Medical Education Monday – Social Media

Today’s Medical Education Monday is going to take a bit of a different direction. I’ve run out of foreign medical students and doctor friends for the time being, so today I’m going to focus on a different aspect of Medical Education – Social MediaIn the mean time, if you know someone in medicine from a country we haven’t covered send them my way – I’d love to have them! If you missed it, you can read through the past editions of Medical Education Monday here

Original Photo Courtesy of Flick Creative Commons User: smemon87
Like other medical student bloggers, my experience has been that, while really wonderful and up-to-date on most all subjects regarding student relations and professionalism, my school has largely ignored the prospect of students or physicians having a presence in Social Media. We’ve had one or two discussions on the subject whereby a (non-tweeting, non-blogging) professor stood at the front of the room and declared “The Facebook” a bad place to spend time. We were basically told not to “friend” patients and that was that. 


This obviously overlooks a very large, and likely more positive, realm of social media – blogs and Twitter. 


Most people use Facebook as a personal outlet – a place to stay caught up with friends and family members. I don’t think any of you need to be told not to friend your patients on your personal Facebook accounts. So, why are we dodging the larger issues? Why are we ignoring the fact that there needs to be a set of rules and examples in place to avoid issues like what happened with the Kansas nursing student who posted a placenta photo on her Facebook*. 


We really need to stand up and demand a defined set of rules for social media use, not because most of us are breaking any rules with our blogs or tweets, but because without one we are all at the mercy of what a school administrator arbitrarily finds to be “unprofessional.” And, as we saw last week with the Twitter & Blogging Physician Professionalism War of May 2011, the definitions of professionalism vary widely amongst people in our profession. 



So, why don’t I simply talk to my school admins and request that a set of rules be put in place? Well, like fellow med student blogger Fresh White Coat said so well, after the lectures and “advice” we’ve been given regarding the use of Social Media I simply don’t trust that a constructive, rather than restrictive, policy will be devised.


That being said, I’m going to take some time over the next few weeks to write some posts about how I feel my use of social media has made me a better student and will make a better doctor. If we can show the nay-sayers just how beneficial the world of Twitter and blogging can be to us as students, perhaps we can move forward in the initiative to get uniform guidance, support and protection laid out. Until then, we are quite literally at the mercy of an arbitrary definition and pliable area of gray. 


I’m going to need your help, though. If you’re a medical student, doctor or patient (that covers basically all of you) please leave a comment telling me how you think social media has positively influenced you. Has it connected you to other students? Other physicians? Given you an outlet to discuss issues that are important to you? Kept you up-to-date? Helped you learn to engage in academic and medical conversations? If you don’t feel comfortable leaving a comment, feel free to contact me.  


Over the next few weeks I’ll compile your positives and many of my own and discuss the pros of social media. We all know the cons and I don’t think I need to waste my time listing that out here, instead I will discuss things like

  • Why I choose not to blog anonymously
  • How Twitter communities of patients and activists have helped me
  • How meeting med students from around the world has been beneficial 
  • Staying up-to-date & aware thanks to Tweeting/Blogging students & docs

I look forward to hearing your opinions!


*I’m not here to debate the rightness or wrongness of this, but for the record I 100% believe the school was in the wrong to dismiss her from her studies. 

Where’s My Hand Sanitizer?

Today is your lucky day – I have some extremly useful, likely life-saving, information to share with you. Everyone isn’t crazy enough to go to medical school, so it’s a good thing there are bloggers like me to save you from the deadly microbes of the Earth that only the board-reviewing med students know about.

Things You’re Doing That Could Kill/Seriously Injure You:

Petting Prairie Dogs
Yersinia pestis, AKA – Causative Agent of the Black Death

 Grocery Shopping
Those nifty mister things in the produce aisle? Deadly.
If you must grocery shop, wear a Legionella-protective mask.

Gardening
Sporothrix-induced ascending lymphangitis waiting to happen. 

Owning Cats
Toxoplasma gondii laden poo.

Feeding Pigeons
Other than being generally disgusting, they carry Cryptococcus neoformans,
which can give you a nasty meningitis if your immune system’s not in tip-top shape.

