Official Magazine of the Australian Medical Students’ Association Volume 45, Edition 1, 2011

In this edition... The Anatomy of the MedCest Medicine 21st Century Doctor

Are Muffins just The Climate Change Care Factor Ugly Cupcakes?

The State of the Nation How to be a Left-Over The AMSA Rep Reports masterchef and heaps more... As a doctor, bank on our support

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Investec Professional Finance Pty Limited ABN 94 110 704 464 (Investec Professional Finance) is a subsidiary of Investec Bank (Australia) Limited ABN 55 071 292 594 AFSL 234975 ACL 353 359. Investec Professional Finance is not offering financial or tax advice. You should obtain independent advice as appropriate. All finance is subject to our credit approval criteria. Terms and conditions, fees and charges apply. Income Protection/ Life Insurance is distributed by Experien Insurance Services Pty Ltd (Experien Insurance Services) which is an authorised representative of Financial Wisdom Limited AFSL 231138 (AR No.320626). Experien Insurance Services is part owned by Investec Professional Finance. Deposit products are offered by Investec Bank. Please obtain a copy of the Product Disclosure Statement by calling us before you decide to invest and to consider if this product is suited to your personal financial needs and circumstances. 2 Andrew Dunn Editor’s Waffle 3 Robert Marshall Welcome from the President 4 Rob Thompson Black Books 6 Hamish Gunn & Bec Ryan Family Expectations of Medical Students ’ 8 Falk Reinholz Wellbeing 10 Greg Leeb Come Fly With Me contents 12 Alexander Cox Specialty Dating 14 Andrew Webster Cultural and Clinical Lessons in China 16 Kerryn Houghton MedCest Medicine panacea

19 Stephanie Cheung Show me the Money Volume 45, Edition 1 July 2011 21 Lee Fairhead Are Muffins just Ugly Cupcakes?

24 The State of the Nation - The AMSA Rep Reports Editor Andrew Dunn 36 Jessica McEwan A Rangers Survival Guide 38 Nick Watts The Anatomy of the 21st Century Doctor Proofing & Design Maya Rajagopalan 40 Suyi Ooi and Yota Yoshimitsu Of Melodies and Maladies Robert Hand 42 Lee Fairhead The Music Digest Tracey McCosh Lee Fairhead 44 Stefan McAlindon The Lizard-Spock Expansion Jamie Kuzich 46 Dr Jay Meekay Thats All Folks Falk Reinholz Alex Cox 48 Falk Reinholz Going Up? The AMSA Executive 50 Erica Parker The Climate Change Care Factor 52 Laura McAulay How to be a Left-Over Masterchef Advertising 54 Kathryn Kerr Why being a Med Student is Awesome Enquiries: Tracey McCosh and Alex Cox 58 Jayne Schoppe Who wants to be a Millionaire? e: [email protected] 59 Xander Whitfield Sheep in Wolves’ Clothing 60 Robert Marshall Speech to the AMA National Conference 62 Dinuksha De Silva Hey Hey It’s Saturday major sponsors AMSA would like to thank it’s major partners for their ongoing support. Editor’s Waffle personal struggle. At the Andrew Dunn end of the day, is this not the heart of medicine?

s you skim this magazine, quite possibly between clinical While they get the ratings A and a pay cheque per episode spare examinationsa thought for or the during poor a coffee-inducedTV medico’s who’ve toilet session,taken that would make our HECS debt a back seat this season to make way for the masterchef look like chumps change, real life behemoth. Poor McDreamy, House, Nina Proudman, they all medicine is a far more interesting had to get out of the way of George the ever-bouncing chef show. We have no scripts, no witty and the strange man with the cravat. However, I do not wish written words to deal with the to discuss food, I wish to discuss what’s on the TV every other unexpected daily challenges, there is no minute.medicine. We could comfortably plonk down on our rehearsal on breaking bad news, and you couches at any time outside of masterchef hours and tune cannot do a retake when you get it wrong into the implausibility of (well, you can, but it’s usually really awkward). the sheer hilarity of Learning the art of human interaction is a on Embarrassing Bodies, or struggle with the inescapable continual challenge. As we move forward in void left in our lives since the axing of All Saints. ScrubsHouse, cringe, the at STIbritish fest genital that is warts our careers we learn to play our role within the system, and just when we think we have figured However, on a slightly serious note are these fictional it out, we find ourselves at the start of curve once dramas truly fictional, or a representation the reality again. It is the art of human interaction that provides Greys that exists for us in the bubble that is medicine? us with constant challenges in medicine, not only how , we interact with each other, but also with ourselves. While it is what challenges us, it also undoubtedly also If you delete the somewhat improbable story lines, what rewards us. these TV shows have the same fundamental formula. Every good (and bad) medical show The theme of this edition of Panacea attempted to has a bad guy, that angry at the world bitter be television shows, with a few other articles which wafted my way throughout the year so far. Prepare to consultant, who loves nothing more than be entertained by the unscripted medcest, be amazed embarrassing their juniors at each and at the stories of your peers, and be proud of the work every available opportunity. They all have that you all are doing around the nation, after all minus the age old nurse vs. doctor battle; the the lights and cameras, our story is far more intriguing touching patient with a dark diagnosis than anything the TV scriptwriters could ever create. and a hopeless future; and a myriad A very special thanks all of the AMSA reps and of love triangles that would make other people that submitted articles, without you, Charlie Sheen look sheepish. like AMSA, this edition of Panacea could not exist. But the underlying tale that Many thanks to Maya Rajagopalan, Robert Hand and keeps viewers coming back, Tracey McCosh for their creative brilliance, and the AMSA executive for their collective creative genius, week after week, is not the unwavering patience and consistent awesomeness. ground breaking surgery to It has been a crazy time creating Panacea for you all, I transplant a heart in utero, hope you enjoy it. Stay tuned for edition two coming nor the diagnosis of the to all leading outlets near you at the pointy end of the 1 in 1000000 condition; year, just in time for some exam time procrastination! it is the weekly stories about human interaction and

2 personal struggle. At the end of the day, is this not the heart of medicine? Words from the Pres While they get the ratings seem to be a reasonable delineation of and a pay cheque per episode Robert Marshall responsibility. The problem is that in the that would make our HECS debt absence of a coordinated approach to s a first-year medical student what Let me explain. look like chumps change, real life workforce and training, it is the individual Aseems like a lifetime ago back in 2005, within the system who will miss out. medicine is a far more interesting I remember picking up a copy of Panacea This year we have seen the (re)introduction show. We have no scripts, no witty and having my eyes opened to the world of of full-fee paying places for domestic Health Workforce Australia has been written words to deal with the AMSA. There were two things that struck students at the new “MD” course; charged with this task of overseeing and unexpected daily challenges, there is no me at the time. meanwhile the overloaded number of advising the medical training continuum, rehearsal on breaking bad news, and you students in the system has reached a but the National Training Plan, due to give The first is that this organisation called bottleneck that means some Australian- recommendations by the end of the year, cannot do a retake when you get it wrong “AMSA” seemed to be doing a hell of a lot trained graduates will start missing out is focused squarely on the numbers. How (well, you can, but it’s usually really awkward). of stuff. Flicking through the pages I read on an internship; other universities are many students should Australia train to Learning the art of human interaction is a about some of the national charity drives, expanding their medical programmes to meet the workforce demands of 2025? continual challenge. As we move forward in medico-political advocacy, competitions, offshore programmes from Malaysia to This is an important question, certainly, our careers we learn to play our role within the publications and projects that by all New Orleans; while still more Universities and answering it is not an easy task, but accounts were keeping the Exec, medical like Curtin and Charles Sturt are lobbying the title of HWA’s project is still misleading system, and just when we think we have figured student societies, and students themselves it out, we find ourselves at the start of curve once hard to open new medical schools in an for the thousands of medical students very busy. In addition, there seemed to be environment of resource-stretched clinical who are worried about the quality of their again. It is the art of human interaction that provides an awful lot of excitement for something training. university and post-graduate medical us with constant challenges in medicine, not only how called “Convention”. I hope that in this education given the current oversupply we interact with each other, but also with ourselves. edition of Panacea, six years later, you All of this really makes you stop and of students within the system. Perhaps While it is what challenges us, it also undoubtedly also get some insight into the remarkable wonder: when did medical education National Training Calculator would have what rewards us. organisation that I am now proud to be a become merely a commodity? been more appropriate? part, and that perhaps you will consider getting involved one day too. One might think that the purpose of our Being a medical student in the middle of The theme of this edition of Panacea attempted to medical education system is to train high- this training crisis often makes you feel like be television shows, with a few other articles which The second thing that I remember is that quality doctors to meet the demands just another model in the assembly line of a wafted my way throughout the year so far. Prepare to I had no idea what the word “panacea” of the Australian healthcare system. But doctor-factory. be entertained by the unscripted medcest, be amazed meant. As I’m sure most of you are aware, moves by most bodies to differentiate and expand their medical programmes suggest What is clearly missing from the debate at the stories of your peers, and be proud of the work a panacea is a cure-all, a remedy to fix any and all diseases. Don’t get too excited that the bottom line is the top priority. is the quality of our medical education that you all are doing around the nation, after all minus though, it is, of course, fictitious, and so Why else would you accept ever-increasing system. The most important thing for the the lights and cameras, our story is far more intriguing you can’t hang up that copy of Therapeutic cohorts of international students when you sake of the workforce, doctors and patients than anything the TV scriptwriters could ever create. Guidelines or MIMS just yet. know there is no guarantee for a job at the alike is to ensure the world-class standards end of all that training? It’s certainly not in of medical education that we have in A very special thanks all of the AMSA reps and This year we have been pushing strongly for the best interests of the students, and the Australia, which the current approach other people that submitted articles, without you, quality medical education in the face of a Australian healthcare system misses out to medical student training threatens to number of worrying trends that have seen on locally trained graduates, so it doesn’t erode. like AMSA, this edition of Panacea could not exist. medical student overload, job uncertainty make sense from a workforce perspective Many thanks to Maya Rajagopalan, Robert Hand and and negative impacts on training become either. We should start by giving our public Tracey McCosh for their creative brilliance, and the the widely-discussed issues in common hospitals and universities the funding and AMSA executive for their collective creative genius, rooms across Australia. While we have You can hardly blame Universities for resources they need to maintain the high unwavering patience and consistent awesomeness. been talking to the people who make key thinking about medicine as a commodity standards of quality clinical teaching. More when you consider that the funding for funding for medical schools may not, in It has been a crazy time creating Panacea for you all, I decisions and highlight these problems in medical places is now less than it was two fact, be the panacea for all these problems, hope you enjoy it. Stay tuned for edition two coming the media, I thought it would be interesting to consider what the panacea, or cure- decades ago, in real terms. That shortfall but a lack of funding does seem to be at the to all leading outlets near you at the pointy end of the all, for these medical education maladies has to be made up somewhere, and root of many of the education and training year, just in time for some exam time procrastination! might be. unfortunately in this case it is coming from issues we are currently experiencing. the International medical student market. I think the closest thing we might have If medical education really has become to a panacea would be an increase to the Perhaps providers of university medical a commodity, than perhaps the best we funding of Universities, a considered and education take the view that it is not can hope for is a sound investment in our considerable financial boost to the training their job to take care of the prevocational future doctors. In the meantime, AMSA will of medical students. and vocational training of doctors once continue to look for that elusive panacea. they leave medical school, which might Don’t hold your breath. 3 BLACK BOOKS Rob Thompson (UWS) reminds us that we can often learn more from books found outside of the med library.

hether you are gunning for top spot or scraping by with pass and a hangover, there is one thing that any Wmed student needs for success: books. Obviously we’re more than familiar with the staple text books, but think back to the days before OSCE Practice and Anatomy Spot Tests, when you actually had time for recreational reading. While most students find it difficult to justify prying their nose away from their Guyton or Boron for long enough to pick up something that isn’t just there to teach you science, recreational reading is good for your mental development in other areas, particularly interpersonal communication skills (potential for a research project into the amount of recreational reading in surgeons?)

That’s where the following list comes in. Five books that are both interesting to read and have enough medical content or themes that you might be able to trick yourself into thinking you are really learning something. These books are five of the (read “the only five”) books I have managed to read since I started my degree, and didn’t regret any of them. They each have their different attractions, and I have tried to give you an idea of what I got from the book as a student, rather than the standard literary guff of blurbs and newspaper reviews.

Blind Faith – Ben Elton: A cracking comedy set in a post-apocalyptic world, in the year 56ATF (After ‘The Flood’), where science is outlawed and feelings and beliefs are protected and supported by the law. Elton is probably best known for his writing on the cult British comedy Blackadder, and Blind Faith is equally as funny while also making some social commentary that hits close to home. He deals with the consequences of the prohibition of science, specifically medicine but also brings up a few other “medical student” themes: ignorance is wisdom, nakedness is modesty and anyone who attempts to keep their life private is deemed perverted, so all activities and photos are posted online for all to see. Has Elton not really created a new world, but rather recreated a week at Convention?

First Do No Harm – Leanne Rowe and Michael Kidd: While not a fiction book, First Do No Harm is a fascinating read about coping as a doctor in the 21st century. It uses the classic notion from the title and reshapes this to remind us that you can only uphold this value if you ensure that you do no harm to yourself in your practice. This book is a gift to each new cohort every year, and at first I thought it was a bit of a waste of space, but after leafing through some of the chapters, I realised just how easy it is to sacrifice our own health for the benefit of our degree. With strategies of prevention, signs to look out for in yourself and colleagues and techniques to cope once things do get difficult, it’s a must read for any aspiring doctor. 4 House of God – Samuel Shem Back to the comedy, House of God is a satirical novel which tells the story of Dr Roy Basch and the psychological damage caused to Basch and his fellow interns during their term at the House of God hospital. Incorporating issues such as the excessive hours of work, unexpected increase in responsibility and duties and the failure of the attendings to be bothered teaching, it will give you a new appreciation of your own internship when you reach it, and make you thankful you aren’t training in the Seventies: though the hair was cooler, internships not so much. The author Samuel Shem (a.k.a. Stephen Bergmen) is a guest at this year’s Convention, and is sure to share some of the fascinating insights into this book, as well as his other writings.

Medical Mysteries: From the Bizarre to the Deadly . . . The Cases That Have Baffled Doctors – Ann Reynolds and Kenneth Wapner I was given this book by a friend when I told them I wanted to go into medicine, and after reading it, I’d never been more certain that I wanted to. The book takes its stories from an American TV show and chronicles various fascinating medical cases. The accounts are sufficiently balanced between medicine and literature to keep you hanging on to find out exactly what the hell is going on. This is definitely for anyone keen for being mildly grossed out or for those gunners who want to be able to diagnose absolutely everything (Note: the likelihood of you seeing someone like The Tree Man on a regular rotation is probably pretty slim)

The Doctor’s Book of Humorous Quotations: A Treasury of Quotes, Jokes, and One-Liners About Doctors & Health Care – Howard J. Bennett The title says everything about this one. Again a gift, I resort to this whenever I feel things are getting a bit too heavy during semester time (pure gold during my neuro block). Filled to the brim with a broad spectrum of medical humour including the classic “Doctor, Doctor…” jokes, specialist stereotypes, famous quotes from movies and TV as well as a decent amount of crudeness and lewdness to satisfy even the most hardened medico.

