Tuesday 27 December 2011

GAMSAT preparation schedule

http://www.emergencyone.com.au/

Hi again

Firstly, there are plenty of people who have been following these posts and not a single one has been brave enough to put forward a differential diagnosis :)

For what it's worth, Googling the symptoms will probably give you the diagnosis (look for the keywords in the vignette). In the future, EmergencyOne will be giving away free places in its reasoning training course for the first person to email the answer to a 'What's the Diagnosis' problem on the company's contact page.

As for today; the post on reading materials was our most popular so far. So in keeping with the theme of preparation guides, I've decided to compile a suggested list of exactly what to study and how to study to minimise time wasted, minimise stress and maximise your chances of success. These will be available as ebooks here very soon.

But as a rough guide:

1 month full time is more than enough
If you have a science background, less is more (it took me a month because I hadn't studied it previously)
Aim to split your time between
-1/3 sciences (see the books in the reading list)
-1/3 humanities- this is up to you, I've outlined a few good books, but the list is endless. Aim for anything that's deep and meaningful and makes you want to contemplate your navel or the world at large (remember thinking is GOOD and Gary Larson is excellent!)
-1/3 puzzles, problem solving and GAMSAT questions

A dirty little secret is that you can combine your humanities revision with your liesure time if you promise to think while you're doing it. It's one of the last times in your life as a doctor that you'll be able to watch great movies, read great fiction and love your wife up with some poetry all in the name of 'studying'.

Here's a parting thought that will change your world if you will let it. It's called Pareto's law or Pareto's principle. It's a concept from economics that's applicable to many real life models (a bit like natural logs, Pi, the golden ratio etc etc). Put simply, in life 20% of the input is responsible for 80% of the output (or products).

This is applicable to work, home, family etc. When it comes to your GAMSAT study, 20% of your preparation will account for 80% of your realised grades on the day. Your challenge, given that you CAN'T know it all, is to try and identify the 20% of study/revision/learning/reading that will get you the most Brownie points on test day. Unfortunately there is no 'bonus credit' section where you can demonstrate just how smart you really are. In the GAMSATs, you're not trying to showcase your talent, instead you're trying to hone your talent to a pinpoint with the single mission: answer the question. It's all about jumping through hoops like a good doggy! (That last line, sad but true is often the theme for the rest of your medical career; the exams, college applications, mentor reports and so forth never stop....you'll always be jumping through hoops)

I applied Pareto's Law to my own GAMSAT revision before I'd even learnt about it. For me it took the form of skimming through the practice exam, identifying common themes, then taking a pen to the contents page of my bio/chem/org chem and physics books. I crossed out the things they were unlikely to ask questions about (ie I almost completely neglected plant biology, ecosystems, origins of life etc) and highlighted the things that they tended to ask questions about often (genetics, Newtonian physics, electronegativity etc). By the end of this process I'd cut the contents of each book by about half and suddenly found myself with half as much to read....I then dedicated the spare time to increasing my humanities and reasoning revision.

Remember that the more efficient you are in your preparation and on exam day, the better your chances will be. At the top end of the oxygen dissociation curve (aka the GAMSAT percentile chart), 5 points is the difference between a competetive score and just being one of the crowd!!

Good luck
http://www.emergencyone.com.au/

Sunday 25 December 2011

What's the diagnosis?

www.emergencyone.com.au

A 4 year old child presents with a fine macular papular rash confined to the torso with concurrent lethargy and fevers around 39-40 degrees Celsius. The rash feels sand papery to touch. It is blanching. It does not extend to his face, although his face (with the exception of his mouth) appears flushed. The rash is pruritic.

He has a non productive cough. Two days previously he complained of a sore throat. No one else in his family or contact group has been sick.

1-What is your leading diagnosis/diagnoses?
2-In/on which body part might your expect to see a sign to help confirm your diagnosis?
3-What sign would you expect to see?

This is a true account of a patient I recently saw and is reproduced with permission of the parents.

