Tuesday, September 16, 2014

Confessions of a Workaholic - Deadlines

Is this little blog becoming sort of a busy-o-meter for me? Only my readers can tell. But anyhow, this post is going to be a summary of whatever happened during the past first week of IC2.

This semester, we have to complete 4 modules:
a) Tropical Medicine [TM]
b) Gastrointestinal Medicine and Hepatology [GI-HEP]
c) Reproductive, Endocrine, Genitourinary and Breast Medicine [REGUB]
d) Central Nervous System, Movement, Locomotive and Forensic Medicine [CNSLMF]

To be honest, it is going to be a very packed semester.

Nearly all the Tropical Medicine topics were squeezed into one single week - last week, to be exact. But I must admit that it was exhilarating, learning about all those bizarre creatures such as cestodes, nematodes, trematodes, plasmodia and understanding the mechanisms of dengue fever. However, my weekends have become so packed - reading material, lecture notes, supplementary exercises, case studies and all, that I think I may become cross-eyed later in the semester. But it will be fun, I am sure, once we've got the whole picture in mind.

Let me see.

I need to:
Finish studying TM, finalize the paper on restraints-usage among Klang Valley road users, finalize the IC3 guidebook, oversee the September-October projects pertaining to The PEN, complete the articles on Dengue and Ebola for the November-December issue, arrange interviews with lecturers for the Cutting Edge column, and revise my anatomy before CNSLMF dawns upon me. Oh the joy of being a medical student, forever busy without time to think about time-wasting nonsense.

Holidays over, work has started. but it ain't a sin to dream of such serene scenes

Sunday, September 14, 2014

Today Is The Day

I guess it is about time - better to say it now than to allow further delays.

I knew you were the one I would desire to spend my life with; the one I would want to cherish, care for, look after and love more than anything else.

The journey would be difficult; the challenges many. But time and tide wait for no man- and I guess it is time to consolidate what I have long wished to say:

I love you truly, in body, soul and mind. I take you to be my constant companion, my life-long dedication, the spring from which my life draws meaning, the source of my inspiration and the light of my life, both now and in the days to come.

Till the seat be truly filled, this will hold fast.

A whole new exciting journey lies before us

Thursday, September 11, 2014

What Should I Get For Junior Cycle

Good day to all juniors, current and future.

The basic principle [based on personal experience] is to use one to a maximum of 3 books per field [might seem too little, but after two years of med school, this will be practical advice].

The recommended books are as follows:

a) Anatomy - you need one text and one atlas.
You can use a combination of one or two texts as follows: Clinically Oriented Anatomy [Keith Moore, Agur Dalley] and/or Clinical Anatomy [Snells] AND Netter's Atlas of Anatomy/ Grant's Atlas of Anatomy.

Grants' Atlas has got helpful tables/notations at the bottom of each page, whereas Netter's provides very very detailed illustrations of the human body. My personal preference is Grant's. But you decide - you want a very complete atlas (Netter's is like a map of Malaysia with every single kampung and jalan kecil listed in it, whereas Grant's gives you all the important anatomy without bogging you with the tiniest details, and Grant's will prove to be useful for card-signing too]
For JC3 - you will need Snell's Neuroanatomy and Monkhouse's Cranial Nerves.

b) Physiology - the recommended combination is:
- Guyton + Linda Costanzo's Textbook of Physiology
- Guyton + Sherwood
- Guyton + Berne-Levy's Textbook of Physiology
My recommendation is either one of the first two listed above.
And on top of that, get a quick revision book for physiology - 'Physiology' from the BRS series written by Linda Costanzo is the best option

c) Biochemistry - the first-and-best text for all beginners is the Lippincott Illustated Series Biochemistry book, by Harvey. Master this text and you will do very well for the exams. It makes your lecture notes simpler to understand. So, my advise is read this alongside your lecture notes. The second book is Harper's Biochemistry - but read this if you have the time for it.

d) Pharmacology - Rang-Dale's Pharmacology is still the best book by far. And, for pharmacology, try to get a revision book - 'Pharmacology' from the Deja Review series is one of the best. Try to avoid thick books for pharmacology because the thick books tend to be littered with plenty of ambiguity and 'still-under-research' stuff whereas your exams require you to answer based on current knowledge. So, Rang is still the best.

