Going Green!

I just got my green!

Now just to keep up and continue contributing as a member of the awesome forum, without which I would certainly not be where I am today.

In other news…

I was rather surprised when KK called me yesterday evening to inform me I had gotten the job, especially after the recent debacle regarding the overdosing of two cancer patients, one given 24 times the stipulated amount of 5-fluorouracil. Either ways, I’m still slightly conflicted as to whether to accept this job, since I would only be there for 10 days before flying to Melbourne to settle my housing problem. I anticipate they would spend a good 3 days training me, another 2 days for me to settle down to routine, leaving just 5 days of me working before I quit and they have to hire and train someone else. From an administrative point of view, it doesn’t quite hold up. But they seem to be in a dire need of staff, and my conscience doesn’t feel too happy just leaving them in the lurch.

On the med school front, I had my medical checkup a couple of days ago. Got my xrays and blood test taken at Paragon’s Point Medical Centre and Radlink, both recommended by the Australian embassy for student visa purposes.

Note for Singaporeans: You need to bring your PASSPORT. IC won’t do. =\ I had to drive home to get my passport! Epic waste of time.

The doctor was pleasant enough, chatting about how his sons were both doctors now, and asking if my dad was a doctor as well, then proceeding to stab me with a needle. Curious isn’t it, how so many people ask if my dad is a doctor? Does it really matter? Some argue that lots of kids in medical school are the offspring of physicians, but there is an equal and unrepresented number of non-physician families in medical schools as well.

Anyway, all the test results came back negative. I’m one step closer to medical school again.

Still waiting on the info pack from Monash. It’s unnerving how long they take to send the info packs to international students. The only reason why I feel one step ahead of the other international students is thanks to updates from the local students on the forums. I.e., knowing the start of school is on the 27th of January and not the 1st of March as the offer letter states. Knowing about FOBS day before Monash sends the letter. Knowing about immunization and police checks and first aid courses. If I didn’t have my additional info source, I would be booking my flight for mid February, not have tickets to Melbourne in December, not be prepared for immunization or police checks, and would not be booking first aid courses now.

I hope they send out the info pack soon. There are 9 other internationals out there who might have no idea what’s happening.

Textbook Crazy

My mom and I have recently developed a nasty habit of pre-med school shopping. After getting the full offer last week, preparations for med school next year has gone into full steam, buying tickets for flights, textbooks, arranging for visas, health checks and police screenings. It has been a hectic week.

Not to mention, tomorrow morning I’ll be heading down to KK Women and Children’s Hospital for an interview. Over the next couple of weeks, I’ll probably be serving a short temporary tag on in the pediatrics’ emergency department to get some exposure and gain some context in which to better understand what I’ll be learning in slightly over 2 and a half months. And a little extra (which I’ll only blog about once I get into it…)

So today, mom and I went book shopping after a nice yummy brunch. We headed off to Yun Nan medical bookstore at Bras Basah and bought my first medical textbook! Kumar and Clark’s Clinical Medicine. I also managed to get Wheater’s Functional Histology, a book that was at least twice as expensive in Kino. The books were not only cheaper at Yun Nan, but the lady at the counter also gave us lots of very helpful advice on which books were good and which not to buy. While her tone was a tad condescending, I could really feel she was passionate about what she did, and really wanted to help. =) She was really knowledgeable about the books in her store, advising me which I would need, which were better or more popular, and suggesting some other books I might require in Year 1. Really nice lady.

We couldn’t find Netter’s Atlas of Human Anatomy there though, and she recommended we went to the NUS Co-op to find it. NUS was horrid to navigate about. Since neither mom nor I had any experience in NUS, we ended up spending most of our time driving in and out of carparks to nowhere and reversing out of dead ends. We did eventually find the medicine and science co-op and found a neat little stack of Netter’s. And having a quick flip through the pages, I can see what all the rage is about.

I have a suspicion that Netter’s was the book Hans Bacher was talking about when he spoke to me earlier this year about medical school. He mentioned he knew someone who did an arts degree, then went on to medical school, later becoming one of the world’s most famous medical illustrators. Netter is definitely one of them. And he graduated from design school too! His drawings are gorgeous and extremely detailed. I would have to struggle to turn off the drooling art student in me to study this book properly.

