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103

Ophthalmology Lecture - Tropias & Phorias (part 1/2)

This presentation demonstrates an approach to eye-movement disorders commonly seen in an ophthalmology or optometry clinic. This is the first half of the lecture, and focusses on large-angle tropias and how to document and name tropias (exotropia,esotropia,hypertropia,hypotropia).  
Nicole Chalmers
over 5 years ago
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3
29

Ophthalmology Review: Are babies myopic or hyperopic?

Are babies more hyperopic? Yes, young children have small eyes, so that the image forms behind the retina. However, children are also able accomodate and bring the image forward to compensate for this. This is a review question I recorded for ophthobook.  
Nicole Chalmers
over 5 years ago
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3
86

The Precise Neurological Exam

Ptosis is the lagging of an eyelid. It has 2 distinct etiologies. Sympathetics going to the eye innervate Muller's muscle, a small muscle that elevates the eyelid. The III cranial nerve also innervates a much larger muscle that elevates the eye lid: the levator palpebrae. Thus, disruption of either will cause ptosis. The ptosis from a III nerve palsy is of greater severity than the ptosis due to a lesion of the sympathetic pathway, due to the size of the muscles innervated. As an aside, the parasympathetics run with the III cranial nerve and are usually affected with an abnormal III cranial nerve.  
informatics.med.nyu.edu
over 5 years ago
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3
56

Ophthalmology Lecture - Pediatric Eye Exam

http://www.ophthobook.com This video lecture demonstrates some of the difficulties we have examining children in the optometry or ophthalmology clinic. Kids ...  
YouTube
over 5 years ago
Foo20151013 2023 1njk26?1444774138
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133

Doctor or a scientist?

"One special advantage of the skeptical attitude of mind is that a man is never vexed to find that after all he has been in the wrong" Sir William Osler Well, it's almost Christmas. I know it's Christmas because the animal skeleton situated in the reception of my University's Anatomy School has finally been re-united with his (or her?) Christmas hat, has baubles for eyes and tinsel on its ribcage. This doesn't help with my trying to identify it (oh the irony if it is indeed a reindeer). This term has probably been one of the toughest academic terms I've had, but then when you intercalate that is sort of what you choose to let yourself in for. I used to think that regular readings were a chore in the pre-clinical years. I had ample amounts of ethics, sociology and epidemiology readings to do but this is nothing compared to the world of scientific papers. The first paper I had to read this term related to Glycosaminoglycan (GAG) integrity in articular cartilage and its possible role in the pathogenesis of Osteoarthritis. Well, I know that now. When I first started reading it felt very much like a game of boggle and highly reminiscent of high school spanish lessons where I just sat and nodded my head. This wasn't the end. Every seminar has come with its own prescribed reading list. The typical dose is around 4-5 papers. This got me thinking. We don't really spend all that much time understanding how to read scientific papers nor do we really explore our roles as 'scientists' as well as future clinicians. Training programmes inevitably seem to create false divides between the 'clinicans' and the 'academics' and sometimes this has negative consequences - one simply criticises the other: Doctors don't know enough about science, academics are out of touch with the real world etc... Doctors as scientists... The origins of medicine itself lie with some of the greatest scientists of all time - Herophilus, Galen, Da Vinci, William Harvey (the list is endless). As well as being physicians, all of these people were also respected scientists who regularly made contributions to our understanding of the body's mechanics. Albeit, the concept of ethics was somewhat thrown to the wind (Herophilus, though dead for thousands of years, is regularly accused of performing vivisections on prisoners in his discovery of the duodenum). Original sketches by William Harvey which proved a continuous circuit of blood being supplied and leaving the upper limb. He used his observations to explain the circulatory system as we know it today What was unique about these people? The ability to challenge what they saw. They made observations, tested them against their own knowledge and asked more questions - they wanted to know more. As well as being doctors, we have the unique opportunity to make observations and question what we see. What's causing x to turn into y? What trends do we see in patients presenting with x? The most simple question can lead to the biggest shift in understanding. It only took Semmelweiss to ask why women were dying in a maternity ward to give rise to our concept of modern infection control. Bad Science... Anyone who has read the ranting tweets, ranting books and ranting YouTube TED videos of academic/GP Ben Goldacre will be familiar with this somewhat over used term. Pseudoscience (coined by the late great Karl Popper) is a much more sensible and meaningful term. Science is about gathering evidence which supports your hypothesis. Pseudoscience is a field which makes claims that cannot be tested by a study. In truth, there's lots and lots of relatively useless information in print. It's fine knowing about biomarker/receptor/cytokine/antibody/gene/transcription factor (insert meaningless acronym here) but how is it relevant and how does it fit into the bigger picture? Science has become reductionist. We're at the gene level and new reducing levels of study (pharmacogenetics) break this down even further and sometimes, this is at an expense of providing anything useful to your clinicial toolbox. Increasing job competition and post-graduate 'scoring' systems has also meant there's lots of rushed research in order to get publications and citations. This runs the danger of further undermining the doctors role as a true contributor to science. Most of it is wrong... I read an article recently that told me at least 50% of what I learn in medical school will be proven wrong in my lifetime. That might seem disheartening since I may have pointlessly consumed ample coffee to revise erroneous material. However, it's also exciting. What if you prove it wrong? What if you contributed to changing our understanding? As a doctor, there's no reason why you can't. If we're going to practice evidence-based medicine then we need to understand that evidence and doing this requires us to wear our scientist hat. It would be nice to see a whole generation of doctors not just willing to accept our understanding but to challenge that which is tentative. That's what science is all about. Here's hoping you don't find any meta-analyses in your stockings. Merry Christmas.  
Lucas Brammar
almost 6 years ago
Foo20151013 2023 1n3lsmi?1444774158
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164