e) Histology - Use the Histology Module on Moodle - all the pictures there WILL be tested in the exam - and everything that will be tested in the Histology exam during your summatives will be taken only from this site. Although Histology tends to be neglected among PU-RCSI students, PLEASE DO NOT neglect this subject because it is one of the cornerstones of understanding Pathology in Intermediate Cycle 1. You must be able to recognise the cell types in a given tissue - there should be no blind reliance on the lab technician to tell you what it is, given that we all know how hospitals are like here. You must make it a point to study histology over the weekends - it doesn't take long since there are many pictures with labels. And, the Histology Module on Moodle is just the bare minimum - you can use it to pass the exams but that doesn't mean you are ready for the real stuff in IC1 onwards - so, although nobody will tell you this, I'm telling you to get yourself a Textbook of Histology [preferably by Junquiera] and study it alongside the Histology Module on Moodle. Recognition of tissues and cells without doubt is the main outcome of studying histology.

f) Embryology - everyone says they hate it - but if you think of it, it is actually one of the cornerstones of medicine. You need to know it to understand the various abnormalities you will encounter in the hospital. Everyone will tell you that they leave it till the last minute - but it really is a waste to ignore such a precious subject. The recommended text is Langman's embryology [the other text, if you like, is Keith Moore's The Developing Human]. Studying embryology using just the book can be really horrible, so make full use of the video links on Moodle - these links are often ignored by PURCSI students but the truth is, they make embryology SO EASY to understand. Also, Youtube has many fantastic simple-to-study videos for embryology. And there are plenty of sites that provide even better-and-simpler explanations/diagrams than the mainstream texts.

g) Clinical Medicine - Over the course of your studies, you will encounter the mention of a few diseases, for example, myasthenia gravis in NM, and phenylketonuria in CPB. To be able to understand, and not memorize, it would be great to know more about the disease, right? So, a book on clinical medicine would be of great use to you. The best text for Junior Cycle students is Kumar and Clark's Clinical Medicine.

g) Pathophysiology - This is an option which I still strongly recommend. To understand how abnormal physiology leads on to disease states, use Porth's Pathophysiology.

Lastly, if you have any questions that cannot seem to be quickly resolved by looking through your books, DO NOT HESITATE TO GOOGLE.

For example, if you are finding some parts of anatomy to be rather tedious, and the explanation in the book isn't helping, GOOGLE or GOOGLE IMAGE it. The images on Google are often more interesting, colorful, better labelled, or even better-angled than some of the textbook drawings. So, be flexible - Googling is not a sin. And referring to Wikipedia is encouraged if you need a rough answer in a short time.

For pharmacology, sometimes the side-effects of a drug can be difficult to understand - GOOGLE for the answer.

For physiology, there are also fantastic sites to aid in learning your physiology - for example, you can use cvphysiology.com for cardiovascular physiology. In other words, if the Internet helps you find answers fast and accurately, why not use it alongside your books? :)

I hope this helps. For your anatomy lab sessions, remember to find the answers to the questions in the lab book the night before the lab session - it will make anatomy learning VERY interesting and you get to ask the anatomist deeper questions instead of trying to run after every word he's rattling about. Preparation reduces stress. Sleep late if you need to.

In short, yes, it looks like a costly bomb now, but they will be of valuable help in your studies. Studying without books is like sailing the oceans without a map.

If you have any more queries, don't hesitate to ask - and yes, at the middle/end of ANY lecture, if you got questions, STOP the lecturer and ASK. No need to be shy. The lecturers appreciate that somebody is actually asking or else nobody is going to talk to them.

PS: 
A medical dictionary is a good investment. The choices are Dorland's Illustrated Medical Dictionary - the full sized version. But I do not expect you to carry it with you to college daily since it is quite a huge volume. Home use only. But if you can get the App version (ask a tech-savvy friend), you may do so. The other option is the Oxford Medical Dictionary.