Sooooo, med student/doctor/microbiologist/nerd friends, what’s your favorite microbe? I know there are a TON of slightly amusing germy-things I didn’t choose to illustrate here, tell me the ones that have stuck with you!


Images courtesy of Flickr Creative Commons: p_a_h, Andrew in Durham, erix!, eviltomthai, eggybird

Medical School in The Caribbean

Over the course of this series it has become very apparent that medicine is a competitive occupation no matter what country you live in. This holds true to higher degree in some countries more than others. Brenda, a Canadian in the midst of getting her MD from a Caribbean medical school, was nice enough to do a write up for me on what it’s like to get your medical degree from a school in the Caribbean. The Caribbean school route is becoming extremely common amongst American and Canadian students and I felt it was an avenue that definitely needed to be covered in the Medical Education Monday series. I’m really excited to have Brenda’s information to share with y’all today. Please feel free to email me with questions and I will make sure she or I finds the answers for you. As always, comments I’ve added are included in orange font.

Picture I took last summer of St. Matthew’s University residence hall in Grand Cayman.
It literally backs up to crystal clear water & white sand beaches, not fair!
Medical schools have been popping up in the Caribbean for many years now. These institutions offer the opportunity for individuals who have not been able to get into a Canadian or American school a chance to still persue their dream of becoming a doctor. Each school is slightly different, so please do your research when thinking of applying. Also, be wary that some schools are not exactly permanent – they get built and try to get as many students as they can and then shut down. In addition, some schools are not approved by all governing bodies, so please do your research! There are some really good ones that have been around forever and are getting to be as competitive to get in as an American school, but before you apply you need to figure out which ones are appropriate. (Click Here for information on Accredited  Caribbean Medical Schools).

My journey was tough. I went back and forth with several options. When I finally decided to pursue my dream of medicine I didn’t have the time to go through all the required courses in a Canadian university. I did my research and found a school where they offered a pre-med program where, for 8 months, we covered the basics – anatomy, chemistry, medical terminology, etc. With a good GPA I was automatically admitted into the MD program at this school. Attending a Caribbean medical school is slightly more difficult because we are seen as international medical school graduates, but I think in the end it’s all worth it.

Getting In:

How old is one when they begin medical school?
With the Caribbean schools the average age is slightly higher because most individuals have pursued other careers before starting. However, there are also those coming straight from undergrad. For pre-med programs, you need as little as 2 years of undergraduate work to get in.
What exams does one have to take to get in?
Each school in the Caribbean is different. Some require the MCAT and some do not. For the pre-med program, it is not required.
Is there any required pre-requisite coursework?
The required courses to get in are very similar to the US schools.
Is it a competitive occupation?
It is beginning to become a little more competitive to get into these Caribbean schools. Some are becoming as good, and very close to being as competitive, as US schools. The required GPAs are getting higher and higher each year.
What are you called at this stage of training?
Pre-Med

Being In:

How long is it?
Four years
How are the years broken down?
Two years of basic sciences on the respective island. Two years of clinical training in the United States. There are some clinical rotations where the Caribbean students are learning right alongside American students.
Describe your typical day.
Semesters 1-3: These are purely basic science. Beginning either 8 or 9am and going all the way to 4:00pm, you sit in a classroom where the professor lectures. Each semester has 4 subjects. After classes, you study. There are “blocks” which are computer-based exams every 3 weeks for each class. At the end of the semester you take a shelf exam that is written. This exam contains old USMLE Step 1-type questions and it is the same exam written by the students in the US. (These are exams written by the National Board of Medical Examiners, or NBME, and they are what my US medical school uses as block finals as well).
Semesters 4-5: Book-type lecturing is decreased at this point and students are doing more hands-on training, like learning to take histories and physicals. We also go to the local hospital.Comprehensive Exam: This is written at the end of Semester 5. It is basically a cumulative shelf exam. It is required in order to go on to take USMLE Step 1.
3rd year rotations: Family Practice, Ob/Gynecology, Internal Medicine, Psychiatry, Pediatrics and Surgery rotations with a shelf exam at the conclusion of each clerkship. Most accredited schools have students do 3rd year rotations at their affiliated US hospital, not in the Caribbean. (Not surprisingly, since many of the Caribbean med students are American, this layout is almost identical to the layout of medical school in the US).
If you choose a specialty, when do you have to decide by?
Most people will decide what specialty they want to go into by the end of their 3rd year rotations.
What are you called at this stage of training?
Medical Student

