More Advice You Don’t Need: Textbooks

Hello troopers! Condolences on getting into med school, if you have. Don’t give up on your dream, if you haven’t (but maybe consider an easier dream).

Today we’re talking tomes. Med textbooks cost several arms and legs, and the reality is you won’t be needing every single one of them. In this post I will attempt to dispense advice on which ones I think are absolutely crucial, and which ones you can borrow or rent or even do without.

Without further ado,

Crucial Basics

Anatomy. Here we use Netter’s Atlas of Human Anatomy for the pictures (internationally renowned) in conjunction with Last’s Anatomy for the descriptions. You will need these for the rest of your life.

*Just FYI – those homemade textbooks the Anatomy department sells you in first and second year are actually useful for passing anatomy, but utterly useless for the rest of your live.

Physiology. The Guyton and Hall Textbook of Medical Physiology is recommended, but there are other like the Ganong that are probably just as good. If I’m being honest, I have to admit that I didn’t spend much time reading Physiology textbooks, because they’re pretty much all long-winded and boring (f you know of one that isn’t, please leave a recommendation in the comments!) but you absolutely have to know how systems work and these texts are the way to do that.

Pathology. Here we use the Robbins and Cotran Pathological Basis of Disease. It’s long-winded, but you should get it because after you learn how systems work you have to learn how they fail, which helps you figure out how to fix them.

Crucial basics only get more relevant as you advance in your career, and you will constant be using them as references. Yes, the editions will constantly be updated but the core material will remain the same. Think of these books as investments in your future.

Clinical Necessities

Textbook of Clinical Practice. Such as the McLeod’s. Highly indispensable book, full of instructions and techniques for histories and examinations. You will use this from third to final year. Even once you’re confident in your skill set, the McLeod’s is still a book you turn to from time to time.

Oxford Handbook of Clinical Medicine. I love small books that pack a punch. The OHCM is first class for information dispensed in bite sized portions that still cover all the necessary basics. I see residents walking around with this book (it’s pocket-sized too). Nuff said.

Textbooks of Surgery, Obstetrics/Gynaecology and Paediatrics. Yes, all three. Because when you’re in school they’re incredibly valuable.

For surgery, we use the Bailey and Love’s Short Practice of Surgery as a reference text (have a love/hate relationship with this book – it is huge and long-winded but surprisingly fun to read). A pocket-sized textbook for surgery is also useful. I prefer the Surgical Recall (and Advanced Surgical Recall), but some think it’s inadequate. I found it extremely adequate for my senior surgery rotation and remarkably easy to read.

For OB/GYN we use locally published textbooks. The Textbook of Obstetrics by Roopnarinesingh is perfectly tailored to our exams and clinical setting, despite being several years old. Similarly the Textbook of Gynaecology by Bharat Bassaw was written by most of the people who teach and test us. Basically? Get these books.

For paediatrics, we use Nelson’s Textbook of Pediatrics, but I think any well-respected textbook would do for paeds. Just make sure to pick one that you’re comfortable with because you will most likely end up teaching yourself this subject.

Nice Knowing You

Your first and second year textbooks of Histology, Embryology and Pharmacology don’t get much use later in your clinical years. Or maybe it was just me? Once you’ve learned the material and passed the exams anything else you need to know can be answered with a quick Google.

These books can be rented or bought and resold to junior students: DiFiore’s Histology, Langman’s Embryology, the Rang and Dale pharmacology text. Don’t get too attached to those names.

Fluffers

Any specialty textbook: Ophthalmology, ENT, Dermatology, Rheumatology, Orthopedics etc etc.

You can borrow all of these for the duration of your rotation. Even if you’re planning a career in the field, five years down the line (when you actually start your residency) you’re going to need an updated edition anyway.

That concludes our session, I think. Questions? Disagreements? Leave ’em in the comments. Good luck my friends. And happy studying.

For Shari, who asked about WJC

What are some other things you liked that Mona Western had to offer, that Mona didn’t? (pro/cons of both campuses).

You guys, this is my absolute favourite topic (barring Doctor Who, Jane Austen, The Bloggess, and also right now Hozier).

The Western Jamaica Campus was like a second home to me. I loved the people, the campus and the atmosphere; I am hopelessly biased. But I will try to give you some amount of objective information (don’t take my word as gospel, guys).

Starfish

That time we found a starfish at the beach.