For those wondering about the Health, Behaviour and Society module, the lecture notes should suffice. And if you interested in reading further, Google. The book that is recommended for this module (photocopy it - the original is costly) is Psychology and Sociology Applied to Medicine (Illustrated Colour Text series).

Good day!

Monday, September 8, 2014

The Med School Report - Day 714

I can't believe the past two years have flown by just like that. Today, I step into the world of Intermediate Cycle 2.

And I can only gasp in awe and wonder as the action-packed week unfolds before my eyes - days of back-to-back lectures, of epic topics compressed into the space of a few hours, of yet another hectic race against time. I can feel the hot and invigorating flow of adrenaline course right through my veins as I behold the rich tapestry of Tropical Medicine reveal itself before my naive eyes.

Yeap. IC2 is going to be about lots of topics crammed into 12 weeks. But I know I can do this if I trust in the Lord and His providence.

IC2 - Day One may have been a tad tiring - but I'm still going to take you by storm nonetheless.

Tuesday, June 24, 2014

Confessions of a Workaholic - Long Drives

It's been a hectic day - standing by the roadside playing I-spy for the sake of the observational study - can be quite tiring especially when we have to stand under the afternoon sun for up to 3 or 4 hours.

And then when you arrive home, you need to key-in all that data - up to 1800 cars per day - and Excel can sometimes be a pain in the arse. And on top of that, complete the daily log and write a short report for each day.

Learn how to use SPSS, read up for the Physiology quiz - I think my physiology seems to have rusted quite a little (and so the need to go through Guyton - again)

And then there are the articles I need to complete by the end of this month for the July 2014 issue of The PEN - about 4 in total.

My table is starting to look like: A scientist looks up gloomily from a mountain of paperwork

Yeap, but without the coffee mug. I am kicking the coffee habit for the next 3 months - until my new semester begins in September.Till then, I don't wanna smell even a whiff of Nescafe!

So, yeap, my day begins early - at around 5 am - because I need to finish keying-in data for the previous day, and then quickly browse through Google Maps to check out the perfect locations to plant ourselves for the observational study.

And then go for a quick jog.

Then it's the observational study from as early as 8 in the morning right up till 5 or 6 in the evening; and then the day's not over yet because we need to transfer all our 'I-spy intelligence' to Excel. This can take up to 3 hours to key-in and double check 1800 cars and 500 over motorcycles on average per day. We need to reach up to 10,000 vehicles and above in order for the study to be significant.

And the fact that the Klang Valley is about to experience a severe haze is not helping.

At around 9 at night, it is time to begin drafting the research paper - reading up various articles on accident rates, careless drivers, lack of awareness in the usage of restraints and etc. Interesting to note that for a small nation like Malaysia - we have one of the highest mortality rates due to RTAs in the world. I am not surprised, given that nearly half of all the cars I observed weren't wearing their seat belts - and there was a sizeable portion of vehicles which had 'back-seat parties' comprising of unbelted kids dancing to their boom-box unaware of the danger they've placed themselves in.

By 11, I'm already feeling so dead tired - but then again, I need to stay up in case my beloved calls to discuss some matters pertaining to studies. And this can last till late at night. But I don't mind because my beloved is dear to me!

Then, I try to write a few paragraphs for the articles per day - and catch up on my reading because these articles ain't flossy - they're based on papers and all that, so, again reading and more reading.

So, my day ends at (give or take) 2 in the morning, And then sometimes I can't sleep - so I go for a drive. At night - yeap - but it's fun because you get to own the entire road. And I'll just sit by the lake and talk to my beloved. My beloved listens to me, even when I decide to 'call-up' at such an ungodly hour.

But overall, this has got to be one of the most solid summer breaks in my life ever!

Transmission ends.

Signing out.


Sunday, June 22, 2014

Confessions of a Workaholic - 'Blind Pay'

Blind pay - or 'gaji buta' in Malay, is the term we use for someone who has been paid to do his job, but is not taking his work seriously.

Someone who takes 'blind pay' takes their pay for granted, and refuse to render the appropriate services for which they have been paid to do; in fact, some take it a step further and play truant, taking as many leave days as they are permitted to take - and for rather flimsy reasons - using whatever means they can use - such as fake medical chits.