5 family expectations of medical students

by Hamish Gunn and Bec Ryan (UTas) Being the studious souls that we are, we have not sexual misconduct tribunals you faced throughout spent a lot of time watching Modern Family (well not your (most likely short) career. Enjoy it while it’s there that much time), but thanks to Wiki we think we have but don’t let their rainbow light blind your better the general understanding of what it’s all about (kind of judgement. like our medical degree). Type Three So, you’re on the way to getting your MBBS. It’s Pressure cooker tough, we know. It most likely wouldn’t have been possible without some form of support along the way. Like Jay and Gloria (the older, successful male with This issue of Panacea, we look at your own immediate a beautiful, young trophy wife), perhaps your own (modern) family. mother has something to prove. She brings more than smoking looks to the family – she can produce Type One a successful heir to the family name, which is where Dysfunctional you step in. Digressing from the real story, perhaps your workaholic surgeon father also has something to Phil and Claire Dunphy, whilst loving parents, often prove. No child of his will be dancing on Broadway, neglect their brainiest spawn. Sound familiar? Your no matter how well they did in Year 10 Interpretive mum and dad fail to recognise your continuous dance class. In a nutshell, you will pass medicine. outstanding performances in all arenas – be it sporting, Furthermore, you will get HDs. Your name will be community, or of course, academic. They’re probably inscribed on the Honour Roll for the third generation too busy attending your younger brother’s Parent running. You will hate your life. But hey, your parents Teacher interviews (delinquent), or plotting ways to will be pleased? And it might even end in a free nip and ensure your promiscuous teenage sister doesn’t have tuck for your trophy wife mother. Our advice for you? a pregnancy scare (again). Never fear, they will come Appease your parents, but only if this degree is really to recognise your brilliance when the time comes to what you want. Pull a few of Ke$ha’s favourite moves fund their retirement condo in Noosa. Our advice: Grin – brush your teeth with a bottle of Jack™, have a dirty and bear it. And it’s ok to feel superior. free for all, and talk about P-Diddy whenever possible. Perhaps they will learn what they should really be Type two worrying about. Progressive parents But let’s be honest – Modern Family is an American Perhaps your parents are more like sitcom after all. Not exactly real. Cameron and Mitchell, Our families aren’t like this, gay parents with an and we’re guessing yours adopted Vietnamese aren’t either. So next daughter. Although time your mum makes not necessarily gay, you unpack the throughout your life dishwasher during they have surrounded you SwotVac, don’t by a rainbow bubble of love. immediately return with Ain’t No Mountain High Enough is your “You have NO idea how theme tune – they won’t let anything STRESSED I am right now! Do stand in the way of their precious you WANT me to FAIL?! You are caramel baby and their dreams. sooooooo inconsiderate!!” – stop, This leaves you in a bit of a pickle. breathe, and remember – They would think you were wonderful it could be worse. regardless of how many patients you killed and how many

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DEFENCE UNIVERSITY SPONSORSHIP NOW RECRUITING: MEDICAL, NURSING, DENTAL, PHARMACY, PHYSIOTHERAPY, RADIOGRAPHY AND ENVIRONMENTAL HEALTH STUDENTS. 7 ellbein WFalk Reinholz (AMSA Community & Wellbeing Officer) explains g yet another reason why medical students are special, and what AMSA is doing about it...

ver the last few months, you may have seen AMSA of students felt that they had received formal teaching Odoing a lot of work around medical student on these issues. The survey also found that one-third wellbeing. When we talk about wellbeing, we are not of medical students have no general practitioner, and just talking about mental health. Indeed, the notion this figure rose to 56% for international students [8]. of good wellbeing must also include maintaining your physical, emotional and financial health, to ensure that Throughout our time at medical school, it becomes you have a balanced lifestyle, enjoy what you are doing evident that mental health, and wellbeing more and set yourself up for a long and rewarding career. generally, has a huge impact on how well we travel through our medical education, and life. It is likely that most people reading this would know a friend or colleague, or perhaps even themselves, who has So, why is it such an important issue? had to deal with difficult times during medical school. Although we would like to be, medical students are It may come as a surprise to know that, statistically, not immune from physical illness, life crises, mental medical students exhibit lower psychological wellbeing health problems; and just tough times in general. And than age-matched peers and the general population [1- when you combine this with a demanding degree and 6]. Some studies have suggested that almost a quarter a plethora of other commitments, it is no wonder that of medical students show signs of depression, and of sometimes things can get a bit much these, a quarter will experience an episode of suicidal ideation [7]. However, wellbeing as an issue for medical However, perhaps one of the biggest issues among students is not new and AMSA has been active on the medical students is actually accepting this fact, wellbeing front since it’s inception – it was actually admitting that we are not immune to problems and one of the core reasons AMSA was created in the first knowing when, and how, to ask for help. Alarmingly, place! 56% of students in the AMSA/NZMSA survey responded that they thought there was a negative In 2009, AMSA and the New Zealand Medical stigma associated with medical students experiencing Students’ Association (NZMSA) conducted a survey stress and distress [8]. So, as we continue to promote which proved to be a watershed in how AMSA, and the healthy wellbeing, reducing stigma must also be a wider profession, viewed medical student wellbeing in major focus. Australia. The results showed that half of all medical students believe that there is a stigma associated with undergoing stress and distress and only 56% per cent 8 All students in distress must be given easy access to the In addition to new wellbeing initiatives mentioned, best and most helpful resources available. However, AMSA continues to foster our existing projects. all discussions about mental health and wellbeing Recently, the winners of the 2010 AMSA/MDA should not be focused purely on crisis management. Healthy Body, Healthy Mind Campaign were Medical schools, and their students, should also be announced – congratulations to the winners from concentrating on the task of raising awareness of Flinders Medical Students Society and the runners- wellbeing as a topic. It is not about singling out people up from Monash University Medical Undergraduates’ who are struggling, it is about making sure that all Society (MUMUS). AMSA will be continuing the students make wellbeing a priority and not just an after Healthy Body, Healthy Mind in the second half of the year. AMSA also continues to run the Get-A-GP “statistically, medical campaign, which encourages all medical students to have a GP that they see regularly, as well as directing students exhibit lower them to GPs wiling to bulk-bill medical students. In light of the earlier statistics [8], it is essential that more psychological wellbeing than work is done to ensure that medical students have a GP who they can confidently and confidentially use as age-matched peers and the a first port of call when they are unwell. general population” Overall though, the most important thing we can all be doing is continue the conversations about thought for when things start to go awry. We should wellbeing to ensure that medical students, and their be encouraging everyone to acknowledge that, along medical schools, appreciate the importance of good with passing exams and dressing up in outlandish wellbeing and take active steps to ensure it becomes costumes, looking after their wellbeing is essential to part of everyday life at medical school. enjoying their time at medical school. When you think Healthy, well-rounded students become healthy, of wellbeing as incorporating all elements of holistic well-rounded doctors who are more likely to impart health (physical, mental, social, financial, professional) it healthy behaviours to their patients. In the interests of is hard to argue with the fact that there is nothing more our education, our profession, and our future patients, important in your life than ensuring the wellbeing of it is vital that medical schools, student organisations yourself and those close to you. and individual students all recognise, prioritise and To this end, AMSA has been significantly increasing its promote wellbeing so that the medical students of efforts in wellbeing. The first half of 2011 has seen the today can become the healthy doctors of tomorrow. release of ‘Keeping Your Grass Greener: the wellbeing guide for medical students’; the inaugural AMSA References podcast being on wellbeing; the production of a fact 1. Aktekin M, Karaman T, Senol Y, Erdem S, Erengin H, Akaydin M. Anxiety, depression and stressful life events sheet on wellbeing; and the inception of Well Net, the among medical students: a prospective study in Antalya, Turkey. Med Edu. 2001;35:12-17 2. Henning K, Ey S, Shaw D. Perfectionism, the imposter phenomenon and psychological adjustment in medical, AMSA Wellbeing Network that connects wellbeing dental, nursing and pharmacy students. Med Edu.1998;32:456–64. 3. Lloyd C, Gartrell NK. Psychiatric symptoms in medical students. Compr Psychiatry. 1984;25:552–65. representatives from each and every Australian 4. Toews JA, Lockyer JM, Dobson DJ, Brownell AK. Stress among residents, medical students, and graduate science (MSc/PhD) students. Acad Med. 1993;68(10 suppl):S46–S48. medical school to facilitate ideas sharing and project 5. Toews JA, Lockyer JM, Dobson DJ, et al. Analysis of stress levels among medical students, residents, and collaboration. This year is also the first time the role graduate students at four Canadian schools of medicine. Acad Med. 1997;72:997–1002. 6. Psujek JK, Martz DM, Curtin L, Michael KD, Aeschleman SR. Gender differences in the association among of the Wellbeing Officer has formally featured in the nicotine dependence, body image, depression, and anxiety within a college population. Addict Behav. 2004;29:375–80. AMSA Executive. This focus and public presence 7. Givens J, Tjia J. Depressed medical students’ use of mental health services and barriers to use. Acad Med. 2002; 77: 918-921 on wellbeing is important if we want to increase the 8. Hillis JM, Perry WRG, Carroll EY, Hibble BA, Davies MJ, Yousef J. Painting the picture: Australasian medical emphasis and solidify student wellbeing as an essential student views on wellbeing teaching and support services. Med J Aust. 2010; 192(4):188‐190. focus for both medical schools and students. 9 10 Come Fly With Me...

Greg Leeb (Bond University) takes us to a place where a new set of D-cups can be arranged while you sit by the in-pool bar; Or how about a cheeky facelift followed by a beach party? It’s not some weird mix between nip/tuck and Baywatch, its medical tourism and it’s been taking off for a while.

stimated to be worth approx. $60 billion a However, when all is said and done and the year, the fast growing industry of medical patient returns home, follow up contact with Etourism involves people travelling overseas the surgeon is likely to be pretty minimal and for a go under the knife. It’s pretty popular, with regardless of any hospital or hygiene issues, at least one in every three Australians open to the surgical complications can arise and if they do, idea of going overseas for a medical procedure. this usually falls on the public health system back The most common destination choices are low in Australia. to middle income nations with Thailand, India, Malaysia and Philippines being the favourites for If you end up coming out looking more plastic Australians. With the most common procedures than fantastic, there’s often little that can be by far being cosmetic followed by dental and done. As all of us that have had to sit (sleep) about 10% more major surgeries. through arduous medico-legal lectures would know; In Australia, the liability and responsibility Companies and hospitals have begun putting that doctors have to their patients is very high. together special packages to appeal to the Overseas, this often isn’t the case, even more so medical tourist in all of us. One of the current for foreign patients and most cases of malpractice leaders in this form of holiday is Destiny get dismissed and many patients have found it Meditravel. Starting from the low-low price of hard to find a surgeon in Australia willing to work $4800 the average punter can have the “Breast on another’s creation. Implant Getaway”, a package that includes flights in and out of Phuket, breast augmentation Ethically, another factor is the implications on the surgery, 10 nights at a 5 star resort. Not a bad locals of these countries. With the vast amount of move on paper, especially considering the same money that doctors stand to make from foreign procedure alone can cost over $10,000 on patients, there is the likelihood of the creation of a Australian soil. So far so good, a cheap two-tier medical system. The majority of medical way to get a new set, mixed with a resources stand at risk of being turned away from few mojito filled days by the pool in the local population in the face of higher profits, Phuket, hell, bring the kids along make it as doctors of the region are lured away from the a family holiday! public sector and rural health networks. Regardless of where you sit on this one, it’s quite “If you end up coming clear what the next step is. out looking more The Price Is Right – Medical Tourism Edition, plastic than fantastic, which I predict Larry Emdur to reclaim his throne there’s often little that for. can be done” 11 thinks choosing a specialty has similarities to

Alexander Cox (University of Notre Dame Fremantle) speed dating. We asked him to write an article explaining this absurd concept......

12 With the numbers of medical students increasing that extra blood and more screaming is a positive... every year in Australia, the daunting concept of maybe ED? Others may think that eight hours a choosing which path to take can sometimes be too day of vagina sounds great. Easy! Obs and Gynae much. For most, being a doctor means you can for you. But you can even take it broader than that. administer drugs, look important and fix people’s Do you like prescribing and Dr House-ing patients to health issues. Little do they know however that figure out what’s wrong with them? Then physician Medicine encompasses a plethora of possible I knight you, however if you just want to stab courses with which to take such as med or surge, someone in their chest and glue parts of their heart Gynae or gen med, ED or cardiothoracic and the list together, well my son either complete murdering goes on. Here we have a jibber jab about different psycho with a hint of humanity or surgical is where specialties and what is the best approach. you shall be. This can go on for ages and in fact it does, depending on your degree 2 or more years to “Just when you thought it be precise. The reason why is because there are so many different specialties and sub-specialties and was becoming easier choosing yep even sub-sub-specialties that it can become between vagina, scalpels, drugs quite daunting. and skin, up strolls a specialty I know what you’re thinking, “it still sounds pretty that covers more than one.” easy really” when you are not only an idiot and your mum is too but you are also so so wrong. Just when you thought it was becoming easier choosing Choices are everywhere nowadays, do I want a between vagina, scalpels, drugs and skin, up strolls a pink sweater with beige pleats or pink pleats with a specialty that covers more than one. General med or beige sweater...so many decisions!! Not surprisingly, internal medicine specialties cover a bit of everything choices are also found in pretty much every facet really and so does GP with patients turning up on of our lives too including work, holidays, family life a day to day basis with everything from psych to and social. With the world moving forward as it fatties, paeds to oldies and warts to diarrhoea. It is is, speed dating has become even more popular, not only for this reason but also many others that finding partners for those sick and tired of waiting have made broader specialties such as GP and gen for the right man or woman to come along or for med such an attractive specialty to be a part of, you those whose biological clock may have ticked a few literally have no idea what the next patient through more times than others. With this approach not the door might have. only can you meet a huge number of people (a lot of which are quite creepy, or so I read I mean) but you No matter what specialty you decide to take in the can also dispense with the ones that have no hope future, the speed specialty dating will come, and and still manage to meet plenty of “opportunities” you, like most will end up at the end confused and so to speak. This however is now what it is like with less money for no reason. But when it does when choosing a medical specialty. Each student happen and you know it will, grab that big fat gets several weeks in each specialty before finishing, specialty by the horns and take it kind of like a speed dating service for med students. for a ride before you decide. The problem with this is that well as always (for me at least) it is all too confusing, happens way too fast and as always I am left unsatisfied at the end with a giant mess to take care of on my own. As with any dating regime there are pros and cons depending on the person. Some may say 13 Cultural and Clinical Lessons in China Andrew Webster (AMSA VP External) recounts his latest adventure to Zhejiang University First Affiliated Hospital, Hangzhou, China