Disclaimer: This post is written based on my rose-coloured memories of life at WJC some 3+ years ago. The Todd just reminded me that life at WJC was actually not all that awesome.

We had to fight for some basic requirements (good sized classroom, proper streaming, actual anatomy specimens), and a lot of the time we were doing the best we could with what we had. What made it easier to bear was the relaxed, ready-to-help atmosphere of the western campus and the gorgeous, gorgeous surroundings.

wave goodbye

Additionally, things might have changed for better or for worse. You can get up to date information on WJC happenings from their Facebook page or on their blog, The WJC Insider.

Let’s get into that pro/con list.

WJC vs Mona

WJC Mona
Class sizes small – 20-30 people Class sizes HUGE – 200-400 people
Student:specimen and student:teacher ratio relatively good Brand new anatomy lab with lots of space and small group sessions
Tutors are (usually) readily available Lecturers have dedicated office hours, more students to compete with
Lectures are all streamed via network that might not work Lectures live or streamed depending on lecture theatre
Consultants teach anatomy Mostly residents and anatomists teach anatomy
Have to travel to Kingston for major labs No travelling required
Small, close-knit group of people Sprawling campus; easy to disappear
Breathtaking view of the Bay/beach/airport Mountains. Sometimes cold.
Hall of residence has a pool Campus pool that is currently out of service
Some clubs, some diversity of students Wide variety of clubs, wide range of nationalities etc.
The beach is RIGHT THERE. Liguanea is right there?
Less social events, almost no night life (except Hip Strip) Everything happens in Kingston. No, seriously.

WJC actually seems to come off worse in the comparison (sadface) but again I’m not exactly a valid or reliable judge (I’m actually a notoriously unreliable judge – ask anyone). If there are other specific concerns you have about either campus, feel free to post them in the comments or even call the campus of interest (I don’t have all the answers, guys, sorry) and share their response here.

Much love,

Robyn

For Christiane, who asked a Really Big Question

Dear Robyn,

I am from Trinidad and I got accepted into medical school at Mona. Could you tell me all that I need to know concerning medical school and how to care for myself while I am in Jamaica? Tell me how you managed because this is a new experience for me and I could use all the help and advice I can get.

Dear Christiane,

First off, congratulations on getting into medical school! (Or condolences, depending on how long you’ve been following this blog).

I want you to know that there is no simple answer to your questions. Five years into medical school and twenty-odd years of living in Jamaica and I’m still figuring most of this stuff out. A lot of your experiences here will be trial- and trial- and trial-and-error because they will likely be very unique experiences. (It is best to embrace this fact from now).

The best I can do is give you a few sweeping generalizations. (If you would like more specific answers, please leave specific questions in the comments)

I don’t know where to begin so I’m giving you your very own blog post (yay!) for people to comment on and share their own bits of advice. My hope is that this will turn into a giant crowd-sourced repository of advice for surviving and thriving medical school at UWI Mona (your place to shine!) much like my other (massively supported, I love you guys) post on medical school. (I will love you guys even if there is no support on this post).

I’ll kick-start the discussion with what I’m hoping are the starts of answers to your very valid, questions and share the links to some posts where I’ve gone in depth on a few topics.

New experiences are scary! And exciting! There’s so much potential, so much could go wrong; you want to run towards it with your arms wide open or hide with your teddy bear in a blanket fort (the teddy does not judge). I understand your need to feel prepared, but there’s no possible way to prepare for everything. What follows is my (hopeful) guide to keeping you alive and reasonably sane.

Medical School

See my (mostly) comprehensive post here: What is UWI medical school like?

Generally speaking, medical school = university + dead bodies and loads of studying.

Aside from the dead bodies, it’s pretty much like any other science major. Get used to the smell of formalin, and studying all the time. If studying all the time is your bag, congrats! If not, you will need to do some degree of adjusting.

First year med students hit the ground running with the sheer volume of information they’re expected to absorb and regurgitate, and the sad part is you will forget most of it. Later on in your 4th and final years some of it will actually start to make sense. Accept this fact from now.

Keep yourself healthy. This means physically, emotionally and mentally. Eat right and get some kind of exercise – foster the good habits early, or you will end up being the intern with a stomach ulcer who collapses on the job (true story).

