Aussie-Chinese Girl Reflects on Her Med Practitioner Journey

 As the Melb Weather Goddess has finally decided to grace us w/ more summer-like temp and weather cond (here and there 😅😭), everyone I know who is not otherwise (forcibly) tied indoors (i.e. effing exam season pour moi 💀) is rushing to beaches, parks, and outdoor dining seats. But as everyone knows, Australian nature is out to get us, from the hole in our ozone layer to our deadly animals, so now is as good a time as any to raise some sun protection awareness.  A newly published study by Canadian researchers discovered a phenomenon they're dubbing the "sunscreen paradox", which is basically when people feel invincible after applying sunscreen so they are more inclined to engage in dangerous sun-exposure activities such as  going to the beaches when the UV index is dees as being extreme   not taking other sun-protective measures e.g. wearing a hat, UV outer layers only applying sunscreen once and never reapplying inadequate amount and/or covereage of sunscree...

To celebrate Halloween as a med student, thought it would be fun to delve into my (current) Top 5 most disturbing medical conditions/px. I will, however, spare y'all the gruesome images, but you're welcome to search them yourself out of morbid curiosity, but disclaimer, what you will find is defs NOT for the faint-hearted. So w/o further ado...BOOOOOO #5 - Fournier gangrene 🤢 What is it? Acute necrotic (cell death) infection of the scrotum, penis, vagina, vulva, or perineum (groin area).  B/g info Incidence: 1.6 in 100,000 males (M:F 10:1) (altho I've already come across this > 1 🤮) Can be: idiopathic (of unknown cause/origin), colorectal, urogenital, or cutaneous origin/spread Implicated in: anorectal abscesses, UTI, post-op Comorbidities/Risk Factors - Immunocompromised/immunosuppressed state - DM (px 60% of cases) - Morbid obesity (BMI > 40 if asx, BMI > 35 if sx)  - Alcoholism - Liver cirrhosis  - Crohn's - SLE  - HIV - Malignancies  - Insufficien...

aweoifjaweoifj I just did my long case exam yesterday morning, now anxiously a/w results to come out tomorrow, but tbh, will not be surprised if need to resit (for several reasons, both personal and external). FYI - long case is an exam style used in BPT (basic physician training) where you have 1 hr w a pt to take a comprehensive hx and o/e, 10ish min to organize your notes and thoughts, then 10ish min to present your findings, imp and issues list to the examiners, then ans their qs for another 10-20mins (or what I like to call "be executed"). @unimelb med school, the examiners are not in the room w u for the first 1 hr, but they've done their own consult for 15mins before you see them, and you're given a list of the pt rx and obs. It is by far the scariest and (in my opinion at least) easiest to fail exam in MD2. It has defs been a thundercloud over my head for the whole year which I've tried my best to ignore (maybe a bit too much...😅) but I've been slappe...

The medical school system and healthcare system have an uncanny ability to suck the joy, aspirations, childlike curiosity, and genuine empathy from its students and healthcare workers.  Don't get me wrong, I'm not regretting my decision to return to the system, but when you've been in the hospital for 7hr+ UNPAID and just there for the experience and your own learning, then gone home and realized you still have a Mt Everest worth of lecture content to plough through, there's no way you won't ask "why am I doing this to myself?" "am I just a sucker for punishment?"  I for one am lucky enough to have personal responses to this which are "Remember that time when you saw the resus team bring someone back to life from cardiac arrest?" or "Remember when Mr B was super grateful for you spending 2hr talking to them like another human and they confided their struggles with suicidal thoughts to you first and not their treating team?" et...

I’m sure y’all have heard about different learning styles, so much so that you probably have ear callouses 💀 BUT hear me out, this is super important in med school, esp transitioning from pre-clin to clin. And imma just focus on two broad category - practical v textbook learner .  First of all, IT’S A PROCESS , a process that took me nearly 2 years to figure out so don’t fret if you feel like you have no idea how to juggle placement time v desktop study time until end of 1st year clin or even beyond. BUT if I could give MD1 me any advice, it would be to actually sit down and think about how I learn best (ugh boring I know but I promise it will save you so much grief later)  Why do I think knowing if you’re a practical or textbook leaner is particularly important for clin years? Cuz you will hear all kinds of advice about how much time to spend in hospital v at home or in a library or wherever you study best. I’ve heard anything from “wish I spent so much less time in hospital...

aowiejfaoweifj oaweifj  First time witnessing a heated argument between 2 different medical teams and tbh still a bit shooketh. Not gonna name names here but it was also an extremely dumb argument that at its core is nothing more than politics and completely unrelated to patient care.  Long story short, we had a new pt in ICU who was apparently referred to X team as the home team but no one from ICU or ED called them about it (the pt still showed up on X team's inpt list). A very irate X team reg came storming to our team and kicked up a fuss about how that's super disrespectful and if they knew the pt was going to be under them and not just a consult, they would've brought her consultant over to r/v the pt. She kept cutting off our consultant to the point that the consultant actually said "I apologise for the miscommunication but let's not forget that we're all here to do what's best for the patient, and regardless of whether the pt is under you guys or an...