So after today’s purchases, my textbook stack has grown a little. Here it is next to my phone for some size comparison.

We later went on to Funan to 1. Buy ma’s outdated Korean drama, and 2. Drink arguably the best Ya Kun coffee in Singapore.

The shop turned out to no longer carry the outdated Korean drama, so after a quick coffee, we went about looking for luggage; an exercise that eventually turned into a hunt for a good netbook.

Now, I’m using a really pretty, fantastic, amazing Macbook Pro, currently. However, it does weigh a very hefty 2.5kg. As much as I love how it is awesome with pdf files and looks really pretty, I found myself looking at the much lighter, cheaper, and simpler netbooks. I’m terribly tempted to buy a Samsung N120 netbook simply to chuck in my bag and bring from class to class, then return home every night to write essays, make presentations, and do revisions on my larger macbook pro. Though I’m worried I might slowly lose the need to have two computers and eventually stop using either one. A decision on this would take a couple more weeks of thinking. Not like I’m pressed for time anyway…

So a bit more studying before sleep time. Tomorrow promises to be an exciting day.

Self-Teaching Anatomy

If I had known anatomy books would be full of pictures, I might have taken this as my undergrad course instead.

Kino was a treasure trove of shelves upon shelves of books and I managed to find most of what I was looking for (with the exception of Human Anatomy by Mary Marieb)

For those who are raising their eyebrows at the colorful coloring book, it’s not one of those with big pictures for kids to color in. The book contains the basics of anatomy and allows for students to color in groups of muscular tissue, systems, skeletal structures, etc so they can better understand and memorize the different groups as well as origin and insertion points of muscular tissue.

Quite a well drawn book by Kapit and Elson. Very detailed and concise. And quite highly recommended for those learning anatomy! I took a quite read through the first few pages while in the car and it has not only been really well done, but also made it very much easier for me to learn the concepts of anatomic planes, sections, and terminology.

This book should sound familiar to most people. It was the inspiration for the name of the popular television series Grey’s Anatomy. Gray’s Anatomy (the textbook) is a highly well known and used textbook in the world of medical schools (as far as I can tell so far) and I can definitely see why.

 

With gorgeous diagrams, fantastic paper quality, in depth explanations and descriptions all segregated into easy to search categories, it isn’t difficult to see why this is such a popular book.

Righto! Enough chit chat and time to get down to work again! =)

12 types of med student

All from this wonderful site I’d recommend as time out brain food.

http://theunderweardrawer.homestead.com/scutmonkey.html

I think I’m going to start off as the Questionable Admission. Then gradually morph into the guy giving patients his apartment. =\

I wish I had two brains

2 sets of eyes, 4 ears, and two right hands.

And of course, a whole stack of notepaper.

After inquiring a bit on the forums about what I would need to prepare myself for Year A of med school, the one answer that came out resoundingly was Anatomy. Now, I don’t know much about anatomy aside from what I picked up right till high school, and certainly do not profess having an in depth knowledge about the subject at all.

So I do what I’ve been doing for the past couple of weeks. Watch documentaries.

http://www.youtube.com/watch?v=S9WtBRNydso&feature=PlayList&p=9A701D54E8896D0E&index=0&playnext=1

Youtube is host to an awesome playlist of lectures on General Human Anatomy from UC Berkeley. Having watched the first lecture, I can safely say I share the same enthusiasm as the professor about anatomy, and I’m simply itching to learn more. I have 3 months to shovel down as much of this as I can before starting school. Helps a lot that the professor is not only very clear and concise about her information, but also rather entertaining.

I’m contemplating buying some anatomy books before I begin school. They might serve to be helpful through the course of my study, especially if they are really clear and help me memorize the planes of the body easier. Time to head down to Kino soon…

This evening, Papa and Mama brought us all out to Taste Paradise at Mosque Street for dinner as a mini celebration of my getting accepted into medical school. Though dad is still a bit hesitant to celebrate, thinking that at any moment, Monash would withdraw its offer. Mom on the other hand is really excited too. =) It’s great seeing her so happy. I feel like this time, I’ve done them proud.

Lulu bought me my first stethoscope! =) the Littmann Cardiology III that I had been eying. I’ll do a proper post later on about this choice and how I came to this decision having compared the Classic and the Cardiology. Right now, it’s getting a tad late. Sleep, then tomorrow, back to studying!

