AMSA Panacea 2010 Edition 2 - American Express Edition by The Australian Medical Students' Association

Panacea Vol 44 No 2 079

Panacea The Official Magazine of the Australian Medical Students’ Association. ‘The Colour Edition’ Proudly Sponsored by American Express Volume 44, Edition 2, 2010

Panacea Vol 44 No 2

Editorial President’s Address AMA gives green light to red book? doctors don’t colour in the borders RUral ≠ Brown Word. A(n)U: AMSA Student GOld. 6jhigVa^Vc BZY^XVa 6hhdX^Vi^dc Yes please! Can i have some mauve that?

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I relish the fact you’th to ketchup with me. Ginger-ly Colour-blind? Rainbow Connection C’mon, Hand over your Khakis

I’m off to the country, be Sienna later. Looking to the fuchsia white and wrong the fine art of Chat-reuse Into the wild: convention review Sub-lime academia sports day: a palette of fun HIJ9:CI B:B7:GH=>E >H ;G:: a thousand pictures must surely Passion-fruit pit HD ?D>C I=: 6B6 ID96N 6C9 :C?DN 6 A>;:I>B: D; colourful language

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i’m not a-green with that Blue-ribbon worthy I]Z 6B6 ^h i]Z dcan ^cYZeZcYZci! it don’t matter whethercVi^dcVa kd^XZ d[ Vaa YdXidgh ^c it’s red or white blue-balling it 6jhigVa^V# Ndjg bZbWZgh]^e back in black ZchjgZh e]nh^X^Vch ]VkZ V hVn ^c i]Z YZkZadebZci ‘remier league article d[ i]Z ]ZVai] hnhiZb How did you get to be so very Well red? ndj l^aa aZVY ^cid Gettin’ brassy i]Z [jijgZ#

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02 Panacea Vol 44 No 2

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__ __ ___ ___ __ __ __ _ _ _ _ _ _ _ __ __ ___ ___ ___ __ __ __ ___ _ _ _ _ _ _ _ __ _ __ __ __ __ ___ ___ ___ __ _ __ __ ___ ___ _ _ _ _ _ _ _ _ __ __ __ __ __ __ __ __ __ __ __ ___ ___ __ ___ __ __ __ __ __ __ _ _ _ _ _ __ __ ____ ___ __ __ __ _ _ __ __ __ __ __ ___ ___ __ _____ ____ __ __ __ __ ___ _ _ _ _ _ _ _ _ __ __ __ __ __ __ ____ ___ _ _ _ _ __ __ __ __ ___ ___ __ ___ __ __ __ _____ ___ __ ___ ___ __ _ _ _ _ _ _ _ __ __ __ __ __ ___ _ __ __ _ ___ _ _ __ __ __ __ __ ___ ___ __ ___ __ _____ __ _____ _____ ___ __ __ __ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ __ __ __ __ __ ___ ____ __ __ __ ____ _ _ _ __ __ __ ___ ___ __ ___ __ _____ ___ __ __ __ __ _ __ __ __ _ _ _ _ _ _ __ __ _ _ _ _ _ _ _ __ __ ___ ___ __ ___ __ _____ _____ ____ __ _ __ __ __ _ _ _ Editorial jared panario _ _ _ _ _ _ __ _ _ _ _ _ __ __ ___ ___ __ ___ __ _ _____ ____ _ ____ ___ __ __ _ _ _ _ _ _ _ _ __ __ _ _ _ _ The Death of the teaching hospital ross roberts-thomson __ __ ___ ___ __ ___ __ __ _____ _____ ____ ___ __ __ _ _ _ _ _ _ _ _ _ _ __ __ _ _ __ __ ___ ___ __ ___ __ __ _____ _____ ____ ___ __ AMA gives green light to red book? dr michael bonning _ _ _ _ _ _ _ _ _ _ _ _ __ __ ____ ____ __ _ _ doctors don’t colour in the borders steve peterson _ ____ ___ ____ ___ ____ ____ ________________ ______ ______ ___ __ _ _ _ _ _ _ _ _ __ __ __ __ __ ____ __ __ __ ____ ___ __ RUral Brown Word. tim bromley __ __ ___ ___ __ ___ ___ _____ _____ __ ____ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ A(n)U: AMSA Student GOld. rob olver __ __ ___ ___ __ ___ ____ ____ _ _____ __ __ __ _ _ _ _ _ __ __ _ _ _ _ _ _ __ __ ___ ___ __ ___ ____ ____ _____ __ __ Yes please! Can i have some mauve that? various _ _ _ _ _ _ __ _ _ _ _ _ _ __ __ ___ ___ __ ___ _ ____ ____ _____ ___ _ _ _ _ _ _ __ _ _ _ Amsa Rep Reports _ _ __ __ ___ ___ __ ___ __ __ __ _____ _____ _ _ _ _ _ _ anderson __ __ _ __ ____ ___ _ _ I relish the fact you’ve mustard the strength to ketchup with __ me. __ __ will __ __ ___ _____ __ ____ _____ _ _ _ _ Which Disney Character are you? daina rudaks and amy schirmer__ ___ ____ ____ ___ ____ ______ __________ __ _ _ __ __ ___ __ ___ _ _ _ _ _ __ __ ____ ___ __ __ _ _ Ginger-ly stefan mcAlindon _ _ __ __ ___ ___ __ _____ ____ _____ _ _ _ __ _ _ _ Colour-blind? aaminah khan __ __ ___ ___ __ _____ ____ ____ _ _ _ _ _ _ _ _ ___ ___ _ _ Rainbow Connection james pearlman and lesh satchithananda __ __ ___ ___ _____ _____ _ _ _ _ __ __ ___ ___ __ _ _____ ___ C’mon, Hand over your Khakis justin chau _ _ _ _ __ _ _ __ _ _ _ _ _ _ _ _ _ _ __ ___ __ __ __ __ __ I’ll white what I wanna White, Dammit! sam whitehouse __ __ ___ ___ __ ___ __ _ _ __ _ _ _ _ I’m off to the country, be Sienna later. ellen hardy __ __ ___ ___ __ _____ _ _ _ __ _ __ __ ___ ___ ___ _ Looking to the fuchsia natalie ngu _ _ _ _ _ _ ___ __ __ ___ __ __ _ _ _ white and wrong spence watson _ _ _ _ _ __ __ ___ __ __ _ _ the fine art of Chat-reuse stephen kunz __ __ ___ ___ _ _ _ _ _ _ _ _ _ _ _ Into the wild: convention review __ __ __ _ __ __ _______ Sub-lime academia sabin smith _ _ _ _ __ __ ________ _ _ _ _____ sports day: a palette of fun steph flukes and kate mcKenzie ____ ___ _ __ ________ _ a thousand pictures must surely be worth vermillion words jared panario ___ _ _______ __ ___ __ ____ _ ___ _ ___ Passion-fruit pit hannah sexton ____ _ ___ ___ _ _____ _____ ___ ____ ___ ___ colourful language cameron gofton ___ ___ _ _____ ___ ___ _ _ _ __ ___ _ ___ _ You are so bluetiful it hurts mary-jo flavel _ _ ___ ___ _ _ _ _ ___ ___ ___ ____ _ _ _ _

Contents ≠

_ _ __ __ __ __ __ __ ___ _______ _________ _________ ___ ____ __ ___ __ ___ ____ ___ ____ ___ ____ _ _ _ _ _ __ ____ __ ___ __ ___ ___ _ __ ___ ___ _ ____ __ ____ ___ _ _ ___ ___ _ __ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ___ _ _ ___ ____ _ ______ ___ _______ ____ ___ __ ___ ___ __ __ _ ___ ____ ___ ____ ___ ____ _ _ ___ ____ _ ___ _ _ __ _ ____ _ ____ __ __ _ __ __ ___ ___ __ __ __ ___ __ ___ ___ _ ___ __ ___ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ ___ ____ ___ ____ ___ ____ ___ ____ __ ______ ___ _______ __ ___ __ ___ ___ __ _ ___ ____ _ ___ _ __ ___ _ _ _ ____ _ ___ _ __ _ ___ __ _ ___ ___ __ _____ ___ _ ___ ____ _ _ ___ ____ _ _______ _________ ___ __ ___ ___ __ ___ _ ___ ____ ___ ___ ____ __ _ _ _ ___ __ _ _ _ ___ ___ ___ _ __ _ _ _ ___ __ __ _ _ _ _ _ _ _ ___ ____ _ ___ _ ___ ___ _ _______ _________ __ ___ ___ __ ___ __ __ ___ ____ ___ ___ ____ __ _ __ ___ ____ ___ ____ __ __ ___ __ _____ __ __ __ __ __ __ _ ___ __ ___ _ __ ___ ___ _ ___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ___ _ _ _ _ _ _ _ ___ _ _ _ _ _ _ _ ___ _ _ _ _ _ _ ___ ____ _ __ _____ _ ___ ____ ___ ____ ___ ____ ___ __ _____ _____ __ ___ __ ___ __ ___ ___ __ __ _ ___ ____ ___ _ _ _ _ _ _ __ _ ___ _ _ ___ ___ _ _ __ __ ___ ___ _ _ _ _ _ _ ___ __ ______ ____ _ ___ __ ___ ___ __ ___ __ __ ___ ___ ____ ___ ____ ___ ____ ___ ____ _ ___ _ _ _ _ ___ _ _ ___ ____ __ __ __ _ ___ __ __ __ _ ___ ___ __ ___ _ ____ __ ___ __ _ ___ _ _ _ _ _ ___ ____ _ ___ _ ___ ___ ____ ___ _______ __ ___ __ ___ ___ __ ___ __ ___ ____ ___ _ _ ___ ____ __ ___ ____ _ _ _ _ _ ___ ____ _ __ __ __ __ __ __ __ ___ __ _ __ ___ ___ ___ _ ____ _ ___ ___ __ ___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ___ _ _ _ _ _ ___ _ _ _ _ _ _ _ _ ___ ____ _ __ __ ___ _ ___ ____ ___ ____ ___ ____ ___ ____ _________ ___ __ ___ ___ __ ___ __ ___ _ ___ ____ ___ _ _ _ _ _ ___ _ _ _ ___ ___ _ _ __ __ __ _ ___ ___ _ _ _ _ _ _ ___ ____ ___ __ ___ ___ __ ___ __ ___ ___ __ ___ ___ ____ ___ ____ ___ ____ ___ ____ _ _ ___ _ _ _ _ _ ___ ____ _ __ _ __ __ __ ___ __ __ __ __ ___ __ __ ___ ___ __ _ ___ _ ___ _ _ _ ___ ____ _ _ ___ ____ __ __ ___ ___ __ ___ __ ___ ___ _ _ ___ ____ ___ ___ ____ ___ __ _ _ _ _ __ _ __ _ ___ ___ _ _ _ __ __ ___ _ _ _ _ _ _ _ _ _ _ ___ _ _ _ ___ _ _ _ _ __ _ ___ _ _ _ _ _ ___ ____ _ _ _ _ _ _ _ _ __ __ __ __ __ __ ___ __ __ __ __ ___ ____ ___ ___ ___ _ _ _ _ _ ___ _ ___ ____ __ __ ___ ___ __ ___ __ ___ __ __ _____ ____ __ ___ __ __ _ _ _ _ __ _ _ _ _ ___ ____ _ _ _ _ _ _ _ _ ___ ___ __ __ __ __ __ __ __ ___ __ __ ___ ____ _ _ _ _ _ __ __ ___ ___ __ ___ __ ___ ___ _ __ _ _ _ ___ ____ ___ __ __ __ __ __ __ __ _ __ _ _ _ _ _ ___ _ __ __ _ __ __ ___ ____ __ __ __ ___ ___ __ ___ __ __ _ _ _ _ _ ___ _ __ __ __ __ __ __ __ ___ ___ __ _ _ _ __ _ __ __ __ __ __ __ ___ ___ _ _ __ __ __ __ __ __ __ _ __

5 6 8 9 10 11 13 16 24 26 28 30 32 34 35 36 37 38 40 41 42 45 47 5254 54 55 56 58 59 60 62 64 66 70 70 71 75

___ ___ ___ ___ i’m not a-green with that bec ryan ___ ___ ___ ___ ___ _ _ _ _ _ ___ ___ ___ ___ Blue-ribbon worthy rob olver ___ ___ _ ___ ___ ___ ___ ___ ___ _ _ ___ _ _ _ _ ___ ___ _ _ it don’t matter whether it’s red or white falk reinholz and will stokes _ _ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ __ ___ ___ ___ ___ blue-balling it priyam jha ___ _ _ ___ _ _ _ _ _ _ ___ ___ ___ _ ___ ___ _ _ __ ___ ___ ___ ___ ___ back in black em rischbieth and nelson granchi ___ ___ ___ ___ ___ ___ _ _ _ ___ _ _ _ _ _ ___ ___ ___ ___ _ ___ ___ ___ ___ ___ ___ sacrebleu IFMSA in montrÉAL! seb leathersich ___ ___ ___ ___ ___ __ ___ ___ _ _ _ _ _ ___ ___ ___ ___ ___ ___ ___ ___ ___ _ ‘remier league article tim coppafeel ___ ___ ___ ___ ___ ___ ___ _ _ _ _ _ _ _ _ _ ___ ___ _ _ _ _ _ _ _ _ _ _ _ _ ___ ___ ___ ___ ___ ___ How did you get to be so very Well red? various ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ _ _ _ _ _ _ Gettin’ brassy stephen kunz ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ __ ___ ___ ___ ___ ___ ___ ___ _ _ __ How a change ... red train sam whitehouse _ _ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ Vector: The Official GHC magazine ___ ___ ___ ___ ___ ___ __ How to apply for American Express gold card ___ __

Panacea Vol 44 No 2 03

panacea Edition 2 Volume 44 September 2010

Proudly sponsored by

American Express

Editor Jared Panario Graphic Designers Robert McCusker Doug McCusker Priya Nandoskar Proofing Tom Crowhurst Tim Bromley Amy Schirmer Daina Rudaks Rob Olver

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

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. Proof 5 August'10-(11:57am) All material in AMSA remains the copyright of AMSA or the author and may not be reproduced without permission

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04 Panacea Vol 44 No 2 10-0336

20%

Mem

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disc

oun

I’m back. Missed me haven’t you? You may think Jared Panario (Publications) is full of himself. But it’s all just a front for his inner aesthete.

Editorial

(As a side note; I would like to aver that histology slides will be the next big t-shirt print phenomenon. I think they look rather nifty. And if that makes me a nerd... well... embed me in paraffin. I have no intention of becoming a pathologist, but I’m a med student. Ergo dork extraordinaire.) Cro-Magnon man knew colour was important. Red be danger. Or be food. Green be plant. Black be dead. He lived day Litigiously speaking, to day by his cones and rods. That, and his compensation for giant recessive forehead. Have you ever seen complete loss of sight is equivalent to death claymation television series Gogs? Definitely itself. Sight is that important to worth a look. Haven’t seen it since I was everyday life. Imagine: you’re out at a fourteen or so, I laughed a lot then... hmm. club on the prowl, wanting to pick up Maybe take that advice with a grain of salt. that genetically superior (read: attractive) Anyway, I digress. Isn’t that what a partner. What’s the first thing you do? You magazine is all about anyway, digression? have a bit of a squiz. You could argue that Colour is intangible; technically just you could get to know someone a bit better an artificial interpretation of polarised through the other senses as well. But I wavelengths of light. You can’t hold green would wager licking their ear, sniffing their in your hand, the green doesn’t even exist. hair or pawing their face isn’t going to get Despite this, entire industries rely on you many brownie points. You’ll probably our instinctual response to this fluff. Red be thumped by their lug of a boy/girlfriend is known as an appetite stimulant and that resembles a love-child of Roseanne disinhibitor; ergo the plethora of fast food Barr and John Goodman. Or pick up said megaliths that use red as their primary monstrosity. Enough said. corporate colour. Blue slows thought Think about the social implications of processes and suggests solidarity; financial imperfect vision as well. I can personally institutions worldwide are almost uniformly attest to this. As an arguably ‘festive’ ten blue (in the USA, blueness is primarily year-old, receiving my first pair of glasses due to their quadruple bankruptcy status) definitely did not enhance my meagre social (Apologies for the awful pun, this edition is status. Sure, the status and symbolism of full of them). glasses has changed in recent years (in no I could wax lyrical on the impact of colour small part to torrential marketing), they still in medicine. Every walk of medicine needs imply a physically inferior specimen. A man colour to function. From black, tarry stools not made for hunting/gathering, more of an to congenital cyanotic heart defects to indexing/cataloging type. heterochromia, we as physicians would be

Welcome to the Colour Edition of Panacea. This edition is sponsored by American Express. AMSA knows you expect quality benefits as part of your membership, so AMSA has specially negotiated for members an offer from American Express. To learn more, please visit our website www.amsa.org.au/content/memberbenefits .

lost without our spectral aptitude. Enough about this bloody ethereal theory. What’s the deal with the cover again, I hear you ask? Why on earth are two animals gracing the cover of what is an ostensibly medical magazine? And why does this particular editor have a penchant for graphics that involve conflict in some sort of animé style? Octopodes are fantastic creatures. The smartest of all invertebrates, they are capable of solving complex puzzles beyond the grasp of many mammals. They also have the ability to alter their image on a whim: veritable Lady Gagas of the animal kingdom (and just as androgynous). They converse, camouflage and conceive all around this remarkable ability. And like the oddball starlet, image is everything to them. Our avian friend here, now he’s the observant one. Birds of prey rely on their keen vision for survival. With the right insight and perception, even the illusional cephalopod is discovered. He may be inadvertently threatened by DDT with his offspring being crushed with poor shell integrity, but DDT is colourless so you can’t blame him. Sculpted by evolution, macerated by civilisation. And why are they fighting? For dramatic effect. Not much else. I could read into it a little more, but that’s the crux of the argument. Lookin’ good is what covers should do. Just like me. I hope you enjoy this second edition. It certainly has been a labour of love. I am seriously looking forward to seeing what next year’s Publications Officer brings along. Cheers for now - JP. Panacea Vol 44 No 2 05

Ross robertsthomson (President)

h t a e D

examines the murder scene that is the value of tertiary hospitals for medical students. Cause of death? Read and see.

g e n h i t h al + i ac p e s t o h

e h T

In an environment of exponentially increasing medical knowledge, instantaneous communication and Star Trek-like technology, what will medical education look like in the future? This is the question that often plagues policy makers and university administrators as they try to keep pace in the arms race that is medical education. The medical education landscape has changed dramatically over the last 100 years. So it’s understandable that undergraduate education will change to fit in with this new world order. The amount of information in medicine has increased exponentially and continues to increase. This is because the number of people undertaking and publishing research has increased, they are sharing it with the world, and people are being able to read it and act upon it very quickly. Biomedical knowledge has exploded. We end up going deep and 06 Panacea Vol 44 No 2

learning more and more in specific areas. About 20 years ago, there were 20 specialties and now there are over 200. My own brother, finished medical school, became a cardiologist, became an electrophysiologist, and is essentially now a ventricular electrophysiologist. So, I asked him the other day when he grows up which ventricle he wants to specialize in? For a right ventricular electrophysiologist to be teaching medical students, I would question the breadth of knowledge he would be able to impart and what are the types of patients that he’s seeing and their importance for a medical student. So with the plethora of knowledge

in each specialty, we need to decide, what’s important… and that’s going to get political for the colleges. The healthcare system is also changing, and I’m not just

talking about the funding of it. Patients with common and chronic diseases are no longer being managed in our traditional teaching hospitals. These institutions are kept for those who have significant illness or illness that necessitates some intervention. We as students, need to know the common stuff first. We need to know how to manage asthma, hypertension, high cholesterol, diabetes, depression, osteoporosis, all of which are primarily managed in general practice. The traditional tertiary teaching hospital is a thing of the past. The hospital environment is no longer a good learning environment for medical students, and possibly interns as well. As subspecialisation expands and logistical stressors move more patient management to the community, students need to follow the patients. Students need to be where the patients are, and increasingly they are being managed in the community. There are a number of other levers that will continue to

with any of these. And certainly the pursuit of excellence is crucial to ingrain in the doctors of the future. However, we have between 4 and 6 years here in Australia to learn the information required for an undergraduate medical education. What troubles me is the fact that many older doctors expect medical students to learn required from a university medical education? what they learnt at medical school. I don’t Interestingly, it is in the UK and the US know any consultant who learnt about that much of the international work on the pharmacology of imatinib or HIV what is required from a medical education, replication when they were at medical has been done. In the UK, the government school, but they expect students to know has produced publication called the anatomical path of the ansa cervicalis. Tomorrow’s Doctors, which they released University medical education is in 2002 and which has undergone many undergoing significant change. It revisions. This publication looks at what raises the question as to whether the is required to help develop the doctors of Australian Medical Council’s current the future. This revealed the importance system of accrediting courses against no of the following: communication skills; set standards can guarantee the quality interprofessional learning; encouraging of Australia’s medical education in the curiosity and research; promoting public future. With the growing number of health perspectives; assuring quality of medical schools in Australia, establishing learning and promoting innovation in broad and transparent guidelines for teaching; and preparing students for the the content and delivery of a university modern world (which means allowing medical education would enable rotations in other countries and to study universities to provide students with languages whilst studying medicine). In similar core competencies but a diversity the US, they are a little bit simpler and of extended skills and knowledge. The they break it down to 4 pillars: broad idea of a national curriculum or barrier understanding of anatomy, physiology, exam is fraught with problems; however, biochemistry, pathology, etc; leadership accrediting bodies in medical education and professionalism; communication; and must be transparent and proactive to the pursuit of excellence. ensure our future doctors are equipped for I think there’s probably no argument the future healthcare environment. shape medical education. Patient views on what they want from doctors (eg. good communicators) and the litigation system, which has brought about more and more defensive medicine will continue to play a major role in how we educate future doctors. So what should be

Panacea Vol 44 No 2 07

AMA gives green light to red book?