n route to Hangzhou for my 5th year medical areas within the Zhejiang province with a team whose elective, I thought it would be a good idea to learn aim is to treat and track patients who are infected with Esome basic Chinese greetings and phrases with Hepatitis B, tuberculosis and HIV. which to impress my hosts upon arrival. Armed with some podcasts and a Lonely Planet phrase book, I set These visits are part of a statewide research project about trying to remember the basics of ‘hello’, ‘where that is aiming to model the incidence and prevalence is the toilet’ and ‘thank you’. rates of these three important infectious diseases in the Zhejiang province. It is quickly apparent when Of course, in such as short space of time my efforts were participating in these outreach clinics that infectious essentially fruitless and I had learned almost nothing diseases, particularly hepatitis, are a massive public upon touchdown in China. As you might have guessed, health concern for China. It is also clear that there are my complete lack of ability with Chinese was to prove significant issues with access and utilization of health important when a case of ‘Chinese whispers’ meant care among the rural populations in this area. that my date of arrival had been lost-in-translation. Coupled with a phone that was not working and an The reasons for this are complex, though a arrival time in the late evening when no one was in the significant contributing factor must surely be the airport, meant that this soon became an interesting lack of formal primary care services (i.e. no GP situation! Channeling my acting abilities and using props workforce) in much of China. This lack of access such as my stethoscope and lots of gesticulation, I was to health care in rural communities, coupled with able to be pointed into the direction of a bus which was the high personal cost of accessing health care in hopefully heading towards Hangzhou City. the cities may be factors that are contributing to the persistence of these communicable diseases. I eventually arrived in the right area and was greeted by some mortified hosts the following morning. Certainly this initial experience prepared me well to handle the many other culture shocks that were to come in the Lesson 2 following weeks. Rural populations often have poorer access to health care but in China this disparity is particularly apparent. Lesson 1 The contrast between the health facilities in rural areas Chinese is a difficult language: it’s worth learning the and the city was striking. My base hospital, for example, basics before you get on the plane. the Zhejiang University First Affiliated Hospital, is a huge health campus located in the center of Hangzhou. My In the last 20 years, China has undergone a massive department alone (Infectious Diseases) was housed in population shift from rural areas into the big cities. This a monolithic 20-storey building that had approximately has been particularly evident in the highly populous 400 inpatient beds and a staff of over 500 doctors, and relatively wealthy east coast of China, where my nurses and allied health. In addition to the clinical wards, elective in Hangzhou was based. As a result of this there were also laboratories and research institutes population shift and limited health resources, ‘health within this section of the hospital. This close proximity care silos’ have been created in the major cities, whereas of clinicians and researchers, along with the sheer rural centers and small towns remain largely under- scale of the place, meant that this was a constantly serviced. During this placement I travelled to regional stimulating elective location. 14 This elective was not only a chance to learn about the practice of medicine in a country outside of Australia, but also a chance to learn about the rapidly changing nature of modern China. During my stay, I was invited Lesson 4 into the homes of some of the doctors to celebrate Medical students sometimes feel the need to be invisible the Chinese Spring Festival (Lunar New Year) – a very on ward rounds and constant mobile phone use is even memorable experience. The generosity and hospitality more common among Chinese doctors than it is here. of these people was exceptional and on many occasions I was fed and looked-after to the point of Another striking difference, from a health perspective, embarrassment. is the lack of formal, organized primary care in China. There is currently no national General Practice training program and there is little provision for doctors to Lesson 3 work in the community. Because of this, the health If you have indigestion from eating too much, don’t tell system largely functions around triaging patients in your Chinese hosts as they might force you to eat cured hospital emergency departments and treating within duck’s stomach as a remedy! the hospital system. As a result, there are significant difficulties with chronic disease management and Being an observer of medical education in a major patient follow-up. This was a fascinating aspect of the Chinese teaching hospital was also fascinating: I have health experience in China and surely, the status quo never seen medical students trying to become so that is highly inefficient and costly, must change in the invisible during ward rounds! Not only would the coming years. students attempt to remain out of the way of the doctors, but they’d also actively try to avoid discussion and examination of patients – this was most obvious Lesson 5 when one particular medical student spent the entire China is a fascinating place which is just too huge diverse 3hr ward round looking at his phone! This is not an to experience in a single visit. I will certainly be returning exaggeration. I don’t entirely understand the reason to China in the future, and with the current rate of for this behavior and perhaps it was partly due to my growth and change in this amazing country, it’ll likely be presence taking focus away from teaching the Chinese a different place altogether. students, however, I can certainly say that this behavior would not be conducive to learning.

“This elective was not only a chance to learn about the practice of medicine in a country outside of Australia, but also a chance to learn about the rapidly changing nature of modern China”

15 ralian confere aust of nce SCIENCE & MEDICINE IN SPORT Fremantle, 19 - 22 October 2011

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edcest is a portmanteau of the English Med school is in many word medicine in this instance used to ways simply an extension Mdescribe medical students and incest of high school. As one a noun used to describe sexual relationships who attended an All Girls High “Optimising Health and Fitness Speakers including: between people classed as being too closely School – I love nothing more than related. Medcest for those of you unfamiliar my morning tea served with a hot slice of – Participation, Prevention and ~ Dr Richard Bouché with the term is used to describe liaisons weekend gossip. Whilst drunk and disorderly Podiatric Surgeon between medical students both at the same behaviour is fun to relive in the cold harsh Performance“ The Sports Medicine Clinic, Seattle uni and between unis. light of day, MedCest is oh so much juicier. Whether it be a sneaky pash on the dance ~ Mr Mark Fenton Whilst on initial inspection medcest may sound floor or the start of a new med romance. as inviting as a 7am ward round. On closer Public Health Advocate inspection you may find it to be as inviting By far my favourite medcest moment does Boston Are you interested in keeping up with the latest as a long weekend. Medcest like all medical not involve the couple at all but rather my ~ Refshauge Lecturer encounters has a number of end points. From somewhat naïve friend who for the purpose of multidisciplinary sports medicine & sports those who will go on to marry and have 2.5 confidentiality will be known simply as Ms GC. Professor Ken Fitch future doctors, to those which result in much Her highlight of our medball was not our PBL science? Sports Physician and Academic Perth awkwardness and the possibility of Facebook tutor shredding up the dance floor to the beats ~ Professor Martin Hagger defriending. of our head of anatomy and his “band” but ~ Conference program available online now @ acsms.sma.org.au instead her discovery of two of our classmates Professor, School of Psychology and Convention week is by far my favourite time ~ Hands-on workshops in diagnosis and treatment in an intimate embrace outside the venue as Speech Pathology of the year not only because of the stellar she waited for her ride hidden behind a pillar. ~ Presentation of the latest research findings Curtin University, Perth academic program but also for the networking But do not despair for GC, she is now engaged ~ Symposia on latest interventions, techniques and that occurs at night. Convention week provides in med relationship of her own. ~ Professor Romain Meeusen approaches an amazing opportunity for medcest to be Head of Department, Department of observed and if you are game to be engage in, Medcest is something that is present in all ~ Internationally renowned speakers and presenters Human Physiology in all its glory on a truly national scale. medical schools and if you haven’t heard about ~ Trade exhibition Vrije Universiteit Brussel, Belgium it or been involved you are just not getting the Nothing fills my heart with as much joy except ~ Social program including: Welcome Reception, Trade most out of your medical education. So don’t perhaps this years amazing Academic Program exhibition opening, Poster drinks and Conference Dinner ~ Dr Erik Witvrouw be shy get amongst it. Head of Department, Department as using the morning tea break to attempt all included in the cost of full registration to determine the identity or at the very least Plus you can help spread the key objectives of Physical Therapy and Motor the university of a friend’s latest conquest. of AMSA to connect, inform and represent. As ~ Over two hundred and fifty Free Papers and Posters Rehabilitation Interuniversity medcest both your own and well as give me something to talk about on a ~ Unique cross-disciplinary networking Universiteit Gent, Belgium that of your friends is one of the best forms of Monday morning. See you all at Convention – For further information please contact: Sports Medicine Australia, PO Box 78, Mitchell ACT 2911, Australia networking without which I would have much Is it unethical to use my role as Academic Co- p: +61 2 6230 6671 | f: +61 2 6230 6676 | e: [email protected] | w: acsms.sma.org.au less Facebook friends. Convenor to network?

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18 Find out more at www.agpt.com.au Show me the money: An Incentive based Practice? Stephanie Cheung (ANU) debates incentive vs evidence based practice

In the famous scene from Jerry Maguire, Tom Cruise Program (PIP) was developed, and is administered by (Jerry) and Cuba Gooding Jr. (Rod) immortalize the Medicare Australia on behalf of the Department of Health catch-phrase – “Show me the money!” Performance and Aging. General practices can apply for as many of based Return on Investment (ROI) is a key indicator in these incentives as they are eligible for. In fact, they can the economic and business world, and as much as we’d pick and choose from a list of 13 incentives available on the hate to admit it, a notion of which medical practice is not PIP. Services range from afterhours and quality prescribing immune. to cervical screening and procedural incentives, as well as practices willing to conduct an annual cycle of care Current fee-for-service arrangements have been found to for patients with chronic conditions such as asthma and encourage quantity rather than quality, where seeing a high diabetes. number of patients means the receipt of higher payments through Medicare reimbursements and is practiced by Are we slowly moving into some at the expense of taking the time required to meet ongoing patient needs. In an attempt to improve the quality incentives-based medicine instead of care provided by general practices the Practice Incentives of the evidence-based medicine bestowed upon us as medical students?

With so much on offer, are we at risk of being “incentivized” into providing a healthcare service based on the promises being made to us? Are we slowly moving into incentives-based medicine instead of the evidence-based medicine bestowed upon us as medical students?

The idea of financially rewarding “good medical practice” is not exclusive to the Australian healthcare system. Countries such as the US, UK and Canada are adopting “Pay-for-performance” strategies to drive quality healthcare improvement in their hospitals and general practices. These schemes involve doctors being paid by health insurance companies and funding 19 bodies according to the quality of care they provide for never been more crucial in ensuring appropriate patient their patients. Such incentive payments are based on a care and protecting doctors from moral decline. The ideals ranking which reflects how well a doctor is “performing” of beneficence and non-maleficence are indispensable in terms of patient care, follow-up and outcomes. For in clinical practice, especially when practitioners are put example, performance benchmarks such as screening a set into the increasingly difficult position of making decisions proportion of eligible patients with diabetes can earn extra between serving patient best interests and their own. Failing payments based on the number of patients admitted to clinician morale and discrepancies in health care access are the program. Rewards then continue with bonus payments some of the concerns already being voiced amongst the being made when specified health outcomes are achieved. American medical community. In some schemes, penalties are imposed when quality goals for healthcare are not met and doctor ranking goes Pay-for-performance programs have yet to be introduced down. Clearly, medicine has become a serious business in Australia at the primary care level although a pay-for- and it may well be that in addition to our medical degrees; performance program targeting public hospitals was piloted a business degree would help us navigate better the waters in Queensland in 2007. Initial installments using pay-for- of clinical practice in the 21st century. performance have been given for work performed up until June 2008, however current data on the impact of At this point it would be fair to point out that the this new system is limited. Phased approaches to easing incentives proposed by the Australian PIP do play a role Australia into pay-for-performance methods has been in highlighting significant areas of need. In addition to the proposed by some authors. Suggestions include “pay- services mentioned earlier, others such as indigenous for-participation” schemes focused on optimizing quality health, aged care access and domestic violence incentives control, standards and measures of performance that would can work to support GP clinics in serving their community. be used to develop pay-for-performance frameworks. It is There is indeed prime focus on preventive care and care of clear that the existence and development of incentives chronic diseases which are important for improving patient based programs is certainly well and alive in the Australian outcomes within the primary care setting. The basis for healthcare system. Therefore, ongoing debate around the introducing these schemes stems from an intention which use of pay-for-performance initiatives in augmenting clinical is arguably well-meaning and noble. However, it would practice will likely persist amongst the less enthused. be naïve to ignore the additional benefits that medical practitioners are receiving in the process and the affect this For every story, there is always an ending. At the end of has on decisions regarding patient care and treatment. This Jerry Maguire, Jerry finds that his relationship with Rod would surely have an influence on the types of services that (his “investment”) has turned from one of business to one some clinics will feel inclined to offer as well as the patients of a close, personal friendship. This realization allows him they prefer to see. to fulfill what he set out to achieve: his mission statement for honest business in the sports world. For us as future With the previous fee-for-service scheme, it was recognized health professionals it is perhaps worth acknowledging that a high throughput of patients resulted in unnecessary that, despite our humblest efforts to provide the best prescribing, tests and referrals. On this premise, it is difficult standard of care, none of us are completely safe from the to understand how adding more incentives to the bag is adverse effects that such financial incentives will bring. meant to deter the hand of those who are predisposed to Nevertheless, hope remains as we remember that to serve undermining patient needs in the face of monetary rewards. in this profession is a privilege and that it really isn’t all The danger lies in the motivations behind medical practice about the money. Our true rewards are not reflected by where the patient-doctor relationship is potentially reduced our bank balances but by the integrity of our decisions to a business transaction with additional investments on the and sustained relationships with our patients, long after the side. Upholding the clinical maxim “first, do no harm” has credits have finished rolling. 20

ugly are muffinscupcakes? just The simple answer to that is NO, absolutely not, and Lee Fairhead (UWA) is here to tell us why.

is a common misconception that muffins Now, the main difference lies not just in the Itand cupcakes are the same thing. Firstly basic formula but in the way the mixtures are just let me tell you a cold, hard fact: they’re combined. Cupcakes are simply very small not. Muffins are not just ugly cupcakes without cakes, the preparation is largely the same as a the icing. No, they are a distinct and delicious large cake and usually involves beating butter, breed of baked good often discriminated sugar and eggs and then adding everything else against because of their rough, overflowing until you have a very smooth, runny texture. exterior, in favour of the pretty little cupcake decorated with sugary frosting. Traditional muffins on the other hand often call for an oil or melted butter as the fat rather than I am quite the fan of baking muffins and after creamed butter. They also commonly don’t sampling one, many people have commented have eggs. The major difference though is to me that they can’t possibly understand how the mixture should be combined. When how to make muffins, they never seem to rise it comes to mixing muffins, you need to leave properly and are just too difficult. I too thought the electric beater in the cupboard. Instead, this until someone took the time to explain the prepare a wet mix and a dry mix separately and answer: you have to stop baking muffins like then add the dry mix to the wet. The mixture is cakes. They have their own formula and baking then stirred gently, preferably with a wooden strategy and once you get the hang of it you’ll spoon, until it is only just mixed. This is most wonder why you even bothered with anything peoples’ fatal mistake: the trick is not to batter else. the poor little muffin mixture into being a cake. Just stir gently and once it is just combined, The problem you see is that many people only stop. Over-mixing leads to flat, heavy muffins differentiate between the muffin and cupcake that no one wants to eat. based on its looks or the fact that muffins have fruit and nuts in them and cupcakes are sweeter So, clearly, muffins and cupcakes are very with icing. But that is not the end of it. There different. In fact, muffins are actually more are some very important technical differences, akin to a quick bread, baked in the shape of a which mean that these two baked products of cupcake. deliciousness are nothing but distant cousins. And with that I could leave you here with an Now this may seem to be just a silly academic overdone pun about some French Queen but point, and perhaps it is. But, unlike some sort I will rise above it and simply leave you with a of directional sausage debate, at least there is recipe for some delicious mango muffins which a real and discernible difference between these should give you ample opportunity to see the two food products and, appreciating this is difference for yourself! bound to leave you with a much greater sense of satisfaction next time you enjoy one of these delectable delicacies. 22 Mango Muffins Ingredients 800g sliced mangoes (tinned with juice or fresh) 125g (4T) melted butter or margarine 1 cup brown sugar, sifted 4 cups SR flour 2 cups of Natural yoghurt

Pre-heat oven to 180°C. Combine butter, yoghurt and mangoes as your wet mix. Sift in sugar. Gently fold in flour until just mixed, being careful not to over-mix. Bake in muffin tinsuntil golden brown. You know they are cooked when you lightly tap the top and it springs back. Makes 12

23 The State of the Nation The AMSA Rep Reports

University of Adelaide by Aakriti Gupta (AMSA Junior Rep). What’s Been Happening: Never a dull moment in the life of an Adelaidean. Since Dec 2010, the AMSS has held the legendary Skullduggery (with all 2000 tickets selling out in one and a half days) and a Harry Potter-themed MedCamp, initiating the first years into the ‘Magical World of Medicine.’ A continuous stream of events have followed including Clinical Welcome Drinks, President’s Keg, Close the Gap BBQ, MedCricket, AMSS-FMSS volleyball, MedFooty, Inter-year debating and the much loved Jazz Night.