How Health Evangelism Can Give Us More Out of Life Than We Can See

As more and more knowledge about our health is becoming evident, people everywhere are looking at new and innovative ways like Health Evangelism as a means of treatment. Getting a clean bill of health is a challenge for many people these days. For that reason many people are looking at different types of health care options that may stray a bit from the traditional but still give the patient needed relief from their physical problems. This is where new approaches have come in to help gain control of many of the medical issues that many people have to face. What is Health Evangelism? The expression ‘health evangelism’ is defined as an applying of the principles of healthful living in a way that includes physical laws that have been set forth by God to act in our lives. This is simply recognizing that God, as the provider of life, created us to function in a very specific way. Many of the physical health problems that we face are a direct result of going against those inborn laws that he set forth. Health Evangelism is a means of identifying those laws and not only using them within but passing them on to others in an evangelizing work. Benefits of Health Evangelism Your knowledge of the physical laws that he has set in motion have been instrumental in helping to improve a number of major health concerns of many people. For example, just coming to an understanding of your diet and how certain foods were designed to nourish your body can help to improve blood sugar health, cholesterol levels, cardiovascular conditioning, and your immune system among other things. Higher Spiritual Plane As you see how this understanding has had a major impact on the improvement of your health you will reach a point where, you will develop a personal relationship with your creator and the things he’s provided. Your care for your health and physical well-being will not be just taking care of yourself but you will come to view it as a part of your worship to your spiritual benefactor. By doing this, you will have reached a higher spiritual level that you may not have discovered otherwise. We have all been wonderfully made and our appreciation for our creation is a demonstration that we are part of something that extends far beyond our own personal world. Learning the details of Health Evangelism can open our eyes to many of the things unseen from the world around us. For more information, visit http://www.pambrarmd.com/contact.php.  
Enrica
over 5 years ago
Foo20151013 2023 eztttu?1444774181
3
128

