AMSA Panacea Volume 44 Edition 1

panacea

Official Magazine of the Australian Medical Students’ Association

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Panacea The Official Magazine of the Australian Medical Students’ Association.

‘The Communication Edition’ Volume 44, Edition 1, 2010

Panacea Vol 44 No 1 01

Contents Editor’s Note Jared Panario President’s Address Ross Roberts-Thomson What, No Funny Bone?

Sam Kirchner The AMA and AMSA: two key voices Dr Andrew Perry Just Semantics?

Joel Menzies 40 Hail Marys, a Whole Lot of Patients Steve Pearson ‘Cos I Look Good in Leather Cale Lawlor iPhone Apps You Need for Medicine Dani Bersin If Dinosaurs Could Talk Tessa Kennedy No Fingers Crossed Lachlan McMichael Myths Undermine Medical Education Grant Ross Boombalada Rhapsody UQ MedRevue AMSA Rep Reports A Bullet with Butterfly Needles Kerry Jewell Life Outside of MBBS...

Bec Ryan & Hamish Gunn Molten Chocolate Fondants Rob Olver Moist Raspberry Cake Daina Rudaks Create a National Curriculum Sam Kirchner The Secret Stealer Jess Webster Dear Journal: You’re Awesome.

Steve Hurwitz & John O’Donnell The Mystery of the Wandering Pen Max Mollenkopf Stalkbook Ed Christian Facebook Stalking Survey Luke SB Parlez-vous franÇais?

Rob Marshall NRLDS Tim Bromley Charming the Pants Off You! Cameron Gofton Email Debate: Cons Daina Rudaks Email Debate: Pros Alfred Phillips Hobart 2010: A Convention MMSE Words That You Needn’t Ever Know Will Stokes The Name of the Game is ‘remier League Tim Coppafeel Vector: the Global Health Network Publication Jargon Schmargon Caitlin van Oers Say It Like You Mean It Hanika Roberton Jared Panario TXT SPK. It Drivz Me Fkn Nutz Disclaimer: published articles reflect the views of the authors and do not represent the official policy of AMSA, unless stated. Contributions may be edited for clarity and length. Acceptance of advertising material is at the absolute dicretion of the editor and does not imply endorsement by the magazine or AMSA. The material in Panacea is for general information and guidance only and is not intended as advice. No warranty is made as to its accuracy or the currency of the information. AMSA, its servants and agents will not be held liable for any claim, loss or damage arising out of reliance on the information in Panacea.

All material in AMSA remains the copyright of AMSA or the author and may not be reproduced without permission

02 Panacea Vol 44 No 1

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Panacea Edition 1 Volume 44 June 2010

Editor

Jared Panario

Graphic Designers Robert McCusker Doug McCusker Priya Nandoskar

Proofing

Tom Crowhurst Tim Bromley Amy Schirmer Daina Rudaks Panacea is proudly produced by the Australian Medical Students’ Association Limited (ABN 67 079 544 513) for all medical students around Australia.

Address: 42 Macquarie St, Barton ACT2600

Advertising Enquiries: Andrew Shepherd and Will Stokes e: sponsorship@amsa.org.au p: 02 6270 5435

Editor’s Note shiny new Panacea logo makes the Ed very happy. Thanks Rob!

Jared Panario (Publications) likes to make editorial

comments within these small subtext sections. And give a bit of an idea about the articles you’ll read.

You never stop talking. From the moment your face peels from the pillow until you crash on the couch, there is always a conversation going on.

Internal, external, with friends, with acquaintances, at work, at home, out, at parties and occasionally out loud with yourself. It’s what makes us who we are, and why we all came into medicine in the first place.

But why do we do it? What is that certain something that drives us to make that contact? Well, there are two very simple responses to that question. You’re either an idiot, or a philosophising punce. We’re human. We crave contact - it’s embedded in our societal structure and our genome.

Deal with it.

But I suppose it’s the matter of how

we communicate that makes the difference. Some people seem

inherently adept at connecting with others, having a natural way with words and that magical quixotic characteristic, charisma. And others... well, they don’t seem cut out for other people. Or maybe life in general.

Neither of those statements are necessarily true. The only way you get good at something is doing it again and again and again. Hence why I acquire mad online game skillz (yes skills with a ‘z’) immediately prior to exams. And the only

way you learn to communicate better is by doing it yourself and, of course, making mistakes. You learn from them and move on.

That is the crux of medicine - learning how to communicate. It’s why MBBS lasts so long and why there are many hours expected of us. You can’t tell someone how to communicate - they have to do it to get their own style.

That’s why the theme of this Panacea is about communication. As media constantly evolve, especially to encompass a more electronic focus, we are expected to be competent and confident in each of these as future medical officers. Keeping on top of it all is no mean feat.

OK, so you’re just over half of the way through this article and you’re probably wondering how on bloody earth the cover graphic is related to the theme?

Even I’ll admit it is a bit tenuous. BUT, and stay with me for a few lines, look at the snake. It’s a bit better than most, having two heads and all. Despite this, it’s still being throttled by a singular hand.

Maybe if both heads had communicated with each other more clearly, they wouldn’t be in that situation.

That’s the danger - if you don’t communicate well, it can be even more dangerous than if you didn’t

communicate at all. The singular hand shows that. There is always the temptation to take the easy way out: to lie, to omit, to make happy. Sometimes they get the better of us.

And other times I can forget to listen just as important. It or its lazy cousin, half-listening, are more often than not the source of arguments, unwanted action, or lack thereof.

So, maybe the symbolism of the cover is a little nebulous. But that is countered by the fact that it looks freakin’ awesome.

HUGE Thanks go out to Rob McCusker (Adelaide) and Doug McCusker (incapacitated) for spending many an hour creating this. And for many of the internal graphics. To Priya Nandoskar (Adelaide as well) for providing some of the fantastic graphics as well. In addition, thanks to the many AMSA Reps and the people who have submitted articles - you have made this edition possible.

It’s been a pretty mad few weeks making this edition for you - hope you enjoy. I’m already looking forward to making the next edition. Out September time!

Cheers, Jared Panario Panacea Vol 44 No 1 03

President’s Address Ross robertsthomson (President)

communicates his reliance on good communication to communicate.

Communication /kuh-myooh-niKEY-shuhn/ (noun) 1. The act or process of communicating; fact of being communicated.

2. The imparting or interchange of thoughts, opinions, or information by speech, writing, or signs.

3. An opening or connecting passage between two structures.

4. A joining or connecting of solid fibrous structures, such as tendons and nerves.

‘The communication lecture was rather ordinary as the speaker was not a brilliant communicator, which impeded communication between my brain and eyes; thus provoking sleep. What an agglomeration of miscommunication!’

As our highly-esteemed and outrageously well versed editor has alluded to - communication forms the cornerstone of our profession. It seems only appropriate that this issue arrives at a time when medical students are popping up in seemingly every form of communication in existence.

Thus, I thought it pertinent to begin with a communicatory institution in the Western World, the newspaper, which has taken the medical education system to the sword of late in more ways than one...

Earlier this year the front page of The Australian read ‘Training Fails To Prepare New Doctors’. This was following the public release of the biggest study into medical education in Australia. The study exposed two main themes on medical education: 04 Panacea Vol 44 No 1

that students didn’t feel prepared in many areas of medicine; and that they value clinical placements more than any other element of their course. AMSA has always maintained that students need high quality clinical placements. Unfortunately, we currently lack the objective means of determining the quality of a clinical placement in undergraduate medical training. We are requesting changes that we are unable to measure, yet every student understands how useful and empowering a great placement can be. It is a very sticky situation that we need to be able to communicate to others effectively in order to enact change. So how do we tackle arguably the biggest issue facing medical education in Australia today?

This is the question AMSA will be trying to help answer this year through the AMSA MedEd survey. We want to find out what makes for a good clinical rotation for medical students; whether it be the number of tutorials, the patient load, a high clinician to student ratio or the institution of a juggling octopus in every third hospital bay. These are crucial questions that we must answer in order to advocate constructively for improved quality of placements.

In December ’08 the Council of Australian Governments (COAG) allocated $1.6b to Health Workforce Australia (HWA).

Over $500m of this funding was for improving the capacity and quality of clinical placements; which even the staunchest of anti-COAGulants noted to be a significant bleed from the governmental coffers. HWA is now developing the best way to distribute these funds to the Universities and Hospitals whilst monitoring the improvements in the quality of placements. Hence, the acute importance of this issue.

Already this year we have seen a confirmation that all Commonwealth-Supported students will be guaranteed an internship and $632m investment to increase the number

of internships and specialty training places.

Furthermore, the $1.6b announced at COAG in 2008 has started to be allocated with many Universities receiving funding for new clinical training sites. These are all positive moves by the government. Unfortunately, about one in four graduates still are not guaranteed internships. This is a huge issue because the students who are not guaranteed internships have the biggest debts (up to $270,000!).

To help start addressing this problem AMSA Council in February passed a policy on the regulation of medical student numbers. This essentially said that we cannot continue to increase medical student numbers without first knowing the capacity of our clinical training environments and the number of junior doctor training positions. The Medical Deans have backed this statement and have recently stated that medical student numbers should be capped for a period of two years.

If everyone is singing the same tune then hopefully this will soon become a romantic, harmonious reality.

It doesn’t matter if it’s singing, dancing, miming or shadow puppets, effective communication makes life easier for ourselves, our colleagues, future patients, everyone.

Whether you’re interested in rural health, global health, gaining leadership skills, listening to inspiring doctors or just want to communicate other students from around Australia there is an AMSA event for you.

We have already had the inaugural National Rural Leadership Development Seminar and with the National Convention, Training New Trainers, ThinkGlobal Workshop, Global Health Conference and the National Leadership Development Seminar still to come, there are many opportunities to get involved. Make sure you are not one of the few who miss out, otherwise we will never get to communicate with one another. That would leave me to interact with only my Labradors - and there are only so many things we can talk about.

What,

Feel deficient in your anatomy? That’s what you’re told anyway. Sam kirchner (PR) says this isn’t good.

No Funny Bone?

The issue of medical students and anatomy teaching has reared its head once again. You may have seen the front page of The Australian on Wednesday 31st of March which ran the headline ‘Student Doctors Skipping Anatomy’ Or you may have seen the article published in the Australian and New Zealand Journal of Surgery which reviewed anatomy education in Australian and New Zealand medical schools and on which the news story was loosely based.

The article states that the total hours of anatomy teaching averaged 171 hours but was highly variable, ranging from 56 hours to 500 hours. The article’s authors claim that when compared against historical data there has been a major decline in time allocated to teaching gross anatomy. However, one key finding published in the article was largely omitted from the public debate and it is far more significant than the historical comparison. In the authors’ own words: the average total hours for Australian

and New Zealand schools (171 h) is comparable with US figures [and]... is nearly 50 h greater than the reported average for UK and Irish medical schools This is a telling statistic. It tells us that by developed world standards we are performing well and it reminds us that historical comparisons are not always useful or necessary. For instance, we know that students today learn

differently than students in the past, with decreased didactic

learning and more self-directed and small group learning. And so the fact that the article reports only on anatomy teaching and not anatomy learning (or knowledge) becomes very relevant. The article does not recognise the countless hours that students spend poring over anatomy texts, or learning anatomy in the operating theatre or in outpatients.

And another thing... It does not follow, necessarily, that decreased teaching of anatomy is directly proportional to decreased knowledge in anatomy

(as seems to be the undercurrent of this debate). Further, as the sum of all medical knowledge grows and areas like pharmacology and medical genetics become increasingly larger, detailed and better understood, teaching time becomes naturally tighter and unless we increase the length of our medical courses we must be prepared to be flexible with our valuable teaching time. At the same time we must ensure that our doctors are well rounded and prepared for medical practice in the twenty-first century.

Functional and clinically relevant anatomical knowledge is essential for any practicing doctor; of this I have no doubt. But there are so many things that are essential for doctors to know, that it becomes very important how we balance unlimited wants (eg. Cardiologists calling for more cardiology, surgeons for more anatomy etc.) with limited resources (time and money). This is a terribly difficult task, but one thing is certain – using the “back in my day” argument is not good science. So, if surgeons think we need more anatomy, then logically they must first assess our level of knowledge (not simply analyse teaching), then justify why a house officer (RMO, JHO) or GP would need to know more than they currently do. As we listen to their justification, we must remind ourselves that there is no point learning anatomy (or anything else for that matter) for the sake of learning anatomy and every minute of teaching time in medical curricula should be justified with this perspective in mind. What is essential for a GP to know? What must a house officer know to be safe and competent?

Finally, let us not forget the significant amount of postgraduate training and experiences that lies ahead of our medical students, and that we will be forever learning and utilising anatomy.

Panacea Vol 44 No 1 05

the AMA and amsa: two key voices for one medical profession These two bodies are intractably linked. The question is: How? dr Andrew perry (Chair, AMA Doctors in Training Council) gives an unique insight.

In addition to his role as Chair of AMA Council of Doctors in Training, Andrew is also: Emergency Medicine Registrar, Adelaide South Australia Inaugural AMSA Honorary Life Member 2007

06 Panacea Vol 44 No 1

The night before writing this article I was invited by AMSA to participate in their much anticipated corporate governance review. I was invited to participate predominantly in my role as the Chair of the AMA’s Council of Doctors in Training (AMACDT), which is the section of the AMA with which AMSA has the greatest contact and involvement. The reason for having such a high level of involvement between the two bodies is obvious – AMSA is interested not only in medical student issues but also in those matters which have the potential to affect medical students whilst still at medical school or shortly thereafter. Good examples of these matters include AMSA’s intensive lobbying on internships, and their involvement in the Australian Curriculum Framework for Junior Doctors which many say has a curriculum eerily similar to that of most medical school’s final year curricula. Of course the AMA is also heavily involved

in representing the medical profession on both of these issues as well and more often than not the AMA and AMSA find common ground and together are able to communicate and reinforce key messages.

The second reason I was invited to take part in this corporate governance review is my own personal involvement with AMSA, having sat on the AMSA Council for the last 3 years of my degree, including 2 of those years on the AMSA Executive. Since graduation 6 years ago I have maintained a close interest and link with AMSA through both personal friendships and my various AMA roles, which is an organisation I transitioned into shortly after starting my internship.

As the corporate governance expert asked a range of questions relating to AMSA’s primary role in seeking to improve the welfare of Australian medical students and how it could best achieve this the conversation inevitably came around to the issue of

where AMSA and the AMA sat in relation to each other.

I found myself answering a number of questions revolving around the relationship between these two bodies and this made me really focus on what is an issue that is of great importance to the medical profession. It is vital - and I would argue an obligation - for doctors to have a say in how the next generation of doctors is trained as they will rely on them whilst they are juniors and then eventually hand the baton on. And the majority of medical students would have a keen interest in what is occurring to doctors now as that will shape the medical system that they will shortly inherit. So good communication and collaboration between those groups representing doctors and those representing medical students is key.

I was asked how well the AMA and AMSA communicated – and my response was that the lines of communication, both formal and informal between the groups were incredibly well established.

On the formal front, there was surprise at how inclusive the AMA was of medical student views.

This is through the incorporation of AMSA representatives on all relevant AMA committees including full voting rights on Federal Council. On the informal front I can cite a fresh example from this very evening of writing this article when the AMA President gave me and then the AMSA President a call to get our thoughts about a medical student making inappropriate comments on a social media forum so as to help inform his response to media

enquiries on that matter.

AMSA in turn has always made reciprocal efforts to allow the AMA to provide its perspective to AMSA on medical student issues through formal invitations to the AMA President and AMACDT Chair to attend AMSA Council meetings and other formal events.

And without exaggerating informal communication would occur on almost a daily basis between the AMSA Executive and AMACDT Chair and council members via phone calls, emails, face-to-face catch ups at mutually attended meetings and even Facebook.

However one of my closing comments to the corporate governance expert was that while the links between the AMA and AMSA were strong there was no doubt that they were 2 separate identities. I reflected that in all my time involved with the two organisations (which is approaching a decade now) that there had not been one instance where either party had not treated the other’s views with respect nor acknowledged rights to independence.

And I left the session realising how fortunate the medical profession is that it has two strong independent bodies representing both medical students and doctors.

With such a solid history between AMA and AMSA, and with so many issues of mutual, vital importance, I have no doubt that the AMA and AMSA will continue to communicate, collaborate and advocate on behalf of the medical profession from first year student to senior specialist for many more years to come.

Panacea Vol 44 No 1 07

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wrong article, buddy. in fact, wrong magazine

Cement Inc.

dang The Ed finds himself in the curious position of receiving two nearly identical articles. (see pg 63 for next) Joel Menzies (UND) also has neologism.

Just Semantics?

Only just two years have passed since starting my studies in medicine, whilst most of the time the amount of information presented leaves me bewildered and wondering if I’ll ever feel on top of it. Obviously there is a very long way to go but we are all getting there.

Along the way we learn a new language that can be at first very confronting. Hypertrophic pulmonary osteoarthropathy, endoscopic retrograde cholangiopancreatography, pseudohyperparathyroidism.

Two years ago, such phrases with their inordinate number of syllables left me completely baffled; now I understand them. It leaves me thinking however, how useful is this extensive jargon?

Does adopting all this Greek and Latin and who-knows-what-else into the medical vocabulary actually help with patient care and our understanding. I think most of the time the answer is yes but there are times that the answer is no, and it can be fatal.

Now we can just cast it aside as frivolous, “it’s just semantics” is a regular response, or “it’s just another bit of nomenclature”.

I actually think these responses can be slightly ignorant as we need to know exactly what we are talking about. If I say tree, you all know what I am talking about. It is very important we place clear

understanding and meaning to each word.

Many mistakes occur in medicine due to miscommunication so having ambiguous meanings to words, or homonymous words is a disaster waiting to happen.

The two most dangerous terms we face in medicine are not even words. They don’t even satisfy categories such as being a noun or a verb.

They are sinister and dangerous. They are known as prefixes. Two particularly insidious prefixes that can create such disturbing ambiguities are hyper- and hypo-. How many times have we all asked for clarification “sorry was that hyperkalaemia or hypokalaemia?”

Instituting the wrong treatment according to the said diagnosis due to confusion surrounding these nasty prefixes is simply absurd. O or er can mean life or death.

Identifying a problem requires a solution; I often find literary manners intangible but this deadly scenario is very simply solved. We don’t even have to change both prefixes, just one. We don’t even have to change all four letters, just two.

With a change to two letters, confusion is avoided and lives saved. I propose we adopt ‘lopo-’ as a replacement to ‘hypo-’.

The patient is lopotensive, he had abnormal blood findings he was loponatraemic. The pt has hyperthyroidism. Never again will

you have to pause and ask – “sorry was that hyper or hypo?” Credit actually goes to the US performing artist known as FLORIDER when introduced in “Shorty got Lopo”.

Why can’t we change words in medicine, we know the surgeons are moving away from eponymous mysticism. Apologies to Gabriel Fallopious and Bartolomeo Eustachio but we all know how archaic their tubes are.

I have similar feelings towards dilatation.

Who introduced the extra syllable in the middle? Dilation is just so middle class.

How does it actually benefit the meaning of the word? What extra information does the ”ta” in dilatation give us? When do we use dilation rather than dilatation?