Getting Out:

What exams do you have to take?
To work in the US we are required to pass the United States Medical Licensing Exam (“USMLE”). We take “USMLE Step 1” after our second year, it is an 8 hour exam covering basic clinical sciences. “USMLE Step 2” has a clinical knowledge part and clinical skills part that has to be passed before graduation at the end of your 4th year. “USMLE Step 3” is taken at the end of your residency training.
Do most people graduate?
Because of the intensity of basic sciences not everyone graduates this portion of the training, each class loses around 1/5th (20%) of their students.
When are you finally considered a “doctor?” 
After your 4th year of med school you graduate and are offically an “MD.”
Do you have additional training or do you start working immediately?
To work in the US you must do a residency in the US. Getting a US residency as a graduate of a medical school in another country is tough, but not at all impossible. Everyone applying to residency in the US must be a medical school graduate (or soon-to-be graduate) and must have passing scores on the USMLE Step 1 and Step 2 (Clinical Knowledge and Clinical Skills portion). However, passing is not usually good enough to get you the residency you want – it’s competitive and the higher your score the better your chances. 
What’s the average debt for attendance?
Each school is different but it can range anywhere from $98,000 to $212,000. Of course, this is only the tuition and you must factor in the price of housing, which can vary substantially. Also, the cost of plane tickets to and from the island when you want to visit your home. 
What are you called at this stage of training?
After graduation you are officially a “doctor.” For your first year of residency you’ll be considered an “intern” and for the rest of your residency training you will be referred to as a “resident physician.”

Being Out:

Most of these students are working towards a career in US medicine and their salaries/schedules/licensing/etc. will not differ from physicians who graduated from a US medical school. For information on physician salaries, job security, specialities, licensing, etc. in the US, see Medical School in the United States.

Past Medical Education Monday Posts:

Gluco$e…Like Ke$ha

I hate Biochemistry. I am not good at it – I never have been and I likely never will be. It is horribly mundane and nit-picky and I harbor a certain degree of hatred for it simply because I am so bad at it. In fact, during my first semester of medical school when I was taking Biochem, I was relatively certain the admissions committee had accepted me purely for the sadistical pleasure of following along as I lost my frickin’ mind. At the time I wasn’t even entirely positive that I wasn’t the main player in some twisted social experiment built on the medical student version of The Truman Show. However, today a great professor from our school was finally able to put biochem into some terms I could understand. 

“Gluco$e is currency. Like Ke$ha.”

“Gluco$e is money. Glycogen is money in your wallet. If you have too much in there it’ll hurt your ass when you sit down, so you put it in the bank as fatty acids. You don’t want all your money in the bank, though – if you have that much currency it should be working for you…so you put it in a 401k as amino acids. You can get to the Glycogen in your wallet quick, but you have to go the ATM to get fatty acids out and it takes a little longer. You don’t have immediate access to amino acids because they’re busy doing another job, but after a while they will finish and you can turn them back into gluco$e if you need to.” 

I wish someone had made glycolysis that simple while I was drowning in catabolism vs. anabolism during our biochem block last year…I also wish that paragraph literally summed up even half of what we need to know about cellular gluco$e banking.


Other pearls from today’s lecture: 

  • John Elway has 2,3-Bisphosphoglycerate to thank for his multiple 4th quarter comebacks and apparently above average number wins at home.
  • Don’t tell the parents unless they ask: 
I have three more 7 hour lecture days in this review series, so I’m sure I’ll have a couple more high points to share with you guys by the middle of next week.


In the mean time, share your favorite nerdy medical memorization tools. 
  • Do you prefer mnemonics like the “MOPS” of S. pneumoniae or “Some Lovers Try Positions They Can’t Handle” for the carpal bones?
  • Do you make goofy pictures and flow charts?
  • Are you such a gunner you sleep with your book as a pillow and absorb algorithms of gram-positive vs. gram-negative bacteria while you sleep?

If you have a picture of your flow charts/drawings/graphs (I posted a few of mine here) I would LOVE to see them! Seriously! Share!