To some, the government restructure of the national health system is just a string of words. Michael bonning (CDT Chair, AMA) discusses its impact on the future for medical students. You would think that Governments would have stopped publishing little red books by now. They seem to be linked with poor historical stereotypes. However, the Australian Medical Associaton’s Committee for Doctors in Training (AMA CDT) has recently been spending it’s time going through the Council of Australian Governments (COAG) Health Reform package initiated under the former Prime Minister, a small red manifesto that proposes to reshape healthcare in Australia. The most important point of the reform agenda for all medical students and (soon to be) junior doctors is the Commonwealth’s commitment to fund 60% of education and training costs of doctors. Taking the majority share of funding in this area is new ground for the Commonwealth government and they are proposing that to pay for 60% of something you firstly need to determine what makes for 100% of clinical training. This is therefore an interesting situation we find ourselves in: trying to quantify the cost of clinical training turns out to be very difficult indeed, and perversely, it actually gets harder the better the training is. To show you just how hard it is to quantify and cost clinical training, let me give you a scenario. Think about a day on the wards with a surgical team: 08 Panacea Vol 44 No 2

it starts early (with a ward round) and often finishes late. During the ward round you get quizzed on anatomy, pathophysiology, and microbiology; you get none of the answers right (that’s OK we’ve all been there), you watch as the registrar communicates with a patient’s family regarding their diagnosis, while the resident ensures that once the team leaves the nursing staff will be available to continue discussions with the family. You head off to theatre and while waiting for the first patient to be anaesthetised a surgeon shows you how to do singlehanded ties. And it’s only 8am… All of this overt and implicit teaching has happened in the space of the first hour of the day. It will continue with some easily identifiable components (lectures, tutes, clinical case presentations) and some very unquantifiable ones too (discussions in the tea room, a conversation with the consultant at the end of the day). It is this breadth

of experiences that makes clinical teaching so important

to everyone’s progression to independent practitioner. The bits and pieces that are gleaned from random conversations with peers and supervisors would be very unlikely to make it into the quantified 60%. And this is the danger. If we are left with just what is easy to quantify

(and therefore fund) we will have a bare skeleton of what clinical training is now not an environment that rewards excellence and time taken to teach in nontraditional ways. The AMACDT is the in the process of looking at the elements of clinical training that can be effectively quantified and also looking at ensuring that not just “items” are costed and paid for, but that clinical support time for teaching, training and research is protected and valued. This should promote a culture of best practice and innovation. While we have concerns regarding the ability of teaching and training to be measured, we applaud the effort to do so. Encouraging this discussion ensures that there is better funding for everyone’s training and that even the quality of supervision is addressed. Encouraging the discussion means that we can all have our say on what comprises clinical training. And from the point of view of the AMACDT this is a key aspect of our lobbying. We represent what our members want. Speak up and we’ll take your issues all over the country, to whoever will listen. Stay quiet and we can’t successfully make a difference for you. So you need to get active now that the election is over and mobilise with your medical society and your state branch of the AMA to ensure that your clinical training is all that it should be.

doctors don’t colour in the borders

Think you’re trapped by the degree you’ve chosen? Steve peterson (ANU) disagrees vehemently; the world is your oyster.

In the middle ages when one completed university, a graduate was deemed to know everything there was to know. Sadly this is no longer the case, even at universities with a high medieval content such as Notre Dame Fremanatle. Who could possibly know all the signs of carcinoid? Who would want to? Despite this though, I’d like to suggest that having a medical degree is the modern equivalent of medieval universal knowledge. This is because doctors are everywhere. I don’t mean that with the current intern glut your taxi driver and hairdresser are likely to be UQ grads, though this may soon be true. I mean that doctors find their way into many aspects of life beyond mere medicine. Doctors are often business people. Many doctors are small business people, they have been known to acquire several practices and make it into a large, profitable company. Medical supplies and technology companies, locum and recruitment companies, and medical defence organisations have boards stacked with doctors. From there business-orientated

doctors can spread and prosper further. Doctors are involved in public life. People as politically diverse as Brendan Nelson, former Norwegian and Australian PMs, and Al-Qaida’s number 2 are former doctors1. Doctors are scatted through the public service and government organisations. Doctors are prominent in community and special interest groups (think Bob Brown or doctor groups on either side of the abortion debate), and internationally Médecins Sans Frontières’s bread and butter is as doctors with a global conscience. On a local level, I would imagine that doctors have leadership roles in their communities out of proportion to their numbers. I have to use my own experience here sadly, but I know doctors who currently work in Canberra who coach football teams, are scout leaders, give concert piano concerts, are Presidents of their soccer clubs, are quite involved in their local Church etc. Indeed one was nominated for Canberran of the year in 2008 for services to the community. Even a doctor who works in the medical field could be a world apart from his

colleagues. He could work with the defence forces, in or out of hospital, at sea, in space (a NASA astronaut is a former ED doctor2), on the sporting field, or in jail (popular for U West Syd grads who want to see their uni mates). She could put down the stethoscope and work as a medical administrator, researcher, educator or a medical Dean. Johns Hopkins medical school in the United States is one of the world’s top medical institutions, in the same league as Harvard and the ANU. Only 85% of their graduates go into medicine, the other 15% being snapped up by business, government and a host of other organisations. Being a medical

student takes special skills and a strong work ethic, and this is easily transplanted into other areas.

Your medical degree is no limit to where you will work or what you will do. As a final year student, I wonder just where my 80 odd colleagues will be in 25 years time. I’m sure I’ll be in for some surprises.

1 - Wessely, S, (2007), “When doctors become terrorists” in New England Journal of Medicine, 357 (7), pp 635-637 2 - NASA biography Michael Barratt, Dec 09, http:// www11.jsc.nasa.gov/Bios/htmlbios/barratt-mr.html

Panacea Vol 44 No 2 09

Don’t let the marketing fool you. There’s much more to rural health than the stereotypical campaigns. It’s a huge issue, as TIM BROMLEY (Rural and Indigenous) explains.

RUral

≠ Brown

I’m pretty set on rural medicine. I’ve had a long time to think about it, I’ve done a lot of placements, been to a lot of towns, read a lot about it and now fight pretty hard for it and will continue to do so. Over the years I, like many students, are exposed to much of the advertisment and promotional material for rural medicine and despite it working on me, I think it is lacking in a few areas. Central to the problem is that rural medicine uses particular images and concepts to advertise to students and as a result, rural medicine attracts a certain type of medical student. When evaluation of promotion and recruitment factors is undertaken, said medical student or doctor will simply be repeating those same factors. To put it another way, we’re creating and perpetuating our own stereotypes. We’re teaching people what they should like about rural health, filling their heads with pre-prepared statements about the benefits of rural practice and priming their answers. Rural health generates and perpetuates stereotypes about the kind of person who should work there and the kind of people who’ll be your colleagues. For example, ask students (particularly those who like rural health) to come up 010 Panacea Vol 44 No 2

Word.

one rural town” hence why I don’t think the stereotypes do rural health justice. I believe we need to promote a more diverse rural health picture, one that will with a song, dance or skit involving rural encourage a diverse range of students and and they’ll typically play something like junior doctors. “Cotton Eye Joe” and dance around like I suspect there is a large population bogan yokels in their blue wife-beaters and blunt-stone boots. Trust me, I’ve seen of students and doctors who find some aspects of rural medicine very enticing it happen many a time. and would move there except for one or Take a look at some of the other two factors. It maybe related to lifestyle or images used to promote rural health. clinical practice. Typically (but not always) they utilise Whilst recognising and supporting an older Australian, male, Caucasian, those students who will enjoy the wearing an Akubra, usually a farmer in a traditional aspects of rural medicine, our flannelette shirt. Often the doctors are similar: doctors who’ve been a part of the focus needs to turn to those who aren’t smitten with the entire package of rural community for generations. life. These are the people who, with a The people who are missed in this bit of effort, will find their way into rural picture are those who don’t quite agree with this culture. It pushes people out, just medicine, and hopefully never find their way out again. like any other stereotype. This includes We need to start asking the question those who want to work but don’t want to been scrutinized within their community, of these people “If we could offer you anything, what would it take for you to go minority groups without support from rural?” like-minded people, and those who like What benefits from urban practice do better fashion that flannelette and better we need to find, create or emphasise in coffee than Nescafe Blend 43. rural medicine in order to make it more Rural health could become a much competitive and more attractive? more vibrant place if we dispelled these Whilst we keep rural medicine’s unique stereotypes and began to encourage a factors, we need to look at what the greater breadth of student interest. missing ingredient is, in order to break the I’m a big believer in the phrase “If reluctance of students. you’ve seen one rural town, you’ve seen

A(n)U: AMSA Student GOld. Congratulations to David Corbet of the Australian National University for being the winner of the inaugural AMSA National Student Award. The AMSA National Student Award is a new initiative in 2010, allowing one medical student in Australia to be recognised for outstanding achievements to their medical school and the wider community. Applications were reviewed by the National Council in July and a winner chosen. Though all of the nominees were incredible, David stood out as a leader, a mentor and an inspiration for students everywhere. He has a great passion for medicine and leads the charge in a variety of philanthropic pursuits including fundraising and personally tutoring Sudanese refugees. He does this while maintaining excellent academic results, pursing an interest in the performing arts and raising a family. I had the great pleasure of interviewing David recently and though Iâ&#x20AC;&#x2122;ve had to truncate some of his answers, hopefully you will still be able to appreciate what a truly deserving recipient he was.

New for 2010, the AMSA National Student Award recognises the oustanding achievments of David Corbet. Rob Olver (Membership) reports. Rob: Why did you choose to study medicine? David: In Year 10 my ambition was to be either a pilot or a doctor. But starting a band with some mates must have distracted me as I ended up studying Music and Arts at Melbourne Uni. This led me to a career in the performing arts. While I thoroughly believe the arts are a vital contribution to a balanced and healthy society, I struggled with the transitory nature of the work and the difficulty making a liveable income. I started to think about other professions that had more tangible contributions to people, which lead to me exploring the option of becoming a paramedic. And ultimately, following this line of thinking, I arrived at medicine. It has been such a privilege to study medicine and will continue to be a privilege when I am practicing.

Rob: Aside from medicine what are your other passions? David: As you may guess from the first question, I am passionate about the arts. I continue to maintain an arts practice as much as I can within the limits of study. My most recent involvement was as a composer for a dance show created by Dr Grace Walpole in Melbourne in July this year. I have also collaborated on a number of short dance films, including one that was awarded an International Jury prize at a film festival in Portugal last year. Iâ&#x20AC;&#x2122;m a bit of a geek and love pretty much any new technology. Iâ&#x20AC;&#x2122;ve been building database driven websites for some time, and while studying I have created a few resources for medical student learning. I am also keenly interested in mobile technologies, which are changing the way we practice medicine. Rob: What motivated your work with refugees? David: My partner works for a community organisation called Companion House Assisting Survivors of Torture and Trauma, which is a health and counselling service that supports Panacea Vol 44 No 2 011

refugees and asylum seekers. One of our key lecturers at ANU, Dr Christine Philips, also works at this service, so I have had a lot of exposure to the social and medical issues encountered by refugees. There is a lot of misunderstanding in the general population about refugees and asylum seekers, and the current political climate does little to address this. There are many, many examples of refugees gaining residency in Australia and going on to contribute in meaningful ways to Australian life and culture. In recognition and encouragement of this, I facilitated donations from ANU medical students and staff to provide a number of scholarships for refugee students. Rob: As a person with very diverse interests, what advice would you offer to junior medical students to help them maintain a good work life balance? David: The phrase “work life balance” gets used a lot, but I feel like the focus should actually be on “life balance”. I think balance in our lives is predicated on finding sustenance in what we do. Work and study can be sustaining, as can family, sport, art and many other hobbies. Each aspect of our lives can feed into and support the others, and giving our many interests, including work, some attention or space can recharge us and help to maintain our energy levels. I strongly believe that getting involved

012 Panacea Vol 44 No 2

in student groups, in sports groups, in research, in tutoring, in medical forums; and contributing to something that interests you provides sustenance in the long run. I think a quote from Sir William Osler sums things up nicely, “we are here to add what we can to life, not to get what we can from life.” Rob: What’s an issue that you would like to take this opportunity to educate the medical students of Australia about? David: I have been inspired by the recent work of UK philosopher Toby Ord, who has set up an organisation called Giving What We Can. His basic premise is that we have the ability to change the amount of poverty and suffering in the world by agreeing to forgo some of our monetary wealth. He has done research into cost-effectiveness of various charities in order to provide greatest impact from donations. You can read more about the project here: http://www. givingwhatwecan.org/ I did a few little calculations looking at just the ANU medical school and worked out that if each of the next three graduating years (we have less than 100 people in each year) donated just 1% of their income we could raise more than quarter of a million dollars over 3 years. In Internship the real cost (after tax deduction) of 1% works out to about $380 a year, or about $7.25 a week, the

equivalent of 2 cups of coffee a week, or a sandwich for lunch, or the weekend newspapers, or a pint of beer. Our giving power as a group is far greater a force than as an individual, imagine if every medical graduate in Australia gave 1% of their income. With current numbers that would create close to 6 million dollars from each Intern year. The potential health benefits to be made with this amount of money are enormous. As future doctors we have a huge earning capacity as well as a unique set of skills to be able to share with the world. I hope to see personal philanthropy in medical graduates become an embedded trait, and currently I am working to establish an philanthropic Alumni organisation for ANU grads. If anyone from other universities is interested in these ideas, please get in touch. Rob: To finish on a lighter note, the theme of this Panacea is colour so can we ask what your favourite is? David: The toughest question of the lot… I’m not sure I should commit to just one colour, but I love the colours of the Australian bush. If I had to be pinned down though it would probably be a deep blue. Congratulations again David! If you have a student in your Medical Society you believe is deserving of national recognition consider them for the 2011 AMSA Awards.

Yes please! Can i have some mauve that? Rob Olver

(Membership), Jen Mcauliffe (Griffith), and Daina Rudaks (Community) give your tastebuds a cavalcade of delights. Mid year “break” is over and for first years uni has rocketed at light speed ahead. I am sure that the second, third and fourth years feel no different. With this “welcome back” I have experienced increased stress and sympathetic nervous activity and my craving for, well let’s face it, any sort of food really! But for the purpose of this article here’s some tasty baked treats! I have found just one problem (aside from my expanding waist line). I don’t have any bloody time to bake! And so in the spirit of this publication (and not at all procrastination) I went in search of some recipes that I could “want mauve of ” and that I could complete with my severely limited time budget. I hope you enjoy them. They have served me well. Jen provides the recipes for chocolate cake, her eponymous 2-minute noodle concoction and the amazing brownies. Daina has chipped in with her Thai patties, and Rob: what else would we expect of him? The equally ridiculous, complicated and delicious triple chocolate tart. A vertiable feast in a slice. Turn that broiler on and get cookin’.

MAGIC CHOCOLATE MUG CAKE

I know! I couldn’t believe it either, it really is as good as it sounds! And it has the ADDED bonus that it is only the size of a mug and not a whole normal cake, so if you gorge and eat the whole thing there isn’t as much of a reason to hate yourself later. Of course: they are incredibly easy to make, so once you’re through with the first, its difficult to ignore the temptation of just making a new one. Ingredients 4 Tablespoons plain flour 4 Tablespoins sugar (white is best) 2 Tablespoons cocoa 1 Egg 3 Tablespoons milk 3 Tablespoons oil 1 Large-ish mug Method 1. Mix flour, sugar and cocoa in a largeish lightly greased mug 2. Add egg and stir 3. Add oil and mix well (get rid of as many flour bumps as you can) 4. Put in microwave (on high power) for 2½ -3 minutes 5. Wait until the cake has stopped rising and set before you remove it from the microwave and devour Try some extra chocolate or peanut butter for a gooey gooey centre.

JEN’S ‘GOURMET’ 2-MINUTE NOODLES

2-minute noodles: a staple of any uni student’s diet. This one is awesome just because I made it up and it’s definitely a healthier option for when you have had too much mi goreng (if that’s possible). All ingredients (other than the noodles) are interchangeable with ones of your own preference. Please note the ‘t’ is pronounced in gourmet here.

Ingredients 2-Minute noodles of your choice Lettuce, shaved Cucumber, chopped into cubes Tomato, cubed Feta cheese, crumbled Beetroot, cubed Tinned tuna, broken up Salad dressing Method 1. Put it all in a bowl and mix 2. Eat I have also made this with vegies instead of salad or ham or meat instead of tuna. It’s also a great way to make a salad more filling!

Panacea Vol 44 No 2 013

some mauve that? cont... AMAZING HEALTHY BROWNIES

Yes, you DID read the title correctly. I said it: I said HEALTHY brownie. This recipe has the equivalent of just 1/3 of the calories of a regular brownie and still somehow manages to be uh-may-zing! I get to stuff my face, satisfy my want of junk food while surreptitiously deceiving my body and still fitting into my skinny jeans; which makes this brownie the king of exam period food! This recipe I have found is also really great for people with allergies or food preferences. You can replace almost anything: the flour with gluten free flour, add more cocoa, less choc chips, no nuts. It really does lend itself to being altered so don’t be afraid to pretend (if only for a short time until the fire starts) that you too can be a budding “Masterchef ”. Here’s where you start… Ingredients 1 Cup unsweetened apple puree 1/3 Cup of cocoa 3/4 Cup of SR Flour 1/2 Teaspoon of baking soda 1/2 Cup of sugar (I use brown but you can use anything or less if you like) 1/2 Cup dark/milk choc drops 3/4 Cup walnuts Method 1. Preheat oven to 175⁰ 2. Place apple puree in a bowl, sift in cocoa, flour and baking soda 3. Add sugar and salt and mix – until just combined (Don’t mix it too much cause it will make the brownies tough) 4. Gently fold in the chocolate drops and walnuts 5. Place mixture in a 20x20cm lightly greased pan and bake for 25-30mins. The middle will still feel a little gooey but mostly set 6. When its done, take out of the tray and place on a cooling rack and slice onto squares You could wait for them to cool down before you eat them or…not. 014 Panacea Vol 44 No 2

Thai Chicken Patties

There’s something about Thai food. That special mixture of sour, spicy, salty and sweet. The fresh burst of flavour in your mouth. And these patties are no exception. These are perfect served as an entree in the lead up to a green chicken curry. Or, if on a hotter summer day, a really kicking rare Thai beef food, complete with whole chunks of chilli. Mmm. I’m getting ahead of myself. Ingredients 1 Tablespoon chilli jam 350g Chicken mince 4 Kaffir lime leaves, chopped finely 1 Egg white 1 Tablespoon oil 150g Snow peas 1 Cup basil leaves Handful chopped roasted cashews Method 1. Mix together the chilli jam, chicken mince, kaffir lime leaves and egg white in a bowl 2. Shape into patties. Your choice how big or small. This recipe will make around 6 small patties 3. Heat oil in pan. Add patties and cook on each side until cooked through 4. Add snow peas and basil leaves to pan for 1-2 minutes 5. It’s all in the plating. Well, that’s what Masterchef tells me at least. So, grab a brilliantly coloured plate (see, this actually fits into the theme of this edition) – I love this dish on a red platter! Spread the basil and snow peas on the platter, place the patties atop and sprinkle with cashews 6. Serve with sweet chilli sauce, or make it multicultural and add a dob of Greek yoghurt

some mauve that? cont... Triple Chocolate Tart

Method 1. Combine the milk, cream and sugar in a small saucepan and Are you sitting down? Good. This dessert will make you weak gently bring it to the boil while stirring slowly at the knees, both in flavour and density of calories. 2. Then take it off the heat and add in the broken chocolate, This tart is dangerously rich, so save it for a dinner party and whisking until smooth severe it in small portions. Decorate the ganache artistically with 3. Add in the egg and whisk again berries and leave your guests wanting more. 4. Pour the mixture into the blind baked tart case and return it to the oven for 5-10 minutes. Itâ&#x20AC;&#x2122;s cooked when it is firm on top 1. Pastry but still wobbles gently. Allow it to cool completely Use a sweet short-crust recipe youâ&#x20AC;&#x2122;re already familiar with. Make enough to roll out into a 28cm loose-based tart tin. 4. Chocolate Ganache Ingredients 2. Creamy white chocolate mousse: 3/4 Cup of double cream Ingredients 300g Dark coverture chocolate (grated or chopped finely) 2 Egg yolks 1 Teaspoon vanilla essence 2 Tablespoons of caster sugar Method 1 1/4 Cups of cream 1. Heat the cream in a saucepan until it has just boiled 150g White chocolate (chopped finely) 2. Remove it from the heat and stir through the chocolate until Method it has melted and the mixture is smooth. Allow to cool 1. Beat the egg yolks and sugar until thick and creamy 2. Heat Â˝ a cup of cream in a saucepan until warm and then 5. Putting it all together stir in the egg yolks and cook over a low heat until it thickens Method 3. Stir in the white chocolate until melted 1. Make the pastry and roll out into the tart tin 4. Cover and refrigerate until cold 2. Make the white chocolate mixture and allow it to cool 5. Whip the remaining cream and then mix in the cooled 3. Start blind baking the pastry case while mixing the chocolate chocolate mixture 4. Pour the chocolate mix into the blind baked case and continue to cook 3. Bitter Chocolate Layer 5. Allow to cool completely, then finish off the white cholate Ingredients mousse and spread evenly over the dark chocolate layer. Return 100ml Whole milk the tart to the fridge 280ml Double cream 6. Make the ganache and allow it to cool slightly before 15g Caster sugar pouring it over the tart 175g Bitter chocolate 70-85% (chopped finely) 7. Allow it to set in the fridge 4 hours or overnight 1 Large free-range egg 8. Serve with berries

Panacea Vol 44 No 2 015

Kyle Sheldrick

University of Western Sydney EVENTS SINCE ED 1

Debating Grand Final, a sports night, LDW, Careers Night, PBL Group World Cup

Steve Peterson

Australian National University EVENTS SINCE ED 1

Med Revue 2010 – The Phantom of the Operating Theatre (featuring yours truly as phantom), Medsoc mixer, post exam parties, Convention 2010 & GHC 2010, Tour of Parliament MOST AMUSING ANECDOTE From the “school leavers can be a bit too sheltered files”: A group House including meetings with Health Minister and Shadow Minister, ‘Big Issues’ speech night with local and federal of first years were starting anatomy, one male (school leaver) politicians, ‘Life after graduation’ evening with talks from student points to a male cadaver’s crown jewels and asks the tutor if that’s normal. The tutor is puzzled and answers that yes, financial, accounting and insurance companies, Well being evening, training for keenly anticipated ‘Staff vs Students’ and that’s more or less how they look. The student freaks out. Only after being calmed down by one of his female friends do we find ‘Yrs1/2 vs Yrs 3/4’ soccer matches, numerous ‘when I grow up’ events on medical career paths. out the problem, his looks really different. Long story short, said student was introduced to the concept of circumcision. I’ve MOST AMUSING ANECDOTE heard of sheltered, but sheesh. Toss up between watching fellow student mistake the orthopaedic registrar as a wardsman, and watching yet another BIG NEWS FOR YOUR UNI future doctor doing a baby check and managing to spray urine The first ever cohort has gone rural! Leaving in July a quarter over the baby’s mother. of our cohort went to Lismore and Bathurst. After much fanfare with the local news they’re settling in well. By the time BIG NEWS FOR YOUR UNI this edition goes out we’ll hopefully have had our first ever Ceremonial tearing up of parking places to build new parking presidential debate for candidates for medsoc president, to places leaves year-long absence of parking places at the Hospital. be moderated by yours truly. Congratulations to our debating Students forced to call Ambulances to get to hospital each day. champions Sean Williams, Tom Chetserman and Craig Mattern, Flat screen computers in every PBL room but the whiteboards who trumped all in their path to win the series undefeated. are still rubbish.

Eliza Wziontek

Cameron Gofton

University of New England EVENTS SINCE ED 1

University of Sydney Events Since Edition 1

BIG NEWS FOR YOUR UNI:

The USyd flag was held high by its delegates at Hobart, with everyone gearing up and donning the ‘official’ Sydney lion costume for Sports Day. During a lull of the day, USyd were cavorting on the savannah to the DJ, with ‘Lion King Appropriate Dance Moves’ apparent to forlorn onlookers. Enter UQ, replete with zebra print snuggies. We’ve all seen enough David Attenborough documentaries to know what happens when carnivores and herbivores interact. This incident has now been termed ‘Lions Attack’, and is available on Youtube for all to witness the mayhem!