I have never received a satisfactory response to these ponderings. The most valid so far has been “It sounds more impressive in front of the patients”. Do we really want to add the complexity of an already impressive sounding language just for the sake of it? Present and future tense forget dilate, use dilatate. Past tense, forget dilated, adopt dilatated, and my favourite, dilatational. Is it a word?

I just don’t know. Some of you may try to accuse me of sterilising our language, stifling vocabuleric creativity but I say we have no room for this in medicine when lives are at stake.

Panacea Vol 44 No 1 09

40 hail marys, 5 our fathers and a whole lot of patients

in Australia 160 years, offering health _____________________________ care long_______________________ before there were alternatives, ______ and they currently_________________ manage 10% of the ____________ nation’s patients through 75 hospitals __________________ ___________ (9,500 beds), 530 aged care services ________________________ _____ (19,000 beds) and 8 hospices. To some _____________________________ Catholic ethos is a downside, and _the ____________________________ having just______________________ done a women’s health term _______ I see the irritation of being unable to clip _____________ ________________ Steve Peterson (ANU) gives us 26,678 reasons why someone’s fallopian tubes Caesar ___________________ post __________ private sector hospitals deserve our respect. if that’s what they want. But this is not a _________________________ ____ fatal flaw, on balance the nation benefits ______________________________ from the_________________________ presence of Catholic hospitals. and that should be addressed, but In Canberra, the bradycardic this___________________________________ ___________________________________ Whilst this is only a personal experience, it’s also true that of___________________________________ the 664 ‘treatments heart of the nation, there has been some __________ ___________________________________ ______________ having been a student in both Canberra’s or operations’ tallied by the ABS, 660 are recent controversy and debate___________________________________ in regards _____________________ ___________________________________ ___ public and Catholic private hospital it is available at a private hospital in Australia. to the role of a Catholic private hospital in ________________________________ ___________________________________ ____________________________ the latter that has happier staff in a better Another stick to whack private hospitals providing health care in the ACT. Not all _______ ___________________________________ ___________________________________ _________________ atmosphere who are nicer to students, but when they of what has been said was ___________________________________ complementary with, certainly in Canberra, is___________________________________ __________________ ______ then again others might get disheartened receive public money to treat public towards this hospital, much of it sadly _____________________________ ___________________________________ _______________________________ by images of a____________________ crucified man when they patients. Possibly this is unwarranted lacking___________________________________ in fact and reason. I think a dual ____ ___________________________________ are trying to get better. Still, diversity is or abused in some cases, but overall public and private hospital system works _______________ ___________________________________ ___________________________________ _________ a good thing in our health system and it the public system receives $27 billion well for Australia, so I decided to find __________________________ ___________________________________ __________________________________ should be tolerated and encouraged. of public funds for 60% of the nation’s a_ few figures to back up this apparently ___________________________________ ___________________________________ _______________________ patients, where as the___________________________________ public system ludicrous thought.___________________________________ ____________ ____________ I should say that whilst I don’t think we receives $7 billion for 40% of patients. _______________________ ___________________________________ ___________________________________ could do without private hospitals, we _ Like it or not we need our private Prima facie it looks like good value.

The __________________________________ ___________________________________ __________________________ definitely couldn’t do without public hospitals.

Australia has 557 private productivity commission also notes _________ ___________________________________ ___________________________________ _______________ hospitals. They shoulder the largest hospitals, boasting 26,678 beds, half a that private hospital admissions are ____________________ ___________________________________ ___________________________________ ____ health care burden, are more accessible million ED visits, 7.7 million patient days, cheaper, shorter and are less likely to _______________________________ ___________________________________to_____________________________ all Australians, perform the majority of and 50,000 full time equivalent staff. give a hospital acquired infection. ______ ___________________________________ ___________________________________ teaching, and are__________________ all round awesome too.

This is a large chunk of the health care _________________ ___________________________________ ___________________________________ _______ I just wanted to point out the foolishness Not only are some hospitals private system, representing 40% of all patients, ____________________________ ______ of some_________________________ of the more extreme anti-private but some are also Catholic, another and can’t just be replaced overnight. ___________________________________ __________ ___________________________________ ___________________________________ ______________ exists. In 2010 Some regular criticisms of the private outrageous proposition.

However I argue hospital commentary that _____________________ ___ they form a vital part of Australia’s health Catholic hospitals are also a useful___________________________________ and health care system is that only___________________________________ limited, ________________________________ ___________________________________ ____________________________ care system and I can’t see that changing irreplaceable piece of our health care profitable procedures are preformed at _______ ___________________________________ ___________________________________ in our careers. _________________ puzzle. Catholic hospitals have been private hospitals.

There is some truth to

010 Panacea Vol 44 No 1

Cale Lawlor (UNE)

reckons what you wear to hospital can make your future. Or seriously obliterate it.

Hospital!

A whole new world of excitement, action, romance and of course...even most importantly...fashion. As with everything, the hospital fashion world is a dynamic, gurgling monster that will chew you up and spit you out if you’re out of line. It is a harsh world, comparable to school in the amount of psychological scarring that can occur. So by no means is this a guide to appeasing the shallow, judgemental beast that is the health system. It is merely a framework of critiquing yourself and an explanation to the unfortunate image you may be accidently portraying.

The Blank Slate This classic design is one that is possibly the least offensive to the most people.

It usually involves bland colours, no patterns whatsoever, and an absolute coherence to the laws of minimalism. For men it would involve a white shirt, and black pants, with similar matching belt and shoes...and for the ladies, a nonstatement top with pants to match and shoes (which in this case are allowed to possibly have a bit of a pattern). Though this design is safe and popular, it will ensure you are just part of the crowd.

Notable Quote: “I’ve been hurt so many times before” Potential Career: General Practice

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The Individualist these are the kind of people who are most likely to be noticed by the beast for their attire selection. They may look normal from afar, but as they come closer, the eyes start to differentiate and notice something is not quite right...whether it be the silk-embroidered notepad, the bright socks, the penis stethoscope, the snake skin shoes, the optical illusion shirt, or most outrageously, the Mohawk. Let’s admit it, we all have these urges, but for the moment, we may need to suppress these flamboyant inklings until we are qualified and paid.

Notable Quote: “Don’t let the MAN keep you down. ” Potential career: Paediatrics

The Glitterati

The Naturalist

The Over-driven Studier

The other end of the spectrum is those who go overboard and think that a regular visit to the hospital and regular interview of the latest cholecystectomy patient is a chance to break into the fashion world, albeit at a low level. For the guys and girls, this includes designer clothes, accessories and any type of styling. It has also been noted that a feature of this for guys is the ritual known as “manscaping”, for women, the rules blur.

Notable Quote: “I don’t need to ask questions, I look so good they’ll tell me anything I want to know. ” Potential career: Orthopaedics

Full frontal nudity. Yes we may all love it, but this as a rule doesn’t go down well at hospital. Not to say that it is uncommon, but it is more prevalent in the patients rather than the eager students. This fashion statement is usually followed by a shift kick out the door of your medical building, which, if naked, could lead to lower gastrointestinal tract trauma.

Notable Quote: “We’ve all got one!”

Potential career: Psychiatry

We all know this design, and out of all of the designs here, it is the one most likened to a homeless person. Though admittedly a few med students may have trouble with being on the good side of fashionable, most know enough to keep themselves out of trouble, except this bunch of misfits. Classic examples of this include an inverted tie, creases in clothes, running shoes, garish colours, clashing themes and patterns from the carpet at your local RSL and a general demeanour of having just woken up. For extra points, body odour can be added.

Notable Quote: “I don’t care about your family....what is the dosage of your antidepressants?”

Potential career: Pathology

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+

iphone apps you need for medicine

Dani Bersin ( James

Cook Uni) gives yet another reason for the loathsome loners not yet part of the iPhone supercollective to hate ourselves 014 Panacea Vol 44 No 1

So you think you’re tech savvy and you’ve got yourself an iTouch or an iPhone. Well Congrats!

Now that you’ve got it, you need to be able to flaunt it to your peers, impress nurses and allied health staff with your impressive knowledge on the wards or hold it under the desk during PBL, looking up answers and appearing like the smart kid to that Consultant who’s signing your appraisal form next week.

So this is AMSA’s guide to the Apps you NEED in order to achieve all of the above.

First things first: You get what you pay for. There are thousands of Apps out there. Some are free, some are not. While the free ones are great, you may find it worthwhile to spend the extra dollars to get an App that really stands out and is highly recommended by clinicians.

Next, the internet: You’ll find that while you may download full Apps, when you want to access info, they often try connecting to the internet. Great if you’ve got Wireless at the Med School or 3G on your iPhone. Not so great if you don’t have Wireless network or 3G reception in the concrete maze of the hospital.

So we’re past the formalities, what are the Apps?

iCHM: For students who understand “copyright” to mean copied correctly/ copied exactly/copied in its entirety, this is a must. For all the PDF notes and CHM files you may have procured for yourself or the online Books you’ve managed to get your hands on (how you did it is not our problem), this is a great App that will allow you to view these files on your iPhone. For all the money you’ve saved, may we recommend possibly paying for the Full Edition?

Wikipedia Mobile and Wikipanion: Anyone in the last 10

years who’s graduated from Med School will tell you they couldn’t have done it without Wikipedia. You’ve all seen the Facebook Groups. So Wikipedia has finally released their official App for the iPhone so that you may browse the new-age student bible. That being said, the more popular App for accessing Wikipedia appears to be Wikipanion.

They’re both free so we’ll let you be the judge.

+ = MedScape: From the online

providers of eMedicine, this is without a doubt one of the best Apps available for iPhone and to sweeten the deal: it’s free! This App has a reference for over 6000 drugs, including OTC, as well as drug interaction checker. It has a section for diseases and conditions and more recently, clinical procedures, with videos.

Check out a similar App Epocrates.

MedCalc: The one thing MedScape has been criticised for is its lack of a medical calculator. Come along MedCalc, a free medical calculator that gives you easy access to complicated medical formulas, scores, scales and classifications. It has detailed info about each formula and you can keep a list of the most frequently used.

iRadiology: Based off Dr Lieberman’s online tutorials, this App is fantastic for learning and reviewing radiology principles and pathologies. There are over 500 images to access with labels as well as case findings and discussion.

What makes this App amazing is that not only is it free, but the all the info is downloaded onto your iPhone, so no WiFi or 3G required when you use it. For more detailed radiology and cases, check out Radiopaedia.org for some free and low-cost Apps.

Eponyms (for students): This is

a great little App, perfect for Ward rounds and PBL when you’re quizzed about the difference between Berger’s Disease and Buerger’s Disease. With over 1700 descriptions, it’s well categorised and there’s a “Learn Mode” too. Because we’re students, it’s free.

Diagnosaurus: From online reviews,

this is the most useful App ever invented for morning rounds. You can search by organ system, symptom or disease, with over 1000 differentials to choose from.

It’s a simple App, with brief descriptions but for less than $2, you can’t really go wrong. For an App with greater detail and more diseases at a slightly higher cost, check out Differential Diagnosis by the BMJ Group.

Sex-Facts: Lastly, the most popular “medical” App on the iTunes App Store, the people can’t be wrong, right?

With hundreds of interesting facts like “Everyday, around 200 million couples around the world have sex”, it’s a wonder how we ever got by without it. It’s free, so worth a laugh anyway...

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Move over Reptar. Stand aside Littlefoot. Tessa Kennedy (UNSW) is the new giant lizard in town. And she’s got something to roarrrrrr about.

if dinosaurs could talk

As millions of tonnes of volcanic ash from an Icelandic eruption wreak havoc with air travel across Europe and the UK, my kindergarten dinosaur studies are brought to mind – were they really wiped out by volcanic eruptions causing sulphurous ash and acid rain? Asteroid Armageddon? Or a more insidious change in climate?

But more concerning to my egocentric 21st century self is the thought, are we next?

It’s more than just a passing thought – we are obsessed. As medical students, we are challenged with the idea of our own mortality at an earlier age than most, and from the first path prac onwards, every cramp or headache is an AMI or glioblastoma multiforme until proven

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otherwise. A little bit of knowledge is a dangerous thing as we self diagnose with morbid fascination of mixed delight and dread, almost hoping the blood film comes back abnormal.

Understandably, as future physicians it’s pretty easy to think of things within us that could kill us, but what about what’s happening outside?

It has been postulated that climate change is the greatest threat to health in the 21st century – worst case scenario, millions of people displaced in Asia Pacific as sea levels rise, hurricanes, droughts and infectious disease will sweep continents; heck I will get Dengue fever sitting in my backyard in suburban Sydney. Although this is a much more realistic threat, it lacks the adrenaline eliciting fear of death by colossal planetary explosion – just

look how many millions Hollywood has generated from our macabre fascination with the end of the world. Sadly no writer will try to market a film based on a bad guy dubbed “Eyjafjallajökull”.

There is however a basis in reality for volcanic doom saying. An Icelandic eruption and subsequent famine in 1783 wiped out a quarter of the population in Iceland itself, and tens of thousands of people throughout Europe succumbed to the deadly sulfuric acid fog. Luckily, it wasn’t harsh enough (or at least we were canny enough) to make it through - this time.

Realistic threat to our continued existence or not, these events do remind us of our fundamental fragility. We are small, spineless (in the Stegosaurus stakes), and slow – so what makes us so enduring, and gives us the ability to

change the world around us, albeit for better or worse?

Speech. Language. Communication. It is our saber teeth, our piercing claws, the source of our super strength against everything bigger and by rights scarier.

It allows us to work together to identify and deal with many threats to our health and safety and ensure continued world domination, assuming we don’t stuff it up in the midst by losing sight of the planet for the WMDs. Unfortunately the more we build our knowledge bank, the more we start to find out things we possibly didn’t want to know – that we have a life limiting disease, that an asteroid is going to hit in 2 days; or gosh darn it stuff we just didn’t need to know – like these pivotal realities:

+ There have been over fifty million Mr. Potato Heads sold since it came out in 1952.

+ Most lipstick contains fish scales. + It is estimated that at any given time around 0.7% of the world’s population is drunk. (More during the first week of a given July.) + According to suicide statistics, Monday is the favoured day for self-destruction. + “Scientists” have calculated by the Bible and other theological writings that the temperature of hell is 718°C. + 45% of Americans don’t know that the sun is a star. (Actually, that one’s just incredibly sad.)

If our counterparts of 65 million years ago had figured out this language

jazz, perhaps instead of hating on the velociraptors someone could have asked why they were so pissy all the time, and channeled their energy into some species saving teamwork so they’d still be around today. Maybe if dinosaurs could talk now they could give us some what-not-todo’s for surviving the all but inevitable apocalypse?

Ultimately, we have to be receptive to learning from the mistakes and conclusions of the past so we can build on what we know as a collective human consciousness, and don’t have to go rediscovering everything as individuals. That is our challenge. So be it a true ancient reptile or just an ancient professor of medicine: if dinosaurs could talk… would we listen?

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no fingers crossed we all remember Do little innocuous to communicate. our parents chiding us As future doctors we’ve been for lying and constantly lies infiltrate your educated to be ethical in our telling us to keep our life? They sure do actions and communication. promises, but as we get Holding this in the highest mine. Lachlan older our lives aren’t regard protects us from not Mcmichael black and white. It’s only degrading our personal grey. We are constantly (Adelaide) has a look. integrity but the integrity making promises of the whole medical throughout the day profession. Without this, from the relatively minor to the critical. we will lose the trust that patients, and the It may always seem much easier to tell public, place in our hands. the screaming patient in the ED waiting This all seems all well and good, but the room, that the consultant will be there pressures of life often create situations soon. Or telling a consultant that you did where a broken promise is the easy way perform a particular examination, when out. So how can we actually ensure that we you did not. All to avoid confrontation. do keep our promises and the trust of our Stating you performed an examination patients? How do we ensure that we “Say without performing one could result in what you mean and mean what you say”? dire consequences. And falsely reassuring Look at how you communicate. Are a patient is really not an appropriate way

1

you just saying what they want to hear?

This is important to identify and change.

It means you are most likely building hope and expectations that cannot be met. Omission, avoidance of a topic or handballing a difficult subject to someone else is not really good either. These types of communication may make you and your patient feel better in the short term. They are not successful long term strategies and do not keep your integrity in tact.

Review the strategies that you can use to communicate with patients in a truthful way. Many patients may expect you to humour them and tell them what they want to hear. You’ll recognise these situations when you feel like the truth will let the patient down. Advise the patient in direct and clear terms why their care may be delayed or why the consultant may not be able to attend to them immediately.

At least thinking about these strategies will assist in developing more ethical and honest communication with patients.

As hard as you try there will be times when you simply cannot keep a promise. Again, it is honesty that is the best mediator in these circumstances.

An apology, taking responsibility and rectifying the situation are the best steps to take. There should be no excuses and no buck passing. Take responsibility and apologise directly to the patient. Most patients will respect you for it, even if they don’t say it.

2

3

“Say what you________________ mean and mean ___________ is what you say” ___________ _ a phrase that should

be glued to the back of our minds at all times. The most important lesson to draw from keeping promises is not to fall into the trap of taking the easy way out. You’ll only end up letting down the patient, your integrity and your parents.

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‘Evidence’ Based Myths Undermine Medical Education Too often we are blind-sighted by assumptions about our education.

Grant Ross ( UMelb) takes a serious look at what goes on behind the premise of tertiary studies in medicine Example Question from Section 1 of UMAT

Botanists studied a rainforest in Nicaragua that had been ravaged by Hurricane Joan in 1988. They found that in the following ten years the number of tree species had increased by at least 200%, and up to 300%, in eight storm-affected plots. Other plots not affected by the hurricane showed little if any such increase.

From this information, it can be concluded that A hurricanes play an important role in ensuring the long-term survival of tropical rainforests.

B when the dominant trees in an area of tropical rainforest are destroyed, other species are given a chance to flourish.

C the overall life of a tropical rainforest is increased if large areas are occasionally levelled to the ground.

Research and evidence hold a powerful place in our academic culture, and rightly so. Definitive, objective proof of the likelihood of one hypothesis over another has earned its merits in the solution to a number of historical and ongoing problems.

But how readily is evidence liable to cause havoc when misused or misunderstood?

Answer: In a recent tutorial from a Medical Education Unit tutor about history taking, we were told that we need to ‘shape our history taking to enable the patient to speak rather than the history taker’. What this meant was not cutting the patient off in the first sentence, which ‘according to research, happens in an average of 18 seconds’. Armed with my experience of seeing highly qualified

B

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practitioners routinely cut patients off when they wander away from the history, I commented to the tutor ‘is that always possible? Surely the doctor makes the diagnosis so knows what to explore, not the patient?’ I was promptly told that cutting the patient off would forfeit ‘necessary information about the condition’ and cause me to ‘miss clues about the diagnosis’ .

Hang on a moment! Isn’t the whole point of training to be a doctor to know what to ask and find out irrespective of what the patient chooses to say? How negligent would a doctor be to miss the diagnosis because the patient didn’t offer the information? ‘Well, sorry I missed that cancer Mrs Brown. If only you’d mentioned your drooping eyelid and sweatless face then I’d have understood you have a Pancoast’s tumour.’

I further asked, ‘Is there any evidence from an objective study that shows that cutting the patient off at 18 seconds actually lowers the accuracy of the diagnosis compared with any other method? Is it harming people?’ She stared at me blank-eyed.

She replied, ‘but you would miss things if you don’t allow them to speak’. I repeated myself, ‘but is there any evidence or is this just your opinion?’ She stood blank as my group hid their sniggers. The point is, our tutor didn’t know of any evidence, despite her viewpoint.