Have appropriate outlets for your emotions; suicide is a very real danger for people in this career. Some/most med students study hard and party harder as a way of stress-relief. Find your stress-reliever and hold on to it with both hands (and feet, and your teeth too. Don’t let that fucker go).

Medical school is very self-directed; what you put in is what you get out. You should have a reasonable idea of what you want and what kind of doctor you want to be. The guiding light in med school is not passing exams, it’s being a clinician. You’re going to need to prioritize your activities (academic and co-curricular) according to the type of person you want to be when you graduate.

That sounds a little heavy.

My point is, when you’re confronted with decisions that seem hard or information that seems pointless (a lot of it will seem pointless in first and second year, it’s hard to tell the difference) the choices you make now will influence what kind of doctor you are five years down the line.

I’m not telling you to stay in the anatomy lab until midnight every night (unless that’s what you want to do – no judgment there), just be aware of the difference between your short-term wants and your long-term wants.

And make friends. Making friends in medical school is awesome. You need people to get your weird med school jokes, and to commiserate about how horrible this all is and why didn’t you just do business.

Taking Care in Jamaica

Jamaica is pretty much the same as everywhere else, except slightly scary and dirty and people harass you if you’re not from here. So, pretty much the same as everywhere else.

Stay clean, keep hydrated and don’t be an obvious target*. If you need to eat, bear in mind that food is expensive here (blame the IMF and our sliding dollar). If you need somewhere to live, you can read my post on student housing.

Hang out with people who don’t do medicine (you will need the break). Living on hall is a good way to meet those people. Get involved! University is a much more fulfilling experience when you’re involved in things you’re passionate about with people who are similarly passionate.

Something I wish I had known – you can do whatever you want as a medical student, especially in first and second year. Med school is not an amputation of your life outside of medicine. You can write songs, start a charity, go to Literature classes, join a professional dance company. If it’s your passion – go for it!

I hope I managed to answer at least some small part of your questions.

Much love,

Robyn

**

*Not being an obvious target = keep your wits about you, read all the campus security bulletins/advice, trust your instincts (unless you have bad instincts, in which case I would suggest not trusting your instincts). 

**

Advice from my classmates include:

First, would be not to worry about getting all the books that are required. The library is reliable and you will meet fellow students that will help you, so travel light if you can. Always have a working phone with credit. Take time to enjoy what the island has to offer, and be balanced with work, family and friends.

And of course. . .

Don’t. Go. 

Run as far away as possible.

Advice Across the Board

(No more classes, no more books / No more teacher’s dirty looks. In celebration of the end of my training, I’m sharing tidbits of advice from the last six years of my life. Because there’s no advice like unsolicited advice).

What I Wish Someone had Told Me

Before I started Medicine . . .

Stay in the Arts, create yourself, establish boundaries and priorities, travel, push through the fear and conquer the unknown. Own the unknowable. Get advice from as many people as possible about how to do what you want to do, not just about the best thing for you to do. Stick to your guns.

In first and second year . . .

Pay more attention in Anatomy class. Actually, forget that. You were probably better off break dancing at the back of the room when no one was paying attention. Study just enough to pass your exams, real medicine won’t start for another two years. Anatomists and physiologists are not real doctors, but they can still fail you. It gets better. It does.

In third year . . .

Read the small books and commit them to memory – the OHCM is going to follow you for the rest of your life. Do not ever trust the administration to get things right. Have at least five white jackets to start with, add more as necessary. Spend your time on Paediatrics learning Paediatrics, not feeding and consoling fussy babies. Switch consultants if you have to. Don’t lose your enthusiasm for participating in clinical duties; pace yourself. Don’t assume it’s always going to be this exciting because it. won’t. be.

In fourth year . . .

Leave UHWI every chance you get. Deliver your elective assessment to the Dean’s office yourself; no one is going to do it for you. Give up on ENT classes from early (you’ll only sleep through them); spend all your time reading instead. Pay more attention to ECGs on Emergency Medicine. Pick the rural places for community health; the people are nicer. Do not start the habit of calling ‘Empathy point!’ every time a student says something supportive during a history/counselling station. Read more Radiology than you think is necessary.

Start MBBS prep from now – find a study group you’re comfortable with, who moves at your pace. Get organized with PPQs and lectures and notes from the graduating class. Do it now so you don’t have so much to do later.

In fifth year . . .