Something Amusing: Three words: keen first years. Our past president in MBBS V welcomed the first years as ‘Dr. Mark Nicholson,’ offering three prestigious medical student research scholarships. A flurry of enquiries and applications subsequently flooded Dr Nicholson’s inbox. Disappointing for the excited applicants who were informed that “a tragic turn of events has led to Dr. Mark Nicholson contracting Bovine Spongiform Encephalopathy whilst processing postmortem specimens” and that the scholarships on offer would be cancelled until further notice…

Big News For Adelaide: AMSS and FMSS conducted a joint survey over Jan/Feb 2011 to gather student opinion on internship allocation in South Australia. A submission from these results was sent to SAIMET (South Australian Institute of Medical Education and Training) in Feb 2011. This resulted overall in positive outcomes for students, achieving one-year internship contracts, non-merit based allocation, and preservation of current priority ranking in optimised preference allocation. The future implementation of network-based internships instead of the student preferred single hospital internships however remains on the agenda. Student concerns with regards to assessment, continuity of education and welfare are actively being addressed.

Bond University by Greg Leeb What’s Been Happening: MedBall, Trivia Night with HMSA, MedEagle ,Scrubcrawl with Griffith, World’s Greatest Shave, Anatomy Challenge (won by the team “three asians and a token white guy”), Elective Night

Something amusing: The addition of the word ‘demi’ into the dictionary as the world’s most universal term to describe most any situation.

“Hi nice to meet you, my name is shitting cow” – Stephen Shih-teng Kao

Dr. Najeeb’s unofficial role as lecturer at Bond University

Big News for Bond Uni: Welcome to the new cohort of Bond Uni med students who have begun their long walk to doctorness this semester. Congratulations to the MSSBU team who helped raise $1800 towards Leukaemia Foundations – World’s Greatest Shave. Deakin University by Amy Wong What’s Been Happening: 2011 kicked off to a smashing start, with a big welcome to all the first years during O-week with a welcome barbeque and market day on campus, followed by a cocktail party by the waterfront where students from all year levels mingled for the first time ever in Deakin’s SOM history. This was followed by med camp a week later where first years were introduced to med student life and practical skills such as suturing and plastering.

Elections took place in March, and many enthusiastic first years jumped on board with our medsoc (MeDUSA) bringing new energy and life to the school. We’ve had a handful of academic sessions such as an electives seminar and clinical schools sessions, and fundraising activities such as the Christchurch bake sale by our Global Health Group UHAD (Universal Health @ Deakin).

Students in clinical years had their own fair share of fun and socializing as well just before Easter – with a PRN Wonderland Cocktail Night and a pool competition between the 3rd and 4th year students. On a more serious note, we have been going through a long process of accreditation with AMC, and on an even more serious note, preparing our delegates for convention and GHC! Watch out Sydney!

Big News for Deakin: Our first lot of 4th years will be graduating at the end of the year – we look forward to seeing them as interns all over Victoria and Australia!

Flinders University by Neville Fields What’s Been Happening: O-week, FMSS 2011 MedCamp, Rubik’s Cube PubCrawl, Quiz Night, FMSS Family Beach Day, Shave for a Cure, 2011 FMSS MedBall – “Under the Cover of Darkness”, FMSS vs. AMSS Volleyball Comp (clearly we won…), 2nd Hand Book Sale, FMSS Strategic Planning Night, Birthing Kit Day in conjunction with HHRG and FUNMSA, HHRG Heat Cocktail Night, FUSS Lawn Bowls Night and far far too many “unofficial” boat racing try-outs.

Something amusing: The breakdown of an official FMSS Convoy car on the way to MedCamp held in the Flinders Ranges about 275km away… this occurred at 5PM on a Friday night in peak hour traffic on South Rd. Carrying vital supplies such as the pigs hooves for suturing the next day and yours truly (yes I am vital), multiple med students stood guard next to the car on the side of the road awaiting RAA in shifts… funnily enough that night 4 different med students all went by the same name as per the RAA members card; or so the RAA and tow truck company thought… ultimately a sweet hire car was employed and GLEE was enjoyed by all on the trip up!

Big News for Flinders: The official opening of the NT Medical School run by Flinders University in conjunction with Charles Darwin University! With the first group of med students taken on this year, we here at FMSS are very proud to support and represent this wonderful group of students and are extremely excited to see how things progress up in the Territory. Where else can you get first-hand experience with croc bites, box jellyfish stings and blue ring octopus paralysis. 25 Griffith University by Justine Cain What’s Been Happening: We farewelled our graduating cohort and welcomed in the new year and our new batch of victims first years with a disorientation weekend, complete with a BBQ lunch, jumping castle, barefoot bowls and our guide to medicine ‘Embryo’. We combined with Bond to host a scrub crawl through some fine Gold Coast establishments. We have hosted various academic peer tutorials, professional speakers and a peer mentoring meet and greet.

To focus on relaxation we provided some mindfulness sessions and the family event aptly named ‘Parasympathetic Picnic in the Park… to rest and digest’. We participated in Relay for Life, raising much needed funds for cancer research, as well as a blue party to raise funds for mental health.

Something amusing: Or most cringe-worthy…a second year student was in a simulated (fortunately!) obs and gynae history taking exercise: Student: How many times have you been pregnant? Patient: Once. Student: Great, boy or a girl? Patient: It was an abortion.

Or most embarrassing, to date, by yours truly: Consultant: Now feel for the enlarged lymph node. Me: Err is that it? Consultant: That’s the mandible.

Big News for Griffith: For those seeking an update on the common room situation – this is now a beautiful large common room, fitted out with new furniture and even a ‘stress reduction device’ aka a punching bag. Provided by our year 1 and 2 coordinator. Seriously.

James Cook University by Laura McAulay What’s Been Happening: Since the graduation of JCU’s class of 2010, the new JCUMSA executive headed by the wonderful Christine Pirrone has been at the forefront of providing “wholesome” activities for our students including:

Sign on BBQ with the launch of the BRAND NEW JCUMSA WEBSITE – check it out at www.jcumsa.org.au!

Med camp at Airlie Beach which we mark as a HUGE SUCCESS given that no-one was seriously mauled by sharks or crocodiles, attacked by irikanjies or taken to hospital, despite the first years best efforts!

JCUMSA Debating Series in which we saw Med 3’s triumph over the Med 1’s successfully arguing that Medcest DOES NOT equal success. A controversial topic we know – but maybe think about this result next time your caught looking at that girl across the lecture theatre!

UN Trivia Night – was an amusing night for all, eventually won, although controversially by the GERMAN TEAM in laderhousen who “conveniently” got the 1st placed team disqualified after a cheating incident with an I-phone that shall not be named!

Something amusing: Un-named O&G Resident: “Laura, whats the name for a 3rd-4th degree tear during birth called” Laura: “Isn’t it just a 3rd-4th degree tear” Un-named O&G Resident: “No Laura, It’s a VAGANUS” (pronounced: vag-anus) Laura: “No way – that’s a serious medical term!?” Un-named O&G Resident: “ Of course!”

2 days later: Consultant: “Laura what’s that” Laura: “It’s a Vaganus” Consultant: “You really are a little special, aren’t you laura” Lesson of the story: vaganus is NOT a real medical term for those as gullable as myself! 26 Big News for JCU: Convention – JCU’s greatest attendance ever! JCU students over mid year break are riding from Townsville to Sydney, raising money for angel flight!

Monash University by Catherine Pendrey What’s Been Happening: O-week Shenanigans – new Monash meddies shared many bright ideas about futures in medicine and memorable night on the town. MedCamp – all survived the weekend in rural Victoria to welcome new meddies World TB/Close the Gap Day – brought together the MUMUS, Ignite Global Health Group and WILDFIRE rural health club to advocate for better world health Pleasant Friday Evenings – have allowed students to let their hair down and enjoy a night away from study ThinkTank - continues to forge ahead, writing policy to develop student skills and advance medical student wellbeing and community health from a local to global level MedOrchestra - harping on and sounding blissful. Good Friday Appeal Volunteering – the MUMUS Community and Wellbeing facilitated involvement in the annual Royal Children’s Hospital appeal. AMA Doctors in Training Carefactor Workshop – took Victorian students through survival skills for personal wellbeing and peer support Year 5 lecture series - provided final year students important skills training for jobseeking and internship Monash University Konvention Enjoyment Group (MUKEG) – is building up for July

Something amusing: There is ongoing debate at Monash about the the etymology for the proposed verb ‘ThinkTanking.’ Advocates for policy development argue that ThinkTanking should relate to the noun think-tank, defined by the Oxford Pocket Dictionary as ‘a body of experts providing advice and ideas.’ Opponents have pointed out that clothing would require unconventionally large pockets to fit Oxford’s pocket edition and have instead put forth a definition to describe a sport, inspired by chess boxing, that would combine alternating competitive rounds of thinking and armored conflict.

Big News for Monash: The new-and-improved MUMUS has forged ahead with the separation between academic and social functions, allowing improved academic representation and social events alla Vita Bella. Monash University registered record numbers for the Global Health Conference and was in close third, at last standing, behind only two of NSW many medical schools. Monash has also punched above its weight for Convention and looks forward to bringing the force of numbers to the biggest AMSA events of the year.

The University of Newcastle by Rosanna Olsen What’s Been Happening: First Year First Day, Ocamp, ‘First Incision’ cocktail party, Charity Launch Trivia Night, Amazing Beach Race, Cops & Robbers Pub Crawl, Electives Night, The Great Debate

Something amusing: Grad Ball 2010 featured as the after dinner speaker none other than the recently appointed University of Newcastle Pro-Vice Chancellor of the Faculty of Health – Dr Nicholas Talley, of textbook fame. Dr Talley was heard to remark during his speech that should such and such an event not occur, “well then I jizz in my scrubs”. Please put that in your next book Talley.

Big News for Newcastle: A major review of the BMed course has been announced, and everything is on the table. The next few years could see a big shakeup at Newcastle. Can we again deliver a revolution in the way medical education is delivered in Australia? Can we stop resting on our laurels of 30 years ago? It’s an exciting time for us and our UNEMSA brothers in the JMP.

27 University of Notre Dame, Fremantle by Kate Hooper

What’s Been Happening: MED100 O-Camp, Back to School Uniform Party (Social), Med100 Survival Night (Education), Surgical Interest Group Lecture Night (Surgical Interest Group/Education), Day in the Park (Sport/ Wellbeing), PBL Games (Social), Rural Night (Rural), Suturing Night (Surgical Interest Group/Education), Bed Push (Social Justice), Movie Night (Social Justice), Cocktail Party (Social), SJOG Clinical Skills Night (Education), Women in Surgery Dinner (Surgical Interest Group/Education)

Something amusing: Participating in medical trials to earn some cash on the side is a well worn path for many medical students. Trials can ask some interesting things of participants. A trial being run in Perth needed healthy females to test out a new type of lubricant… Testing involved you, a special kind of...rabbit, aforementioned lubricant, 4 hours in a room with some special dvds and at least 30 thrusting movements. You got to keep the rabbit...

Big News for ND Freo: Organisation of the West Australian Leadership Development Seminar with UWA has begun and Footy training is well and truely underway (better bring it UWA)!

In 2011 we will have our biggest Convention delegation ever at Sydney! We’ve been busily preparing the best group costumes you have ever seen and we’ll be bringing back our day uniform...GG eat your heart out.

University of Notre Dame, Sydney by Kerryn Houghton What’s Been Happening: MANDUS has started the year with a bang! We have had MedCamp, Med2 Orientation and our Circus Freaks Themed Harbour Cruise. But don’t be mislead MANDUS is not all about having a good time with the profits from our Harbour Cruise helping to fund our Birthing Kit Assembly Day later in the year.

Whilst our Academic and International Health Teams ensured that they would not be left behind by hitting the ground running with both our Life Beyond Uni Series and our International Health Study Program well underway.

Something amusing: My awkwardness following a good 20 minute rant to one of the scrub nurses about why I would hate to become a radiologist. Only to discover whilst scrubbing with my Reg, that he is leaving surgery for radiology. Add to that my pitiful attempt to get out of my hole with “But you are going to do INTERVENTIONAL radiology.”

Big News for ND Sydney: Not only do we finally have a Dean and are slowly returning Professor Gavin Frost to Freo but quite possibly more exciting MANDUS finally has its own website! Check it out @ mandus.org.au – hey its only 4 years in the making!

28 University of New England by Linus Armstrong What’s Been Happening: 2011 kicked off with the annual OCAMP (joint with Newcastle), providing a good opportunity for first years to get to know each other. First incision, UNEMSA’s icebreaker social event of the year was also a huge hit by all accounts. Med week this year consisted of a scribble themed pub-crawl, fluoro bowling and laser tag, sports day (including the commencement of cascade cup practice), and many other social events. The GPSN trivia night was also a massive success, seeing stacks of prizes being won and fun had by all. Finally, our annual Medicine Ball was held on Saturday the 14th of May. It provided us students with a great opportunity to raise money for the Armidale hospital and to the thanks the clinicians and staff for their teaching and support. There were also student performances, raffles and silent auctions, which made the night a highlight of the year.

Something amusing: During OCamp, one of our students decided to ‘get in touch with nature’ by going for a midnight nudie run on the beach. Upon being questioned WHY he continued to stay naked afterwards, he promptly replied with “It’s mine, and I will show it to whoever I want!”. Touché

Big News UNE: Our search for a new head of school has finally come to an end! Professor Peter McKeown has accepted the position of Professor and Head of the School of Rural Medicine at UNE. Professor McKeown has extensive experience and clinical expertise and is a respected senior surgeon with an international reputation. Welcome Professor McKeown!