Now, I have an axe to grind against those who are on the 'blind take' - but even more so if it is a teacher or lecturer.

Yes - I have a HUGE axe to grind against lazy lecturers and teachers. Why? Because I have a great respect for those who tirelessly render their services in educating our children - so, to give these lazy braggarts equal recognition together with the hardworking ones is an insult!

You think you're not lazy, then well what do you call this, madam? Let me shove this down your face and let you tell me what this is:

Going to class, gossipping with your favourite pet students instead of teaching Math as stated on the timetable
Spending nearly 15 minutes minimum nagging students for some mistake as big as 'being noisy' - seriously? What did you mama teach you about throwing the baby with the wash water? If you were a learned woman, all you need to do is to single out whoever the chatterbox is, and just give him a stern warning. Oh wait - maybe they are noisy because they don't see what they can learn from you - because all you give are half-hearted lessons, more scolding for even the pettiest things, and your biased tantrums. Hey, we aren't blind to how you can sweetly dote on your pets - and suddenly within earshot of the boy who whistleblew on you, turn into a nasty cold-blooded ogre.

You lazy lump of pernicious malaise! Don't think that being an educator means you can teach as and when you like - especially if you are on the Government's payroll.

AND stop hiding behind excuses like 'I have got a family to take care of!' or 'Sorry, I am just too tired to prepare lessons for you' or 'I am not gonna teach this class because they don't want to learn' - because: ONE - YOU ARE PAID TO DO THE JOB, REGARDLESS OF WHAT HAPPENS; Two - you are being paid with the PUBLIC'S money, not just the money of parents of 'good tame kids'. And shamelessly using your family to justify your sloth absolute laziness in school is the worst type of insult you can publicly smear on your family's honour!

Would you like it if another teacher did this to your child? Going to class 10 to 15 minutes late with the consistency of clockwork, taking lots of precious time blasting at students for even minor issues that in my honest opinion, is like firebombing a colony of ants; teaching students how to read form the textbook instead of teaching Biology; not bothering about the welfare of students who have been entrusted into her care because she's just too engrossed making money at her tuition center - oh wait, did I tell you that she really does only the bare minimum in class too?;  telling students that you are taking a rest from talking for that day - and then repeating that same sentence every other day when Aunt Flow supposedly comes to visit you. Oh wait - and then being RACIST and BIASED in your class - children are not blind, madam. If this was America, you might end up in hospital - with a nice shot to your incorrigible, wicked brain.

Madam - where is your dignity? Have you no fear of God above?

You take what is not yours - you eat of what you did not earn! And as surely as the wealth of the corrupt brings no peace to the household of the wicked, your ill-gained income will condemn you, both now and in the hereafter!

And what is worst is you have turned a sacred duty -- the education of young minds - into a profession that is gradually gaining ignominy in Malaysia by the day.

I am angry - because when a person swears the ikrar or oath, upon becoming an educator - she has sworn upon herself the sacred duty to guide children towards the correct paths, and to foster the growth and holistic development of their minds.

Instead, you fail to see the great duty you have taken upon yourself, and instead think of it as 'your iron ricebowl' - 'oh, it's just my dayjob to keep myself alive; nah, I'm just paid to do this, so you know what, I'll make this simple and just do the minimum - after all, I'm just a government servant - oh, and students are so smart nowadays, and rich - they can go for their own private tuition'.

Madam - hellfire waits for those who betray the trust already given to them! And no, not everyone is rich enough to pay for tuition for 8 subjects a month!

Young lives are placed in your care - for you to carefully mold and guide, cherish and encourage; yet you still dare to be calculative with your job! Stop blaming everything on your paperwork and difficult parents - because this COMES WITH THE JOB. PAPERWORK - every government servant is affected, so shut up; also stop saying you don't have enough holidays - you should ask the MOs and HOs about their holidays!

Do you snuff out a flickering candle? Do you break a bruised reed? Do you honour the responsibility of molding young minds into great thinkers and statesmen? Ask yourself, woman!