Prepare for each clerkship like it’s the final exam. Take really good notes on everything – that way you can revise your notes and not the whole textbook. Ignore the consultant who tells the third years not to end up like you. No guilt-tripping about your study habits. As early as possible, ensure the Dean’s office has all your elective forms. Spend less time in the classroom and more time assisting at procedures or reading on your own.  Keep a tight hold on the small books (Surgical Recall, OHCM, Toronto Notes).

Medical school drags its feet when you’re stuck in the middle or at the beginning, but when you look back from the end of the road you fully appreciate the whirlwind/ thunderstorm/ cacophony of experiences you’ve lived through. It is a lot to live through but you can survive it; you can even do it well, if you try hard enough.

Housing at UWI – where do you turn?

This post is about homelessness. No, scratch that. It’s about finding a home. Not the metaphorical place where your heart is, just a roof and two walls where you will be (relatively) safe and sheltered.

In some ways I have so much experience figuring out where to live and in some ways I have none at all. It depends on who you talk to. Whatever amount of advice I have I’ll be dispensing here, and you can use it as you see fit. Just to be clear, this is about finding college accommodations for students specifically for limited time periods, though I suppose my methods could be applied to more grown up living needs as well. You’ll see for yourself.

Real estate is such a scary topic. At least it was for me. And I guess it’s scary for any high school graduate who has decided to leave home and pursue the university dream but who (gosh darnit) just couldn’t get on hall. More on that in a second. I like to break down scary topics into smaller steps. Bite-sized chunks like

  • Options
  • Where to go for help and
  • How to do it on your own

Your two most obvious options for housing when you’re a university student are, of course: on campus and off campus. As cool and exciting as hall life seems, the reality is that only a small percentage of university students actually live there. The majority commute from home or other places either by choice or because they couldn’t afford the fees/got kicked off hall.

UWI (it’s always UWI on this blog, sorry UTECH) has so many halls of residence. And they keep adding more. The quick and dirty list in order of awesomeness (uh, personal preference? More detailed assessment will probably follow when I muster up the research effort):

  • New Postgrad (Marlene Hamilton Hall)
  • Towers (Elsa Leo Rhynie Hall)
  • Mary Seacole
  • A. Z. Preston
  • Rex Nettleford
  • Taylor, Irvine, Chancellor

That’s eight (well seven, MSH and Chancellor are gender-specific) fantastic moderately livable places to choose from all within walking distance of your 8AM and 6PM classes.

There are many advantages to living on hall. It’s also a lot safer to get used to an unfamiliar city when “home” is somewhere that it matters to people when you don’t show up.

advantages

But for the rest of us who love jumping in and getting our feet wet, who get a thrill from adult-type independence, there is the off campus route.  Be the master of your own affairs! Pay those bills! Cook those meals! And yes, invite whoever the hell you want to invite over for however long you want (subject to the terms set out by your landlord/lady).

For those of us thinking about living off campus, this is where you start.

The UWI Lodgings Office

I cannot stress how helpful this place is. It took some warming up to their methods (and you better not be in a rush) but they’re great at matching you to a place that fits your budget. Added bonus: they vet all the accommodations that they recommend to students. They’re big on location, so they won’t drop you somewhere in the middle of Tavern Drive or Mona Commons without warning. You’re far more likely to find a Mona Heights address if you go this route (whether or not this is up your alley).

Flyers, Flyers everywhere.

Read the noticeboards. All of them. All the time. I have gotten so good at this that Kat takes a firm grip on my elbow whenever we pass one, just so that I won’t slow down. Seriously. There’s always some place for rent. Also? Know your crowd. The apartments advertising at the Faculty of Medicine are not the same as the ones advertised in the Faculty of Humanities.

Google is Your Friend

Once upon a time I used to think that nothing we ever did in Jamaica was easy to find on the internet. I still think that, for the most part, but a lot of the time I am pleasantly surprised. Don’t be shy about searching the websites of real estate agencies for rentals you want. Something might be out there. Pitch in with a friend or two and rent a fully furnished house. (They are not all heart attackingly expensive). Real estate agents do open houses on Youtube now. It’s a brave new world out there, kids.

Useful Websites:

Know Your Own Mind

Before you go house-hunting it’s good to have a list of questions to ask your prospective landlord/lady. Simple stuff like whether bills are included in the rent, if there are frequent water or power outages in the area, if there is wifi, if they have any rules for tenants (most will). Think about your own lifestyle and what you can and cannot put up with.