Prep Time

Ten years ago, I wouldn’t have agreed with myself when I say

“Three months isn’t alot of time”

Well, it really isn’t.

After visiting AusEd yesterday to certify my University transcripts, I was then briefed on what other documentation and procedures I would need to complete before leaving next year. Three months seems like a very short amount of time, especially since less than 24 hours ago, I had already given into the probability that I would never get into medicine or leave Singapore to study.

So now, I’m left with a passport expiring within the next two years, no police check, no clue about my current vaccination status, and the list just keeps growing. Things that need to be done within November:

1. Extend passport to 2015 (or at least till my visa expires)
2. Head down to Cantonment Police Complex to get a police check (requires one passport size photograph)
3. Do a serology test (cause I don’t want to redo all my vaccinations)

My mom suggested we fly down to Melbourne over one November weekend to check out the school and accommodation in the suburbs surrounding the university. Must remember to bring a camera…

Currently, I’m waiting on AusEd to process my transcripts for the purpose of converting my conditional offer to a nonconditional offer. That should be done within a week.

I’m pretty sure I haven’t had a Boostrix or meningoccocus jab yet… Not entirely sure about hepatitis… They should just attach me to a drip and give me all of them over a couple of days.

Speaking of which, I need to go down to the blood bank to donate blood next week. Anyone else interested in going? They’re pretty short on A- blood, but I’m pretty short on iron. And I’ve been coughing my lungs out for the past week.

Progress Bar 70%

For the past two weeks, my mornings have been quite a roller coaster of emotion, starting with my inevitable waking up and staring at my phone in anxious anticipation at 6am. The phonecall I wait for never comes, and I end up with a sinking feeling of mixed relief and dismay.

So what exactly have I been doing for the past couple of weeks since my return?

Well, I’ve been shopping.

I read up alot on an ongoing debate in America regarding the teaching of Creationism (now called Intelligent Design) in classrooms. Did some research on climate change and the differing opinions and hypothesis in the scientific community (i.e., Cloud cover and solar irradiation). Played a whole lot of playfish.

Oh yes. And fell sick and got semi-well.

I’m going to take a few paragraphs out now to rant a little at the doctors at the Silver Cross clinic that serves the community of my neighborhood. Some of you already know the entire shebang since I kept complaining about it. You can skip to the next dotted line to continue with the rest of the post.

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On my first visit to the clinic, I presented with a incessant nosebleed and mild fever, and informed the doctor that I had been in Australia for the past 3 weeks and only just returned the day before. The doctor told me the nosebleeds was due to the dry weather in Australia (disregarding the fact that my nose only bled in Singapore, and was fine overseas), and the fever was due to the nosebleeds. He prescribed me with nose drops and sent me off without anything else.

On the third day of my return (1 day after seeing Doctor #1) my fever continued to climb after the nosebleeds stopped, now spiking at 38ºc but fluctuating wildly with lows of 37.4ºc. I began getting severe headaches and a slight rash began to develop on my legs and back. So I go back to the clinic and see the attending doctor at the time, Doctor #2. This time my mom went with me to make sure I got some medicine, or at least some reasonable explanation.

Doctor #2 asks some questions and quickly realizes that Doctor #1 had put “returned from Australia 3 weeks ago” instead of “was in Australia for 3 weeks”. He then performs a general examination, finding no visible inflammation. No coughing or sneezing was present. He explains that I do not have a fever (fever has to be 37.5 and above), and the rash is due to friction in the dry weather of Australia (also disregarding that the rash developed when I returned). He says I have a non-localized minor viral infection and he can’t do anything about it.

My mom at this point gets a little flustered and asks alot of questions about H1N1 and whether I might be at risk. The doctor becomes visibly irritated with us (this is only 3 minutes into the visit) and gives curt, short, and rather uninformative answers, saying he can’t do anything unless we want a blood test, which he cannot do for us in the clinic either. After this visit, I was sent home with no medicine.

Now (1.5 weeks later) the rash has spread to my arms, up my back, on parts of my scalp, down most of my legs to my feet and soles. The fever comes and goes still, some days at 37.5, some days completely normal at 36.9. I’ve got a dry cough, and random muscular aches. And I have daily headaches and resort to up to 6 panadols a day.