This I tell you (and your cohorts): Until you realize the enormity of your trespass, you are persona non grata to me. Period.

Friday, June 20, 2014

Confessions of a Workaholic - Tolle, lege!

On more than one occasion I have been asked questions on what I have done to keep myself alive for the past two years and what I believe has prevented me from stepping over the edge of sanity. 

But before you read what I am going to say, I must remind you that these were written by a mere ordinary student who was not born a genius, neither does he possess any superhuman attributes such as photographic memory. These were written for all students, regardless of their 'starting point'. 

First - Know what you are supposed to do!
Do what you need to do, and finish it up if you have to. Minimize daily 'leftovers' (i.e. unfinished lectures). Tie yourself to your chair if you need to; use Stay Focusd if you have to.

On Sunday evening, take a close look (NOT a glance!) at your weekly calendar and see what lectures are in store - print them out and start with Monday's lectures: Flip through them, and print/download relevant reading materials pertaining to that lecture. For example, I used to print out pages of Kumar and Clark's Clinical Medicine ebook relevant to the lectures I would be having for that week, preferably before attending the lecture. You may read through it before the lecture if you have the time - the keypoint is to prepare your materials and get a rough overview of what is to come. So that you don't waste your study time printing stuff during the week days. 

Know what you need to do - every medical student should, by the second semester, realize that EVERY day is study day. By now you should know that you MUST and NEED to study consistently. You have new lectures each day - so try to get into the habit of completing your notes for/finish studying that lecture on the same day it was delivered. Of course, do not hang yourself if you can't do it all, but definitely try accomplishing them on the same day because lectures tend to pile up really quickly when untouched. Or else get them done the next day and not later!

For that, it's best to keep a diary - keep a daily list of the lectures or stuff you're supposed to read up on. Once you know what you're supposed to do, act on it! No point keeping a beautiful list if you're just going to laze off. In med school, there is no such thing as 'lazing' or else you shall be acing your way to that event everyone hates called 'Last-Minute Hell'.

Know why you are doing it
Many of us would have literally sung the 'Lazy Song' - the anthem of all procrastinators - at some point in our lives, especially in med school. We kick off our shoes, fling ourselves on the bed, ignore our school files, and just daydream on Youtube, Facebook or some other place where we choose to tell ourselves  the all-too sugary fatal advice that 'that lecture' can wait another hour. 

Maybe the reason why you think there is no urgency in picking up your notes and reading them intelligently is because you don't know why you need to do it.

The most powerful motivator is this: You are not doing this for your lecturer - no, not Dr Skantha, Reddy or Kamalan -  neither are you doing this to please anyone else - you are doing this for yourself, to be a competent medical doctor, to be a houseman who can stand on his own two feet without hiding behind someone else's skirt. If you feel you can't push yourself to study, then maybe you ain't cut out for medicine because you can't see the fact that the life of a future MI patient depends very much on whether you studied the therapeutics of MI when you were in med school. Yes, it can be a boring, dry and meaningless bunch of powerpoints - but if that is going to stop you from becoming the good doctor you wanted to be, then maybe you weren't doctor material to begin with. 

Study - NOT read
Test your understanding. Don't just read it like how you read a newspaper or a novel - like 'Oh, I've read this so yea, I kinda know something like that' - big mistake. I've done this error many times, but I've learnt the really hard way that this 'tactic' is NOT good for you, so remind yourself that there is no harm burning the midnight oil testing yourself over and over again while studying. Don't rush like a rambler through your lectures; while reading through them ask yourself questions, make notations on your lecture notes or make mindmaps along the way. Just plain reading and colouring your lecture notes with highlighter ink is NOT going to be of great help. Watch videos for OSCEs and rape that search button while looking up Google Images for anatomy. It really helps. Go all out in involving as many modes of learning - be it visual, audio or kinesthetic. Nobody said you can't use Google. And nobody said you could use Wiki (just don't tell my lecturers that).

Scribble (legibly)on your lecture notes - no point keeping clean notes because it's the amount of knowledge you obtain that counts! Add in whatever you think you've found useful from your extra reading or from Google! Because lecture points are just the gist; you need to further your understanding by reading up elsewhere! Which brings us to the next point.