Medical School in Greece


Today’s Medical Education Monday guest blogger is Zoe, but since we’re all friends around here and her friends call her Jo (@Jo_Med on Twitter), that’s what we’ll stick with as well. Jo is a 21 year old, 4th year medical student at the Aristotle University of Thessaloniki in Greece! She tells me she hasn’t yet decided on a specialty area, but is interested in Neurology, Psychiatry, Internal Medicine, Immunology and Medical Ethics. When she’s not busy learning the ins-and-outs of medicine, she enjoys reading, playing Sims 3 and studying up on some Bioethics. Keep reading for a peek inside the Medical Education system in Greece, I’m thinking it looks like a beautiful place to learn to be a physician. 

Faculty of Medicine, Aristotle University of Thessaloniki in Greece

Getting In:
How old is one when they begin medical school?
You begin medical school right after high school, so at 17-18 years old.
What exams does one have to take to get in?
There are no specific exams, like the MCAT in the USA. All high school students sit some exams at a national level at the end of high school and from those grades it is determined in which school you are going to enroll. You can apply to many different schools (e.g. Medical School, Engineering School and Physics School).
Is there any required pre-requisite coursework?
You must take Maths, Biology, Chemistry and Physics in high school and sit for the before mentioned exams in these subjects to be able to apply for med school.
Is it a competitive occupation?
Yes it is! You need to get really good grades in order to be able to get into medical school. But the only criterium is your grades, there is no interview or personal statement or CV.
What are you called at this stage of training?
Well, before you get into med school you are just a high school graduate.

Being In:

How long is it?
Medical school in Greece lasts for 6 years.
How are the years broken down?
The first two and a half years are pre-clinical, the next two and a half clinical and the last one is like the intern year in the USA.
Describe your typical day.
Pre-Clinical Years: Some hours of mandatory labs and some nonobligatory lectures. The subjects that are covered include Medical Physics, Medical Informatics, Anatomy, Physiology, Biology, Genetics, History of Medicine, Biochemistry, Social Health, Statistics, Hygiene, Histology, Embryology, Microbiology, Pharmacology, Pathology, English Medical Terminology.
Clinical Years: Obligatory clinic hours and some optional lectures for each course. We do “rotations” in Surgery, Internal Medicine, Urology, Orthopaedics, Anesthesiology, Neurology, Psychiatry, ENT, Cardiology, Pulmonology, Dermatology, Opthalmology, Pediatrics, Ob/Gyn, Forensics & Toxicology, Neurosurgery, Emergency Medicine, Pediatric Surgery, Radiology. The last five are not actually rotations, just lectures and in some cases also labs.
Sixth Year: We spend our day at the hospital. We do Internal Medicine for 3 months, Surgery for 3 months, Obstetrics&Gynecology for 3 weeks, Pediatrics for 6 weeks, Neurology or Psychiatry for 3 weeks and Primary Care for 4 weeks.
If you choose a specialty, when do you have to decide by?
We have to decide until we graduate. After our graduation we apply for the specialty we want.
What are you called at this stage of training?
Medical Student

Getting Out:

What exams do you have to take?
You just need to have passed the finals in each subject. There are no extra exams, like the USMLE in the USA.
Do most people graduate?
I believe they do. Few people quit medical school. Some of them take long to finish it though. This is a usual phenomenon in all schools in Greece.
When are you finally considered a “doctor?”
When you graduate.
Do you have additional training or do you start working immediately?
You can start working immediately, but you won’t find a job. Almost all medical school graduates choose to specialize in a particular field of medicine.
What’s the average debt for attendance?
Medical School is free in Greece. All medical schools are public, there are no private ones. So, there are no tuition fees.
What are you called at this stage of training?
After you have graduated, you are called a doctor. Once you get accepted into a program you’re a Resident Doctor.

Being Out:

What’s the average salary?
There are no data on this, but it can vary a lot depending on the type of practice, the city, the specialty etc. Considering the economic crisis in Greece, the salary is not really satisfactory.
Is the job security good?
I wouldn’t say so. It is a saturated profession, so it’s difficult to find a job and it’s also hard to run a successful private practice.
Can you switch specialties?
I think you can but you need to start all over again.
What are you called at this stage of training?
When you are done with your residency training you are called a specialist.