In my opinion, I have a really mild case of H1N1. Minus the rash which seems like an extra symptom.

I suppose I am pretty miffed at the doctors at Silver Cross.

1. take the time to listen to your patient and take down the correct history. There’s a whole world of difference between “returned 3 weeks ago” and “was there for 3 weeks”. Especially in a H1N1 hotspot like Melbourne.
2. Try to explain your suggested diagnosis properly. I didn’t exactly buy the “dry weather in Australia” to explain my nosebleeds, given that my nose only bled in the much more humid environment of Singapore.
3. Don’t just dismiss your patients. You may see dozens of patients a day, but a patient sees just one doctor. Getting irritated with their questions and treating them so flippantly is highly unprofessional, and definitely not what I have been studying clinical ethics to become.
4. Ask more questions. I had to ask all the questions like “do you think it is contagious”, “are there any steps I can take at home to alleviate the symptoms”, and “I work with young children. Should I be taking an MC”. If he had just let me walk out of there, I might have gone back to work, and spread my unknown itchy sickness to all the kids.

Sigh… I understand doctors these days have to deal with alot of probably well but think they are very unwell patients who stream in droves to clinics. But their goals are not to waste your time. Ambroise Pare said a physician’s job is to cure occasionally, alleviate often and console always. It’s in cases like these you should push yourselves to practice the other two aspects of what makes this such an admirable profession.

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Anyway…

It’s the second week of October now. So the results of the Monash GMS interview should be out any time now. To be honest, while I hope for the best, I’m expecting the worst. I’m actually waiting for the email to come in the morning saying “Dear Yuying, we regret to inform you….”

My parents sat me down during lunch today to discuss what they feel I should be doing should I not make it to med school this intake. I know their qualms about me trying another year. I’m their first born, and the only graduate. And yet, unlike their friends’ kids, I don’t hold a steady job, haven’t started my career, and don’t have a rock solid plan for the future.

They discussed with me today the possibility of me taking a joint ACCA ICPAS course leading to a CPA in 3 years, all the while working at my dad’s office to learn the ropes. After getting CPA, I might get to be a partner, and take over the business my parents built from scratch.

I feel a bit of moral obligation to study accounting, to be honest, as much as the thought repulses me to no end. None of their kids has taken up accounting, and with the other two of this trio with someone formed ideas of their futures, that leaves just me to pick up the pieces.

Sure, I don’t mind so much. With this job, it’s stable, I know I can provide for my family in the future, my parents’ life’s work is safe. But my heart screams it’s not what I want.

But then again… Am I just being childish and selfish, clinging onto these dreams that are never meant to be? I’ve wanted to be a great many things in my life.

I’m so sure I want to be a doctor. I’m so sure I want to save lives, make a difference with these hands of mine. I’m so sure I was meant for something greater.

But what if this certainty of mine is wrong?

I need more time to think about this.

The Interview

Okay.. So the interview is now over. To be honest, I’m quite disappointed in myself. I felt like I didn’t answer the questions to their satisfaction, hadn’t considered certain angles of the scenario, couldn’t think in those particular ways.

Didn’t, hadn’t, couldn’t.

Makes me wonder if I’m really suited to becoming a doctor.

I found out today that there are 25 interviews being held for 10 international spaces, rather than the 15 I originally figured. Some of the folks who interviewed with me today already have offers elsewhere. If only I were so lucky. Choice seems to be a luxury to me.

Not that the people at the interview weren’t nice. Not at all. They were awesome. Once we all started talking, it was easy making new friends. Might be showing some of them around Singapore tomorrow before we all fly off.

Yep. I’m flying off on Sunday night to Perth, then heading to Melbourne, and driving to, hopefully, my new school down in Gippsland.

But after today, medicine feels even more out of reach.

Today was the closest I’ve ever been to medical school. But I’m not sure if I would have given my answers any differently. I stated the key stakeholders, their probable qualms with the issues at hand, my point of view, then stood by it no matter what the circumstance. I think I did okay. But is okay enough?