The University of Melbourne by Eric Lo What’s Been Happening: UMMSS Careers Night, UMMSS Trivia Night, UMMSS @ Run4theKids 2011, UMMSS Movie Night for the Japanese Natural Disaster Victims, Western PFA (Code Black),

Something amusing: While on Psych rotation, the Medical Student Syndrome reared its ugly (sometimes apt) head – Psychiatrist: So do you have any other questions about that? Student: No, I don’t think so. Thanks so much for the morning Psychiatrist: Okay, so you sure you don’t have any other questions for me? Student: No Psychiatrist: because I have time and if you have anything you’d like to talk about, I have time now.

Big News for Melbourne: For a couple of years now, we have been bereft of new blood; fresh meat as it were. Thanks to the much talked about Melbourne Model and its medical offering the MD Programme, Melbourne people have been invigorated with their enthusiasm and readiness to join the medical fold.

While the MDs are here to stay, one mustn’t forget the importance of the MBBS cohort. At Melbourne, we haven’t. Both cohorts are well represented within UMMSS and with the faculty. The Faculty understands that while the new needs assistance getting up and running, the old needs support to help continue the high standard of education. All in all a great transition period for Melbourne.

29 University of New South Wales by Henry Ainge Allen What’s Been Happening: Since the year kicked off with the 1st years’ MedCamp we’ve been entertained by the comedic genius of MedRevue, shocked by the debauchery of the annual Pubcrawl, serenaded by the musos of ClassicQuest, and shown our charitable side at the Amazing Raise. (when we aren’t busy preparing for Convention).

Something amusing: Paeds OSCE station. Do a basic paediatric examination (Height/weight/HC) on this child. Student walks in: “Hi im....where’s the child” Paediatrician: “%&#$, he must have gotten out again”

Big News for UNSW: Our brand new lecture theatres and student area are being torn down to make way for...something.

University of Queensland by Bav Manoharan What’s Been Happening: Welcome back keg, First year welcome BBQ, International student BBQ ( some did the rain dance to well), UQMS Sports Day, UQMS Ashintosh Coffeehouse, Tomfoolery, Family BBQ, UQMS May Ball, UQMS QLd Medical Orchestra Performance- Sinus Rhythmia

Something amusing: Our social convenors and academic/community representative elections in February were quite heated this year with some younger candidates taking to posting their GAMSAT & GPA scores on our forums…. Suffice to say, last I checked these individuals had quit UQ med, had name changes and fled to Melbourne, where they felt more accepted.

Big News for UQ: The UQMS has launched its brand new website this year! After leading the pack in the AMSA best medsoc website competition every year, failure last year stirred the competitive spirit of our newly formed multimedia team. Following a lot of preparation, testing, abuse, jokes about Canadians and someone trying to hack our old website, we have a brand spanking new, shiny, glimmering, fandanglely smooth new website. Check it http://uqms.org. That trophy is ours.

Oh - there’s other stuff that is important as well, like new quotas for grad entry MBBS/undergrad entry BSc/MBBS students (in affect for 2013), the UQMS having new offices, our first group of American students starting their clinical years in our New Orleans Clinical school.

I’m sure there’s more, but with days till my O&G exams and just having worked out that ‘synto’ is not some type of alternative music loved by midwives, all I can think about is post exam inebriation.

30 The University of Sydney by Jessica McEwan What’s Been Happening: MedSoc Re-Structure and Elections, New SUMS Website, New Clinical School Opening, Closure of the SUMS Bookshop, O Week Activities, MedCamp, Delegate Improvement Committee (DIC) Meetings in preparation for Convention, Red Party – Where’s Wally Theme, MedBall – Masquerade, MedSoc Retreat, RAW Surf Weekend, Rural Discovery Bus Weekend, NSW MSC Annual Cocktail Party, World’s Greatest Shave Fundraiser

Something amusing: My most amusing time so far this year was the shenanigans that occurred during our first year Med Camp. Being forced to stay sober as a mentor on one of the two nights meant that I was witness to many amusing anecdotes. This is included but was not limited to naked cartwheels, the goon lagoon and sexy loving times in the bush! However my favourite story of the weekend was that of our most outrageous new first year who obliterated himself so much on the first night that we were forced to call an ambulance to take him to hospital. We were shocked when he returned to camp the next day having walked over 20km to get back because he was so determined to keep joining in on the fun!

Big News for USyd: It’s our 125th Birthday this year! Happy Birthday SUMS!!

The University of Western Australia by Kaitlin McGinnis What’s Been Happening: Graduation of 100% of last year’s 6th years, Grad Week and the Dedication Ceremony were fabulous, Fresher Camp for our LAST batch of straight-out-of-high-school freshers, Dragonboats, the Freshers lost, again, and the 6th years won, again, Fresher Welcome – no one remembers anything, TEFKAFR (The Event Formerly Known as Fresher Rivercruise) – held at a different, on-land location. Totally awesome, just sayin’, Student Grand Rounds tutorials for 3rd years, Relaxation and Stress Management Workshops, 4th year camp, Global health information and projects nights, Allied Health – the biggest student-run event in WA, AMSA ThinkTank meeting.

Something amusing: TEFKAFR was held at SciTech – the WA equivalent of the Powerhouse Museum or Questicon. This is after all the boat companies in Perth decided to ban WAMSS from holding events on the water. Not only were SciTech letting us on site, they also let us loose IN THE EXHIBITS. We got to play with gravity, light, things that move and a bunch of nostalgia inducing displays. WAMSSy good times ensued, lots of dancing, some responsible inebriation and a fair bit of macking, all in a colourful educational backdrop just waiting to be broken. As a testament to the medical professionals of tomorrow, WAMSSunists were very well behaved, only one plush shark toy found its way into an aquarium, and everyone got out alive. And to top it all off, SciTech are open to the idea of potentially maybe having us back. But not Science Union, they are banned forever.

31 The University of Tasmania by Golsa Adabi What’s Been Happening: First Year Orientation, Med Camp, Societies Day, Med Welcome, International Student Function, TUMSS Cocktail Party - ToyChest, Pre-Clinical Lunches, Clinical MDO Lunches, MedSoccer, MedNetball

Something amusing: It’s a full house, Imagine a nightclub filled with characters from your ToyChest, drinks are flowing, dance floor is going off (with excited Lego men), a game of twister is happening near the bar, there is a swimming pool of balls, what could possibly go wrong? Well, only a Fire alarm and the evacuation of the entire nightclub!

Big News for UTas: With student numbers at an all time high for our University, and confusion amongst students regarding Clinical School Placements choices, TUMSS has been working on developing a ‘Clinical Schools Information Handbook’. This publication, due to be released in late May has detailed information about each of the three Clinical Schools including details about individual rotations at each hospital.

Other new initiatives for the year include the TUMSS Leadership Development workshop and the TUMSS Graduation Seminar.

TUMSS Cocktail Party has so far been the highlight of the TUMSS social calendar for 2011 with one of the largest attendance on record. The theme of ‘ToyChest’ was well received by all and resulted in attendance by characters such as Superman, Troll dolls, Little red riding hood, Lego men, Aladdin, Pocahontas, ,Cat Woman, Elmo, The Cookie Monster and even Ken and Barbie! Get set for the next biggest event of the year…TUMSS MedBall.

The University of Western Sydney by Samuel Rajadurai What’s Been Happening: The UWS Medical Society (UWSMS) kick started the year with an edition of eMUWS (mUWS blast), one of our major publications, which is being delivered to all students on a three-weekly basis to keep them “up-to-date with the need-to-know- NOW”. Another publication, “Neoplasm” was released to the new first years before they commenced med school – it is in effect a useful guide containing relevant information about our executive, AMSA, Medcamp etc.

After taking over the reins from last year’s UWSMS exec, the new exec have big plans for 2011. Successful events that have already been held including O week 2011, Welcome back BBQ’s for each year, Med Camp 2011 – Pirates of Campbelltown + “Sailing the 7 Seas” Party, PBL Games + Movie Nights, Blue Moon Party, Twilight Festival, UWSMS Electives Night

In 2011 the UWSMS is interested in further increasing its services to members via the development of our Membership Benefits Scheme (MBS) and the companion Membership Benefits Card. Experiencing great success in its inaugural year 2010, the MBS established partnerships with many local businesses – allowing students to present their cards and receive a discount on certain goods or services; this attracted students to stores and increased their businesses.

Future big events planned for the rest of the year include the Leadership Development Workshop, Halfway dinner for our 2013 graduation, UWS Inter-year Sports Night, AMSA debating series, AMSA vampire cup, Surgical + Medical clinical workshops, First ever UWSMS 2011 Graduation Event.

Something amusing: It was during the winter of 2009 that a friend went missing for one of the nights of Brisbane’s AMSA Convention, and couldn’t recall anything from the night. On the flight back to Sydney the next day, he noticed an aching pain in his gluteal region. A little concerned and now curious to find out what was causing the pain, he went to check out this painful region of his body. What he discovered cleared up some of the haziness left from the ‘unrecallable night’. To his surprise, and shock, was a large tattoo of the name of an unfamiliar person (of the female variety)... Big News for UWS: 2011 has definitely been a well anticipated and exciting year as this is the first time our med school has a full house, with students from years 1 to 5. Especially important is that we will be producing our first ever UWS medical graduates – Huge News!

University of Wollongong by Nishan Yogendran What’s Been Happening: Med Camp 2011, Pub Crawl, Electives Night, Women in Medicine, Clinical Mixer

Something amusing: Upon commencing their first day on full-time hospital rotations, a new Phase 2 student was randomly selected by the Professor of Medicine during the orientation pep-talk, and asked what his plan was today. Amongst the nervous cohort and various doctors in the auditorium, the student confidently replied, “I aim to expose myself to as many patients as possible”.

Laughter ensued at his unfortunate choice of words.

Big News for UoW: It is with great amusement that we welcome (steal) Prof Alison Jones as the next Dean of the Graduate School of Medicine (GSM aka the GiSM). Prof Jones is currently Dean of the School of Medicine at the University of Western Sydney (UWS). She was awarded her MB ChB and MD degrees from the University of Edinburgh Medical School, and later spent 8 years at Guy’s and St Thomas’ Hospital in London where she was a consultant physician and clinical toxicologist as well as Head of Medicine. Before taking her current position at UWS she was at the University of Newcastle where she held the position of Professor of Medicine and Clinical Toxicology. She is an active researcher having published >150 peer-refereed articles and book chapters.

Prof Jones will assume the position on June 1, 2011.

We thank Prof Don Iverson (Interim Dean) for his amazing support and dedication.

33

A Rangers survival guide by Jessica McEwan (USyd)

Outwit. Outlast. Outplay. I thought about changing the well-known catch phrase of the Survivor TV series but then I realised that these three little words really encapsulate all that is need to survive Convention week. Let me explain....

36 Universities that do this well: The Convention Committee – Always well-seasoned Rangers that Outwit manage to do all this and more! This really covers the academic portion of the week although could be applied to other areas. Can you outwit other med students with Universities that do this poorly: your witty debating comebacks or the best question in the plenary Bond – pretty sure only 3 of them even made it to Convention last year session? To outwit another med student you need to utilise more than the natural smarts you have always relied on to get you through your barrier assessment. Outwitting at Convention takes the challenge to a whole new level. You know a Ranger is smart, as everyone here has Outplay already overcome the barrier that is registration – an often-elusive quest. Outwitting another Ranger requires training, detailed planning and often careful timing – oh and an audience to witness your feat! Outplay comes into full force during sports day. Sports day requires a combination of physical strength, skill and strategy to outplay other Outwitting other Rangers often comes in handy in the lead up to Rangers. All of which can be applied to any activity during the day Convention especially when it comes to costuming. Many a facebook from EMC to tug-of-war to Cascade and Pipps Cup. Again to outplay group has been created by a Uni to give Rangers a forum to throw on sports day and EMC rigorous training must be undertaken. around costuming ideas only to be infiltrated by another Ranger who takes advantage of them. Rangers must be diligent in the lead up to Universities that do this well: convention to ensure that their original ideas are kept secret until the Tassie and Adelaide – As evidenced by their performances in big night so that they might win the best costume of the night. both the Pipps and Cascade Cups over countless years. Being able to outwit is an extremely important trait to have but other UQ – As evidenced by their knockout performance elements are needed. in the Tug-of-war at Hobart ‘10 Universities that do this well: Universities that do this poorly: UWA – as evidenced by their debating win in Hobart ‘10 Unknown Unis – Unknown because they UQ and USyd – as evidenced by the zebra and lion costuming that never seem to get on the scoreboard for lead to the infamous lion hunt of ’10. anything at sport day.

Universities that do this poorly: Outwit, Outlast, Outplay is a deadly combination and something that every Ranger should posses Melbourne – need I say more! in order to survive Convention. This can only be achieved by rigorous training in the lead up to Convention and is your only means of survival. A Ranger or a group of Rangers who Outlast can harness these traits and display them to the fullest extent would undoubtedly be a contender for the Convention Cup. Convention is all about outlasting whether it is the last man/ woman standing at social or just making it to every event of the week. Many will perish along the way. It takes stamina and determination to be able to survive a Convention week. For those experienced Rangers, think back, how many people do you know that made it to every single event during a Convention week? This in itself is not an easy feat. Newbie Rangers – take note! Getting in training now by going out every night and then attending every lecture at uni (and no you are not allowed to sleep!). Only a well-trained Ranger could pull something like this off – this challenge is for the all-rounder Ranger.

For those of you that like to perfect one thing at a time then you should attempt to outlast at the social nights. Many a temptation will try to lure you away from being the last person standing including weariness, the possibility of getting lucky and the 2am kebab run. To outlast you need to anticipate these temptations and work on resisting them in the lead up to Convention. Being able to outlast is a valuable quality in a Ranger.

37 The Anatomy of the 21st Century Doctor

Nick Watts (AMSA Global Health Officer) outlines the qualities demanded of the next generation of doctors.