The practice of medicine requires the doctor to collect information (history and examination); discriminate between relevant and non-relevant information; formulate a hypothesis (a differential diagnosis) test the hypothesis (ordering tests, eliciting signs) and then either arrive at a diagnosis or adjust the hypothesis.

Childhood xanthems are my favourite demonstration of this process. They often vary only subtly and the diagnosis is often in the details. The study of medicine requires the acquisition of facts by reading. In this case, the study of childhood xanthems will make certain of the above key words stand out. The process of reasoning then allows the doctor to formulate a hypothesis, seek proof of this hypothesis and favor one diagnosis over another.

The GAMSAT is no different. The study of science is essential to understand the vignette. The practice of reason is what imbues in the candidate the ability to selectively discriminate, logically derive or creatively solve the problem posed by each question.

Feel free to post your answers below. I will reveal the answer in the coming days.

Cheers
David

www.emergencyone.com.au

Thursday 22 December 2011

Merry Christmas and thanks

Hi all

Wow, what a first week in business! My wife and I launched http://www.emergencyone.com.au/ as well as this blog on the 17th of December this year. Since then we've had an overwhelming show of support!

In that 1 week, our blog has had 210 views and we're now starting to see visitors from around the world. Our website has now had 350 visitors and over 1000 page views. It turns out the GAMSAT reading list and 5 tips for preparation were excedingly popular. We have started to receive a steady flow of enquiries and booking customers. To those customers, we extend our heartfelt thanks for your trust and patronage. We look forward to doing business with you and we trust that we can play our role in your success for the GAMSAT in 2012.

To all of our customers, affiliates, family and friends, we wish you all a Merry Christmas and a Happy New Year. We will resume blog posts as well as continuing to update our website early in the New Year....when the real work begins!

Sincerely

David and Kerry

Wednesday 21 December 2011

GAMSAT Reading List

www.emergencyone.com.au

Hi all

Time for another update. A friend's boyfriend is attempting GAMSAT this year and she asked some time ago what I did to prepare. I've already outlined what I DID, so I thought I might post about what I READ.

So here goes, my GAMSAT reading list. I guarantee that the following list contains all of the requisite knowledge to pass GAMSAT (this is not something miraculous, it's posted in plain English on the ACER website). PS: please excuse the lack of Harvard referencing :)

Science:
  • Chemistry and Chemical Raectivity: 5th edn, Kotz and Treichel (well written)
  • Introduction to Organic Chemistry; 2nd edn, Brown (nothing was going to make me love organic chemistry, but this book helped me to not hate it entirely!)
  • Biology, 5th edn, Campbell, Reece and Mitchell (I love this book and it's currently serving as my mouse pad!)
  • Physics Key Ideas: 3rd edn, Essentials Education (this was my actual physics book for year 12, it's alittle clunky but solid)
  • My year 11 maths book (can't remember it's name but it was as useless at that time as it was in high school....but I did a lot of practice questions to hone my mathematical skills)
  • Mensa Logic Brain Teasers
Humanities:
  • Defying Hitler: Sebastian Haffner (an illuminating account and cautionary tale of being a regular person in pre-NAZI Germany, great book)
  • Kidnapped: Robert Louis Stevenson (one of my favourite books as a child)
  • Treasure Island: Robert Louis Stevenson (another fabourite)
  • Tao Te Ching: Lao Tzu (a little less reader friendly, only read part of it)
  • Oliver Twist: Charles Dickens (I've tried on multiple times to read Dickens and always struggled with the style of writing; when I finally comitted to reading this I LOVED it! Great for honing your language manipulation skills)
  • The Story of My Life: Helen Keller (an amazing book and all round amazing woman)
  • English Passengers: Matthew Kneale (won the 2000 Whitbread Book of the Year, my all time favourite book, I've read it 3 or 4 times now!)
  • Angela's Ashes: Frank McCourt (before it was a sequel and a movie and a t-shirt and a breakfast cereal....thanks Oprah....it was just an all round top read....another of my favourites!)
  • The New Testament (I was tempted to put Jesus as the author....but that might offend some people :) I'm not religious, but that doesn't mean there's nothing to be learnt from some of the wisest people the world has ever seen)
  • The Annalects: Confucius (what a legend, top read)
  • The complete works of Gary Larson (if you get his humour you basically a shoe in for the humanities)
Movies
  • Lorenzo's Oil
  • Patch Adams
  • Good Will Hunting??
  • Shawshank Redemption
  • There were more but I can't recall off the top of my head
Music
  • Vivaldi
  • Pachelbel
  • An assortment of other classical music that I found inherently easy to listen to, I think the main album was entitled 'The Best Classical Music of All Time Ever' or somthing similarly silly, but the music was great
I would also highly recommend the BrainWaves app from the iTunes store. It uses binaural tones to induce certain states of mental activity. It's not entirely mumbo jumbo, there is actually some degree of scientific, peer reviewed evidence behind its efficacy, though I won't proport myself to be an expert in the field!

