Hospital Allocation

Today we received our allocations to the hospital that we'll be learning at for the rest of our courses after this year. I wanted to be at a major metropolitan hospital but before even entering the course I didn't get that luxury. I was down to a choice between two hospitals, and I preferenced one over the other because I really only liked one of them, the other one seemed like a bit of a dump...anyway, so of course I've been allocated to the hospital that I didn't really want. Hooray, right? Ah, me. I just can't shake the idea that not being at a major hospital is going to affect my internship chances somehow, and by extension my ability to get into whatever training course I want later (I say that rather than 'my ability to get into neurosurgery', as a hat tip to the fact that I will probably change my mind in the future -- everyone does, multiple times). If I'm going back to Perth after my MD course then I guess it doesn't matter as much...but what if I don't go back to Perth? There's actually a lot of unknown in my future at the moment.

They only let you change clinical schools in very specific circumstances, and I don't meet any of those circumstances, but just in case I sent them an email tonight saying that if anyone happens to want to move out of the school that I wanted, and has to move to the one I'm to go to at the moment, then I really wouldn't mind being someone they think of to swap with that person. I guess that's the best I can do!

Having said all of this, I know that I am still going to get a good education. I'm still going to go to my hospital and get as involved as I can without annoying everyone. I guess I was just hoping to get involved in that 'big hospital' feel, with all the important consultants and surgeons (I'm thinking neurosurgeons of course) around. Not that they'd have any time for me, but still. Also, the facilities at the metro hospitals are a bit nicer.

Adios,

Circle

GP Visit!

I've got my first ever visit to a GP tomorrow, and it's 1am and I should really get to sleep because it's at 9am tomorrow (today?). I'm super excited! A lot of my friends have already been on their GP visit and they report various amounts of involvement -- some have just been sat in the corner, but some have been able to even take blood! I hope my GP is really willing to let me get involved, because I will absolutely do anything he's comfortable with me doing. I'd be a bit stressed out about doing an interview, but like last time I'm sure that once I'm doing the interview I'd be ok. I mean I've practiced on people before, so it shouldn't be too bad to take that and do it with a real patient.

Next year I'm going to actually go to a GP every friday I think, which I wasn't so sure about initially but now that I think about it I think it's going to be really good. It will not only let me get integrated with a community, and see patients come back time and time again, but it'll give me really practical skills and great patient contact. In some way though...I have a small voice at the back of my head that's saying that I hope it doesn't convince me to be a GP. I will keep an open mind though, because if seeing a GP work really gets me excited, then why not be a GP.

Exciting times in my world! Wish me luck!

-Circle

Contracts For Difference

Hola!

A long time ago I used to not be into medicine at all, and was in fact well and truly obsessed with contracts for difference (CFDs). Why were you so obsessed with them, I hear you ask? Well, it's pretty simple. Basically, trading a CFD is the same as trading a share, except for the same change in price in the underlying security you make either a much greater loss or a much higher profit. For example, the other day I was trading USD/AUD with a leverage of about 99.75%. Normal share trading you can think of, for the purposes of comparison, as a CFD with a leverage of 0%. What you get is what you can pay for. With the CFD I was trading the other day, I was only having to come up with 0.25% of the total value of the goods I was trading. Now when something increases in price by $2, if you buy at the bottom price and sell at the top price you only get $2 for every share you were able to buy. If I was to buy that without using CFDs, I might only be able to buy a few hundred of those shares because my money isn't being leveraged. However, if I was to buy with a CFD I could leverage my money and have the buying power of say $10000, without actually having anywhere near that amount. Now I can buy many more than a few hundred of those shares, and so even though the price difference is still just $2 I am now making a much grander profit. 

The downside to this of course is that if it had gone down $2, I could have just put my family into bankruptcy (quite literally -- leverage can be extremely powerful in CFDs, such as my 99.75% example above). At the moment I use extremely tight stop losses (automatic levels that you set where, if the share trades at that value, it automatically sells them for you, to 'stop' your 'loss' hence the name) and I only trade in small amounts. However, it's still easy to see how powerful these things are: I think I traded 2 units of gold, which I needed to put I think $6 on the line for (that's instead of having to put out about $3000 to have 2 ounces of gold...). The share price went the way I thought it would, and I took a profit pretty quickly, and the profit ended up being $10. That's $10 above my $6, so by the end I had $16 on top of my reserve cash. Now, you're probably thinking 'so what, that's $10, who cares!' but think about this: that ends up being a 167% profit. Now, change my $6 into $6000, and all of a sudden out of that small price movement I've made a clear $10000. $6000 usually would only have bought me about 4 ounces of gold if I had no leverage, so my profit would have only been about $20 ($5 per ounce, because before I owned 2 ounces and made $10). You can clearly see that a $20 profit after putting $6000 on the line is not quite as good as a $10000 profit for putting the same amount of money on the line.