Rounding the corner in to the 21st century, we and the needs of the patient and population, find ourselves both celebrating the centennial including: a narrow technical focus without anniversary of the seminal Flexner Report contextual understanding; poor teamwork; on medical education, and facing the rising predominant hospital orientation at the expense challenges of modern healthcare.1 of Primary Health Care; quantitative and qualitative imbalances in the professional labour Acting as ‘Emerging Drivers of Change’, market.2 these challenges take the form of a changing demographic – one which is both ageing, and The education of health professionals (the experiencing an unprecedented prevalence ‘knowledge brokers’) occupies a privileged of chronic disease – increases in societal and unique interface between the generators empowerment, gross health inequities between (Universities) and recipients (patients) of and within countries, and the dire health impacts knowledge in our healthcare system.2 Such a of globalisation, and climate, to name a few. The privilege creates an obligation to train students recent Global Independent Lancet Commission in a way that produces a 21st century medical on health professional education presents the professional capable of strengthening health case that without reform, our medical education systems in a globally interdependent world, system risks falling out of touch with the looking to meet the needs of patients and populations it was set up to serve.2,3 populations in an equitable and efficient manner. Such an imbalance will result in a fundamental AMSA fundamentally believes that health is mismatch between graduate competencies about people, and with a health system and health education reform agenda sweeping The next question becomes “how?” – how do we across the globe, we wonder “what kind of health ensure we’re trained to best serve our patients professional do we need to be to meet the needs and populations? The answer is threefold: of tomorrow’s populations?” clarity about the dynamic challenges in modern healthcare and the kind of professional that Determined to find an answer to this question, can tackle them; an attitude of responsiveness AMSA searched far and wide, and with the help with the curriculum that educates us; and an of the Lancet, universities across the world, and involvement in the extracurricular activities the World Federation of Medical Education, we available to us. may just have an answer for you! A rich engagement in extracurricular activities, st 2-5 This 21 century medical professional is: as well as a curriculum which espouses the principles of a 21st century medical professional Socially Accountable: will help to develop a health workforce ready to tackle the future challenges in healthcare. In line They’re responsive to the needs and health with this, AMSA joins a call for a renaissance priorities of the community and capable of towards a “new” 21st century professionalism directing services and resources to areas of — centred around the interests of patients and health inequity. populations, team-based, socially accountable and upholding a strong service ethic. 4,6

A Systems Thinker: 1. Flexner A. Medical education in the United States and Canada: a report to the Carnegie Foundation for the Advancement of Teaching. New York; 1910. 2. Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new They have a comprehensive understanding century: transforming education to strengthen health systems in an interdependent world. The of their role within the healthcare system and Lancet. 2010;376(9756):1923-1958. 3. The Association of Faculties of Medicine of Canada. The future of medical education in the community, and are able to apply this Canada (FMEC): a collective vision for MD education. Ottawa; 2010. understanding to a patient-centred model of 4. Boelen C, Woollard B. Social accountability and accreditation: a new frontier for educational institutions. Medical Education. 2009;43(9):887-894. care that values a social determinants approach. 5. The World Federation of Medical Education. The Global Role of the Doctor in Health Care. Copenhagen; 2011. 6. Australian Medical Students’ Association. AMSA policy on Global Health in the Medical Globally Interconnected: Curriculum. Canberra; 2010. They work towards increasing global interdependence by harmonising health and education systems, embracing international networks and alliances, and harness global flows of educational content, teaching resources and innovations for the local context. An Advocate and a Leader: They recognise the social responsibility of the medical profession to advocate for the equitable distribution of health. They actively engage with the various political, economic, environmental and social determinants of health, working with key stakeholders from every profession to safeguard the right to health for the populations they serve. Of Melodies and Maladies

Suyi Ooi and Yota Yoshimitsu (Deakin Medical School)

edical school is a challenging time and It is quite clear that music has an intertwining studying can become an all-consuming harmony with medicine. And not surprisingly so. Mpassion for many of us. As we gradually Both require focus, some determination (although morph into a bleary-eyed, two-legged creature living mostly ambition), dexterity (unless you play the and breathing medicine, it is so easy to forget that viola*), listening skills and an eye (and ear) for all of us have other interests, whether it be baking, detail. Both can be therapeutic. There is something sports and the easily forgotten (but not uncommon truly satisfying about a sublime blend of harmonies, in the medical fraternity) playing music. “What are which is similar to the euphoria felt when you finally your plans for the weekend?”“Nothing much, just discover you can hear Grade 1 heart murmurs, heading off to band camp”. After the immediate or the reassuring metronomic beep of the heart fears of a 6.00 am wakeup fanfare from the brass monitor – a beautiful illustration of the fact that section dissipate, one realises that rehearsing in a there is beat, rhythm, volume and character within cold dusty hall in the middle of woop woop with all of us. your fellow music nerds is a passion that lies close to many of our hearts. Alternatively, the basis of History is replete with famous doctors who have your so-called passion may be more mundane, managed to combine a love of music and medicine. when you find yourself digging out the old guitar Fritz Kreisler, born in Vienna in 1875, become a that you were too lazy to practice in high school, world renown concert violinist before he was 20 but now suddenly feel like strumming in desperate years old, but gave this away to study medicine. He need for an Activity of Daily Procrastination (ADP). went on to become a medical officer in the Austrian 40 Army, but there must have been some dissonance tendonitis, carpal numbness or left forearm pain in this plan because he eventually realised that along the ulnar border[2], you should think “could music was his first love, and went onto become this person be a muso?”. And vocal cord fibrosis? one of the greatest violin virtuosos of all time.[1] The treatment ain’t over until the fat lady sings.

Aside from all the serious medical stuff, the question “The all-encompassing relationship begs - why are so many medical students and doctors between music and medicine is musical? Henry Wadsworth Longfellow once said “music is the universal language of mankind”. There relevant not just for Doctors cum is nothing quite like the camaraderie, the shared passion and the friendships arising from music Musicians, but also for non-musician which can unite diverse groups of people, medicos doctors” included. After prolonged sessions banging your head against Kumar and Clark or sleepless nights on-call, musos have the pleasure of being able to However, interests do not necessarily have to swap their stresses for the soothing caresses of compete and many doctors have managed to Schubert, Beethoven and Mozart (or, if so inclined, make music and medicine co-exist within their the decidedly less soothing Sonic Youth, Barry lives. Aleksandr Borodin happily led a career as Manilow or Megadeth). Some of us actually wanted a composer, cellist and a chemist. The pioneering to study music but needed a key change, not to surgeon, Theodor Billroth (remember the c[h] mention a vocation that doesn’t make us look like ords of Billroth?), was an accomplished pianist, chai latte-sipping hippies carrying around machine violinist and music critic. And we cannot forget the guns in large cases. towering achievements of Albert Schweitzer, 1952 Noble Laureate, physician, theologian, philosopher, We could continue to speculate, but we’d musical scholar and organist. rather leave the issue undiagnosed. Our only recommendation is that before you dust off that The all-encompassing relationship between music old trombone, triangle or harmonica (as therapeutic and medicine is relevant not just for Doctors cum as it may be), may we suggest that you get the Musicians, but also for non-musician doctors. informed consent of your housemates before you Tickling the ivories is not so fun when 75% of all unleash your cacophony? music-related maladies (like muscle and ligament injuries) arise from pianists (followed, in decreasing * One of the authors (YY) vehemently disagrees order, by string players, guitarists, woodwind with this absurd, violinist-centric notion. players and drummers)[1]. So if you see rotator cuff

References

1. Cerda, JJ., Art in Medicine: musicians, physicians and physician-musicians. Trans Am Clin Climatol Assoc, 1993. 104: p. 228 – 34. 2. Potter, PJ., Jones IC., Medical Problems affected musicians. Canadian Family Physician, 1995. 41: p. 2121 – 28. 41 THE MUSIC DIGEST Lee Fairhead (UWA) reviews some auditory awesomeness...

Bon Iver – Bon Iver Released June 17, 2011 The wait is over. After producing the truly memorable debut ‘Emma, Forever Ago’, Bon Iver are back with their follow-up self-titled album. Led by Justin Vernon, the loose-knit group has produced a beautiful album described by the lead singer himself as “a little less achy”. Three years in the making, the album has track titles riddled with place names such as Michicant’, ‘Calgary’ and our very own ‘Perth’. Eloquently crafted lyrics and simply beautiful music make this album a winner from the opening track ‘Perth’ to the closing, 1980s inspired, Beth/Rest. While you might find it hard to make sense of some of the lyrics, there is no doubt that Vernon is a poet; and Bon Iver make sublime music. Similar to the surrounds in which it was recorded, ‘Bon Iver’ is best listened to curled up in front of log fire, red wine in hand. But even if you aren’t whisked away to a romantic log cabin, it’s still a great listen.

Hugh Laurie – Let Them Talk Released May 9, 2011 House. Making music? I know, and blues music at that. Apparently earning $400,000 an episode wasn’t enough so Laurie has fulfilled a lifetime dream to make a blues album which was launched by his first live performance in the home of blues, New Orleans, back in March. Clearly this is just a side venture for a middle-aged guy with the means and opportunity to experiment with his talents (Laurie is a classically trained musician with a long history of musical pursuits). With ‘Let Them Talk’, he pays tribute to the music he loves, covering 15 songs along with guest artists Sir Tom Jones, Irma Thomas and Dr John. To be honest though, I only made it through three songs. Maybe it is because it is House, maybe it is the pretty dull song-writing; I don’t know. Either way, it just doesn’t sound right. As Laurie himself explains ‘I am a white, middle-class Englishman, openly trespassing on the music and myth of the American south.’ Well, at least he is honest.

42 The Wombats - The Wombats Proudly Present... This Modern Glitch Released April 22, 2011 Propelled by their popularity among teenage girls, festival-goers and commercial radio stations, The Wombats have become the indie ‘it’ band of the year. ‘Modern Glitch’ is their sophomore album and offers up more of the same catchy records that made them famous on the indie circuit back in 2008. However, beneath their glossy, up-tempo presentation, the Liverpool natives are actually quite a serious band, with a serious leader. For lead singer Matthew Murphy, the album is particularly personal with some pretty dark and brutally honest lyrics, influenced mainly by his battle with anxiety and depression. In particular, Anti-D chronicles his relationship with the drug citalopram and Jump Into The Fog tells the tale of a sad, lost young man taking a prostitute back to “the kind of place you should bring your own UV ray”. Of course, not every song is as deep and other tracks such as Techno Fan and 1996 just speak directly to twenty-somethings out to have some fun. In the end though, the dark lyrics combined with the festival anthem music doesn’t quite fit, but, as most teenage girls will tell you, it is still worth a listen.

Seeker Lover Keeper – Seeker Lover Keeper Released June 3 2011 Combining the talents of three of Australia’s foremost female songwriters – Sarah Blasko, Holly Throsby and Sally Seltmann – Seeker Lover Keeper was garnering interest well before its official release. Prior to the release of the album, the trio released three songs onto their website along with three theatric and artistic videos featuring acclaimed Australian actors – Barry Otto, John Waters and Aden Young. The artistry defines the project. Throughout the album, each artist alternates as lead vocalist, and, most often, it is singing a song one or both of the others has written. It is a true collaboration that effortlessly incorporates beautiful and dazzling sing-along pop tunes centred around the theme of love and relationships and how difficult it can often be once they’re ours to lose or keep. Bridges Burned and Even Though I’m a Woman are definitely highlights, but the whole album is beautiful, not ground- breaking, but beautiful nonetheless. 43 The Lizard-Spock Expansion

Stefan McAlindon (AKA Baron Von Stefanburg) of Flinders origin, knows that you have to be brainy to be a med student, but some people go that little bit further....

E = MC2

44 hat would you be if you were attached “Nerds everywhere can “Wto another object by an inclined plane, wrapped helically around an axis?” The answer is wear their Star Fleet screwed, and a nerd. But that’s ok, geek sheek is in (or so I keep telling myself), with med students all around the country “making it so.” But uniform with pride (from how does one spot one of these reclusive creatures. Nerds have learnt to leave the pointy ears at home when venturing into the final frontier the safety of their (human interaction), making them difficult to identify. If you’ve gotten the nerd references I’ve already made, then give yourself the Rimmer mothers’ basement of salute and get back to your comic books, you’re a nerd. course)” Ok, so I figure about half you reading this have picked up a comic book by now. Unfortunately the rest of you aren’t off the hook just yet. While none of the above are diagnostic (except the Melbourne Uni Before you start claiming you’re not a nerd, just a jock that was too one), they are positive predictors for being a nerd. Where did the word cool to play sports, let’s examine what makes a nerd: nerd even come from anyway? It was the brain child of (the-not-a-real) Dr. Seuss, first appearing in his book, “If I Ran the Zoo,” where a nerd 1) If you have ever said the phrase: “it’s not cartoons, its anime” features as an imaginary animal. Popular culture has the word nerd 2) You study at Melbourne University originating from the inverse of drunk, knurd, as nerds are considered shy, socially awkward people, unlike an intoxicated person. 3) You don’t play rock-paper-scissors, you play with the following rules: “Scissors cuts paper, paper covers rock, rock crushes lizard, lizard This seems an almost contradictory statement. I’ve been to poisons Spock, Spock smashes scissors, scissors decapitates lizard, convention, and I’ve seen how much med students can (and do) drink, lizard eats paper, paper disproves Spock, Spock vaporizes rock, and as it and yet I’ve also met a lot of you med nerds. How can you be both always has, rock crushes scissors” a knurd and a drunk? The answer is that nerds are cool, well not all nerdy characteristics, but popular culture has borrowed several nerdy th 4) You get the following joke: A neutron walks into a bar and asks how traits to make people stand out as individuals. 20 century nerds were st much for a drink. The bartender replies “for you no charge.” pioneers for 21 century individualism. Who would have guessed that those 4-eyed, spotty little urchins would actually change modern 5) You have more than 2 seasons of any TV show on DVD society?

6) You have been called, or have called another a noob In fact nerds have accomplished some great things in the last 100 years. They took us to the moon, and then tried to convince us that it was 7) You bear the scars of being pwnt all a conspiracy. They invented the computer, and then they invented Windows to get back at Jocks. Yep, the world would be a pretty 8) You hang things off your belt (phone etc) different place without nerds. Nerds everywhere can wear their Star Fleet uniform with pride (from the safety of their mothers’ basement 9) You own a Mac because you think it’s cooler than a PC of course). Finally I’d like to give a shout out to the people that dressed as Dr. Who and the TARDIS (Time And Relative Dimensions In Space 10) You own a PC – but you already knew that) at convention last year. You sir are a revolutionary, one who sees beyond the restraints of social norms and 11) You have ever threatened someone with: “Someday you will be reaches ever forward towards greatness – and you are also the biggest cleaning my swimming pool” nerd I have ever seen.

45 thats all, folks

Dr Jay Meekay was asked by Panacea to dictate an article whilstspending time in witness protection. He was told it could be on the topic of his choosing, but instead, appears to have dictated his latest auditory hallucination....

Editor’s Note: If you can’t make sense of this article, you’re not alone...

46 h, the rushed, last minute, “we can’t print until Are we becoming a society of gestalt? I have to you submit your article” article. My old friend. admit, that I don’t know whether that was the best aTime and age may bring wisdom, but with wisdom word choice, but it’s a bit of a current favourite word comes an increasing apathy towards rectifying ones of mine (I have a rotating roster), and I wanted to slip tardiness and outward disregard for the institution it in more than once in this article. of deadlines. Why is that?