The sad reality is that, irrespective of whether the evidence is out there or not, many people in medical education and administration still just base their zest for their assertions loosely on evidence and mostly on bias or personal opinion. Such opinions are not entirely without merit; it is just that they are limited and have the effect, I would like to argue, of tempting the individual to stretch the evidence beyond what it really proves.

An article in MJA evaluating the place of Problem Based Learning (PBL) in

the curriculum made an argument along these lines. In 2005, Sanson-Fisher and Lynagh evaluated the evidence leading to the adoption of PBL and also the evidence of its efficacy generated over the last ten years. Most striking was the overall impression from the evidence that the authors had regarding the efficacy of PBL. They stated, ‘Evidence that PBL curricula lead to greater retention and recall of information and a strengthening of hypothetico-deductive reasoning is not robust and is mostly absent from research findings. As this is one of the educational rationales for adopting a PBL curriculum, one must question the reasons for the continuing growth in popularity of PBL…. in spite of empirical reviews suggesting PBL’s effectiveness may be limited.’

have reviewed the research and found that there are no links to any of these claims.

They are just spin; they are meaningless.

A British pilot study for a meta-analysis of PBL’s performance made the point that ‘very little information was given in the papers from which data was extracted about the design, preparation or delivery processes of either the PBL intervention or the control to which PBL was being compared .

Even if there was robust evidence for PBL working for whatever endpoint, what is to say that the kind of PBL is the same one delivered elsewhere? Everybody does it differently, and where is the evidence that these differences do not matter?

I have had a few experiences in my own PBL classes that I’m sure no selfrespecting medical academic would have intentionally let slip through the system.

There was the time I had to explain to my tutor that I expected the patient to be breathless on the basis of ‘his lung having collapsed’. The tutor, admittedly an IT engineer, had trouble understanding the biomedical link from the ‘concept map’ in his ‘facilitator guide’.

There was also the occasion when a fellow student suggested that 28 people from the same family reunion started vomiting 8-24 hours after an outdoors picnic because of a genetically inherited stomach cancer that miraculously chose to present at the same time.

The tutor, a molecular geneticist from the faculty earning some extra cash, described the hypothesis as ‘perfectly valid’ and could not understand my opposition to it being written on the board as the same likelihood as staph poisoning. I felt that a tutor has the obligation to step in and explain to students when their hypotheses are just plain stupid. Isn’t part of teaching establishing what is wrong as well as what is right? Is this the kind of educational experience we are surrendering our

empirical reviews suggesting that PBL’s effectiveness may

be limited’.

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This interested me greatly in light of the amazing claims that the powers that be lined up to attribute to PBL. I hopped on SCOPUS and dug up a range of papers.

All authors waxed lyrical about the intentions of PBL to build such skills as: - dealing with problems and making reasoned decisions in unfamiliar situations - reasoning critically and creatively - promoting deeper, rather than superficial learning - promoting retention of knowledge (and most impressively) - improving motivation to learn.

Thinking deeper! Improving motivation to learn (for everybody?)! High praise indeed. But none of the papers spouting them could find any evidence to even suggest these claims, never mind (retrospectively) support them. Lynagh and Sanson-Fisher are among many who

medical profession too?

Sadly, any complaint (particularly from a mere student, God forbid we might have some credibility as the people actually experiencing the PBL approach first hand!) about the model of PBL delivery by ‘non-medical graduates’ and the potential for misinformation and poor study methods are generally ignored.

Counterviews to PBL are not considered to have any validity whatsoever on account of the strength and conclusive unanimity of non evidence elsewhere. The evidence based brick wall if you will. And this forceful approach doesn’t stop there.

The Advanced Medical Science year was a compulsory year of research activity in the Melbourne University MBBS curriculum. Clearly, it wouldn’t be compulsory if the course designers didn’t have strong beliefs on the topic.

There is no way there is any empirical evidence stating ‘B Med Sci’ students kill less patients, but based on a number

of experiences and observations, the Professors clearly thought strongly enough to impose this experience on all of the medical students.

I found this ‘compulsory’ aspect very confronting given that another bank of people, including prominent medical educator and scientist Professor Trefor Morgan, described the AMS program as ‘the most stupid thing imaginable’.

So what was the reality? Well many students had a fun and productive year, churning out a publication that they will need to get into specialist training. Many had a dismal year and were disappointed by their disinterested or incompetent supervisors. My own experience was churning out a hideously substandard research project and had the choice to either fail the year because it was so poorly planned or cram it through so I could get on with my life back in the hospital system.

There is no clear evidence on AMS to say it is bad. There is, however, an incredibly good argument, overwhelmingly shared by every medical doctor I speak with that the AMS year should at the very least have been voluntary. From this I can simply ask, why the iron fisted zeal in making AMS compulsory? Why wasn’t it open to negotiation and case making?

I can only suggest that AMS had other benefits for the medical school. $5000 gets paid out to the supervisor from Melbourne University whilst $27000 comes in via HECS and government funding; there must be about >150 students doing it. Unless the AMS administration office on level 7 required a few million dollars to function, I can’t see how AMS didn’t run a profit. But, alas, that kind of evidence won’t hold up; unless you happen to be the ACCC. On a happier note, there was a recent win for appropriate application of evidence in regards to medical student selection procedures.

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The University of Queensland has scrapped the interview process for its student selection. Head of the School of Medicine for UQ, Professor Wilkinson argued that: ‘the interview score adds very little predictive value’ to subject performance. In the face of this he has decided to ditch it in favour of focusing on what he can get right, that is selecting for what can be selected for and teaching the rest. Is this not a reasonable use of the evidence? In my ‘evidence-free’ opinion, he has shown a remarkable sensitivity to

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the limits of evidence.

In response, Wilson and Harding made an argument that Wilkinson’s lack of interview will forgo the consideration of: social equity, “fitness-to-task”, community expectations and a corporate responsibility What do these things even mean?

Nothing apparently. Wilkinson scoped the research and found that whatever these things are, they have nothing to do with an interview. The things that Wilson and Harding want to protect have been shown, by evidence, not to even be attained by the interview. So once again, why the zealous opposition? They were contradicted by the evidence!

There are plenty more issues in medical

education designs and debates that could fit this mould such as graduate versus undergraduate arguments and the horrific and shameful failure of ‘Self Directed Learning’ policies. The SDL experience is such a tragic and horrific mistake of history that I am far too biased and will write about it in a separate article.

But the point is simply this. We are all fighting to create the best medical experiment. But how often is the ‘evidence’ cited by proponents of a viewpoint actually in direct support of a syllogistic premise rather than just in vague support?

As intellectuals we should all be aware that the two are vastly different, and masquerading one as the other, either actively or passively, is inaccurate and at worst blatantly fraudulent.

I, for one, have been the subject of some highly underwhelming experiments on medical education. I have found SDL to be a disaster; PBL to be excellent, but frustrating and more limited than admitted; interviews to be overrated and collectively AMS and the change of Medicine to purely graduate, to be profit driven exercises masqueraded as evidence based improvements.

At the end of the day, there is little more needed to produce a successful model than open and honest debate about what should constitute the best design. Alas, all of our intellectualism, experience, evidence and knowledge combined come to nothing if we fail to be objective, and accept the limitations of any evidence before us.

BOOMBALADA RHAPSODY The title says it all. UQ’s Med Revue sinks its teeth into Australia’s obesity epidemic.

Pi be zz sit a y’s

TASTY

Give him some french fries, He’ll be in ecstasy Or maybe a meat pie But he’ll never eat celery.

If you are wise You’ll look at his thighs and see He’s just a Fat Boy, (Fat Boy) he’ll get no sympathy Because he eats a lot at Dominos Maybe fat, Maybe slow Wearing curtains as clothes, isn’t that attractive - to me, to me Summer, you don’t understand Obesity is on the rise Half the world has been up-sized Better, get used to thunder-bums Be careful that you don’t get in their way Summer, ooo The legion of the fried We’re screwed if they decide to try take over!

Too late, our time has come An army will arise With manboobs and thunderthighs Goodbye Skinny bitches - You’ve had your go

O

AMSA’S Gonna realise that thin people will always lose Summer ooo (look out here’s the fat show!)

You will surely cry I hope you see that fatness is for all!

The war on obesity has just found its enemy OMG OMG we need to stop the fat show!

Thunder thighs and Wobbly Flab - very very frightening me

Need a way-o, Need a way-o to beat their flab-o, to beat their flab-o KFC and Dominos Magnificoooo I’m just a fat boy, nobody loves me He’s just a fat boy from a fat family Now he’s a large revolutionary Are you all with me - see our skinny foe!

Boombalada! Go - They’re gonna

have a go - have a go!

Boombalada! They’ll change the status quo - status quo Boombalada! They’ll eat their skinny foe - Skinny Foe Gonna have a go - have a go Change the status quo Kill the skinny foe - ooo Go, go, go, go, go, go, go Oh mama mia, mama mia, mama mia, we need hope The corner store has a burger put aside for me, for me x 3 So you think you can stop me from eating these fries Come here and check out the size of my BMI! Oh baby, wanna eat you up baby!

Just gotta pig out - get me some burgers and beer Ooh yeah, ooh yeah Look at all the fatties Anyone can see We should be lap-banding We should be lapbanding… for free Take me to a Domino’s…

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amsarepreports amsarepreports amsarepreports amsarepreports amsarepreports amsarepreports amsarepreports

Ania Smialkowski

Eliza Wziontek

Sebastian Haiart

Notre Dame Fremantle

University of New England

Flinders University

Events To Date

‘Twas a wild start to 2010 in the wild, wild west! Freshers were taken to O Camp for a fun filled weekend of dress up parties, sponsorship talks, Yahoo juice (infamous O Camp punch), midnight beach swims and, of course, boat races. The Back to Uni Uniform Party left hazy recollections the next morning with some stellar costume efforts that would put convention to shame! The Games of the VI PBL Olympiad saw 15 teams competing for the prestigious title this year, with PBL 8 stealing the lead and the title off the 4th years with some impressive Tobasco sauce skÖlling and raw onion eating. Two words: loose cannons.

MSAND launched its Surgical Interest Group this year, with Prof Kingsley Faulkner as the keynote speaker at the launch event. The Second Annual MSAND Rural Night was a great success, complete with bales of hay and flannies.

Most Amusing Anecdote

“Excuse me, but who are you?” (Final Year student to Clinical Dean)

BIG News for your uni

Fremantle Dockers have surprised all this year, and are 3 out of 3 and sitting around 4th place on the ladder….W ho would have thought? Freo, way to go!!

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Events to Date

The year kicked off with First Incision cocktail party. El Presidento Ross educated the meddling of the AMSA family, and judged the dance off where first years were promptly introduced to medcest. Crazy O Camp with UNewcastle. UNE kids are balancing the mind, body and soul with fortnightly discounted yoga and body balance sessions, bush walks and BBQ at the swimming hole in National Park. Visit our new website unemsa.org!

Most Amusing Anecdote

Third years have begun placements, and with their separated ways come PBL by distance, via the internet. Problems do arise when the laptop becomes locked in the car and student outside of car.

However, the student impressively ‘snuck in’ late to the teleconference with no one noticing. Snaps indeed.

BIG NEWS FOR YOUR UNI

Apart from this being the inaugural UNE contribution to a Panacea? Yep, I think that’s pretty big news. Armidale’s ‘Hospital’ has been noticed: $5.5million has just been announced to turn our ‘hospital’ into a clinical school. Big news indeed!

Events to Date

Welcome BBQ, Quiz Night, Surfari, Rubik’s Cube Pub Crawl, 2nd Hand Book Sale, Shave for a Cure

Most Amusing Anecdote

The first incision of the year during dissection ended up being on a student and not the cadaver. Med has a steep learning curve! Only took two scalpel safety lectures before everyone got the idea.

BIG NEWS FOR YOUR UNI

We’ve got a big contingency going to both Convention and GHC! Slowly but surely, Flinders is returning to its glory days. A big thanks to this year’s 1st Years for being so involved, and of course to the 2nd Years for being so inspiring!

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University of Adelaide

Edward Christian

Steve ‘Steve’ Peterson

Notre Dame, Sydney

ANU (Canberra)

Our events thus far: Skullduggery, Medcamp, PresKeg and Jazz Night. We have our education lecture series, Med Footy, Miss Med and Men of Med and Allied Health Night coming up.

MedCamp - see below. We had our first couple of International Health lectures. So far we had an overview of the MDGs from The Global Poverty Projects’ Simon Ross.

Soon to have ticked off eradicating poverty and hunger, and will learned all about ensuring sustainability.

We have a whole lot of global health, academic, social and career events scheduled for the rest of the year, which everyone is looking forward to getting off the ground...

O Week, Med School mixer, Research project evening, rehearsals for ‘Phantom of the Operating Theatre’, Convention team bonding activities.

Edward Gibson

Events to Date

Amusing Anecdotes

Med Footy, the iconic tradition at Adelaide, was under threat. Usually scheduled for all students to attend (read: no lectures), our Prez heard this may not be. So, he was gearing up for a fight when meeting the Dean. Two minutes into the chat, our Dean interrupted him with glassy eyes, and said, “Do the sixth years still win?”. There was a solemn nod. “You’ll get your day off, and Med Footy will always be a part of our calendar.” May 7th. Get there.

Big News

Our Medical School has turned 125, and we have celebratory events coming up. We are dealing with the moving of our 6th Year’s graduation ceremony to a rather inconvenient time. I couldn’t not mention the 1 in 4 South Aussies invading Hobart in July, how much are you all going to love that!?!

EVENTS TO DATE

Most amusing anecdote

Our biggest event thus far has been Medcamp, of a buccaneering variety.

There was some interaction between 1st and 2nd Year and at one point, some of the boys asked the girls to dance, causing us to proclaim the pirate theme a resounding success.

Big news for your uni

Our spearhead 3rd Year group have been unleashed on the health system in NSW and VIC that they are all enjoying. Some more than others have found out that you don’t need to have a long neck to be a goose

EVENTS TO DATE

MOST AMUSING ANECDOTE

We always love the new 1st Years, and it’s great to see that we always have particular personalities that come up every year.

The guy who is really good at sport, the girl who knows everything about medicine before starting her degree, and the guy who dances in the nude in a bar at O Week. So, good to see the selection process working year after year.

BIG NEWS FOR YOUR UNI

Nothing much, apart from debate about a PRINT term being introduced next year, but I guess when your university is the best in Australia according to the Times Higher Education University rankings, you can’t do much better than that.

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Will Cundy

Dani Bersin

Bond University

James Cook University

Medball, Anatomy Challenge, Trivia Night, Medcamp (raised over $9000 for the Royal Flying Doctor Service), Elective Night

Cairns Clinical Sign-on, AMAQ Orientation, Townsville Sign-on BBQ, Darwin Welcome Drinks. Med Camp. Noone died. Mackay Clinical Cocktail Cruise.

Managed to find a boat that hadn’t been destroyed by Cyclone Ului. Cairns Clinical Cocktail Party in May. By Convention, we’ll know how Bungee Jumping went– in formal cocktail attire – in the rainforest!

EVENTS TO DATE

MOST AMUSING ANECDOTE

Losing my virginity to a nurse.

BIG NEWS FOR YOUR UNI On one starry night in December, Bond University gave birth to its inaugural graduating cohort. Although lacking proximity to Jerusalem, no frankincense or myrrh, and virgin-less for miles, we did have 65 wise men and women.

However, the birth was not without some complications, such as the teething problems to be expected of a new mother, but all baby checks have been clear to date. Fledgling graduates were quick to leave the nest and spread their wings interstate with only 45% of graduates remaining with mother Queensland.

While our pioneers are off saving lives, turning water to wine and being crucified, med life at the nest has never been better.

Our new Dean of Medicine has the task of carrying our next cohort to full term – iJesus 2.0!

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Events To Date

Most Amusing Anecdote

(in FML format): Today I went for a community visit with the Nurse from ACAT. We got talking in the car to pass the time. Nurse: “Today’s my wedding anniversary and my daughter’s birthday.”

Me: “Oh Happy Birthday! My brother shares the same birthday as my parent’s anniversary too! How old has she turned?”

Nurse (wiping away tears): “She would have been 29 – she died of SIDS!” FML

BIG News for your uni

Our uni is getting big – really BIG. JCUMSA was expecting 180 new 1st years, but 209 rocked up. Lastly, Bond has acquired our foundation Dean and we’ve thrown in another senior lecturer, because we care so much. And it seems the 007’s need all the help they can get!

Jonathan Da Silva

University of Queensland

Events to Date Orientation, Keg 1, Honours Workshop, 1st-Year BootCamp, Trephine Editors Reunion, President’s Reunion, Sports Day, Case Studies Evening, International Students Info Evening #1, Medical Specialties Evening, TomFoolery.

Most Amusing Anecdote

The motto of the UQMS: Domine nos dirige (God help us!).

Big News FOR your Uni MBBS Curriculum review is ending, while the UQ SOM AMC review is starting up, along with our own internal review!

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Tessa Kennedy

Helen Freeborn

Jane Herbert

University NSW

University of Wollongong

EVENTS TO DATE

EVENTS TO DATE

Jazz on the Lawn, Medcamp, College Cup Touch Footy, Pubcrawl, Military Medicine Night.

MOST AMUSING ANECDOTE

Medcamp 2010 was Bootcamp by name and nature, as a new campsite saw campers trekking in the rain down a forest track too narrow for buses to reach, and sleeping in wooden bunks in outdoor cabins without bathrooms.

Fun was had by all, but one first year in particular awarded the Epstein Barr award for 8 separate spit exchanges during toga party. Look out ladies of convention, he will be looking to take a plunge into YOUR gene pool.

BIG NEWS FOR YOUR UNI

MedLawn has officially been reclaimed, after several years of lying dormant under a construction site for the Lowy Building!

The fact this houses the Children’s Cancer Research Institute made it much harder to complain about in the interim…

EVENTS TO DATE Med Camp 2010, Pub Crawl, the Inaugural WUMSS Med Revue, Upcoming events include: Public Speaking Workshop, Cocktail Party

MOST AMUSING ANECDOTE

Unfortunately nothing that is PG rated, although...this one time a 1st Year at Med Camp ended up in the kitchen stark naked!

For further information, find a 1st Year UoW student.

BIG NEWS FOR YOUR UNI

For the first time, UoW has students across all four years, ensuring enough material was provided for a Med Revue.

Thus, the inaugural UoW Med Revue was born. Few academics were spared in a hilarious look at the idiosyncrasies within our med school. Performed over two nights, the team led by Dell Carter, Lloyd Malone and Meghan Gunst ensured frivolity, laughter and, entertainment was had by all in attendance.

Griffith University

(Dis)orientating a group of unsuspecting 1st Years at O Camp on the Gold Coast.

Seasoned, they joined the annual Scrub Crawl of 300 scrub-clad med students wreaking havoc on the GC. We’re now holding movie nights, hosting professional speaker seminars.

MOST AMUSING ANECDOTE

The enthusiastic and perverse GUMS exec decided 2010 was the year for the inaugral GUMS nude calendar.

This risqué yet tasteful publication features students, skeletons and medical paraphernalia in compromising situations that captivate the imagination of the observer. The hype has now subsided but the question remains – who is Mr July??