Just Go For It

The way to feel like you actually know what you’re doing is just to do it. Call the number on the ad, go to the places you want to see, ask questions, take pictures, consult with everyone you know. For every 20 places you inquire about at least one might be sublimely perfect for you in a way you will probably appreciate more when you have been house-hunting for nearly two years. Or maybe they will all suck. But either way you’re getting knowledge that is pretty much invaluable to you as an adult.

Because that’s what you are now: a rent paying, meal-cooking, house-hunting adult. So go out there are be wonderfully, smashingly, amazingly terrible at it.

Mona vs. St. Augustine: A Comparative Analysis

Recently I was asked about the differences between preclinical years at UWI Mona and UWI St. Augustine. Answering the question necessitated research on my part which turned up undergraduate handbooks detailing the MBBS courses at both St. Augustine and Cave Hill. I used my own experience of the Mona courses because I figured they would be more accurate that any handbook I found online. (On that note, if anyone who has studied at Cave Hill or St. Augustine wants to share experiences please do). What follows is my ridiculously detailed comparison of the two campuses.

Brief background:

The University of the West Indies Mona campus was the first to offer medical education, as far back as 1948 when the university itself was founded. Since then, we’ve been at the forefront of medical education in the Caribbean (at least until US offshore medical schools began taking up residence).

In 1979, Trinidad’s St. Augustine campus opened what was to become the Eric Williams Medical Sciences Complex and launched its own medical school. Cave Hill’s medical programme received accreditation in 2006 and created its Faculty of Medical Sciences in 2008.

If we’re talking about years of experience churning out medical professionals, Mona leads with 66 followed by St. Augustine with 35 and Cave Hill brings up the rear with 8. But a good medical school is more that the sum of its years.

(I won’t be discussion Cave Hill’s courses here because they pretty much follow Mona’s system to the letter).

On its website, the St. Augustine Faculty of Medical Sciences boasts that it is the only Caribbean medical school to offer the problem based learning system, a modality that is actually occasionally employed by its counterparts at the Mona campus. We call it case based learning and it forms a significant part of our third year courses. But the Trinidadian med school does a lot of other things differently.

At first glance the structure of St. Augustine’s preclinical years is a little confusing to me. The end results of the courses are the same but Trinidad sets their classes up with an international sort of panache.

Pre-Clinical “Paraclinical” Courses

Course Mona St. Augustine
Fundamentals of Disease and Treatment Year 1 Sem 1 Basic Paraclinical Sciences Year 1 Sem 1
Biochemistry/Biology Cell Biology* Year 1 Environment and Health Year 1 Sem 1
Molecular Medicine* Environment and Health
Intro to Embryology & Histology Year 1 Sem 1 No similar course.
Neurosciences Neuroscience of the PNS No similar course.
Neuroscience of the CNS Neuroscience and Behaviour
Basic Haematology Year 1 Sem 2 Basic Paraclinical Sciences Year 1 Sem 1
Health Care Concepts Year 1 Sem 2 Communication Skills and Healthcare Interactions* Year 2 Sem 1
Intro to Medical Practice 1 Year 1 Sem 2 The Health Professional and Client Care* Year 2 Sem 2

Pre-Clinical System Based Courses

Course Mona St. Augustine
Locomotor System Year 1 Sem 1 Year 2 Sem 2
Cardiovascular System Year 1 Sem 2 Year 1 Sem 2
Respiratory System Year 1 Sem 2 Year 2 Sem 1
Digestive System Year 2 Sem 1 Year 1 Sem 2
Endocrine System Year 2 Sem 1 Year 2 Sem 2
Renal System Year 2 Sem 2 Year 1 Sem 2
Reproductive System Year 2 Sem 2 Year 2 Sem 2

*There was no description available for the course so I made my best guess as to the correlation.

UWI St. Augustine covers a lot of ground with their Basic Paraclinical Sciences, basically smushing together a range of courses that Mona keeps separate (Fundamentals of Disease and Treatment, Haematology, and a little bit of Health Care Concepts). Mona may offer its students more breadth and depth with the subjects by keeping them all separated.

They also have a three-tiered Applied Paraclinical Sciences course that pulls out the pathologies of the various clinical systems to study them as separate entities (with emphasis on diagnosis and management). This might help train clinical thinking by linking complicated pathophysiology with presentation and management, something us Mona students struggle with when we hit the wards.