Past Medical Education Monday Posts:

Red Bull Smoothie Recipe

Did you know there are people in this world who never drink caffeine? I know. 

I KNOW. How could they deprive themselves of such a tasty and exciting drug? And more importantly, why would they even want to?


Well, apparently, there are studies that link caffeine consumption to incontinence, hypertension, osteoporosis, empty bank accounts and other not so desirable states.

However, like any good scientist, I choose to ignore the correlations nay-sayers have shown between caffeine and things that make kids cry and focus on the abundance of studies indicating that my drug of choice might actually be beneficial. I mean, who wouldn’t want to decrease their risk for breast cancer, lower their chances of spending time in the hospital for an arrhythmia, keep the creepy naked guy in their brain a bit healthier and happier or simply be more awake, alert and happy? Sadists. That’s who.

In honor of my obvious state of addiction, and at the request of one of my favorite friends inside the computer – @fizzlemed – as well as one of my friends from outside the computer – @scheske – I am going to share with you my new favorite caffeinated addiction:

Red Bull Smoothies

Ingredients

  • 8.3 oz Red Bull*
  • ~1/2 Cup Frozen Strawberries
  • ~3 Frozen Peach Slices
  • ~4 Tablespoons Guava Juice
  • 1.5 Scoops Orange Sherbert
  • Handful of Ice

I like to add a splash of milk and Torani’s Vanilla syrup to mine, but Donnie prefers them without the added creamy, sugary goodness. Obviously, the recipe is not super even close to exact – if it’s too thin just add more strawberries or more ice. 



This recipe was derived from the ingredients of a similar drink we were spending way too much money having someone in a chain smoothie store make for us. We couldn’t find a recipe online, so we made one up. It’s really good – I’m not a big fan of the way Red Bull tastes in general, but this doesn’t have that strange bite at all. It’s really quite delicious.


*We’ve also made them with Sugar-Free Red Bull and there is absolutely no difference in taste in my opinion.

Medical School in Saudi Arabia


Today’s Medical Education Monday post is written by Faten (@splendidfull on Twitter), a 23-year old final year medical student in Dhahran, Saudi Arabia. She loves painting and reading in her free-time, is interested in Pediatrics (me too!) and Ophthalmology (definitely NOT me too!) as areas to focus on for her future specialty, and keeps a neat little tumblr blog of all the interesting things she finds online. It still amazes me how well all of the students & doctors who have helped me out with this series can speak and write in English.It’s seriously impressive. Thanks for the great write-up, Faten!

I think the fact that Twitter can so easily connect us with the rest of the world is AWESOME!

Getting In
How old is one when they begin medical school?
You start right after high school, so 17-18 years old.
What exams does one have to take to get in?
Getting into any medical college in the Kingdom of Saudi Arabia (KSA) depends on multiple factors: high school GPA (the higher the better chance of getting in), scoring high in 2 exams and of course passing the interview. One of the two exams takes place during high school and the other after graduation from high school. The former tests the analytical thinking and general informations and the latter tests basic sciences and English.
Is there any required pre-requisite coursework?
No.
Is it a competitive occupation?
Very! Thousands of high school graduates apply and compete for a limited number of seats each year.
What are you called at this stage of training?
Med Student

Being In

How long is it?
Six years leading to MBBS (Medical Bachelor and Bachelor of Surgery)
How are the years broken down?
Pre-Clinical Years – 3 and a half years.
The first year is actually a prep year, during which basic sciences like Biology, Chemistry and Physics plus English are taught. Based on the students GPA in that year, some universities divide the entry into med school, dentistry, nursing or health sciences. That’s not done in my university (http://www.ud.edu.sa/web/en), here you continue med school promptly. After the prep year comes Physiology, Anatomy, Histology, Biochemistry, Pathology, Microbiology, Immunology, Parasitology, Family and Community Medicine, Psychology, Forensics and Basic Clinical Skills.
Clinical Years – 2 and a half years.
During these years we take rounds in Internal Medicine, General Surgery, Psychiatry, Obstetrics and Gynecology, Pediatrics, ER, Ophthalmology, ENT, Orthopedics, Neurosurgery, Urology, Radiology, Anesthesia and Dermatology.
Describe your typical day.
Pre-Clinical Years: Attending lectures and labs in the university.
Clinical Years: It varies according to the specialty, but in general attending bedside clinical teaching, clinics and surgeries, having lectures and preparing tutorials. Some specialties mandate attending morning reports and rounds with the team. In my university the day usually starts at 8am and ends at 3pm.
If you choose a specialty, when do you have to decide by?
During the internship which is the 7th year, right after graduation.

