Ductus 2014 Edition 2

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Welcome: from the editors

THINK OF THE KIDS

Welcome: from the president 4

HEADBANGING: NATIONAL MEDICAL RISKS BARRIER AND EFFECTS EXAMS 9

AN UNPARALLELED EXPERIENCE

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THE CURRENT STATE OF BMPs

INTERESTING MEDICAL READS

RECAP: HALFWAY PARTY 30

THE PEN REVIEW

BACK COVER STUFF

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LIFE ON EXCHANGE IN NOTTINGHAM 28

GP CLUB: WHAT’s ON? 32

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RANDOM NEWS AND OTHER STUFF

Ductus Doctor 34

HARRY POTTER AND THE PRINCIPLES OF MEDICINE

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WAYTE’S WECIPES

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RECAP: TEDDY BEAR HOSPITAL

SHANNON’S TAKE ON ESCAPISM

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36 DUCTUS 2014 EDITION 2 Content Editor: Lachlan Gan Design and Layout Editor: Ming Yong publications@UNMS.ORG.AU

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COVER: THE HOGCASTLE CREST

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FROM THE EDITORS: SWAN SONGS, AMONG OTHER THINGS

I had to wrestle with Lachlan to write the Editor’s note this time – he usually plays my laziness to my own disadvantage by writing one too soon, way before I even start thinking about Ductus. So why am I so adamant about writing this one? Seriously, who even reads the Editor’s note? You can say this is my swan song. I have been on MedSoc running Ductus for the last 2 years, and now 6 editions wiser, it’s time for me to move on to bigger things like taking medicine more seriously. I ran for this position, young and naïve way back in 2012 when some of you were still stressing out about HSC and UMAT – crazy how time flies when you put it in context – because I needed a creative outlet in a dry world of PBL and Sontag’s ironically colourful lecture slides. I suppose, I have to thank MedSoc for this opportunity, because Ductus has definitely filled the void in my creative life. And I suppose that’s what I was trying to achieve with this edition of Ductus, which I unofficially dub the “creative edition.” It never ceases to amaze me how creative and talented our peers in the medical degree can be, which is very annoying and unfair because most of them are already smart, athletic and good-looking.

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Take MedRevue for instance – you have about 70 medical students who not only study in a degree

that makes us “the brains on campus” (I quote from YakTV), but can also dance, sing, act and/or play a musical instrument. And then you have the likes of Ductus, where you realise there’s a handful of med students who can write amazingly well too. And finally, where both circles overlap, you have the people we absolutely detest like Andrew Shannon and Toby Hunt who can sing, act, dance, play a musical instrument, write well and play sports. But I digress.

Studies have shown that being creative helps you cope with life, or at least that’s what I’ve heard (I am far too lazy to PubMed that shit and reference this). Say we take this as fact, you’d see why being creative is necessary in a life filled with self-directed learning, not having the slightest clue about what’s going on and pretending like we know what’s going on when we really don’t. I’ve also heard that creativity and medicine do not traditionally overlap, but I call bluff. Studies have shown that creative doctors are better doctors in terms of empathy and taking better histories, plus they are better at thinking outside the box when diagnosing and planning management options. While I pulled the last sentence out of thin air, it probably is true. I do know for fact though that being creative is important if you want to do well in PBL; this demonstrated by a friend of mine who hypothesised one week in 3rd year that the patient is ill because she was bitten by a vampire.

I do know with full certainty, however, that creativity is important for mental health and wellbeing. I see medicine as a life of black, white but mostly grey – everything is so theoretical and hypothesised, and even in the practical setting, people and patients on the wards can easily bring our spirits down. For me, being creative acts like a form of escape, to a world of imagination and colour where I am the painter and I have full control of what I’m doing. Now, compare this to medicine


and you’d see why this is a healthy activity. Before I go on sounding like I’m on LSDs, I end with a final urge. Be creative and don’t be afraid of exploring your creative side. It has certainly helped me cope with my med life, and I am quite certain it will help you in one form or another. Take this from someone who is now 6 Ducti wiser. So that brings my swan song to an end. Goodbye forever Ductus, it’s been one hell of a ride with you. Ming A

On behalf of Ming and Lachlan, Editors

FROM THE PRESIDENT: THE YEAR IN THE LIFE OF THE PWESIDENT

As I write this article, MedSoc elections are well underway and my year as President is almost finished. I want to share with you some of the achievements that we have made this year as well as the highs and lows along the way. I have been lucky enough to have a fabulous team of people to work in and together I think we have managed to put on some amazing events this year. From social to academic and everything in between, I like to think that MedSoc is able to add a little bit to everyone’s med school experience; here are a few of my highlights. First Incision was a resounding success, with our new venue of Wests being perfect to welcome a

new batch of first years to Newcastle. We also had over 450 people in attendance which makes this the biggest First Incision in memory! We also ran two highly successful OSCEs nights, where both 1st and 3rd years could put their clinical skills to the test. At Newcastle we are always looking for more formative examination and it was great that we could expand the OSCEs night program this year.

The second annual MedBall was a chance for everyone to get dressed up and celebrate in style. Lovely food and free-flowing drinks combined with wonderful promotion and decoration made MedBall a night to be remembered. I think that we also found a balance of trying to keep tickets as cheap as possible while covering the costs of everything needed for a great ball. Looking to the future and we have a simply spectacular MedRevue to look forward to. Having seen some of the extraordinary work that has gone into this year’s show, I can guarantee that it is not to be missed! Aside from putting on almost weekly events, MedSoc also has a very important advocacy role in ensuring that we have the best medical education we can. Some of the key things that I think we have achieved in this area are: • •

• • •

Ensuring that PBL and clinical skills groups have a capped number so that students get the most out of this sessions

Helping to develop more structured student support processes to ensure that people have the appropriate support needed to complete their degree Working with the faculty to have the course reaccredited for the next 5 years

Continuing to advocate for students as the start of the MD program gets closer Working with AMSA to advocate for the needs of all

Australian medical students, especially around the area of mental health and wellbeing

For me, this meant attending somewhere in the order of 50 meetings of various committees over the year and receiving literally thousands of emails. It has been a great experience to work so closely with the medical faculty and I encourage each and every one of you to be as proactive as you can in shaping your medical education.

This year, we have also gone through the process of incorporating MedSoc so that it is recognised as a business entity in itself. This will allow much more stability for the organisation and also opens up a whole new range of exciting events that could be run next year. This has been a year’s worth of effort that has involved us learning significant amounts of business and taxation law in the process and I thank Laura for her leadership of this process.

Finally I must acknowledge the work that has gone into this publication that you are reading today. Ming and Lachlan have put timeless amounts of effort into delivering you three editions of an extremely professional set of publications. With that, all that remains is for me to wish the incoming MedSoc Committee the best of luck and thank everyone who has made it such a joy to serve as President this year. James Y

UNMS 2013/2014 President

VOTE FOR YOUR NEXT UNMS COMMITTEE!

Voting for the next committee and executive for UNMS to serve from 2014 to 2015 is still open on Blackboard. The future of MedSoc’s events, advocacy and student-support platforms lie in your hands, so make sure you vote! More details can be found on Blackboard.

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By Hannah Sycamore & Stephanie Smith

The last year has been an amazing time for Charity at UNMS. We have had successful BBQs, raffles, an awesome Trivia Night and have had 23 medical students run their hearts out at the City2Surf. All of these events have raised over $4600 so far, with plenty more to come.

We couldn’t have done this without YOU! The students who have partied, run, and consumed all in the name of the amazing charity that is Fair Go For Kids. As a major benefactor for LeapFrog Ability’s Fair Go For Kids program, the medical students of UoN should be proud. Your generosity has funded numerous programs for many kids in a variety of situations. Thank you for your support in 2014!

Fair Go For Kids is an initiative of the local organisation LeapFrog Ability. They are based here in Newcastle, and their primary aim is to raise funds and assist local children in need. Unfortunately, we often hear about the unnecessary hardship that some children face due to long waiting times for assistance with treatment, equipment and support. This is happening every day, with many children fall through the cracks of government funding and community projects – luckily, Fair Go For Kids is there to help.

FAIR GO FOR KIDS PROFILE: HEATH

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Meet Heath. At eight and a half years old, he is a bright, polite, and enthusiastic child, giving 110% to everything he does.

However, a few years ago, Heath’s parents noticed that he was having muscular problems. His legs locked up playing soccer, and it seemed like every muscle in his body would just not cooperate.

Heath struggles focussing his eyes, has poor balance and postural control, poor body awareness and low muscle tone. These factors have lead to his poor bladder control, speech dyspraxia and poor eye control. It is a constant effort for him to concentrate on complex instructions, and so he gets distracted easily. Understandably, Heath’s family spent all their time and money trying to figure out what was wrong with Heath, and to treat it. Paying for numerous GPs, paediatricians, psychiatrists and other specialists took a great toll on the family of six. Unfortunately, Heath’s condition does not meet criteria for funding from the National Disability Insurance Scheme, nor fulfil any disability labels, and so he is ineligible for any governmental financial assistance. By this point, Heath was really struggling. He used to love school, but was starting to shut down and withdraw. He found the learning really difficult. He started to lose confidence in his knowledge and abilities. It was really tough. Things took a turn for the better when their application for assistance from Fair Go For Kids was received and approved. The Sensory Clinic in Maitland generously donated sensory classes to FGFK, who then approved them 6 occupational therapy sessions for Heath, providing him and his family with invaluable skills, knowledge, and ability to manage his symptoms. As Heath’s symptoms arose from lack of muscle control, The Sensory Clinic developed exercises and activities for Heath, addressing both his problems with sensory input subsequent motor output. Due to Heath’s sessions, and exercises designed to improve his fine and gross motor control, Heath has been managing his symptoms. His grades have improved, he is inter-


acting classsmates, playing soccer, and most importantly, Heath is happy and healthy. As a major benefactor for LeapFrog Ability’s Fair Go For Kids program, the medical students of UoN should be proud. Your generosity has funded similar programs for many kids in many different situations. Thank you!