Another difference is that Mona combines systems in a semester based on anatomical location, while St. Augustine combines them based on physiological function. For instance Mona pairs the cardiovascular system with respiratory while St. Augustine pairs it with renal.

Overall I think the difference lies not with the quality of the subject matter, but with a student’s individual learning preferences. The Mona and St. Augustine campuses present the same basic information in markedly different ways, letting the University of the West Indies appeal to at least two totally different kinds of student.

Ultimately the decision to study at a particular medical school depends on a lot more than academic offerings (which are usually fairly universal). Prospective undergrads have to think about tuition and travel costs, career opportunities and willingness or ability to leave home. But if you’re seriously taking into consideration how you will be taught (and not many people do but it is more important than you realize) then hopefully this analysis helps you make the right choice for you.

Of course the right choice would be to forego medical school altogether and save yourself.

As always, thank you for listening. And please, I love comments and the discussions they spark. Drop a line telling me if you agree or disagree with anything or if I helped you in any way.

*

References:
St. Augustine MBBS Handbook
Cave Hill MBBS Handbook

Financing a Dream: how do you pay for medical school?

Before I start, I want to say happy birthday to my good friend Tricia over at triciatallen. She deserves all sorts of wonderful today and I hope she gets it!

And now, back to our regularly scheduled programming.

Getting accepted into medical school is great. I was ecstatic for the first four hours after I got my confirmation email and then reality began to set in. Reality being the dramatic 7 figure tuition costs – money I had never seen (except on TV) let alone conceived of any one person having in their bank account all at once. Hello, Reality.

Which set me on the most hectic, exhilarating and distressing summer of my life thus far. Finding lots of cash in a few short months was about to be a roller coaster ride.

(Just to say that scholarships are totally an option, if you can successfully grab one. I couldn’t so. . .)

Credit: hailandwind.com

My super-awesome team of money-baggers comprised myself, my mother and my aunt (who’s practically a second mother to me). We spent July running around Montego Bay visiting every single loan institution in the city. Scotia Bank, NCB, even the Credit Union all demanded the same thing: collateral.

What is this collateral of which you speak? Collateral means having to prove that you have either (A) the exact amount of money you want to borrow already stashed in an account somewhere or (B) assets equivalent to the value of the loan you’re requesting.

Credit: hasslefreeclipart.com

I, a novice in this realm of grown-up financial navigation, was completely flabbergasted. Why on earth, I wondered incredulously, would you need to borrow the money if you already had it? I continued to vent my ire at banks and their ilk as we stalked the streets between buildings. I came close to throwing in the towel.

One friendly raincloud (you’ll see why I call it that later) that kept us company in this desert of “Please lend me – No” was the Student Loan Bureau, a private organisation semi-funded by the government but mostly running on loan reimbursements. But the SLB would not cover tuition costs that were not government sponsored.

Credi: collegescholarships.org

Government sponsored? The UWI publishes two lists of tuition costs annually. One for students from contributing countries whose governments usually pay 80% of tuition costs (a full list can be found here) and one for foreign nationals (meaning everyone else).

Even though Jamaica is one of the contributors to the UWI our government has by and large squandered all our money so that they only sponsor some students, especially in the Faculty of Medicine where tuition costs are roughly twice everyone else’s. To offset the burden, the Faculty in my time offered 50% bursaries to a good many students. This is the offer I had received.

My options? Wait a year and receive government sponsorship when I entered the next class. Find a way to come up with 1.5M or find a way to get that 80% Government sponsorship. The first wasn’t an option. And when I had exhausted the second, I set my sights on the third.

Credit: stop-painting.com

My mother and I made the trip to Kingston (a trip I hadn’t made since I was about six) for an appointment with the Dean of Medicine. We questioned, he explained. We petitioned, he hesitated. We begged, and he offered a possible solution. I leaped . . .

. . . and landed in the pioneering MBBS cohort at the Western Jamaica Campus, a solution that worked out well on all fronts. At home, I wouldn’t need to pay pesky hall fees and I managed to receive the 80% sponsorship which let me approach the Student Loan Bureau (who were only too glad to sink their claws into me).

But selling my soul to the devil (a devil with 9% interest rates and a gorgeous moratorium period) is whole other story. Student loans never rain but they pour.

