I’m sure there are times when all us GPs feel under-appreciated — by our patients, staff, specialist colleagues or society in general. You can’t blame them for sometimes taking us for granted — it’s part of the human condition. People don’t value what they have until they lose it, whether “it” is the ability to walk or a domestic fairy who makes sure there’s always spare toilet paper.
It’s a common lament that we can’t be at our own funerals to hear how much we’re loved. Mind you, eulogies are rarely objective and balanced. Nonetheless, it’s a pity we’re not around to hear the praise — deserved or otherwise — that is expressed once we’re gone.
The long-serving, somewhat-taken-for-granted GP has a non-fatal way of bringing out the appreciation in his or her patients and staff: moving on.
After 10 years of GP-ing in the Noosa hinterland and a lifetime of living in south-east Queensland, I headed south of the border: to northern NSW. The hardest part of the move for me — harder than selling my house in a depressed market, harder than dealing with banks, builders, real estate agents, solicitors and Australia Post, harder even than trying to get rational answers out of my telecommunications company after they cut off my internet and phone prematurely — was telling my patients that I was leaving.
I knew many of my patients were very attached. I knew they’d come to me expecting to receive a loyal, life-long partner kind of doctoring, rather than the one-night-stand variety. But I had no idea how difficult it would be to break the “I’m leaving you” news again and again and again.
Hard as breaking up a relationship may be, at least you only have to do it once when you leave a romantic partnership. For me, telling patients I was leaving felt a bit like breaking up with hundreds of boyfriends, one after the other after the other.
You may interpret this as my being too close to my patients or not close enough to my boyfriends, but the fact is I found the protracted process exhausting, emotionally draining and just plain horrible. The “it’s not you, it’s me” part goes without saying and
I know I am far from irreplaceable, but seeing the tears well up in countless eyes because of the words I’ve uttered was enough to break my tender heart.
Looking on the bright side, as I am wont to do, if I’d ever felt under-appreciated, I sure don’t now. I received more expressions of gratitude in those last three months than I did in the previous decade. To hear how influential I was in some of my patients’ lives put a warm glow in my battered heart. And as much as it hurt me to see my patients upset, it probably would’ve hurt me more if they’d been completely indifferent to my leaving.
However, I did please someone. Mrs L had been trying for years to get her husband to agree to move interstate to be near family. His last remaining excuse was that his multiple complex medical problems meant that he couldn’t possibly leave me, his long-term GP. A grateful Mrs L rang me within hours of my informing them of my impending departure to say:
“He’s finally come around. Thank you so much for deciding to leave us.”
It’s nice to be appreciated!
(This blog post has been adapted from a column first published in Australian Doctor www.australiandoctor.com.au/opinions/the-last-word/the-last-word-on-moving-on- )
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/
It is understandable why resume writing is daunting for most students – they haven’t achieved many significant things at such young age and they have difficulties to present usual things as something extraordinary. However, you shouldn’t give up on your efforts, because you will be surprised by all things your potential employers consider valuable. All you have to do is find the right way to demonstrate your achievements and relate them to the job you are applying for.
The following tips will help you write a great resume that will represent you as an ideal candidate for every employer.
1. Start the process by listing your experiences. You cannot tackle the challenge right where it gets most difficult, so you should gradually work your way towards the precise professional language. Start with brainstorming and create a list of all experiences you consider significant. You can draw experiences from all life aspects, such as school, academic activities, internships, prior employments, community service, sports, and whatever else you consider important. Look at that list and distinguish the most motivating experiences that led you to the point where you currently are.
2. Target the resume towards the job. Sending the same generic resume to all potential employers is a common mistake students do. You should tailor a custom-written resume for each job application, representing experiences and skills that will be relevant for the position you’re applying for.
3. Present yourself as a dynamic person. Find the most active components of your experiences and present them in the resume. Focus on action verbs, because they are attention-grabbing and make powerful statements (trained, evaluated, taught, researched, organized, led, oriented, calculated, interviewed, wrote, and so on).
4. Mark the most notable elements of your experiences and use them to start your descriptions. An employer couldn’t care less about the mundane aspects of college or internships, so feel free to leave them out and highlight your persona as a professional who would be a great choice for an employee.
5. Show what you can do for the organization. Employers are only looking for candidates who can contribute towards the growth of their companies, so make sure to portray yourself as someone who can accomplish great things in the role you are applying for. You can do this by reviewing your experiences and highlighting any success you achieved, no matter how small it is.
6. Don’t forget that your most important job at the moment is being a student. While you’re a student, that’s the most important aspect of your life and you should forget to mention that you are an engaged learner in your resume. Include the high GPA and the achievements in your major as important information in your resume.
7. Describe the most important academic projects. At this stage of life, you don’t have many professional experiences to brag about, but your academic projects can also be included in your resume because they show your collaborative, critical thinking, research, writing, and presentation skills.
8. Present yourself as a leader. If you were ever engaged as a leader in a project, make sure to include the information about recruiting and organizing your peers, as well as training, leading, and motivating them.
9. Include information about community service. If all students knew that employers appreciate community service as an activity that shows that the person has matured and cares for the society, they wouldn’t underestimate it so much. Make sure to include information about your activities as a volunteer – your potential employers will definitely appreciate it.
10. Review before you submit! Your resume will require some serious reviewing before you can send it safely to employers. This isn’t the place where you can allow spelling and grammatical errors to slip through. The best advice would be to hire a professional editor to bring this important document to perfection.
One of the most important things to remember is that writing a great resume requires a lot of time and devotion. Make sure to follow the above-listed steps, and you will make the entire process less daunting.