But don’t worry - it’s not over yet. We have raised a lot of money for this outstanding charity - but there’s so much more to come. So, get excited!

COMING UP IN SEMESTER 2

Argyle House: Home to the stickiest d-floors and only the best Novocastrians. A delightfully classy venue for those wishing to experience an evening of social interaction with fellow medical students.

Coming up on August 27th is the annual Charity Party. Get your creative juices flowing because there will be prizes for the best HERO OR VILLAIN costume. Are you Harry Potter? Maleficent? Batman… or Robin? Regina George?

Something from the trolley dear? We’ve concocted some super special Potterised treats for the delight of your tastebuds. Acid pops, chocolate frogs, liquorice wands, Bertie Botts Every Flavour Beans, and much more, with all proceeds from the trolley going to Fair Go For Kids. Have your booked your Medrevue tickets yet? Want more information on FGFK? Go to leapfrog.org.au

Want to get involved? Find Hannah or Steph on Facebook, or email us at charity@unms.org.au

Recap: UNMS Runs City2Surf for FGFK ► Iductus

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Reprinted from the Age National. http://www.theage.com.au/national/

AC/DC should switch to playing Moon River instead of Highway to Hell, in order to reduce neck injuries from headbanging, according to new Australian research published in the British Medical Journal. And douching with Coca-Cola is an ineffective contraceptive, because sperm can swim faster than the Coke in the race for the cervical canal. If it sounds like the prestigious journal has gone a bit crazy... well-spotted. The annual Christmas spoof edition is full of outrageous `research’ reports, tongue firmly planted in medical cheeks. While not all the reports are outright made-up, many are. Nevertheless, each year serious news outlets fall for the straightfaced press releases put out by the journal in advance of publication, and write them up as fact.

Last year no less an outlet than the BBC po-facedly reported that men are naturally more comedic than women because of the male hormone testosterone. This came from a report on male reaction to unicycles, and an edition that researched a genetic basis for Harry Potter-style magic. This year’s BMJ Christmas edition examines `evidence’ of a link between the performance of the Welsh rugby team and the deaths of Popes. It suggests that screening for colorectal cancer could be scheduled to coincide with Christmas and birthdays, to encourage attendance, and reveals that Oliver Twist’s diet in the poorhouse was highly under-nutritious. A related podcast explores the medical value of frankincense. However the standout report is by Associate Professor Andrew McIntosh and his research assistance Declan Patton, from the University of New South Wales.

In a study of head and neck injury risks in heavy metal, they compare the headbanging styles of cartoon slackers Beavis and Butthead, with the live-action movements of Wayne’s World stars Wayne and Garth.

“When head banging at a tempo of 164 beats per minute to I Wanna Be Sedated, the range of motion of Beavis’ head and neck is about 45 degrees, which is below any injury threshold of both the head and neck injury criteria,” the peer-reviewed study said. “Butt-head, however, preferred.. a range of motion of about 75 degrees (predicting) headaches and dizziness. It is well understood, however, that cartoon characters are able to tolerate greater than normal impacts without injury. “Another legendary pair of head bangers, Wayne and Garth, head bang to Bohemian Rhapsody at 138 beats per minute with a range of movement of about 45 degrees. Because of the low range of movement, no injuries were predicted... though the characters in the back seat of the car demonstrated a noticeably larger range of motion and might be at risk of head or neck injury.” The researchers suggest “possible interventions” such as substituting adult-oriented rock such as Michael Bolton, Celine Dion or Enya.

“For example, encouraging bands such as AC/DC to play songs like Moon River... (and) public awareness campaigns with influential and youth-focused musicians such as Cliff Richard.”

Associate Professor McIntosh told The Age that the “science is good” because he applied methods used to study sport and motor vehicle accidents. However it was clearly written tonguein-cheek. “We are trying to have a dig at ourselves, and people like me who work in injury prevention,” he said. “It’s not meant to create paranoia about headbanging. But I am sure that the humorous element will drop off somewhere along the line.”

Associate Professor McIntosh said he was a fan of rock bands such as the Stooges and the Dead Kennedys. Declan, the other author of the paper, played in a hard rock band. Neither are headbangers.

December 18, 2008

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By Josh Darlow

The National Barrier Exam has been floated regularly from around 1996, as proposed, it would be a common exam taken by all students at Australian medical schools sometime in their final year. Passing the exam would be a pre-requisite to practice as an intern.

THE CURRENT SYSTEM OF AUSTRALIAN MEDICAL EDUCATION

Currently, the Australian Medical Council assesses and accredits each medical school against a set of common standards and certifies its graduates as competent interns (or not).(1) Currently, the AMC accredits 18 Australian medical schools programs (2), offering M.D., MBBS, BMBS, B. Med (whaddup), and MChD programs. Each school has differing emphases, but all are assumed to create desirable graduates as defined by the AMC.

WHY CHANGE?

Why change this process?

Pressure for a NBE is coming from three sources: (i) Intern Places

As described many times in this august journal, the traditional guarantee of an intern place for all domestic students may end. (3) This raises the question of

who should miss out. The general answer to this is ‘the least deserving’.(4) If your definition of ‘the least deserving’ is those people who performed the worst at medical school, then a common examination of medical school knowledge looks like a good bet for prioritizing intern spots.

(ii) Medical Mishaps

Each of the states, but especially Queensland (5), has suffered from some very public mishaps including the hiring of unregistered interns, fraud, negligence, and manslaughter. Although very few of these events involve junior doctors, there is a perceived need to reassure the public with a new, national layer of accreditation aimed at guaranteeing minimum safety standards (as distinct from ranking graduates).

(iii) Standardisation

The Productivity Commission has been pushing to reduce costs in medical education, and to create a national market for interns and for health professionals. A National Barrier Exam would allow the comparison of graduates in a national market. A national exam would also facilitate international recognition of Australian graduates, and the entrance of overseas-trained interns and residents.

(1) For example, the AMC advised that our proposed M.D. program required revision before it would accredit it. High drama all around. (2) Number correct at press. Macquarie, CSU, and Curtin would all like this number to increase. (3) As it already has for international students. (4) And Toby. But I repeat myself. (5) Shocker. (6) http://informahealthcare.com/doi/abs/10.1080/01421590600622723 (7) Mostly other tests. With the exception of supervisor ratings, most of these studies estimate the ability of success in one examination to predict success in a subsequent examination.

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WOULD A NATIONAL BARRIER EXAM WORK? If we do decide to rank graduates based on a NBE, would it work? Would a test serve as an accurate predictor of ‘being a good doctor’? Statistically, the answer is ‘yes’: meta-analysis (6) does find correlations between performance on standardized tests (predominantly the American USMLE examination) and measures of future clinical performance.(7) However, the same meta-analysis finds NBE-like tests are poorer predictors than OSCE marks, GPAs or a good old letter from your Dean.(8) These results rather undercut the arguments for an exam as a means for ranking interns.

As well as an NBE’s relative ineffectiveness in predicting clinical performance, an exam would likely lead to changes in the medical school ecosystem. Currently, the dogma is that one medical school education is as good as another.(9) The absence of any statistics proving otherwise has allowed medical schools to develop their own flavours and areas of innovation. A national barrier exam, however weakly linked with clinical reality, would result in a definitive ‘best’ and ‘worst’ medical school. The likely result: medical schools increasingly teaching to the test (some U.S. medical schools explicitly structure their curricula around the USMLE(10)) and intense competition within medical schools.(11)

ALTERNATIVES These concerns appear to have dampened earlier enthusiasm for a national exam in favour of increased collaboration between medical schools. Medical schools are increasingly standardizing their assessment whilst preserving the options for each school to retain its own teaching priorities such as indigenous health or tropical medicine. Newcastle has experimented with the Australian Medical Schools Assessment Collaboration, where twelve medical schools shared fifty anatomy and physiology exam questions, with the aim of benchmarking and sharing scarce assessment expertise. Indeed, Medical Deans Australia handed down a report in March explicitly aimed at increasing medical school collaboration and providing an alternative to a National Licensing Exam.

So, what should we do? In the current environment of internships for all, and a public that trusts the current system, extensive effort to rank medical students in the absence of a good predictive metric seems folly. Closer medical school collaboration seems to have the potential to increase standardization and efficiency, satisfying the Productivity Commission’s concerns. My personal solution, should the intern crisis come upon us, is to select for lucky interns by randomly binning excess applications – after all, who wants an unlucky intern?