I came, I saw, I survived (4th Year Part 2)

You didn’t think we were done, did you?

Image not mine.
The offsite clerkships conclude with Ophthalmology (10 weeks), Anaesthesia (5 weeks) and Orthopaedics (5 weeks).

Ophthalmology

Goals:

  1. See/do every last thing on your procedure card. Seriously. They will send you back to the clinic to see/do things.
  2. Learn when to refer (all the time).

Opthalmology at KPH was a fair experience (I’d give it a 5/10. Anaes gets an 8). There are a lot of patients but you don’t really get much guidance. The lectures are good but the consultants disappear right after and the residents are always too busy to teach. Bonus: they will tell you which patients have pathologies that you can see.

Ophthalmology at Cornwall was my saving grace. The consultant takes you around the clinic on your scheduled day, looking for interesting conditions, and she teaches ophthalmoscopy technique at the same time.

The bonus of UHWI is that the clinic is more organized with specific patients attending at specific times (eg. retina clinic) but the residents are not as . . . easy-going as those elsewhere.

Penultimately. . .

Anaesthesia

Image not mine.

Goals:

  1. Read all the time so you can present your topics to the residents (the only way to learn)
  2. Learn how to manage an airway
  3. Know Basic Life Support like the back of your hand. Know it better than the lyrics to your favourite guilty pleasure song.

I did Anaesthesia at KPH and liked it. Everybody was willing to listen (on Anaes they don’t teach, you have to read up a topic and talk about it) and the consultants were nice. Probably because there were a lot of them so no one felt too pressured (take notes, every other specialty). There is a wealth of OT experience because KPH is basically surgery central. As long as the elevator is working. Seriously, can we get some foreign investors working on our hospitals instead of our roads? At least if accidents happen on the bad roads the victims will have somewhere to go.

And lastly:

Orthopaedics/Ophthalmology

Image not mine.

Goals:

  1. Learn the theory behind the common orthopaedic problems
  2. Learn the practical management of the same i.e. reducing, casting, splinting fractures etc.

I did Orthopaedics at (can you guess?) Cornwall. It was a half-and-half experience for me because despite getting good lectures and clinical teaching, there wasn’t a wide variety of patients presenting during our stint. That and you have to remember to go looking for procedures. Nobody’s sitting around waiting for you to come put a plaster on them. Unfortunately. But the residents and consultants were more than willing to teach and grill you to death and talk you out of ears.

Bonus: Orthopods, as a hazard of the trade, are really, really good looking. That is total objectification, but I’m just saying – if you’re a girl (or guy, no judgement) who’s into shoulders and arms this clerkship is the ultimate viewing experience.

*

Hope you liked the mini-series. (See Part One). If you found it useful (or amusing), please (do me a favour and) leave a comment saying so. Feedback makes one feel so appreciated.

We’ll do this again when I graduate med school. :)

Been there, Done that (4th Year Part 1)

Here it is. Finally. I know you’ve all been waiting eagerly for this. What?

The ultimate guide to surviving (nay, thriving) in your fourth year of medical school at the University of the West Indies, Mona.

Image not mine!

Ha. Ha. We are better doctors than you. :|

It’s a harrowing year. Five blocks of thirteen clerkships, some of them running concurrently. Where will you find the time to eat, sleep, live a little? But don’t despair. You can actually enjoy fourth year here.

*Disclaimer: You will see the golden seam of my bias toward Montego Bay (home) and the Cornwall Regional Hospital running strongly throughout this post. Just embrace the fact that Cornwall > UHWI.

We’ll start with the offsite clerkships. First up:

Obstetrics

Goals of clerkship:

  1. Deliver babies
  2. Learn as much as possible about common gestational problems and emergencies.

You definitely want to aim for Cornwall Regional Hospital or Mandeville Regional Hospital, which excel at the practical aspect (i.e. catching babies). Lots of babies, limited baby-catching competition. You can easily complete all your deliveries  on site. At Kingston Public you’ll be competing with midwifery students (scary!) and at UHWI there are comparatively fewer babies to catch.

Bonus! Kingston Public has a super-dedicated, totally great post-DM resident who loves students and will teach you everything under the sun if you can pin him down. Like a leprechaun, only instead of gold you get good grades.

Next up . . .