BIG NEWS FOR YOUR UNI

Construction has begun on the new 750-bed Gold Coast University Hospital due for completion at the end of 2012. An exciting and reassuring prospect for Griffith students now and in the future, as many more intern places, teaching opportunities and resources become available. Of particular relevance to Griffith students is the potential for free, onsite, bountiful parking, far from the evil eyes of heartless Southport parking inspectors.

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Steve Hurwitz

University of Newcastle EVENTS TO DATE

Done and to come: First Incision Cocktail Party, Med Camp (combined with UNE), Ninjas Vs Pirates Pubcrawl, Surgical Interest Club’s Central Sterilisation Unit Tour, Beach Sports Day, Electives Night and the Great Debate.

Wake Up! Birthing Kit Night, Red Week and Party.

MOST AMUSING ANECDOTE

Who says tutorial rooms are just for study? A single used blister pack of Levonorgestrel 1500 mcg (morning after pill) was found in one of the bins. That raised the question of what are people doing in the tute rooms? But that also raised the question, why are you looking through the bins?

BIG NEWS FOR YOUR UNI

We managed to nerd it up and sweet talk our faculty into creating a MedSoc “course” on the e-learning portal. Our lucky medical students have “MedSoc” right next to their actual Medicine courses! We look damn sexy with our brand new black and white membership cards. One guy got number 007. He’s definitely the most awesome guy going around.

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Michael Loftus

Steve Kunz

Monash University

Deakin University

O Week activities of Gippsland: Australia Day BBQ, golf tournament, laser tag and an introductory lecture or two.

Of Clayton: including Futures Forum, MedFest, Ignite’s Trivia Night, Wildfire’s Get Plastered (literally!) Night, and a retreat down at Philip Island. Med Camp, Launch of (the original) AMSA ThinkTank again in 2010.

Orientation Cocktails Med Camp AMSA National Tour & St. Patrick’s Celebration Karaoke Fundraising Headshave End of Rotation Mixers

Events to Date

Most Amusing Anecdote

A 3rd Year student on anaesthetics halfway through a surgical list: an emergency case was brought in, which the theatre board read as “bone-flap operation”. Iodine was painted on the patient’s abdomen, the student thought twice. Acute abdomen maybe? Minutes later the student witnessed the surgeons remove a loudly wailing ‘appendix’ that was quickly whisked off to NICU. So, that’s what ‘code green’ stands for.

Big News from Monash

The establishment of MUKEG (Monash University Konvention Enjoyment Group) over summer means that Monash’s Convention Team will be – as always – a force to be reckoned with in 2010, with our chants ringing strong over the still waters of Hobart.

Events To Date

Most Amusing Anecdote

A paediatrician discussing how the segregation of general and paediatric emergency departments have been positive in more ways than expected: “You’d be there, examining an asthmatic patient, with a gunshot victim in the bed next to you, bleeding everywhere… ruining your shoes”

BIG News for your uni

We’ve had our 3rd batch of students commence, and had the first group hit hospitals. Our annual Medical School Oration saw the opening of the new clinical school, with a riveting lecture on climate change and health from Dr Aaron Bernstein, from the Harvard Medical School Center for Health and the Global Environment.

Students are looking forward to the interuniversity mixer, seminar series, and the ever looming July GHC and Convention, Derwentside.

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Golsa Adabi

Robert Marshall

Cameron Gofton

University of Western Australia

University of Sydney

University of Tasmania

Med O-Camp. This event, held on the memorable first Friday of Med 1 at the University of Sydney, challenged these still naive students in ways that they will never experience again. It made them work as teams to overcome the many challenges on the obstacle course of death and destruction. Global Health lecture series starting with a bang, a new MedSoc Council being elected in an epic 5 hour MedSoc meeting, and that is just the start.

First Year Orientation, Med Camp, Societies Day, Med Welcome, International Student BBQ, Med Cocktail Party, Pre-Clinical Lunches, Clinical Lunches, Pleasant Friday Evening, Med Soccer

Events to date

We’ve welcomed the latest batch of medical, dental, podiatric and health science students to UWA at the annual Fresher Camp. Lookout ®, the WAMSS charity arm, has been in full swing as it washed its way to another successful Scrubber Day carwash. Social Reps had students going wild at the Perth Zoo, an appropriate replacement for the annual ‘Rivercruise’ function. But what dreams may come...

MOST AMUSING ANECDOTE

Overheard on a ward round: Registrar: “How many tablets would you prescribe per rectum?”

Student: “Well, I assume the patient only has one rectum...”

BIG NEWS FOR YOUR UNI

A recent hailstorm that tore through Perth last month has caused damage to University buildings to the tune of “tens of millions of dollars” according to our Vice-Chancellor.

This weather of mass destruction also took out the entire Medicine Faculty building as well as the main medical lecture theatre.

Students missing out on a couple of lectures rejoiced.

Events to date

Most Amusing Anecdote

Who knew that this young group would have to attempt to block venereal diseases thrusted upon them by second years, in a visual representation of the constant battle for preventative sexual health. The Pope would not be a happy man...

Big news for your uni

[Pretty sure something has happened.

Not sure what though.] - Ed

Events to Date

Most Amusing Anecdote

Student computer lab being used as a sleeping hub following TUMSS’s biggest event of the year…Med Welcome.

TUMSS Med cocktail 2010 boasted a pod of killer whales bigger than any seen in the Southern Ocean.

Big News For Uni

We have Australia’s newest Medical school – this magnificent building’s architecture is in fact inspired by a giant phagocytic cell. Be warned, late attendance to lectures may result in severe endocytosis. Local student breaks into the AMSA voting server to become Australia’s inaugral Medical Bachelor of the year. In 2010 TUMSS has the achieved its biggest membership sign up on record! There will be no need to book excess baggage home conventioneers, ‘The Cups’ will be staying on the ‘Apple Isle’. FACT.

Panacea Vol 44 No 1 029

Some would say that the title has a very tenuous link to the article below. Interested? Kerry Jewell (Monash) explains.

a Bullet with Butterfly Needles Mister M. Jagger once sang that you can’t always get what you want. And speaking of all things jagged, how sharp is the kick of a general anaesthetic pulsing up your forearm veins? No really, it burns like a little molten bitchy. But if you’ve never undergone surgery (or couldn’t be bothered to do a bit of extra “research” on your anaesthetics rotation) then you may just think I’m being an overdramatic dramatiser (clearly the third worst kind of dramatiser, just behind people who wear more than five items of gold jewellery at a time... and Natarsha Belling).

You see, I write to you from the infirmary that is my bedroom.

An infirmary not because it is full of delirious geriatrics screaming for help because the stench of Debug is melting the hospital gowns off their backs, but rather because I’m marooned here while recovering from a third molar extraction... times four... oh no!

On second thought, infirmary is probably not the right word to use in this context. Not sure about you, but to me “infirmary”

conjures up that black and white print of an iron lung ward filled with polio patients...

or maybe the hospital in ‘Pearl Harbour.’ Either way we’re not really talking about the beneficence of medical students undergoing minor elective procedures to further their ability to empathise with patients stuck on the emotional amusement park ride of emotion one may feel when admitted to a facility teeming with soul-sucking health practitioners who would rather figure out the cinematographic intricacies of their self-indulgent internal monologues based around “never-gonna-happen’ trysts with female practitioners who didn’t put a ring on it and like

the graphic here is in NO WAY associated with the above article

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their admirers are completely focused on upholding a clinical ruthlessness that prevents them from treating their patients like anything other than diseaseriddled fleshy fun-bags on a production line towards the million dollar question on our life’s game of “Who Wants To Be The Most Kickass House Style Diagnostician?” Or are we?

So now having surpassed gold-jewellery abusers on our list of overdramatic dramatisers, let’s see if we can’t make it to the number one position by the end of the article.

As I was saying, between the ups and downs of postop recovery (the lowest point being the night I had to stomach an entire pureed roast meal... meat, potatoes, greens and all), I’ve had a few hours to reflect on my “patient’s-eye” view of hospital-life. And like any good med student I’ve philosophised this experience to the point where reality gives way to a surrealist landscape of melting clocks – one where the notion of prophylactic removal of non-vital organs as a learning tool (and to prevent that rampant disease:

ignorance) actually makes sense.

Speaking of word-limits and conclusions: now is the time to have a friend whip out your appendix, loosen your tonsils, and if you’re relatively hardcore, maybe even have them pry out a kidney (whoa, free kidney!). Who knows what kinds of horrors you’ll discover in your local hospital whilst at the receiving end of a potentially MRSA-loaded scalpel? And by horrors I mean those elements of dayto-day hospital life that seem benign from a meddie’s point of view, but which are highly

intimidating for a patient in a backless gown. Namely the transfer from the bed they wheel you in on, and the one in the middle of the operating theatre that’s just a little bit too high for a graceful transition.

And if you’re unwilling to part with a bit of available scraptissue for the patients, then at least do it for the opportunity to view an incensed Natarsha Belling reporting on the pure insanity of today’s medical students. Because as Billy Corgan once sang, I am still just a rat in a cage... and as a medical student, you really haven’t lived until you’ve put yourself in the cage.

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General Practice TRAINING

Dr Aileen Traves GP REGISTRAR

A career in General Practice provides many benefits: 没 Dynamic, team-based medicine 没 Continuity of patient care 没 Flexible working hours 没 The opportunity to subspecialise 032 Panacea Vol 44 No 1 Image: courtesy of Tropical Medical Training

For more information visit

www.agpt.com.au lovedesigngroup.com 2680

Australian General Practice Training

bec ryan and hamish gunn (Tasmania), like

Queen, want to break free. But at what cost? And, pray tell, does it involve a tabloid-style questionnaire?

Life That’s what we said too, ‘what life?’ Being Med students, we feel as if we need to show the outside world that no, we don’t have time for a social life. Our course is a lot more demanding than any Arts degree. “What’s that? You have more than ten contact hours this week! Oh, and you’re really stressed? Try forty on for size – and that’s without my volunteer work.”

If hours = effort = worth, then more hours = more effort= more worth. We will never admit it, at least not to them, but using this formula, our degree is unequivocally more valuable than all others.

However, where do you draw the line? It’s all too easy to get bogged down in the stress of it all and forget to practice any self-care; but having said that, how many extracurricular activities are too many?

of mbbs...

To help uncover what type of student you are, here’s a quiz from the Apple Isle: What’s your life like outside Med?

It’s Saturday night. We find you? a) With Talley and O’Connor, followed by dinner with friends. b) Wearing Friday night’s shirt.

It worked then, why not now? c) Working. Like every Friday and Saturday night. d) In the computer lab. Your internet has already been capped from downloading last week’s lectures.

Officeworks just called. Most likely the message will be: a) Officeworks??! b) Michael, your sales assistant, to wish you a happy birthday. c) A casual call to all club members – there’s a sale coming up. d) Sponsoring you next month’s charity marathon. It’s six trainings a week, but you just couldn’t say no.

When your friends are asked to describe you in a sentence, they respond with: a) ‘I don’t see them around much. They always seem to be napping in lectures or in a hurry to get somewhere else.’ b) ‘He/she is pretty quiet. And needs to put their hand down in lectures, no one cares.’ c) ‘Oh, THAT one! Such a loose unit.’ d) ‘I want to be him/her.’

Exam week. You are thinking about? a) No-Doz. Sleep is for the weak. b) Smoke and mirrors. Both from the club last night AND for your study plan. c) Nothing out of the ordinary. Perhaps a bit of what you revised that afternoon before hitting the gym. d)A black void, you’re wrecked after work, marathon training, a chapter of Davidson’s and volunteering at the local soup kitchen.

The scoring system was looking like the Convention09 ballot so we scrapped it. We have enough faith in you that you’ll see the point of our little quiz: It doesn’t pay to live in a Med bubble, nor does it pay to deny university’s existence.

A life outside of Med is not necessarily rated by the number of hours you fill with extracurricular activities – juggle too many balls and eventually one will drop. Your non-MBBS life is up to you.

Do it.

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Molten Chocolate Fondants Rob Olver (Membership) isn’t

just a pretty face. He also cooks a jaw-dropping dessert. Seriously.

Ingredients:

- For prepping the pans 50g melted butter Cocoa powder for dusting - For the fondants 200g of 75% cocoa chocolate 200g unsalted butter 200g brown sugar 4 whole eggs 4 egg yolks 200g plain flour

Method

The following recipe does not get the Heart Foundation Tick of approval. It is not endorsed by the AMSA Wellbeing Working Party. It is in no way condoned by the AMSA Health and Wellbeing Policy. This is a hot, rich, decadent winter dessert.

It’s the perfect dish to impress someone else’s girlfriend.

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When prepared correctly this can be an impressive looking dessert, and there’s nothing quite so satisfying as cracking open the cake outer and having the liquid chocolate centre spill across the plate. Though I’ve recommended it with a butterscotch sauce and vanilla ice cream it can be just as enjoyable with cream or with a fruit coulis.

Serves 8

3 Preheat the oven to 200cc. These fondants can be made in a variety of different moulds.

Individual ramekins are best, but muffin trays will do.

4 Melt the 50g of butter/margarine in the microwave and use a pastry brush to coat the sides and base of each mould. Add a spoonful of cocoa to the bottom of each mould and shake it until the sides and base are covered in cocoa. Tip out any excess cocoa.

5 Using either a double boiler or a microwave gently melt the butter

and chocolate together.

Once combined set it aside to cool for 10min.

6 Use an electric whisk to combine the eggs, egg yolks and sugar until thick and pale.

7 Sift the flour into the egg mixture and beat to combine.

8 Continue beating the eggs and flour while slowly adding the chocolate and butter until combined.

9 Divide the mixture evenly between the preprepared moulds, place them onto a baking tray and into the oven.

10 Bake for 8-15 minutes (Note: Muffin pans will cook faster than ramekins). The fondants are ready when the top is cooked and the edges have started to come away from the moulds.

It is better for them to be undercooked and have the liquid centre preserved.

11 Leave the moulds to cool for a minute before turning out. To turn them out run a sharp knife around the edge of the mould and turn out into your hand and then place straight onto the plate.

Serve with the butterscotch sauce and a good quality vanilla icecream.

Moist Raspberry Cake

In contrast, this girl makes up for unfortunate homeliness with a zest for baking. Daina Rudaks (Community) tantalizes the tastebuds.

We’ve come a long way with raspberries. While Ancient Greeks used raspberry plant roots in beauty products, people now enjoy them fresh, frozen, on their necks, or baked in a cake. So which shall I help you to enjoy today? Well, I don’t know what’s in your garden or in your freezer, and I am not well-acquainted enough with you to intrude your personal space. Alas, a recipe for a raspberry cake will just have to suffice (until Convention at least).

If you feel like living on the edge, try adding some crushed nuts to the topping before baking. Whether you are partial to Hazel or more to Wal, it’s up to you!

This deliciously tangy dessert is a true chameleon of cakes. Served warm with custard (or cream) at a winter dinner party or enjoyed al naturale upon a tartan picnic rug in a park, this cake is sure not to disappoint and is perfect for every occasion.

Ingredients 60g butter, softened 1 ½ cups (330g) brown sugar 1 tsp vanilla 2 eggs 1 cup (150g) plain flour 1 cup (150g) self-raising flour 1 tsp cinnamon 300g carton of sour cream 500g frozen raspberries ¼ cup (55g) brown sugar, extra 1 tsp cinnamon, extra

Method 1 Preheat oven to 160C. Prepare a round spring-form cake tin with baking paper and lightly grease the edges.

2 Use an electric mixer to combine the butter, sugar, and vanilla (and then maybe a little more vanilla - my thoughts are that a little more vanilla never hurt anyone!)

3 Once well combined, add one egg at a time, beating well after each addition.

4 Use a wooden spoon or spatula to fold in both types of flour and the sour cream in two batches (if you don’t have sour cream, or want to experiment, buttermilk makes for a good substitute). Gently fold in the raspberries.

5 Place the mixture into the prepared pan.

6 Sprinkle the extra sugar and cinnamon over the top and place in oven.

7 Cook for 1 hour 15 minutes or until a skewer inserted into the centre comes out clean.

If the top is becoming too brown, then lay alfoil over the tin and continue cooking.

8 Remove from the pan and cool for 5-10minutes. Best served warm – can be served with custard or cream, but is also delicious without these.

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using this â&#x20AC;&#x2DC;internetâ&#x20AC;&#x2122; thing to create a national curriculum

Sam kirchner (PR) doesnâ&#x20AC;&#x2122;t beat around the bush. He wants a

national curriculum.

The logical progression of the anatomy debate previously mentioned is the national medical curriculum debate. It is a topic on which I have strong personal opinions, and I stress that these opinions are my own and do not, necessarily, reflect the opinions of the executive or AMSA as a whole. To the issue...

There are 19 medical programs in Australia, producing several thousand graduates per year.

Each program has its own unique curriculum (mostly), its own unique assessment, its own unique clinical placements (of unique length) and its own unique course requirements.

To me, this arrangement is illogical.

Surely there cannot be 19 equally good ways to teach and assess medicine? And surely it is inefficient to have 19 curriculum medical schools creating their own curriculum and student resources?

Medical graduates are free to move and practice nationwide (soon to be made even easier by national registration) and it is

036 Panacea Vol 44 No 1

assumed that all MBBS graduates know roughly the same stuff.

Perhaps a more accurate thing to say would be that they have the same minimum medical knowledge required to practice medicine safely, under the appropriate supervision. If this is then the case, why is medicine taught differently around the country?

Why does my medical school and your medical school each spend an extraordinary amount of time deciding on and creating course content when we all need to know the same thing anyway? Thus to me, this is why curriculum should be developed and overseen nationally.

I would like to make an important clarification...I think we should be looking to nationalise the way we teach certain aspects of medicine (not all of it) and increasing the collaboration between medical schools.

For the purposes of demonstration let us take obstetrics and gynaecology as an example. Obstetric physiology

is the same in South Australia as it is in Queensland (indeed as it is in the United States). What students need to know about pre-eclampsia in New South Wales is the same as for those in Western Australia. The differential diagnosis list for antepartum haemorrhage does not change across state-borders, nor does the clinical approach to this patient.

So why do we insist on each medical school teaching O&G in its own way completely independently of one another?

We have to take a short aside to consider online learning, before moving on. Methods of online teaching and learning are the way forward for medical education and I can only see this method of content delivery becoming increasingly popular.

Via the internet, we can provide lectures, interactive clinical cases, tutorials, written information, pictures libraries and a whole host of other great learning tools and resources. Best of all, putting material online makes it flexible.

It can be used multiple times and

used when it suits the student (at 8am for the early birds or at 2am for the night owls); and, most importantly online material can be standardised. It can be used after hours, which means more time can be spent in clinics and on the wards. Of course, live lectures remain important and do have a place and I am NOT advocating replacing tutorials, but I think it is time to recognise that a lecture to 200 students is not always (perhaps is not ever) the best way to impart knowledge from an experienced consultant to a lowly medical student nor is it an efficient use of time or resources when you appreciate that it is being multiplied by the number of medical programs in Australia (19).

But back to the O&G example, at my university it is taught with plenty of ward and outpatient

contact time, an online lecture series and weekly tutorials with integrated case-based learning.

And the content of our online lectures + quizzes, is as true for me as it is for you, and could so easily be delivered at JCU (for example) that it almost goes without saying. So why donâ&#x20AC;&#x2122;t we share this series with other medical schools? And by extrapolation, why does each medical school produce their own O&G course material, such as handouts, booklets, background lectures and the like? Plus, by working together we could free up O & G staff to increase small group and one-on-one teaching.