All told this reading list is worth about $500 from any online book seller or, to quote Good Will Hunting, about $5 in late fees from your public library. It took me 3 1/2 weeks of solid reading for 10+ hours a day to get through this lot and take notes. Best time I ever spent and it achieved what I set out to achieve.

As a side note, remember there is a rate of memory attrition to anything you learn. Let's assign it an arbitrary value of 5% per day. Cramming every day for a solid month before test day is better than a year of studying 1 hour per day. 5 years down the line I remember officially none of what I studied, but I could re-learn it all in a month if needed. Of course studying an hour each day is a good habit and worth while to do, but bear in mind that the GAMSAT is an 8 hour (ish) Battle Royale. You need to go into that thing like a finely tuned athlete ready to smash the competition. Maybe study for an hour a day for the 11 months before February, but in February/March, you train like your life depends on it!!

Good luck peeps!

An argument for going into business

www.emergencyone.com.au

Last night I did something a little kookie and new ageish. I wrote down a list of the things that I wanted to achieve for 2012. Not surprisingly I came up with wealth and success....but here's the kicker; when I stopped to define what wealth and success meant to me I got the following.

Wealth: family, love, excitement, fun and learning. If I can have all of these things in abundance I will be the wealthiest man I know.

Success: achievment of my ambition and fulfilment of my potential. If I can do these two things with dignity and humility, then I will be the most successful man I know.

As for money, well that just frees up time for me to pursue the true definition of wealth and success....

When I was discussing my ambitions with my wife the other day (many of which have nearly nothing to do with being a doctor), she asked me if I hated medicine. Frankly the answer is no. I love medicine. I love being a doctor.

But I define being a doctor as helping people, healing the sick, teaching others, leading my community and improving the experience of human kind. Then I ask myself how much of that I do in my daily work.....

Don't get me wrong, I like my job and I feel a sense of moral obligation to serve my lot in my local community; but I fear that our society has created a system which devalues the doctors role down to administrative pen pushers and walking script pads (in fact a nurse told me that to my face today). Vital tasks indeed, but certainly not the altruistic goal that plays on the mind of every first year medical student.

I realise that much of this is in no small part the result of being an intern and the bottom of the pecking order, but I sometimes question if it actually gets better as one rises through the ranks. It would appear 'zum augenblick' that there's just a lot more meetings, more report cards, more budgets, more administration.

As an aside, I have a mentor at the moment who's kind of my hero. I won't mention his name for fear that I will inflate his ego....but he lets us take care of his patients as equals, then he double checks our work to make sure there's no mistakes, then he sees the patient himself as a doctor. Not in a fashion that's condescending or distrusting, but in a fashion which shows that despite his rank, his primary aim in life is to be an excellent clinician. If I can be half of that person when I reach his rank, then I will be successful.

