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Re: med curriculum

Posted by alexandra_k on September 3, 2014, at 18:00:03

In reply to Re: happy, posted by alexandra_k on September 2, 2014, at 23:01:20

so the wonderful wonderful wonderful learning lady passed on this link for me... and i've been able to view the manuals that the med students are given (and have to sign off they have read) about the med program... and so i spent a few hours last night reading through that...

and things start off mostly okay. the first two years very science focused. they do have a cadaver lab and they also have an imitation clinic, thing. you don't have to act as a model for other students - they won't penalise you if you don't provide your consent. i guess i thought... things mostly seemed okay. and your cadaver died of something and you have to figure out (with your team who is all working on the same one) what that might be... over the course of the year... so that sounds kinda cool, actually.

and then in the third year they transition you a bit to 'real patients'. and i guess that is simply one of those things that they never can totally prepare you for and either you take to it or you... do not. not much transition though, really. you... follow a pregnant woman through till the baby gets born and stuff. as a way of learning about that. infant development. i really liked that, actually. as a way of learning about that. i guess that little kids concern me because i have no experience with them, really. i've never even held a baby. i have no idea how i would feel. i think it would be alright because (this will sound odd and bad)... it would be on my own terms. i would have the power to put it down. i choose to pick it up. it isn't like it grabs at my leg when i'm least expecting it... not for a few more years, at least... there was another special study like that as well... i can't quite remember what it was but it sounded really wonderful, again.

then your fourth year you have a bunch of placements through different areas. and the class gets split off and people get shipped off... that worries me, actually. the idea of being shipped off to who knows where...

the books... the tone of them progressively changes. they are all sort of cuddly almost early on. all... friendly. later on they are all 'you have to do this or else y will happen to you' (e.g., you have to get your *ss to maaori week or else you won't pass the year) or you have to get to y day or else you will be in danger of not passing competency requirements... i guess... attitudes change over the years... and it looks like the attitudes of the student docs becomes progressively 'do i have to?' 'do i have to, really?' and 'but what if i don't?????'

but then noticing things like how you have to work one long day per week... how you have to be on call up to 10pm one day per week. how in your 4th year you get one 1/2 day per week for study. not just individual - but group tutorial activities are chucked into that time... then only 1/2 a day every two weeks in your fifth year... and tutorial activities again... and i see why 'do i have to? i mean, really? what if i don't?' might start to catch on... then something about if the house doc gets sick or goes on leave and you are in your 6th year you can take on their duties for up to three weeks... AND NOT GET PAID BECAUSE IT IS A WONDERFUL LEARNING OPPORTUNITY FOR YOU! mmm hmm... i see...

and there is A LOT about how... you are expected to be proactive about seeing patients. and about holding instruments in a very long operation is probably not the best use of your time. and about how being given after hours access etc etc is a privaledge that you have a glorious learning opportunity 'do I HAVE to match the hours of the house doc???'

oh dear.

the... uh... the areas of med i was most worried about... pediatrics... obgyn... psychiatry, even... are saved up for near the end. year 5 or 6, i forget. guess they are saving them up for increased emotional maturity.

there were various things that reassured me. they were pretty clear on how you were NOT to write prescriptions, sign death certificates, request labs etc etc etc. all these things mean a big whopping safeguard about being dumped with too much responsibility, i think. and so your supervising people can't think you are too much of a pain in the *ss for bothering senior people all the time... because you simply have to. no way around it.

the thing that sticks out as concerning for me is... probably the thing that is most concerning for all. which is a great shame, really. because... it does affect me more, i think. but it also affects us all. and there simply won't be any shortage of people trying to get accommodations for it.