The Armidale kids have had a busy few months fending off the chilly temperatures. From the dance floor of another successful Medicine Charity Ball, to the awkward poses of popular body balance classes, there has been something for everyone. MedWeek was a hectic week of trivia, movies, sports, costumes, fairy floss and the highlight of course being the red jelly-shot syringes. ThinkTank was launched with a very enthusiastic and opinionated group to discuss implications of alcohol and sponsorship policy. UNEMSA hosted a university wide glow in the dark party and has been getting academic with an inspiring inaugural Electives night and Women in Medicine Panel. UNEMSA has continues to balance the body and mind with the launch of the UNEMSA soccer team proudly wearing their beautiful white jerseys. They have been playing proudly sometimes with too much enthusiasm. This month brings the end of a dynasty at UNE. Rowan Walker and Alexander Whitfield have been steering the UNEMSA ship for their third year running and will sadly be handing over their reign. As our founding fathers, they have been absolutely dedicated to the UNEMSA cause and have definitely left their constitutional mark, in the form of compulsory jokes to begin meetings. Thanks for your hard work!

016 Panacea Vol 44 No 2

USyd has been a busy watering hole during the last couple of months. So many amazing events have happened, the biggest of which was the ever popular Medball, this year themed ‘MadMed’. Screening of last years’ Med Revue ‘Slumdog Medicare’ was an absolute smash hit, with over 250 people turning up to this event.

Most Amusing Anecdote

Big News for YOUR UNI

USyd’s med revue is on the table for mid September, with the title ‘Cadavatar’. This promises to be the biggest and most amazing med revue to hit Australia, with first years working endlessly to pull off this feat. In other news, the Lambie Dew Oration is coming up, with Australian of the Year Professor Pat McGorry headlining the most prestigious event on the MedSoc calendar.

Ania Smialowski

University of Notre Dame, Fremantle EVENTS SINCE ED 1

University of Western Sydney

We had the first MSAND and WAMSS joint bedpush through the streets of Fremantle, which raised money for Radiolollipop at Fremantle Hospital for new children’s ward playground. Education sessions have been extremely popular featuring Fiona Wood, clinical skills sessions, elective night and a movie night. The MSAND cocktail party was the biggest and loosest we’ve seen yet with half the bar tab going in the first 90 minutes!!! AMA cocktails were also a highlight of the social calendar with the biggest turn out to date. And of course we had 24 brave MSAND rangers representing the only way we know how at convention. Just gone: our Med-ball – “A night at the Oscars”. It was a truly glamorous night.

Notre Dame, Freo

University of New England Australian National University

Panacea Vol 44 No 2 017

Edward Gibson

University of Adelaide EVENTS SINCE ED 1:

Semester two rushes on with no relent in the extent or volume of AMSS events. By the time of publication the Society will have had a smashing MedBall, Perk’s Finances Night, year 6 lawn balls, year four halfway dinner and preclinical pub crawl. We also have had numerous academic evenings with some amazing speakers ranging from the SA Minister of Health to a leading burns surgeon. Second semester brings our charity based MedRevue and several health related events such as Corporate Cup and the City to Bay Fun Run. The Flinders/Adelaide rivalry will be revived with various events planned and a great debate coming up.

Jonathan Da Silva

University of Queensland Events Since Ed 1

International Students’ Info Evening #2, Surgical Specialities Evening, ANZAC Memorial Ceremony, UQMS Family Picnic, Money Matters, Queensland Medical Orchestra Concert, James Scott Recognition Morning, Ashintosh Teddybear Hospital, Ashintosh Coffee House, Med Revue, UQMS Information Evening, UNMDG Pre-Elective Workshop, Strategic Planning Weekend, Policy and Constitution Review

most amusing Anecdote

Funny Quotes from Medical students: “Why would you want to palpate a prostate rectally?” One student speaking on sexual health, “My mum’s a sexual health nurse, so I’ve learnt some great tricks!” MOST AMUSING ANECDOTE: Attending our ‘Men’s Health Night’ after which the Doctor who Student, “So tell me about the pain in your uvula.” Patient, had given the lecture on men’s health issues got a little too merry “You mean the pain in my vulva?” and, much to the amusement of those gathered by the bar, was Big news for your uni asked to leave the after-party. This year marks the inaugural Patron’s Sporting Day and Family Picnic. The UQMS Queensland Medical Orchestra was BIG NEWS FOR YOUR UNI: revitalised, with it’s first concert attracting more than 200 guests Adelaide lost the Cascade, Pipps’, Debating and EMC trophies, and raising more than $2000 for the Ashintosh Foundation, the we’ll be coming for them in Sydney! charity arm of the UQMS. The UQ School of Medicine was awarded $14.3-million as part of the Innovative Teaching and Training Grants. The UQ SOM, with input from the UQMS, has created the Medical Student Leadership Program, the first of it’s kind in Australia Golsa Adabi Sebastien Haiart

University of Tasmania Events since ed 1

Pre-Convention Bonding Party - Getting ready to enter the wild, AMSA National GHC, AMSA Second Council – hosted in Hobart, AMSA Convention Hobart2010, Dis-O-Week – Getting back into it, Live Below The Line – Fundraiser Event, TUMSSAMSA Blood Drive, Careers Evening, Quiz Night

Most Amusing Anecdote

We all know the anxiety and anticipation associated with getting an intership job offer! Having said that, its good to put things into perspective. One of our final year students narrowly missed out on a first round job offer at the RHH. I offered my sympathy & tried to reassure him about second round offers; however, his reply came as a pleasant surprise: “Its fine, I’m fine, they OBVIOUSLY don’t realize I’m the first Tasmanian Graduate to ever win 2 cascade cups”. Can’t argue with that one!

Big News For Uni

Internship job offers may not be a guarantee for us in the next few years. Unfortunately this reality hit home for this year graduating medical students in Taswegia. Despite a promise by the state government that all local domestic students will have jobs in Tasmania if they want one, over 15 students were faced with the prospect of not having an internship job in 2011. Luckily AMSA, TUMSS and our state AMA have been lobbying hard to meet demands both in 2011 and beyond. Don’t forget CONVENTION and GHC! Big thanks all! 018 Panacea Vol 44 No 2

Flinders University EVENTS SINCE ED 1

1st Year Tutorials, Suturing Night, Overseas Electives Evening, HEAT Funder Raiser Cocktail Party, Surgery Pathway Info Session, GP Pathway Info Session, MSF Speaker, RFDS Flights, Autopsy Visits, And Medball. It’s a wonder how we have time to study health psychology!

MOST AMUSING ANECDOTE

Despite eons of combined life experience, Flinders students are still failing health psychology. Too bad the biopsychosocial model wasn’t around when Aristotle was teaching us anatomy. Guess we should have less events...

BIG NEWS FOR YOUR UNI

FMSS is organizing the first Mental Health in Medicine seminar, an important, new event aimed at informing students about mental health issues faced by students and doctors including stigmitazation and what mandatory reporting means for us. We have enlisted many notable speakers including Professor Patrick McGorry AM, Australian of the Year for 2010, and Professor Michael Kidd AM, President of the World Family Doctors Organisation, in what FMSS hopes may be a template through which other MedSocs may tackle similar issues in their own student body.

University of Queensland University of Adelaide

University of Tasmania

Flinders University

Panacea Vol 44 No 2 019

Steve “Lurwitz” Hurwitz

Rob Marshall

Semester 2 started off with a smash with the Titanic Halfway party. We’ve shown our childish side with a Teddy bear hospital. Then we’ve also had ER party, Saving Jane Doe Emergency Challenge, Medical Leadership Development Seminar, Charity Week, Med Ski trip, Rugby V Law and Med Revue.

There has been a lot of movement on the ground here at WAMSS. Socially, things continue as they usually do, with a good mix of classy cocktail parties and slightly more raucous affairs in the lead-up to Convention 2010. Meanwhile, the clinical students have been hard at work teaching the younger years on our Student Grand Rounds programme, while the Wellbeing gurus have been meditating and relaxing their colleagues into a zen state.

University of Newcastle Events since ed 1

Most Amusing Anecdote

A Novacastrian was missing one morning at convention. Some concerned delegates went to the AMSA Booth saying they couldn’t find him and that “he left with a girl last night, didn’t come home and we can’t find him this morning, do you think he’s ok?” “We’re sure he’s fine” the Convention organisers responded.

Big News for your uni

We have a new Pro Vice Chancellor of health. You may have heard of Nicholas Talley? Well I can tell you we have. In Newcastle we all have read Clinical Examination by Talley & O’Connor, so we’re bloody excited about Talley coming here to GAI!!

Dani Bersin

James Cook University Events Since Ed 1

Close-The-Gap Forum, Trivia Night, Townsville Clinical Cocktail Party, Med Ball

University of Western Australia EVENTS SINCE ED 1

MOST AMUSING ANECDOTE

My best moment in medicine was accidentally getting an answer right on a ward round. When asked to describe the symptoms of Ménière’s disease, and having absolutely no idea, I replied, “I don’t know... but it rings a bell.” The consultant replied, “Yes, very clever, it is indeed an inner ear disorder characterised by tinnitus. Well done!” I took the credit.

BIG NEWS FOR YOUR UNI

A bit of rebranding goes a long way, as the long-standing AMSA Sub-committee at WAMSS, now known as the WAMSS ThinkTank, has been revitalized this year so much so that they have actually put together a policy for consideration at AMSA July Council. The policy (which can be found on the AMSA website) relates to the new system of registration for medical students, and how AMSA is advocating on your behalf. Jane Herbert

Griffith University Events Since Ed 1

Griffith has been busy balancing the extremes of student life. The first years recently overcame the first of many gruelling exams to come while the fourth years breathed a sigh of relief Most Amusing Anecdote after their finals. Delegates returned home from Convention to Up North at our humble medical school, we’re sometimes pressed for resources, hence this advert by the Head of Anatomy: detox at the GUMS Wellbeing Breakfast. As we approach the end of year chaos, we aim to maintain our “zen” philosophy by “I need another anatomical man for Open Day in August! The working hard and playing harder. Uni is willing to pay! The only requirement is that you are in reasonably good form and that you are happy to wear a g- string.” Most Amusing Anecdote BIG News for your uni While on placement with them, a second year student recently learned of the true kindness and dedication of the Qld JCU just had its final AMC accreditation in July and is poised Ambulance Service when they briefly detoured en route to a to become an “established” medical school. After 10 years “Code 2” to rescue a koala in need. The koala survived. So did of existence, we certainly hope so! To prove we’ll be capable the Code 2…we think. doctors, JCU won the Emergency Challenge at Convention – not at all unexpected. We picked up a flashy new Vampire Cup Big News for Your Uni too! JCUMSA has fun-filled and educational events lined up this After returning from the summer holidays we were greeted with a semester to keep our momentum going. Further, we hope to see common room an eighth of the size it used to be (the remaining the launch of our new website before the year is out. 7/8ths being converted into a book shop), Griffith students have been protesting! The hunger strike was incidental as noone could access their food given that the room has a 4 person capacity. But finally our voices and grumbling tummies have been heard. The School recently announced its plans to return the student common room to its former 50m glory. This case serves as an example to all of the power and effectiveness of whingeing.

020 Panacea Vol 44 No 2

University of Western Australia University of Newcastle

? AMEX

Griffith University James Cook University

Panacea Vol 44 No 2 021

Justin Yousef

University of Melbourne Events Since Ed 1

Pre-internship advice seminars, Careers Day, Sports Day, Trivia night, final year graduation dinners.

BIG NEWS FOR YOUR UNI

iPads trials to commence at hospitals next year - Angry Birds here we come!! First official intake of the new Western Hospital Clinical School. Our MD program is undergoing final stages of accreditation, with UMMSS. Exciting times ahead.

Will Cundy

Bond University EVENTS SINCE ED 1

Careers Night, Half Way Dinner, Sports day, Talent Night

Helen Freeborn

Wollongong University EVENTS SINCE ED 1

Convention and GHC. Due to second, third and fourth years having exams, most of our events are in the second half of the year. However, a team from our Global Health Group WUHOW donated their time and skills over the winter break to assist with medical aid in Vanuatu.

BIG NEWS FOR YOUR UNI

Fourth year students have finished their final set of exams for medicine and are through to some of the more enjoyable elements of a medical student’s life: elective time! Secondly the llawarra Health and Medical Research Institute (IHMRI) was officially opened on July 20. The IHMRI is a partnership between UOW and the South Eastern Sydney and Illawarra Area Health Service (SESIAHS) with a vision to provide excellence and innovation in health and medical research that will lead to better health services and a healthier Illawarra community.

MOST AMUSING ANECDOTE

My first day on psych ward. I am asked to see a young man with acute psychosis who presented late last night. Armed with a pharmaceutical branded pen and progress notes, I begin with “So what brought you here today?” My nonchalant question rapidly unwound whatever sanity to which he was clinging. He began by bolding revealing his extravagant 15-hour adventure. First he had to clamber through wetlands and swamps in his suburb to ‘get back to nature’. He then proceeded to build his three-storey tree house, complete with hammock and his mysterious pet monkey. My inane nodding only seemed to encourage his rapid speech and grandiose delusions. It was about this time that he took off his shoes and socks, his hands clearly shaking when untying the laces. He then explained the intricate politics of the jungle and the universal connection with the environment. Somewhere in the middle of his ranting he raised his arm to show me his ‘blue’ skin, the sweat stains clearly visible beneath his grey t-shirt. He thought he was in Avatar, and I was his leader. My rapport building technique was clearly working wonders, but was doing nothing to calm his extremely agitated state. This continued over the next three weeks the patient was admitted to the ward. The consultant was bemused as to why his psychosis was not decreasing in intensity. Little did he know that I was playing Avatar behind his back on ward rounds, flinging arrows and sometimes connecting our ponytails.

BIG NEWS FOR YOUR UNI

Stephen Kunz

Deakin University Events Since Ed 1

Since the last Panacea and by the time this is published, down at Deakin we’ll have had a “Casino Royale” Ball, the inaugural “Pro re nata” cocktail evening, a medical and surgical careers evening and the monthly karaoke and trivia nights.

Most amusing anecdote

Hilarity-wise, a joke passed on from one of the paediatricians: What do you call a pair of orthopedic surgeons trying to read an ECG? A randomised control trial. It becomes double-blind if you turn one of the ECGs upside down. Ed Christian

University of Notre Dame, Sydney EVENTS SINCE ED 1

Seminars on life after uni Global Health seminars Social events Convention Hobart 2010 Chicken sandwiches for lunch Perusing while crusin’ (harbour cruise) Smashed (like guitars) other faculties in a uni sports day

Our Professor of Surgery, Patrick Warnke, is working with a group of Bond MBBS students on a four-week stem cell cultivation course, something very unique to the Faculty. Three Bond medical students have had the unique opportunity to work in the team of Europe’s most prestigious tissue engineering MOST AMUSING ANECDOTE network “MyJoint” during an intensive four-week stem cell To assume makes an ass out of u and me cultivation course at Bond University. The course focused on the cultivation of stem cells which will ultimately be used to help BIG NEWS FOR YOUR UNI Fantastic gourmet schnitzel burgers!!! patients ‘grow their own’ replacement body parts. 022 Panacea Vol 44 No 2

Wollongong University AMSA Rep Reports Monash University photos for Monash kindly provided by Roy Ong, available at www.wix. com/royong/Roy-OngPhotography

Michael Loftus

Monash University EVENTS SINCE ED 1

Monash Med Hoodies, MUMUS has taken over 350 orders for their new Hoodies. Ongoing Representation: MUMUS has been speaking with the Faculty about a number of academic issues including anatomy teaching, placements for Extended Rural Cohort (ERC) students, and the scaling of marks. Back to Base (Monash Gippsland) – the second B2B was an even greater success than the first, and included academic sessions covering case studies and Law and Ethics sessions which were well received by all. Interaction between Year A’s and B’s was bolstered by a Q&A session, and the social event that followed.

MOST AMUSING ANECDOTE

A Monash student was feeling pretty chuffed with himself having managed to get through post-ward-round coffees with the head of neurology and their senior team without saying anything too embarrassing or unintelligent. Upon going to the bathroom afterwards, however, he was horrified to discover that he had somehow managed to transfer the black texta marks from his coffee lid onto his nose, and now looked much like a chimney sweep.

BIG NEWS FOR YOUR UNI University of Notre Dame, Sydney

Following MUMUS being awarded “Best MedSoc website” at July Council; proudly our Dan Yore was announced as the recipient of the prestigious AMSA President’s Award. This recognised his many contributions to AMSA over many years, including convening GHC in 2008 and establishing the inaugural AMSA ThinkTank at Monash Uni.

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I relish the fact you’ve mustard the strength to ketchup with me. Will Anderson

(Paddlepop Lion, Notre Dame Sydney) doesn’t want you sucking his blood...but if you insist... 024 Panacea Vol 44 No 2

currently dating a succubus. You may not realise it, but you too have fallen victim to such a demon. The demon I am referring to is medical school. Before you know it, this degree has swallowed you. It starts calling the A succubus is a female shots, influencing your decisions, and it demon who prays on innocent mortifies your social life. But why do we men, using seductive techniques to let medicine do this to us? If you ask me, manipulate dudes away from their mates. it all boils down to priorities. We get so No man is safe, and once hooked, nothing caught up in our studies and potential can be done to save a friend from the careers that we lose focus on what’s truly succubus’s love fuelled grasp. Chances important: our friends and family. are a friend of yours has fallen victim to a It’s hard to maintain relationships succubus in the past, and you no longer outside medicine, but it’s by no means hear from them. Throughout history, impossible. Many of us have a girlfriend humans have successfully trapped only or a boyfriend, some have both. three succubae; one of which was found Regardless, medicine places massive to have x-ray vision and could hide restraints on the amount of time we can underwater for up to 7 minutes. I am spend with our partners. This causes

pretty easy to keep your friends close. Try giving them a call, sending a message, or writing something stupid on their facebook wall. All these simple things that show you’re options willing to make an effort, and show your that’s what matters. still thinking Now let’s focus on your homies. How of them. That’s all many times have your friends contacted it takes. Remember, the you, to see if you want to catch a movie, time you spend with these people go to a party, or even just hang out, and will form the memories you look back on you’ve responded with ‘sorry, I have way and laugh. I look at it like this: I’d heaps too much study to do’. It happens to us rather tell my grandkids about the time all. I acknowledge there are times when my mates and I polished off a keg and we have to enter lockdown, but seriously, three of us ended up in the cells, than from time to time you need to choose bore them with the story about the time your mates over the books. If you would I treated some fat bogan’s asthma! Sadly, prefer to spend 2 hours studying some if you consistently choose the medical lame arse metabolic pathway than catch succubus over your friends, stories of up with your best friend to see how their relieving asthma will be the most exciting weekend was, then I feel sorry for you. you have, and your grandkids will think All friendships are dynamic, they you blow. require equal input from both parties, and All relationships are about compromise, without this, they soon turn to dust. It’s and its time the medical succubus made arguments and frustration. There is only one way around this; prioritise your partner above med school. Placing your studies before your significant other is completely selfish, and it’s exactly what the medical succubus wants you to do. Why not fight back and do something your partner wouldn’t expect? Buy them the shoes they like, invite them over for dinner and answer the door naked, or even just tell them they’re hot. Everyone enjoys a little spontaneity. It’s these

compromise with you. Do yourself a favor. Ditch the textbooks once in a while and go out and do something with your mates, or blow off placement and take your babe for a lazy lunch down by the river. Sure, it won’t advance you towards that career as a neurosurgeon or whatever, but it will remind you that you are alive. Panacea Vol 44 No 2 025

Which Disney doctor are you?

You’ve always had an amazing understanding of the natural properties of the things around you, and now you’ve learnt how to charge for it. From Willow Bark to funky berries, you will change the world with your cure of mild irritable bowel syndrome!

Calm, sweet and eternally patient, Cinderella is a princess who knows all about things that change at midnight. And what better training for sundowning geriatrics, delirious UTI grannies and all other little old cuties that become your worst nightmare wearing only one slipper at 12 o’clock?

Who is Tiana we hear you ask? We thought that too! Apparently she is a Disney Princess, but no one really knows who she is. Perfect for medical admin – the hidden world of medicine; just the spot for the quiet, unacheiver.

You are in love with your pet wolf, friends with a teapot and a candlestick and run around singing songs in English in the middle of France. There is only one place for you my dear, and psychiatry will have it all! 026 Panacea Vol 44 No 2

1. I am: a. A male medical student (1) b. A female medical student (1) c. A lion (50) 2. I arrive at the hospital: a. With the emergency retrieval team (1) b. When it suits (2) c. In a pumpkin carriage (3) 3. I start my day with: a. A short black (1) b. A poison apple (2) c. A pot of English Breakfast (3)

If you can’t spot a poison apple from 10 feet, you’re going to have great fun in a career in anaesthetics! The propofol is the white stuff, and just go from there. Patient sympathy will be a plenty, and you even have 7 little helpers to aid in every patient transfer!

You have mastered the gift of getting yourself out of a coma with a little bit of mouth-to-mouth, now it’s time to put it to good use on your patients! Sleeping Beauty has studied hard in her trauma skills, even getting some practice with the constant flow of princes that have come to blows in climbing her tower!

Which Disney doctor are you? 4. On the ward I: a. Am surrounded by (short) helpers (1) b. Am writing in the notes (2) c. Am the ‘White Prince of Venepuncture’ (3)

9. If I could wish for one thing it would be: a. A star (1) b. To be a real boy (2) c. An internship place in 2012(3)

5. If my patient is asleep, I: a. Come back later (1) b. Grab the defib paddles (2) c. Kiss them, to see if they come back to life and fall in love with me (3)

10. My favourite drug to prescribe is: a. Peter Pan-adol (1) b. Nala-oxone (2) c. Belle-adonna alkaloids (3)

The man with the biceps, the brawn, and none of the brain… you were born to be an orthopod! And you know that you will just look dashing in your scrubs and big, white gumboots!

6. To make the medicine go down, I use: a. A spoonful of sugar (1) b. A restraining order (2) c. A nasogastric tube (3) 7. My biggest gripe with scrubs is: a. The drawstring is always missing (1) b. They look like pyjamas (2) c. They are very difficult to get on over a mermaid tail (3) 8. My preferred writing instrument is: a. My free drug company pen (1) b. My favourite, dependable Mont Blanc (2) c. My quill (3)

If you have ended up at this square, you should not be in medical school. You are a lion, and will probably not make a very good doctor. Unless you intend to be a gynae surgeon.

And by nephrologist, we mean dodgy black market kidney salesman. Your background in the bazaar opens infinite career paths, and selling kidneys out the back door of your clinic is a fantastic way to make a quick buck, and maybe even win a princess or two!

A strange choice one may argue, but what other specialist could actually afford the upkeep of Snow White, Sleeping Beauty and Cinderella on a single, private salary! Plus, we hear you have lots of time to spend on holidays, entertaining each of your many ladies in their respective far far away lands.

We hear you’re good with a slippery fish, and that makes you perfect for scopes in our book! Any bloke that can keep a hold of a struggling mermaid with her fat octopus godmother yelling blue murder from the decks is welcome to grab a camera and… well, you get the picture!