Dealing with Personal Illness in Med School

Hey guys! I’m Nicole and I’m a second year medical student at Glasgow University. I’ve decided to start this blog to write about my experiences as a med student and the difficulties I encounter along the way, hopefully giving you something you can relate to. Since June of last year I have been suffering with a personal illness, with symptoms of persistent nausea, gastric pain and lethargy. At first I thought it was just a bug that would pass on fairly quickly, but as the summer months went on it was clear that this illness wasn’t going to disappear overnight. I spent my summer going through a copious amount of medications in hope that I’d feel better for term starting. I visited my GP several times and had bloods taken regularly. After 2 months, I finally got given a diagnosis; I had a helicobacter pylori infection. I started eradication therapy for a week and although it made my symptoms worse, I was positive would make me better and I’d be well again within the week. The week passed with no improvements in my condition. Frustrated, I went back to my GP who referred me for an endoscopy. Term started back the next week and despite feeling miserable I managed to drag myself out to every lecture, tutorial and lab. Within a few weeks I began to fall behind in my work, doing the bare minimum required to get through. Getting up each morning was a struggle and forcing myself to sit in lectures despite the severe nausea I was experiencing was becoming a bigger challenge each day. In October I went for my endoscopy which, for those of you that don't know, is a horribly uncomfortable procedure. My family and friends assured me that this would be the final stage and I’d be better very very soon. The results came back and my GP gave me a different PPI in hope that it would fix everything. I waited a few weeks and struggled through uni constantly hoping that everything would magically get better. I gave up almost all my extra-circular activities which for me, the extrovert I am, was possibly the hardest part of it all. I wanted to stay in bed all the time and I become more miserable every day. I was stressing about falling behind in uni and tensions began to build up in my personal life. It got to the point where I couldn’t eat a meal without it coming back up causing me to lose a substantial amount of weight. I got so stressed that I had to leave an exam to throw up. I was truly miserable. I seen a consultant just before Christmas who scheduled me in for some scans, but it wasn’t until January. I was frustrated at how long this was going on for and I thought it was about time I told the medical school about my situation. They were very understanding and I was slightly surprised at just how supportive they were. I contacted my head of year who arranged a visit with me for January. During the Christmas break I had a chance to relax and forget about everything that was stressing me. I got put on a stronger anti-sickness medication which, surprisingly, seemed to work. The tensions in my life that had built up in the last few months seemed to resolve themselves and I began to feel a lot more positive! I met with my head of year just last week who was encouraged by my newly found positive behaviour. We’ve agreed to see how things progress over the next few months, but things are looking a lot brighter than before. I’ve taken on a new attitude and I’m determined to work my hardest to get through this year. I’m currently undertaking an SSC so I have lots of free time to catch up on work I missed during the last term. My head of year has assured me that situations like the one I’m in happen all the time and I’m definitely not alone. I feel better knowing that the medical school are behind me and are willing to help and support me through this time. The most important thing I have taken from this experience is the fact that you’ll never know the full extent of what a patient is going through. Illness effects different people in different ways and it may not just be a persons health thats affected, it can affect all aspects of their life. This experience has definitely opened my eyes up and hopefully I’ll be able to understand patients’ situations a little better.  
Nicole Mooney
over 5 years ago
29748
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Cranial Nerves Examination - Normal

Orientation, Memor Asking questions about month, date, day of week and place tests orientation, which involves not only memory but also attention and language. Three-word recall tests recent memory for which the temporal lobe is important. Remote memory tasks such as naming Presidents, tests not only the temporal lobes but also heteromodal association cortices. Attention-working memory Digit span, spelling backwards and naming months of the year backward test attention and working memory which are frontal lobe functions Judgement-abstract reasoning These frontal lobe functions can be tested by using problem solving, verbal similarities and proverbs Set generation This is a test of verbal fluency and the ability to generate a set of items which are frontal lobe functions. Most individuals can give 10 or more words in a minute. Receptive language Asking the patient to follow commands demonstrates that they understand the meaning of what they have heard or read. It is important to test reception of both spoken and written language. Expressive language In assessing expressive language it is important to note fluency and correctness of content and grammar. This can be accomplished by tasks that require spontaneous speech and writing, naming objects, repetition of sentences, and reading comprehension. Praxis The patient is asked to perform skilled motor tasks without any nonverbal prompting. Skills tested for should involve the face then the limbs. In order to test for praxis the patient must have normal comprehension and intact voluntary movement. Apraxia is typically seen in lesions of the dominant inferior parietal lobe. Gnosis Gnosis is the ability to recognize objects perceived by the senses especially somatosensory sensation. Having the patient (with their eyes closed) identify objects placed in their hand (stereognosis) and numbers written on their hand (graphesthesia) tests parietal lobe sensory perception. Dominant parietal lobe function Tests for dominant inferior parietal lobe function includes right-left orientation, naming fingers, and calculations. Non-dominant parietal lobe function The non-dominant parietal lobe is important for visual spatial sensory tasks such as attending to the contralateral side of the body and space as well as constructional tasks such as drawing a face, clock or geometric figures. Visual recognition Recognition of colors and faces tests visual association cortex (inferior occiptotemporal area). Achromatopsia (inability to distinguish colors), visual agnosia (inability to name or point to a color) and prosopagnosia (inability to identify a familiar faces) result from lesions in this area.  
Neurologic Exam
over 8 years ago
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2
39

The Ultimate OphthalmoloGAME

Players compete using their knowledge of Ophthalmology for the honour of the Ultimate OphthalmoloGAME trophy pictured in the centre of the board Rules 1. Before rolling the die, players must complete an ophthalmology based challenge 2. The type of challenge the player must complete is dependent on the colour that their piece is on at the beginning of their turn 3. All players begin on Dark Purple (Multiple Choice Question 3. Categories are as follows Blue: Visual challenge, competitor looks into one of 5 randomly selected cups and must identify the type of retinal pathology as would be seen when using ophthalmoscopy Lilac: Case based question, clinical judgement question based on features of history and examinatio Silver: Eye Pictionary, other competitors must guess the ophthalmology related word via the competitor's artistic skill Dark purple: Multiple choice question, competitor must correctly select the answer to an ophthalmology based questio 4. If the competitor successfully completes their challenge, they are allowed to roll the die and move their piece forward accordingly 5. However, if the competitor fails to complete their challenge, they are not permitted to move forward and must complete a challenge of the same category on their next turn 6. The winner of the Ultimate Ophthalmology trophy is the first player to make a full circuit of the iris, reaching the pupil in doing so.  
Emma Papworth
over 8 years ago
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136

Eye disorders

Various eye complications and disorders Image :https://docs.google.com/open?id=0B8Ss3-wJfHrpei1ULXN1X1dOdDQ Facebook : http://www.facebook.com/ArmandoHasudungan  
Nicole Chalmers
over 5 years ago
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2
37

Comparative Eye Anatomy (ophthalmology)

http://www.ophthobook.com A video rich examination of the various eyes in the animal kingdom, and what they can teach us about the human eye. The first half of this lecture discuses the progression of ocular complexity from single-celled organisms through mammalian eyes. The second half discuses alternative eye designs such as mirrors, compound eyes, slit-pupils, and inverted retinas.  
Nicole Chalmers
over 5 years ago
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40

Wilson's Disease

Inheritance: autosomal recessive Pathology:copper incorporation into caeruloplasmin in hepatocytes and and its excretion into bile is impaired so copper is deposited into organs (firstly liver, then basal ganglia) Clinical: - Presents in children with liver failure/jaundice - Presents in young adults with CNS signs e.g. ataxia, tremor, dysarthria  - Eyes: kayser fleischer rings (gold ring around iris)   
almostadoctor.com - free medical student revision notes
over 5 years ago
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Ophthalmology Lecture - Eye Anatomy Part 3

http://www.ophthobook.com This lecture covers the retina, optic nerve, eye muscles, and the orbital bones. This was excerpted from the complete anatomy lectu...  
YouTube
over 5 years ago
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Ophthalmology Lecture - Eye Anatomy Part 1

http://www.ophthobook.com This lecture covers basic eye anatomy. This is the first 6 minutes of the powerpoint, which can be viewed in its entirety at Ophtho...  
YouTube
over 5 years ago
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2
36

20 Eye Exam Tricks

http://www.ophthobook.com 20 examination for ophthalmology or optometry providers. Covers techniques for detecting malingerers, facticious blindness, macular...  
YouTube
almost 5 years ago
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2
64

Ophthalmology Lecture - Pediatric Eye Exam

http://www.ophthobook.com This video lecture demonstrates some of the difficulties we have examining children in the optometry or ophthalmology clinic. Kids ...  
YouTube
almost 5 years ago
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2
15

Ophthalmology Lecture: Amblyopia

This video excerpt describes how amblyopia develops in children. Basically, if one eye doesn't see well from an early age, the wiring never forms correctly b...  
YouTube
almost 5 years ago
Foo20151013 2023 aoqg73?1444773932
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85

A Humble NHS?

A Recap Last week in my personal blog I reflected on humility as defined by James Ryle: God given self-assurance that eliminates the need to prove to others the worth of who you are and the rightness of what you do. Ryle suggests, from 1 Peter 5:5-7, that central to humbling ourselves is throwing our cares on to God. Every concern, care and fear being hurled on to God who is faithful and powerful enough to handle them. When we know that we are loved by Him no matter what and that He is in control no matter what, then we remove the need to prove ourselves or protect ourselves. We become humble – secure enough to allow God to be in control and to serve others. Once our eyes are lifted from ourselves we are able to see others to love and serve them. Stafford Hospital Just before writing the last post I was reading an article about the report by Robert Francis QC on the appalling treatment of patients at Stafford Hospital. One of the recurring comments made by many different people is that the pressure of targets and incentives increasingly displaces focus on compassion and patient care. When doctors, nurses and managers alike are bombarded with ever increasing and regularly changes hoops to jump through and targets to meet, no wonder their attention and efforts are dragged from patient care. I’ve seen something of the effects of this in a family member who for many years worked as a Health Visitor. In their decades of service they saw an ever increasing and ever changing string of targets and goals alongside cost cutting moves that stripped resources and personnel. Their desire to be compassionate and offer the best care possible became more and more stressful until it finally proved too much. She recently changed jobs. Now I’m not trying to attack the NHS and I am well aware that so many people receive great care. But this is not a new concern that is being bandied around with fresh vigour in the light of Stafford Hospital. What struck me is that it demonstrates on an institutional level what also seems true at a personal level. Namely, that when we are forced to operate from a place of insecurity we begin to miss the most important things. NHS services have to meet targets to receive funding to simply keep operating – there will be no patient care if there is no hospital. Oftentimes, especially as a leader, we can live with a sense that, unless we meet expectations or make people like us or recognise our worth, then we’ll have no influence to do any of the things we know we are called to do. The secret of personal humility is to recognise that we are already loved by our Father before we even move our finger; to recognise that He is control and we can throw every care on Him. A person who can live from that place of security finds, free from the need to prove themselves or their actions, can begin to simply do what they are made and called to do. They are no longer pulled in different directions by a multiplicity of cares. What about an institution? It strikes me that a similar solution is needed for the NHS. Is there a way to give security for doctors, nurses and caring professionals so that they are able to do what they are called to do without constantly watching their back? Obviously there is a need for accountability for the safety of patients and to ensure a good standard of care, but the constant need to prove worth and achievement cannot be helpful for those who are called to compassionate care. I’m not a healthcare professional. I don’t know exactly what this would look like. But I recognise in the diagnosis of struggles in the NHS, God’s diagnosis of struggles in many people’s lives. The way He designed us to live with Him is often a good basis to begin to imagine a new way for every level of society to function. So, my question is this: what would a humble NHS look like? To whom could a National Health Service throw it’s concerns and cares?  
Rev Samuel Pollard
over 6 years ago
Foo20151013 2023 xc9z4h?1444774045
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3762

Undergraduate Co-Ordinators: Help or hindrance?

Thanks to those who read my last post. I was encouraged to hear from my colleagues at Med school that the post sounded very positive and hopefully. A few of them queried whether I had actually written it because there was a noticeable lack of sarcasm or criticism. So... the following posts may be a bit different. A little warning - some of what I post may be me playing "Devil's advocate" because I believe that everything should be questioned and sparking debate is a good way of making us all evaluate what we truly think on a subject. With no further a do, let's get on to the subject of today's post .... An Introduction to Clinical Medicine The previous year was my first as a clinical med student. Before we started I naively thought that we would be placed in helpful, encouraging environments that would support us in our learning, so that we were able to maximize our clinical experience. My hope was that there would be lots of enthusiastic doctors willing to teach, a well organised teaching schedule and admin staff that would be able to help us with any difficulties. I hoped these would all be in place so that WE medical students could be turned from a bunch of confused, under-grad science students into the best junior doctors we could possibly be. It seems that medical school and the NHS have a very different opinion of what clinical medical teaching should be like. What they seem to want us to do is 1) listen to the same old health and safety lecture at least twice a term, 2) re-learn how to wash our hands every 4 weeks, 3) Practicing signing our name on a register - even when this is completely pointless because there are no staff at the hospital anyway because the roads are shut with 10 inches of snow most of the time, 4) Master the art of filling in forms that no one will ever look at or use in anyway that is productive, 5) STAY OUT OF THE WAY OF THE BUSY STAFF because we are useless nuisances who spread MRSA and C.Dif where ever we go! How we all learn medicine and pass our exams is any ones guess! Undergraduate Co-Ordinators - Why won't you make life easier for us? While at my last placement I was elected as the 3rd year student representative for that hospital. While I was fulfilling that role it got me wondering what it is that Under-grad Co-Ordinators actually do? I thought this may be an interesting topic of debate. 1) Who are they and how qualified are they? 2) what is their job description and what are they supposed to be doing? 3) Are they a universal phenomena? or have they just evolved within the West Midlands? 4) Does anyone know an under-grad Co-Ordinator (UC - not ulcerative colitis) who has actually been more benefit than nuisance? 1) UC's as a species are generally female, middle aged, motherly types who like to colonize obscure offices in far flung corners of NHS training hospitals. They can normally be found in packs or as they are locally known "A Confusion of co-ordinators". How are they qualified? I have absolutely no idea, but I am guessing not degrees in Human Resource Development. 2)I am fairly certain what their job should involve: 1) be a friendly supportive face for the poor medical students; 2) organise a series of lectures; 3) organise the medical students into teaching firms with enthusiastic consultants who are happy to give them regular teaching; 4) ensure the students are taught clinical skills so that they can progress to being competent juniors; 5) be a point of contact for when any students are experiencing difficulties in their hospital and hopefully help them to rectify those problems to aid their learning. What do they actually do? It seems to be a mystery. I quite regularly receive emails that say that I wasn't in hospital on a certain day, when I was in fact at another hospital that they specifically sent me to on that day. I often receive emails saying that my lectures are cancelled just as I have driven for over an hour through rush hour traffic to attend. I sometimes receive emails saying that I, specifically, am the cause of the whole hospitals MRSA infection because I once wore a tie. I never receive emails saying that such and such a doctor is happy to teach me. I never receive emails with lecture slides attached to them so that I can revise said lectures in time for an exam. I NEVER receive any emails with anything useful in them that has been sent by a UC! Questions 3 and 4, I have no idea what the answers are but would be genuinely pleased to hear people's responses. The reason I have written this blog is that, these people have frustrated my colleagues and I all year. I am sure they are integral to our learning in some way and I am sure that they could be very useful to us, but at the moment I just cannot say that they are as useful as they should be. To any NHS manager/ medical educator out their I make this plea I am more than happy to give up 2 weeks of my life to shadow some UC to see what it is they do. In essence I want to audit what it is they do on a day to day basis and work out if they are a cost-effective use of the NHS budget? I want to investigate what it is they spend their time on and how many students they help during a day? I would like someone with a fresh pair of eyes to go into those obscure offices and see if they can find any way of improving the systems so that future generations of medical students do not have to relive the inefficiencies that we have lived through. I want the system to be improved for everyone's sake. OR if you won't let a medical student audit the process, could you manager's at least send your UC's to learn from other hospitals where things are done better! If we (potential future) doctors have to live by the rule of EVIDENCED BASED MEDICINE, why shouldn't the admin staff live by a similar rule of EVIDENCED BASED ADMINISTRATION? Share good ideas, learn from the best, always look for improvements rather than keep the same old inefficient, pointless systems year after year. My final point on the subject - at the end of every term we have to fill in long feedback forms on what we thought of the hospital and the teaching. I know for a fact that most of those forms contain huge amounts of criticism - a lot of which was written exactly the same the year before! So, they are collecting all of this feedback and yet nothing seems to change in some hospitals. It all just seems such a pointless waste. Take away thought for the day. By auditing and improving the efficiency, of the admin side of an undergraduate medical education, I would hope the system as a whole would be improved and hence better, more knowledgeable, less cynical, less bitter, less stressed junior doctors would be produced as a result. Surely, that is something that everyone involved in medical education should be aiming for. Who is watching (and assessing) the watchers!  
jacob matthews
over 6 years ago
%3fr=0
2
112

Extolling the benefits of learning plans

“You’re a boring whore! Fix it.” The barked criticism came like a slap in the face. The director of Les Miserables was right, though. I was a boring whore. Actors need to immerse themselves in their roles, shed inhibitions and squelch embarrassment. I was not managing to do this while rehearsing the Lovely Ladies prostitute scene. My performance was overly self-conscious and restrained. Three days later I found myself at a medical education conference, attending a session discussing learning plans. A popular tool in adult education generally, and a training requirement for all GP registrars, learning plans are actively disliked by many. Done purposely and thoughtfully, they can be of great benefit; completed hastily or reluctantly because they are compulsory, they are next to useless. I have to confess that, as a registrar, my own learning plans were dashed off with little thought, submitted and then promptly forgotten. I’d never thought this technique would work for me. At the conference, the attending educators were instructed to each write a learning plan that addressed an aspect of their non-medical lives. We were asked to choose something that we genuinely wanted to improve. I instantly knew what I’d write about, and completed the task with seriousness and sincerity. The facilitator randomly picked a few participants to read out their learning plans. The topics were predictable: “I want to exercise each morning”, “I want to get at least seven hours of sleep a night” and the like. Yes, you can see where this is leading ... I should have anticipated being called upon, but when the “We have time for one more, how about you?” came, along with direct eye contact and a kindly smile, I momentarily panicked. Surveying the room of mostly middle-aged, male faces, many of whom I didn’t know, I considered making something up on the spot. Instead, I stood up, took a deep breath and read out: “I want to be a more exciting whore.” I then outlined my proposed methods for achieving this objective and how I intended to measure my progress. Without explanation, I then sat down. Silence. Not a sound. Most eyes were glued to me, the others looking anywhere but. The atmosphere was thick with shock, amusement, confusion, suspense and fascination. I didn’t leave them hanging for too long. After my disclosure as to why I chose the topic and the context in which I was “whoring”, there were audible sighs of relief and a sprinkling of laughter throughout the room. It was memorable for those present. Four years later, I still get the occasional question about my “whoring” when I run into certain educators at conferences. I am pleased to report that my learning plan well and truly achieved its aim. I enacted my plan exactly as written and practised diligently. I knew I had been successful when the director instructed me to “Tone it down a bit. This is a family show, you know!” I now feel a lot more comfortable extolling the benefits of learning plans to unconvinced registrars. I tell them: “I used to think that I wasn’t a learning plan-type person either but I’ve discovered that if you choose a relevant and important objective and spend time and effort working out how to achieve it, the technique can really work.” I tend to leave out: “It didn’t do much for my medicine, but it turned me into a fabulous whore.” This blog post has been adapted from a column first published in Australian Doctor. Dr Genevieve Yates is an Australian GP, medical educator, medico-legal presenter and writer. You can read more of her work at http://genevieveyates.com/  
Dr Genevieve Yates
over 5 years ago