The wait till the interview was agonizing. I got up at 8 in the morning, for the first time in weeks not dreaming about an interview (I instead dreamt of donuts with wings). I ironed my clothes, laid them out, took out all my accessories (watch, phone, earrings, necklace) and laid them out in neat OCD-like rows parallel to my clothes. Then sat. And waited. And waited. And tried thinking. Then gave up. Then waited.

The interview itself was pretty straightforward. I got there a good 45 minutes before my interview was due to start. Talked to everyone who came in to check in for the interview. Turns out that nearly all of us applied for Monash. The lady then explained to us how the interview was going to work, then brought us to the floor below for the interview session.

Each interview was held in a separate room. It was just a table, two chairs, and a laminated paper in front of you with your scenario for the session. Each session lasted 7 minutes, inclusive of the time taken to knock on the door, enter, greet the interview, sit down, and read the question. I think I used up nearly all the prompts available. And in a Singaporean O Level student sort of perspective, this is a bad bad bad thing.

I felt that a majority of the questions called upon a prospective student’s own background. I’m not sure if that’s what they intended, but I felt like if I were someone else, someone born in another culture, another country, my answer would be different. For example, it is acceptable in asian cultures to discipline your child by hitting them or yelling at them. It is unacceptable in Chinese cultures to share a bed with a member of the opposite sex if that person is not a member of your family. As a person who has never had children before, my first concerns go out to whether the caretaker is in the right frame of mind, rather than “that kid might be backing up towards the road”.

I’m really uncertain about my answers, really. If they were good enough. If I stated myself clearly enough. I’m not even sure if I might give different answers if I had to do it all over again.

So I guess those really are my answers. And that was really me. Now it’s up to the interviewers to decide if “me” is who they’d like to see become a doctor.

Tomorrow

Will be D-Day.

Interview is set for 4.20pm, lasting 81 minutes.

81 minutes that may change my life.

It’s all a bit terrifying and electrifying at the same time. All wrapped in a haze of disbelief. In 17 hours, I will be the closest I have ever been to medical school. The giddying sensation of excitement is intoxicating and causing a bit of a headache which I should, wisely, choose now to sleep off.

Interview Resources

This is actually already posted on Paging Dr. But here it is on my blog in case any readers don’t frequent that site and need some help preparing for the interview.

There are actually quite a few sites out there which help in preparing for the MMI format that Monash (as well as several other universities) employ in screening med school hopefuls. This is, by no means, an exhaustive list. You should constantly try to formulate your own perspectives on the issues they’ll bring up, always taking into account the different available viewpoints.

The interviewers will be looking for the following in your answers:

1. Good Communication Skills
2. Sense of caring, empathy and sensitivity
3. Ability to make effective decisions
4. Ability to contribute as a member of a team
5. Appreciation of place of medicine in wide context of healing
6. Sense of vocation, motivation, commitment in the context of medicine

The ethic scenarios given will circumnavigate these themes and you have to try to show them. Clinical Ethics (McGraw Hill Medical) highlights the order of consideration in the discussion and consideration of ethical dilemmas:

1. Medical indications
2. Patient preferences
3. Quality of life
4. Contextual Features

I just started on this book this morning. It’s a pretty lengthy and dense read, but very informative overall. A book that’s highly recommended, but I unfortunately cannot get a hold of in Singapore, is Ward Ethics: Dilemmas for Medical Students and Doctors in Training. It goes through quite a few scenarios that med schools tend to favor, apparently.

Here’s a website which discusses various scenarios which might come out during the interview for discussion.

http://pagingdr.proboards.com/index.cgi?….read=329&page=1

This one has some questions which can get you started (you might need to scroll down a bit):

http://pagingdr.proboards.com/index.cgi?….play&thread=308

I’m assuming there’ll be plenty of questions regarding ethical issues. So here are a couple of sites I’m looking at to prepare for that:

http://www.nhmrc.gov.au/health_ethics/health/index.htm
http://www.cmaj.ca/cgi/collection/bioethics_for_clinicians_series
http://bioethics.net/

And some sites regarding current affairs in the world of medicine:

http://www.6minutes.com.au/

I find that discussing issues with friends and family members helps in seeing different perspectives and new ideas. I’ll try to post up some of my own notes regarding past interview scenarios over the weekend. Please post any of your own thoughts. Some intellectual exchange would be excellent to haul me out of my own inner rambles.