Getting Out

What exams do you have to take?
Students must pass all the courses up until the sixth year, then there will be certifying exams. The words certifying exam can send the chills down a medical student’s spine, they are in medicine, surgery, OB-GYN and pediatrics. The clinical exams carry the biggest chunk/bulk of the marks.
Do most people graduate?
Fortunately enough, the majority are hard workers so yes, most of us graduate. I think the percentage of Saudis dropping out of med school is rather very small.
When are you finally considered a “doctor?”
Once a person gets the medical degree at the end of your 6th year one is called a doctor. 
Do you have additional training or do you start working immediately?
After graduating from med school, a year of internship is mandatory (which is divided into: 2-3 months in internal medicine, 2-3 months in surgery, 2 months in OB-GYN, 2 months in pediatrics,1 month in family and community medicine, and elective 1-2 months).
In order to register in one of the residency programs, interns must pass the Saudi Commission for Health Specialties (SCFHS) exam. It’s not a practice license exam, it only demonstrates that the intern meets the standards required by the SCFHS. It is a prometric/computer based, the contents are somewhat equivalent to the ones in USMLE part 2. The results of the SCFHS exam add up with the college GPA into the application of any specialty. Some of the competitive specialties, like the surgical ones, have another exam of their own. Those specialties exams involve a written part and an interview afterwards.
Getting accepted into the specialty isn’t the end of the story, you’ll have to get sponsored by a hospital to pay the specialty fees, or you can pay them yourself. Getting the sponsor is a contract, in which you agree on working for that hospital during and after the residency program and you get your residency fees paid and a monthly salary.
What’s the average debt for attendance?
Colleges belong to the Ministry of Higher Education and they’re totally free, in fact you are paid 1000 riyals (about $260) a month during your college years. There are couple of private medical and dentistry colleges, but their fees aren’t sky high and some students can get scholarships to get in. Public and private ones are equally strong and each has pros and cons. As mentioned earlier, the residency programs require payment, the fees range between 5,000 – 8,000 SR per year ($1,460 – $2,130), paid by the sponsored hospital or the residents themselves if they didn’t get accepted.
What are you called at this stage of training?
Once you get accepted into a program you’re a Resident Doctor.

Being Out

What’s the average salary?
It is difficult to estimate, it varies among hospitals, specialties, work hours and postgrad studies.
Can you switch specialties?
Yes. But you’ll do all the residency applications from the start.
What are you called at this stage of training?
When you’re done with your residency program and get the board you’re a Specialist.

Past Medical Education Monday Posts:

For My Mothers

A lot of people grow up saying they hope they never turn into their mother…I hope I turn out to be just like mine. Happy Mother’s Day to the most loving, selfless and beautiful person I’ve ever known!! Thanks for teaching me to be forgiving and genuine and for always making sure I knew I could do anything I put my mind to, I’d be lost without you. I love you, Mom!

August 1986
Snuggling. 🙂 See my teensy head poking out over there?
My first Christmas – December 1986
I’m sure that striped hat was cute in the 80’s??
1987
She even loved me when I was toof-less.

Putting a penny from my grandpa in my shoe on my wedding day. 
Easter 2010
Covered in mud after ATV-ing through the Jungle in Cozumel, Mexico.
Caribbean Cruise – Summer 2010
Caribbean Cruise – Summer 2010
Holding Baby Jaden

And no Mother’s Day blog of mine would be complete without mention of another woman who has played a pivotal role in my life, my Step-Mom. Some people get step-monsters when their parents re-marry, I literally got a second mother. Thanks for always being so supportive and understanding. I love you and I’m so happy I got you as my Step-Mom!!

July 18, 2009

The Day I Vacuumed My Freezer

Have you ever been alone in your house and heard a really strange noise reverberate from another room? Something that sounded awfully similar to what you can only assume is the racket a nuclear bomb might make if it came crashing through your kitchen skylight? I have.