At any rate, I've decided to start my own business in order to become a better doctor. In order to interact with my customers in a meaningful way that leaves them feeling that their money was well spent and their trust was justified. I've started my own business to free up my time in order to build the wealth and success that I've defined earlier. Next year I will serve 3 months as a doctor in Nhulunbuy in Arnhem Land where I hope I can begin to fulfil my potential as a doctor. Then 2013 or so, I think I will spend some time with Medecins doing something that helps improve the human experience. It's terrifying. But it's worth it. And its possible because of business.

PS: Hi Jussie and Carmel's mum, I hear you've been reading this, thanks for the support!!

www.emergencyone.com.au

Tuesday 20 December 2011

Are GAMSAT courses worthwhile?

www.emergencyone.com.au

Again I have a vested interest here, so I will tell it like it is.

"Is there any point in doing a GAMSAT course?"
"Well that depends very much on what you would like to learn"

The GAMSAT is an exam which aims to test all of the knowledge and skill that the candidates have accumulated over the course of their life. It aims to select excellent students from a large cohort of would be doctors. Lets face it, right or wrong, everyone seems to want to be a doctor and the failure rate in the exam is 80-90%

In answering the above question, one needs to take into account what it is that they hope to learn in order to succeed at GAMSAT. If you know or think you know everything you need, then a course is not likely to add anything to your life. But then again, if you ask any doctor how much they know about everything, the answer will always be "very little". The purposes of self directed learning and life long learning are the identification of ones deficits and gaps in knowledge and the relentless pursuit of filling these gaps. It's a trait highly desirable in future doctors and emphasised in the GEMP from day 1.

With respect to a course, you should ask yourself what it is that you hope to achieve. If you want to improve your chemistry/physics/biology knowledge then there are ways to do this; text books, private tuition and GAMSAT courses can all add something to your abilities. If you want to improve your reasoning, then yes a reasoning course will also help you to do this. Why reasoning? Because failure to identify and utilise reasoning skills in the GAMSAT is the primary reason that candidates fail despite hours of preparation and revision. Having knowledge but failing to apply, manipulate, extrapolate and interpolate information is the reason that most people underperform in the GAMSAT (interestingly it's also why many people with autism spectrum disorders often perform very well).

With respect to money, courses can be expensive, but nothing worth having comes easily or cheaply. The GAMSAT costs about $400, courses and prep materials can cost anywhere from $200 up to $2000. I went back and repeated year 12 science at a local public high school for free and then spent $2000 on a beach shack to be in solitary confinement for my study. At the end of the day, money is a factor, but repeating the GAMSAT over and over can be an expensive venture. Besides, once you're in give some consideration for the cost of achieving that dream. For me is was $240,000 in lost income (it's near impossible to work significant amounts during a medical degree), $35,000 in course fees and $80,000 in consumer credit to keep my family fed. Medicine it turns out is an expensive propostion, preparation should be factored into your budget from day one.

Choosing a course or not is something that only the candidate can decide after consideration of what he or she hopes to achieve. But ultimately the question should be, what do you hope to learn.

Good luck everyone.

www.emergencyone.com.au

Monday 19 December 2011

Bahahahaha

5 tips for GAMSAT preparation

Hi again

This blog is still in its infancy, but I hope it's proving useful or at least mildly entertaining for those of you staunch or foolish enough to read it :) Before I get started, this isn't a plug for our business, though as always the link is included at the end if you'd like to dig deeper. Rather this is a genuine attempt to reach out to those of you planning to sit GAMSAT in 2012.

5 tips for GAMSAT preparation

For starters, my GAMSAT journey went something like this;

-Save $2000 and don't enrol in a course...instead, 'borrow' your flatmate's (a primary school teacher) textbooks for chemistry and biology, procure an organic chemistry text book from somewhere (I genuinely can't remember where) and track down your dusty copy of the year 12 physics and maths text books.