So, if there's so much profit to be made out there by the calm and logical investor, why didn't I go into it! Well, I read a very wise share trader once say that to be a day trader you can't do it on the side -- it has to replace a job. It takes a lot of time to watch the markets, and be in a position of knowledge about the share price, rather than guessing where you think it's going to go. At the time when I was thinking about going into CFDs in a big way, I just couldn't see myself sitting at a computer all day as being much fun. And if it really did happen in a big way for me, if I retired in a couple of years with a billion dollars in my pocket (my dreams were big, ok) then what? There's only so much you can sit on a beach sipping cocktails! At that time as well I was getting veeeery interested in medicine, so I decided that I would give medicine a go and see where it takes me. Of course my attitude to medicine is now very different -- even if I could be guaranteed of billions in CFDs I wouldn't stop pursuing medicine -- and I'm very glad that I decided to not go into CFDs.

As mentioned though, I have been doing the odd trade here and there recently, and as long as I don't put much money into it it could be just a nice distraction. I intend to set up a trade in the morning, and not touching it again until the evening, seeing what happened with it and learning about what went wrong for about 5 minutes. If it could be a nice little earner on the side as I go through these next years then that would be pretty nice!

Regards,

Circle

Update-yness!

Hello!

Long time no speaketh! I've been extremely busy just recently, not that that really surprised me. Ahh we have done so much, and in such a short period of time.

The lectures continue to come thick and fast. My OneNote system is working fantastically for me, allowing me to organise all of my notes and include helpful diagrams as well. OneNote doesn't do much tracking of the notes you write but you can export it as a PDF, then import that PDF into Word...anyway, so right now I have about 65000 words of notes, over more than 300 pages! We look at each other and wonder how on Earth we're going to study all of that for the final end of year exams, where everything that we've learnt in the year will be assessed. It's going to be intense I'm sure.

Speaking of assessment, I had one of those recently! It was our first one. Below is the very nice bell curve of results:

Guess where I was! Right smack bang on top of that curve. I got basically the average mark, which is far, far from where I want to be unfortunately. So it's time to knuckle down and get my groove on! The test was on only lecture content that we did between the start of the year and the day of that test, but we have a test coming up in I think about 4 weeks that will assess the lectures we've had since, PLUS the content of the labs from the whole year thus far! I have a few friends that are second year med students here, and they say that everyone sort of does ok in the first test, and then gets demolished in the second test. I intend to not be one of those people that gets demolished :P Things will be better for the next test!

Some exciting news! The QS World University Rankings just released their 2012/13 lists, and Medicine at the University of Melbourne is number 9 in the world! We're basically only behind big names like John Hopkins, Oxford, Harvard etc! That blew my mind, and I think I have told everyone I can about it. I am so proud to be here, and hope my cohort can be the one to take us higher!

We have been doing some pretty interesting things here recently. In our Principles of Clinical Practice subjects we sometimes get patients to come in so that we can practice interviewing them, in a fishbowl format so that the other people in the class sit there and watch you, so that you can get feedback on your interviewing afterwards. I did mine last week, and I stressed about it a lot beforehand. When he introduced himself he said he had shortness of breath, and that's fine, but then he said he also had a smoker's cough...well, basically I had to interview him not just about his shortness of breath, but his cough too, AND his smoking habits haha. It actually went extremely well though! The patient, when the interview was finished, basically as soon as our tutor asked him to give feedback he pretty much exploded with praise, he was so animated and it seemed like he was extremely impressed! He said that he felt extremely comfortable with my interview style, that there was a great flow and he felt like I had really given him a lot of sympathy and listened to what he had to say. I was stoked with that!! Then other people in the group were able to give me feedback, and it was all much the same. I was pretty happy with that!

I think the last time I posted I was still doing cardiovascular medicine? Well, we're actually up to gastrointestinal medicine now, having completed respiratory already. Basically, everything we do seems to revolve around diarrhoea. We have seen some not so pretty pictures, let me tell you that...the worst have been pictures of parasitic worms. My god. And someone had the idea of eating parasites so that they would eat all the extra food that we eat that we don't need, to stave off obesity...no thanks.