Emergency Medicine/Radiology/Medicine and Humanities

Goals:

  1. Fill your procedure card.
  2. Learn how to site IVs like a boss (and read ECGs with more than passable competence)
  3. Not fail Radiology

This rotation was only offered at UHWI and CRH in my year (2015). Hands down, Cornwall was the better choice. You end up competing with six students instead of thirty, and in one morning you can see a kajillion times the patients UHWI sees in a day. Procedures are endless, the teaching is superb (dedicated, nice consultants. Not that the UHWI consultants are mean. It’s just that, well, Cornwall rocks), and you don’t have to fight to the death over catheterization sets. Mostly because there aren’t any. Ha.

I only wish I had stayed awake for at least one of my Radiology classes because we got some great teaching from one or two people while I was catching z’s. Medicine and the Humanities is pass or fail so the most I can sell is the sheer entertainment of listening to one of the lectures ramble on about the history of Rome. Which is hilarious now, but later on in another clerkship you will wish he would teach the subject at hand. Less hilarious at the time, but still pretty hilarious in retrospect. (I really hope I passed).

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Part One of a two-part post on “Hey, look what I did!” To be continued . . . later. Do you agree, disagree? Tell me in the comments!

Clinical Advice: “Wear Good Shoes”

If I could give you one piece of advice to surviving your clinical years, “wear good shoes” would be it. The rest of my advice has no basis other my own meandering experiences.

General Words

1. Be nice to the nurses, even when they’re not nice to you (and most of the time they won’t be). The phrase “kill them with kindness” has never been more appropriate.

2. Don’t be the student with the smartphone who spends their time on ward rounds tweeting.

3. Do be the student with the smartphone who looks up the answers to share while the consultant’s back is turned.

4. Never lose your consultant on ward rounds. They will prove impossible to find.

5. Patients will die. You will not be prepared.

6. Try to remember to sleep and eat.

7. Invest in a notebook that can fit in your pocket. Take it everywhere.

8. Don’t overdo it. Whatever people may believe, persons in the medical profession are just as human as everyone else. We all have limits; respect them.

9. Go to school. Please.

10. Don’t be a suck-up. In the future you’ll be practising medicine with the colleagues you spurned, not the superiors you kissed up to.

11. Be prepared to suck. Now, as a junior, being wrong is funny and correctable. As a senior, consultants will fail you for killing your hypothetical patient. Make your mistakes now.

12. Don’t take medicine personally. Your aptitude on the wards/in clinic is not a reflection of who you are as a person. Some days will be better than others but don’t let the horrible days make you doubt your self-worth.

13. Always take the opportunity to leave UHWI. Cornwall Regional and Kingston Public Hospitals are where you will get all most of your practical experience. And everyone is nicer there.

14. Get used to packing, un-packing, re-packing and doing it all over again in a matter of weeks.

15. Lower your expectations, of everything: doctors, patients, the government, the facilities. The joy of medicine is really more like a resigned indifference.

16. Don’t expect kindness or for things to be easy, so be grateful when they happen.

17. Balance your time. Med students study hard but they party harder.

18. Recognize that each consultant thinks his/her word is gospel. Like all gospels, they will frequently contradict themselves.

Academic Tips

19. You will never get asked about the topic you read the night before. You will always get asked about the topic you said you were going to read later.

20. So read. Read all the time. Read everything.

21.  Prepare for your tutorials. You will actually be able to follow the discussion.

22. Dress appropriately. This is a hospital – there are gross things everywhere. The less skin you show, the harder it is for the microbes to get you. And you don’t want to be the student in the consultant’s anecdote about wardrobe malfunctions.

23. Common things are common. Don’t be the med student who hears hoofbeats and thinks “Zebra!” (But if you are, don’t worry. We’ve all been there).

24. Practice your clinical examinations. All the time, everywhere, on anybody who will let you. You can graduate without knowing how to site an IV, but you will fail third year if you can’t competently examine an abdomen. (You won’t, but everyone will think you’re an idiot anyway).

25. Hold on to that sample case note from Introduction to Medical Practice. It will come in handy for your multiple graded case notes in third year.

To all the third years about to start their junior clinical rotations on Monday, good luck and Godspeed.

Edited to add: Oh my goodness, the abdomen station was removed from this year’s junior exams and that makes me hopping mad! (It is also probably way harder to catch the bad students now).