I’m a klutz. Always have been. Probably always will be. I blame my clumsiness on the fact that I didn’t crawl. Apparently I was sitting around one day and toddling on two feet the next. Whatever the cause, it’s a well-tested fact that I’m not good on icy footpaths. Various parts of my anatomy have gotten up close and personal with frozen ground on many an occasion. Not usually an issue for a born-and-bred Australian, except when said Australian goes to visit her Canadian family during the northern winter. During one such visit, I found myself unceremoniously plopped onto slick ice while my two-year-old niece frolicked around me with sure-footed abandon. I thought, “There has to be an easier way.” As freezing water seeped through my jeans, providing a useful cold pack for my screaming coccyx, my memory was jogged. I recalled that a lateral-thinking group of New Zealand researchers had won the Ignoble Prize for Physics for demonstrating that wearing socks on the outsides of shoes reduces the incidence of falls on icy footpaths. To the amusement of my niece, I tried out the theory for myself on the walk home. I don’t know if I had a more secure foothold or not, but I did manage to get blisters from wearing sneakers without socks. I love socks. They cover my large, ungainly clod-hoppers and keep my toes toasty warm almost all year round. You know the song ‘You can leave your hat on.’? Well for me, it is more a case of ‘You can leave your socks on, especially in winter. There’s nothing unromantic about that… is there? I’m not, however, as attached to my socks as a patient I once treated. As an intern doing a psychiatry rotation, one of my tasks was to do physical examinations on all admissions. Being a dot-the-i’s kinda girl, when an old homeless man declined to remove his socks so that I could examine his feet, I didn’t let it slide. “I haven’t taken off my socks for thirty years,” he pronounced. “It can’t be that long. Your socks aren’t thirty years old. In fact, they look quite new,” I countered. “When the old ones wear out, I just slip a new pair over the top.” I didn’t believe him. From his odour, I would have believed that he hadn’t showered in thirty years, but the sock story didn’t add up. He eventually agreed to let me take them off. The top two sock layers weren’t a problem but then I ran into trouble. Black remains of what used to be socks clung firmly to his feet, and my gentle attempts at their removal resulted in screams of agony. I tried soaking his feet. Still no luck. His skin had grown up into the fibres, and it was impossible to extract the old sock remnants without ripping off skin. In retrospect I probably should have left the old man alone, but instead got the psych registrar to have a peek, who then involved the emergency registrar, who called the surgeon and soon enough the patient and his socks were off to theatre. The ‘surgical removal of socks’ was not a commonly performed procedure, and it provided much staff amusement. It wasn’t so funny for Mr. Sock Man, who required several skin grafts! From my perspective here in Canada, while I thoroughly commend the Kiwis for their ground-breaking sock research, I think I’ll stick to the more traditional socks-in-shoes approach, change my socks regularly and work a bit on my coordination skills. References: PHYSICS PRIZE: Lianne Parkin, Sheila Williams, and Patricia Priest of the University of Otago, New Zealand, for demonstrating that, on icy footpaths in wintertime, people slip and fall less often if they wear socks on the outside of their shoes. "Preventing Winter Falls: A Randomised Controlled Trial of a Novel Intervention," Lianne Parkin, Sheila Williams, and Patricia Priest, New Zealand Medical Journal. vol. 122, no, 1298, July 3, 2009, pp. 31-8. (This blog post has been adapted from a column first published in Australian Doctor http://www.australiandoctor.com.au/articles/58/0c06f058.asp) 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
almost 7 years ago
http://fhs.mcmaster.ca/medicine/geriatric/docs/Geriatric_Handbook08.pdf : This link leads to the Geriatric Survival Handbook by Brian Christopher Misiaszek, MD, FRCPS (C) Assistant Professor of Medicine Michael G. DeGroote School of Medicine at McMaster University. It's a handy overview for anyone starting/reviewing a Geriatric rotation.
over 5 years ago
Providing a detailed overview of respiratory medicine in one short volume, Respiratory Medicine Lecture Notes covers everything from the basics of anatomy and physiology through to information on a full range of respiratory diseases. Whether approaching the topic for the first time, starting a rotation, or looking for a quick-reference summary, medical students, specialist nurses, technicians and doctors in training will find this book an invaluable source of theoretical and clinical information.
about 5 years ago
Guest Blogpost for: Progressive collaborative refinement on teams: implications for communication practices
This article demonstrates the importance of oral and written communication between members of medical teaching teams in a busy teaching hospital. The authors have made excellent use of genre theory to examine the challenges facing senior and junior doctors, attending physicians and medical students as they share patient care while working in a complex hospital environment. These challenges included fragmented continuity of care due to regular staff rotations and shift work, compounded by time constraints and patients with complex healthcare needs. Communications broke down on many occasions, at times affecting patient care, and the authors provide useful recommendations for reform and further research.