College is going great too. I probably aren't leaving my room as much as I should though, because it's so easy to stay in my room! The meals here seem to have become stuck in a rut of not being all that great...having said that, there was a curry tonight that was pretty good! They have a fondness for soggy brown rice, which is disgusting.

That's probably a big enough post now, I'll post again soon when I think of something interesting.

Regards,

Circle

A Taste for Clothes

When I moved to college, I was told that we'd have several black tie events. Coming to college I'd only owned one business shirt, let alone a suit, and let alone a tuxedo, so be told that in 2 short weeks I'd need to be able to deck myself out in finery was quite a shock to the system. So, having just recently worked out how to use EFTPOS (I was afraid I'd swipe the card the wrong way and look like an idiot...or something), I went to the city in search of a tux.

I found a menswear shop that had a large banner saying some big discount sale happening plastered over the front of the store, so I hopped right in. The first thing that I said to the salesman was that I needed a tuxedo, and so he proceeded, like any salesman would given the opportunity, to sell me something that was anything but a tuxedo. At the time I was thrilled to bits with it -- my first suit! -- but after consulting my most informed friend on these matters I was told that it was in fact a business suit. A good business suit, but a business suit nonetheless. Back to the drawing board.

Like any good scientist, I researched the topic. I quickly entered a world of shawl vs peaked vs notched, winged vs turn down, and satin faced vs self faced. I found that the tuxedo looks deceptively similar to the business suit -- but in fact there are several critical factors that separate the two, even down to whether the trousers have hems or not. I searched for and wide on the subject: on current styles, on styles that I liked, on styles that are definitely out of fashion. I researched etiquettes, standards and optionals. I profess now to be a slight expert on the black tie event in general, and especially on the correct components of a man's tuxedo. I thoroughly enjoyed learning all that I could on the matter, because it's a part of life that I haven't ever been a part of before. Woe betide any salesman that tried to sell me a self-faced jacket lapel now.

Armed with this fresh knowledge, and a topped up bank account, I skipped the cheap discount suit shops and went to David Jones (ok, so it's no Armani store -- it's the best thing my budget can do though). I didn't even bother looking at the suits before finding a salesperson. I asked for a tuxedo and credit to them they did show me an actual tuxedo, but the lapels were highly peaked and while I know that that may be in fashion now, and perhaps more formal, I think a more timeless look is the shawl. Over the next few hours I went from David Jones to Myer and back and forth (luckily in melbourne they are just across the street from each other), and gradually constructed my suit. There was a very limited selection of pleated wing-collared shirts, but they did have one in my exact size. The shoes were particularly hard to get -- I knew exactly what I wanted, but neither of the stores seemed to have something similar. In the end Myer had an almost exact match in their storeroom, but they were damn expensive. I do love them though.

I've worn my tux twice already and the third occasion is just next week. Wearing it, and knowing that you've spared no expense to put together such a correct set of pieces that you could wear it to a dinner with the Queen, makes me feel like a million dollars. For someone who is still really not out of his tshirt and shorts phase buying such a formal piece was a true eye-opener. One of my friends (that same classy friend that informed me about my suit) recently showed me this particular site, the website of Brooks Brothers. I've use to never be able to understand how women could spend so much on clothing, but I'm ashamed to say that I do now. If I could buy everything that Brooks Brothers sells for men, I would in a heartbeat. I would blow every paycheck I get on their clothing. I realise the value of good clothing now. So much in female fashion may be about buying a label, but I don't believe the same can be said about the clothing that Brooks Brothers sells, and perhaps most mens clothing in general. They're not cheap, but the quality of the clothes reflects that. To wear nice clothes is a luxury that I haven't pursued before. I wouldn't say that I'm intoxicated by it, because I still wear my tshirt, shorts and thongs to uni every day. But when you go to Myer and feel the difference between a $20 polo shirt and a $50 polo shirt for instance, I will almost always now go for the latter.

Why am I writing about this? I'm not sure, I guess I find it an interesting story. It's probably a bit of a personal journey for me, going from slightly ignorant, to a point of self-awareness and probably materialism. Is it materialist though? I would care if someone burnt my tux to a crisp, but I think that that's more because I don't have a job at the moment so all my money doesn't come back. If I had a good paying job, and someone to look after other than myself, I think that my priorities would be vastly different. Hmm, perhaps this isn't the end of this personal journey.