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Ginger-ly Bloodnuts aren’t just eyesores, apparently they’re medically aberrant too. Who knew? Stefan mcalindon (Flinders). Prince Harry, Lindsay Lohan and Ronald McDonald: while at first these people may seem very different, they in fact have many things in common. They are all famous, are likely to have a substance abuse problem and seem to be allergic to the sun. That’s right, they are all red heads. Sure we’ve all heard of them, but there are a lot of fallacies intertwined with the truth when it comes to our fiery cousins. This article aims to clear up some of these misconceptions, and probably introduce some new ones. Scotland has the world’s largest proportion of red heads, with 13% of the population showing a little rust on top, and 40% carrying the recessive red hair gene (the MC1R gene). Being of Scottish heritage myself, I can honestly say that this fact scares the crap out of me. Worldwide approximately only 1-2% of the population has red hair, but this has never stopped them from being high achievers. Our newest PM sports a fiery hair cut, although perhaps not quite as fiery as the temper of our previous PM. Other famous red heads (in no particular order of 028 Panacea Vol 44 No 2

historical significance) include the Egyptian pharaoh Ramses, Ginger Spice and Vincent Van Gogh (although he did wear a hat to cover his hair). By now you are no doubt asking, “If I ever do meet a redhead, what will they look like?” Well nobody truly knows, but there are several theories. Red headed people generally exist somewhere on a scale, with the most fiery being referred to as ginger. Gingers often have pale skin, orange hair and freckles, and avoid sunlight. This is not to remove themselves from the public eye, but because the pale skin of gingers does not have the same melanin content of people with a darker skin tone. This makes gingers more susceptible to melanomas, via UV-induced DNA damage. On the other end of the scale are the “day walkers.” These people may claim to have “strawberry blonde” hair, but make no mistake, they are red heads. Perhaps most interestingly is that the differences do not stop there. Studies have

shown that red heads are more sensitive to fire (I’m not kidding, if

you don’t believe me; Liem EB, Joiner TV, Tsueda K,

Sessler DI (2005). “Increased sensitivity to thermal pain and reduced subcutaneous lidocaine efficacy in redheads”. Anesthesiology 102 (3): 509–14) and less sensitive to pain caused by electricity. How these studies ever got clearance by an ethics board is beyond me, but there must be some application for their findings. As mentioned earlier; red heads have a mutated MC1R gene, which leads to an altered MC1R (melanocortin-1) receptor found on melanocytes. MC1R recognizes melanocytestimulating hormone released from the anterior pituitary gland, which normally results in the production of black eumelanin, however the mutated receptor phenotype results in the production of reddish pheomelanin instead. And hence a red head is born. Throughout history, red heads have been both revered and feared. The fiery Celtic warriors were some of the most respected throughout history, while the (I assume ancient) Greeks believed that red heads

became vampires upon death. Until hard scientific evidence is found to support or disprove this theory, I cannot speculate on the accuracy of that belief, but until that day, one cannot be too careful. A report by the Courier Mail in 2007 stated that due to the recessive nature of the red headed gene, our ginger friends could soon be facing extinction; however this study was later found to have been conducted by a hair-dye company and disregarded by the scientific community. Red heads have proven throughout history their passion and ambition to achieve great things, and have recently gained control of our great nation. So next time you see a red head, give them a hug, shake their hand, or vote for them if you are so inclined, their ancestors helped to shape the world. And you never know, you may carry the recessive gene and your children may be part of tomorrow’s little rust covered generation.

Stimulate your mind with student membership

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Australian Medicines Handbook 2010 on USB Handy evidence based drug reference tool, to enable you to compare drug information. For renewing student upgrade members only. Valued at $125

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Receive your bonus gift and more today! Join the RACGP or renew and upgrade your student membership. Visit www.racgp.org.au/student or freecall 1800 331 626 ^ Available only to RACGP student upgrade members who join the RACGP or renew their membership for the full 2010/11 financial year * Offer only available to members who join the RACGP as a student upgrade member. Offer not available to FREE online student members.

Panacea Vol 44 No 2 029

Colour-blind? Aaminah Khan ( James Cook, Townsville) explores the effect that racism has on medical students. trained doctor or offered a (perhaps inadvertently) insulting comment about Muslim women who cover their heads. It isn’t the same as being yelled at in the street, but it still hurts – even more so because the rules of professionalism dictate that we as students have no right of reply. We can only smile and nod and perhaps make a non-committal noise of implied agreement, and then try and change the subject. The medical world does not exist in a vacuum. I cannot choose to leave behind my race and my skin colour when I set Racism foot inside the hospital. I cannot pretend to be a white person when I clip on my ID isn’t always a badge. There is no easy way of ensuring blatant thing. that I do not encounter racism in Not everyone will yell insults at you in the workplace. I cannot choose the street. Not everyone is in a position not to hear every Jayant Patel where they can deny you opportunities joke or off-hand comment because of the colour of your skin or the about “all these language in which you say your prayers. foreigners taking over”. Racism is not always a thing witnessed I cannot change the out in the open; it is insidious, subtle, and fact that some of institutionalised to the extent that we do these comments not always realise it is there. have been directed Not all patients are racist, just as not all at me. I cannot people are racist. In my years as a medical change the fact that student, I’ve talked to plenty of patients, they hurt. and I must admit that the issue of my Racism in patients race has been much less of a discussion exists. Of course, point than the issue of my sex. (If you are this problem is bigger a female medical student and have never than just the medical had a patient ask you how many years profession – some patients until you qualify as a nurse, you should are racist because some people count yourself lucky.) Thankfully, I have are racist. However, unlike the world not yet had a patient refuse to be seen by outside the hospital, where the targets of me due to my race. racist comments have the right to defend But racism isn’t always as blatant as that. themselves, we medical students are For every patient who has complimented often placed in situations where we must my name or been fascinated by my temporarily abnegate that right. religion, there is one who has made a Should that mean we should stay quiet casually racist remark about a foreignabout racism from our patients? Inside

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the walls of our hospitals, perhaps. But we do not exist in a vacuum. We all have identities outside the hospital. We can refuse to use racist language or condone its use in others. We can spread the word that racist behaviour is not behaviour that we as medical students – indeed, we as members of society – do not accept. And we can do what I’m doing, and write articles like this one so that people know that there is a problem. And maybe, one or two people will listen and realise that their jokes and comments are hurtful, and that their behaviour needs to change. It’s a small step – just a drop in the ocean, perhaps – but it’s a start.

Are you interested in a flexible and exciting career? Are you interested in procedural Are you interested inwork? a flexible and exciting career?

Are you interested in Do you want to procedural work? MAKE A DIFFERENCE?

Do you want to AGPT MAKE ad A DIFFERENCE?

THEN BE A GP! THEN BE A GP!

Dr Aileen Traves GP REGISTRAR

For more information about the Australian General Practice Training program visit

www.agpt.com.au Image: courtesy of Tropical Medical Training

Panacea Vol 44 No 2 031

lovedesigngroup.com 2709

www.agpt.com.au For more information about the Australian General Practice Training program visit

Rainbow Connection

Ever tried frogs’ legs? For shame, James pearlman and lesh satchithananda (Newcastle) think, as you’re a cannibal.

Unfortunately for Newcastle students such as James Pearlman, they have come from their original metaphorical “swamp”, and essentially wandered into a University campus that was built on a swamp (it doesn’t mean they don’t love it). James’ interpretation of this, is that we will end up better than the rest of the medical students in Australia, and their “pretty” and “pretentious” campuses.”

After the writer of this article finally finished watching the Muppets Movie (1979) at 3am in the morning, it’s fair to say that an epiphany was had. For those of you that have not actually listened to Kermit’s song, “The Rainbow Connection”, I strongly urge you to do so; as the parallels that can be drawn from our lives to Kermit’s are undeniably strong. As such, I came to the conclusion: A medical student’s life can essentially be likened to that of Kermit’s adventure from his swamp to Hollywood in the Muppet Movie. From a lowly homestead life, or a suburban experience, a medical student generally comes from humble origins, only to be stirred by an idea. The idea, whether it’s because mother and father

As Kermit The Frog said, “Why are there so many songs about rainbows;

032 Panacea Vol 44 No 2

And what’s on the other side?”

wanted you to do medicine; the nice side-effect of wealth that comes along with being a doctor later on; or like Kermit, the idea of making millions of people happy because we’re so talented. Whatever the reason for the idea to become a doctor, it motivated the student to sit a barrage of entry examinations, and for some, this might be the fork in the road (if I may direct your attention to Kermit’s fork in the road...). Medical students persevere through this first level of trials to begin studying, researching and fraternising with other medical students at conventions... Now a medical student must pass through a series of exams, for some it will only be four years worth, and

others up to six. Never mind if a year is repeated or forgotten, it allows for more time in limbo. Yes limbo is this period of gathering knowledge, (learning to touch and feel) poking and prodding, with essentially little to no responsibility and no consequences... yet. At this stage in the Muppet Movie, Kermit encounters the villainous Doc Hopper multiple times. For those of you who had a neglected childhood: Doc Hopper wishes to force Kermit to be a spokesperson for his fried frogs legs chain of restaurants. Medical students will also get chased by villainous people such as Doc Hopper: they’re called pharmaceutical companies. Like in Homer’s Odyssey, they use Siren’s to draw you in, only to shipwreck you before the graduation ceremony. Whilst a medical student must make the most of their short time in limbo, they must also ensure that their idea, their goal does not get hidden behind the dust clouds that they make. Throughout these tests and trials medical students will also gather a lot of baggage. Whether this baggage is due

to swinging the stick around too much, or perhaps it’s a better sort of baggage, friends (or both). Like Kermit, medical students have the uncanny knack to be able to make a lot of friends within their course, and for those who are brave enough, even outside their course. I call friends ‘baggage’, because like Kermit when they all get stuck in the desert, they will depend on you at some point in time. However good friends, like

with ‘em, you can’t live without ‘em. We grin and bear it, cause the nights are long. I hope something better comes along!” So now a Medical Student approaches the end of his time in ‘limbo’ and as a student. This is often a daunting time, and one may even think “What’s on the other side?” The fact is... after all of this time, all of the trials, and all of the friends that they have acquired... it will not matter good baggage, will not always what is on the other side of medical need you to carry them... they school, because at this point in time also can carry you at different you will be ready to face up to reality, to points in time. consequences and to responsibility. If not, Enter: Miss Piggy. (Or Mr Piggy... then perhaps this is not the right degree whatever floats your boat) for you... or like Fozzie bear with a big Yes, this will happen to all medical smile say “I’m a professional. I’ve had three students at some point in time. Like performances...” Kermit, you will spot her through a So to all of you Medical Students, crowd... she will light up your night... live life with a smile, don’t act like a and then become totally obsessive professional – but be a professional, like Miss Piggy. Kermit is sitting at a experience the world and it’s people and bar contemplating Miss Piggy and her don’t be a sourpuss (a.k.a. Oscar the smothering, and meets a pianee playin’ Grouch). dog called Rowlf. Rowlf offered some very “Life’s like a movie, write your own interesting insight on women: “Can’t live ending, keep believing, keep pretending...”

Panacea Vol 44 No 2 033

C’mon, Hand over your

Khakis

Khakis = car keys? Yeah? Anyway, Justin CHau (UNSW) writes about drunk driving.

___________________ saying ridiculous things like: ___________________ “I hate those ambulances ___________________ that drive really slow with their ___________________ sirens on. There’s one behind ___________________ me now. So annoying.” ___________________ or shouting out: ___________________ “Lumos Green!” every single ___________________ time the traffic-lights change ___________________ colour and pissing itself laughing. ___________________ or drunkenly texting to a BFF: Stereotypes aside, driving I_____________________________________________________________ have to confess, “Just tried to flash my under the influence of alcohol headlights at an oncoming I_____________________________________________________________ love driving, but I _____________________________________________________________ is a major contributor to motor driver to warn him of a cop but find it gets in the way of my _____________________________________________________________ vehicle accidents amongst drinking most of the time. I think it was too dark for him _____________________________________________________________ young adults and represents It also doesn’t help that to see my chest.” _____________________________________________________________ a major throbbing headache that due to my acetaldehyde In my opinion, with the aid _____________________________________________________________ to the police, health system dehydrogenase deficiency, of alcohol, there’s a perfect and community every early I_____________________________________________________________ suffer from ‘A sian Flush’ time and place to listen to any _____________________________________________________________ Saturday and Sunday morning. song, including Nickelback. syndrome whenever I _____________________________________________________________ consume alcoholic beverages. Impairing both reaction and But you don’t find yourself _____________________________________________________________ judgement, it’s an established Medically termed as driving off a cliff very often. _____________________________________________________________ fact that with enough alcohol, ‘EtoHriental Erythema’ (by So what to do? _____________________________________________________________ even Lewis Hamilton would me), it takes less than one Despite the heavy television _____________________________________________________________ have the driving skills standard drink to get my face and billboard advertisements _____________________________________________________________ equivalent to an asian woman it has become clear that fines, glowing as red as the traffic _____________________________________________________________ driving a Toyota Prius. lights I would speed through demerit points and random So what is it like? if_____________________________________________________________ I was smashed. Forget breath tests aren’t enough to _____________________________________________________________ From an observer’s breathalysers, a colour-chart or deter the invincible-feeling, _____________________________________________________________ perspective, drink-driving spectrometer is all that it would goonhead from taking a stab at _____________________________________________________________ seems akin to being in a take to grade my BAC levels. driving home whilst smashed. _____________________________________________________________ bumper car. All confrontation, Discouraging risky behaviours Thus, one of the primary _____________________________________________________________ no destination, no steering reasons why I don’t drink like speeding and drink-driving _____________________________________________________________ and no brakes. Every single and drive is the fact that the requires new, innovative _____________________________________________________________ thing on the road is on-coming measures that neither pure chances of my rosy-face not _____________________________________________________________ traffic and it’s like playing getting stopped by police legislation nor education have _____________________________________________________________ dodgeball, except that the whilst driving is equivalent to been able to do. _____________________________________________________________ balls are of course 2 tonnes of catching a flight with a turban That’s why I propose that _____________________________________________________________ on and not having one’s luggage metal zooming along at least speed bumps emit a ‘scream’ _____________________________________________________________ sixty kilometers an hour. Of ‘randomly’ checked. On the when we go over them. The _____________________________________________________________ course, the ethanol-saturated other hand, one could state roads would be safer, since we’d _____________________________________________________________ that all asians technically don’t cortex can’t assess this danger all immediately drive slower. _____________________________________________________________ and is having too much semidrink & drive. Because they I know a lot of people are _____________________________________________________________ can’t drink, nor can they drive. conscious fun presumably behind me on this. “Mum, I need you to pick me up. The police just banned me from driving, which is totally unfair, since I thought it was perfectly legal to drive after only having 9 points...or ‘pints’ as the police spell it.” “What?! 9 pints? Why were you driving at all?” “Well I had drunk so much, I could barely walk-” “WHAT?! You could barely walk and you still drove??” “So? What does walking have to do with driving?”

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I’ll White what I wanna Sam whitehouse white, dammit! (VPE) doesn’t care for your colour swatches, public hospitals. Or for your lifeless duvets. No panache.

White is purity. White is sterility. It is a tasty beverage (when consumed from an adequately filled vessel), a crisp bleached shirt, and equal to black, brown, yellow or any other skin colour in the context of race. White is the colour of clouds, the colour of snow and, as Wikipedia will have you know, a perception evoked by light that stimulates all three types of color sensitive cone cells in the human eye in nearly equal amounts and with high brightness compared to the surroundings. As Will Stokes repeatedly tells me, white is the root of the word brilliant. I would retort that brilliant in fact comes from the French briller meaning ‘to shine’ but sometimes ignorance is bliss. It is also the first syllable of this author’s last name and hence the motivation for this article. As medical students well accustomed to traipsing the corridors of this country’s teaching hospitals, we are used to the medicalisation of white (or more accurately the whitification of medicine). White is commonplace in our hospitals for a couple of reasons. Firstly, because doctors like to look smart and crisp and enjoy the authority that a white coat apparently bestows upon them. Secondly, because patients who’ve consented to some stranger digging around inside them like to, at least, think the place is clean. So hospital administrators find all sorts of ways to extend the ‘white illusion’. White corridor walls abut cold white linoleum, the harshness intensified by the stark white of the overhead fluorescent lights. In the wards you find patients in white gowns, with white dressings, sandwiched between white sheets and white blankets. It looks dull, but astonishingly hygienic, that is until the soiling begins. I used to work part-time for a

private pathology lab servicing most of the private hospitals in Adelaide. By comparison to the main teaching hospitals, private hospitals ooze patient comfort through the simple use of colour in their decor. Instead of white the walls are canary yellow or ocean green, and the bed linen is patterned and at least visually interesting, if not attractive. These hospitals have stepped away from the traditional all-white sterile façade of our teaching hospitals and as a result they are as happy a place as a hospital can be. The question then is why do public hospitals persist with their bland, sterile whiteness? Certainly we’ve seen the beginning of a shift away from white. At the Royal Adelaide Hospital and other teaching hospitals in SA the surgical units, with the exception of some orthopedics departments, have hung up their white coats in response to infection control demands and simply because the times they are a-changing. The fact of the

matter is that white coats are filthy. If, on the first day of wearing,

your coat escapes without a sullying of bodily fluids it is good to go for perhaps another day. Wear it much beyond this and you might as well take an agar shower in the infectious diseases ward. The thing about white is that shit shows up on it (that’s why I don’t buy white jocks). Ask yourself - when was the last time you saw a spotless clean lab coat being worn around the hospital? Unless the coat is brand new or has recently been dunked in a bucket of White King it just doesn’t happen. The same goes for white bed linen – it becomes visibly soiled so rapidly that sometimes it is changed multiple times in one day. But we continue to use it. I used to work functions as a waiter/ barman. Having done a few hundred over

the years I can say that the best looking events were the ones with tables decked out in black tablecloths, rather than those with white. The benefit of black over white is that if some idiot spilt delicious red wine on a black tablecloth half an hour into a function, no one would realise until they leant their white-shirted elbows in it. The classiness of the event is maintained until much later in the night when Uncle Bert vomits into the lectern. In this situation what’s more important is the illusion of cleanliness, rather than cleanliness itself. And therein lies the conundrum. In the hospital environment infection control is paramount, but do we nonetheless need to be so trigger happy that we end up changing linen sometimes multiple times a day due to visible soiling? If we were to adopt colourful linen in our hospitals is there a legitimate risk of losing track of dirt, germs and body fluids – and if so will this really increase infection rates? If one were to compare and contrast infection rates between public ‘white linen’ hospitals and private ‘colour linen’ hospitals the answer may well arise. Or it may not. Either way I have no interested in conducting such a study but would point out that in theatre, where the maintenance of a sterile field is of utmost importance, we in SA at least wear blue scrubs and use green drapes. If keeping track of filth is the rationale underwriting the use of white in hospitals one would have to call this counterintuitive. If we can manage the theoretical increased infection risk associated with a more colourful hospital system and phase out the use of stain-magnetic white, we could embrace the cost savings that would surely flow from reduced linen traffic. And wouldn’t our hospitals be more fun?

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I’m off to the Ellen Hardy (UNE) ponders intangible country, be Sienna differencethebetween ‘city’ and ‘country’, and what that later. means to her.

Growing up in Sydney, I thought that on the whole it was a friendly sort of place. It was rare to encounter a nasty person. Regular sunshine gave most people a happy glow, even emos would unwittingly have sunlight bouncing off their greasy hair and lip-chains. It was therefore difficult to believe that country people could be, as is often said, friendlier than city people. Then I moved to Armidale. On the first day of my first year of my Medical degree, the senior staff specialist came to our college to invite all the medical students to lunch on his farm. There we met one of the other hospital physicians, and the families of both doctors. We were told that they would both come around once a week to help us in their own time, and if we ever got sick of college food, that there was always room at the table. Right, so that’s what friendly means. Why are people so generous here? Armidale is a small university town, with one hospital, two traffic lights and eleven churches. With most of the permanent population employed as lecturers or school teachers, and thousands of students living on campus, it’s a pretty liberal place for somewhere two hours 036 Panacea Vol 44 No 2

from the coast. Sure there is only one cinema, but it hosts a French film festival every year. There may not be a nightclub in sight, but there are eight pubs, and not one of them has a cover-charge. Perhaps they’re just used to welcoming people. With thousands of students descending on the place every February, and just up-and-halving-the-populationof-the-town every holidays, the “townies” treat everyone the same, whether they’re here for one residential school or for a lifetime. Though many move on, a large number get stuck here, pulled in by the extra gravity of the mountain that the town sits on: I’d better do my Honours. Oh, why not do my Masters? May as well get my PhD now. I’ll just do a little bit of lecturing. Whoops, may as well retire here too. Perhaps they are less stressed. For a start, there’s less traffic, to be honest there’s no traffic. Petrol prices haven’t changed at all in the past two years – no matter the price of a barrel of oil it’s always 127.9c per litre here. Not only that, a full tank will probably last you the whole term. Money is less of a problem too, college is cheaper than in a capital city, usually by about five thousand dollars, and pennies saved can be spent at pubs that don’t have a mark-up for the

tourists. Perhaps it’s because there’s more going on. It may seem paradoxical,

but when there’s only one or two places to go, both of those places will be packed. No-one

is paralysed by indecision about what to do, be it the wool-expo, the autumn festival fun-run, or a night out on the town, everyone will be out to make it an awesome night. Perhaps it’s the small town syndrome: everyone knows everyone, so learn to get along. When there’s less than two hundred medical students all taking classes together, living together and going-foetal-before-exams together, a tight bond starts to form. Maybe you don’t like someone, but you’re going to be seeing them every day for the next five years, so it pays to play nice. For whatever reason, the people in Armidale are all too willing to open their hospital and their hospitality to us. We’ve been told by many patients (most are seen a dozen times by students during their short stay) that they just want us to stay in the country. I think the well renowned generosity of country people is working its magic; I’m beginning to be sucked into the vortex of friendliness myself.

Looking to the fuchsia The future of medicine has never looked brighter. Thanks to the constant glow of computer screens, we have never been more connected to cutting edge practices, products and procedures. With access to YourDiagnosis.com, mydr.com. au and our good friend Wikipedia, the average consumer has a wealth of up-tothe-minute information at hand. Yet with all this fast-forwarding into the future, have we forgotten about the origins of medicine? A Google search goes a long way and I found that not only have some current practices persisted for thousands of years, but that ideas are constantly being rediscovered and researched. But you are connected, well-informed and up-to-speed med students. You already know this. Let’s start around 1000 BC, in Mesopotamia, a region covering modernday Iraq, Syria, Turkey and Iran. It was here that the physician Esagil-kin-apli wrote his bestseller – The Diagnostic Handbook. This medical text covered an extensive list of symptoms, which were correlated with the diagnoses of various diseases, suitable therapy and expected prognosis. Sound familiar?