Understand - not memorize
If you are just gonna stick to your lecture notes, you will NEVER fully understand what you are studying, I guarantee you! Books, Google, Youtube - use any of these while studying! All three are equally good, trust me. If there is anything you don't understand whilst reading your lecture notes for the first time - Google it immediately! No point memorizing that Koplik spots is pathognomonic for measles if you don't even know what it means if somebody said that you had the pathognomonic feature of blind-memorizer's-disease of not understanding what you're saying yourself. 

Want to know if you have understood something yourself? It's when you are able to picture a logical and systematic outline of what you've studied in your head without gray areas. And knowing the WHYs and the HOWs and the IFs. 

To remember, repeat - and repeat - and repeat
This applies to all subjects - for Juniors, this is called for in Biochemistry and Anatomy; for the older ones, Microbiology, Immunology, Pathology and Therapeutics. Yes, sci-fi sounding drugs names and their mechanisms of action need time to digest - and the same thing goes to anatomy and microbiology. Repeat them to yourself or to a study buddy/friend as frequently as possible - and don't wait till it's study week to do that!

You think you can remember it all or get a hang of it by just reading once? Then you don't know what you're talking about, boy. And when the exam's round the corner, you'll be sorry. 

Say no to procrastination
Stay Focusd is one of the greatest miracles ever! If you have a soft spot for Facebook, why not use the 'nuclear option' of Stay Focusd to block Facebook out of your study life for good? And yea, I know books and googling for medical stuff is boring, but you know, it surely pays when you can stand up to Dr Kamalan and confidently answer his questions without cooking up half-truths in public. Stop putting of for tomorrow what you can do today! Today's lectures should be studied (preferably) by today. This includes the extra reading for that chapter too. I know, sometimes the lecture touches on concepts that are totally new - and having about 3 to 4 of those in a single day can put somebody off - but running away will only cause subjects like Biochemistry to finally take her bloody revenge for your negligence just before the summatives!

Start early
Unless you want to die of stress and despair. Even for those who start early, study week burnout is still a VERY real thing, so if you still think you can play the 'last minute' card for JC3 onwards, then try doing that for all 12 cranial nerves and triangles and foramina and ganglia and fasciae and whats not. Without starting to say 'I'm so screwed I'm gonna die'. 

Find your outlet
Stress is a real thing, but if you know where to release all that pent-up pressure (apart from smoking and going on a one-way no-strings-attached 'bungee-like jump' off KLCC), you should be able to maintain your sanity.

Go for an hour's jog - sweat it out! Attend CF or whatever recreational activities you can be part of. Don't just study all day! And - going on FB or jacking off to porn is NOT a solution. Might as well do something more constructive during that time then such as exercise, reading novels or blogging. 

Pray and believe
Although I have placed this last on the list, it is actually the MOST important. I believe that I am not here by coincidence, and I believe that the true purpose of life (in all its aspects, including medical school) is to do the will of God. Praying works for me - it helps to assure you that there is Somebody above who knows what you are going through and is in total control of the situation no matter how hopeless it is. Med school can be a lonely place at times, and sometimes we feel lost amidst the mad-hatter race of studying-sleeping-nasty-lecturers-kiasuness-boring-lectures-that-make-you-feel-WTH, but knowing that there is Someone you can turn to in your darkest hour can be a rather comforting thought, and even a source of inspiration if you are starting to feel that insidious bit of despair creeping in. It was in med school that I began to believe the truth behind 'I can do all things through Christ who gives me strength'. 

Now, doing all the above DOES NOT guarantee that you will be totally free of medical school (or summative exam) stress - many of us will still feel the tight tension. But these steps WILL ensure that you will have a better life in medical school - less sleepless nights, less heart-pounding moments, less air-in-the-brain days. 

You are in med school - your main and most important priority is to study to save lives - and because it deals with lives, it is natural that it be demanding in scope and extent; it is not so much about you enjoying college life, because if that is what you really want, then well, you need to think about that.

That's all.