Conversations with Medical Education
almost 7 years ago
The vestibular system. This image shows the central part of the vestibular system( the system responsible for providing information concerning gravity, rotation and acceleration) showing: 1. occulomotor nucleus 2. trochlear nucleus 3. abducent nucleus 4. vestibular nuclei 5. vestibular
almost 6 years ago
Book of the week (BotW) = The Darwin Economy by Prof Frank Being a medical student and wanna-be-surgeon, I am naturally very competitive. I know exactly where I want to end up in life. I want to be a surgeon at a major unit doing research, teaching and management, as well as many other things. To reach this goal in a rational way I, and many others like me, need to look at what is required and make sure that we tick the boxes. We must also out-compete every other budding surgeon with a similar interest. Medicine is also a dog-eat-dog world when it comes to getting the job you want. Luckily you can head off into almost any field you find interesting, as long as you have the points on your CV to get access to the training. In recent years, the number of med students has increased, but so has the competition for places. The number of FY1 jobs has increased but so has the competition for good rotations. The number of consultant posts has increased, but so has the competition for the jobs. To even be considered for an interview for a consultant surgeon post these days a candidate (hopefully my future self) will have to demonstrate an excellent knowledge of anatomy, physiology, pathology and demography. They will need to have competent surgical skills and have completed all of the hours and numbers of procedures. To further demonstrate this they will need to have gone on extra-curricular courses and fellowships. They will also need to show that they can teach and have been doing so regularly. They must now also have an understanding of medical leadership and have a portfolio of projects. Finally, they will have had to tick the research box, with posters, publications, oral presentations and research degrees. That’s a long list of tick boxes and guess what? It has been getting longer! I regularly attend a surgical research collaborative meeting in Birmingham. Many of those surgeons didn’t even get taught about research at medical school or publish anything until they were registrars. Now even to get onto a good Core Training post you need to have at the very least some posters in your chosen field and probably a minimum of a publication. That’s a pretty big jump in standards in just 15 years. In two generations the competition has increased exponentially. Why is that? Prof Frank explains economic competition in Darwinian terms. His insights apply equally well to the medical training programme. It’s all about your relative performance compared to your peers and the continual arms race for the best resources (training posts). However, the catch is, if everyone ups their performance by the same amount then you all work harder for no more advantage for anyone, except for the first few people who made the upgrade. The majority do not benefit but are in fact harmed by this continual arms race. I believe that this competition will only get worse as each new year of med students tries to keep up and surpass the previous cohort. This competition will inevitably lead to a greater time commitment from the students with no potential gain. Everything we do is relative to everyone else. If we up our game, we will outperform the competition, until they catch up with us and then relatively we are no better off but are working harder. Why is this relevant? I know everyone will want to select “the best” candidate, but in medicine the “best” candidate doesn’t really exist because we are all almost equally capable of doing the role, once we have had the training. So there is no point us all working ourselves into the ground for a future job, if all our hard work won’t pay off for most of us anyway. But we can’t make these choices as individuals because if one of us says that “I am not going to play the game. I am going to enjoy my free time with my friends and family”, that person won’t get the competitive job because everyone else will out-perform them. We have to tackle this issue as a cohort. How do we ensure that we don’t work ourselves into the ground for nothing? Collectively as medical students and trainees we should ask the BMA and Royal Collages to set out a strict application process that means once candidates have met the minimum requirements, there is no more points for additional effort. For instance, the application form for a surgical consultant post should only have space to include 5 peer-reviewed publications. That way it wouldn’t necessarily matter if you had 5 or 50 publications. This limit may seem counter-intuitive and will possibly work against the highly competitive high achievers, but it will have a positive effect on everyone else’s life. Imagine if you only had to write 5 papers in your career to guarantee a chance at a job, instead of having to write 25. All that extra time you would have had to invest in extra-curricular research can now be used more productively by you to achieve other life goals, like more time with your family or more patient contact or even more time in theatre perfecting your skills. If you were selecting candidates for senior clinicians, would you rather pick an all round doctor who has met all of the requirements and has a balanced work-life balance or a neurotic competitor who hasn’t slept in 8 years and is close to a breakdown? Being a doctor is more than a profession, it is a life-style choice but we should try to prevent it becoming our entire lives.
over 6 years ago
How do you succeed during your third year of medical school? How do you do well in your clinical clerkships? How do you "honor" a rotation (and since when is honor a reverse transitive verb)?
over 5 years ago
I am now doing a thyroid surgery rotation. This morning we had a tutorial regarding management of patient with grave's disease (hyperthyroid). We were asked about what are the options that available for them. One of the participants highlighted the so called "block and replace regime" in which we are giving patient with carbimazole (block) and thyroxine (replace). The problem is, despite giving carbimazole alone, why do we need to add on thyroxine in managing hyperthyroid patient since this thyroxine might worsen the condition. Any ideas?
about 8 years ago