 If you're from Aus, you would know my pain of waking up at 6:30am but feeling like it's only 5:30am BECAUSE IT TECHNICALLY WAS until Sun 1/10 when we skipped from 1:59am straight to 3:00am, essentially losing 1hr of much needed beauty sleep 💀 Pair that w AFL Grand Finals long weekend in Vic and you have a miserable workforce and miserable students w morning classes/lectures/placements 😓  In keeping w this awful phenomenon, I thought I would post about our body's natural circadian rhythms, certain physiological diurnal patterns, and why the 21st c. living style w overstimulation (screens, but also mental and physical) is a nightmare for our body's natural daily cycle 😑  (yes, this is now how I spend a large portion of my free time now, yes, super nerdy, but who isn't in med, and no, don't believe any health profesh when they say they aren't nerdy, they are nerdy, just not like god tier nerdy w/in nerd popln LOL)  What is the circadian rhythm? - Body's...

What better time to talk about concussion than the Footy Finals? (also, only barracking for the Pies cuz I still have pride as a Victorian LOL - open to who I barrack for the long term → only recently got into footy a bit) Also notice how we Aussies can't even be bothered to say Magpies, nope, its just Pies 😂 But back to health awareness topic of the day → CONCUSSION IS A SERIOUS PROBLEM IN HIGH- CONTACT SPORTS AND NOT TO BE JOKED ABOUT. Personally, I can no longer watch a rugby game in peace thanks to my experience as a sports medic last year and all the near misses and actual head traumas and injuries and concussions and don't even get me started w spinal cord injuries (SC inj) 💀 So what do we actually mean by concussion? - Medical def: altered mental function or level of awareness due to a head injury → considered a MTBI (mild traumatic brain injury), can be transient or more serious, +/- hosp px and admission - (My) layman's def: head knock → concerning enough for me ...

 If you’ve read my very first post, you’ll know that I was struggling a hekking lot w life and med school in 2021 and was dx w adjustment disorder mid 2021 and took 1.5yr LOA before recommending 2nd year med this year. Well, it’s only since like mid year this year that I felt comfortable enough to explicitly say, yeah I had adjustment disorder, yeah I have a psych l, yeah I’m on escitalopram.  Apparently I’m a good “fake it til you make it” person cuz subject coord at Western clin school thought I was like totally ready and eager to come back from Feb when actually I was internally screaming, attending ward rounds just to hide in library or bathroom or anywhere else (no I’m not disclosing my secret hideout, everyone has to find their own in each hospital, and trust me everyone needs one) until last 2 weeks of Sem 1.  Also massive newly discovered pet peeve: don’t assume I’ve always been an extrovert and happy to start convo and be proactive and whatnot so I don’t struggle...

 “9yo not likely to have sexually transmitted epididymo-orchitis but maybe times have changed, I don’t know, I don’t tx < 16yo” “Pt usually don’t like suppositories, expect the French, but they’re a diff breed”  “You can get nephrostomy tubes w a string tied to it so pt remove it themselves by pulling on the string - not that pleasant but in Canada, completely public sys so no choice - they just gotta suck it up and get on w it” “[causes for blah are blah etc] and a whole bunch of other stuff” → dis why med students perpetually stressed 💀

Reflection of the day: BRAIN FOG → Dis kid got overly excited over the 26 sunny weather in Melb and forgot about the cursed temp diff and landed herself w most likely the common cold (tested COVID -ve thankfully 😁), potentially bacterial infection secondary to viral currently (only now experiencing coryzal sx w productive yellow/green sputum 🤢). Last few days finding it difficult to concentrate on lectures and brain-intensive learning in general, so thought I would look into this common phenomenon known as brain fog.  So what is brain fog?  It is NOT an official medical term  It is used by pts to explain their sx of difficulty concentrating, focusing, performing daily tasks (e.g. taking much longer to do something than they normally do) etc Can be ACUTE or CHRONIC  What causes brain fog? One study conducted by Dr Ali Mazaheri (A/Prof in Psychology at the University of Birmingham) shows that inflammation is implicated in brain fog and directly affects attention Th...

 I was today years old when I found out that coffee round is a VICTORIAN thing. Ok, sorry all other states and countries, Imma stay right here in the coffee capital of the world (apparently). Apparently it's only a team dependent thing in other states (and St Vs????? what r u guys doing????) Coffee round is like THE team building exercise within a hospital, heck even surgeons will go for coffee rounds if time permits → it's what UNITES all clinicians and the first step of medical students feeling like they're part of a team and not just a pot plant...mostly 😅 Anyways, coffee round is soooooo important in Melb (and imma assume whole of Vic cuz come on, who isn't addicted to coffee and caffeine round here?) that during transition from pre clin to clin, older med students will give a COFFEE ROUND ETIQUETTE lecture to the naive newbies full of unadulterated excitement and passion for finally interacting with real patients (and I pray to god that they never lose it in the f...