If you’ve been following this blog since January you might remember the Christmas Gift Awards post I did at the beginning of the year. If not, I’ll bring you up to speed by informing you that the award for Seriously Awesome Gift went to a dozen Jones Soda bottles my youngest little sister personalized for Donnie & I. 


These would be an awesome gift for anyone, but seeing as our last name is so astonishingly unique that we share it with a drink brand who lets you personalize their glass bottles, it’s even more awesome. 


Anyway, I was studying at the house one day and decided I wanted a coke*. We rarely have anything carbonated in the house, so I assumed I was out of luck considering I was far too lazy to make the four block trip to Walmart to purchase one.


After 5 minutes of pouting I remembered we had an entire box of (room-temp) Jones Soda in the pantry. So, I did what anyone wanting a cold, fizzy drink would do, I put one in the freezer and went to study “for a few minutes” while I waited on the left side of my refrigerator to do it’s job. 


…I’m sure you can see where this is going. 


Three-ish hours later, I’m sitting at my desk reading about pyelonephritis and IgA nephropathy (okay, so that’s what I was supposed to be doing, no need to lie on my own blog) tweeting and I hear what can only be explained as the Bad Boys 2 mansion explosion scene going on in my kitchen. 


So, did I jump up and run in there to survey the damage and locate survivors? Nope. I did what anyone with the supernatural ability to instantly forget just about anything would do – I looked around the office, thought “what in the good Lord’s name was that?” and went right back to updating my Facebook status. 


…then I thought, “Man, I really want a coke.”


…then I remembered I had one in the freezer.

This is not my freezer – it belongs to someone who had a similar accident.
Mine looked a lot like this one would look if you tossed a handful of this in it.

And, just in case you were wondering, shards of Jones-Soda-bottle-glass do look a heck of a lot like frozen cream soda…which happens to be a spitting image of the little pieces of ice that accumulate on bags of frozen peas after they have been hanging out in subzero weather for approximately 10 months. 


The rest of my day consisted of placing every last frozen food item and freezer shelf into our sink, washing sticky glass shards and ice spicules off frost-bitten left overs, and – you got it – vacuuming cream soda and broken glass out of the inside of our freezer.

…and I still never got my stupid coke. 

*Y
es, the nasty rumors are true, in this part of Texas all fizzy, flavored drinks are “cokes,” not just Coca-Cola. I probably should have included that in the Dialect Debates post. 

Medical School in Australia

Today’s Medical Education Monday spotlight will be on a country I would absolutely love to visit someday – Australia! @sunlightandsnow is an extremely busy junior doctor in Australia who was nice enough to take some time out of her crazy schedule to help me out with this series. When she has some free-time she enjoys reading about politics and playing computer games. She just completed her medical degree at the end of last year, so she should be able to give us a great account of the medical education system “down under.” She mentioned that she was open to answer questions and clarify, so if you have a question feel free to tweet her or leave a comment here and we’ll make sure to get it answered!  

Griffith University School of Medicine in Queensland, Australia

Getting In
How old is one when they begin medical school?
It depends – Australians can study medicine as undergraduates or postgraduates. So they can start immediately after high school (usually around age 18), or can be quite significantly older when they begin. Sometimes they’ve done other university degrees first, often they have not. I was 19 when I started.
What exams does one have to take to get in?
There are always 2 and often 3 requirements to get into medical school. They are:
1. High school/university marks of a reasonable level to get in.
2. If applying for undergraduate, the completion of the UMAT – (university medical admissions test). This is an IQ like exam that takes place over a few hours. If applying for post graduate, the completion of the GAMSAT (similar, but probably harder test – I didn’t do this, as I did an undergraduate degree).
3. Interviews at the individual universities (varies from university to university about the requirements or whether they require interviews at all).
Is there any required pre-requisite coursework?
When I applied, no. This may have changed in the last six years.
Is it a competitive occupation?
Yes. I believe about one in eight applicants get accepted into medical school.
What are you called at this stage of training?
Medical student wannabe? 