I’m thinking that maybe Kumar and Clark had some Babylonian influence on their work. We can go back even further to 16th century BC Egypt – the origin of the mystical Edwin Smith Papyrus. This textbook on trauma surgery includes forty-eight traumatic injury cases complete with physical examination, treatment and prognosis. It includes

Natalie ngu(Monash) takes a

interesting approach to soothsaying: poring over ancient history medical textbooks. Hmm.

instructions for suturing open wounds, immobilising head and neck injuries and using honey to combat infection – all of which are recommended today in the legendary Murtagh’s General Practice. Heading back to the Middle East, you may find Abu al-Qasim’s Kitab al-Tasrif , a 30-volume medical encyclopaedia used extensively in both Islamic and European medical schools until the 17th century. A Merck Manual of the Middle Ages perhaps? It’s not just in texts that ancient ideas and practices have reappeared. The concept of health as a state over which we have at least some control seems to have origins in ancient India. The Charakasamhitã, an Ayurvedic text emphasises that health and disease are not predetermined but are defined by the constantly changing triad of mind, body and spirit. Extrapolate this to the WHO’s “state of complete physical, mental and social well-being” and we have a match. The Charakasamhitã also suggests that quality of life is dependent on a balance of a healthy diet, sufficient rest and regulated intimacy. Food, sleep and sex – few would disagree that these remain crucial to the human psyche today. So it’s through my rose-tinted glasses that I look into the ‘fuchsia’, which on closer inspection, appears more familiar than expected. Futuristic medicine may involve nanotechnology, diathermy and gene therapy but ancient texts, practices and ideas should not be overlooked. They’ve had thousands of years of refining and expert critique, and will probably remain even when our colour wheels have stopped spinning for good.

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white and wrong We all know that medicine is filled with more questions than answers. Filled with conflicting ideologies, swayed by political motivations as much as public opinion, the medical landscape changes constantly. We have lectures highlighting ethical dilemmas ranging from lap-banding in youth to euthanasia. We even have a PBL case in 2nd-year structured around the sole point that medicine is filled with uncertainty. One thing we don’t focus on is the grey area in patient communication. Mixed signals, misconstrued ideas and misinterpreted words often mark the beginning of the end of the positive doctor-patient journey. Knowing we don’t always have the answers, let alone a complete understanding of the patient, the question then becomes, “how do we navigate the grey areas without losing the doctor-patient relationship?” I believe that first we need learn to ask the correct questions.

Arms akimbo, mind adrift, face askance? Spence Watson (Queensland) reckons you really need to tune in to listen to patients. of people we, as medical students and young doctors are exposed to, the more we are able to construct an accurate image in our head of the world around us. With this more representative picture, it will be easier for us to identify some of the issues our patients face. We can then step back and look at these differing - and sometime conflicting - ideas and experiences our patients have.

What do we hear patients saying?

Then we must understand what our patients are actually saying. From the time we are born, we are exposed to the ideologies of those around us: family, friends, siblings, teachers, religious leaders, even doctors. Each interaction imparts a lesson about life and the world around us, whether we know it or not, slowly moulding our view of our surroundings until we have our own What are patients saying? From History Taking 101, we learn the perception of the environment we exist in. As a result, each time we experience who’s, what’s, when’s, where’s and how’s are the golden tickets to finding out what something - an event, emotion or idea - it we need to know to help provide the best is mounted on this background that is medical care. In Clinical Communication, formed from our perception of how the world works. Just as a patient’s ideas and we get taught to show empathy when experiences influence the vision of their people show emotion. We listen to world around them, so do our ideas and the patient, take in what they say, nod experiences influence ours. empathetically, then provide the best The trick then becomes understanding advice we can for their condition. What our perception and realising it is just that. we are not really taught is to question: For example, if I were to say to you, Why are they feeling like that? Why did they make that choice? Why did they use “I don’t like the beach,” there a loads of different interpretations based on what those words? Understanding what a patient is saying I mean. To some, a beach is a beautiful, white-sanded place of alcohol and (and often actually asking) is more relaxation. To others, it is pebbly, cooler than just listening to their words. It is ocean’s edge with rough waters. Still to understanding where they are coming others, it may be the place they grew from. Doing this takes experience, up, along with an abusive sibling and often the type that many of us do not negligent father. I know it is a simple have. It involves seeing people from example, but the point is clear. How we different races, different socioeconomic backgrounds, different religions, different view the world is based on our perception of our experiences. sexualities, different abilities, different This small but important idea is ages… you get my drift. The wider variety

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vital, as it changes the nature of our communication with our patients. Once we recognise the mould, or filter, we are perceiving the world with, it allows us to step back, pull that filter aside, and see the world and patients more objectively.

What are we saying?

The next step is seeing how this filter we have affects how other people, including patients, see us. This is a much more difficult thing to do, as it requires us to sit down and truly deconstruct and analyse our ideas, our words and our behaviours. We start to critically think about the word-choices we make, based on the ideas we have, and realise the impact of that on those around us. We slowly become aware of the body language we exhibit when our words are silent. We begin to understand that, just as we sometimes struggle to understand where a patient is coming from, so do others with us. I have heard people argue that it is impossible to separate ourselves from our experiences and perceptions as it defines who we are. I agree, but that is not what I am suggesting. Instead, we must look at ourselves, truly acknowledge what influences have shaped our ideas and subsequently our filter, and recognise that once we take off the filter, we can start to see the world around us objectively. Recognising these filters, we can truly start to understand what a patient is asking of us. Then we are in a position to truly provide the best care.

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the fine art of Chat-reuse Stephen kunz (Deakin) gives us a tongue-in-cheek

guide to the lost art of conversation.

Imagine: You’ve spent the past 8 weeks surrounded by hospital staff, speaking latin and focusing on everything medical. You’re at the point where you see a Mercedes with the number plate CRP-254 and immediately think “bacterial infection”. While this is beneficial in terms of your course, it may mean that your non-med friends and family will gain a glassy-eyed look and find an excuse to play with their iPhones when you open your mouth. And then look at you in frustration when you whip yours out, and talk about the latest medical app you’ve downloaded. You’ll find that what’s missing in that situation is that you’ve lost the ability to make conversation for its own sake, a key social skill in any interaction. This phatic communion, coined by Bronisław Malinowski1, is vital in terms of a bonding stratagem while maintaining appropriate interpersonal distance. It also allows you to gauge what is important to the person you’re talking to, enabling you to find common ground and explore it appropriately.2 You can signal your mood and sense that of the other person, establish priorities and show that fundamentally you have friendly intentions and desire some sort of positive interaction.3 Finally, it can fill the space that would otherwise be an awkward silence. Here are a few topics that may help you in your quest to relearn small talk. - Ask about the weather. As we all (bar pathologists) experience meteorological 040 Panacea Vol 44 No 2

activity at some point in our day, this is a safe topic that allows for interaction. - Television and film. An increasing amount of people enjoy moving pictures, and you would be surprised at just who, both young and old, has watched television. - Post colonial feminism. The feminist philosophy that the issues affecting women aren’t able to be universalized has repercussions on half the world’s population, and so you have a

high chance that the person you’re speaking to is either a woman, or knows a woman somewhere, so will be able to relate.

- Recent shared experiences. “Good party last night, wasn’t it?” 4 allows you to then talk about what happened. It also allows offers the potential for gossipsharing, which can strengthen your interpersonal bond. The final example, however, illustrates how the level of detail should not go beyond the bounds of interpersonal space. “Yes, it was a good party, I was a little tipsy” is an appropriate response, as opposed to “Oh god yes, I got so drunk I threw up in the oven, and the plumbing this morning was devastated”. So, you are in the position where you can make small talk with most anyone. Try it out when next you’re bored, with friends, or even strangers in the supermarket, and see how your conversational skills improve tenfold.

1 Citation needed. 2 Here you will find I have fallen into the trap of overanalysis, and assumed the relationship between us allows for such insight to be made. I have suspended the rules of small talk so as to allow the appropriate information to be given, and do not advocate doing so in everyday interactions. For when to use it, see “Making deep and meaningful talks” 3 Small talk then too allows for a myriad of later interactions, including business partnerships, Facebook friendships, and possibly even romantic liaisons. 4 This assumes that you went to the party.

Into

the

wild convention review

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Sub-lime academia

forget… The week flew by with conventioneers being ooed and ahh’d by some incredibly magnificent plenary sessions – the likes of which will not be seen again (yes that is a challenge Sydney 2011!). Forty years from now Conventioneers were taken into the when you are recalling to wilderness of medicine by diving into a your grandkids about the wonderful program so diverse and exciting that no experiences you had back in your medical one even dared to yawn during any of the school days – you will be speaking plenary sessions – despite only receiving about one thing and one thing only: the several hours of sleep from the night glorious week that was the Hobart2010 before. Laughs were had, tears were shed Convention. We like to think that part of this is because of the sensational academic and passions were ignited as the plenary program that took place during the week speakers razzled and dazzled the crowd in (actually we know it is…). To see people the short periods of time that they were given. We would love to go through the making their way to the plenary hall for program name by name but we wont as a 9am start with a Berocca in one hand, we have been given a world limit and this a red bull in the other and a very sexy by listing awesomeness of each individual snuggie wrapped tightly around them is speaker – we would exceed this limit by at something that we shall never come to

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Missed out on the academic program? Sabin Smith (Academic Co-Convenor) gives you plenty of reasons to rue that decision.

least 4 times. Not to be outdone by the sheer brilliance of the plenary program, the afternoon workshop program made sure to delight all who came across its path. From playing with tiger snakes to mastering the art of wine tasting using some of Tasmania’s best wines – there was sure to be something that tickled the fancy of every single delegate (yes there were some medically focused sessions in their too!). Throughout the week – the field trip sessions were as heavily contended as a fight between Mohamed Ali and Rocky Balboa. Despite our original intentions of having signup for the session take place at 0830 every morning with the opening of the AMSA booth – we were stunned by the stream of people that showed by before 8am every morning to sign up for the days field trip sessions. To all of you we say sleep is for the weak and kudos to you on your magnificent efforts! Overall the week was one of sheer magnificence. Friendships were forged, inspiration was contagious and all who made the journey to the shores of the edge of the world left with an unforgettable experience of having entered the wild…

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sports day: a palette of fun Steph Flukes and Kate Mckenzie (Sports

Day Co-Convenors) ran a day like no other. And are very much fond of exclamation marks.

Were you at sports day this year? If not why not? I hear it went off ! In fact, I hear that it was the best sports day there has ever been! The sun was shining, the frost was melting, the drinks were flowing and the DJ was pumping! Not to mention the challenges, which were awe inspiring! Competition was the order of the day as Australia’s finest young type A personalities competed for the sports day shield! Tassie, with the home ground advantage, took out the title this year. But props go to the runners up Griffith and third place winners UQ who put in a brilliant effort in unfamiliar climactic conditions. The Welch Allyn Emergency Medicine Challenge (EMC) was a challenge to be reckoned with. Most teams stepped up to the plate and put in a stellar performance. A few people took our ‘preventative medicine challenge’ April Fools’ joke a little too seriously, one injured female was questioned on

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her pap smear history and a patient experiencing an AMI was lectured on his salt intake. Congratulations to JCU whoâ&#x20AC;&#x2122;s brilliant team work and medical knowledge won them the trophy and Welch Allynâ&#x20AC;&#x2122;s extremely generous first prize! Congratulations also to Tasmania and Notre Dame Fremantle who took out 2nd and 3rd place! The athleticism of delegates came to the fore as conventioneers battled it out in the three legged race, the sack race, the footy kicking, the penalty shoot out, the sumo wrestling, the mechanical bull and enjoyed themselves on the jumping castle and gee whizzer. The late for uni race became pretty heated as competitors resorted to throwing milk at each other in

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a bid to secure the title. The tug of war was briefly stalled as the USYD lions hunted the UQ zebras across the savannah. They were eventually rounded up however and the Zebras managed to overcome their lowly position in the food chain and tug to victory! As usual the Cascade and Pipps cups were hotly contested this year. Tassie managed to take out both cups by a narrow margin, closely contested by defending champions Adelaide. All in all Sports day was a challenge for mind and body and showcased the competitive nature and sporting prowess of Australian medical students. Canâ&#x20AC;&#x2122;t wait to see what Sydney serves up! See you all there!

Jared Panario

a thousand pictures must surely be worth vermillion words

(Publications) gives us an overview of what can only be described as an epic week of social events.

Whew. After two years of planning, four-hundred and seventy two hours of meetings and six thousand megalitres of coffee or other caffeine-based products, it came. We saw. And it conquered the picturesque idyll that is Hobart for seven glorious nights of wanton abandon. If you were there, you would’ve seen the sights of this heavenly beast. And even now, weeks after the event has long since left the shores of the Derwent, Taswegians can still hear the faint echoes. A tuft of faux fur drifting in the wind, a drop of iridescent body paint in a rainstorm, a waft of the aptly named McSTEMI lingering on our palates. Yes, indeed, Hobart2010’s social program changed life for good. It all started on the Sunday night at Tattersall’s Hotel: a deep, booming voice from the clouds shook the earth, told us to repent our sins for the end was nigh. It was decreed that this was the End of the World as we know it. So what else could we do? We ignored said advice and partied like ‘twas 1799. Dinosaurs arose from their fossilised graves and devoured many an angel, unicorn and the occasional skeleton. Power Rangers and even Noah and his animals tried to quell the rising levels of vice, but somehow just got embroiled in the oft-talked about but seldom seen mack wheel. Fortunately the prophecies of apocalypse were about as accurate as that bedlamite Nostradamus, and we all managed to make it to night two: Rubik’s Party at the Hobart Showgrounds. As Huey Lewis and the News sung, it really is so hip to be a square. Especially when a glowing Rubik’s cube is suspended above your head. And you get DJ KID KENOBI playing a mind-blowing set with stellar lighting. Nerds and oddly clothed colourPanacea Vol 44 No 2 047

mismatchers alike boogied in awe of the set up. And some birds for some reason. On the note of colour, this convention was the foundation of the equally uninspired (perhaps even moreso) but slightly wealthier cousin of body paint: the morph suit. It reigned supreme on many a night of convention. Effective in photos: you betcha. Exciting as an idea: no, not really. And one would imagine ridiculously hot, being full body synthetic

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material and all. Anyway, I digress. After addling our minds trying to figure out that blasted final side to the cube, we became so disoriented on Tuesday that we became Lost on an Island at Isobar. Armed with little more than a genie bottle, a good lei, and a decent serve of lobster, we dared to venture even further into the wild. Our wits, invertebrate friends and able bodies served us well all night long, with many a pseudo-tribal dance and luau

enjoyed. An unexpected highlight was the treasure trove of Adeladies that thought it prudent to make their costumes out of chocolate coins. Tasty smears ensued. Wednesday night brought us the pubcrawl: an essential continuation of Sports Day (well done again girls), where delegates were handcuffed to one another and dragged around Salamanca Square, the hip place to be in Hobart (no squares this time though, unless youâ&#x20AC;&#x2122;re

from Melbourne). One girl managed to have herself a total of SEVENTEEN handcuffers, and had the bruises around her wrist to prove it. Who knows how, but delegates managed to make it in one piece to Thursday night, only to find they were being frostbitten 42 Below in Hotel SoHo. Santa and his little helpers (literal little helpers, we had midgets for the night) checked his list twice, and did not find us on the ‘nice’ list. Nonetheless, many

a naughty boy and girl found a present that was unwrapped with untold glee. Tannenbaums and snowmen alike were accosted by a pack of excitable huskies; be assured that no yellow snow was consumed… to our knowledge at least. And Friday? It seems that the theme of Crime and Punishment appealed immensely to the A-personality crowd of medical students, who were tired of their many long years of submission to the medical hierarchy and wanted to get their

own back. Role-playing was taken to a new level. Costumes this night were great, ranging from some Ga-Ga inspired police officers, to Iron Men, to the hilariously costumed Hamburglers. The highlight of the night was the appearance of Miami Horror – the crowd went off to their disco-house throwback style. In typical style the Fairytale Ball Night was an elegant and sumptuous end to the night. Everyone looked like they just walked out of one of the Grimm Brother’s Panacea Vol 44 No 2 049

more elegant fables (think Snow White or something), and were entertained by our very own hypnotist who made entrĂŠe a rather memorable occasion. The mythical forest of ball night extended past the afterparty into the wee hours of the morning at the traditional Champagne Chicken Breakfast, where many a dragon was slayed by a knight. All in all, it was one helluva week. But even more, Iâ&#x20AC;&#x2122;m looking forward to Sydney 2011. It will be amazing. 050 Panacea Vol 44 No 2

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Passion-fruit pit One could compare a convention night to a to-life-scale Pro Hart painting: a huge beautiful mess. Be prepared, writes Hannah Sexton (Adelaide).

When it comes to the Convention Dance Floor, an experienced delegate sees past the chaos, the injuries and the filthy combination of sweat, saliva, paint and ethanol to focus on the incomparable exuberance the Floor has to offer. However, for others – indeed, ‘amateurs’ – a sense of uncertainty and terror are not uncommon. These individuals should take heed of the following advice – it will guarantee an excellent night out, every time.

1. Wear VolleysTM

The fundamental rule, particularly for girls. VolleysTM (or cheaper varieties of canvas-lined footwear) permit the wearer to jump and land gracefully, moonwalk, break-dance or do that thing where you run up the wall and do a flip. The full herringbone synthetic sole provides essential grip on the beer-soaked, grimy floor. Furthermore, they eliminate the inevitable sore-feet dilemma facing every girl who wears heels. They are a Godsend, even if you are forced to sacrifice style for comfort.

2. Apply deodorant liberally

Strangely enough, every social venue at Convention seems to have a severe lack of adequate air-conditioning. One wonders if they actually have the heaters cranked 052 Panacea Vol 44 No 2

up in those places. Amid the crush of half-naked bodies, the physical exertion of dance and your full-length polar-fleece bear costume which sounded like a good idea at the time, you will sweat in places you never thought possible.

3. Do not incorporate a skijacket into your costume

Even if the theme for the night is ‘skijackets’. Don’t do it. See above.

4. Dance in character

To prevent the traditional ‘So…what are you?’, the way you dance can make a somewhat ambiguous costume all the more obvious. Dressed as a robot? Get those jerky arm motions down-pat. Dressed as a wolf ? Incorporate ‘pawing’ and ‘panting’ into regular dance moves. (Licking is not advisable). Dressed as a

stripper? Dance normally. Dressed in a T-shirt and jeans? Just get out.

5. Be assertive

We’ve all been there. You’re just trying to get to the bathroom/bar, but those slutty Adelaide girls are refusing to budge out the way. In these cases, a short, sharp jab in the back with an elbow never goes astray*. This technique may also be utilised on the actual dance floor when others are cramping your style, or when that stalker from UQ won’t leave your friend alone.

6. Dance approachably

Make yourself easily accessible and you’ll soon find yourself locking lips with a hottie from WA. Avoid dancing in a tight circle of friends - this behavior deters potential encounters with new

‘acquaintances’ from other universities. Similarly, dancing using slashing arm movements often keeps others at bay.

7. Avoid consuming fluids of unknown origin

No more drink tokens? Forgot to bring cash? You can just scout around for abandoned, half-empty beverages in the vicinity, right? WRONG. You may find “urine” deep trouble…

8. Learn the classics

All the old favourites like Livin’ on a Prayer, Run to Paradise and Ke$ha’s Tik Tok are guaranteed to crop up sooner rather than later. Learn the lyrics so you aren’t left mumbling awkwardly in the corner like a debater from Flinders. Also become familiar with the tune of Sidney Sampson’s timeless masterpiece,

Riverside. You’ll see why.

9. Never mack a painted face

Not only are you oblivious to their true looks and gender; depending on the colour of the body paint you may be mistaken for having either a face rash or a beard.

10. Beware of dangerous costume accessories

Be on the alert for oversized, lolling, out of control papier-mâché heads and flailing novelty swords. Also be cautious when dancing near a group of “Huskies” who are tied together with authentic harnesses. Although creatively brilliant, this costume poses several hazards to passing ski-jacket clad Melbournites, including tripping, tangling or choking. * Violence is not condoned by AMSA in any form at all.

Panacea Vol 44 No 2 053

colourful

language

There are times in every medical student’s life where situations arise of a negative nature. Now in the majority of these situations, I am sure that there are those among us who rise above these times and persevere. However, I am even more sure that we will occasionally cross the line of acceptable language when we encounter what appears to be the influence of a malevolent demi-god intent on crushing our very spirits. Here are some situations, where you might admit that ‘inappropriate’ language is fully justified: -When you physically cannot find a patient you were looking after, particularly pertinent if the patient is either paediatric or has Alzheimer’s. -When you notice that your latex glove has ripped halfway through a manual disimpaction. -When you have to insert an IDC in an overtly creepy guy who has been attempting to crack onto you for the past hour. -When you open an exam booklet and realise that absolutely nothing you have studied for the last 6 months is contained therein. -When the Government announces that they’ve screwed up the Healthcare Reform because they were too busy focusing on

So, some people think they’re pretty good looking. Mary-jo Flavel (Notre Dame Freo) suggests we get a tape measure to their face. Beauty is the aesthetic sensual delight experienced when encountering something with a combination of qualities. It is different for each individual, just look at The Ugly Truth for the different perspectives of man and woman in the pursuit of love and happiness. We all look for the outer beauty according to our individual definitions which attracts us to that certain someone, it piques our interest to learn more. This means that in our perception of true beauty it is more than skin deep; for that beautiful person on the outside, can be rotten on the inside and it taints the perspective. What many may not know 054 Panacea Vol 44 No 2

If the editor were to take below advice, he would be dropping c-bombs all over the joint. Hopefully Cameron Gofton(Sydney) is joking. ‘boat people’ -Upon finding out the Government lied about its promise to give you an intern place. -In the Gastro department, ‘nuff said. -In the middle of an OSCE station and you’ve completely forgotten what you were supposed to be doing. -When offering to shake a patient’s hand only to realise that: a) they’ve had a stroke and can’t use their arm; or b) they’ve had their arm amputated.

-After mistakenly asking a patient if they have any other ‘cool’ diseases after taking a history about inoperable brain tumour

-Upon realising that you’ve stupidly chosen to do your elective in a country that doesn’t speak English, whilst simultaneously noticing that you’d question your abilities in Medicine in English. -Upon realising that you’ve been slagging about your incompetent clinical tutor slightly too loudly in their waiting room and noticing that all their patients are listening to your conversation. -After throwing a penlight at a wall in an OSCE after it’s failed to work, only for it then to turn on. -Waking up at Convention and realising that you haven’t picked up another med student, but a Tasmanian local.

You are so bluetiful it hurts is that beauty has a number regardless of the individual. It is the proportions by which something is constructed to which we derive aesthetic pleasure - this is known as the Golden Ratio defined by the number Phi ( φ = 1.618033988749895...). This number has been used for centuries not only in mathematics, but also extensively in architecture such as the Panthenon, the Pyramids, and Notre Dame. Many of the renaissance artists used this proportion in their works as seen in Da Vinci’s the “Divine Proportion”, and Salvador Dali’s “The Sacrament of the Last Supper”. Even composers have used this ratio to create beautiful pieces,

such as Erik Satie and Chopin. This ratio has also been observed in nature itself as in spiral seashells, roses, even the facial features of a tiger. Thus beauty is perceived by any of the senses - an aesthetic body, a work of art, a beautiful fragrance, a delightful sound. From this it is easy

to see that a human being has many facets in which to be considered beautiful.

There is the initial visual component, where all body parts and features are composed in accordance with the Golden Ratio; the face is proportionally constructed, as are the features of the body. George Clooney and Jessica Simpson are popular

examples of phi-proportions defining beautiful faces. This visual construction drives the attraction, it catches our eyes if you will. Next is how a person sounds, the composition of notes and tones in a person’s voice adds to our perception of the person; each reader would be familiar with the song “Video Killed the Radio Star”, just as talkies killed the stars of the silverscreen. As you can see our initial perception is based on the common sensual experience of a person. However the essence of man and woman remains undefinable, and it is these unspeakable characteristics that drives us mere mortals in our pursuit of emotional nourishment from those around us.

i’m not a-green with that

Bound to be a contentious piece. At least amongst those who give two hoots about skØlling. Do you care? Let Bec Ryan (Tasmania) persuade.