I actually had a semblance of an actual piece of social Perhaps it’s just me. Perhaps the aging process to commentary forming in my head about a paragraph which I’ve been subjected, has, rather than endow and a half ago, but it has since left, and this article has me with a heightened ability of self-reflection and deteriorated into yet another stream of consciousness empathy, instead simply served to enhance my ramblings that has most likely done nothing more narcissistic qualities, augmenting my indifference than to instil a sense of doubt as to the lucidity of to the deadline-stretching angst of one particular my grasp on the world outside my own reflection. publications officer. It is widely supposed that narcissism is inversely Ah, narcissism, that’s where we started this whole proportional to chronological age. Why then, do thing. Yes - shirking on one’s commitments and openly I find myself scraping against the splinters of my not caring about it. I actually do care a little though, compassion barrel in order to empathise with the Mostly because I know that men with eyebrow torment my constant putting off of writing this rings (or bolts? What do you call that?) hide a raging article is causing an other? Probably because the aggression behind an impressive façade of calm and shoes I’m supposed to be imagining myself walking understanding. I won’t be burnt twice. They also in are not particularly nice. His actual shoes. No tend to do you a whole bunch of favours recently. metaphor there. I don’t like his shoes. They won’t do. So, this article comes delivered to you after an epic struggle against my own apathy and inflated I realise that I’m beginning to sound a lot like sense of self worth. I’ve even resorted to giving my the protagonist from American Psycho, which is own reputation a flogging in the quest to produce surprising, because I’ve never read the book. But something. As my father always told me – when the comparison still occurred to me. Is it wrong or you think you’ve got nothing on which you can lean, unethical to make a pop culture (is that even pop remember that you’ve always got double-negative culture?) reference if one is not intimately acquainted self-depreciation. with the actual material, and only the gestalt created by previously absorbed references (hopefully made by people who actually have read/seen/heard the Editor’s note: While I do indeed have an source of said reference). I think it’s OK. A deep dark eyebrow piercing, any “raging aggression” secret of mine is that I have never seen Star Wars within will be avoided upon submission of an – well, none of the “proper” episodes anyway – article that actually makes sense for Panacea 2. however, I don’t feel the slightest bit dirty at making a Star Wars reference or understanding one when it crosses my path.

47 Going up?

It’s that classic one liner that we’ve all used at one time or another, but is it really the ideal elevator chatter? Falk Reinholz (UWA) presents a guide to navigating this oft-fraught social dynamic.

n this modern era of multi-storeyed residential awkwardly amongst the poorly selected musical and commercial infrastructure., using an elevator overtures, thoughts come to mind: ‘do I ask a follow is a part of daily life for most of us. In light of their up question?’, ‘they didn’t really give me much to work Ipopularity, one might reasonably assume that using the with, should I force the situation further?’ and ‘if a elevator should be a simple matter of getting on at one dialogue is actually established, do I really want to tell a level and stepping off at the desired stop. Unfortunately complete stranger anything about my life?’ As you both though, this short interlude in the day can present many ruminate and wrestle with your inner demons you will challenges. probably find you have gotten to where you are going before you even know it. Now that is one way to negotiate this situation. It is clearly suboptimal. A far better approach is this: Setting the scene akin to asking that pretty girl that catches your train everyday what the time is to get the conversational You are one of two people using the elevator. You are ball rolling, simply ask in a friendly manner ‘hey mate/ on the ground floor of a large building (say, for example, ma’am/sir/dude/friend, would you mind pressing a hospital) and have patiently awaited the elevator. As level four for me?’ This is an ideal opener as it is a non- it opens you notice there is already someone on board intrusive request that immediately breaks the ice and that has made the rookie mistake of getting on an lightens the mood (hence why manner is so crucial). elevator going down with the intention of actually going This should allow for a gentle start of conversation up (something else that really pushes our buttons!). As but remember to keep to superficial topics (who does such they are a little flustered, promptly alight their want to share personal details about themselves with level and take a stance near-ish to the button panel. complete strangers they will never see again, after all?). Some favourite topics include local sporting teams, the weather of late, topical news stories (elections, natural disasters, etc) and the Bristol scale. If things go the other Two differing scenarios: way and you get a cold-blooded button-pressing non- talker then you have not lost out either. The first moment is crucial. One must be figuratively and literally on the front foot to contrive this social And, as tough as this is to admit, at the end of the day construct to achieve a desirable outcome. Firstly, one you could probably just calmly press the appropriate could probe with the tried and true “going up?” and button, do nothing and stand there in silence. I am not variants thereof, like “so, level seven, eh?” This will entirely convinced, but there has been some speculation almost certainly result in an uncomfortable exchange, recently that it will not change your day what so ever. regardless of who has started it. The natural answer and the polite response in essence is ‘yes.’ But where to from there? As that monosyllabic answer is lingering 48 “...allow for a gentle start of conversation but remember to keep to superficial topics...”

49 nce upon a time (quite recently), climate change was cited as the greatest health threat of the 21st century.1 Despite this, the medical profession has not reacted in any significant way. The question now raised is Oshould we, and do we actually need to do anything about it? The proposed disastrous effects of climate change are difficult to contemplate. Extrapolations in climate data commonly seem like huge exaggerations that are far from legitimate. Indeed, climate change is the bad guy and latest health fad in a recent media explosion, with hypochondriac concerns over the threat of climate change being likened to those of SARS and Swine Flu. In effect, this scare campaign has warped the perception of real threat in the minds of our health professionals, who deal with media hype on a daily basis. Furthermore, the health profession is new to this sort of advocacy, and we’re only just beginning to understand it. The idea that humans will respond organically to climate change, adapting to any challenges thrown our way, is not an unjustified one. All organisms need to adapt to their environment to survive. Peak oil production was reached a few years ago and supplies are rapidly declining.2 Eventually, when we run out of oil, there will be a natural shift toward alternative energy sources and an associated incidental reduction in emissions. So should we put efforts into fighting for these changes ahead of time? Debate over the existence of anthropogenic climate change has largely settled. It is now widely agreed that climate change is enhanced by human activities, and is worsening as our greenhouse emissions soar to greater heights. Whether or not the human element of climate change is certain, it cannot be denied that rising global temperatures are already causing havoc, with very real threats to global health. The World Medical Association has adopted a model storm surges and king tides.7 Many more small island that understands the health effects of climate change nations are expected to be underwater by 2050.8 A rise as primary, secondary and tertiary impacts.3 Primary in sea levels of 45cm (a conservative estimate) would health impacts include heat waves, injuries after submerge over 10% of Bangladesh and displace 5.5 floods or fires, and infrastructure collapse; secondary million people.8 Indeed, given current rates of rising sea consequences are spread in vector-borne diseases, levels, the number of climate refugees is expected to food- and water-borne infections, and allergies; and the swell to 250 million by mid-century.8 tertiary consequences include famine, local and regional conflicts, displacement, refugees and developmental If these things are already happening, and all evidence failure.3 suggests that they will continue to worsen, should Australian health professionals be outraged at the lack “this scare campaign has warped of adequate action on climate change? the perception of real threat I say yes. When considering our climate future, we should hope for the best but prepare for the worst. in the minds of our health The proposed effects of climate change, even the professionals, who deal with conservative ones, are too humbling to simply ignore. Climate change seems like a distant problem here in media hype on a daily basis” Australia and it’s easy to just assume that the necessary strategies will be implemented eventually. However we We’re already seeing these effects. In 2010, 42 mustn’t forget that many countries, many of which million people were forced to flee their homes due to are responsible for a comparatively smaller proportion natural disasters.4 We’ve seen glacial lakes flooding of emissions, are already fighting our fight. As health st in the Himalayan region, huge landslides in Uganda, professionals in the 21 century, we should be advocates catastrophic cyclones occurring with increased for the health of all, and we have a responsibility to frequency and severity in the USA and floods in ensure that we advocate for the prevention of further Pakistan. Here at home, continuous drought and suffering in these vulnerable populations. furious bushfires are becoming the norm. The habitat As someone wise once said: “If climate change is as of the Aedes aegypti mosquito has spread further devastating as predicted, the Earth is at stake and we South in Australia than ever before, bringing waves must act now. If it is not and we act now, then we risk of dengue fever in unfamiliar locations.5 Kenya, the accidentally helping the world. There are comparatively world’s fourth-largest tea exporter, faces significant very few consequences of inadvertently creating a threats to livelihoods and economic status as changes cleaner, greener future for our planet.”9 in temperature and rainfall cause crops to fail.6 In early 2009, we saw the first ever ‘climate refugees’ when 2700 people left their homes in the Carteret Islands after battling decades of worsening

References 1. Costello A, Abbas M, Allen A, Ball S, Bell S, et al. Managing the health effects of climate change. Lancet and University College London Commission. 2009. 2. Aleklett K, Höök M, et al. The Peak of the Oil Age – Analyzing the world oil production Reference Scenario in World Energy Outlook. 2010. Energy Policy 38(3):1398-1414 3. Lidegaard Ø, Ricketts M. Climate Change and Health Care. World Medical Association. 2009. 4. Internal Displacement Monitoring Centre. Displacement due to natural hazard-induced disasters. Norwegian Refugee Council, Norway. 2011. 5. Russell R, Currie B, Lindsay M. Dengue and climate change in Australia: predictions for the future should incorporate knowledge from the past. 2009. MJA 190(5):265-268 6. Van de Wal S. Sustainability in the Tea Sector: A Comparative Analysis of Six Leading Producing Countries. SOMO Centre for Research on Multinational Corporations. 2008. 7. Morton A. First climate refugees start move to new island home. The Age, Australia. 2009. 8. Belt D. Bangladesh: The Coming Storm. National Geographic. 2011. 9. Katherine O’Shea, WAMSS’ esteemed Environment Officer. Breakfast, June 2011. You’re Hot then you’re Cold: How to be a left-over masterchef

Laura McAulay (JCU) shows how to cook like a masterchef without that knob Curtis Stone getting anywhere near your kitchen....

“Woman, where’s my dinner”. Although extremely barbaric, this is a phrase my boyfriend (yes, surprisingly still current boyfriend) has used to me (yet more surprisingly) on more than one occasion (although it was said, I must admit, in jest). So it got me to thinking - getting dinner on the table is pretty hard sometimes after a long day at the hospital, university or for those poor soles that have to do so, work! Whilst, I must say, I am a bit of a domestic goddess, I too, struggle to think of things to cook that are not only easy and long lasting but also work well the next day for lunch; because I’m sure that you all know that waking up at 7am and finding something for lunch in a coffee deprived stupor is not only hard, but semi-impossible!

To take the hassle out of that horrible early morning food cupboard scramble for tinned tuna, rice crackers or Mee-Goreng, take a look below and check out how to be the King or Queen of the student tea room next lunch hour! (All meals are gluten free – if you use the right ingredients :D)

52

Tomato Pasta with Chicken (or without for the vego’s out there)

Ingredients 1 can tinned tomatoes (Coles brand – low low price of 75 cents!) 1 onion – diced/chopped/massacred – however you roll really 1 teaspoon of crushed garlic 1 dash of oil (olive/canola/vegetable – whatever floats your boat) 2 rashers of bacon (OPTIONAL – only for those carnivorously inclinded) 1 chicken breast/thigh (OPTIONAL again) Handful of fresh basil or dried herbs Pasta – depends on how much eat! Gluten free works well too

Steps: Place a pot of water on the stove and wait for it to boil. Add a pinch of salt and pasta. Heat oil in a pan on medium heat – add onion, garlic and bacon – cook un- til onion is soft. Add tomatoes to pan and simmer until they reduce. Add chicken and cover pan (optional, if your pan doesn’t have a lid, don’t stress) until chicken is cooked. Toss through cooked pasta and serve!

Worlds easiest mushroom risotto

Ingredients Aborio Rice 1 onion – diced/chopped 1 teaspoon of crushed garlic 1 cupish (depends how expensive mushrooms are!) of sliced mushrooms (button or field are good) Dash of oil (I use olive) 2 rashers of bacon (optional – I think you might have seen by now that I LOVE bacon!) 1 Litre(ish) of vegetable stock (vegeta is pretty awesome and only $3 a box – just add boiling water) Dash of white wine – if you’ve got it left over from the other night Knob of butter (if you want the fatty bombatty option that I eat) Parsley 1 cupish of Grated cheese – parmesan is really nice, but whatevers in your fridge will be just as good

Steps: Heat a little oil in a pan over medium heat – add onion, garlic and bacon until onion is soft. Add mushrooms and wine (if wanted) and sauté until the mushrooms are soft. Add all of your rice (read the packet for how much you need for the amount of people you are serving) and stir until well mixed through. Add a little of your stock at a time, stirring until all stock has been absorbed, continue until you run out of stock and the rice is soft (it should nearly triple in volume). The rice should be a creamy consistency. At this point you want to add the butter and half of the grated cheese and mix through (mmmm butter) Mix through some chopped fresh parsley and serve with a sprig of parsley and some grated cheese (you can skip the parsley if you want!)

Left over magic:

Store pasta with sauce in an air-tight container in the fridge for next day magic, or slide it into the freezer for a welcome microwave meal in the future. 53 Why being a med student is awesome by Kathryn Kerr (newcastle)

I’m a mature age student, so being asked to write an so they know just how lucky they are to have made it into article about why being a med student is awesome whilst this profession. Every day that you’re not getting yelled simultaneously referencing MTV Cribs is kind of tough. It at by a judge, cutting dead skin off some old lady’s foot or would be way easier for me to write an article that references, hanging upside down from a pole is a good day. say, Midsomer Murders. In fact, you’re going to be a For those who aren’t aware, MTV Cribs is a show that gives you a tour of various celebrities’ homes. Along the way, doctor. there’s some celebrity gold: Akon congratulates his chef for Do you remember how many kids in your primary school keeping him “unhungry”, and Mariah Carey boasts she has said they wanted to be a doctor at some point? Sure some completed “like, 500 hours of beauty school”. If you can of them changed their minds, but a lot of them didn’t. A lot think of a way to link this admittedly addictive show to the of them went on to sit the UMAT or the GAMSAT (or both - awesomeness of being a med student, you’ve got a better more than once), and never got as far as first year med. You brain than mine (and yeah, I thought about doing a virtual made it, and you’ll keep making it, and eventually you’ll be a tour of the places med students hang out, but as a mature doctor. You had a childhood dream (or a teenage dream, or age student, I am familiar only with the library). a quarter-life crisis dream), and you’re going to get to realise it. Yay for you champ. In the end I gave up on the MTV Cribs thing entirely, and decided I’d just focus on why being a med student is the best thing ever. Because it is, and I can prove it. So, adopting the But best of all: you’re not a typical med student logic that any concept, absolutely any doctor yet. concept at all, can be distilled into five dot-points that fit on an index card, here are my five reasons why being a med As a med student, you get to do a lot of the cool stuff student is awesome: associated with being a doctor – like strutting round with a stethoscope draped round your neck – but at the end of People tell you stuff the day, your responsibility is limited, and so are people’s expectations. It’s OK for you to stuff up, faint, hold a CXR Private, personal stuff. They trust you, and that’s cool. You upside-down, or laugh at inappropriate times. Pretty cool, learn a lot about life, and about people, without ever having yes? to be more than 500m from the hospital coffee machine. You get to know people you might otherwise never meet, and you find out a bit more about what kind of person you are. And if you don’t like the kind of person you are, there’s always going to be one touchy-feely-type PBL tutor who’ll be only too happy to help you on your journey towards being just a bit less of a knob. You get to look at gross stuff OH MY GOD CAN YOU BELIEVE THE STUFF THAT CAN GO WRONG WITH YOUR BUM?!?!? Who knew? It’s disturbing, it’s fascinating, and it makes for some great (appropriately de-identified) anecdotes. You’re not a lawyer/ podiatrist/stripper. These days, a lot of med students used to be Something Else. They’ve had a previous career, or at least studied towards one, and 54 Australian Medical Association Your voice in the health system of the future

Student MeMberShip iS Free so join the AMA todAy And enjoy A lifetiMe of professionAl benefits. the AMA is the only independent, national voice of all doctors in Australia. your membership ensures physicians have a say in the development of the health system you will lead into the future. Contact details www.ama.com.au/jointheama phone: 1300 133 655 email: [email protected]

Who wants to be a millionaire? by Jayne Schoppe (ND Freo)

Even before I knew that I had actually had a chance at getting into med, it has always been a life goal of mine to have a Wikipedia page. And I’m not talking the kind of entry that one of your friends makes about the fact that you ate 12 burgers in one sitting that never gets uploaded because one of the moderators decides that your achievement isn’t ‘notable’ enough, I’m talking the real deal. And after conducting a RCT or two, I know I’m not alone.