Stay classy,

Circle

Taking the steps

We had a practical lab today, and we learnt how to take blood pressure in a number of ways, both manually and with machines of various size and ability. It sounds mundane, and plenty of people in all walks of life can do it, but it sure was exciting for me at least to get out my stethoscope and use it on someone else for the first time! It was fairly hard to find the brachial pulse on most people, but I'm sure that with practice that'll become second nature. As part of the lab we are able to take part in a research project organised by the medicine faculty, investigating blood pressure. It's the largest study of it's kind in the world, so it's no small thing. Part of it is to do with changes in how long it takes for our heart to readjust itself after we go from laying down to standing. My blood pressure went below 25mmHg when I stood up...that's really not good. Then I took an anti angina drug and repeated the experiment, and the blood pressure stayed lower for longer, which was what we expected. It gave me a thumping good headache too, because it worked by vasodilation.

On another note, the pharmacology lecturer made us watch this video, because...here's the scary part...it summarises most of the drugs we're going to have to be very familiar with by the end of the year. Fantastic.

Regards,

Circle

Microsoft OneNote

So, I figure it's a good time for an update! Lots has been going on and it's all very exciting.

Yesterday was my first day of actual proper medicine, as in learning things. It was an extremely full on day as well, starting at 9am and ending at 6pm. That was an ordeal, but thankfully we had an hour break in the middle of it all. So during the day we had 5 lectures and 1 case supported learning (CSL) tutorial. The lectures were pretty interesting, but were mostly introductory in nature. For example, we had general introductions to pathology, physiology and histology. It was a great chance for me to trial a new note taking system -- using Microsoft OneNote.

To put it briefly, it promises to change everything. No more do I look at a densely packed lecture screen and despair, because now I can just bang out everything on the keyboard. You can either organise all your subjects with separate notebooks, or, as I do, have a single notebook for the course and have tabs for each subject. Each tab in each notebook can then have pages...and its on each page that I write the lecture content. I don't use any of the fancy templates to structure a page -- they have too much frill for me. I even organised a few sub-pages in one of my pages -- blood, bone and cartilage are sub-pages to the page 'connective tissue'.

So already there is a vast amount of granular organisation available, but it gets better with a couple of tricks. Firstly, it has an almost instantaneous search function, so if I want to find out where I have previously been taught about something I can just quickly type the string into the search and have listed the page it's in, and when you then press enter on one it takes you straight to the instance it's mentioned. Secondly, having found an interconnection between two separate pages...you can then actually produce a link that will take you straight there to be placed in your other, current, note. So in the example I've just searched for something and it's come up in this other page before, clicking on that result takes me straight to where I've mentioned it, and right clicking on that mention and pressing 'copy link to paragraph' will give me a text link to place in my current page that will take me straight to the previous mention of the thing. It boggles my mind, and is probably going to be the biggest thing that keeps me now doing electronic notes. Thirdly though, I keep a wonderful little program open called 'snipping tool'. If you're unfamiliar with it, get familiar with it quick -- it basically lets you copy exactly what you want from the screen to your clipboard to be pasted anywhere. So for example, I'll have my lecture notes open as a PDF while I'm at the lecture, and if the lecturer has used a particularly good picture or table to illustrate an example then I can quickly pop into the snipping tool, crop around the picture or table, and paste it straight into my notes. WOW.

Aside from lectures -- which are a breeze now with my new system -- we've had a few tutorials as well. The CSL this week is about a patient with headache, photophobia, general malaise (what a favourite term), lethargy, cerebral disturbance and a bad temperature. It only took him 3 hours to get much worse, so his friends took him to hospital. We decided it was probably an infection, and more specifically probably a meningitis. We discussed things like what sort of history we would take, what tests we would order, etc. For the record, we'd start him on prophylactic antibiotics (types that cross the blood brain barrier, too) order a lumbar puncture and test the CSF for a number of things -- protein and glucose levels (will rise and fall respectively in the case of bacterial meningitis), cell count (PMN's will be high in bacterial infection, whereas lymphocytes will be high in viral infection), and you can do tests to detect bacteria in the CSF as well. It was a much better CSL session than last week's ones, because we'd all prepared a bit for this topic so we all had something to contribute.

We also learnt a bit about how to show patients that we're listening to them in our principles of clinical practice (PCP) tutorial. Things like when to use open questions, when to use closed questions, non-verbal techniques to use, etc. It was fun! This morning I had a lab where we tested the patient's CSF for the presence of bacteria, except the test was inconclusive...which sounds lame but it's still a result, and could point to the bacteria being Neisseria group B because apparently they don't get picked up by the test we did very often.

It seriously feels like a whole week has gone by already. This year is going to be crazy...crazy, but fantastic.

Regards,

Circle