 Today is Day 1 of Dementia Action Week 2023 in Aus (which J only found out about on the drive to work today from ABC News Radio 8:20am), so I thought it would be good to do a series on dementia like I did w mental health last week 😊 What is dementia? - Dementia = umbrella term used to describe a collection of signs and  sx  involving cognitive function decline (problem-solving, memory, planning, language etc.)  -  Single word descriptors include but not limited to: Degenerative ( = worsening over time)  Global ( = affects entire brain ∴ multitude of varied sx) Umbrella (term = dementia is actually used to described a variety of sx & signs that are caused by disorders/ conditions of the brain) Variable ( = b/c dementia is an umbrella term of signs & sx,  every individ dx w dementia is affected differently) Late-onset ( = most pt are dx later in life ≧ 65yo, BUT Also young-onset  (~28,000 Aussie estimated to live w young-onset d...

Dear brain, I hate the way you overthink, And the way you cause self-doubt.  I hate the monkey who drives my car,  I hate it when you don’t let go.  I hate your dumbass downward spiral,  And the way you drag me down.  I hate you so much it makes me sick.  It even makes me self-reflect.  I hate the way that you are me, I  hate it when you lie.  I hate it when you make me laugh.  Even worse when you make me cry.  I hate it when you just shut down,  And the fact you gave no signs.  But mostly I hate the way I don’t hate you, Not even close, Just a tiny bit.  PS if you didn’t get the reference, bloody go and watch one of the greatest if not the greatest coming of age film ever. RIP Heath Ledger

“A Victorian coroner is again calling for the introduction of pill testing after a man died from an MDMA pill known as the Blue Punisher at a festival last year – the fourth coroner to do so in six years.” - Opening statement from  Coroner again pushes for pill testing after ‘Blue Punisher’ death  ( The Age ).  What is “blue punisher”?   - high potency MDMA/ecstasy* - Small blue pill w Disney+ Marvel TV Show Punisher logo (skull) on it What is pill testing?   - Centre for VOLUNTARY, CONFIDENTIAL, NOT REPORTABLE pill testing - Will inform attendee composition of their drug to facilitate better informed decision making - Education and advice can also be given if desired Introduced as a drug harm reduction policy - Currently being trialled in ACT and QSD, no plan to roll out in VIC as of yet   Why is pill testing endorsed by many?  - Independent r/v conducted by Dr Anna Olsen on outcomes of pill testing at Canberra’s Groovin the Moo festival in Apr 2019 ...

Please pay doctors esp junior doctors overtime!  Also don't have ridiculous working hours like 14hrs!!!!!  US wtf are y'all doing? Avg working hours for residents are 40-80hr/wk, w some occasionally logging 136hr/wk     🤯🤯🤯😡😡😡  Ya'll know that according to the Fair Labour Standards Act (FLSA) (for USA before people get ansty at me that this is an Aus only privilege):  ANY WORK OVER 40HR/WEEK IS CONSIDERED OVERTIME and SHOULD BE APPROPRIATELY REMUNERATED!!!  Feeling really lucky that in Aus our avg working wk as junior docs is 50hrs + PAID OVERTIME. What are you doing America (follow @DGlaucomflecken )    Lemme show by example below what overworked, sleep-deprived doctor/health professional interaction can be.  This is an ACTUAL convo I had w a final year med school friend at 7pm when we’ve both been up since 5:50am  What friend actually said: “[mutual friend] dipping Ortho rounds cuz she’s not surgically orientated and is...

Pretty sure I experienced a hypoglycaemic event today around 1pm --> was told by gynae to try intermittent fasting restricting intake from 10am to 6pm so only had a cup of coffee (+ disgusting TCM) at 7:30am in the morning. Ward round did not finish until 12:33pm (which is early for gen med let's be honest 😅😭) and by 1pm I experienced bilat paraesthesia down UL  to entire hand & fingers, and eyelid twitching L > R......anyways not good + sx resolved spon post-prandial 😅 Revised eating schedule --> 2 eggs (or up and go if I snoozed one too many times XD)  ← highly recommend this insta pg for daily dose of dark humour 😁😈💀 ( @momsbehavingbadly )

 Was just in the backyard pulling out weed that seemingly grew outta nowhere after heavy rain from the last 2 days in Melb (thanks Melb Anemoi, got me excited about Spring coming and then hitting me w hekking cold rainy winter temp and weather 😡), and was hit by a med analogy as you do (#justmedstuff).   Weeds = cancer cells → both grow uncontrollably and mad fast, wrecking havoc to the perfectly good body/lawn; in getting rid of either, you inevitably will destroy some good grass / normal healthy cells respectively 👿 Rain = glucose → preferentially stolen by the cancer/weed to the detriment of everything around it 🌧 Gardener = multidisciplinary team (MDT) of health professionals, family, friends, and community → both try to treat (tx) and manage (mx) the cancer/weed 👮 Garden tools = all the investigations (Ix) and tx options for cancer → getting rid of the tougher growths 🧰  Surprise dog turd(s) hidden in the grass = rude new or recurrent cancer diagnosis (dx) ...