(8) Appendix 4. Hamdy H, Prasad, K, Anderson MB, Scherpbier A, Williams R, Zwierstra R, Cuddihy H. Medical Teacher, 2006;28(2) 103-116. (9) This is not true. See the penultimate slide: http://www.som.uq.edu. au/media/371245/Leo%20Davies%20Preso.pdf (10) Dexter J, Koshland G, Waer A & Anderson D. Mapping a curriculum database to the USMLE Step 1 content outline. Medical Teacher. 2012 [cited June 2014]; 34(10):e666-e675. Available from PubMed Database. (11) If you think that Newcastle is laid back now, in the early days of the B. Med final marks were simply made up; at graduation graduates were allocated marks dependent on the selectiveness of their desired hospital. (12) http://www.medicaldeans.org.au/wp-content/uploads/MedicalDeans-Competencies-Project-Stage-3-Final-Report-FINAL.pdf

AMSA@UNMS PRESENTS: PUPPY PICNIC Studies have shown University students’ stress levels can be significantly reduced during peak study and assessment period – but how? With PUPPIES!

Spending just a few minutes with these furry friends can lower stress hormones, improve your outlook, and increase oxytocin levels.

On the afternoon of September 4 at the University of Newcastle, the AMSA@UNMS Subcommittee invites you to join us for “Puppy Picnic” – a chance to play your stress away with some adorable Delta Therapy Dogs, while also checking out some of the support services available to you at our wellbeing expo. We hope to see you there!

AMSA@UNMS PRESENTS: 1ST VS 2ND YEAR DEBATE It’s time.

Year 1 and Year 2 will face off in the next round of the UNMS debating series. Our debaters will put their wit and intellect to the test as they explore 2 topics impacting on the everyday life of the average medical student. But the stakes are even higher this time, as year reps from the losing team will be punished with an ice dunking for the Winter Ice Challenge! Funds raised from the challenge will go towards Leap Frog Fair Go For Kids. Come along for a laugh, support our Year 1 and 2 debaters, and watch someone get dunked in icy water on August 28, from 6:15pm at GT Bar!

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Recap: MedBall 2014


By Jim Fann

CONVENTION SUCKS

And I am so sick and tired of defending it all the time. I’m sick of selling Convention as “The best seven days of your life”. I’m tired of watching the cynical raise of an eyebrow as I try and tell people why this will be the best thousand dollars that they could possibly spend. I’m sick and I’m tired of over-selling the academic events and networking opportunities to compensate for the completely misguided stigma that Convention is some sort of piss-up party orgy hybrid.

It’s got to the point where I feel like a missionary trying to preach the God that is Convention. And make no mistake, as much happiness as those seven annual days of Convention bring to my life, it’s definitely no God and it definitely doesn’t need no preaching. So I am going to be genuine. I am going to be straight-up. I am going to share with you my convention experience – uncensored, raw, naked. Going to Convention to me, is like going to a whole new country, a country where only Australian medical students can get to. There’s a different culture, we have our own customs and traditions. It’s governed by their own politics, they have a completely different level of social etiquette and skills such as skimpy costume making- an often dismissed skill in the land of Australia- is one of the most valuable in the country that is Convention. So let’s start on that – skimpy costume making and 5 things that I learnt about it during Convention: 1.

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Perception is everything. Example: I attempted to dress as a Cherry to a social night themed “Untouched”. That night I came to the harsh realisation that Cherry costumes also look very similar to Tomatoes and Apple costumes – both more common fruits, and both easier conclusions to reach when one is intoxicated.

2.

3. 4.

5.

If you are going to use props and if say, said prop was going to be whipped cream, before spraying whipped cream on a lady/man that you may be interested in – check if they are vegan. It would definitely save a very potentially awkward situation. Fake breasts garner a lot of attention.

Capes keep you warm and make you look majestic but will increase your risk of drowning while in a foam party. Suspenders make everything look bigger and better.

But costumes are a night- time thing at Convention. The adventures during the day, while more conservative, are brighter, bigger and inspiring. Here are 5 things I realised during my daytime adventures: 1.

2.

3. 4.

You are going to cry. Your Limbic system is going to go into overdrive. The speakers give you inspiration. They break your heart and mend it again in the same talk. Some make you angry and some make you feel inadequate. Some speakers offer you the solution, and then another will tell you that there is none. You will feel emotion during academic. I expressed it through tears – happy, sad and inspirational tears. You most likely will cry too. If you are going to propose to a complete stranger as part of a “mini day challenge”, don’t do it by sticking post-it notes onto a baby goat and then try to pick up and hand a goat to them. This is a bad idea because a) it is weird b) She may be afraid of goats c) Baby goats don’t like it that much When debating, if you suck, just start making fun of how badly you’re doing. Self-derogatory humour is the best 4) While learning advanced suturing techniques you feel


5.

like an absolute and complete badass and can better emphasise with how surgeons are generally more up themselves.

A genius will command attention. Dr Patch Adams, one of the academic speakers, was a crazy, radical, tortured, genius. He had many “different” ideas and a burning dislike for our non-communist healthcare system. It was like meeting a type of person you’d never met before and it was a privilege to be able to finally meet a genius.

While I love academic at Convention – I would pick the night time escapades every time. They make for the best stories and reinvigorate your passion for pure joyful fun. In case you haven’t noticed already, there is a recurring theme of learning through this article. Here are 10 more things that I have learnt from social nights: 1.

2. 3.

4. 5.

During a UV paint war, the secret is stealth. While it may be appealing to charge Kamikaze style into the abyss of paint covered bodies, the reciprocal fire that you will receive just isn’t worth it

The University of Newcastle is in the Top 8 medical schools of Australia when it comes to sculling beer When leading your 30 people strong delegation of pirates into battle with the pirates from the University of Melbourne on Sports day, make sure to be the aggressor. You will have the advantage.

Don’t lie down during a foam party when you’re heavily intoxicated. Drowning is a real risk, as is aspiration pneumonia

While riding mechanical bulls, squeeze your thighs very tightly together and flex your hips. It’s all in the hips.

6.

7. 8. 9.

Don’t go up to all one thousand medical students at convention, yelling I passed and high fiving all of them. Though it is extremely exciting that you passed, and you are with fellow medical students so they are genuinely excited for you, you will tear your throat from all the screaming and it will get infected. (It’s a month since I was at Convention and I am still sick)

So that is why Convention sucks. Because you can’t know if you like a country until you’ve been there, until you’ve lived there. Come live at convention with me. Melbourne 2015. Let me show you, my country. By Helen Nevell

ANYTHING COULD HAPPEN

Group costumes are great, but be prepared… it leads to some group loving

What’s large, moist, and has the highest number of medical students in any one room?

On the bus, I learnt of: Yogi bear, what people wished ladies were and what AMSA rangers do in the morning, in the evening and late at night.

Enter a week of the largest student run event in the world. It begins with an auditorium of 1800 medical students from Australia and New Zealand dancing to Hawaii-Five-O (trust me, it has to be seen to be believed), indoor fireworks, and Hugh Jackman.

So much group loving

10. ‘remier league. It may be the most elite and epic drinking game known to all men, women and dinosaurs. A game where Bon Jovi does not sing, a place where kumquat is not an exotic fruit and where Ciao (Chow) does not mean goodbye in a foreign language.

Yet the highlight every Convention is undoubtedly the people. We can break as many World Records as we like, get as many world renowned surgeons to speak, party in the most exciting and bizarre place possible, but none of those things are what “makes” convention. What “makes” convention is the culture at Convention, a culture that has been established by generations and generations of medical students.

We past and present medical students, have created our own country, inside of a real country and this country that we have created – Convention - is my favourite place to go. It is my happy place. We have our own country in a country, and only we medical students can get to this country in a country. It’s inception. But real life. And that is so hard to explain.

Convention!

Excited? So was I.

Being my first Convention, I was known as a ‘Convirgin’. I arrived in Adelaide with a suitcase of faux fur, sequins, and spandex, with little knowledge of how my convention experience would unfold. Never did I expect to be blown away by an array of such diverse and engaging speakers that would mold the academic program into one that would reignite my eagerness to pursue Medicine in the post exam period… …Nor did I envisage that I would end up on stage in a ‘Spicks and Specks’ spoof with Anna singing from a gynaecology textbook as I attempted to guess song titles.

Wednesday was Sports Day, which involved me running around an indoor basketball stadium dressed as one of the “Pirates of Novocastria”. What we lacked in talent, we made up for with enthusiasm and plastic swords. Luckily, Newcastle fared slightly better in the Emergency

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◄Continued Medical Challenge and Sports Day games than mine and Anna’s singing debut.

For Ned and I, Thursday’s academic was replaced by a spontaneous trip to Kangaroo Island thanks to RDWA and Ned’s ridiculous luck at winning competitions. Not only did we get to see a beautiful part of Australia, but gained valuable insight into life as a country GP and listened to Dr Tim Kelly’s impressive collection of “I fell on it” stories…never have I seen anyone so enthused about a PR exam. The trip instilled an interest in rural medicine and was a highlight of my week. Convention would not be complete without its social nights filled with body paint, scanty costumes, amazing venues and foam parties. This was a fantastic opportunity to mingle with delegates from other universities and to support local liquor businesses. The costuming was well worth the effort, as was the recovery from the multiple strains of conventionitis that ensued. Convention offers something for everyone and promises to be a memorable week. I will definitely be back for more…See you in Melbourne 2015!

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The world is your convention.

July 5-12 2015 Melbourne Convention & Exhibition Centre


By Andrew Shannon

Ah yes, medical school. Or as I like to think of it: the all-consuming, life-dominating experience that masquerades as an educational institution.