Being In

How long is it?
Undergraduate is anything from 5-6 years. Postgraduate is 4 years.
How are the years broken down?
This varies significantly from school to school – most do at least 2 years of basic sciences (with clinical exposure thrown in), and then the remaining time is more clinical exposure. Obviously the length of the degree can make this vary significantly – six year degrees often have 3 years of basic sciences, 1 year of research and then 2 years of clinical training.
Describe your typical day.
In the early years, we’d usually have one morning of PBL (this is “problem based learning,” it is practiced at many medical schools in the US as well – but not at mine) where we “opened a learning problem” – a clinical scenario where we’d read through a patient scenario and realise how little we knew. We’d then come up with a list of things we didn’t know and needed to study. Usually the following few days would then be spent with lectures related to the scenario, teaching us the science behind it. We’d sometimes have an anatomy/histology lab based around this as well.We’d have a day of clinical exposure, and then we’d have a closing PBL towards the end of the week, where the tutorial group would get together and go over the areas we hadn’t understood before (and hopefully we would by then!)
In my final year, I’d spend probably ~30-40 hours a week at the hospital doing clinical exposure. We’d attend ward rounds, examine patients, take histories, and help the junior doctors. We’d have a few hours (2-4) of lectures/tutorials/week on top of that to make sure we were advancing, but mostly we were expected to self direct our learning (I guess using the skills we learnt in the early years, by identifying what we didn’t know).
If you choose a specialty, when do you have to decide by?
Not until after medical school – usually towards the end of internship (post grad year 1) or residency (post grad year 2).
What are you called at this stage of training?
Medical student.

Getting Out

What exams do you have to take?
Varies from university to university. I didn’t have any official “finishing exams” – it was more a continuous assessment type thing where I’d do a term in a speciality (like psych), and then at the end of that term do an exam in that speciality. There weren’t any big exams for me, but other schools often had big barrier exams.
Do most people graduate?
I think about 90% of the year I started with will eventually finish – some of them failed and are repeating, but mostly people get all the way through.
When are you finally considered a “doctor?”
Good question.
After my last day of university? (end of October)
When I’m registered with the medical board? (early January)
The day I started work? (mid January)
When I actually received my degree at the graduation ceremony? (April/May)
From my point of view, it was probably in mid-January when I actually started working as a doctor.
Do you have additional training or do you start working immediately?
We had a week’s worth of orientation and training at our individual hospitals, but we then start working. Internship, residency and specialty training are all considered training despite us working.
What’s the average debt for attendance?
In Australia you can have the government assist you with paying (known as a Commonwealth Supported Place [CSP]), and you owe them money through the Higher Education Contribution Scheme (HECS). In this situation they pay for a significant amount of your fees, but the cost depends on how long you take to do the degree (how many units of coursework you do). I went through this system and owe the government approximately $45,000.
You begin paying this debt off once you earn above a certain amount per year. I pay about $48/week…so that will take a LONG time to pay off! (This amount is taken out on top of the standard taxes that we pay. You have other options for paying it off, including paying up front as you go through the course, which comes with a lovely discount.)
There are also full fee paying places (FFP), in which case you don’t have the support of the government paying a large amount of it, although you are still able to borrow the money from the government and pay it back later. I did not have one of these places and so I’m not sure how much they cost, but I think it varies from about $100,000-$250,000 depending on the university.
What are you called at this stage of training?
Junior doctor/intern/resident.

Being Out

What’s the average salary?
Varies from state to state, and at what stage you are at.
Post graduate year 1 (PGY1) = Internship, PGY2 = Residency. Interns (which is what I am), are paid a varying base salary depending on the state. The lowest paid state is Victoria (~$50,000), the highest is Queensland (~$65,000). Many people can be paid more than this once you include overtime. Your pay goes up each year as you’re more experienced and progressing through the ranks. 
PGY3+ = Specialty Training (called “registrars” at this stage).
Specialty training takes anything from 3-6 years depending on the specialty (and whether you take time off, or take longer for various reasons). Once specialty training is complete, you are a specialist/consultant in that area. Dr Harris (@richharris2) could give you a better indication of how much specialists can earn! (Salary will vary depending on your specialty).
Is the job security good?
I feel like it is…
Can you switch specialties?
Yes. As internship and residency is a generalised teaching/experience, you aren’t even in a specialty at this stage. Even once you start training in a specialty, you can change.


Past Medical Education Monday Posts: