Picture showing different causes of abdominal pain in the areas which they tend to affect. (note: some of the causes in the Left and right iliac fossa can affect both sides although they are only drawn in one!) http://leadonpaper.blogspot.co.uk/2014/01/the-acute-abdomen.html#more
over 6 years ago
Because of the snail's pace that education has developed at, most of us don't really know how to study because we've been told lectures and reading thousands of pages is the best way to go, and no one really wants to do that all day. That's not the only way to study. My first year of medical school... You know when you start the year so committed, then eventually you skip lectures once or twice... then you just binge on skipping? Kinda like breaking a diet "Two weeks in: oh I'll just have a bite of your mac n' cheese... oh is that cake? and doritos? and french fries? Give me all of it all at once." Anyways, when that happened in first year I started panicking after a while; but after studying with friends who had attended lectures, I found they were almost as clueless as I was. I'm not trying to say lectures are useless... What my fellow first years and I just didn't know was how to use the resources we had– whether we were keen beans or lazy pants, or somewhere in between. I still struggle with study habits, but I've formed some theories since and I'm going to share these with you. Reading While reading should not be the entire basis of your studying, it is the best place to start. Best to start with the most basic and detailed sources (ex.Tortora if it's a topic I'm new to, then Kumar and Clark, and Davidson's are where I usually start, but there are tons of good ones out there!). I do not feel the need to read every section of a chapter, it's up to the reader's discretion to decide what to read based on objectives. If you do not have time for detailed reading, there are some wonderful simplified books that will give you enough to get through exams (ICT and crash course do some great ones!). I start with this if exams are a month or less away. Later, it's good to go through books that provide a summarized overview of things, to make sure you've covered all bases (ex. Flesh and Bones, the 'Rapid ______" series, oxford clinical handbook, etc.). These are also good if you have one very specific question about a subject. Video Tutorials**** After all that reading, you want the most laid back studying you can find. This is where Meducation and Youtube become your best friend. (I can post a list of my favourite channels if anyone is interested).I always email these people to thank them. I know from the nice people that run this website that it takes a tremendous amount of effort and a lot of the time and it's just us struggling students who have much to gain. Everyone should use video tutorials. It doesn't matter if you're all Hermione with your books; every single person can benefit from them, especially for osce where no book can fully portray what you're supposed to do/see/hear during examinations. Some youtube channels I like https://www.youtube.com/user/TheAnatomyZone https://www.youtube.com/user/ECGZone https://www.youtube.com/user/MEDCRAMvideos https://www.youtube.com/user/awolfnp https://www.youtube.com/user/harpinmartin https://www.youtube.com/user/RadiologyChannel Lectures We're all thinking it, lectures can be boring. Especially when the speaker has text vomited all over their slides (seriously, If I can't read it from the back of the lecture hall, there's too much!. It's even worse when they're just reading everything to you, and you're frantically trying to write everything down. Here's the thing, you're not supposed to write everything down. If you can print the slides beforehand or access them on your laptop/ipad/whatever you use and follow along, do that. You're meant to listen, nod along thinking (oh yes I remember this or oooh that's what happens? or Oh I never came across that particular fact, interesting!). It's also meant to be a chance for you to discuss interesting cases from the a doctor's experiences. If you're lucky to have really interactive lecturers, interact! Don't be shy! Even if you make a fool of yourself, you're more likely to remember what you learned better. If you happen to be in a lecture you're completely unprepared for (basically 70% of the time?). Think of it as "throwing everything at a wall and hoping something sticks." Pull up the slides on your smart phone if you have one, only take notes on interesting or useful things you hear the speaker say. If all else fails, these lectures where tell you what topics to go home and read about. Tutorials My university has gradually increased its use of tutorials, and I couldn't be happier. Make the most out of these because they are a gift. Having the focused attention of a knowledgeable doctor or professor in a small group for a prolonged period of time is hard to lock down during hospital hours. Ask lots of questions, raise topics you're having trouble understanding, this is your protected time. Discussions In group study activities, this is particularly hard to make the most of when everyone in your group varies in studying progression, but even so, it can be beneficial. Other people's strengths might be your weaknesses and vise versa– and it's always helpful to hear an explanation about something from someone at your level, because they will neither under or over estimate you, and they will not get offended when you tell them "ok I get it that's enough." Myself and 3 of my medic friends would meet once a week the month or two leading up to exams at one of our houses to go through OSCE stations and concepts we didn't understand (food helps too). Besides peer discussions, you should take advantage of discussions with doctors. If the doctor is willing to give you their time, use it well. Practice Questions I am a practice question book hoarder. Practice questions book not only test and reaffirm your knowledge, which is often hard to find if your exams are cumulative and you have little to no quizes/tests. They also have concise, useful explanations at the back and, they tell you where the gaps in your studying are. For my neuro rotation, the doctor giving the first and last lecture gave us a quiz, it was perfect for monitoring our progress, and the same technique can be used in your studies. Practical Clinical Experiences If you freeze up during exams and blank out, and suddenly the only forms of text floating around your brain are Taylor Swift lyrics, these are bound to come to your rescue! "Learn by doing." Take as many histories as you can, do as many clinical exams in hospital, and on your friends to practice, as you can, see and DO as many clinical procedures as you can; these are all easy and usually enjoyable forms of studying. Teaching Have you ever had an experience where one of your peers asks you about something and you give them a fairly good explanation then you think to yourself "Oh wow, I had no idea that was actually in there. High five me." If there is ever an opportunity to teach students in the years below you or fellow students in your year, do it! It will force you to form a simplified/accurate explanation; and once you've taught others, it is sure to stick in your head. Even if it's something you don't really know about, committing yourself to teaching others something forces you to find all the necessary information. Sometimes if there's a bunch of topics that nobody in my study group wants to do, we each choose one, go home and research it, and explain it to each other to save time. If you're doing this for a presentation, make handouts, diagrams or anything else that can be used as an aid.
over 6 years ago
Teaching resource designed for Peninsula Medical School Students, who sit an exam called the AMK. This exam is an MCQ based exam and covers a number of clinical scenarios. This booklet specifically looks at the common causes of headaches.
over 9 years ago
The Pharyngeal apparatus refers to the development and function of the clefts, arches and pouches which contribute to form the major components of the head and neck. Understanding the derivatives of the clefts, arches & pouches is initially time-consuming, however it lays a strong foundation to understand the clinical relevance thereafter. Hopefully this visual mnemonic will allow you to memorise all the derivatives of the pharyngeal apparatus with ease.
over 7 years ago
What really causes addiction — to everything from cocaine to smart-phones? And how can we overcome it? Johann Hari discusses.
almost 5 years ago
Introduction to the documentary web series that celebrates scientific curiosity, informs about the human brain thru exploring the achievements of Dr. Marian Diamonds's life in science.
over 4 years ago
Deep brain stimulation is becoming very precise. This technique allows surgeons to place electrodes in almost any area of the brain.
over 4 years ago
I'd like to tell you a curious story. Jane was a 52 year old woman in need of a kidney transplant. Thankfully she had three loving sons who were all very happy to give her one of theirs. So Jane's doctors performed tests to find out which of the three boys would be the best match, but the results surprised everyone. In the words of Jeremy Kyle, the DNA test showed that Jane was not the mother of two of the boys... Hang on, said Jane, child birth is not something you easily forget. They're definitely mine. And she was right. It turns out Jane was a chimera. Chimerism is the existence of two genetically different cell lines in one organism. This can arise for a number of reasons- it can be iatrogenic, like when someone has an organ transplant, or it can be naturally occurring. In Jane's case, it began in her mum's womb, with two eggs that had been fertilised by different sperm creating two embryos. Ordinarily, they would develop into two non-identical twins. However in Jane's case the two balls of cells fused early in development creating one person with both cell lines. Thus when doctors did the first tissue typing tests on Jane, just by chance they had only sampled the 'yellow' cell line which was responsible for one of her sons. When they went back again they found the 'pink' cell line which had given rise to the other two boys. This particular type of human chimerism is thought to be pretty rare- there are only 30 case reports in the literature. (Though remarkably both House and CSI's Gil Grissom have encountered cases.) What happens far more frequently is fetal microchimerism- which occurs in pregnant women when cells cross the placenta from baby to mum. This is awesome because we used to think the placenta was this barrier which prevented any cells crossing over. Now we've found both cells and free floating DNA cross the placenta, and that the cells can hang around for decades after the baby was born. Why? As is often the case in medicine we're not sure but one theory is that the fetal cells might have healing properties for mum. In pregnant mice who've had a heart attack, fetal cells can travel to the mum's heart where the develop into new heart muscle to repair the damage. Whilst we're still in the early stages of understanding why this happens, we already have a practical application. In the United States today, a pregnant woman can have a blood test which isn't looking for abnormalities in her DNA but in that of her fetus. The DNA test isn't conclusive enough to be used to diagnose genetic conditions, but it is a good screening test for certain trisomies including Down's syndrome. Now, we started with a curious tale, so lets close with a curious fact, and one that's appropriate for Mother's Day: This exchange of cells across the placenta is a two way process. So you may well have some of your mum's cells rushing through your veins right now. In my case they're probably the ones that tell me to put on sensible shoes and put that boy down... (FYI: This is a story I originally posted on my own blog)
Dr Catherine Carver
over 7 years ago
I read an article recently that 90% of surgical trainees have experienced bullying of one form or other in their practice. That’s 90%. That’s shocking. Worryingly it is highly likely that this statistic is not purely isolated to surgery. This is evidence of a major problem that needs to be addressed. We don’t accept bullying in schools and in the workplace policies are in place to stop bullying and harassment– so why have 90% of trainees experienced bullying? I can relate to this from personal experience, as I am sure most of us can. Prior to intercalating I had always had the typical med student ambition of joining the big league and taking on surgery. I had a keen interest in anatomy, I had decided to intercalate in anatomy, I did an SSC on surgical robotics, presented at an undergraduate surgical conference and had a small exposure to surgery in my first couple of years that gave me enough drive to take on a competitive career path. I took it upon myself to try and arrange a brief summer attachment where I would learn as a clinical medical student what it is like to scrub in and be in theatre. At the beginning I was so excited. At the end every time someone mentioned surgery I felt sick. It became apparent very quickly that I was an inconvenience. I think medical students all get this feeling – ‘being in the way’ - but this was different. This was being made to feel deliberately uncomfortable. I asked if I could have some guidance on scrubbing in and this was met with a complete huff and annoyance because I didn’t know how to do it properly (thank goodness for a lovely team of theatre nurses!). I even got assigned a pet name for the week – the ‘limpet’ (notable for their clinging on to rocks) that was frequently used as a humiliation tactic in front of colleagues. By the end of the week I dreaded walking into the hospital and felt physically sick every morning. Now some people might say ‘man up’ and get on with it. Fair enough, but I’m a fairly resilient character and it takes a lot to make me feel like I did that week. This experience completely eradicated any ambition I had at the time to go into surgery. Since then I’ve focused elsewhere and generally dreaded surgical rotations until very recently where I managed to meet a wonderful orthopaedic team who were incredibly encouraging. Bullying can be subjective. Just because a consultant asks you a difficult question doesn’t mean they’re bullying you. By and large clinicians want to stretch you and trigger buttons that make you go and look things up. If it drives you to work and develops you as a professional then it’s not bullying, but if it makes you feel rubbish, sick or less about yourself then you should perhaps think twice about the way you’re being treated. Of course bullying doesn’t stop at professionals. Psychological bullying is rife in medical schools. We’ve all been ‘psyched out’ by our peers – how much do you know? How did you know that when I didn’t? Intimidating behaviour can be just as aggressive. Americans dub these people ‘Gunners’ although we’ve been rather nice and adopted the word ‘keen’ instead. Luckily most medical schools have a port of call for this sort of behaviour. But a word of advice – don’t let anyone shrug it off. If it’s a problem, if it’s affecting you – tell someone. Bullying individuals that are trying to learn and develop as professionals is entirely unacceptable. If you would like to share similar experiences, drop them in the comments box below.
about 6 years ago
Clinical Skills Resuscitation station Assess danger of situation. Approach. “Rouse”. Assessment of consciousness. Gently shake shoulders. Use pain e.g sque…
over 9 years ago