Faced with an onslaught of completely irrelevant information, constant timetable adjustments and extremely pedantic lock-out policies from certain cardiologists, it isn’t surprising that many of us wish to find a way of escaping the tedium of University life… if only for a few nights. This wish isn’t unique to medical students, it’s just a lot harder to harder to achieve as one. Students of other Faculties are able to employ relatively simple escape strategies: Engineers generally aspire to find and talk to a human girl, and those belonging to a less gender-challenged Faculty require nothing more than a plan that begins and ends with intoxication.

Unfortunately, med school saw the intoxication move coming and countered it by insisting that the drinking game endorsed by medical students across the country is also the only one in existence where a written exam must be taken before anyone is willing to admit you’re any good at it. No, really. A. Written. Fucking. Exam.

Hilariously, the same ‘layers who insist that this is okay are usually the same people who, a few weeks before stuvac kicks off, spend their time expressing their dislike of exams and bitterly insisting that written exams are a poor measure of competence anyway. I’m confident they spotted the irony of this behaviour long before they read this paragraph, but then again these are the same people that can’t count to 4 properly.

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So if drinking isn’t a viable option, what’s left? As I see it, the only remaining method of escaping med school is taking a leaf out of the cra-

zy person’s handbook and choosing to live in some kind of fantasy world. Convincingly pulling off such a drastic move normally requires an unfortunate genetic predisposition, or being old enough to make Darlow’s age sound sprightly. However none of that is necessary because, in an unusually merciful twist, med school features an organisation solely purposed with creating and immersing med students into a fantasy world. Yep, I’m talking about Med Revue. Don’t let the “Med” bit fool you, this society has almost nothing to do with medicine. Med Revue thus represents a perfect escape, a magical place where more than 10 medical students can gather without immediately beginning to talk about things like the Krebs Cycle. There are some catches of course.

For one, I’ve been threatened by a tiny New Zealander girl more times than I can remember – which I suppose wouldn’t be so terrifying if she wasn’t able to somehow throw kicks at my head height… or if I could understand a word she was saying.

For another, there is the ever-present danger that the fantasy becomes too real and the character you play merges with your own personality, placing you somewhere on a spectrum straight out of the DSM. It is more common than you may think: Toby now so closely resembles Ron Weasley (the character he will soon portray), that when his best friend isn’t around to save the day, he just sits outside his house and cries. (Note, photo on the next page) Seriously.

Of course, these downsides apply only to the people actually in the show. And by happy coincidence there’s a way to participate in this fantasy without going that far: being in the audience. Sure, that isn’t an entirely risk free choice either, but the worst thing


MEDREVUE IS BACK FOR A SIRIUSLY GOOD TIME There once was two men who had a silver dream; To reproduce what he saw on the silver screen; But it wasn’t enough to recreate; So they wrote a new script; And they made it great! It follows the story of young Harry Potter; And his evil arch-rival, perfidious plotter; But don’t let ye think that the world is of magic; It’s of medicine, woe, and comedy tragic. A boisterous journey, a fanciful take; Of music and whimsy to make your sides shake; With Dancing and Singing and wisecracks galore; And let me tell you, one hell of a score.

Caption: Toby (right) is defeated by a simple lock and key mechanism and sits on the ground crying while waiting for Nick to show up.

that you can experience as an audience member is watching Ned and Emma make out – and I’m pretty sure they won’t be doing that this year (well… not on stage anyway).

So on the 29th or the 30th of August (or both if Scott is blackmailing you), put down that boring textbook on something-ology and experience the kind of on-stage magic that can only be created by a group of people desperately trying to pretend that they won’t have to go back to being med students once the show is over.

Tickets are selling quick. Buy yours at bit.ly/uonmedrevue. All proceeds will go to Leap Frog Fair Go for Kids.

Are you an enraged fan of ‘Remier League and want to throw some abuse my way?

Write to me at bonjoviwasaterriblesubstituteforthenumber4@ hotmail.com begin your letter by completing this sentence: “It is in no way a buzz kill to play a drinking game with as many rules as ‘Rem because…”

The first step was scripting, a tedious task; Twenty K words, no trifling ask; Next came auditions, a chance to go judging; This task taking over the time once spent bludging. Rehearsals so joyous, the glee and the mirth; Observing creation, the musicals birth; The dancing and singing and acting abounds; And all through the theatre our laugher resounds. So come down and join us, and witness the glory One tenth of the cohort will help tell the story Last weekend of August, the dates for the show So don’t be a lame-wad. Just fucking well go!

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By Hannah Coleman

Teddy Bear Hospital 2014 was a huge success. Bears and toys were rounded up by the children of Newcastle and carted down to Civic Park on Saturday 19th July.

The turnout of kids was exceptional considering the dreary day. Bears, giraffes, pandas and more were examined by our lovely student doctors. Some were then given a special vaccine or had a swab taken. Animals were all X-rayed to check for any bone problems, size permitting. Thea Durbridge took a special liking to the microwave X-ray machine and balled her eyes out when mum Kate and dad Kurt (third year students) took her home. Parents of the region were extremely grateful for the opportunity as some had experienced difficulties trying to get their child to go to the doctor; I received positive feedback all around. Our facepainters were kept busy turning children into various super heroes and butterflies. A huge thank you to these girls! The baking was up there with the best cupcakes and cookies I have seen to date at a Medsoc bake sale; again a massive thank you to all our fantastic bakers. Zoo boys, a children’s band from Sydney who are playing this year at Splendor in the Grass, kindly donated CDs to give out to the kids and to play musical statues. Unfortunately the weather did not allow musical statues to take place but the donation was really appreciated.

The Newcastle Herald did a feature article on the event and was very impressed with both the purpose of the event and the dedication of all involved to put on this free event for the Newcastle community. Little Hands of the Hunter also contacted us to do an article on Teddy Bear hospital. Both parties sent photographers along on the day to capture the event and write their respective articles. This is a fantastic compliment to Medsoc and the University of Newcastle Medical School.

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Thank you again to everyone who helped out!


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UNMS Presents MedRevue 2014

Friday & Saturday, 29th & 30th August 2014 Griffith Duncan Theatre, the University of Newcastle Tickets available from bit.ly/uonmedrevue Starring Peter Enks as Harry Potter & Daniel Chilton as the Dark Lord


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By Alex Scott

I signed a Bonded Medical Place (BMP) contract over three years ago, and like many others, I did so without much of a second thought, as the imposition of the terms of the agreement were a requirement to claim my place in the medical program. I then put the agreement in the back of my mind, and it wasn’t until now that I have begun to think about what the agreements actually means in terms of my future career.

The BMP scheme was introduced in 2004 to address the shortage of doctors in outer metropolitan, rural and remote areas of Australia – it is offered to a quarter of all Commonwealth supported applicants at all medical schools. Those who accept the BMP scheme are contractually obligated to undertake a return of service obligation (RSO) in a district of workforce shortage (generally outer metropolitan or rural areas), equal to the length of their medical degree. The RSO only becomes compulsory once the participant gains fellowship of a specialist college, although up to half of the RSO can be completed in the vocational training period prior to fellowship. At this point it is difficult to find specific information on what constitutes an area of workforce shortage for specific specialties, however I was recently informed by another BMP holder (working at registrar level) that she will be able to work in her specialty (anatomical pathology) in the Sydney metro area – suggesting that perhaps the department is becoming more lenient and flexible, at least for niche specialties. At this point it is too early to formally evaluate whether or not the scheme is effective, as very few practitioners have commenced their RSO period, although at this early stage it is looking like the scheme is failing to meet its target of supplying medical officers to under supplied areas. So far (as at the writing of the Mason Review in February 2013) only one participant has commenced their RSO, and three participants have “bought out” of the scheme. Buying out of the scheme equates to repaying 75% of the total Commonwealth contribution towards the medical degree, and is evidently an attractive option for those who do not wish to commit to years of

practice in a rural area (due to career ambitions, family, or otherwise). An unintended consequence of this is that for many a BMP is merely an alternative to a full-fee paying medical course.

Commitment to this scheme is fraught with other issues too. Many participants have expressed concern over the complexity of the scheme and its lack of flexibility, the perception that it is a coercive program, and a perceived lack of support and mentoring for those practitioners required to go work in a district of workforce shortage. The Australian Medical Students’ Association has taken issue with the scheme too, believing that “the Bonded Medical Places Scheme may be ineffective in its ability to address workforce shortages and more effort should be made to inform prospective medical students of their future obligations,” and that other means of attracting doctors to areas of workforce shortage should be prioritised.

If this scheme is failing to work (and there are certainly some strong reservations about the BMP at this point) then should it be reformed or abolished? The scheme is unlikely to be abolished at this stage, but reform is certainly on the cards. Some options discussed in the Government’s Mason Review are to cut the length of the RSO in half, in order to make “buying out” less attractive, and increased support for BMP students by increasing their engagement in rural communities through sponsored placements. A more radical alternative to the BMP (although arguably more equitable) is to require a universal RSO of all recent medical graduates in workforce shortage areas, as is done in South Africa through a “community service” year. Interestingly, a legal barrier to this option in Australia is that medical conscription (which an RSO may be interpreted to be) is constitutionally prohibited.

So what does all this mean for you if you are a BMP holder? At this point it may seem that ten years from now you will either be commencing a 5 year RSO, or not (if you choose to fork out the big bucks), but watch this space and maybe with continued advocacy from AMSA, the AMA, and others, the powers that be will change things for the better.