In the future (the one in my dreams) there would be a national board tasked with creating and overseeing the clinical medical curriculum that would have a

logging on... and on.... and on...

multitude of subcommittees tasked with specific curriculum development and implementation â&#x20AC;&#x201C; for instance a committee for surgery, a committee for medicine, one for psychiatry etc. etc. Perhaps even the Colleges would play an increased role, with the College of Obstetricians and Gynaecologists tasked with creating a set of minimum requirements (knowledge, clinical reasoning and practical skills) for medical students and then providing a framework for learning and teaching.

Such a framework (whomever it was created by) could include online lectures with online interactive cased-based learning, modules and assessment. There could be pre-written cases for local consultant-tutorials and recommendations and materials for local tutorial topics. This material would merely supplement a local medical course not take it over; and, all the while (in this imagination land) there would be plenty of flexibility, plenty of consultant contact time and plenty of locally-driven content.

There are several principles that I hope to see drive medical education â&#x20AC;&#x201C; efficiency, co-operation, quality and standardisation. And creating safe and competent doctors that are the best in the world should be our aim. I see no other option

but to nationalise aspects of clinical medical education to be true to these values and aims, and entrust aspects of their curriculum development and teaching to national expert bodies. And, too, we should look to the internet to deliver standard course content in an engaging and efficient manner.

Oh, and we should all probably do the same PBL/CBL cases too....

Panacea Vol 44 No 1 037

The Secret Stealer Context: as a result of having his deepest secret stolen from him, nine year old Sydneysider James Winchester IV has been cast into a strange limbo-state; half-cursed, and with the ability to see secrets in the eyes of every person he encounters, and furthermore, the ability to steal those secrets. However, past these abilities, there are certain (significant) disadvantages to being half-cursed!

Therefore, in order to correct the situation, James has just chased the Secret Stealer halfway across the world in an effort to get his own secret back. He has been taken to the bank, if you will, of all the secrets that have been stolen in the past several hundred years...

So here he stood, before the room in which his deepest secret lay. Beyond the doors James could tell there lay a heavy darkness, in which tiny, strange lights flickered and winked.

The lights, he soon discovered, were secrets, taking the only form they could when displaced from their owners. They were furtive little things, darting here and there; little strings of words made from a ghostly, coruscating whiteness, all wrapped up into tiny balls that were forever changing shape, as the words whizzed in and around themselves like haphazard electrons. There were millions of them, and in that endlessly vast, dark room it seemed to James that he was under an inconstant heaven, filled with fickle stars and fireflies.

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Jess Webster (Wollongong) obviously has a few

secrets of her own! A published author and a medical student. This is an excerpt from her novel.

“I wonder where my secret is…” James whispered to himself.

As if in response to his words a certain secret appeared before him (or perhaps he had moved towards it – he really had no way of knowing, in that blackness).

He found himself frowning as he looked upon it, for it was a tiny, pathetic thing, with drops of powdery golden light falling away from it to land near his feet, like tears. His was a sad secret, he knew.

But there were other secrets nearby, he noticed. With a quiver of excitement he realised that they belonged to children and teachers from his school – dozens and dozens of them. Some were sad and seemed to drop tears, like his own. Some were angry, emitting a light that possessed the subtlest of crimson tints. Some were embarrassing, and seemed to shrink away from him accordingly. Some were dear and sweet: childish ambitions that had been left unspoken.

What was it that Blythe had said to him?

He would be rid of the half-curse once he had his own secret back. If he could take the secrets of his schoolmates and then his own, James reasoned, he would be

rid of the curse, and still have secrets to make use of ! And better yet, he would be able to keep Miss Mason-Smith out of the whole business.

Heedless of his previous feelings of unease, James grasped as many secrets as he could, drawing them inward as Domenic had shown him. At last he came to his own secret. He felt a strange warmth as he pulled it towards his chest – that vague, empty feeling that had plagued him seemed to disappear, and for the first time in several days James Winchester smiled.

He had his secret back.

But past the warmth, past the new feeling of completeness, James felt something… disquieting. It was like that time he’d eaten too many sweets at a lonely school Christmas party without his parents, and he’d known he was going to be sick. A strong heaviness settled over his soul; all the sadness and anxiety and anger of all those secrets pressed down upon his little chest.

It was then that James realised, feeling as if he were plunging down an endless black well, that he had done something very wrong.

Stimulate your mind with general practice A career in general practice offers many benefits such as variety, high patient contact and flexible working hours.

The breadth and depth of intellectual knowledge required by general practitioners makes general practice not only a rewarding career but also an intellectually stimulating one.

Whether you are working towards a career in general practice or still considering your options, as a medical student you are invited to take up RACGP student membership.

Free online student membership Free online RACGP student membership* enables you to access useful resources and services to support your medical education, including gplearning interactive online medical education, The RACGP John Murtagh Library online resource centre, the college’s weekly Fridayfacts newsletter, discounts on hardcopy publications, free membership of the college’s National Rural Faculty and more.

Upgrade your student membership For a small fee you can upgrade your RACGP student membership* to receive all these online resources plus additional hardcopy resources such as a subscription to Australian Family Physician and more.

Join the RACGP today Download and complete an application form at www.racgp.org.au/student or call 1800 331 626

* For the RACGP Affiliate student membership period of 1 July 2010 – 30 June 2011. ‘Medical students’ entitled to this membership are undergraduate medical students and graduate students enrolled full time in medical programs including Bachelor of Medicine and Bachelor of Biomedical Science

Panacea Vol 44 No 1 039

hurwitz Dear Journal: You’re Steve and johnathon o’donnell gush over awesome. their icons of the medical

journal world.

There are over 500 medical journals in the world. I’m no mathematician, but I believe that works out to over 1 billion new articles daily. As each article consists of around two-thousand words and the average human mind reads at 100 words a minute (according to research on students at the University of Newcastle) – you would be approximately 633 years behind on your first day. With all the big developments being hidden within these new journal articles, how are you meant to stay on top? Well do not fear, this article will give you an infallible and accurate run down of the only six medical journals you need to know…

New England Journal of Medicine This journal is widely recognised as the top medical journal in the world. It has very strong links with a small university called Harvard and boasts an impressive impact factor of 50.017. This impact factor represents the average number of citations to articles published within a journal. So to break it down for you, the NEJM is pretty damn important.

Since its creation it has ‘evolved’ in a unique way (it offers podcasts of recent articles) and no one can seem to ‘get rid of it’ (the NEJM is the oldest continuously published medical journal in the world).

It has a strong emphasis on internal medicine, hyperlipidaemia and logomania. So unfortunately if you are a budding surgeon this may not be the journal for you.

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The British Medical Journal The BMJ knows no boundaries, providing research on most of the medical specialties and has even been known to comment on broader global and social issues. It has made strong political statements on the state of affairs in the Middle East, which did lead to a backlash against it, as some viewed it as stepping outside of the realms of a medical journal. However it’s moves like this that sets the BMJ apart from other journals.

The BMJ also has a little brother called the BMJ Student, which you should check out at: http://student.bmj.com. It has a strong focus on medical students and provides novel (if not slightly lame) interactive educational tools (like word searches). The main areas of research in the BMJ are breakthrough research in dental realignment, photophobia and solar urticaria.

The Lancet This 187-year-old journal not only has a cool name but also is one of the most important journals in the world with an impact factor of 28.4. The Journal was becoming so jam-filled with insightful research it had to give birth to 3 new journals: The Lancet Neurology, The Lancet Oncology and The Lancet Infectious Diseases.

The Lancet hasn’t avoided controversy.

In 2005 it rejected the efficacy of homeopathy (it took them that long?), it has criticised the World Health Organisation and has even called for tobacco to be banned – which would have criminalised 26% of the United Kingdom.

If a journal could have balls the Lancet would.

The New Zealand Medical Journal This isn’t really a big or important medical journal. I’m just impressed New Zealand has one! Although in 2002 due to financial reasons it had to discontinue its print versions – there is a rumour that their funding was diverted into agriculture – for the various zoomanic activities undertaken with their woolly, white, national symbol, yet this is unconfirmed.

The Medical Journal of Australia The MJA has an impact factor of 2.5. Many would make the obvious conclusion that this is because it is an insignificant journal. Wrong. The problem with the MJA is that it is reporting on a population with very little wrong with it, on a country where major health risks such as obesity and alcoholism simply do not exist – so it has very little to report. Yet, I think it goes without saying that this is the most important medical journal ever.

With the “bigger” and “more important” journals you can always argue that they aren’t relevant to our perfect Australian patients but the MJA covers that.

It has become even more relevant to medical students, in our current ‘climate’, as it has helped highlight the impending medical graduate ‘tsunami’!

Australian Medical Student Journal and Medical Student Journal of Australia The AMSJ is due to release its first publication in April 2010! It is the first publication of its kind and accepts submissions from all Australian medical students and will aim to publish articles that have a particular relevance to our medical students. Conservative estimates predict that the AMSJ will overtake the NEJM by July next year, and less conservative estimations predict that it will become more popular than The Beatles, Mother Teresa and Ghandi.

Darren, the taxi driver I met last week after one of the Medical Society’s social events told me that ‘he was more excited about this than in 2009 when electricity came to Newcastle’. You should be too.

Check out the website http://www.amsj. org/. It’s sure to be legen…dary.

To be unequivocally honest, the MSJA is the best thing to have come out of Canberra, possibly since their land was stolen from New South Wales. In the most over-governed state in Australia where there is nothing to do except visit the Questacon or go for a late night cruise around Fyshwick, this Journal must be a welcome relief for many tormented Canberrans.

The most alluring aspect of this Journal is that it not only publishes student research, but also allows students to communicate their views on topical issues, to read about overseas electives undertaken by other medical students and to gain more insight into the life of current health professionals.

Online information about the MSJA can be found at http://msja.anu.edu.au/.

max mollenkopf (Wollongong) implies he doesn’t

mind if you ask him to do a PR. But woe betide the student that touches his shiny ballpoint pen.

The mystery of the wandering pen The wandering pen was the topic originally prescribed to me for this short foray into my limited literary talent, but having wracked the deep recesses of my tender, non critically acclaimed mind, no words came forth to provide humorous thoughts on the matter.

My non-Pulitzer winning writing talent could only focus on what an annoying task favours are in medical school. Whether it be a seemingly more attractive bachelor at school asking you to write their “Panacea Bachelor of the Year” application for them (and only making the finals), or that interview-style ethically challenging question of “will you sign off my name on the attendance sheet?” (for the record I did, but I think I spelt your surname wrong).

Favours are constantly thrown at people every day of the week, regardless of the outcome, and with a total lack of respect

to the now official “beer economy” . To quote a friend of mine from across the desk, who I asked a favour of to proof read this piece, favours really are a

pain in the arse.

Of all the deeds out there (aside from “Will you help me get rid of the body?”), the one that sends me precariously close to ending it all is the borrowed pen. This act itself is not the blow to the giving portion of my soul.

It is the moment when you look across, in the soft light of the lecture theatre, and see that beautiful piece of BIC engineering wandering sensually across their lip. Then, the death knell. The crafted tip is inserted between the teeth, and gnawed upon like an antelope in a David Attenborough film. Amazingly, this adjective driven foray has somehow ended with a wandering pen.

And as a favour to readers everywhere, it managed to come to an end.

Panacea Vol 44 No 1 041

f

Stalkbook: Social network or creepy cctv?

I used to spend a lot of time on facebook - loading photos, looking at friends’ photos, finding and adding friends I had made from life – both past and present. It fast became to email what Sydney is to Melbourne - a more refined, evolved and sophisticated cousin. Its sharing capacity was fantastic: loading photos onto the web and tagging the people involved and allowing them plus your other 548 closest friends to see said photos. Shortly afterwards, that annoying, vain person could facemail you and demand you take a photo down because (usually she) states “OH MY GOD I LOOK SO UGLY/FAT etc.” She probably does, and people need to know about it. What’s not to love?! You can stick a photo up and spend all week paying out that poor, insecure person.

You need to do something while you’re at work, so it may as well be entertaining.

Facebook became one of the biggest means of procrastination ever, and it was a useful, efficient way to communicate and share photos.

042 Panacea Vol 44 No 1

I went travelling after my first degree for seven months. During that time I met five or six people. One or two of these people were nice and I then added them to facebook and I haven’t since seen or spoken to again. But I could if I wanted to, because we’re friends now. Also while I was away I could keep tabs on people who were back at home. I’m friends with my mum on facebook so while I was away she could post regular photos of how my herb garden was blossoming under her careful eye. For travelling, it was perfect. It was a two way street in which I could see what was happening back at home, and others could be jealous about what I was doing overseas.

More recently, extra features have been added. Facebook has had a facelift and in my old age I struggle to find where everything is anymore. As soon as I get used to it BAM, it changes again. As far as I understand, you can now play games, have a farm (??), chat, have groups to make correspondence easier between

f

Ed Christian (ND

Sydney) paints an eerie picture of what facebook is doing to your life. And then goes on a bit of a rant.

people before they go into the wild in Hobart2010, have stupid groups to see how many people will fall for your lies, have more stupid groups about who will have the most people in their groups, add people you don’t know, spam people, advertise and probably a whole lot more useless things that I have even less interest in than plucking your grandfather’s eyebrows.

Some people think facebook is dangerous. My old man always shakes his head and tells me how it will get me into trouble. It’s probably true; I have heard stories about future employers looking up their possible employees to see what they get up to ‘out of office hours.’ Many of my friends have changed their names on facebook so that this type of thing doesn’t happen to them. I doubt anybody would hire most of us if they saw some of the photos the paparazzi manage to get at your average medical get-together.

(Hopefully we are guaranteed jobs at

the end of this course and don’t need to worry about this.) In truth, I think dad’s right. I believe many people have cancelled their FB accounts recently because they didn’t like so many people being able to see photos of them and what they had been doing. They wanted their privacy back. Some people such as AMSA-National-coordinator-nowmoviestar Tom Crowhurst didn’t catch on to facebook quickly because Adelaide didn’t have the internet at the time. Now, he doesn’t want it because, he states, “I’m already famous I don’t need to be any more famous.” He wants to keep his privacy for as long as he can before his film career really takes off and he and Will “Womble” Stokes start making Entourage Mach 2: “strawberry blonde boys go to bollywood.”

Perhaps I’m straying a little far from whatever point I was tying to make. The privacy thing is a legitimate concern and one aspect of the internet and facebook I feel we are yet to fully appreciate.

Perhaps only the secret services such as ASIO, MI5 and the FBI/CIA (in order of international importance) are aware of how far they can delve into our lives and dig up our deepest, darkest secrets.

Things like DJLSB from Notre Dame Freo actually being more woman than man. Things like Nick Young’s fetish for feet. Things that rock you to your very core. Fast forward your brain 20 years and try to imagine what it will be like when someone from our generation finally

runs for PM or another political high office. Are we going to be able to dredge up their old facebook page and see them in a slightly inebriated state resting in a gutter or car surfing? Goodbye ambition, goodbye future.

Events are perhaps the most annoying thing about facebook. Let me preface this rant by saying I am also guilty of this annoying, rude and inconsiderate habit.

I just hate it when people say they will come and then don’t rock up. They are nearly as bad as the people who write ‘maybe.’ MAYBE? Maybe you will come if your friends do. Maybe you will come if you don’t get a better offer. Maybe you will come when you have a spine. MAYBE you’re not invited anymore, you wanker.

I’ll tell you a little story. I invited sooooo many people to my birthday party. Heaps of them said yes, some were honest and said no and the rest were non-committal.

So, off I went and made fairy bread for 120 people. Needless to say, 4 people rocked up, then left early because it was so lame and I had to eat 6 loaves of bread on my own. No wonder I’m bitter, I can’t get out of bed without a crane.

Facebook is no longer Sydney compared to Melbourne. It is no longer the highly evolved spawn of email. It has turned into a rogue uncontainable mutant, similar to that of Eve from Adam. You never know where you stand; you never know what will happen next. It will amuse you for a while but in the end, it’s going to bite you in the arse.

Panacea Vol 44 No 1 043

Facebook Stalking Survey In recent years the power of the Facebook has taken on unprecedented importance in the lives of medical students. Before Facebook, friendship used to be tough because you actually had to be in people’s presence to be their friend. But now with just a point and a click you can become friends with almost anyone. This ease of contact and anonymity has given rise to the phenomenon of Facebook stalking.

Like regular stalking, it allows the stalker to covertly gather information about a person they are interested in - the stalkee if you will. The stalkee is most

often a person you have never actually met, or spoken

to, but have frequently visited their Facebook page looking for photos, wall posts and status updates. The stalkee may be in a class of yours, work at the local coffee shop or maybe you briefly saw them at a party.

From an open Facebook profile, important information such as relationship status can be gathered and is obviously vital to the success of a stalker.

Additionally you may do some research and suddenly develop an interest in Cougar Town simply because this is your stalkee’s favourite TV show – and you’ll need something to talk about when you have a “chance” meeting outside their bedroom window.

Medical students are renowned for high levels of Facebook stalkerism. Take this simple 10 point questionnaire do determine if you are at risk.

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This edition is plagued by doppelganger articles for some reason. Luke SB (ND, Freo) take two

You might be a Facebook stalker if: 1 You are disappointed when you click on a person’s profile picture only to find that you cannot access their profile and photos because their profile is private. “Oh God this is bullshit! Why is their profile set to private?!”

2 You search through a list of 500 names – by first name only – looking for that random person you met last night at the Fresher welcome.

3 You spend hours of precious study time viewing photo albums and pictures of people you have met only once. But will hopefully meet again ;) 4 You spend hours devising funny status updates to encourage people to write on your wall so you look popular.

5 You search through your friends’ friends to find hot people to add as friends 6 You hit refresh every couple of minutes on a stalkee’s Facebook page in case the status “In a

relationship” is a typo. The even more disturbing “Engaged” status is met with hours of planning how you could break up the happy couple.

7 Your misinterpretation of a poke resulted in a restraining order.

8 You try and scam people out of their phone numbers by pretending you lost your phone and you need everyone to send you their number - including the hot blonde you met at the Back to Uni party but barely spoke to and pretty sure she never wants to see you again.

9 You click on the creepy and pointless ads down the side of the page instead of ignoring them like everyone else. I mean why would you want to “Meet hot Christian singles”?

10 You get frustrated by picture shrinkage. “What am I meant to do with a tiny 300 x 300 pixel photo?” You know what I’m talking about – pow pow.

Parlez - vous franÇais?

Rob Marshall

(UWA) explores the funny, bizarre and often scary world of Engrish for patients.

You’ve heard it all before.

“Most of your diagnosis will be made on the patient history, so the first step to becoming a good doctor is to develop good communication skills”. Somewhat ironically, the lecturers who espouse this particular brand of First-Year-of-MedicalSchool wisdom tend to be the kind of “communicators” who have you silently wishing for a natural disaster to take place right then and there in the auditorium, just so you don’t have to listen to another minute of their incessant ramblings.

Unfortunately, as you progress further into clinical medicine, you realise that they were right.

Not only is good communication a vital skill for our future profession, it can also be a challenging one, particularly when dealing with a patient who speaks English as a second language, or in some cases, not at all. According to the 2006 census, English is the primary language spoken in the home for only 79% of the population. This means that for one fifth of Australians, the language you use to

elicit their history, or even break bad news, may lie somewhere on a spectrum from familiar to incomprehensible.

