had a look at what university required what forms, tests, results, standards. I discovered that I was not doing the right pre-requisites and enrolled in a new course at the start of the year: a Bachelor of Medical Research, whose first year is almost identical to the first year of the old UTAS MBBS course, where we take Human Biology, Chemistry, Histology and Cell Biology, Data Handling and Statistics, Genetics and Evolution.

Looking at the different universities’ requirements was all pretty daunting, the standard is so high, but there was one thing that was pressing on my mind: UMAT.

Undergraduate Medical and Health Sciences Admissions Test. At first, I thought this wouldn’t be too bad. I had always been pretty fine with psychometric testing; I had a very high IQ, tests didn’t bother or stress me much, I was a fast thinker and reader and I considered myself a “people person” so I wasn’t worried about Section 2.

A friend gave me some interesting advice: do a prep course. I purchased an online preparation course to help me along the way (not mentioning which one because of advertising conflicts).

BIG MISTAKE NUMBER ONE: I never did the exercises on it. Hundreds of dollars down the drain. Why? I don’t really know. The stress of working and uni and business and homework and everything? The fact that I just moved out of home and being responsible for myself after 20 years of living with my parents was too much? I have no idea, but I regret the complete arrogance I displayed towards the test by not preparing. What an idiot.

The test did not feel right on the day. I forgot my pens and pencils and had to run home. I was stressed, I contracted a cold the day before. It just wasn’t right, and the results showed.

Percentiles of 81, 79, 63. I didn’t even know whether this was good or not for a while, but after asking a few people online I realised that the general standard of other applicants was a lot higher. So this was the first time I really faced it - I was not going to get into medicine. Lo and behold, I received no interviews for Adelaide, UWA, UNSW, UNCLE or UWS.

It’s very easy to spiral into depression when something you think about every few seconds of the day all of a sudden turns on its head. My uni marks suffered. I spent a lot of time in bed, and didn’t see a lot of my friend for a long time.

Through all this I knew I needed to prepare for starting another course. I applied for many allied health courses, knowing I needed to stay in the industry I had finally chosen. Physiotherapy was at the top of my list, so I applied to Melbourne and Sydney Unis, then came Optometry (at Melbourne and UNSW), Podiatry at UWA, and lastly pharmacy and paramedic studies.

I had gotten used to the idea of pursuing one of these degrees and I wasn’t feeling too bad about it after a while. Don’t get me wrong, none of these degrees are anything to sneeze at, but when you want something else, it’s hard to take your mind off it.

I studied hard for my exams last year to get a high GPA, and it ended up being pretty good, around 6.5, which is pretty good for a former medicine course. It equated to a UAI/ENTER/TER of between 98.5 and 99. I was happy with that. That would put me in good stead for my courses.

But, before this all happened came a day that I don’t think I’ll ever forget. It was my last exam, the 10th of November 2006, the day of my Histology Practical Exam. Someone mentioned the day before that some offers for 2007 UTAS placements were coming out, so wondering if I got Pharmacy or Paramedic Studies, I checked it online that morning.

“Bachelor of Medicine and Bachelor of Surgery (Bonded)” was what read the middle of the page. I think I passed out a little. I was just expecting nothing like it. I cried a little bit, ran to my flatmate (who was also pursuing medicine) and told him, he checked it and got an offer too.

It’s a funny feeling to get when all of your expectations are less than what you achieve. You are shocked and humbled and elated all at the same time.

I want to make it clear - I was lucky. I got my place because the university had six places reserved for people to transfer from the Bachelor of Medical Research into the MBBS. I believe all things happen for a reason, and I know I was meant to end up where I am now. Whether it is for my benefit or whether I am going to do something very important in the future for others, I know this is where I am supposed to be.

Incidentally, I also got into Physiotherapy at both Melbourne Uni and Sydney Uni, and Podiatry at UWA, so that was a bit of a confidence booster.

So here I am! Ready to blog the new 5-year medical course at UTAS. You have my entry background, so you know where I’m coming from. Hopefully my posts will let you get to know me over the duration of the course, and I hope you enjoy reading.

That’s enough for now, type to you later!

Post by HAYDEN

Hello friends, fellows, colleagues and sundry.

I thought I’d dedicate my first post on this blog to a bit of an introduction. My name is Hayden, and as of the 26th of February 2007 I am officially a medical student. Most of you who are reading this blog will have some idea about what it takes to become one and will understand what obsession can mean when it comes to what you want out of your education, your career and your life, and how the pursuit of this elusive degree can get under your skin. For those who do not, you’ll just have to guess.

It is with this suggestion of obsessive behaviour that we begin a journey through medical school that I share with my friend Michelle, a recently graduated nurse who decided she wanted to get more in-depth knowledge about the practice of health care and that “RN” weren’t enough letters after her name. She will post soon.

My decision to pursue a career in medical fields began a few years ago, somewhat later than most people claim to have started. I was studying a Bachelor of Commerce and Arts, meandering between majors and taking more first-year introductory courses than I care to mention, and becoming increasingly disillusioned in my confidence as to how this degree will take me anywhere in life.

Don’t get me wrong, I know that both Arts and Commerce are very important degrees and the skills I gained from two years of it I wouldn’t trade for anything, but the reality is that I did not like where that sort of education was taking me. I didn’t want to be a teacher, business didn’t interest me, the thought of being an academic for the rest of my life made me wet my pants a little, and I didn’t see any other prospects in my immediate future in which I would be interested.

So slowly realising that I really needed to get out while I could, I took to my friends. I have friends from all different degrees, and I undertook a little research. I asked my friends what they liked about their degree, what they didn’t like about it, where they saw themselves in five years etc. etc. etc. until I had a bit of an understanding about their motivation for their chosen course of study.

But something peculiar happened when I was at my friend Rob’s house. Rob is a (now) fourth year medical student, and I was browsing the plethora of textbooks on the shelf in his bedroom. I took one down to have a look at…

… about two hours later, I looked up, and realised that I had been reading it the whole time. WHAT? Reading a textbook for FUN? This was definitely not me at all. There was something wrong here. I actually found this interesting?

This kickstarted a long chain of events in my thought process. What did I really know about medicine? What did I know about what you undertake as a practicing medical doctor? Am I really interested in this degree that I dismissed so long ago because I didn’t think I liked the sight of blood?

I realised pretty quickly that by some strange process of elimination, I simply could not see myself doing any other degree. Nothing could offer me the same mix of flexibility, challenges, career prospects, and satisfaction of my (newfound) curiosity of human health and disease as medicine.

And so began the obsession.

More on this another time…