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By Dr Andra Dabson

PATIENT-CENTREDNESS IN THE JMP

Written exclusively for Ductus, August 2014 My first job is to thank all of you who completed my online survey in semester 1. The response rate was 42% of all enrolled students in the JMP which gives me sufficient numbers to obtain significant results. I’m very grateful to you indeed.

This piece of my research was designed to discover what characteristics of the students of the JMP are associated with their “patient-centredness”, and whether patient-centredness is associated with characteristics I predicted from my previous study.

A person is considered more patient-centred the more strongly they agree with ideas such as: “the doctor should consider the patient’s concerns in the management of his or her illness” or “the patient should be involved in all decisions regarding his or her health”. The concept of patient-centredness has been increasingly part of the healthcare discussion over the last fifty years and is now considered central in the planning of healthcare services and the training of healthcare personnel. The measure of patient-centredness I used in the survey is called the Patient-Physician Orientation Scale and was developed by Professor Ed Krupat and his colleagues at Harvard Medical School in the late 1990s. It is divided into two subscales which are called “caring” (meaning that the doctor understands the impact of the illness on the patient) and “sharing” (meaning that the doctor is willing to share information and decision-making with the patient).

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It was originally used in the United States where the mean scores of medical students over several studies ranged from 4.6-5.1 (out of 6). Scores varied at sites in other countries with means of: 3.7 in Nepal, 3.9 in Greece, 4.0 in Saudi Arabia, 4.1 in Singapore,

4.3 in Sweden and 4.7 in Brazil. In international studies of medical students the results have been associated significantly with gender, ethnicity, stage in the medical course, career preference, “humanism” score, and religiosity.

In the JMP the mean score was 4.5/6 with a standard deviation of 0.4. The population in the study was very similar in terms of demographics to the JMP as a whole, though in the study population the proportion of males was 41% compared to the JMP figure of 49%. The significant differences between groups were that females were more likely to score higher for patient-centredness than males (0.17 points), international students more likely to score lower than domestic students (0.23 points), students who spoke English at home scored more highly (0.16 points) and students from rural areas scored more highly than those from urban areas (0.17 points). There was no significant difference with age, early or later years in the course, previous history of illness or previous connections with healthcare.

For the sharing subscale the differences were larger with female students scoring 0.21 points higher than males, domestic students scoring 0.29 points higher than international students and students from a rural background scoring 0.19 points higher than those from an urban background. The significant results on the caring subscale were the same as those for the total score, though generally slightly smaller, but with the addition of 0.12 point higher score for students who had previously experienced a significant illness or injury. Unlike the studies done in several countries there does not appear to be a fall in patient-centredness in the later years of the course, which is similar to the findings in Sweden. The new finding that I haven’t seen anywhere else is that students from rural areas are more patient-centred than students form urban areas (p = 0.001). For the question about whether male or female doctors would be better at


understanding a patient’s concerns, female students and indigenous students were more likely to think that a female doctor would understand the concerns better and students with higher scores on the PPOS were more likely to believe that male and female doctors would be equally understanding.

When asked about how much they felt their gender would impact their career choice female students were 3 times as likely as males to have a higher score for this question, and students in years 4 and 5 were 2.7 times more likely to have a higher score than students in years 1 – 3. Students form rural areas were more likely to think that their gender would impact their choice of a career and students who identified as LGBTQI were less likely to expect such an impact. Higher scores for expecting an impact on the progression of a prospective career were seen for female students, indigenous students, students from rural areas, students in years 4 and 5, and students whose language at home was not English. Feeling more comfortable working in a community setting was strongly associated with being an older student and with having a higher score on the PPOS. Feeling more comfortable with the hospital setting was higher in students in years 4 and 5, prior employment in healthcare, international students and students whose language at home was English.

Expecting to enjoy your medical career was strongly associated with a higher PPOS score, though there were no other significant differences from the demographics for this question.

While the differences I’m reporting are significant (p < 0.05) and some highly significant, the absolute differences are generally not large. For example, while there is a 0.17 point higher mean score on the PPOS for females than males (p < 0.001), the males are still well towards the patient-centred end of the scale. I’ll be analysing and writing about the data a good deal more over the next 12 months – I promise you

won’t have to read it – but I thought you might like to see the results “hot off the press” as a thank you for your help with the data itself!

If you would like to comment on these results or ask questions you are welcome to e-mail me: andra. dabson@newcastle.edu.au Thanks again. Andra Dabson t

By Papadakis et al

DISCIPLINARY ACTION BY MEDICAL BOARDS AND PRIOR BEHAVIOUS IN MEDICAL SCHOOL

From the New England Journal of Medicine, December 2005 Conclusion: In this case–control study, disciplinary action among practicing physicians by medical boards was strongly associated with unprofessional behavior in medical school. Students with the strongest association were those who were described as irresponsible or as having diminished ability to improve their behavior. Professionalism should have a central role in medical academics and throughout one’s medical career. Full text: bit.ly/D2Article1 By Hojat et al

THE DEVIL IS IN THIRD YEAR: A LONGITUDINAL STUDY OF THE EROSION OF EMPATHY IN MEDICAL SCHOOL

From Academic Medicine, September 2009 Method: Four hundred fifty-six students who entered Jefferson Medical College in 2002 (n = 227) and 2004 (n = 229) completed the Jefferson Scale of Physician Empathy at five different times: at entry into medical school on orientation day and subsequently at the end

of each academic year. Statistical analyses were performed for the entire cohort, as well as for the “matched” cohort (participants who identified themselves at all five test administrations) and the “unmatched” cohort (participants who did not identify themselves in all five test administrations).

Conclusion: It is concluded that a significant decline in empathy occurs during the third year of medical school. It is ironic that the erosion of empathy occurs during a time when the curriculum is shifting toward patient-care activities; this is when empathy is most essential. Implications for retaining and enhancing empathy are discussed. Full text: bit.ly/D2Article2 By Sierles et al

CHEATING IN MEDICAL SCHOOL

From Academic Medicine, February 1980 Conclusion: This study demonstrates that cheating is extremely frequent (87.6%) among premedical students. Although the frequency of medical students cheating (58.2%) is significantly lower than 87.6%, the majority of students continue to cheat in medical school. The most disturbing finding was the positive correlation between cheating in school and cheating in patient care; there was a continuum from cheating in college, to cheating in medical school in didactic areas, to cheating in clerkships in patient care. Because of this finding, the authors suggest that cheating in medical school may be a predictor of cheating in medical practice and that there is a group of students at particulat ar risk for dishonest medical practice: those who cheated in college are cynical about cheating, cheat in medical school, and are dishonest in their care of patients as medical students. Full text: bit.ly/D2Article3

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By Seshika Ratwatte

EXCHANGE IN NOTTINGHAM

One of the great opportunities offered to us at Newcastle med school is the opportunity to go on exchange for one semester in 4th year. You get the chance to apply half way through third year and generally 6 students are chosen to go over to Nottingham to complete their WACH semester. I was lucky enough to be one of those students last year and thought I’d share a snapshot of my experience.

LIVING IN NOTTINGHAM

Most students try to directly swap into one of the incoming Nottingham exchange students houses. This is great because you integrate with local student really quickly! Unlike Newy where we live all over the place, most medical students / students in general live in a suburb called Lenton. It’s walking distance from the hospital, walking distance from the shops walking distance from everyone else’s house, and it’s even possible to walk to ‘town’ (though there is a 1pound bus if you’re lazy). In terms of cost of living, I found living in Nottingham was fairly comparable to living in Newy.

ACADEMIC LIFE IN NOTTINGHAM

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Unfortunately, if you think exchange in Nottingham is going to be a massive bludge you’re sorely mistaken. 75% attendance is expected and you a rewarded with a coloured certificate at the end of each rotation if you achieve this (seriously). However, I thought the teaching was fantastic! We got given an actual timetable (a weird experience for a clinical year student), and consultants took the time to run great, well organised tutorials multiple times a week. Of course I would have preferred if they didn’t put compulsory paediatrics lectures on a Friday afternoon (don’t they realise exchange students have a travel

agenda??) but all in all I thought I got great clinical exposure in paeds and O+G over there.

OUTSIDE THE HOSPITAL

Life outside the hospital in Nottingham was pretty fun. Whilst there wasn’t a beach anywhere in the vicinity we still made use of the 2 pound movies at the local cinema, the awesome cheap pubs and restaurants, Wollaton Park aka. Where Batman’s house is and sick house parties (much bigger than ones we throw here). The 4th year medics also put on a musical each year: they buy the rights to the musical, it can’t be being performed on the West End, three shows are out on at the Nottingham play house and members of the public can attend! Four of us took part in their production of ‘Guys and Dolls’ (with one Aussie even taking out the male lead..). It was a great way to meet people and do something completely different to what we would do back home.

TRAVELING ON THE WEEKEND

In the lead up to exchange I thought I’d be travelling to another country every weekend - I mean that’s what living in Europe is all about right? Unfortunately, we had to study a bit more and it cost a but more than I had navely imagined. But we did do plenty of amazing trips: • • •

Opening weekend of the Edinburgh Fringe Festival – singing, dancing, drama, music and of course a bit of Haggis!

Opening weekend of Oktoberfest – costumes, 1L steins of beer and the best pork burgers you’ll ever eat! A week long medical education conference in Prague – would have never been able to afford this if I hadn’t been over there.

A sneaky weekend in Dublin – flights were 40 pounds return!


A girly weekend in Oxford – punting anyone?

Semester finishes at the end of November so I spent 5 weeks after this travelling around Europe which was amazing!

The best thing about exchange is that you make the most of every opportunity! You’re not going to say no to Oktoberfest because you’re studying, you’re not going to go out because you’re only there for five months. You manage to study, travel, try new things and live in a new place all at the same time. This balance is what I’ve brought back to Newy with me – no matter how busy the hospital gets I still want to make time to do fun things here like we did on exchange! If you’re in third year I’d encourage you to apply. Remember – you’ve got to be in it, to win it! However, if you don’t get this particular opportunity, don’t worry, there are two opportunities to do overseas placements in 5th year (SSO and PHCS) so there is an opportunity for everyone!

NOTTINGHAM VERSUS OSLO: QUICK FACTS

Founding Year

1881

Language of Instruction

English

Number of Students World Ranking

34 000

University of Nottingham

120 (Times Higher Education)

Number of Medical Students

Approx 330/ year

Cost of Living

Approximately AUD1 500/ month

Medical Society

Student Accommodation Fee

Interesting Fact Summer Average Winter Average

Nott Medsoc

University Halls of Residence. 15 Halls housing about 4 000 students £9 000 per year

Much of the MRI development work was carried out in Nottingham. 21 °C

1.3 °C

1811

27 700

Universitetet i Oslo

201 - 225 (Times Higher Education)

WACH Semester is taught in English, though a basic knowledge of Norwegian may be helpful Approx 400/ year

Medicinerforeninger

Student Housing administered by the Foundation for Student Life in Oslo Approximately AUD8 400/semester

Higher education is free in Norway. Approximately $70 goes to the student welfare body per term. A research-based university, Oslo is intensively involved in breakthrough discoveries. 22 °C -7 °C

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Written by Ming Yong Recipe by James Wayte

If you don’t know James Wayte, you live under a rock. Seriously. James is the guy every guy wants to be and every girl wants to be with. To seal the deal of perfection, Wayte is also a genius in the kitchen!

Traditionally, Wayte’s Wecipes feature sinfully sweet delights. This time however, Wayte decided to spice things up by giving us the wecipe to a savoury dish: Wasagne!

2.

Add salt and next 5 ingredients; stirring until well mixed.

4.

Cook lasagna noodles according to package directions; drain and set aside.

3.

5. 6.

INGWEDIENTS

• • • • • • • • • • • • • • • • • 1.

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700g lean ground beef 200g Italian sausage 1 large onion, chopped 2 garlic cloves, minced 1 teaspoon salt (or to taste) 1 tablespoon dried parsley flakes 1 tablespoon dried oregano 1 tablespoon dried basil 2 cans whole tomatoes, undrained and chopped 2 cans tomato paste 700g cottage cheese 2 eggs, beaten 1/2 teaspoon pepper 2 tablespoons parsley 1/2 cup grated parmesan cheese 450g mozzarella cheese, divided 12 -15 lasagna noodles

7. 8.

Simmer 1 hour.

Spray a 13 x 9” baking pan with cooking spray.

Combine cottage cheese, eggs, pepper, 2 tablespoons parsley, Parmesan cheese and 1/2 of mozzarella cheese; in a lasagna pan, layer noodles, meat sauce, and cheese mixture; repeat.

Top off with layer of noodles; sprinkle evenly with remaining mozzarella cheese. Bake at 375F for 30 to 40 minutes, or until cheese mixture is thoroughly melted.

DIWECTIONS

Brown ground beef, Italian sausage, onion and garlic.

How freaking delicious does that look!? Wayte, you did it again.


Recap: Halfway Party 2014 “Carnival”


JMP BMed students in all years, Prevocational Doctors (interns and residents), GP Registrars and GPs are all welcome to attend GP Club events held in Newcastle and Gosford. These events are provided free of charge, including dinner and refreshments. The GP Club is a combined initiative of General Practice Training – Valley to Coast and The University of Newcastle’s Discipline of General Practice. Would you like to find out more about a career in general practice in a relaxed and enjoyable social environment? Events usually feature inspiring GPs speaking about why they enjoy their exceptional careers, and showcasing the diversity of opportunity in general practice. Professional skills training is an enjoyable and rewarding activity for GPs and students alike. These sessions are coordinated by the experienced teaching staff of both the Discipline and Valley to Coast with the assistance of volunteer GPs and GP Registrars.

GP Club Events remaining in 2014 Date

Location

Theme

Skills Stations

Tuesday 19 August

Gosford

Vision

How to examine the Eye Year 3-5+JMO 6 hands-on skills stations: 1. Visual Acuity 2. Squint (esp’ly in children) 3. Outer eye 4. Basic ophthalmoscopy 5. Fundus 6. Practicing on mannequins

Newcastle

Trauma

Musculoskeletal How to apply slings, collar & cuff, bandaging & strapping, finger splints, reduction of pulled elbow, neck collars.

Speaker: Julianne Millar, now a local GP, has worked in Africa and Asia for Medecins Sans Frontieres and International Children’s Care Wednesday 8 October

Target audience

Year 1-2

You may register for GP Club events by visiting www.gptvtc.com.au , finding the GP Club page from the Medical Students/JMOs tab on the left hand side, then clicking on the link to RSVP.



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8 8

8

7

8 8

RACGP

BREAATHHE

7

MIPS

MDA

8

7

7 8

7 8.5

8

7

8

8 10 7 Syringe Pen

6

Avant

9

NRHSN

8

7 9

8

9

8 10 7.5 Elsevier

6 NUSA

7.5

8

10

7

8.5 7 8 8.5 GP Australia

UON

8.5

Comfort

8

Ink Performance

6

Novelty/Look

8

Overall Satisfaction

Since the very first medical school was established medical students have pondered – do I use my index finger, or my thumb to paint on this wall? What combination of metal,

So in answer to your most pivotal question, before you take a peek at doctor Ductus and find answers to the questions you are too embarrassed to ask, address the big questions that will shape the rest of your medical career and see which pen you should have been using.

9

So do you really click with your pen? Due to popular demand, a question as old as medical schools itself is finally being addressed – Just which writing instrument do I use?

bone and ivory do I use? Which bird do I pluck my quill from? Right up to present day when we are given access to a plethora of free pens, but does anyone really try them all out?

7

By Julia Zhu, Tobias Hunt and Lachlan Gan


MARKERS COMMENTS: JULZ Overall if this was a decision matrix (one of the few things I actually took away from my 1 year of engineering), I would rank ink performance and comfort very highly. Thus generally, my overall satisfaction comes from these criteria and I’m a big fan of the Investec, MIGA and Breaathhe pens. Special mention to the UoN services pen which amazingly has BLUE ink (such a rare find in the free pen world!). Lastly, I should also mention that another big criteria that would usually factor into my pen favouritism, is the “spontaneity of death”. <rant> Nothing annoys me more than a pen that just won’t die – they start to write in a grey colour that’s hard to read, you put it down, pick it back up a couple of minutes later and it revives with a burst of black ink that lasts about 4 words before going back to a light grey. Why? Just don’t bother!

MARKERS COMMENTS: LACHLAN

Lachlan - My method of pen judging is a little unorthodox among professional circles, but I find that it gets the best results from both me and my pens. Classically pens are judged on their individual components (as you can see in the table

above) - however I try to forget the details and see what the pen says to me as not just an object, but a true companion of the desktop - one that is with me through thick and thin, who will stick with me at my darkest moments of incomprehension (and there are quite a few of those given we are studying neuro at the moment) and celebrate with me at the final period of PBL. For me, the competition ended up between the Australian Red Cross Blood Service pen and MIGA, the medical insurance pen. Now both are coming a little out of the left field, especially with such fine competitors as the mighty Syringe pen and BREAATHHE’s popular ballpoint. However, the Red Cross have served up an unexpected delight with its opaque plastic, stunning silver and red combos and a smooth action that is yards ahead of the rest. I hear the ballpoint is forged by scientists out of a mixture of heavy metals in order to create the ideal ink laying experience, and has recently taken over Toby’s stomach as the roundest object in the known universe.

Which brings us to the MIGA, which at first may seem a little plain. Once you get past the unassuming presence of the pen, you start to notice that beneath the smoky blue paint and the neat pocket clip lies a pen with substance.

Top: Red Cross A worthy contender. Bottom: MIGA Elegant and refined.

As you clasp it in your hand, a warmth spreads up your arm, into your shoulder and torso before enveloping your entire body in an aura as comforting as a hug. It has beautiful paper action and is able to write without hitch in all your normal textbooks. But there is something beyond this - writing with the MIGA seems to transcend the normal scope of pens and elevate the holder to an almost spiritual plane where angels are blowing silver trumpets and God is twinking the stars. I’m not ashamed to say that holding this pen caused a tear to form on my eye before I could blink it away, and I have no doubt that experiencing it will leave you similarly moved. So go and get your hands on a MIGA - this is a pen with soul. Remarkable stuff. Is there a pen you’d like reviewed in more detail in the next issue of Ductus? Is there a pen that you are angry didn’t get enough attention in this review? Do you have strong opinions about pens you want published? Do you want to be on the pen reviewing panel? If you said yes to any of the above, then send an email to publications@unms.org.au.