So, of course, this got me thinking. What does someone have to do to be regarded as notable, to have their name set in history? If we’re just talking Wikipedia (and I say ‘just’ because I can probably think of a few cooler and more exciting things I’d rather have associated with my name than a Wiki page – one of them being a spot in the hot seat opposite Eddie) then all you need is to have ‘received attention from the press or other reliable sources’. So what counts as reliable? – I think that’s another story altogether, you basically just have to have already done something that people might actually care about; Wikipedia is not the place to launch your popularity. There’s also the kind of pivotal issue of the money that one would need to acquire in order to actually become one of Australia’s roughly 200,000 millionaires since no one outside your family is going to remember you for your time in the hot seat and your Wiki page unfortunately isn’t going to bring home the bacon. If we’re talking medicine, I think the obvious thing to do is to make some kind of medical breakthrough; find a cure for a previously incurable illness, discover a new disease (Cushing’s syndrome) (or alternatively just be the first patient to be diagnosed with a new disease [Christmas disease]), discover a new piece of anatomy (pouch of Douglas), or create a better, faster, more accurate surgical technique to replace one that’s currently in practice (the Whipple procedure). A couple of those options are sure to make your bank balance look a little healthier and make you a little better known among your colleagues. Simple, right?

Well with a bit (ok, a lot) of planning, time, training and hard work then this could one day be a reality, but if you’re like a lot of our colleagues and have either just started your medical training, can’t think that far into the future or are simply after a quick and easy rise to fame then what are your options? I’m telling you now, they’re limited.

Option 1

You’re probably at least 200 years too late to discover a new piece of anatomy so your next best bet is to find one that hasn’t been named after someone yet and to extensively explore it as Dr. Douglas did with the recto-uterine pouch (although this was way back in the 1700s). Since mentioning that I’ve struggled to find an unnamed possibility, apart from the greater omentum (and there’s probably not much exploring left to do there), but how about getting a bunch of friends together, having a few beverages and doing some exploring of each others’ anatomy? Even if it doesn’t get you anywhere, at least you’ve had some fun.

Option 2

Alternatively you might have to be the first person to be diagnosed with a new disease, but that’s neither something fun, something you can really control or something that will make you rich. So, I guess that’s out.

So, unfortunately those two options are kind of it for quick and easy ways to medical eponymy. You might have to stick to some study, research or see if you can come up with a new vaccine. As a final word of advice, just remember that you don’t have to have done something good to be well known (think Jayant Patel), so make sure that on your quest to fame and wealth you don’t end up being famous for all the wrong reasons!

57 ing sheep in

Xander Whitfield (UNE) shares his tips for misleading a wolves’Consultant to think you’recloth much smarter than you actually are...

he art of deception is integral to the practice of medicine. We “A well timed question in a tutorial.... will all need to mislead families and patients about prognosis. This is easy, you simply explain that “We’re going to have to is all you need to fool any doctor that Trun some more tests before we can be confident about what’s you are a student destined to pass going on”, then you step out into the hall and consider whether or not you have time for coffee before having to fill out a death with distinction and maybe someday certificate. The real skill, the skill we all must master, is deceiving our teachers. win a Nobel Prize in both Medicine and possibly Peace or Physics” In the pre-clinical years this beguilement is fairly straight forward. A well timed question in a tutorial, knowing something about referred pain before learning the gastro exam is all you need to fool any doctor that you are a student destined to pass with 1) Look interested and full of distinction and maybe someday win a Nobel Prize in both knowledge Medicine and possibly Peace or Physics. It is the clinical years, those months at the pointy end of the degree, where your lives It is simply astounding what some simple body language and are governed by the ebb and flow of the ward round and the tone of voice can do to influence peoples perception of your theatre list, that these small frauds, which had previously sat at intelligence. When walking never wander but always move the level of a party trick in our repertoire of skills, are elevated with purpose. In meetings look like you are following the to high art. conversation by turning your head in the direction of each speaker, occasionally furrow your brows and nod subtly. When So we all must learn and practice some techniques to appear images are put onto a light box move in to study them with more knowledgeable than we actually are. In an effort to everyone else, stand with your arms folded and perhaps place simplify the process I have here listed a number of methods by one hand on your chin as if in deep thought. A balance must which one may achieve the above stated results. These skills be struck here, however. If you appear too involved you will be are here detailed in no particular order and are based upon the asked questions and your ignorance exposed. Stand at the back experience of either myself or my colleagues; I hope you find but not far off and don’t make eye contact with anyone looking them useful and informative. for volunteers. 58 looking shaky then you can always gently remind your consultant 2) Dress well but not too well how important your marks are to their kids’ wellbeing. Try Clothes maketh the man, as they say and you want to look something like: “I really hope I go well in my long case today, I’d professional and capable when you are about the hospital. Dress hate to fail and then be distracted tonight while I baby sit your 4 accordingly, nothing too flamboyant as this will make you stand year old daughter. The home can be such a dangerous place and out and at best mark you in the subconscious of every consultant I wouldn’t want anything to happen to her.” you meet and at worst make then actively persecute you for your choice of shirt. Conversely you can’t look overly shabby; 7) Sex this means ironed and tucked shirts and no incongruent colours. Strike a balance between French Duke and Street Urchin. Again this wont so much fool your consultant into thinking that you’re smart as act as a safe guard against failure. When you see a pen hover over the ‘Not Satisfactory’ box in a rating form offer 3) Glasses sexual favours or begin to remove your clothes, it’s best to be Universally make anyone appear smarter. Buy glasses, even if direct about these things. This approach does of course work they aren’t prescription. Do make sure they have lenses though; best in private rooms; I’ve seen it tried on the ward and while we don’t need any of this lens-less hipster business. If you’re there was a promising start it soon ended in tears and security into that kind of thing you can take your skinny jeans, empty being called. frames and ironic moustache and listen to Pavement in another profession; you won’t cut it in Medicine. 8) Haiku Answer all questions posed to you in haiku. This makes you 4) Learn Latin appear mysterious and wise beyond your years. For example: No need for the whole language, though if you have the time Liver Cirrhosis, Portal hypertension coma, Ammonia, death. learning it certainly wouldn’t hurt, just have the odd phrase here and there; drop them in conversation with your consultant or It takes practice, especially as most medical terms are polysyllabic translate any Latin phrasings they use. Anyone who can rattle but you’ll get there eventually and look like a Poetic Medical off the occasional Romantic utterance looks like a genius and Savant. it’s guaranteed that your registrar and resident wont be able to match you. Here are a few phrases to look up just to get you 9) Learn medicine started: post hoc ergo propter hoc, entitas ipsa involvit aptitudinem ad extorquendum certum assensum,hic sunt This is actually probably one of the simpler and direct ways to dracones, post coitum omne animal triste est sive gallus et make your consultant think you know things- actually know mulier. things. All the time spent learning Latin, choosing your clothes, counting syllables and hiring lawyers for your sexual assault charge could have been spent studying. So put this magazine 5) Questions down and pick up a copy of Harrisons. Go! Do it!

You can’t be asked things if you are the one doing the asking. So there is a rough guide to passing yourself off as someone A well timed and thoughtful question allows you to appear competent enough to be part of Australia’s Medical Workforce. interested and willing to learn and if asked correctly on the right I trust you will practice these skills and implement them with topic does not expose your ignorance. Furthermore, experts of care and poise. As I conclude I must point out that everything all kinds love to talk about their field of expertise and by gently expressed here is not endorsed by AMSA or even myself. You interrogating them you will appear smart, learn something and deploy these deceptions at your own risk and must perform massage your consultants ego all at the same time. your own risk/benefit analysis on a case by case basis; I trust you possess the necessary statistical acumen to perform these 6) Baby sitting calculations. Get chummy with your supervisor and score a gig baby sitting Thank you and Good Luck. their kids, this will most likely be easier in the rural centres which place a greater emphasis on community. Doing this wont so much fool anyone into thinking you’re smart but will give you a better chance of a positive evaluation; you won’t get a bad report from someone who likes you enough to leave you alone with their children. Of course if your end of semester marks are 59 now go take a history from the whiteboard.....

Robert Marshall (AMSA President) recently spoke at the AMA National Conference.

This is what he had to say on your behalf....

Good afternoon doctors, doctors-in-training and to my medical student colleagues up the back, the doctors-in- training-in-training,

Thank you for inviting me to speak to you today on Councillors fly JetStar to our meetings and we put behalf of the Australian Medical Students’ Association. them up in backpackers hostels, so they could hardly say: “for the perks”. It’s my great pleasure to speak to you at the AMA National Conference, and a particular privilege to be But the real reason we get involved, students in AMSA behind the lectern with an audience of doctors, since and doctors in the AMA, is in fact the same. the opposite is what I’m used to at University. It’s because we care. We care about education and If you want to embrace this role reversal, I would training, we care about healthcare delivery and we care encourage those of you up the back to talk noisily about the medical workforce, both current and future. amongst yourselves and if you’re sitting here in the front I expect you to be taking comprehensive notes. I think the reason we care so much about how health Remember: everything today is examinable. is delivered is because we’re taught to. Just as it is the role of the clinician to be an advocate for their patients’ Students often ask us why we get involved in AMSA; health, so too, it is the role of all doctors to be an advocate what motivates us to participate? for health, and for the profession itself. I know Federal Councillors, State AMA Councillors and The reason we demand more is because we expect active AMA members get the same question from their better. colleagues. Why do you get involved? Yes we have world-class medical education and health I guess the main difference is that our AMSA systems, but the only thing it takes for the triumph of 60 mediocrity is for good men and women to stand idly by. AMSA talks a lot about the quality of medical student Let me explain: training. I don’t need to tell this audience about some of the threats to quality education we are seeing: as Last week I went to a bedside tutorial. We were to meet you know the overload of students in the system has a neurologist on the stroke ward in Royal Perth Hospital, reached a critical point in training where there is now the plan was to do some Neuro exams on these patients uncertainty about securing an internship for 1 in 4 with the doctor, and to see some of the classical signs of Australian graduates, and yet we see the enrolling of stroke. ever-increasing numbers of international students when But when I arrived I was not the only student there. there is no guarantee for these students to complete their registration. Eight students had been assigned to this bedside tutorial. Eight. We see students overcrowding the hospital system, and yet some universities are still pushing to open new The neurologist was baffled. Just five years ago, he said, medical schools or remodel the workforce with cohorts there were only two students to teach. This was very of Physician Assistants. We know that we need to make effective; one student could examine while the other higher education more accessible and equitable, and the made notes and offered constructive feedback. Bradley Review calls for participation from students of lower socioeconomic backgrounds, and yet Melbourne But eight students? University has this year opened its new MD course with Impossible to fit them around the bedside, let alone the full-fee $200,000 places for domestic students. I know distress and indignity it would cause the patient to be you are familiar with these issues because the AMA whacked with a tendon hammer by eight people in a continues to join us and help us in speaking out about row. the threats to quality education and training, recognising that today’s medical students are tomorrow’s doctors. So instead of our planned bedside tutorial examining patients, the neurologist had no choice but to take us But still, that question about why we get involved has into a small teaching room, and run through the Neuro not been answered. This is what we talk about, but why exam on a whiteboard. do we talk about it. But as I said, white boards don’t have strokes. Some say it’s because we’re too interested in politics. “Leave the politics to the politicians” one consultant said If training is burdened any more than it is already, I worry to me a couple of weeks ago. Leave the politics to the about the quality of medical education. politicians? No thanks. I worry that eight students is too many to do a bedside The reason we get involved in politics is because that is tutorial, that eight students is not acceptable to the the only way to affect real change with how health and patient, that the increase to 15,000 medical students in education are delivered in this country. the last few years has not been met with a proportional increase in funding, training, teaching, resources and So now you know what we do, and the politics is how we support to our hospitals and our universities and our do it, but this still doesn’t explain why we get involved. doctors. I think the real answer to the question of why we get But most of all I am worried because white boards don’t involved, why I care about the quality of teaching, is have strokes. because whiteboards don’t have strokes. And that is why we get involved. Thank you. 61 Hey Hey It’s Saturday Dinuksha De Silva (UNSW) teases out how med students go to the extreme.....

edical students - we are a strange breed. Marveled at by out until 3am before a 9am ward round is simply ‘practice for the Monlookers for our intellect and discipline, with a simultaneous demanding life of an intern.’ and somewhat counter-intuitive reputation for being the hardest partiers at any university. Studying and staggering our way between the extremes of a normal social hierarchy, we seem to have struck a Selective Learning balance (if balance is the right word) between geek and sleek. We are all aware that alcohol is a significant risk factor for morbidity and mortality. My definition of ‘geek’, among other things, is loose. Indeed, the But it does reduce the risk of coronary artery disease. And we only closest some of us will ever get to data interpretation is tearing through need 10% of our liver to be functional, right? a case of beer on the weekend and calling it a case study (please refer to the Cascade Cup champions). And we’ve all met those who’ve lost themselves on the other end of the social scale, but that’s another Empathy matter. Can we honestly be quality health care professionals without having This article is concerned with the (mostly) social life of the med student. experienced our patients’ concerns first hand? There’s plenty they It is concerned with those of us who manage to exist in a state of limbo don’t teach in tutorials, so we feel it is up to us to engage in some between book-toting and beer-swilling. Do we have the best of both independent learning. At least this way we’re better equipped to worlds? The multiple personality disorder that is seemingly endemic sympathise with alcoholics. among young medical students warrants some consideration. And so The transformation at will between study machine and party we explore some of the major symptoms of our condition: animal is what makes us undeniably the next generation of medical professionals. Because we all know a medical history must be Neural Plasticity complemented with a social history. How comforting for greater society that the future of their health lies in the hands of such a well- It has been seen that the neuron of a typical Australian medical balanced and rapidly-adapting demographic. student adapts measurably to suit the periodically alternating 1 requirements of memory formation and ethanol influx. AMSA National Convention is a tribute to our effortless ability to swap pen and paper for a paper cup. So whether you prefer to don Priority Plasticity a tweed jacket and thick-rimmed glasses or lather yourself in body paint, whether you study full-time or part(y)-time, we are one and the During semester a medical student is rarely seen by non-medical same. We are the medical student. students. It is not uncommon for us to go into social isolation during the week prior to an examination. Following said examination, we proceed to catch up on a semester’s worth of missed partying. 1 You wish this were true. During this time we will call our non-med friends ‘soft’ or insult their sexuality when they refuse to party due to their heavy workload. Sleep Deprivation Too often we find ourselves functioning on dangerously little sleep. Funnily enough, we find ways to justify this to ourselves. Staying

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