-Put them in a suitcase, then fill the suit case with as much unconventional material as you can.....namely I packed the Bible, Confucius' Annalects, the MENSA puzzles book, Helen Keller's autobiography, a few pieces of Robert Louis Stevenson and generally anything else I could find that seemed like a good read.

-Then take the $2000 and rent a beach shack in Kangaroo Island for a month (Dolphin Chalet in Vivonne Bay....highly recommended!)

-Then spend every morning running, every day reading and practicing and every evening fishing

It was cathartic to say the least. Here's what I learnt and what I hope to pass to you.

1-Read: read often, read hard and read widely. Read as much as you can in as many subjects as you can. No education will ever detract from your life and all of it will add depth to you as a person; afterall, medical school isnt looking for the people who memorised a few text books (they WANT to teach you science, they don't assume you already know it) they are looking for a well balanced, intelligent and diverse set of people as the next generation of doctors.

2-Less is more: If you're bored, Google the Pareto Principle. It's good. 20% of your effort will account for 80% of your success. Rememer that the assumed level of knowledge for the GAMSAT is first year uni biology, chemistry and organic chemistry and only year 12 Physics (it's not official but I think year 11 or 12 maths helps too). Don't try to master everything ever written on these subjects, you'll fail at it and make yourself less effective in the basics. 

3-To course or not to course: naturally I have a vested interest here but I'll tell it like it is. Some people find courses helpful, some don't. I did it without a course and I know a lot of other people who did too. I also know a lot of people who did do a course. To the best of my knowledge there is no good evidence to suggest that it helps or hurts, though I suspect ACER is trying to generate such data. At the end of the day, learn the way you want to learn and that helps you. (PS I did to a course for the interview section and yes it did help)

4-Don't study the night before: maybe flick over your notes in a half hearted attempt, but don't take it seriously. Anything you were going to learn you will have by now. Rather invest that time and energy in a massgae, a bath, some good fiction, some manga, whatever floats your boat. Keep it stimulating but not very serious....how many atheletes do you see warming up with a 10km run immediately before their moment of glory?!

5-Que Sera Sera: you might smash it, you might flunk it! At the end of the day you can only do your best. I aced the exam on the first go, but then I got wait listed at the first interview. I was officially rejected the day after classes began in 2006. It got me down for about 2 days, then whilst having an existential funk on a bus I took solace in the notion that if I could be 'put off' by a single failure then I probably wasn't cut out for medicine. If you dont make it on your first, second or eighth try, then THAT'S OK! You have two options, a-) swallow your pride, dust yourself and start preparing for next year (ps; the definition of insanity is doing the same thing over and over and expecting a different result-try something new); b-) decide that maybe medicine isn't the be all and end all and commit yourself to another cause, without an entry exam and with the same gusto!

I hope this helps! As always, I'd love to hear other people's views, experiences, feedback and stories.

Good luck folks

http://www.emergencyone.com.au/

Sunday 18 December 2011

2 ways to get trimethoprim into a child that don't work and 1 that nearly does

Trimethoprim, as it turns out, doesnt taste very nice. So how do you get it into a child with a urinary tract infection.....

Fail 1-halve the tablet and give it to him with lots of water, after all he's a big lad and can do lots of nifty things.....half a cup of water spat on the floor and it dawned on me that even if it had been an M&M, the plan still wouldn't have worked

Fail 2-crush it and mix it with straight cordial. Forget the Panadol mob who foolishly took the sugar out of the children's panacea....I say the more sugar the better....a shot glass of cordial spat on the floor and I was drawing a blank....so I had a taste....low and behold it turns out I was trying to feed him something that tasted a little like a nasty gin and tonic laced with raspberry cordial....fair enough he spat it out

Win(ish)-crush it between two spoons and mix it with honey.....he begrudgingly took it and swallowed it all....I think mostly because it was too difficult to spit out....problem solved :)

Baby asleep, Dad to follow

Gnight all

http://www.emergencyone.com.au/

Saturday 17 December 2011

www.emergencyone.com.au

Wooohooo

Well ladies and germs, our website http://www.emergencyone.com.au/ will be up and running before Christmas time. The majority of the content is written, now all it needs is proof reading and to integrate some payment handling capabilities and hey presto!