Controversial. I wonder what Panacea thought when they allocated this topic to the reigning champion state. Even more so, I wonder why a Pipps member was asked to contribute. And finally, I wonder – Adelaide, was this you? Leaving aside the Pipps Cup and sticking with the topic, we all know that the Cascade Cup is notorious for its hotly contested final between Adelaide and UTas. Let’s be honest, the other Universities are a warm up. Similar to biggame sport, if you will. Nothing will get you laid - or so I’ve heard - faster at Convention than by being a Cascade Champion. Hence, the lads clearly have some subtle (or not so subtle) tricks up their boiler suits – I mean, sleeves – to give them the best advantage possible come race day. But what about the rules, I hear you ask? If you don’t know the correct rules for Boat Racing, do you even DO medicine? Shame. If you do, you will also know the logistics for judging. Man against man,

team against team, beer against beer. Most rapid uni wins. When the time comes for the main event of every Rower’s year, all pretences are thrown out the window. Judging takes on a whole new level. Such a level that it is, we’re not quite sure how it works. But we do know that it works just fine. Re-rows can be dealt with in a sentence: Acceptable if the race was close and there was unacceptable spillage or breaking etc by the winning/both teams; particularly if it created an unfair advantage (even then, re-rows in early heats are rare). My main point on judging does not lie with any statistical analysis of past years or the level of Adelaide’s dissatisfaction in Hobart2010, no. It rests purely on the statement ‘if it ain’t broke, don’t fix it’. The absolute majority of us walked away from Sports Day at Convention this year feeling like we really got our money’s worth. There were costumes, there was chanting, and there were thrills and spills along the way. What sane person would want to regulate the frivolity? (Melbourne, you can sit this one out). Nothing beats the atmosphere of the Cascade Cup. Nothing beats the banter that goes on amongst the universities. But,

ladies and gentlemen, if we were to adjust the way we are today to ensure an (apparently) fairer Race, what would become of everything we know and love about the Cup? The crowd are judges enough. Following from the Cascade Cup official rules, heckling, at the crowd’s discretion, can result in such grave consequences as halitosis and/or a lowered sperm count.1

The bottom line? “It is a sad fact that skølling teams break rules during the Cascade Cup (i.e. when rowers commit

1. Hobart, 2010. Cascade the heinous crimes of spillage Cup Official Rules, AMSA or false starting). It should be Convention Magazine: The the objective of all skølling Guide. p50 teams, both present and future, to stop all rule breaking.1” The judging is not the problem. The responsibility is ours and ours alone to ensure the cleanest possible race to begin with.

Panacea Vol 44 No 2 055

Blue-ribbon worthy

Another great initiatve, the AMSA National Teaching Award has been won this year by Dr Hugh Kildea. Rob Olver(Membership) has a chat to the man in person. Congratulations to Dr. Hugh Kildea of Adelaide University for being the winner of the inaugural AMSA National Teaching Award. The AMSA National Teaching Award was a new initiative in 2010 allowing one medical teacher in Australia to be recognised for their commitment to, passion for, and excellence in, medical teaching. AMSA was looking to celebrate a teacher who had a dramatic impact on individual students, as well as developing a legacy to last well beyond their career. All of the nominees were inspiring individuals but Dr. Kildea’s innovative style, and the dramatic revolution he has brought to clinical teaching in junior years stood out to the National Council. To quote Sam LaBroome Adelaide Medical Students’ Society President, “To measure Dr Kildea’s impact on student learning based purely on his CV would be denying this amazing man recognition of his immeasurable impact on the University’s student body outside of the classroom. To say that Dr Kildea was somewhat of a ‘cult’ figure at the University of Adelaide would be a huge understatement. His quick wit, light056 Panacea Vol 44 No 2

hearted nature and genuine interest in students has seen him become not only well respected, but well loved by the entire student body.” Dr. Kildea worked as a rural GP for nearly 35 years. In his early 60s he settled into a well-deserved retirement but very soon got bored and so in 2000 took on a job as a Clinical Skills tutor at Adelaide University. Since being there he has revolutionised junior student clinical teaching by using Standardised Patients (actors) to allow students as early as their first week to be exposed to history taking and physical examination. These basic skills are then honed with weekly skills sessions that are highly supervised thus allowing for ample feedback. During these sessions students are also encouraged and guided in the development of their clinical reasoning abilities. Dr.Kildea’s other great revolution was the “Med Ed” placement for 6th year students. This allows for a small group of select students to act as tutors for first and second years in their weekly clinical skills sessions and case based learning tutorials, thus encouraging the role of the doctor as teacher, and helping senior students

develop teaching skills. In addition to this it allows greater supervision of the junior students. The response to this initiative is so far very positive and Dr.Kildea is currently looking into some evidence based assessment for this very popular and well received world first teaching initiative. As a student of Dr.Kildea’s I had the pleasure of going through his junior clinical skills programme and was later involved as a 6th year tutor. I have a great personal respect for Dr.Kildea. He is an incredible mentor, an inspiring teacher and he has left a legacy that will benefit medical students in Adelaide for years to come. I had the great pleasure of interviewing Dr. Kildea after the announcement that he had won. Our interview took place after Dr.Kildea had been teaching for 8 hours straight and started with a discussion of the finer points of appreciating aged single malt scotch. Delicious. But from there we progressed to more serious topics: Rob: Hugh what sparked your interest in medical education? Hugh: I had worked as a General Practitioner for nearly 35 years, in which

time I taught students where possible, and was actively involved in training GP Registrars. In 1999 I had to have cardiac stents placed and wanted to slow down. I got bored of retirement very quickly and decided to take up a role as a clinical skills tutor. I’ve loved my career and found great joy in medicine and felt like teaching would give me an opportunity to give back to the career that’s given me so much. Rob: Why did you choose to focus on the clinical education of junior students? Hugh: From 2000 I was a tutor in everything, clinical skills, PBL and medical professional and personal development and realised very quickly that clinical education was lacking and while it was intended that students would pick up these skills in general practice and in the wards it wasn’t happening. The teaching in these environments was too unsupervised and inconsistent for students to actually improve their skills. It was to this end that I started redeveloping the program so that students could perform examinations and take histories in a controlled and supervised environment. As the years progressed we needed more tutors in this environment without increasing the cost of the program any further which lead to the development of peer to peer feedback, where students

were expected to assess each other. We are currently doing research on the efficacy of peer feedback but as year levels grew it became important to increase the number of skilled tutors in each clinical tutorial which lead to the use of 6th years and as far as we can ascertain the world’s first rotation where senior students were taught how to be clinical tutors. Rob: As an expert in medical education what do you believe is the greatest threat to quality medical education? Hugh: I’m concerned that the increase in student numbers is not being met by an increase in funding. Though there is still a place for lectures and didactic teaching the current gold standard in medical education is small group teaching with constant input and guidance from experienced tutors, this simply can’t happen if funding doesn’t begin to increase. Rob: As someone who has worked in medicine for 35 years, and now in education for 10, what do you believe of the concept of work life balance? And how do you maintain a balanced life? Hugh: When I first started we all neglected our families and we shouldn’t have. We shouldn’t be working 10 hours a day, 6-7 days a week, otherwise we won’t

be able to look at people’s problems with a clear mind. I’m very fond of the arts and I ensure I go to every ASO concert, state opera and ballet. Over the last 10 years the standard of performing arts have increased so much to the point that the art is also becoming somewhat of a science. Standing on Pointe just doesn’t seem anatomically correct. Beside that there’s my family and my dogs, three cocker spaniels. Rob: Do you ever plan on retiring? Hugh: Why? I’ve tried that once and I didn’t work so well, I don’t like making the same mistake twice. But I really do think it’s important for students to have older mentors around. Beyond medical experience, as someone whose lived through most of the issues that cause major concern to students I can help them see the bigger picture. Rob: You gave us all some very sage advice before we left for Hobart this year, what was it? Hugh: Don’t get laid and don’t get drunk, with both you lose your dignity! I’d like to thank Hugh for his valuable time sitting for an interview, and thank him for the truly remarkable commitment he has shown to medical education over the last ten years. Your dedication to our education is unabashedly appreciated.

Panacea Vol 44 No 2 057

it don’t matter whether it’s red or white

in W e

Society

So, you thought you’ve seen puns? You ain’t seen nothin’ yet. Falk Reinholz (Perth) and Will Stokes (Womble) pop a cork to celebrate the Wine Appreciation Society.

W A S

Appreciation

__________________________________________________________________________________ consumption of one or two adequately appreciation. “He sang as he drank and __________________________________________________________________________________ filled beer vessels of wine brings. On this One of the most pleasing tasting notes waited till his grapes __________________________________________________________________________________ night and through some forgotten act of on the palate of WAS must be its diversity. fermented, you’ll come __________________________________________________________________________________ dewine intervention, a grape Society was In the brandy (grape-derived spirit) of wine appreciating with me”. __________________________________________________________________________________ borne. this Panacea we ought to focus on how It was with these lyrics that the cork was __________________________________________________________________________________ Being refined and discerning members non-discriminatory the appreciators in popped on the Wine (One) Year Wine__________________________________________________________________________________ of the community we quickly moved to our vine Society are when it comes to the iversary of the Wine Appreciation Society form a constitution, otherwise known __________________________________________________________________________________ colour of their wine; be it red, white, rosé, during the Monday night of Winevention as the Declaration of Appreciation, to __________________________________________________________________________________ yellow, burgundy, etc. While this may be 2010. It is befitting of this colourful __________________________________________________________________________________ cement and ferment what we stood for so it is diversity in other areas that truly edition of Panacea that this memorable __________________________________________________________________________________ and to give as a platform for recruiting devines our Society. Since its inception occasion should fall on a night adorned __________________________________________________________________________________ more people into our shared passion. we have been a Society comprised of with all the colours of the cube at the __________________________________________________________________________________ It soon emerged that in fact we were a members from different states of Australia, Rubik’s Palace in Merlotbart, Shirazmania. society dedicated to achieving excellence we have members from 1st year, right __________________________________________________________________________________ The Wine Year mark is also a fitting time in the appreciation of grape derived __________________________________________________________________________________ through to final year students, we have to reflect on how much this vine Society __________________________________________________________________________________ fermented beverages, when they are served men and women, we have mainlanders has grown since the planting of the first __________________________________________________________________________________ in appropriate vessels that are adequately and Shirazmanians. It is truly one of the grapeseed… __________________________________________________________________________________ filled. Through a sherry effective casketing grape pleasures of being a medical student It had all begun precisely one __________________________________________________________________________________ campaign we found many like-minded that there can be such shared camaraderie year earlier on the Monday night of __________________________________________________________________________________ individuals who wanted to get on over a mutual interest as seemingly simple Winevention in Brisbane as a shared love Bordeaux with our Society. __________________________________________________________________________________ as grape-derived fermented beverages. for the consumption of wine amongst a __________________________________________________________________________________ Like buds springing from a vine and If a single grape is picked, crushed, group of four friends. As fate would have __________________________________________________________________________________ growing into fruit-bearing branches, a pressed, fermented and bottled, the result it, on this night (and not unlike many __________________________________________________________________________________ growing list of PORTfolios from within is meaningless. If instead a grape endures other social evenings at Wineventions) the the Society began to blossom. A coup __________________________________________________________________________________ this same process with hundreds of likebar staff were particularly overwhelmed __________________________________________________________________________________ was staged at Wineball, a haiku poem minded individuals, a delicious beverage and had to resort to the serving of wine in competition initiated and the Wine __________________________________________________________________________________ is created. beer vessels. This pleased us grapely and __________________________________________________________________________________ Appreciation Society started to become Grape times are ahead because after all: we shared in the joy and frivolity that the a vessel for a nationwide blend of shared __________________________________________________________________________________ grape wines drink alike! 058 Panacea Vol 44 No 2

blue balling it Priyam Jha(Bond) The word ‘abstinence’ brings to my mind pictures of conservative politicians in budgie smugglers (guess who), loudly proclaiming that a woman’s virginity is “the greatest gift of giving.” However, judging by the wild romp that was AMSA Convention 2010, ‘abstinence’ in this respect is not a word many medical students deem necessary in their vocabulary. Perhaps abstinence is more relevant to medical students with regards to the lack of it in our lives. As medical students, stress is a constant factor. That feeling of building a fort of neurology notes while skolling down your 19th cup of coffee is surely all too familiar to many of us. However, in this age of emphasis on psychosocial medicine, this stress is equally balanced by hours upon hours of lectures, seminars, and philosophical hallway conversations with consultants about the importance of managing this stress by having a life outside medicine. Anecdotal evidence suggests that we deal with this multitude of advice in one of two ways. Firstly, there is the group of students who ignore it completely,

and spend 20 hours a day curled up in a forgotten corner of the library with a worn copy of Davidson’s. Then there are the group of us who use this stress, and the subsequent

sees both sides of a very topical coin: can medical students justify their methods to unwind? Or is abstinence the cure?

ongoing counselling to “have a life outside medicine” as a justification for excess. A

because hey, I need to relax. Similarly, new shoes I can’t afford are a perfectly legitimate purchase (even if I need to go a justification to NOT abstain. week without groceries) because wearing Convention is possibly the best example them helps me unwind. of this. Try explaining to a non-medical The list of chosen vices is endless. student (or higher ups in your faculty) Whether it be eating, shopping or sex, that you are going out every night, only to drugs and rock ‘n’ roll, many of us have a sleep at 6am, drag yourself out of bed at tendency to over indulge. Yes, we know 8am, and rinse & repeat for 7 days. “But it’s bad for us, but we also know that if we you’re studying medicine,” they say, “don’t don’t find some way to relax, we’ll join the you KNOW how unhealthy that is?” Yes, worryingly high percentage of medical we do. We’ve read the chapters on the students who are depressed. effects of alcohol and sleep deprivation,. However the question remains, does And yet, those of us suffering from PCD this really justify our behaviours? Clearly are already counting down the seemingly many of these are not long-term methods endless, study-filled days till next year so of stress relief and in the future, we will we can do it all again. likely have to find ways to relax that are Others choose to indulge in different less of a strain on our livers, bellies or ways. As far as I’m concerned, an entire wallets. The need to relax and take a break day of study is more than enough from medicine will be with us during our justification to bake a triple layer entire careers, and as such we do need to chocolate cake and eat the entire thing find healthier, sustainable releases. in front of the television in my pyjamas I’ll see you all at Convention 2011! Panacea Vol 44 No 2 059

back in In the modern medical school, the social calendar is arguably as important as the academic schedule. Events range from pub-crawls and presidents kegs, to classy nights such as Balls and Jazz nights. These latter events require more refined attire than the average blue boiler or gold jumpsuit. Gone are the days when a man could simply get away with a hired black tux or girls could wear their one formal dress over and over again. Creativity and flair is now essential in order to make a statement and, as such, fashion faux pas are outrageously common. Similarly, outrageous behaviour is frequent which can be legendary at the right stage of any evening. However, no one wants to be ‘that guy’ who, on arriving, spills a drink on a girls dress as he stumbles past on his way to find the lads forcing them into a premature game of ‘remier league. The table on the right is a brief style guide, aimed at making you look the part and directing your peers’ attentions to some highly fashionable attire as opposed to some highly questionable behaviour.

Em Rischbieth and Nelson Granchi

(Adelaide) don’t beat around the bush: your appearance makes a huge difference to impressions. Follow their guide, and you’ll be sweeeet.

These tips are all to help you get to the event, but are useless without acting the part. Social etiquette often leaves a lot to be desired… hence the numerous bans from function centres that follow med events. There are a few basic stages of an evening: 1. Seemingly sober spouting intelligent, charming conversation, bubbly in one hand, hors d’oeuvre in the other. 2. Tipsy, ‘socially lubricated’, trying out those cheeky one liners 3. Throwing caution to the wind and trying out those even cheekier (and potentially slurred) one liners e.g. ‘Do you like whales?’ (Yes) ‘Oh, good, ‘cause there’s a humpback at my place.’ 4. Hiting up the d-floor with your new floozy, showing off your signature moves. If that ain’t your bag, baby, play the hero and save the Queen (or the little green soldier). 5. Man Love. Girls, the boob brush is a good distraction tool during this time. In a busy place, closely brush past the chosen fella, hanging for just a little longer than is appropriate. 60% of the time it works every time. 6. Re-tasting those earlier hors d’oeuvres. Will you survive the after-party? If not, well at least you are (or were) dressed to kill. 060 Panacea Vol 44 No 2

Get up

Shoes

Accessories

Underwear

Scent

Face

GENTS Light or dark suit? Gauge the formality of the occasion. ‘Black tie’ is self-explanatory but ‘Cocktail’ allows for some leeway. This includes substituting trousers for a stylish pair of jeans (the skinnier the better) or opting for the open collar. Again, gauge the formality. The shirt allows for expression. Colour is great, especially if pale. Nothing too loud though, it’s a shirt not a football guernsey. If staying with white, consider a stitched pattern. Patterns work well with colour too, but don’t make it an optical illusion and keep it simple. The same goes for ties. School shoes, Tigers, Pumas and Volleys (even black ones) are NOT okay. Even the most Bondesque suit can be totally undone by rubbish footwear. Two words, pointy and leather. A simple, stylish bracelet or watch is bound to get a complement and start a conversation. Keep your cash and cards in a slim wallet (the flip ones are still uber cool) to minimize bulges. Leave your stucco Y-fronts in the second drawer where they belong and don a nice (clean) pair of Bonds or CKs. ‘Cause you never know when those shlick d-floor moves are gonna pay off.

LADIES Above all, your outfit must be FITTED. Short or long? It doesn’t really matter any more but remember the golden rule – Boobs OR Legs, NOT Both. It’s skanky. Just like at the casino, always bet on black. Colours can be brilliant when done well. Patterns, however, can be dangerous. Looking like a tropical bird is not ideal (unless that’s the theme at Convention).

Heels, even if you’re 6 foot, there will always be a taller man. Heels are a great non-surgical alternative to a tummy tuck & arse lift so stock up on party feet and suck it up princess. Also, no stockinged toes through peep toe pumps… the Granny look isn’t so hot for 20 somethings. Less is more. Take Coco Chanel’s tip and take one item off before you leave the house.

The big conundrum. Super suction tummy/ thigh/booty tuckers to get that stunning silhouette OR the sexy set to avoid a Bridget Jones moment should my lady lumps entice further exploration or Eagle Rock be played? BO is not attractive, especially on girls. The There is a fine line between musk and pong. Play it safe and apply the anti-perspirant. Do not forget a d-floor will be going off so make sure you dose liberal spray of cologne to the neck and pre-auricular up on deodorant. Top it off with a good perfume. Subtlety is key, you want a man to be intrigued, area. According to the ladies, it’s ‘sex in a bottle’ not nauseated. And smelling amazing is the easiest mantrap in the world! Nothing is worse than thick, caked-on make up. Wash it at least. In terms of the fuzz, play to your Enough said. strengths. If you can only grow a few wisps, or it’s Again, less is more. ginger, clean-shaven all the way. For those more testosterone, be adventurous. Try the designer stubble, the goatee, the mo. Just don’t look like you’re part of the ZZ Top cover band.

Panacea Vol 44 No 2 061

What, you ask? It’s the International Federation of Medical Student Associations.Sebastian Leathersich (UWA) gives you an insight into what sounds like an amazing few days in French Canada.

Sacrebleu IFMSA in MontrÉal! It is the seventh hour of plenary session number four. The Chair calls an urgent 5 minutes toilet break. This is our chance - we jump at it. The AMSA delegation assembles on the stage. A few quick words to the secretary and it begins. The sultry tones of The Ventures draws 800 international delegates into the centre of the plenary hall. You may be asking yourself “In what glorious international forum could Hawaii 5-0 possibly lead to global unity?”. Well, allow me to elucidate... During the first week of August this year, a lucky group of 14 AMSA members converged on the French speaking city of Montreal for a week of hard hitting workshops and training sessions, endless joyful hours of debate in the plenary sessions, and a social program to break down all international borders. The IFMSA General Assemblies, held in March and August every year, offer a chance for medical students from 89 countries across the globe to come together to discuss current global health issues facing our world. The 5 steps to a successful GA can be summarised in the following recipe: The Key Ingredients of a GA - A beginner’s guide to assembling generally: 062 Panacea Vol 44 No 2

1. Plenary Sessions As the core of an IFMSA General Assembly, the nightly plenary sessions are typically characterised by heated debate, breached by-laws, long delays, copious caffeine, disruptive behaviour from certain rogue states, points of order, points of information, and plenty of bemused looks between the Australian delegation. As a general rule the timetable allows three hours for each plenary session; in reality they rarely finish earlier than 2 am. In Montréal, the sessions were interspersed with flash mob dancing to Waka Waka, Lady Gaga, and most importantly, a plenary hall full of students dancing the Hawaii 5-0. If that doesn’t give you faith in the future of the medical profession, I don’t know what will. 2. Acronyms Anyone who has attended a GA will be very familiar with the question “What position do you hold in your NMO?”… The classical answer involves describing how AMSA has a very different structure to most other national member organisations (NMOs), and that we don’t hold the same positions as members from other countries. A far more effective way to deal with this questions is to simply select a couple of consonants and string

them together with your favourite vowel, then say it with confidence and stride away as if you have a very important meeting to attend. This approach cannot possibly fail; it is practically GA social suicide to admit to not knowing the meaning of an IFMSA acronym. And there are a lot. Some examples of real acronyms, as a frame of reference, are: NGO, NMO, CCC, EB, SCOPH, SCORE, SCOPE, SCOME, SCORA, SCORP, NPC, NPO, LPO, LPC, NEO, LEO, NORA, LORA, LOL, LOME, NFD, NOME, NORE, LORE, NORP, LORP, RC, SCOPH-D, SCOPE-D, SCORE-D, SCORP-D, SCOME-D, SCORA-D, EuRegMe, APRM, ROFL, PSDD, TSDD, NTSDD, WTF, PD, LO SCOPH, LO WHO, LORMA, LO UNESCO, LOSO, LO SCORA, LO SCORP, LO SCOME, SUP CO, AM, MM, GA, VPE, VPI, SecGen… confused? 3. Standing Committees (SCs) The powerhouses of activity and projects within the IFMSA are the Standing Committees, which students divide into based on specific interests and projects. They are: SCOPH - Standing Committee on Public Health SCOPE - Standing Committee on Professional Exchange SCOME - Standing Committee

on Medical Education SCORA - Standing Committee on Reproductive health & AIDS SCORP - Standing Committee on human Rights & Peace. Each morning as the sun is rising, the delegates rise with it to make a beeline through coffee shops and cafés towards the academic venue. It is here that the SCs have their daily sessions, during which projects from various countries are presented, small working groups (SWGs) work on priority areas, and external speakers make presentations on key global health issues pertinent to each SC. It is in these sessions that ideas and initiatives are exchanged, support for new projects garnered, and new friendships forged. 4. Social program The end of the plenary session each night is celebrated with an expertly executed social program, craftily conceived to dissolve any remaining national borders. At least it would have been expertly executed if Montréal’s clubs and bars didn’t close at 3am. However despite this minor setback there was an unbelievable amount of dancing to be had each night, whether at the local haunt, “Bains Douches” (which sported a bathtub on the main dancing arena), or outdoors under a night sky punctuated with Sweden’s contribution to the international fireworks competition. The pièce de résistance of the social program is the biannual National Food and Drink Party. The general concept is that each of the 89 member countries brings an item of food native to their country, in addition to a bottle of overproof liquor to add ‘spirit’ to the party. Australia’s standard

contribution is Vegemite (straight) plus Bundaberg OP (also straight); a gentle introduction to the Land Down Under. 5. Sleep To be treated like salt - use sparingly, and add only a pinch at a time. Vary according to taste. With plenaries finishing at 3am, standing committee sessions reconvening at 8.30am, and a significant amount if efficient international fraternising to squeeze in between, sleeping times at a GA average around 2 hours in every 24. And so it was, in keeping with this traditional sleep pattern, that the August GA came to an end in the early hours of Friday morning, as the French Canadian sun crept slowly over the horizon and into our hotel rooms. Reflecting on the past week, I can say with great confidence that this is quite literally a once-in-alifetime experience. The opportunity to spend a week with motivated and inspirational students from all around the globe does not arise every day, and the friendships formed will continue to transcend borders for many GAs to come. For those of you interested in global health, this is an opportunity that is not to be missed. What is the IFMSA? The International Federation of Medical Student Associations (IFMSA) is an independent, non-governmental and non-political federation of medical students’ associations throughout the world. Representing more than 1.2 million medical students worldwide, the IFMSA is made up of 97 National Member Organisations (NMOs) from 89

countries, on six continents. The Federation was founded in 1951 as a Non Governmental Organisation within the United Nations, with the first meeting taking place in Copenhagen, Denmark; 2011 will see the GA return to this historical city to commemorate the 60th anniversary of the IFMSA. The IFMSA sees many projects, events and initiatives take place each year within the different facets of the organisation, and aims to “empower medical students in using their knowledge and capacities for the benefit of society”. The IFMSA Constitution defines the basis and framework of the Federation, whilst the internal management of the Federation is detailed in the IFMSA Bylaws - all 525 of them. These extensive documents are the subject of much debate at the General Assemblies, facilitated and regulated by the allknowing, all-seeing Constitution Credentialing Committee (the CCC). The plenary sessions just wouldn’t be the same without the various suspensions and violations of a bylaw or two! The General Assembly (GA) is composed of representatives of all NMOs, and meets biannually in March and August. The GA determines the activities of the IFMSA, the regulations, the management and elects the International Board and the Supervising Council. General Assemblies also provide a fantastic international forum for medical students to discuss topics related to individual and community health, education and medicine, and to formulate policies from such discussions.