It doesn’t help that the English language is a strange and wild beast. Bill Bryson in his book Mother Tongue, points out that English is, “full of booby traps for the unwary foreigner”. To this already bizarre hodgepodge of a language (and if you still have doubts that it is, consider for a moment the word I just used: ‘hodgepodge’), we, as clinicians, then add an extra layer of complexity in the form of medical jargon. What hope of good communication do we have as medical students, when terminal can mean “close to death” but equally, “the place where you catch an aeroplane”… and isn’t that idea in itself a little terrifying?

More importantly, how do you know if your message got through to someone who speaks a language other than English, or LOTE, to use the popcronym (and yes, I realise neologisms are only making the situation worse)? While I have no idea what it must feel like to be a

patient on the wrong side of the language barrier, I have had a glimpse of the sense of confusion that comes with being out of your linguistic comfort zone.

Last year I took a year off from medicine to study in Paris, a city that is not especially well known for welcoming English-speaking foreigners with open arms. As a quick aside, I think we have the stereotype of the “arrogant Parisian” the wrong way around; when you witness first-hand a tourist barking English questions to unsuspecting Frenchspeakers you have to really wonder if it’s not arrogant of us to assume that everyone can speak English and further, that they should be obliged to do so in their own country… but I digress. After many years of learning French and two months of living there, I had mastered (or so I thought) the art of conversation such that I felt comfortable asking a winemaker at an artisanal market: do you put preservatives in your wine?

Except that in French préservatifs does not mean ‘preservatives’… it means ‘condoms”. What followed was a look of shock, disbelief and then eventually a generous dose of humiliation that I had only experienced once previously in France when I had proudly proclaimed after finishing a meal that I was pregnant. (“pregnant” being a slang term for my literal translation of “full”).

So the next time you encounter a patient who isn’t quite getting their message across, try doing what people had to do for me last year: take the time to listen; and make the effort to understand what they are trying to tell you, even if at first it seems as ridiculous as condom-enhanced wine. Patient communication: we’ve heard it all before, now it’s just a matter of when we start listening.

Panacea Vol 44 No 1 045

National Rural leadership development seminar Don’t let the awkward-toroll-off-the-tongue name deceive you. This was an event unlike any other as TIm Bromley (Rural) explains.

046 Panacea Vol 44 No 1

This really was a momentous occasion. Two of Australia’s largest student organisations (AMSA and the National Rural Health Students Network) for the first time co-running a three day seminar.

Designed for medical, nursing PLUS allied health students from around the nation to meet over some huge issues in rural health with many positive outcomes and directions for the future. Quite a mouthful.

And quite a fantastic event.

With a major focus on rural health, it posed heavy questions to the delegates.

So you’re convinced that you’re going to head out bush – so what? What are you going to do about it? What now? How are you going to overcome the problems?

What’s your plan of attack? And whose door are you going to be banging on?

Delegates got a chance to interact with leaders of national import on rural health and develop key leadership skills. From

politics to leadership to media and, of course, rural health organisations, the big questions were probed and debated. It really was an electric environment at times.

A highlight was the roundtable – a chance for each delegate to talk directly to these leaders, NRHSN and AMSA about their views and ideas. As expected, everyone didn’t agree, but it was fantastic to see such passion and vision from around the country! Many a thought was provoked, fires rekindled and assumptions reconsidered. There is much

promise for the future of rural and Indigenous health.

AMSA and NRHSN would like to thank everyone involved for their efforts. We would particularly like to mention the support of the Graduate School of Medicine at the University of Wollongong, without which the NRLDS would not have been able to go ahead.

Panacea Vol 44 No 1 047

Charming the pants off you!

Cameron Gofton (Sydney) shows

the rest of Australia why Sydney boys are so very, very single.

dignity

048 Panacea Vol 44 No 1

As a medical student, you are now obliged to take part in an activity that is fondly known as ‘MedCest’.

Now, charming these wonderful, some might say marvellous, spectacular, sexbomb, dancers-in-musicvideos-looking young individuals* is a task too onerous for you. However, this task is alleviated due to the ability to charm others with pick up lines that have been labelled by some ‘Geeky’ or ‘Nerdy’.

When in the general public, these pick up lines are used warily at best, however in a MedCest environment, they are guaranteed** to work.

These witty, well thought out, scientifically accurate*** pick up lines will charm even the most stubborn of suitors.

Here is a sampler selection for you to whet your lips on.

‘If my right leg is the cell wall and my left the membrane, do you want to be the cytoplasm?’

‘I wanna stick to you like gluecose’ ‘My adductor isn’t the only thing that’s longus.’

‘Trust me, this is how they did Mammograms back in the old days.’

‘Is your name Flecainide?

Because I think you just made my heart skip a beat.’

‘When you walked in the door your beauty hit me so hard that I have a priapism from all the trauma.’

‘If I was an enzyme, I’d be helicase so I could unzip your genes’ ‘If I was an endoplasmic reticulum, how would you

want me: smooth or rough?’

‘You have 206 bones in your body... want one more?’

‘You’re so hot you denature my proteins’ ‘I wish I could be a coronary artery, so that I could wrap around your heart.’

‘I wish we were in telophase, cause then I could admire your cleavage.’

‘I’m just going to feel your chest for thrills..’

‘I wish I was your learning objectives, because then I’d be really hard, and you’d be doing me on the desk.’

‘My hypothalamus must be secreting serotonin because baby, I want you!’

‘Let’s exchange plasmids - my pilus is huge.’

‘I’ll show you my muscle’s origin if you show me its insertion.’

‘You must be gibberelin, because I’m experiencing some stem elongation.’

‘If you were a bacteria, I’d love to be your phage.’

‘It’s a good thing you’ve got evaporative cooling, cause I’m gonna make you sweat’ *Note: Med students at your med school may not fall into this category. It must suck that you’re not at Sydney. **Note: No guarantee exists.

Any positives are due to their use. Any negative outcomes are due entirely to your delivery of said lines, and no fault nor blame shall be attributed to MedCest pick up lines. ***Note: MedCest pick up lines may not be witty, well thought out or scientifically accurate.

Email Debate: You make me see red and draw out nautical-themed metaphors

Who is more qualified to wax lyrical about beach safety than Daina rudaks (Community)??

Some would say noone.

Whilst others would say everyone. Let’s find out.

I am standing in the middle of a game of Minesweeper. What? You don’t believe me?

Everywhere I turn there are little red flags.

To be more precise, there are 46. I am surrounded by 46 red flags.

If I was at a beach, I would have to be one of the safest swimmers there; having lifeguards watch me swim between 46 flags must be enough to keep me out of trouble, surely. But alas, I am drowning.

I am drowning in the flags, not between them. And Outlook doesn’t have a lifeguard. It doesn’t even have numbers to predict how many flags I should expect to find, or a smiling face to tell me I’m finished, because in this game, there is no end in sight.

So maybe I’m exaggerating just a little.

I am not standing in my own life-sized version of minesweeper, nor am I on a surf-patrol beach, but I am staring at my e-mail inbox. You could easily be forgiven for confusing the three. There are

differences, sure, but at times they seem to be one entity.

Just as in Minesweeper, you have to be careful with e-mail. One false move; one rushed click of a button can end in disaster. The fatal reply all instead of reply mistake. BOOM. Now what are you going to do?

As you struggle to keep yourself afloat, to keep your head above water, you must work faster and faster. But unlike that little drowning mouse that paddled so fast he churned the milk into butter and climbed right out, no butter awaits. Only cramps.

You really shouldn’t go swimming straight after a meal, nor should you attempt to get through 46 flags in a day. It results in cramps. No kickboard or ergonomic keyboard will save you from this one.

Goggles won’t help you either.

It stings to open your eyes when swimming in the sea. It hurts when swimming in the words that fill your

inbox too, but there are no goggles for computers. No total prevention is available. Only partial prophylaxis in the form of meetings or phone calls. Sure e-mail is cheap and easy to open, much like cask wine, but it lacks something – the true bouquet of what is being expressed – and can result in many late night mistakes. I’m no doctor, but the sting of reading word after word after word, long after the sun has gone down and the self-inflicted headaches the next morning can’t be good for your health.

As I send this through (via e-mail) for publication from my Minesweeper beach,

I wish that the real world was more like the movie You’ve Got Mail – where each sound of an e-mail

arriving would not bring another task and red flag, but rather words from Tom Hanks and a red rose. But I am not Meg Ryan, not even close, and for now a (few) dozen red flags will just have to do. Shame you can’t put them in a vase.

Panacea Vol 44 No 1 049

Email Debate: the

Bounteous joy, endless horizons and unparalleled Alfred Phillips (Bond) sounds a teeny bit like a tree-hugging hermit. He did get the bung side of the splendour debate though. Read on.

this tree didn’t want a hug

050 Panacea Vol 44 No 1

Stop whatever you’re doing dudes, because Bruce Willis is launching a signature fragrance. Not too sure about you, but I don’t particularly want to smell like someone I associate with blood, oil grease and explosives residue but I’m sure there are people out there who really, really love the guy and as a result would pay good money for an olfactory approximation of his essence - strength, courage, dignity and baldness.

You know why I had the time to tell you that amazing fact? Email folks... Email.

Three little words that have changed our lives forever.

Some simple reasons why email is the superior means of communication for me: 1 I’m Cheap. Email is free. Australia post charges 55c to send a 50 gram envelope down the road. What a joke? It’s not like we’re made of money right... err... next...

2 I’ve got zero time. I can check my Email on my phone and reply instantly while riding my bike home from the hospital.

This isn’t safe and I don’t recommend but it’s quick people! “Quick and the dead right... ‘nuff said.”

3 I’m nearly illiterate. I think I was born with ‘Doctor’s writing’ and when I type an email, I have a trusty spell checker to make sure that I never make any mistakes.

It’s easy to read and I’ve never seen anything else that can compensate for my

lack of literacy, except maybe a secretary... and she (or he) would probably be emailing the shit out of his/her letters too.

4 I Like Trees. Every time you send a letter in the post, you kill a baby tree.

Yes, that’s right – trees have babies too. Sending emails saves unnecessary printing and everyone knows that recycling is just a right-wing conspiracy/ lie to oppress us lefty Medical Students.

5 I don’t always like people. Right now, I can hear you saying in your whiny voice “...but what about face to face communication?” Some people are just loud and annoying and the beauty of email is that you always have an excuse to not reply or at least been late in replying.

HUZZAH! The compromising ANU bureaucrats would have you believe something along the lines that email is flawed for some boring reason that I don’t know about yet, but keep in mind that it probably took them 2 weeks of meetings and letters to write their retort.

Go with the sure thing. Save Money. Save Time. Save Embarrassment. Save Baby Trees. Avoid whiny people.

Email!

Disclaimer: I love Canberra. i.e. ANU, Questacon, The Brumbies, National Gallery etc

Panacea Vol 44 No 1 051

052 Panacea Vol 44 No 1

Words that you needn’t ever know Will Stokes (Sponsorship) fills our mouths regularly

with unnecessary poteen. Let him now fill our minds with similarly unnecessary vocabulary extenders

As you scamper at the heels of your new consultant with a fellow student, eager for any opportunity to impress, she spins to pose you a question: “Tell me something unique about the word abstemious.” You freeze. You panic. First impressions last, you must say something profound.

“Hard to say professor. I think that my hairdresser once told me that my side part was being distinctly abstemious.” She eyeballs you with an incredulous stare.

Before able to launch forth in a scathing tirade your colleague comes to the rescue.

“I believe he is being facetious professor” she interjects. “Abstemious is a rare word which features each of the vowels in their correct order.”

In a heartbeat your consultant has warmed to your opposite number.

“Excellent! Won’t you join me for coffee?

We can discuss your future whilst at the cafe.” As they make for the door the professor hands you a putrid toothbrush.

“Do you mind scrubbing the toilets for me? It won’t be necessary for you to join us”.

If only you had known that word...

Phantasmagoria

Meretricious

\fan-taz-muh-GOR-ee-uh\ noun: A shifting series or succession of things seen or imagined, as in a dream; any constantly changing scene.

‘Yesterday the emergency department housed a myriad of different people, emotions and medical conditions; it was a true phantasmagoria unfolding around us.’

\MEH-reh-trih-shuhs\ adjective: seemingly attractive but in reality of little value or worth ‘The blonde talking to you is meretricious in the sack.’

Pugnacious \puhg-NEY-shuhs\, adjective: Inclined to quarrel or fight readily; quarrelsome; belligerent; combative.

‘The engineering students approached us en masse, a pugnacious cavalcade of malodorous troglodites.’

Miasma \my-AZ-mah\ noun: a highly unpleasant or unhealthy smell or vapour.

‘A miasma of stale alcohol hung around him like marsh gas.’

Natant

Hugger-mugger

\nay-tunt\ adjective: floating or swimming.

‘I was natant in a pool of fluids this morning and I don’t know why.’

\HUH-guhr-muh-guhr\ noun: A disorderly jumble; muddle; confusion.

‘You realised that in amongst the huggermugger of scantily clad ladies and body painted behemoths behaving in the most outrageous fashion imaginable, you found your true self.’

\fi-KUHN-di-tee\ noun: The quality of being fecund, capacity, esp. in female animals, of producing young in great numbers; fertile.

‘Most students in postgraduate courses display reduced fecundity.’

Fecundity

Panacea Vol 44 No 1 053

fugacious facts about words uncopyrightable is the longest word which has no repeated letters. it is called an isogram the dot over the letter ‘i’ is called a tittle ‘sweaterdresses’ is the longest word that can be typed with only the left hand purple does have a rhyming word - curple. it’s a donkey’s hindquarters ‘redivider’ is the longest palindromic word the only word with five vowels in a row is ‘queueing’ the correct plural of platypus is platypodes

Iconoclast

Lugubrious

Lackadaisical

\ahy-KON-uh-klast\ noun: A breaker or destroyer of images, esp. those set up for religious veneration; a person who attacks cherished beliefs.

‘The ignorant iconoclast vehemently argued that Falk Reinholz was not a great man.’

\luh-GYUH-bree-uhs\ adjective: looking or sounding sad and dismal, especially in an affected manner.

‘The cancellation of the My Chemical Romance tour made emos everywhere lugubrious .’

\lah-kah-DAY-sih-kuhl\ adjective: lacking enthusiasm, careless and lazy.

‘That porn acting was truly lackadaisical .’

Quadrille \kwo-dril\ noun: A square dance for four couples, consisting of five parts or movements, each complete in itself.

‘The infamous quadrille of Melbourne ‘08 ended in three deaths, five conceptions and a “please explain” from Tourism Victoria for inappropriate use of the big red ball of yarn.’

Lascivious \luh-SIV-ee-uhs\ adjective: Inclined to lustfulness; wanton; lewd.

‘The 2010 AMSA Exec are lascivious. All the time. Everywhere.’

054 Panacea Vol 44 No 1

Phillumenist \fi-loo-muh-nist\ noun: A collector of matchbooks and matchboxes.

‘Many keen phillumenists can be found studying medicine at Melbourne University.’

Antidisestablishmentarianism \an-tee-dis-uh-stab-lish-muhn-tair-ee-uhniz-uhm\ noun: Opposition to the withdrawal of state support or recognition from an established church, esp. the Anglican Church in 19th-century England.

‘Anyone who uses antidisestablishmentarianism in a sentence is a knob.’

Opprobrium \uh-PROH-bree-uhm\ noun: The disgrace or the reproach incurred by conduct considered outrageously shameful; infamy.

‘I have never been able to tolerate the company of C. Stokes. The opprobrium which surrounds him, wherever he goes, is entirely justified.’

Wine \wahyn\ noun: The fermented juice of grapes, made in many varieties, such as red, white, sweet, dry, still, and sparkling, for use as a beverage, in cooking, in religious rites, etc., and usually having an alcoholic content of 14 percent or less.

‘Have you heard about the Wine Appreciation Society?’

Time out / Time IN. THe name of the game is ‘remier League Love and/or hate it, ‘remier is a language of its own. Tim coppafeel (Adelaide) gives an insider’s view on the official national ‘rinking game of medical students.

Ever watched ‘Remier League from afar and wondered how such idiotic drunken louts got into medical school in the first ‘lace? If ‘yes’, you must be from Melbourne [FM]; ‘lease feel free to skip to the next article. There is a square in there, my old man; that’s Melbourne style!

‘Remier League is the official national ‘rinking game of Australian medical students. It has evolved over decades and is widely renowned as the most complex ‘rinking game in the world. Though its traditional homelands are Adelaide and ‘Erth, in recent times the game has happily spread to more distant centres. Today it can be seen ‘layed at all major gatherings of medical students, most notably Convention.

We think ‘Remier League is a little like MedSchool generally. You can avoid getting involved if you want to: you can avoid meeting new people, learning new things and getting the most out of your time. Or alternatively you can throw yourself into the whirlpools of ‘rink and learn and come out the other end with friends from all over the country, many new skills, and lots of good stories. So get involved in the ‘ositive feedback cycle that is ‘Remier League.

Competitions: We have ‘ainstakingly constructed a diverse and challenging battery of ‘remier league ‘uzzles such that the intrepid ‘layer can hone his skills in situations where ‘rinking with others is difficult or illegal, such as whilst on a lonely rural ‘lacement, operating heavy machinery, or assisting in surgery.

We ‘romote the game of ‘remier league to all Australian medical students: as such,

NCh

FCR

The ‘Able

GS NR

NCC

the first ‘layer to send correct answers to all the ‘uzzles below to nc@amsa.org. au will receive a highly ‘restigious ‘rize at Convention in 2010.

Furthermore, we are ‘leased to announce the inaugural National High ‘Able ‘Remier League Essay Competition. The rules of this auspicious competition are as follows: 1 Any Australian medical student is eligible to submit one entry; 2 Entries must be submitted to nc@amsa. org.au by Sunday 1 August 2010; and, 3 Essays will be judged by the National High ‘Able Representatives from Western

GM Wmb Gigg

Australian and South Australia on the following criteria: a) Usefulness in ‘romotion of ‘Remier b) Style, eloquence and humour; c) Suitability for ‘ublication in Panacea.

4 Essays must be 600 words or less; 5 Essays may include high-quality photos, diagrams, or other images.

The winner will have their essay ‘ublished in the next edition of Panacea. And of course they will be showered in ‘raise, glory and honour.

The Grammar Panacea Vol 44 No 1 055

‘uzz les ‘Uzzle 1 C: FCR. WRP NGI: ‘Rem BCO: Wmb 1: Wz (+h) 2: Zo (GS) 3: Ch-Ch-1 (-h) BJ: 2 (-h) 5: Bsq-CBg (FCR [GM: Cs / NCh: Cs]) An (GM: A-h / NCh: A+h) Zo (Gig) 6: Ch-Ch-CBg (TCC [NR: Cs / TCC: Cs / Gig: Cs]) 7. CS Questions: 1 In whose court was the ball on line 4?

2 Who made the error?

3 What was the error?

BJ Who was the banger and who was the bangee on line 5?

‘Uzzle 2 C: FCR. WRP NGI: Wz, Zo, Tk, An BCO: NCh. 1: Sp (-h) 2: CS Questions: 1 What was the error?