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By Ductus Dr

LETTER #1 Dear Ductus Doctor, Lately in the romance sector, things just haven’t been going my way. No matter what I try, every girl I approach doesn’t seem to be interested! I’m hitting the D-floor like an anvil but all my usual moves have suddenly lost their potency…the yawn and slide, the bump and grind, the tic-tac in the bottom of the drink I just bought her. One girl turned violent and started yelling about rape, which was totally uncalled for when all I wanted to do was share the minty goodness. Another I thought was giving me the vibe, so I followed her home wearing my ice hockey mask for extra warmth and carrying a sharpened piece of 4mm pig iron to fend off the rats. You wouldn’t believe the scream she gave off when she turned around, and to this day I am befuddled as to why she was so scared. She fled inside her apartment, so I spent an hour scratching her door with my blade while throwing pebbles at random windows in her house and singing Spandau Ballet in falsetto until the police turned up, forcing me to spend an long and confused night in the bushes. Please, help! Where am I going wrong? Thanks in advance, Sexual Assault Sam/ Destined for Court Dennis

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Dear Sexual Assault Sam,

Since you are a medical student, let me begin by first asking you the question, are you ClinConnect compliant? Because I definitely cannot see a person such as yourself having gone through life without a Police Record or something! Or are you like a certain M.K. of fifth year who went through four years of medical school before realising that he had not ever done a placement with the correct documentation? However while this may impact your career in medicine, it is all not really important to the anguish plaguing you and I’ll move on.

I can see what you have been trying to do here Sam, and I think that while yes, you are an absolute creeper and should possibly be locked up for life, you should get some points for effort. I don’t think that in one response I will be able to change your seemingly deep-rooted perversion, so I’ll just give you some tips as to how you could have improved this scenario: •

The ice hockey mask. Yes, winter has come to Newcastle and going out has been complicated by nippier temperatures. But what about swapping the terrorist-garb for a nice fuzzy beard? Girls dig them, and if you don’t have adequate coverage, Conchita Wurst has just launched a new range of seamless falsies.

The 4mm pig iron. Totally natural to be afraid of the Novocastrian rats. They do all carry the bubonic plague. However avoid Finnegan’s next time and go somewhere less putrid, like those wanky new bars popping up all over Darby Street. Alternatively, say goodbye to your dignity and go to Argyle: there place is already so full of vermin, in the form of the Hunter region’s youth, that even the rats stay away. The behaviour outside her apartment. This I must object to. You will not get into her


house like that! You would be far better to leave a tribute (e.g. a dead animal, a Tuperware collection of your semen) outside her door and come back in a few days to pleasantly surprise her and receive her thanks. You’ve got to play it cool.

As always, Ductus Dr does not in any way support the practice of stalking or harassment, but the age of chivalry is not dead and every girl likes a bit of attention.

LETTER #2

Dear Ductus Doctor, I suppose this might be a bit clichéd, but ever since I realised my 29th birthday was just next month I have felt unsure about my long term boyfriend, and a lot of things in general. I just don’t know; it’s as though everywhere I look every young couple look so intense and have their entire romantic experience in front of them, whereas mine is well and truly over ‘the hump’. I come home at the end of each long day of lectures and feel comfortable but not excited to see him – and I think he feels the same way. I truly care for him but I’m afraid that I am wasting my time when I could be out there with someone else, someone who makes me feel that spark again. What do you think Dr Ductus? What thoughts lie within that feathery head of yours? Should I try find love with someone who really rustles my jimmies?

about here is a fairly common complaint, experienced by up to 98% (1) of people. So you are not alone. However, you are completely justified in your concern: “comfortable” is not a word that many zesty almost-30-year-olds want describing their relationship. Ductus Dr has heard this often enough, and often the solution is quite simple. Despite the negative rep that aphrodisiacs have garnered over the past few centuries, these substances that increase sexual desire are not to be doubted. In fact, they have been proven to have a statistically significant effect nearing that of homeopathy! Some sure-fire successes that are guaranteed* to turn up the heat include: •

True love Tracey Dear True Love Tracey

I am so glad that at least one mature-age student reads Ductus Dr too! I guess you are not ALL lame and grown up. What you are talking

Bremelanotide. A synthetic compound that activates the melanocortin receptors MC3-R and MC4-R in the brain. (2) Formerly known as PT-141, it is currently undergoing clinical trials. So far, results are promising but it has the unfortunate side effect of increasing blood pressure when administered intra-nasally. Watch this space!

Ambergris. This musky waxlike substance is produced in the digestive system of sperm whales. As well as the obvious nominal connection, the musky scent has been used since the middle ages as a foolproof bedroom spice-up. (3) So if you have $6000 to spare and are cool with slaying a vulnerable species, it’s worth a try. Tiger penis. In traditional Chinese medicine, the penis of the tiger is said to enhance male virility. Try slipping some into your partner’s evening cocoa and see where it gets you. It is also commonly prepared as a soup. NB: the demand for tiger parts exacerbates the endangered status of them, and most modern nation condemn its consumption. (4) Spanish fly. This type of blister beetle secretes a chemical

compound known as cantharidin. Although a poisoning blistering agent that can cause severe burns, it works in small doses. However, the potential damage to the lining of the GI tract and association with ESRD make it highly dangerous (5)

REFERENCES (1) Figure is a rough estimate based on Ductus Dr’s personal experience and imagination of what being 29 and in a stable relationship would be like. (2) Hadley ME; October 2005. “Discovery that a melanocortin regulates sexual functions in male and female humans”. Peptides 26 (10): 1687-9 (3) Graber, Cynthia; April 27 2006. “Strange but True: Whale Waste is Extremely Valuable”. Scientific American. Last accessed 31/07/14 (4) Harding, Andrew; September 23 2006. “Beijing’s penis emporium” BBC. Accessed 31/07/14 (5) Shamlou, R; 2010. “Natural aphrodisiacs”. The Journal of Sexual Medicine 7: 39-49

LETTER #5

Dear Dr Ductus, A friend of mine recently had a bit of a night out and came out with a few more bugs than he went in with. I’m speaking about the Herp-Derps of course. Anyway, he has been feeling a bit down and out about the whole thing – he is convinced his life is over. How will he ever find the girl of his dreams now? In addition to this, his nether regions have always been a touch on the proximal side and it is something he feels very insecure about. What do you think Dr Ductus? Is it game over from here on? Definitely Asking for a Friend Freddy.

Continue► Iductus

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◄Continued Glad to hear from you Definitely Asking for a Friend Fred,

Sorry to hear about the somewhat permanent guests you’ve…I mean your friend has got staying over. While I don’t have any personal experience with your friends particular problem, Dr Ductus has been around town a few times and can assure you that while discouraging, this is only a slight speedbump down the windy road of love. As for the matter of the millimeters down south, every good lady knows it’s not what you’ve got but how you use it. Just remind your friend to be upfront and open with his future partners – nobody likes a jack in the box, especially the enveloped, double DNA stranded icosahedral type that stays for good.

LETTER #4

Hey Hoes or Bros Billy.

Let’s keep this simple! You may as well hand in your man card, and cut your balls off.

No, in all seriousness though, it is all peachy and lovely with her now, but you watch. She’ll stop wearing matching underwear and start walking around in a dressing gown (not a sexy satin one, a scummy Big W special). Never fear, if your mates’ attitude towards bro-dom stay the same, they will be there when it fizzles out.

A handy alternative, if all that doesn’t sound too promising, would be to round up some of your Missus’ friends to improve her standing in the eyes of your crew-if you get my meaning ;)

LETTER #5

Dear Ductus Doctor,

Dear Ductus Doctor,

Now don’t get me wrong. I enjoy having a slap and sinking a few with the boys as much as the next bloke. Maybe more than the next bloke. Especially if the next bloke …But I’ve been trying to spend a bit more time with the Missus, and I’m troubled. Not because I don’t enjoy being with her, but because I enjoy it maybe a touch too much. Don’t tell the fellas, but sometimes I’ve actually dogged the boys to hang with her. It’s just that a large group of sweaty unwashed hairy men can get a little tiring after a while you know? All that bravado and constant one-upping each other. The smell of testosterone has become endemic to that group now, and it’s a scent I find at times extremely pungent. Do you think I should break it to the guys that I’m going to be spending some time away from them, or do you think I am just ‘whipped’?

I’m a freshly minted first year, and as such I needed your advice. Specifically, on whether to date within our cohort our without it. I know this is an age-old question, but the last Ductus edition to cover it was so ancient it crumbled to dust between my trembling fingers. On one hand, the medicine men of Newcastle University are probably clever, funny and unquestionably destined for future riches and wealth. On the other, I know in my heart that breakups would be extremely messy and that difficult to cope with. Aside from these issues, do you think that it is wise overall to date somebody in medicine, someone who will be subjected to the same huge stresses and soul crushing study hours? Who will go through the slavery of internship and be spat out the other side a grey tired husk of a human being who once lived and dreamed?

Hoes or Bros Billy

Inside or Out Enid

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Dear Enid,

Speaking as someone who may once have been known as a bit of ladykiller around the BMed cohort, Ductus Doctor can assure you that relationships within medicine and meaningless sex with cohort members are two entirely distinct things, which should be kept that way. If you are looking for the former, these “medicine men” should be way down the bottom of your list. While decent for study-related sympathising, relationships should be fun, not boring. And besides, you need a break from the medical school tedium every once in a while. Watching Sontag lectures together on a lazy Sunday morning is not what lazy Sunday mornings should be spent doing (wink wink). Furthermore, the egos of two medical students are bound to clash at some point, unless one of you is a total pushover with no career ambitions whatsoever. Ductus Doctor highly recommends dating outside of the medical cohort, simply for a glimpse into the real world every once in a while. Take a leaf out of a certain high-ranking MedSoc Executive member’s book, and go for someone totally out there, like an older, extremely attractive female police officer.