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Tim Coppafeel (Legend) gives ‘remier league further evidence of the rich and at times unfathomable zeal that many have for the game known as ‘rem. article ‘Layers and Melbournians, The National High ‘Able is the ‘eak authority on ‘remier league in Australia and therefore the world. Our core mission is to ‘rotect and ‘romote the sport of ‘remier league. At the Australian Medical Students’ Association National Convention in Hobart this year, the National High ‘Able held two exhaustive meetings to clarify some ambiguities in our highly respected and highly esteemed game. I hereby ‘ublicly report the recent resolutions and clarifications of the National High ‘Able, by ‘resenting an edited version of the minutes from these two meetings:

style but far in front of their head. Their hands are rapidly brought to the normal antlers ’osition. Concomitant movement of the head or torso to accentuate the ‘rocess of reception is optional.

Resolution 3 ‘ersonal Bon Jovi

‘layer which ‘erforms bon jovi moves of the same type in a game of ‘remier league is guilty of ‘ersonal bon jovi. There may be any number of intervening moves ‘layed by other ‘layers at the ‘able. ‘ersonal bon jovi must be ‘unished by the Chair and results in full vessel consumption. These clarifications were approved by the National High ‘Able.

of a game of ‘remier league, or by any Chair of a game of ‘remier league at any subsequent Gala Ball of the Australian Medical Students’ Association National Convention. A member of the National High ‘Able cannot have a TDR ‘laced upon them under any conditions. This is to ensure that they can ‘lay all available moves and thereby ‘romote the game more effectively. These clarifications were approved by the National High ‘Able.

Resolution 5 Floating Whiz with Alpha

This was discussed but the minutes are brief and the minute-taker cannot Resolution bon jovi recollect the details of the conversation. Total Discriminatory Rules Vague memories suggest that the Total discriminatory rules (TDRs) can discussion revolved around whether the National High ‘Able be ‘laced by a Chair. A TDR refers to a direction of whiz moves, when interrupted Meeting, AMSA National first move made by a ‘layer. For example, by other games, floated and had to be Convention, Monday 5 July the TDR ‘laced on Tarzaan was for antlers adhered to upon the resumption of whiz. 2010, Rubik’s Cube ‘alace The National High ‘Able confirmed the Social Evening, Showgrounds, and meant that Tarzaan was unable to ‘lay antlers as a first move in any game of decision it made at the AMSA National Hobart, Tasmania ‘remier league; he was still ‘ermited to ‘lay Convention in 2008, at which time the Resolution 1 antlers after first ‘erforming another move direction of whiz moves was deemed not Bang the ‘able: which would enable the ball to remain in to float. The key reason was chairability of The game of Chow-Chow-Bang the ‘able must be introduced by the Chair, and his court. A normal TDR automatically ‘remier league. expires with a change of the Chair. can be ‘layed with any other compatible Resolution 6 Double ‘erson invisible ‘erson ‘remier league The Full Moon Clause refers to the game. To be ‘layed with all the other When ‘laying antlers or viking master ‘lacement of a TDR at a Gala Ball of the normal games of ‘remier league, ChowChow-Bang the ‘able must be introduced Australian Medical Students’ Association during a game of double ‘erson invisible ‘erson ‘remier league, the ‘layer initiating as follows: ‘time out, time in, the name of National Convention. To ‘lace a TDR either of these moves must have one under the Full Moon Clause, the Chair the game is Chow-Chow-Bang the ‘able hand ‘erforming the usual movement must call a vote of the ‘layers around ‘remier league.’ approximately thirty centimetres away the ‘able. The same rules apply to votes In Chow-Chow-Bang the ‘able, when during a game of ‘remier league as apply to from their head. This detached hand the ‘able is banged the ball returns to the votes of the Australian Medical Students’ signifies the support which is being court of the Chair. In Kong-Kong-Chi‘rovided by their alternate ‘layer. Association during its National Council. Ba the ‘able, when the ‘able is baed the Therefore if the normal ‘layer is ball returns to the court of the ‘layer who All ‘layers that were ‘reviously timed in at initiating the move, they would detach the ‘able receive one vote, including the ‘layed the ba. Resolution 2 Chair. In the event of a tied vote, the Chair their left hand because the invisible ‘erson – Receiving antlers is always to the left. Conversely if the has a casting vote. If ‘assed directly from one ‘layer to invisible ‘layer is initiating the move, they A TDR ‘laced under the Full Moon another, antlers must be received. The act Clause can only be removed by a would detach their right hand because the of receiving antlers involves the recipient member of the National High ‘Able when normal ‘layer is always to the right. This starting their hands in the typical antlers clarification was approved by the National that individual is acting as the Chair 064 Panacea Vol 44 No 2

High ‘Able.

Resolution 7 Botsquali

the official script of ‘remier league. ‘assed unanimously.

National High ‘Able Meeting, AMSA National Convention, Saturday 10 July 2010, Wrest ‘oint, Hobart, Resolution takahashi Gluteus Maximus ‘remier Leauge Tasmania Resolution 1 There was the ‘roposal from Gluteus Accepted Variations Maximus of a form of ‘remier league Botsquali was clarified by the National High ‘Able as a whiz move.

The criterion for a variation in ‘remier league is that it involves a change in the ‘hysical or verbal moves of the game, or changes the normal ‘enalties. Variations are distinct from simple directions of the Chair, such as ‘stand on one leg’ or ‘sway to the music’. The National High ‘Able will continue to work on the list of accepted variations, adding the creators of the variations where ‘ossible. Naked Chef was actioned to develop regulations and by-laws for Mario Kart ‘remier league. Astro Boy was actioned to develop regulations and byResolution 9 laws for Harvey Got Boomerang ‘im ‘remier league. Womble suggested a new move, entitled Resolution 2 ‘Boomerang’ to be ‘layed during Aussie Cowboy Ocker ‘remier league. It is a flick of the ‘remier wrist (à la throwing a boomerang) which League returns the ball to the chair. The hand Timothy used across the body designates the Coppafeel is to direction in which the boomerang is to be flicked. This could be accompanied by a shout of ‘Boooooooooomerang’ which accompanies the fluidity and speed of the motion. No motion ‘assed, to be ‘abled at the next meeting. whereby one hand would be ‘laced and kept behind the back, but all other components of the game would remain the same. The Chair can nominate for either the left or right hand to be ‘laced behind the back, but this must be consistent around the ‘able with no regard for ‘layer handedness. There was some discussion of the ‘assing of antlers and viking master either left or right in Gluteus Maximus ‘remier league. It was decided that this would not be allowed.

Resolution iku jo Turn Antlers

At one ‘oint, Gigantor ‘erformed ‘turn antlers’. In this move, a ‘layer ‘laying antlers turns one hundred and eighty degrees to face directly away from the ‘able whilst simultaneously dropping one hand and thus ‘assing the ‘antlers to the left or right. The aim of ‘turn antlers’ is to confuse adjacent ‘layers via the one hundred and eighty degree spin. The use of ‘turn antlers’ was rejected by the National High ‘Able as an illegal move.

Resolution 1 Script

Timothy Coppafeel moved that the script for documenting games of ‘remier league ‘ublished in the most recent edition of ‘anacea should be adopted as

disseminate regulations and by-laws for the South Australian version of Cowboy ‘remier league, which will be introduced nationally.

Resolution 3 Slaps

The National High ‘Able ‘assed Three Laws of Slaps: 0. Slaps must be an ‘assing move; 1. All slaps are equal in magnitude; 2. The net slap shall be the vector sum of all slaps. The motion was ‘assed unanimously.

Resolution bon jovi Turn Antlers Clarification

When ‘assing antlers left or right to a directly adjacent ‘layer, the ‘assing ‘layer can rotate a maximum of 90 degrees. This was moved by Gigantor and seconded by Gluteus Maximus; the motion was ‘assed unanimously.

Resolution 5

Gluteus Maximus ‘remier League

Falcon moved that when ‘laying Gluteus Maximus ‘remier league, the hand of each ‘layer that is not to be used (as determined by the Chair) ought to be ‘laced on the gluteus maximus (or general gluteal region) of the ‘layer standing immediately adjacent in the direction of that non-used hand. All other rules of Gluteus Maximus ‘remier league are to remain unchanged. This motion was ‘assed unanimously. The ‘reviously ‘ublished competition regarding the ‘remier league ‘uzzles has been extended until enough entries are submitted; ‘lease submit entries as soon as ‘ossible to nc@amsa.org.au to maximise your chance of success. If you would like to find out more about ‘remier league, you can contact us at: highable@amsa.org.au, or ‘referably you can ‘rink and learn. If you are from Melbourne, you can GFYITM. Timothy Coppafeel

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How did you get to be so very Well red? Frankenstein, Mary Shelley Reviewed by Amy Schirmer

__________________________ Written in the early 20th century, the __________________________ controversial Mary Shelley has set this __________________________ novel in a small valley visited by 97.3% __________________________ of Adelaide medical students whilst __________________________ skiing over summer. Other similarities __________________________ to this subgroup also include the books __________________________ outrageously long narrative and multiple __________________________ chapters before reaching any form of __________________________ point. __________________________ The story itself makes a wonderful __________________________ plot for a 1931 film, but is outrageously __________________________ frustrating for the young medical student. __________________________ The concept of creating a living creature __________________________ from clay and scavenged pieces of dead __________________________ bodies leaves a very large amount of __________________________ questions, especially when the creature __________________________ learns fluent French. The physiological __________________________ anomalies only continue when the __________________________ question of offspring is also brought __________________________ up, as the creature was not made with __________________________ reproductive organs (or at least any that __________________________ were described in detail in the book…). __________________________ And as for the characteristic bolt through __________________________ the neck... well, I can’t ruin all the __________________________ surprises in one short review! __________________________ Frankenstein has been the latest in my __________________________ literary wander through classic ghostly __________________________ tales, including such delights as Dracula, __________________________ The Picture of Dorian Gray and Grug. __________________________ Whilst the book itself was actually quite __________________________ enjoyable, with some lovely scenery, the __________________________ ending was bitterly disappointing. The __________________________ author manages to complete the epic tale __________________________ of tragedy with… well, nothing really. It __________________________ truly mimics the anticlimax of an NGP. __________________________ With all of my negative comments aside, __________________________ I would actually recommend this book __________________________ for those that enjoy the classics, and don’t __________________________ mind a bit of a flop at the ending. The __________________________ read was worth the journey, and I couldn’t __________________________ help but feel just a little sorry for the big, __________________________ ugly daemon!

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Solar, Ian McEwan Reviewed by Rob Olver

Ian McEwan is one of the most celebrated authors of the modern age. Among his many accolades he won the Man Booker prize in 1998 for his novel, Amsterdam, and in 2008 was named Reader’s Digest Author of the year. To date he’s published 11 novels and 2 collections of short stories, Solar being his most recent offering. Solar is the kind of book that makes you wish that you’d just reread Atonement instead. It is an allegorical tale of the arrogance of man and the risk to society posed by climate change. Technically it is brilliant. Yet despite this reading it is largely an exercise in patience. The protagonist is Beard, a Nobel Prize winning physicist whose hedonistic, egodriven lifestyle find him bumbling his way through both personal and professional calamities. Intentionally he is a loathsome character who provokes neither interest nor sympathy from the reader. There are a number of scenes designed to provide comic relief in this otherwise philosophical and topical novel. These vary from awkward love scenes to attempts at urinating outside in subzero arctic temperatures. Though equally well written as the serious elements of the book these feel very forced and insincere, such that as a reader it is a great struggle to feel that there is any imitation of reality. Overall Solar has some wonderful elements and beautiful passages of prose but there is very little to hold the narrative together. It struggles to capture one’s imagination or interest and as such fails in its attempt to highlight the folly of society’s current response to climate change. Though I eagerly await future works from McEwan Solar is one to avoid.

Don’t get bogged down in Cecil’s, Harrison’s or Kumar and Clark: let your mind wander in a few of these choice reads. The Book Thief , Markus Zusak Reviewed By Laura Rudaks

__________________________ Set in Germany at the time of World __________________________ War Two, The Book Thief recounts __________________________ the happenings and reactions to war in __________________________ the little town of Molching. Narrated __________________________ through the eyes of the Grim Reaper, the __________________________ tale follows the life of a young girl, Liesel __________________________ Meminger. __________________________ After the death of Liesel’s brother, we __________________________ see Liesel steal a book at her brother’s __________________________ funeral, before being brought to a new __________________________ family. Here, her new father teaches her to __________________________ read, which sets off a long-standing love of __________________________ books. This drives Liesel to steal further, __________________________ earning her the title of ‘the book thief ’. __________________________ The story more importantly takes a __________________________ look at the relationships that Liesel forms __________________________ with the other children she befriends on __________________________ Himmel Street, the group of apple thieves __________________________ she joins, the Mayor’s wife who gives her __________________________ access to a library, and the Jew her new __________________________ family is concealing in the basement. __________________________ Although set in wartime, this story is __________________________ not focussed on the war itself. It is rather __________________________ a snapshot into the lives of citizens, with __________________________ a focus on how words, books and writing __________________________ affect the lives and relationships of the __________________________ characters. __________________________ This book has climbed in popularity __________________________ and it is no wonder why. It is easy to __________________________ read, the plot progresses quickly and __________________________ there is great depth and insight into the __________________________ characters. It portrays the character Death __________________________ in a unique perspective and by narrating __________________________ from his point of view it gives the reader __________________________ a heightened awareness of the characters’ __________________________ motivations.

Born to Run, Christopher McDougall Reviewed by Rob Olver

Born To Run is the fascinating true story of clashing cultures, the limits of physical endurance and the joy that can be found in one of mankind’s most instinctual, primal activities: running. Imagine a 100 kilometre race, barefoot, under a scorching sun, surrounded by murderous drug lords. The competitors are a bizarre band of a journalist, two drunken surfies, a mysterious hermit known only as Caballo Blanco (The White Horse) and a tribe of Indigenous Americans who have spent generations running for fun, for food and for their lives. This is a race more bizarre than the strangest fiction. Christopher McDougall, a celebrated news writer and competent amateur marathon runner goes in search of the Tarahumara, a mysterious tribe who run ultra marathons on a daily basis. As a result of his experiences Mcdougall is forced to question everything he knew about running, and life. Though at times it delves into exercise physiology and nutrition (only to discover that beer and burritos may be the ultimate pre-race snack) this is not an instructional book on distance running. It’s an elegantly told, humorous story that poses more questions about life and the pursuit of happiness than it does about endurance sports. Whether you have pipe dreams of qualifying for Boston, enjoy a Sunday morning trundle, or think you should only run when something is chasing you, Born To Run will suck you in, make you laugh, and inspire you to challenge the boundaries of everything you believed was never possible.

The Great Gatsby, Francis Scott Fitzgerald Reviewed by Tom Crowhurst

The Great Gatsby is an iconic American __________________________ novel that focuses on themes of illusion __________________________ and reality, morality and disillusionment, __________________________ and obsession with wealth and status. __________________________ It continues to promulgate an achingly __________________________ poignant message nearly one century after __________________________ its publication. __________________________ The text is the length of a slightly __________________________ hyperplastic novella, but within this __________________________ short space Fitzgerald develops a level of __________________________ characterisation comparable with an entire __________________________ Tolstoy volume. The narrator, Nick Carraway, __________________________ follows the life of Jay Gatsby in the Long __________________________ Island and New York City of the Roaring __________________________ Twenties. __________________________ Fitzgerald employs the mysterious and __________________________ ultimately vacuous life of his protagonist __________________________ to explore themes of illusion and reality, __________________________ particularly within human relationships __________________________ predicated on social status and image. __________________________ Gatsby was a man in whose ‘blue gardens __________________________ men and girls came and went like __________________________ moths among the whisperings and the __________________________ champagne and the stars,’ but at whose __________________________ funeral ‘the minister glanced several __________________________ times at his watch... but it wasn’t any use. __________________________ Nobody came.’ __________________________ In the contemporary environment of __________________________ Facebook and the explosion of Veblen__________________________ like fashion accessories, a novel analysing __________________________ the superficiality of post-war America __________________________ expands its power and its relevance. __________________________ Nonetheless the text retains a strong __________________________ capacity to provoke personal reflection. __________________________ For Medical Students developing a __________________________ robotic callousness to the emotional __________________________ and spiritual aspects of life, The Great __________________________ Gatsby will stimulate you into deeper __________________________ philosophical considerations. __________________________ PS. ‘and as the moon rose higher the __________________________ inessential houses began to melt away __________________________ until gradually I became aware of the old __________________________ island here that flowered once... a fresh, __________________________ green breast of the new world. Its vanished __________________________ trees, the trees that had made way for __________________________ Gatsby’s house, had once pandered in __________________________ whispers to the last and greatest of all __________________________ human dreams; for a transitory enchanted __________________________ moment man must have held his breath in __________________________ the presence of this continent...” Wow _________________________

A Confederacy of Dunces, John Kennedy Toole Reviewed by Jared Panario

A novel that has a story of its own: both a debut and swan song; written by a frustrated, unemployed writer who, after seven years of shattering knock-backs from publishers, in 1969 took a garden hose to his exhaust pipe and commited suicide. Posthumously printed, this was the winner of the 1981 Pulitzer Prize. It is easy to see why. Toole follows the story of Ignatius J. Reilly, a self-proclaimed intellectual who sees himself above almost everyone and everything. Opinionated, obese and out-of-work, Reilly should be revolting. But he isn’t. There’s something indelibly loveable about this pretentious slob. A certain childlike innocence and assuredness maybe. Or his complete lack of worldliness. At any rate, Toole manages to blend together elements of the inane, esoteric and pathetic to create a modernday everyman. He must, after 30 years, abandon his philosophical musings and finally find his first job. We follow Ignatius as a hot-dog salesman and pirate-costume wearer amongst other things, at all times egregiously aware of his superiority. It is this stark contrast that gives the novel its texture and depth. At times touching and hilarious, at others absolutely infuriating and nonsensical; it examines the nature of self, the value of aspirations, and ultimately the fallibility of humanity. Some leave no lasting impact, in one eye and out the other. But even now, years after reading it, A Confederacy of Dunces reverberates in my mind. It is a slovenly, complicated and enigmatic friend whose BO feels warm, embracing and enriching.

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Gettin’ brassy The melody that underlies medicine is pervasive but rarely appreciated. Bar those comic articles on why it’s inappropriate to sing “Stayin’ alive” while in ICU, the analogies able to be drawn between music and health are under acknowledged, and it’s the opinion of this reporter that this should be rectified. To start with, one can imagine the musical themes to different parts of the hospital. The blitzkrieg of a surgical ward round punctuated by Wagner’s “Ride of the Valkyries”. A moonlight sonata in radiology. The staccato of “Hall of the Mountain King” in a medical round (with interplaying MET calls). The kumbaya of psychiatry. Those interplaying overtures also reflect the relationships between the teams.

While the radiological adagio may fit in with either the medical or surgical themes, if one was to overlay Wagner with Grieg chaos would result. This may be why there is such dissonance between med and surg teams about the management of a patient. Indeed, within each team the parts are arranged much like a symphony. The steady pulse of a cardiac monitor plays metronome to the piece, as the nurses sing their alto and the medicos come in and have their tenor moments (apart from the resident gunner and their ill-placed soprano). While none of this influences the management of your patients, be sure to think for a while about the part you play in this orchestra, and how it relates to overarching melody.

Hear the music, it will help you and your patients. Stephen Kunz (Deakin) has recently had his ears dewaxed, clearly.

HOW A CHANGE IN SYSTEM COULD STOP YOU FROM RIDING THE RED TRAIN TO FINANCIAL With a title nearly as long HELL as the article itself, Sam Whitehouse (VPE) I have held a number of jobs throughout my time in medical school. I am not averse to supporting myself through part-time employment – indeed why should anyone get a free ride in our society? I can honestly say I have enjoyed most of my jobs and am glad to have developed skills and knowledge in areas outside of medicine. Nevertheless, as an undergraduate student who chose not to pursue a gap year, I never managed to achieve the Youth Allowance independence criteria - earning 75% of full-time award wage in an 18 month period - while studying with 30-40 hours university/hospital contact a week (not to mention independent study, and a life filled with hobbies etc). I’ve heard the same story from many other students. 070 Panacea Vol 44 No 2

There is a significant flaw in the existing system. The independence criteria apply to any student enrolled in ‘full-time study’. It fails to acknowledge that there’s ‘full-time study’ and then there’s ‘full-time study’. For example, let’s pick at random our friends doing arts degrees. They may well be enrolled in full-time study, but might only have some ten hours contact per week, leaving them with ample time to work their way to the end of the Youth Allowance rainbow. I don’t begrudge them this, but feel that for the system to be fair there should be recognition of the commitments of the student’s course including course contact hours, length of the course and the course’s HECS tier. Many students in long ‘band 3’ degrees with heavy contact hours

gives his viewpoint on YouthAllowance.

struggle financially through their course and deserve access to Youth Allowance according to a modified scheme. Given the intensity and time constraints of their courses these students should not have to earn such huge amounts in order to achieve ‘independence’ and hence attract government financial support. It’s important to realise that medical students are not alone – other courses with demanding band 3 structures include law, dentistry and vet science and these students similarly deserve a fairer system.