2 What are the words of the song that would be sung?

3 What would the offender be required to do?

‘Uzzle 3 C: FCR. WRP NGI: ‘Rem BCO: TCC 1: Ch-Ch-CBg (NR [GS: Cs / TCC: Cs]) 2: 1 (+h) 3: Sp (-h) BJ: Fu 5: Fu 6: ?

7: Sp-Sp (+h) 8: 2 (+h) 9: 3 (+h) 10: Wz (-h) 11: Wz (-h)

12: Wz (-h) 13: αb-βp-Wz-βp 14: Ch-Ch-Ku (FCR) 15: Bsq-CBg (FCR [GM: Cs / NCh: Cs]) Ku (GS) 16: Zo (TCC) 17: Xi (GM) 18: Ba (NR [GS: Ks / TCC: Ks]) 19: Sp (+h) 20: Sp-Sp-Sp (-h / +h / -h) 21: CS 22: GFYITM (TCC) 23: CS BL Questions: 1 In whose court was the ball on line 4, 7 and 14?

2 What are the conditions for the initiation of the rare and highly-prized beezlebub-bub-bub?

3 Please list all of the moves that can theoretically precede a beezlebub-bub-bub.

BJ. What was the first error and who made it?

5 What are the words of the song that would be sung?

6 What would the offender be required to do?

7 In which case would this first error be ‘ermitted?

mmmLegend Whiz Wz: Bg: Bn: Ae: p: βb: Bsq: Wsh:

α

whiz bang bounce alley-oop alpha beezlebub-bub-bub botsquali whoosh

Zoom Zo: Sp: Fu: ?:

zoom slap profigliano schwartz

056 Panacea Vol 44 No 1

Viking Master

Takahashi

‘Rem: ‘remier league

Antlers

An: antlers A-h: support antihorsewise A+h: support horsewise PAn: pass antlers TAn: throw antlers

Chow-Chow-Bang Ch: CBg: Cs: Cq: Cqs:

chow bang support cumquat cumquat support

‘Uzzle Bon Jovi

C: GM. WRP NGI: ‘Rem BCO: GS 1: Wz (+h) 2: An [GS: A-h / TCC: A+h] Vm [GS: V-h / TCC V+h] Sp-Sp (+h) 3: Wz (+h) BJ: βp 5: Bn 6: Bn 7: Ae 8: Ae 9: Wz 10: An [Wmb: A-h / FCR: A+h] Ch-Ch-1 (-h) 11: Wz (-h) 12: Bn 13: Zo (NCh) 14: ?

15: Sp-Sp (+h) 16: Ch-Ch-CBg 17: CS Questions 1 Who made the error and what was it?

2 In whose court was the ball on lines 7 and 13?

1: 2: 3: BJ: 5: 6: 7: Tk: 9: Ij:

one two three bon-jovi five six seven takahashi nine iku-jo

Ku: Xi: Ba: Ks:

kuon chi baa support

Kuon-Kuon-Chi-Baa

Vm: viking master V-h: support antihorsewise V+h: support horsewise PVm: pass viking master TVm: throw viking master

Other C: WRP: NGI: BCO: -h: +h: FE: CS: BL: TH: EK:

chair time out / time in name of the game is ball is in the court of antihorsewise horsewise ultra-fast ultra-elite consume brown language toilet hands ‘edical knowledge

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limate myths circulating in the public domain are reaching dangerously high levels. Many of us are unsure of their truth or hesitate to respond, whilst others amongst us react with dismissive fury.

But for the good of all of humanity and our planet we all need to move forward together, to a greener and healthier future. So let us, calmly, examine those climate myths one by one.

1

The world is not becoming warmer OR the world is cooling.

Warming of the climate system is evident from observations of increases in global average air and ocean temperatures, widespread melting of snow and ice and rising global average sea level (Figure 1.1)[1].â&#x20AC;&#x2122; The International Panel on Climate Change (IPCC)1 FRQÂżUP WKDW WKH HYLGHQFH LV RYHUwhelming.

Those who question global warming often assert that since 1998 the world has cooled. This myth arose because the warmest years in the instrumental record of global surface temperatures (which begins

at around 1850) are 1998 and 2005. The period between 1999 to 2004 was cooler than 1998 and some identify this as the beginning of a cooling trend. However, climate systems are complex and affected by many attenuating factors, so that better understanding is gained from long-term trends, rather than isolating a few years of the climate record.

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2

Humans are not the cause of global warming.

This argument often takes several forms: a. Global warming is part of natural cycles. b. CO2 in the atmosphere is natural and ŽŜĆ&#x;ŜƾÄ&#x17E;Ä&#x161; ĹśÄ&#x17E;Ç&#x2020;Ć&#x161; Ć&#x2030;Ä&#x201A;Ĺ?Ä&#x17E; Ĺš

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Panacea Vol 44 No 1 057 ZÄ&#x17E;Ä&#x201A;Ä&#x161; Ć&#x161;Ĺ&#x161;Ä&#x17E; Ĩƾůů Ç&#x20AC;Ä&#x17E;Ć&#x152;Ć?Ĺ?ŽŜ ŽĨ Ć&#x161;Ĺ&#x161;Ĺ?Ć? Ĺ?Ć?Ć?ĆľÄ&#x17E; ŽŜůĹ?ĹśÄ&#x17E; Ä&#x201A;Ć&#x161; Ĺ&#x161;ĆŠĆ&#x2030;Í&#x2014;ÍŹÍŹghn.amsa.org.au/vector

Ç Ç Ç Í&#x2DC;Ĺ?Ĺ&#x161;ĹśÍ&#x2DC;Ä&#x201A;ĹľĆ?Ä&#x201A;Í&#x2DC;Ĺ˝Ć&#x152;Ĺ?Í&#x2DC;Ä&#x201A;Ćľ

Ĺť ĨĆ&#x152;Žž WÄ&#x201A;Ĺ?Ä&#x17E; Ď­

the â&#x20AC;&#x2DC;smallâ&#x20AC;&#x2122; changes in concentration caused by humans are not dangerous to life. c. Temperature and CO2 correlate across time. The fact that temperature often begins to rise shows that CO2 is not the cause of global warming.

To respond to this myth we need to detect that warming is occurring (see Myth 1.) and then attribute this warming to different causes. These potential causes can be clasVLÂżHG DV Âť 1DWXUDO IRUFHV Âť Anthropogenic (human) forces The IPCC, in mapping all the natural and anthropogenic forces with potential to change the global climate, found that: Âť â&#x20AC;&#x2DC;Most of the observed increase in global average temperatures since the mid-20th century is very likely due to the observed increase in anthropogenic green house gas concentrationsâ&#x20AC;&#x2122;. Âť Over this period solar radiation was found to be the most powerful natural force affecting climate and it is â&#x20AC;&#x2DC;very likely that it is not due to known natural causes aloneâ&#x20AC;&#x2122; [1].

These conclusions are based on the instrumental temperature record, not computer modelled past reconstructions. Thus, scepticism about computer models should not equal scepticism about climate change.

There are now many robust models, which can allow us to look further back into the cli-

058 Panacea Vol 44 No 1 2 vector april 2010

mate record and learn more about the relationship between CO2 and temperature. The following is an explanation by Dr Brett Parris2: This chart â&#x20AC;&#x2DC;shows the relationships between carbon dioxide (CO2), methane (CH4) and temperature for the last 430,000 years (or 430 kyr) from Antarctic ice cores and from data from the last century. Temperature doesnâ&#x20AC;&#x2122;t respond in lock-step with the changes in gas concentration. In fact, coming out of the ice ages temperatures generally started to rise ÂżUVW GULYHQ PDLQO\ E\ FKDQJHV LQ WKH (DUWKÂśV RUELW DQG WKH DQJOH RI WKH WLOW RI WKH (DUWKÂśV D[LV >%XW@ WKH rise in greenhouse gases strongly reinforced the warming, increasing higher temperatures and their duration. Temperatures have now risen by around 0.8ÂşC since preindustrial times and another 0.6ÂşC rise is expected because of gases weâ&#x20AC;&#x2122;ve already emitted.

green house gases and temperature, not past reconstructions, were used to support the conclusion of the initial 1995 IPCC Report, and therefore, the IPCCâ&#x20AC;&#x2122;s conclusions are independent of conclusions drawn using the GDWD LQ TXHVWLRQ > @ (YHQ LI ZH GLVPLVV DOO past climate reconstructions, we can still FRQÂżGHQWO\ GHPRQVWUDWH WKH H[LVWHQFH RI DQthropogenic climate change. [2,5]

5 6 3 A large proportion of the sciHQWLĂ&#x20AC;F FRPPXQLW\ GR QRW HQdorse anthropogenic warming.

It is frequently represented in the media and public arena that scientists remain uncertain and divided about the existence of anthropogenic climate change. This is not the case. The IPCCâ&#x20AC;&#x2122;s conclusion is based RQ D IXOO\ WUDQVSDUHQW UHYLHZ RI VFLHQWLÂżF literature that was intensely scrutinized by experts and governments [1]. The consensus was further tested by Oreskes who analysed 928 papers from an objective search for the term â&#x20AC;&#x2DC;climate changeâ&#x20AC;&#x2122; in refereed journals.

Of the 75% of papers that took a position on the consensus, all agreed that humans had VLJQLÂżFDQWO\ FRQWULEXWHG WR UHFHQW ZDUPLQJ [4].

$XVWUDOLD LV QRW D ELJ SOD\HU what we do here does not matter.

Contrary to popular belief, Australia is D VLJQLÂżFDQW JOREDO JUHHQ KRXVH JDV HPLWter. Australians have the highest per capita levels of greenhouse gas emissions in the world [6]. Australia ranks 15th in terms of total gree house gas emissions (1.5% of the global total) [7]. It is also the worldâ&#x20AC;&#x2122;s largest coal exporter, with 233 million tonnes or 30% of the world total in 2005-06 [8]; each tonne producing 2.7 tonnes of greenhouse gas emissions [9].

,QGLD &KLQD DQG WKH 86$ DUH the main polluters and responVLELOLW\ OLHV ZLWK WKHP WR DFW RQ climate change.

Responsibility lies with everyone and we need unprecedented global cooperation to achieve a safe climate for all. However, two principles have been applied to determine who should do how much: 1. The amount of green house gases that countries have already emitted into the atmosphere to date 2. The wealth and means of a country to mitigate climate change

The guiding principle is that all people are entitled to an equal quota of green house JDV HPLVVLRQV 7KH 8QLWHG 1DWLRQV )UDPHwork Convention on Climate Change aims to shift developed economies to green and sustainable, whilst recognising that â&#x20AC;&#x2DC;per â&#x20AC;&#x2DC;Climategateâ&#x20AC;&#x2122; proves that capita emissions in developing countries climate change and climate are still relatively low and that the share of change science is bogus. global emissions originating in developing The main controversy of â&#x20AC;&#x2DC;Climategateâ&#x20AC;&#x2122; countries will grow to meet their social and was about the authenticity of data used in development needs [1]â&#x20AC;&#x2122; which include recomputer modelled reconstructions of past ducing vulnerability to climate change [1].

FOLPDWH D ÂżHOG RI FOLPDWH VFLHQFH NQRZQ DV Ă&#x; paleoclimatology. Doubts raised about posdĹ&#x161;Ĺ?Ć? Ĺ?Ć? Ä&#x201A; Ć?Ĺ&#x161;Ĺ˝Ć&#x152;Ć&#x161;Ä&#x17E;ĹśÄ&#x17E;Ä&#x161; Ç&#x20AC;Ä&#x17E;Ć&#x152;Ć?Ĺ?ŽŜ ŽĨ Ć&#x161;Ĺ&#x161;Ä&#x17E; Ä&#x201A;Ć&#x152;Ć&#x;Ä?ĹŻÄ&#x17E; ÄŽĆ&#x152;Ć?Ć&#x161; sible manipulation of this data was used to Ć&#x2030;ĆľÄ?ĹŻĹ?Ć?Ĺ&#x161;Ä&#x17E;Ä&#x161; Ĺ?Ĺś Ć&#x161;Ĺ&#x161;Ä&#x17E; D^ 'ĹŻĹ˝Ä?Ä&#x201A;ĹŻ ,Ä&#x17E;Ä&#x201A;ĹŻĆ&#x161;Ĺ&#x161; EÄ&#x17E;Ć&#x161;Ç Ĺ˝Ć&#x152;ĹŹÍ&#x203A;Ć? discredit the truths behind climate change. sÄ&#x17E;Ä?Ć&#x161;Ĺ˝Ć&#x152;Í&#x2022; /Ć?Ć?ĆľÄ&#x17E; Ď­Ď­Í&#x2DC; zŽƾ Ä?Ä&#x201A;Ĺś Ç&#x20AC;Ĺ?Ä&#x17E;Ç Ć&#x161;Ĺ&#x161;Ä&#x17E; Ĩƾůů Ä&#x201A;Ć&#x152;Ć&#x;Ä?ĹŻÄ&#x17E;Í&#x2022; This is a myth because, as discussed Ä&#x201A;ůŽŜĹ? Ç Ĺ?Ć&#x161;Ĺ&#x161; Ć&#x161;Ĺ&#x161;Ä&#x17E; ĨŽŽĆ&#x161;ŜŽĆ&#x161;Ä&#x17E;Ć? Ä&#x201A;ĹśÄ&#x161; Ć&#x152;Ä&#x17E;ĨÄ&#x17E;Ć&#x152;Ä&#x17E;ĹśÄ?Ä&#x17E;Ć? ŽŜůĹ?ĹśÄ&#x17E; in Myth 1, direct measures of atmospheric at Ĺ&#x161;ĆŠĆ&#x2030;Í&#x2014;ÍŹÍŹĹ?Ĺ&#x161;ĹśÍ&#x2DC;Ä&#x201A;ĹľĆ?Ä&#x201A;Í&#x2DC;Ĺ˝Ć&#x152;Ĺ?Í&#x2DC;Ä&#x201A;ƾ͏Ç&#x20AC;Ä&#x17E;Ä?Ć&#x161;Ĺ˝Ć&#x152;

4

Whatâ&#x20AC;&#x2122;s in it for us?

7KH 3XEOLF +HDOWK %HQHĂ&#x20AC;WV RI &OLPDWH &KDQJH 0LWLJDWLRQ

Low Carbon Power Generation A term that describes the use of zero carbon sourc-

What?es such as wind, solar and geothermal, low carbon sources such as nuclear and natural gas, as well as carbon-limiting innovations such as carbon capture and storage.

If emissions are reduced, it is predicted that there would be a reduction in particulate air pollution and consequently, mortality. The largest effect would be in India, where particulate DLU SROOXWLRQ LV WKH JUHDWHVW DQG WKH VPDOOHVW LQ WKH (XURSHDQ 8QLRQ (8 ZKHUH HOHFWULFLW\ SURGXFWLRQ IURP IRVVLO IXHOV LV TXLWH FOHDQ 6WXGLHV SUHGLFW VLJQLÂżFDQW UHGXFWLRQV LQ PRUWDOLW\ IURP DFXWH ORZHU respiratory tract infections (ALRI), chronic obstructive pulmonary disease (COPD), and ischemic heart disease (IHD). Costs of implementing low emission electricity production would be substantially offset by reduced pollution-related mortality, especially in China and India [4].

So?

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whereas the effect on IHD and COPD would take more time to become apparent [5].

$OWHUQDWLYH 8UEDQ /DQG 7UDQVSRUW Transport accounts for a quarter of global CO2 emisVLRQV DQG WKUHH TXDUWHUV RI WKDW LV IURP URDG WUDIÂżF > @ Strategies include introduction of low-emission motor vehicles, increasing active transport (walking, cycling etc) and the creation of safe urban environments that facilitate active transport.

Why?

Lower-emission motor vehicles would reduce the health burdens from urban outdoor air pollution, but a reduction in the distance travelled by motor vehicles could have a greater effect. An increase in the distances walked and cycled would lead to ODUJH KHDOWK EHQHÂżWV /DUJHVW JDLQV ZRXOG EH IURP UHGXFWLRQV LQ WKH prevalence of IHD, cerebrovascular disease (CVD), depression, dementia, and diabetes [7].

So?

5HGXFHG OLYHVWRFN SURGXFWLRQ FRQVXPSWLRQ The agriculture sector contributes 10â&#x20AC;&#x201D;12% of total JUHHQKRXVH JDV HPLVVLRQV ZRUOGZLGH )RXU ÂżIWKV RI these emissions come from livestock. A combination of technological improvements in processing products from animal-sources, and reducing the production of foods from animal sources would be efIHFWLYH LQ VLJQLÂżFDQWO\ UHGXFLQJ HPLVVLRQV > @

Why?

Household energy interventions have greater potential to 'LHW PRGLÂżFDWLRQ YLD UHGXFHG LQWDNH RI VDWXUDWHG IDW IURP improve public health in low-income settings. If Indiaâ&#x20AC;&#x2122;s animal sources could lead to both reductions in emissions, cook stove program were completed, 87% of households would and in the incidence of IHD and other CVD at an individual level have a cleaner source of energy, leading to less particulate air pol- [8]. Ă&#x; lution and a reduction in mortality from ALRI, COPD and IHD. zŽƾ Ä?Ä&#x201A;Ĺś Ç&#x20AC;Ĺ?Ä&#x17E;Ç Ć&#x161;Ĺ&#x161;Ä&#x17E; Ĩƾůů Ä&#x201A;Ć&#x152;Ć&#x;Ä?ĹŻÄ&#x17E;Í&#x2022; Ä&#x201A;ůŽŜĹ? Ç Ĺ?Ć&#x161;Ĺ&#x161; Ć&#x161;Ĺ&#x161;Ä&#x17E; Ć&#x152;Ä&#x17E;ĨÄ&#x17E;Ć&#x152;Ä&#x17E;ĹśÄ?Ä&#x17E;Ć?Í&#x2022; ŽŜůĹ?ĹśÄ&#x17E; Ä&#x201A;Ć&#x161; Ĺ&#x161;ĆŠĆ&#x2030;Í&#x2014;ÍŹÍŹĹ?Ĺ&#x161;ĹśÍ&#x2DC;Ä&#x201A;ĹľĆ?Ä&#x201A;Í&#x2DC;Ĺ˝Ć&#x152;Ĺ?Í&#x2DC;Ä&#x201A;ƾ͏Ç&#x20AC;Ä&#x17E;Ä?Ć&#x161;Ĺ˝Ć&#x152; 7KH LPPHGLDWH EHQHÂżWV LQFOXGH D UHGXFWLRQ LQ $/5,ÂśV LQ FKLOGUHQ

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vector 3

Panacea Vol 44 No 1 059 april 2010

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Residential energy use makes up a large part of our carbon emissions. High per head emissions countries like the UK and low per head emissions countries like India require different approaches. In the UK, focus would be on changes to insulation, ventilation control, fuel use, and occupant behaviors, whereas in India, where simple stoves are widely used, a national program to introduce 150 million low-emission cook stoves has been proposed.

Why?

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1

92 countries met in Copenhagen in an effort to reduce greenhouse gas emissions and avert the adverse effects of climate change. Such effects include: species loss, disruption of ecosystems, population displacement, damaged livelihoods, altered agricultural productivity and economic imbalance on regional and local levels [1].Health professionals may be burdened with the fallout from increased frequency and intensity of heat waves, reduction in coldUHODWHG GHDWKV LQFUHDVHG Ă&#x20AC;RRGV DQG GURXJKWV changes of distribution in vector-borne diseases, changes in the risk of disasters and malnutrition [2].