As to the latter (vapid intercourse concluding with nothing but a “see you in HB15 later”), medical students are great! Our course is full of sexually frustrated male medical students who, after relentless hours of Mother-fuelled studying, will jump at the opportunity to get naked and pound feverishly for a glorious twenty seconds. What’s more, they are so self-obsessed and socially awkward that any post-coital Hunter Building Hallway awkwardness will go entirely unnoticed. So there you have it: when it comes to a relationship, don’t dip your pen in the medical school ink. But if you are seeking a good time and a quick shag, dip away! In fact, take that pen and ink and write a whole damn novel.



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MEDICAL STUDENTS COMPLAIN ABOUT LACK OF ANATOMY IN COURSE

MAN IN US COMPLAINS ABOUT WAITING 15 MINUTES IN ED

In breaking news, medical students at Newcastle University have been heard complaining about the lack of anatomy taught in the 5-year course. A student stated, “If you compare it to Armidale, Newcastle has an almost neglectful attitude towards anatomy teaching. Why, just this morning I didn’t know the bony landmarks of the humerus, or the structure of the portal venous system. Compared to Armidale, it is simply unacceptable, and the course coordinators need to do something about it.” Another student remarked that compared to Armidale, the lack of anatomy content could severely impact them once they graduate. UNMS chimed in, saying, “Someone has to step up and take responsibility for the learning of anatomy. Students often find it hard to study anatomy compared to Armidale, especially when they are visualizing gaping bullet and stab wounds in Bob Callister’s muscular chest.”

DENVER, CO – 46 year old Marcus Stillbee is furious after waiting for 15 minutes to be seen at the local Quicky Care Medical Center in Denver yesterday. Mr. Stillbee injured his ankle during an intense game of flag football in an over 40-year-old intramural club league.

Academic staff members have protested, pointing towards the lavish new MSW building and remarking that if students don’t find content extensive enough then they are free to learn extra anatomy on their own – a response that has been laughed at by students of all years as “completely ridiculous” and “absurd.” “If the content isn’t set out in an examinable way by the academic committee, how are we going to copy and paste notes and pictures from the Tortora and Rohen?” asked one student wisely, “I mean sure – all the information is right there in our textbooks, online, in DVD form and in the lecture notes. But as the UNMS stated, someone needs to take responsibility for learning the actual material, and I’ll be damned if it’s going to be me.” Compared to Armidale however, the faculty response offers little hope, and concerns are growing that Newcastle students will soon have to start actually using their brains, eyes and hands - those weird, flappy things at the distal ends of their arms.

machete accident“The nerve of that urgent care to make me wait 15 minutes to be seen!” exclaimed Mr. Stillbee. “That was just to see the provider. Then I had to wait for the x-rays to be taken, then read, and finally a diagnosis to be made.”

“It didn’t end there,” fumed Stillbee. “I had to wait 30 more minutes for paperwork, and then I had to wait 50 minutes at the damn pharmacy to get my pain meds. 2 hours total, just despicable! I was going to miss Game of Thrones if I hadn’t DVR’d it.”

Meanwhile, 2482 miles away, during the exact same moment, in a remote village in a 3rd world country, Mr. Ernesto Jose Rodriguez Jr. injured his leg in a freak machete accident. Mr. Rodriguez works 7 days a week in the sugar fields performing hard manual labor with a machete and makes $50 a week to support his family. In the 100 degree heat, Mr. Rodriquez slipped and accidentally cut his right leg. Limping 11 miles to the nearest medical facility, Mr. Rodriquez patiently waited 4 hours behind 150 others to be seen. The clinic dispensed 5 Tylenol tablets to him, along with some antibiotics and gauze wrap which had been donated by a medical organization. Mr. Rodriquez was grateful to receive medical care and decided to rest 30 minutes before walking the 11 miles back home to start work again tomorrow. Mr. Stillbee was still fuming at home, as he propped his sprained ankle up on his leather sofa, Heineken in hand, while watching Game of Thrones. “The nerve of that ER! I can’t wait to fill out a NEGATIVE patient satisfaction card. They even brought me the wrong sandwich.” Source: Gomerblog


STUDENT LEECHES HEPATITIS PATIENT, DOCTORS SHOCKED

‘REAL WORLD MEDICAL SCHOOL’ CANCELED AFTER ONE EPISODE

In latest news, course coordinators at the University of Newcastle Medical School are stumped over the latest troublesome case brought to their attention, namely that of a first year student who has so far learned all his medical knowledge from the obscure 16th century text De Humani Corporis Fabrica Libri Septum as well as scraps remaining from a vintage copy of Traitè des Maladies. The first person to notice was his clinical tutor, who suspected that something was amiss when the student brought in his personal collection of leeches in tupperware and began setting them upon the arm of a jaundiced patient while muttering under his breath about meconium. When questioned he only said that he had been growing them for weeks and that he had been bloodletting in his own time to practice the correct technique for applying and removing the leeches. “I find it also helps me relax when approaching exams,” he stated. His tutor soon became alarmed when the student rushed off to surgery after producing a box of antiquated capital saws and complete trepanning kit. Closer observation of his person revealed several vials of mercury and a flask of laudanum.

SAN JOSE, CA - The Real World Medical School was immediately canceled by NBC after the first episode last night. “Absolutely nothing exciting happened,” said viewer Stacy Henderson.

On further investigation, it became evident that he had made it past the end of semester exams solely on the strength of his astoundingly good anatomical knowledge. “We thought he just liked using older terms to impress the lecturers,” one classmate mentioned, “sure, his medical science was a bit shaky but we all had a bit of trouble in first semester anyway. I mean, I didn’t know what he was talking about when he mentioned turgescence, cacospsy or humors – he probably just read a section of Tortora that I missed.” Despite the possible complications he might face in the future, the student is adamant that relying on these books won’t disadvantage him at all. The faculty’s decision is awaited with interest, and the smart money suspects that they will promote him to associate professor of anatomy within the week.

real worldJohn went to the library and studied for the entire episode. Emily had ramen noodles for dinner, slightly burned the roof of her mouth, and fell asleep on the sofa watching MASH re-runs. Bill repeatedly held up flash cards walking around the house talking outloud and hitting himself if he didn’t get the card correct. Timothy was found asleep at 8:00pm since he had a gross anatomy test the next day. Other highlights from the show included, Tim going to the refrigerator and becoming excited to realize that he still had leftover pizza and fava bean salad from 3 days ago from a drug rep. The producers stated that they wanted to “kill themselves over boredom” when they had to watch 128 hours of library footage.

On paper the show had all the right ingredients: Young adults in their twenties, medical drama, and product placement. “We had the coffee and energy drink sponsors all lined up but unfortunately grass growing literally beat Real World Medical School in ratings.” He was referring to, “Watch Roger’s Grass Grow”, a home produced show on public access. “These ‘young-adults’ make normal decisions, not TV choices that were supposed to boost our ratings.” “I thought there would be steamy sex and partying just like other shows,” said Henderson. “It was the exact opposite. I felt like going to bed and curling up with a book after watching this show.“

Quite possibly the best part of the show occurred when Emily checked the mail and received her tuition bill. She let out a ‘big sigh’ and tossed the bill on table. Viewers could extrapolate from her reaction that the bill was pretty high. Source: Gomerblog

LIFE EXPECTANCY OF STUDENTS INCREASES AS TEST FEEDBACK IS CANCELED FOREVER Life Expectancy of Students Increases as Test Feedback is Cancelled Forever

In latest news, a statement released by the academic committee announced that, in following with the reduction in test feedback, a total cessation of test score feedback was to be given to students. A spokesperson stated, “We’ve been reducing feedback steadily for the past few years, and have been seeing promising results. Numbers of unhealthy competitions and rivalry have dropped and a community attitude within the cohort has increased to an all time high. The evidence indicates that the best way to help more students to learn and pass their exams is, obviously, no feedback at all.” This includes a termination of all types of feedback: quartiles, percentiles, individual subject scores, and pass or fails. Concerns have been raised after a student in 5th year on the brink of graduation was forced to restart his medical degree after learning that he failed public health in the first semester of the first year - a result that rendered every subsequent pass mark invalid. The committee responded, saying, “It’s unfortunate, but look. Historically, competition between medical students was fiercer than any gladiators ring. Our death rate was rising at an alarming rate and would have soon have been higher than that of people still trying to get in to the course. Compared to then, not a single student has expired due to aggressive academics, and our non-lethal poisonings are at an all time low. You do the math.” Despite the committee’s assurances, students suspected of performing highly are advised to travel in crowds and to eat only pre-packaged food and water. DISCLAIMER: NONE OF THESE ARE TRUE, JUST IN CASE YOU HAVEN’T FIGURED OUT.

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Want to contribute to the next edition of Ductus? Have a love for writing and want your works read? Simply keen to join #TeamDuctus? Send an email our way at publications@unms.org.au! Have a question for someone on the committee? Contact them at: President

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