A note about EmergencyOne, we are a small Adelaide based startup that offers a live 1 day course in the field of reasoning, fluid intelligence and exam strategy for GAMSAT cadidates. We are different to other course providers in the sense that we do not offer a course based on science or humanities content. Rather our course aims to help candidates identify deficits in their own reasoning abilites, teach scientifically validated strategies to increase fluid intelligence and reasoning skills and then to practice applying it to reasoning based exam materials from primary school level right up to GAMSAT level.

The goal at the end of this process is that the candidate will be well equipped to utilise their crystalised knowledge base with excellent reasoning skills in a maximally time efficient manner.

So if you're thinking of sitting the GAMSAT this year, have a look at http://www.emergencyone.com.au/ We would love to hear from you and if you have any questions about our company, the GAMSAT or life in general, please feel free to drop us a line!

Cheers
David

Friday 16 December 2011

Bring on the Primaries

So in an attempt to try and motivate myself, I'm going to start publishing parts of the ACEM primary syllabus and start posting my notes. The aim is to make myself accountable for what, quite frankly, seems a long way away! I'm counting on you people....bust my chops! Also feel free to use any notes for your own personal gain if ye choose!

Week 1 Abdominal Viscera
19.1 Overview of abdominal viscera and digestive tract
19.2 Oesophagus
19.3 Stomach
19.4 Small intestine
19.5 Large intestine
19.6 Spleen
19.7 Pancreas
19.8 Liver
19.9 Biliary ducts and gallbladder
19.10 Kidneys, ureters, and suprarenal glands
19.11 Summary of innervation of abdominal viscera


19. ABDOMINAL VISCERA

Thursday 15 December 2011

Ahhh GAMSAT time

The other day my wife asked me about a GAMSAT preparation course (she likes to entertain my delusion that I have a say about how our money is spent :). Then today I saw a facebook post from one of the students who recently passed through our service; the 4th years have just graduated!

It got me thinking about the 'circle of life' as it were for doctors. We start off with GAMSATs (UMATs if your an undergrad), then once we get into medical school we naturally assume that we're fantastic; then we're promptly busted down to reality by all the sick people and dearths of weighty text that we're to devour.

Then we graduate and again assume that we're fantastic; then we begin our internship and are promptly busted down a peg once again (usually at a MET call where we are officially useless)....and so on and so forth.

Niels Borh said, 'An expert is someone who has made all the mistakes which can be made, in a narrow field'. As doctors, the older we get, the more we specialise, the more we know about less and less and we watch those who will replace us enter 'the machine'. To all the would be doctors, good luck for the GAMSATs, study hard, aim high, respect yourself and the profession to which you aspire and don't forget to have fun. To all of the graduates, congratulations! Try to keep a long perspective of what will be a daily struggle in your internship, I promise it gets better :)

Cheers
David

Hi to all

Hi everyone

Welcome to Emergencyone, this is my first blog. My name is David and I'm a junior doctor and prevocational trainee in emergency medicine in South Australia. My professional interests are emergency and critical care medicine, aeromedical retreival, clinical governance and education.

I also own a small medical consultancy services business with my wife who is a nurse. We specialise in first aid training, GAMSAT preparation courses and training courses for ancillary health care staff. As our training and experience allow, we hope to eventually venture into human resources, medical consultancy and training for doctors and health care facilities as well as the provision of community medical and nursing services.

The purposes of this blog are 3 fold;
-to engage in meaningful exchagne with other docotors and allied health in my field
-to engage with students who wish to become doctors
-and to help promote our business activites via emergencyone.com.au

To those of you who follow and engage with us, welcome! We look forward to establishing long and meaningful relationships with all of you and learning from and with you all.

Cheers
David