Logically then, mitigation strategies to reduce HPLVVLRQV VKRXOG DOVR KDYH EHQHÂżWV RQ JOREDO SXEOLF KHDOWK 8QIRUWXQDWHO\ WKHVH EHQHÂżWV KDYH QRW UHFHLYHG VLJQLÂżFDQW DWWHQWLRQ LQ LQWHUQDWLRQal negotiations [3]. This article intends to give a concise overview on the connection of several strategies with public health and to strengthen the case for mitigation.

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Read the entire 11th issue of Vector online at: ghn.amsa.org.au/vector sÄ&#x17E;Ä?Ć&#x161;Ĺ˝Ć&#x152;Í&#x2014; dĹ&#x161;Ä&#x17E; KĸÄ?Ĺ?Ä&#x201A;ĹŻ ^Ć&#x161;ĆľÄ&#x161;Ä&#x17E;ĹśĆ&#x161; WĆľÄ?ĹŻĹ?Ä?Ä&#x201A;Ć&#x;ŽŜ ŽĨ Ć&#x161;Ĺ&#x161;Ä&#x17E; D^ 'ĹŻĹ˝Ä?Ä&#x201A;ĹŻ ,Ä&#x17E;Ä&#x201A;ĹŻĆ&#x161;Ĺ&#x161; EÄ&#x17E;Ć&#x161;Ç Ĺ˝Ć&#x152;ĹŹ ',E WĆľÄ?ĹŻĹ?Ä?Ĺ?Ć&#x161;Ç&#x2021; KĸÄ?Ä&#x17E;Ć&#x152; Ä&#x161;Ĺ?Ć&#x161;Ĺ˝Ć&#x152;Ć?

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060 Panacea Vol 44 No 1 4 vector april 2010

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ur planet, just like the human body, exists thanks to a beautiful, complex order in a delicate balance that maintains the earthâ&#x20AC;&#x2122;s homeostasis. Millions of interdependent systems, feedback loops and micro-ecosystems mirror the organisation of the human body.

The earthâ&#x20AC;&#x2122;s oceans, forests and ice masses might seem like huge, inert entities but these are actually the organ systems of the planet. The forests are its lungs, ocean curUHQWV DV HVVHQWLDO DV WKH EORRGĂ&#x20AC;RZ DQG VHDsons keep time in the same way circadian rhythms tie together the diverse processes of RXU ERGLHV (DFK VWHS LQ HYHU\ PHFKDQLVP relies upon certain conditions, one of which LV D VSHFLÂżF RSWLPXP WHPSHUDWXUH Furthermore these systems, despite their complexity, have an extraordinary capacity to adapt to physical stress. We have been subjecting the earth to steadily increasing levels of stress, without respite, for almost 200 years now, with a rapid acceleration in the last few decades. At the same time as releasing more carbon into the atmosphere and heating up the planet, weâ&#x20AC;&#x2122;ve been undermining the planetâ&#x20AC;&#x2122;s reserve capacity by obliterating its forests and introducing foreign pollutants into our land and water systems. Over the last few years, the resilience of the planet has begun to buckle.

In humans, the huge functional reserve of the liver will mask a disease process for \HDUV XQWLO WKH RUJDQ ÂżQDOO\ UHDFKHV GHFRPpensation. At the point where a problem becomes clinically evident, the disease state can be so advanced that cure is no longer a possibility. Instead, there is a rapid, systemic deterioration, and the establishment of positive feedback loops that exacerbate the patientâ&#x20AC;&#x2122;s condition.

When people talk about run-away cli Ä&#x161;Ĺ?Ć&#x161;Ĺ˝Ć&#x152;Ĺ?Ä&#x201A;ĹŻ Ä&#x17E;ĹśĆ&#x2039;ĆľĹ?Ć&#x152;Ĺ?Ä&#x17E;Ć?Í&#x2014; ĹľÄ&#x201A;Ĺ?ĹŻ Ç&#x20AC;Ä&#x17E;Ä?Ć&#x161;Ĺ˝Ć&#x152;ĹľÄ&#x201A;Ĺ?Î&#x203A;Ĺ?ĹľÄ&#x201A;Ĺ?ĹŻÍ&#x2DC;Ä?Žž ',E Ä&#x17E;ĹśĆ&#x2039;ĆľĹ?Ć&#x152;Ĺ?Ä&#x17E;Ć?Í&#x2014; Ĺ?Ĺ&#x161;ĹśÍ&#x2DC;Ć&#x2030;ĆľÄ?ĹŻĹ?Ä?Ĺ?Ć&#x161;Ç&#x2021;Î&#x203A;Ĺ?ĹľÄ&#x201A;Ĺ?ĹŻÍ&#x2DC;Ä?Žž

Ĺ˝Ć&#x152; Ç&#x20AC;Ĺ?Ć?Ĺ?Ć&#x161; Ç Ç Ç Í&#x2DC;Ĺ?Ĺ&#x161;ĹśÍ&#x2DC;Ä&#x201A;ĹľĆ?Ä&#x201A;Í&#x2DC;Ĺ˝Ć&#x152;Ĺ?Í&#x2DC;Ä&#x201A;Ćľ tÄ&#x17E; Ç Ä&#x17E;ĹŻÄ?ŽžÄ&#x17E; Ç&#x2021;ŽƾĆ&#x152; Ç Ć&#x152;Ĺ?ĆŠÄ&#x17E;Ĺś Ć?ĆľÄ?ĹľĹ?Ć?Ć?Ĺ?ŽŜĆ?Í&#x2022; ĹŻÄ&#x17E;ĆŠÄ&#x17E;Ć&#x152;Ć? Ä&#x201A;ĹśÄ&#x161; Ć&#x2030;Ĺ&#x161;Ĺ˝Ć&#x161;Ĺ˝Ć? ŽŜ Ä&#x201A;ĹśÇ&#x2021; Ĺ?ĹŻĹ˝Ä?Ä&#x201A;ĹŻ Ĺ&#x161;Ä&#x17E;Ä&#x201A;ĹŻĆ&#x161;Ĺ&#x161; Ĺ?Ć?Ć?ĆľÄ&#x17E; Ĺ˝Ć&#x152; Ć&#x161;Ĺ˝Ć&#x2030;Ĺ?Ä?Í&#x2DC; WĹŻÄ&#x17E;Ä&#x201A;Ć?Ä&#x17E; ĹŻĹ?ĹľĹ?Ć&#x161; Ć?ĆľÄ?ĹľĹ?Ć?Ć?Ĺ?ŽŜĆ? Ć&#x161;Ĺ˝ ϹϏϏ Ç Ĺ˝Ć&#x152;Ä&#x161;Ć? Ĺ˝Ć&#x152; ĹŻÄ&#x17E;Ć?Ć?Í&#x2DC; Ĺ˝Ç&#x20AC;Ä&#x17E;Ć&#x152; WĹ&#x161;Ĺ˝Ć&#x161;Ĺ˝Í&#x2014; ŽžĆ&#x2030;Ĺ˝Ć?Ĺ?Ć&#x161;Ä&#x17E; /ĹľÄ&#x201A;Ĺ?Ä&#x17E; Ä?Ç&#x2021; ĹŻÄ&#x17E;Ç&#x2020;Ä&#x201A;ĹśÄ&#x161;Ä&#x17E;Ć&#x152; DĆľĆ&#x152;Ć&#x2030;Ĺ&#x161;Ç&#x2021; ÍŹÍŹ Ä&#x201A;Ć?Ä&#x17E; /ĹľÄ&#x201A;Ĺ?Ä&#x17E;Ć? Ä?Ç&#x2021; ^Ć&#x2030;Ä&#x17E;ŏƾůÄ&#x201A;Ć&#x161;Ĺ˝Ć&#x152; ÍžĆ?Ç&#x2020;Ä?Í&#x2DC;Ĺ&#x161;ƾͿ Ä&#x201A;ĹśÄ&#x161; Ć?Ĺ?Ĺ&#x152;Ĺ&#x161;Ä&#x17E;Ä?Ä&#x17E;Ć? ÍžĆ?Ç&#x2020;Ä?Í&#x2DC;Ĺ&#x161;ƾͿ

mate change, this is what they are envisioning.

The scary thing is, trying to predict when and where these â&#x20AC;&#x2DC;tipping pointsâ&#x20AC;&#x2122; will occur LV H[WUHPHO\ GLIÂżFXOW <HV WKHUH LV VRSKLVticated mathematical modelling that is used to predict changes, but the models are not perfect. Increasingly there is evidence that many predictions about the speed and severity of climate change have been too conservative.

Trying to deal with this â&#x20AC;&#x2DC;climate feverâ&#x20AC;&#x2122; is akin to treating an entirely unknown patient (a new species, if you like) who is suffering from a disease youâ&#x20AC;&#x2122;ve never encountered.

When the analogy is drawn out in this way, to then look at how the worldâ&#x20AC;&#x2122;s leaders are attempting to address the problem can be quite shocking. Our leaders will try to tell us that there is such a thing as a â&#x20AC;&#x2DC;safeâ&#x20AC;&#x2122; fever of a 2 degree rise in global temperature (though they cannot even make a binding commitment to limit warming to this level). This target (now considered by many as simply impossible to reach) would directly threaten the lives and livelihoods of about 600 million people across the globe. Any doctor who attempted to manage a patient with such callousness would be at risk of being struck off for negligence.

When you think about the planet as a human body suffering from a prolonged fever, and a fever that we donâ&#x20AC;&#x2122;t know how to treat, itâ&#x20AC;&#x2122;s easy to see why climate scientists are so alarmed.

Thereâ&#x20AC;&#x2122;s still time to cool this fever. The community movement continues to gather momentum and demand immediate, decisive action to reduce the impacts of climate change. Doctors and health professionals, medical students included, must raise their voices about this issue, and state that they will not gamble with the health of the planet nor its citizens. Ă&#x;

JARGON SCHMARGON

Caitlin van oers (Griffith) hopes she never acquires

pneumonoultramicroscopicsilicovolcanoconiosis.

for medical school unless they have I feel like I’ve just spent the last rather than having to *feel* for him or her. ___________________________________ ___________________________________ ________________________ previously studied Latin! year learning a new language. Coming This is quite right and proper – but only ___________ ___________________________________ ___________________________________ _____________ from a communications (uh...very nonsometimes.

Usually what our patients If our aim is to communicate quickly, ______________________ ___________________________________ ___________________________________ __ scientific) background my first year in need__________________________ is sympathy. “ I guess jargon does the job when _________________________________then ___________________________________ medicine was spent asking “athero-what?” it comes to colleagues/other students We all know people who use jargon _________ ___________________________________ ___________________________________ _______________ and moaning about why on earth we but is entirely inappropriate with those excessively and inappropriately in order ____________________ ___________________________________ ___________________________________ ____ need all these little sub-languages within outside of the medical circle.

The Oxford sound sophisticated, or to belittle _______________________________ ___________________________________to____________________________ English. To make those who understand Handbook of Clinical Medicine suggests others (the same people who like to dust _______ ___________________________________ ___________________________________ _________________ it feel better? To deceive those who do that the role of jargon, in medicine, can be off their French or Italian in suburban __________________ ___________________________________ ___________________________________ ______ not understand? Or because it’s easier, a self-preserving mechanism.

Insulating restaurants). Or maybe they simply forget _____________________________ ___________________________________ ______________________________ shorter, quicker? doctors, us ___________________________________ from having to deal with the how they sound.

I, um, admit to forgetting _____ ___________________________________ ___________________ emotional reality, in order to give them There is exclusive jargon in all fields of to speak in complete words sometimes, ________________ ___________________________________ ___________________________________ ________ space to think, clinically. study.

Words that baffle us, and halt our exclaiming to my non-med friends and ___________________________ ___________________________________ ________________________________ understanding.

Simple concepts become family I “can’t_____________________ catch up because I need to From page 25 of the 7th edition of the ___ ___________________________________ ___________________________________ impenetrable to the newcomer because do my LI for PBL & Homeo__________ LO’s PLUS OHCM: “We get nearer___________________________________ to the truth ______________ ___________________________________ they do not ’speak the language’ and my IMD LO’s, before D&P tomorrow when we realise that these medicalisms__________________________________ _________________________ ___________________________________ a translator in order to understand.

AND review ECGs!”. are used to sanitise and tame the raw _need ___________________________________ ___________________________________ _______________________ So you buy a dictionary, or spend the data of our face-to-face encounters with ____________ ___________________________________ ___________________________________ ____________ They, rightfully, pointed out whole time scribbling furiously. ___________________________________ In the patients – to make them bearable to us – _______________________ ___________________________________ _ that I sounded like “a complete Netherlands, students can’t even apply so___________________________________ that we can *think* about the patient __________________________________ _________________________ fuEXPLETIVES DELETEDer” (Ed)

Say it like you mean it

Some consultant making you feel like Charlie Brown?

Hanika Roberton (Flinders) gives a ten tips to avoid the wrath of the man (or woman) in the white coat.

Giving a case presentation to a consultant in front of your peers can be a nerve racking experience but these tips should get you started in the right direction.

1 Freshen up before you start. A hectic all night shift may seem like a good excuse to look like a bum but a quick shave and a stick of deodorant will do wonders.

2 Practice, practice, practice. Grab a friend, an intern, a registrar, anyone to practice with so you can work out the kinks before the consultant comes.

3 Aim for 5 minutes, no one likes a rambler.

4 Have a method of going through introduction, presenting complaint, body systems etc so you don’t miss anything out.

5 Speak confidently. Being wrong is the same whether you sound confident or unsure, but being confident and correct will get you more credit than meekly being right.

6 Don’t bullshit. Confident bullshitting may undo all the points you got for being confidently correct.

7 Summarize concisely, have a problem list and an action plan ready to go. Always

try and answer “what do we do next?”.

8 If you don’t know the answer to a question, admit you don’t know it but add in something RELEVANT that you do know.

9 Be open to feedback, it’ll never be perfect. Sure, consultants can make you feel like they did it right their first time but they were students once too.

10 Don’t mix up your patients!

Remember basics like age, sex, and name.

Suggesting a pregnancy test for a 40 year old man named Doug isn’t going to do you any favours.

Panacea Vol 44 No 1 061

TXT SPK. It Drivz Me Fkn Nutz Can’t figure out whether you should ROFL or LMAO? Jared Panario (Publications) doesn’t like the ultimatum you’ve proposed. AT ALL.

OK, I’m going to sound like a cantankerous miser, but I detest what text messages are doing to the English language. Not a new idea I agree, but have you ever sat down and really thought about the insidious influence that texts have over our lives? Recently, I had an experience that made me stop in my tracks and consider the future of our language.

It was on ward round last week. I, like any good medical student, was reading the notes for the patient I was to present at the consultant round later in the day. He had a cacophony of a past medical history, and required input from many different teams (allied health and specialty medical teams) to manage the overall picture.

Each team had seen him over the last few days, each noting their separate and at times discordant plans in varying levels of legibility and clarity. And each with their own abbreviations that, at the beginning of my student life, were none too selfevident.

I am not here to talk about my gripe with

062 Panacea Vol 44 No 1

the dreaded TLA though (three letter abbreviation). That’s another issue for another day. Then a note came from a junior member of one particular team that took me aghast.

To preface my shock, I must admit that I do have a penchant for grammar and spelling. This is accompanied by a tendency to look upon errors made by others with a certain sense of disdain. I have recently finished reading a fantastic novel on the correct usage of punctuation (I recommend it: Eats, Shoots and Leaves

by Lynne Truss). So it was not the idea of the note, but the way in which it was written, that really got under my skin.

“Plz mobilize 2 improv function. BBL 2day to assess.”

BAM. There it was. Not only was there clearly Americanisation (mobiliSe) of this individual’s spelling (yet another woe), but also they had used text abbreviations in a patient’s notes. A binding, legal document, written in the style of a note which is to be passed to your high

school crush across the art room, or your forbidden adolescent facebook love. A piece of information that cannot only be brought up in a court of law, but also a vital conduit for patient care. Do you think that is acceptable?

As you can guess, I did not. Sure, most people could interpret the first sentence (if you can call it that) without any difficulty. The second sentence, however, left room for interpretation. The majority of undergraduate students would be in the same boat as me to know/guess BBL = Be Back Later. But what about people that aren’t text-language savvy? Big Burly Linguist? Best Billiard Lover? Bisexual Bang Licker? It isn’t clear. It isn’t fair to the patient. And it isn’t acceptable.

Another admission: I occasionally have been known to verbalise the term ‘lol’, albeit sarcastically. But the simple fact that I can say it and be understood means that even my ivory tower of pristine language has been affected. There are countless other instances of this figurative

howz lst nite?

Sorry, who is this?

lol ur bff Shazi I beg your pardon?

omg dmy. ur funi

I don’t know who this is

btwitiailwu Oh piss off.

coating of text-speak, but none more horrifying to me than this: The Advertiser, South Australia’s local paper, published an article 15 April entitled ‘Poetry in text-speak’. It gave serious credence to the idea of including text-speak ‘poetry’ as accepted material for the Year 12 English Studies Course.

Teaching that text-speak is acceptable to an impressionable youth, who already are seen as lazy and somewhat illiterate by older generations? That’s not cool.

I’m not going to say that SMS is an abhorrent demon that needs to be eliminated from the world in every form in order for us to have a pure and righteous society. SMS definitely has its place and has made things like organising meetings, getting in contact with awkward people and generally wasting time an absolute breeze. Twenty years ago, trying to catch up with mates at night was an absolute pain in the arse. Now? Three texts and you’re all good, no matter how loud the music is.

My problem is the pervasiveness of the text-speak laws. I am not a shortener of words in any forum, even in text. I simply cannot understand why someone would bastardise our language - something we should all be proud of and embrace.

Furthermore, I do not think the argument of saving time nor of economics will hold up to any cross-examination. It actually takes longer to write the number ‘2’ (1.8 seconds) on a predictive-text phone than the word ‘to’ (1.3 seconds).

I am willing, however, to acquiesce that truncated words and mangled grammar are deemed acceptable by a majority in text speak. I will not harp on about this. What concerns me is the fact that the boundaries of these text-speak laws are being blurred and integrated into the majesty of the English language.

A half-breed mutant is emerging that speaks like a bogan and writes like a fouryear-old with a piece of dried dog poo. A half-breed bestowing their offspring with names like EmLE (Emily), Jsh ( Joshua),

2B (Toby), or my favourite made-up name K8 (Kate).

English is a complicated, crazy mish-mash of almost every language you can name.

And that’s half of its beauty and grandeur - the intricacies and stories behind every one of the million idiosyncrasies. It is at once a vivid history lesson, a political mark and a phonetic delight. But what can we say about the adaptation of text-speak? Will future generations look at our generation as the one which made “English 4 Idiotz” the mainstay of communication?

I may be fighting a war that cannot be won. I may end up in an aged care home bereft of vowels and looked after by people that have no cognisance of the difference between ‘to’, ‘two’ or ‘too’ as well as ‘your’ and ‘you’re’. It may become the norm. I am only one man. One man with an affinity for appropriate apostrophes. If thisso transpires, I shall embrace my PCA like there is no 2moro.

Panacea Vol 44 No 1 063

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064 Panacea Vol 44 No 1

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anacea Volume 44, Edition 1

June 2010