Maybe it’s just me, but I cannot get my head around pharmacology and antibiotics are certainly doing their best to finish me off! My group at uni decided that this was one area that we needed to revise, and the task fell on my hands to provide the material for a revision session. So, the night before the session I began to panic about how to come up with any useful tips for my group, or indeed anyone at all, to try to remember anything useful about antibiotics at all. If only Paracetamoxyfrusebendroneomycin was a real drug, it would make our lives so much easier. Come on Adam Kay and Suman Biswas, get the trials started and create your wonderful super drug. For the mean time I guess I will just have to keep blissfully singing along to your song. However, that is not going to help me with my task in hand.
After a lot of research that even took me beyond the realms of Wikipedia (something I do not often like to do), I found various sources suggesting remembering these Top 10 Rules (and their exceptions)
All cell wall inhibitors are ?-lactams (except vancomycin)
All penicillins are water soluble (nafcillin)
All protein synthesis inhibitors are bacteriostatic (aminoglycosides)
All cocci are Gram positive (Neisseria spp.)
All bacilli are Gram negative (anthrax, tetanus, botulism, diptheria)
All spirochetes are Gram negative
Tetracyclines and macrolides are used for intracellular bacteria
Pregnant women should not take tetracyclines, aminoglycosides,
fluroquinolones, or sulfonamides
Antibiotics beginning with a ‘C’ are particularly associated with
While the penicillins are the most famous for causing allergies, people may also react to cephalosporins
If those work for you, then I guess you can stop reading now… If they don’t, I can’t promise that I have anything better, but give these other tips that I found a whirl… Alternatively, I have created a Page on my own blog called Rang and Dale’s answer to Antibiotics, which summarises their information, so please take a look at that.
Most people will suggest that you can categorise antibiotics in three ways, and it’s best to pick one and learn examples of them.
Mode of action:
bacteriostatic (stop multiplying)
2 mnemonics to potentially help you remember examples:
We’re ECSTaTiC about bacteriostatics?
Erythromycin Clindamycin Sulphonamides Tetracyclines Trimethoprim
Very Finely Proficient At Cell Murder (bactericidal) - Vancomycin Fluroquinolones Penicillins Aminoglycosides Cephalosporins
Spectrum of activity:
broad-spectrum (gram positive AND negative)
narrow (gram positive OR negative)
Mechanism of action
Inhibit cell wall synthesis
Inhibit nucleic acid synthesis
Inhibit protein synthesis
Inhibit cell membrane synthesis
If you have any more weird and wonderful ways to remember antibiotics, let me
know and I will add them! As always, thank you for reading.
http://www.handwrittentutorials.com - This is the third tutorial in the Renal Anatomy series. This video explores the histology of the glomerulus, and discusses the cell types. The juxtaglomerular apparatus is also discussed in detail. For more entirely FREE tutorials and their accompanying PDFs, visit http://www.handwrittentutorials.com
In the lead up to finals time our latest podcast could be really useful for your practical sessions
In it we discuss how you will get the best out of presenting findings to an examiner in a medical student final OSCE or VIVA situation
These situations can be stressful and if you dont think about your presentation [...]
The relationship between patients and doctors has long been based on face-to-face communication and complete confidentiality. Whilst these fundamentals still absolutely remain, the channels of communication across all sectors have changed monumentally, with social media at the forefront of these changes.
Increasingly patients are taking to the Internet to find recommendations for healthcare professionals and to self-diagnose. By having an online presence your business can positively influence these conversations – engaging with the public and colleagues both locally and globally and can facilitate public access to accurate health information. The reality is social media is here to stay, so in 2014 why not make it your resolution to become part of the conversation.
To get you started and so that social media isn’t seen as such a daunting place, SocialB are providing a free eBook containing lots of fantastic advice on how to use social media within the healthcare sector ‘Twitter for Healthcare Professionals’ please visit http://www.socialmedia-trainingcourses.com/top-10-twitter-tips-ebook/ to receive your free copy.
Here are 5 top tips on using social media in 2014:
1. Decide on your online image and adhere to it
Decide how you would like to be portrayed professionally and apply this to your online presence. Create a tone of voice and a company image – in line with your branding and values – and stick to it.
2. Be approachable, whilst maintain professional boundaries
Connecting with patients via social media can help to ease their concerns and develop a certain rapport or trust with you prior to their consultation. However, this must remain professional at all times, and individual advice should not be given. The general rule is that personal ‘friend requests’ should not be accepted; connection over corporate pages and accounts is encouraged to maintain a traditional doctor-patient relationship.
3. Contribute your knowledge, experience and industry information
Social media is a fantastic way to launch an online marketing campaign. Interaction with your patients and potential clients via social networks is an inexpensive way to engage with, and learn from your audience.
As a healthcare professional, you will inevitably take part in conferences, training days and possibly new research. Social media allows you to share your knowledge, enabling your market to be better informed about you and your work.
4. Treat others how you wish to be treated
By engaging with other means that they are more likely to take notice of, and share, your social media updates. Sharing is key and it is this action that will substantially grow your audiences. Maintain your professionalism and pre-agreed tone of voice whilst communicating with others. Make it easy for peers and patients to recommend your level of skill and service, and ensure you recommend fellow healthcare professionals for the same reasons.
5. Consider your audience
Whilst you may be astute at targeting a particular audience as a result of careful market research, always be aware who else can see your online presence. Governing bodies, competitors and the press are just a few examples. Whilst social media tends to be a more informal platform, by following the above points will ensure your professional reputation is upheld.
Thank you Katy Sutherland at SocialB for providing this blog post.
"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.
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.
If you're not happy with your performance, the most likely culprit is your study strategies. The material presented in medical school is not conceptually more difficult than many rigorous undergraduate courses, but the volume flow rate of information per hour and per day is much greater – it has frequently been described as “drinking from a fire-hose.”