- placement. with respect to sorting out accommodation and transport. especially the case since i don't drive. and i know full well i do not want to go to some rural place where they can clear out the paddock next door and pitch me a tent :(

where i live currently... i'm a 15-20 minute walk from the hospital. so i could be on call from here, i guess. i could get to the hospital in 20 minutes if pushed. any time of the day or night. tauranga or rotorua... buses don't run particularly late. and they only run every 30 minutes or so. so i'd need to... get accommodation very close... or take a cab. or maybe get a bike. or ideally (i suppose) get a f*ck*ng motorbike lisence. since most places require you to use street parking anyway and good luck with that unless it really is middle of the night... or else parking is really expensive...

i'd imagine... the people who are placed in the same place probably pool for big shared houses that are close. it really would... make sense. i... honestly... i don't know how i'd go. i'd imagine... the year would be quite a blur, really. like, uh, summer camp. almost like being in the army or something. i honestly don't know how i would go.

even in auckland... south auckland may as well be a different city, really, with commute times... north shore is pushing it. without a car it is impossible. anyway... everyone is in the same boat, i guess. i think... i think they probably do try and match people a bit... putting people with family or whatever for year 5, at least (since you do get paid - about the same as a phd scholarship for year 6 - and year 5 is pretty full on compared to year 4 with respect to your supposed to take 1/3 the caseload of the team and 'pull your weight' with respect to long days and being on call up to 10pm).

and of course i'll need to accumulate appropriate clothes along the way. they start out 'if you can see up it, down it, or through it, don't wear it'. they end up with 'remember that your professional colleagues and patients are judging you on what you wear' or similar. anyway... they couldn't be clearer: NO jeans. NO trainers. dammit. no yoga tights either, i'm betting. sigh. oh... also no scrubs in outpatient clinics or anywhere outside the hospital. they are very clear: they are NOT a status symbol. which of course means... that all the med students think that they are.

ahaha.

anyway... you can do an honours year after year 3 (before the clinical stuff starts up). this sets you up for if you want to do a phd later. they encourage all that stuff blah de blah. if you decide being a doc is not for you (typically discovered during year 4) you can switch to a science degree with another semester of studying or something like that. so...

so...

i guess supports are hard because you are increasingly... well... short rotations. between 1 and 6 weeks. you don't have a bunch of time to be running off to counsellors or whatever. i guess... i guess i see how the shared house thing really is the way to go. then at least you can ask the people there (when you can catch them) for ideas / help with dealing with that weird doctor or that bitchy nurse or whatever... anyway... i guess i do feel scared about whether it is for me or not... but i do think i would really like to give it a shot, for sure.

i'll... probably get year 5 where i grew up... my mother actually lives within 20 minutes bike of the hospital... even though i'd really much rather not live with her... i guess that is there... and it is a huge hospital. and for things like specialist surgery or A&E it is the place to be... so...

i don't quite understand why they don't have halls for student docs on site... probably because then the nurses will want them and then the physios... and then the tea people and the orderlies will point out that they are doing degrees in hospitality or whatever and they are at the hospital on placement, too... and before you know it... sigh.

anyway...

the weirdest thing was reading about psychiatry placement... there were little blurbs... almost recruitment blurbs... guess they are trying to recruit people year 6. and have them want to stay there for their elective (which you get to elect unless you are made to repeat something that you failed). because we are allowed to go overseas for elective year 6... at our own expense... that might well be worth borrowing for... to get to go someplace... to try and set things up for a decent junior doc position or whatever for year 7... for eventual specialisation.

call me crazy... but i think i'd like to do an honors project on curled / clawed toes. after foot surgery. i wonder if they splint them straight if that would prevent the tendons from shrinking into a clawed position. that might make rehabilitating them later (physio etc) much easier. with respect to walking / balance. of course i know that really one does the honours project that one is told to do... we'll see...

anyway... plenty where that came from if somebody steals it...

i really do want this...

oh... psychiatry placement... where i spent... a couple years of my life, really. as an inpatient. seeing what the 'big wigs' (whom i never met) have to say about things... year 6... you get to diagnose a fake patient (an actor). i diagnose: fictitious disorder. ffs. ffs.

 

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poster:alexandra_k thread:1058481
URL: http://www.dr-bob.org/babble/social/20140828/msgs/1070714.html