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millenium development goals

Global health, sustainability and doctors: a teaser 7KH ZRUOG·V ÀUVW PDMRU FRQIHUHQFH RQ WKH JOREDO HQYLURQPHQW ZDV KHOG LQ 6WRFNKROP LQ $W WKDW WLPH IHZ GRFWRUV VHHPHG DZDUH RU FRQFHUQHG DERXW WKH JOREDO HQYLURQPHQWDO GLPHQVLRQ WR LQHTXDOLW\ > @ WKRXJK WKH PHGLFDO SURIHVVLRQ KDG E\ WKHQ D ORQJ KLVWRU\ RI ZRUNLQJ WR SURPRWH KHDOWK LQ ORZ LQFRPH VHWWLQJV > @ H[HPSOLÀHG E\ $OEHUW 6FKZHLW]HU ZKR GLYLGHG KLV WLPH EHWZHHQ (XURSH DQG WKH KRVSLWDO KH KDG HVWDEOLVKHG LQ )UHQFK (TXDWRULDO $IULFD

Ŷ ϮϬϬϵ͕ ĂƐ ƚŚĞ ǁŽƌůĚ ĂŶƟĐŝƉĂƚĞĚ ƚŚĞ ďŝŐŐĞƐƚ ĐůŝŵĂƚĞ ĐŚĂŶŐĞ ƐƵŵŵŝƚ ƐŝŶĐĞ <ǇŽƚŽ ŝŶ ϭϵϵϳ͕ ƚŚĞ ŝƐƐƵĞ ŽĨ ĐůŝŵĂƚĞ ĐŚĂŶŐĞ ĂƉƉĞĂƌĞĚ ƚŽ ĂůŵŽƐƚ ŚĞĂĚ ƚŚĞ ŝŶƚĞƌŶĂƟŽŶĂů ĂŐĞŶĚĂ͘ dŚĞ ŚĞĂůƚŚ ůŝƚĞƌĂƚƵƌĞ ĂůƐŽ ƉƵďůŝƐŚĞĚ ŵĂŶǇ ƉĂƉĞƌƐ ŽŶ ƚŚŝƐ ŝƐƐƵĞ ΀ϯͲϱ΁͘ zĞƚ͕ ƐŝŶĐĞ ƚŚĞŶ͕ ĚĞǀĞůŽƉĞĚ ŶĂƟŽŶƐ ŝŶĐůƵĚŝŶŐ &ƌĂŶĐĞ͕ ƚŚĞ h͘^͘ ĂŶĚ ƵƐƚƌĂůŝĂ ŚĂǀĞ ƌĞƚƌĞĂƚĞĚ ĨƌŽŵ ƚŚĞ ƌŚĞƚŽƌŝĐ ǁŚŝĐŚ ďƌŝĞŇǇ ƌĂŝƐĞĚ ŚŽƉĞƐ ŽĨ ůĞĂĚĞƌƐŚŝƉ ĨƌŽŵ ƚŚĞ ƌŝĐŚ ǁŽƌůĚ͘ dŚŝƐ ŝƐ ŶŽƚ ďĞĐĂƵƐĞ ŽĨ ĂŶǇ ǁĞĂŬĞŶŝŶŐ ŝŶ ƚŚĞ ĞǀŝĚĞŶĐĞ Žƌ ƐĐŝĞŶƟĮĐ ĐŽŶƐĞŶƐƵƐ͕ ďƵƚ Ă ƉŽƐƐŝďůǇ ĨĂƚĂů ǁĞĂŬĞŶŝŶŐ ŝŶ ƚŚĞ ƉŽůŝƟĐĂů ƐƵƉƉŽƌƚ͘ dŚĞ ĐƵƌƌĞŶƚ ǇĞĂƌ ŚĂƐ ďĞĞŶ ƚŚĞ ŚŽƩĞƐƚ ŽŶ ƌĞĐŽƌĚ͕ ĂŶĚ ƚŚĞ ĚƌŽƵŐŚƚ ŝŶ ZƵƐƐŝĂ ĂŶĚ ƚŚĞ hŬƌĂŝŶĞ ;ĚƵƌŝŶŐ :ƵůǇ ƚŽ ƵŐƵƐƚ ϮϬϭϬͿ ŚĂƐ ƚƌŝŐŐĞƌĞĚ ƚŚĞ ƐŚĂƌƉĞƐƚ ƌŝƐĞ ŝŶ ŐƌĂŝŶ ƉƌŝĐĞƐ ƐĞĞŶ ŝŶ ϯϬ ǇĞĂƌƐ ΀ϲ΁͘ ^ƉĞĐƵůĂƟŽŶ ŝƐ ƵŶĚŽƵďƚĞĚůǇ Ă ŵĂũŽƌ ĐĂƵƐĞ

ŽĨ ƚŚŝƐ ƌŝƐĞ͕ ďƵƚ ƚŚĞ ŵĂƌŬĞƚ ŝƐ ůŝŬĞůǇ ƐĞŶƐŝŶŐ ĂŶĚ ƌĞŇĞĐƟŶŐ ŝŶĐƌĞĂƐŝŶŐ ŐůŽďĂů ĐŽŶĐĞƌŶ ĂŶĚ ǀŽůĂƟůŝƚǇ͘ dŚŝƐ ŚĞĂƚ ǁĂǀĞ ŝƐ ĐŽŶƐŝƐƚĞŶƚ ǁŝƚŚ ĐůŝŵĂƚĞ ĐŚĂŶŐĞ͘

Health effects of climate change: primary, secondary and tertiary

ŚĞ ůŝƐƚ ŽĨ ŚĞĂůƚŚ ĐŽŶĚŝƟŽŶƐ ĂƐƐŽĐŝĂƚĞĚ ǁŝƚŚ ĐůŝŵĂƚĞ ĐŚĂŶŐĞ ĐĂŶ ƐĞĞŵ ďĞǁŝůĚĞƌŝŶŐ͖ ĨƌŽŵ ƚŚĞ ĨĂŝƌůǇ ŽďǀŝŽƵƐ ƚŽ ƚŚĞ ŽďƐĐƵƌĞ͕ ƐƵĐŚ ĂƐ ŐĂƐƚƌŽĞŶƚĞƌŝƟƐ ĐĂƵƐĞĚ ďǇ sŝďƌŝŽ WĂƌĂŚĂĞŵŽůǇƟĐƵƐ ΀ϳ΁͘ KŶĞ ǁĂǇ ƚŽ ĐĂƚĞŐŽƌŝƐĞ ƚŚĞƐĞ ĚŝǀĞƌƐĞ ŵĂŶŝĨĞƐƚĂƟŽŶƐ ŝƐ ďǇ ŐƌŽƵƉŝŶŐ ƚŚĞ ŵŽƐƚ ŽďǀŝŽƵƐ ĞīĞĐƚƐ ĂƐ ͚ƉƌŝŵĂƌǇ͛ ĂŶĚ ůĞƐƐ ŽďǀŝŽƵƐ ĞīĞĐƚƐ ĂƐ ͚ƐĞĐŽŶĚĂƌǇ͛͘ WƌŝŵĂƌǇ ĞīĞĐƚƐ ŝŶĐůƵĚĞ ŚĞĂƚ ǁĂǀĞƐ͕ ŚĞĂƚ ƐƚƌĞƐƐ͕ ĂŶĚ ƚŚĞ ƉŚǇƐŝĐĂů ŝŵƉĂĐƚƐ ĨƌŽŵ ĞǆƚƌĞŵĞ ǁĞĂƚŚĞƌ ĞīĞĐƚƐ ƐƵĐŚ ĂƐ ƐƚŽƌŵƐ ĂŶĚ ĮƌĞƐ͘ dŚĞ ůĂƩĞƌ ŐƌŽƵƉ ŝŶĐůƵĚĞƐ ĞĐŽůŽŐŝĐĂůůǇ ŵĞĚŝĂƚĞĚ ǀĞĐƚŽƌ ďŽƌŶĞ ĚŝƐĞĂƐĞƐ͕ ƐƵĐŚ ĂƐ ŵĂůĂƌŝĂ͕ ĂŶĚ ŽƚŚĞƌ ĐŽŵŵƵŶŝĐĂďůĞ ĚŝƐĞĂƐĞƐ ǁŚŽƐĞ ĞƉŝĚĞŵŝŽůŽŐǇ ǁŝůů ďĞ ĂůƚĞƌĞĚ ďǇ ĐůŝŵĂƟĐ ĂŶĚ ĂƐƐŽĐŝĂƚĞĚ ĞĐŽůŽŐŝĐĂů ǀĂƌŝĂƟŽŶ͕ ĨƌŽŵ ƉůĂŐƵĞ ΀ϴ΁ ƚŽ ŚĂŶƚĂǀŝƌƵƐĞƐ ΀ϵ΁͘ DĂŶǇ ŵŽƌĞ ĚĞƚĂŝůƐ ŽĨ ƚŚĞƐĞ ĞīĞĐƚƐ ĂƌĞ ĂǀĂŝůĂďůĞ ĞůƐĞǁŚĞƌĞ ΀ϭϬ΁͘

ŚĞƌĞ ŝƐ ŽŶĞ ŵŽƌĞ ůĞǀĞů ŽĨ ĞīĞĐƚ ƚŚĂƚ ŵƵƐƚ ďĞ ĐŽŶƐŝĚĞƌĞĚ͕ ŚĞƌĞ ĐĂůůĞĚ ͚ƚĞƌƟĂƌǇ͛ ΀ϭϬ͕ ϭϭ΁͘ hůƟŵĂƚĞůǇ͕ ƚŚĞƐĞ ĞīĞĐƚƐ ƐŚŽƵůĚ ĐĂƵƐĞ ƚŚĞ ŐƌĞĂƚĞƐƚ ĂŶǆŝĞƚǇ͕ ƚŽ ƐŽĐŝĞƚǇ ĂŶĚ ƚŚĞƌĞĨŽƌĞ ƚŽ ŚĞĂůƚŚ͘ zĞƚ͕ ĂŵŽŶŐ ƚŚĞ ǀĂƐƚ ůŝƚĞƌĂƚƵƌĞ ĐŽŶĐĞƌŶŝŶŐ ĐůŝŵĂƚĞ ĐŚĂŶŐĞ ǀĞƌǇ ůŝƩůĞ

ĔđĎē ĆěĎĉ ĚęđĊė͙ N ǡ

ĚŝƐĐƵƐƐĞƐ ƚŚĞ ůŝŬĞůǇ ŝŵƉĂĐƚ ƵƉŽŶ ŐůŽďĂů ŚĞĂůƚŚ ĨƌŽŵ ƚŚĞ ďůĞĂŬ ƐŽĐŝĂů ĂŶĚ ƉŚǇƐŝĐĂů ĐŽŶĚŝƟŽŶƐ ƚŽ ǁŚŝĐŚ ŵƵĐŚ ŽĨ ƚŚĞ ǁŽƌůĚ ĂƉƉĞĂƌƐ ƚŽ ŶŽǁ ďĞ ŚĞĂĚŝŶŐ͘ /ƚ ƉĞƌŚĂƉƐ ƚĂŬĞƐ ĐŽƵƌĂŐĞ ƌĂƚŚĞƌ ƚŚĂŶ ŝŵĂŐŝŶĂƟŽŶ ƚŽ ĐŽŶƚĞŵƉůĂƚĞ Ă ŶƵĐůĞĂƌͲĂƌŵĞĚ ǁŽƌůĚ ŝŶ ǁŚŝĐŚ ƐĞĂ ůĞǀĞů ŚĂƐ ƌŝƐĞŶ ďǇ Ă ŵĞƚƌĞ͕ ĂŶĚ ǁŚĞƌĞ ƚŚĞ ŐƌĂŝŶ ǇŝĞůĚ ŝŶ ^ŽƵƚŚ ƐŝĂ ŚĂƐ ĚĞĐůŝŶĞĚ ďǇ ϭϴ ƚŽ ϮϮй ΀ϭϮ΁͕ ĞǀĞŶ ƚŚŽƵŐŚ ƐĞǀĞƌĂů ŚƵŶĚƌĞĚ ŵŝůůŝŽŶ ĂĚĚŝƟŽŶĂů ^ŽƵƚŚ ƐŝĂŶƐ ĂƌĞ ƚŚĞŶ ƉƌĞĚŝĐƚĞĚ ƚŽ ďĞ ĂůŝǀĞ͘ zĞƚ ƐƵĐŚ ĐŽŶĚŝƟŽŶƐ͕ ŝŶƚĞƌǁŽǀĞŶ ǁŝƚŚ ŵĂŶǇ ŽƚŚĞƌ ĚŝĸĐƵůƟĞƐ͕ ĂƌĞ ůŝŬĞůǇ ƚŽ ŽĐĐƵƌ ǁŝƚŚŝŶ ϳϬ ǇĞĂƌƐ͘

The Future

ĞǇŽŶĚ ƚŚĞ ŚĞĂůƚŚ ůŝƚĞƌĂƚƵƌĞ͕ ĨƌĂŶŬ ĚŝƐĐƵƐƐŝŽŶ ŽĨ ƚŚĞ ůŝŬĞůǇ ĐŽŶĚŝƟŽŶƐ ŝŶ ǁŚŝĐŚ ŚƵŵĂŶŝƚǇ ǁŝůů ůŝǀĞ ŝŶ ϮϭϬϬ ŝƐ ĂůƐŽ ƌĂƌĞ͕ ĂŶĚ ǁŚĞƌĞ ŝƚ ĞǆŝƐƚƐ͕ ŝƚ ŝƐ ŐĞŶĞƌĂůůǇ ďŝĂƐĞĚ ƚŽǁĂƌĚƐ ƚŚĞ ŽƉƟŵŝƐƟĐ ΀ϭϯ΁͘ KĸĐŝĂů ƐŽĐŝŽͲĞĐŽŶŽŵŝĐ ĨŽƌĞĐĂƐƚƐ ĂŶĚ ƐĐĞŶĂƌŝŽƐ ĂƌĞ ĞǆĐĞƐƐŝǀĞůǇ ŚŽƉĞĨƵů͕ ƉĞƌŚĂƉƐ ďĞĐĂƵƐĞ ŚƵŵĂŶƐ ĐĂŶŶŽƚ ďĞĂƌ ƚŽŽ ŵƵĐŚ ƉĂŝŶ͕ Žƌ ƉĞƌŚĂƉƐ ďĞĐĂƵƐĞ ĂƵƚŚŽƌŝƟĞƐ ĂƌĞ ĐŽŶĐĞƌŶĞĚ ƚŚĂƚ ďůĞĂŬ ĨŽƌĞĐĂƐƚƐ ǁŝůů ďĞĐŽŵĞ ƐĞůĨͲ ĨƵůĮůůŝŶŐ͘ ,ŽǁĞǀĞƌ͕ ŝŶ ĂĚĚŝƟŽŶ͕ Ă ŐŽŽĚ ĚĞĂů ŽĨ ǁŽŽůůǇ ƚŚŝŶŬŝŶŐ͕ ͚ŐƌŽƵƉ ƚŚŝŶŬ͛ ĂŶĚ ĨƌĂŶŬ ĚĞŶŝĂů ŝƐ ŽĐĐƵƌƌŝŶŐ͕ ĞǀŝĚĞŶĐĞĚ͕ ĨŽƌ ĞǆĂŵƉůĞ͕ ďǇ ƚŚĞ ǁĂǇ ƚŚĞ ŐůŽďĂů ĮŶĂŶĐŝĂů ĐƌŝƐŝƐ ĐĂƵŐŚƚ ŐŽǀĞƌŶŵĞŶƚƐ ĂŶĚ ƚŚĞŝƌ ĞůŝƚĞ ĞĐŽŶŽŵŝĐ ĂĚǀŝƐĞƌƐ ďǇ ƐƵƌƉƌŝƐĞ͘ dŚŝƐ ĚŝƐĐŽŶŶĞĐƚ ďĞƚǁĞĞŶ ƉƌĞĚŝĐƟŽŶ ĂŶĚ ƌĞĂůŝƚǇ ůŝŬĞůǇ ĞǆƚĞŶĚƐ ƚŽ ƚŚĞ ƐŝǌĞ ŽĨ Žŝů ƐƵƉƉůŝĞƐ ΀ϭϰ΁͕ ĂŶĚ ƚŽ ŽƚŚĞƌ ĐƌŝƟĐĂů ůŝŵŝƚƐ ƚŽ ŐƌŽǁƚŚ ΀ϭϱ΁͘

continued on page 2....

Read the full version of this issue online at http://ghn.amsa.org.au/vector Panacea Vol 44 No 2 071

ĆĎĔē čĆęęĊėďĊĊ

[1] United Nations Development Programme. Achieve universal primary education (Success stories) [Internet]. 2007 [updated 2007 Nov 1; cited 2010 Aug 7]. Available from: http:// www.mdgmonitor.org/story.cfm?goal=2/ [2] UNICEF. Press release [Internet]. 2010 [updated 2010 May 17; cited 2010 Aug 7]. Available from: http://www.unicef. org/media/media_53659.html/

INCOMING EDITORIAL NOTE

EDITORIAL NOTE - OUTGOING TEAM

ėĚęčĎĐĆ ĆėĆĞĆēǡ ĎėĐĆĒ ĔĘčĎǡ đĊĝĆēĉĊė ĚėĕčĞǡ ĆĒĎ ĚćčĎ

ĞĚŝĐŝŶĞ ŝƐ ĂŶ Ăƌƚ ĂŶĚ Ă ƐĐŝĞŶĐĞ͖ ƚŚĞ ďĂůĂŶĐĞ ŽĨ ǁŚĂƚ ǁĞ ŬŶŽǁ ĞŵƉŝƌŝĐĂůůǇ͕ ĂŶĚ ǁŚĂƚ ǁĞ ŬŶŽǁ ŝŶƚƵŝƟǀĞůǇ͘ /ƚ ŝƐ ŚĞůƉĨƵů ƚŽ ƚŚŝŶŬ ĂďŽƵƚ ŐůŽďĂů ŚĞĂůƚŚ ŝŶ Ă ƐŝŵŝůĂƌ ǁĂǇ͘ tĞ ĞŶŐĂŐĞ ŝŶƚƵŝƟǀĞůǇ ǁŝƚŚ ƚŚĞ ŝŶũƵƐƟĐĞ ŽĨ ŽƵƌ ǁŽƌůĚ͗ ŝƚ ŝƐ ŶĂƚƵƌĂů ĨŽƌ ƵƐ ƚŽ ĚĞƚĞƐƚ ƚŚĞ ĨĂĐƚ ƚŚĂƚ ƚŚĞ ŐƌĞĂƚĞƐƚ ĚĞƚĞƌŵŝŶĂŶƚ ŽĨ Ă ĐŚŝůĚ͛Ɛ ĨƵƚƵƌĞ ĂŶĚ ǁĞůůďĞŝŶŐ ŝƐ ǁŚĞƌĞ ƚŚĞǇ ĂƌĞ ďŽƌŶ͘ dŚŝƐ ŝƐ Ă ŚƵŵĂŶ ĐŽŶŶĞĐƟŽŶ͘ Ƶƚ ƵŶĚĞƌƐƚĂŶĚŝŶŐ ƚŚĞ ƌĞĂƐŽŶƐ ďĞŚŝŶĚ ƚŚŝƐ ƐƚĂƚĞ ŽĨ ĂīĂŝƌƐ ƚŽ ƉůĂŶ ĂŶĚ ĞŶĂĐƚ ƐŽůƵƟŽŶƐ ƚŚĂƚ ǁŽƵůĚ ƐƚĞƉ ďǇ ƐƚĞƉ ŵĂŬĞ Ă ďĞƩĞƌ ĨƵƚƵƌĞ ƚŚĂŶ ƚŚĞ ƉƌĞƐĞŶƚ ƚĂŬĞƐ ĂŶ ĂƐƉĞĐƚ ŽĨ ƐĐŝĞŶĐĞ͘ /ƚ ŝƐ ƚŚƌŽƵŐŚ ƚŚĞ ƐǇƐƚĞŵĂƟĐ ƵŶŝƚǇ ŽĨ ŽƵƌ ĞŵŽƟŽŶĂů ƌĞƐƉŽŶƐĞ ƚŽ ƚŚĞ ƉůŝŐŚƚ ŽĨ ƚŚŽƐĞ ůĞƐƐ ĨŽƌƚƵŶĂƚĞ ƚŚĂŶ ƵƐ͕ ĂŶĚ ƚŚĞ ŵŽďŝůŝƐĂƟŽŶ ŽĨ ŽƵƌ ƐĐŝĞŶƟĮĐ ƚƌĂŝŶŝŶŐ ƚŚĂƚ ǁĞ ĐĂŶ ŵŽƐƚ ĞīĞĐƟǀĞůǇ ĨƵŶĐƟŽŶ ĂƐ ŐůŽďĂů ĚŽĐƚŽƌƐ ĂŶĚ ĂĚǀŽĐĂƚĞƐ ĨŽƌ ŚĞĂůƚŚ ĂŶĚ ũƵƐƟĐĞ͘ ǀĞƌ ƚŚĞ ůĂƐƚ ϭϮ ŵŽŶƚŚƐ ĚƵƌŝŶŐ ǁŚŝĐŚ ǁĞ ŚĂĚ ƚŚĞ ƉƌŝǀŝůĞŐĞ ŽĨ ĞĚŝƟŶŐ sƚĞĐƚŽƌ͕ ǁĞ ŚĂǀĞ ƐĞĞŶ ŽŶŐŽŝŶŐ ƉƌŽŐƌĞƐƐ͕ ĂŵŽŶŐƐƚ ƚŚĞ ŵĞĚŝĐĂů ĐŽŵŵƵŶŝƚǇ ĂŶĚ ƚŚĞ ƐƚƵĚĞŶƚ ĐŽŵŵƵŶŝƚǇ ĂůŝŬĞ͕ ŝŶ ĨŽƌŵĂůŝƐŝŶŐ ŐůŽďĂů ŚĞĂůƚŚ ĞŶŐĂŐĞŵĞŶƚ͘ 'ůŽďĂů ŚĞĂůƚŚ͕ ŽŶĐĞ ƌĞƐƚƌŝĐƚĞĚ ƚŽ ĂĐĐŽƵŶƚƐ ŽĨ ŝŶƐƉŝƌĂƟŽŶĂů͕ ǇĞƚ ƐŚŽƌƚͲůŝǀĞĚ ƐƚƵĚĞŶƚ ĞůĞĐƟǀĞƐ͕ ŶŽǁ ƚĂŬĞƐ Ă ŵŽƌĞ ƉƌŽŵŝŶĞŶƚ ƌŽůĞ ŝŶ ŵĞĚŝĐĂů ƐĐŚŽŽů͘ tĞ ŶŽǁ ŚĂǀĞ Ă ƐƚƵĚĞŶƚ ƌĞƉƌĞƐĞŶƚĂƟǀĞ ďŽĚǇ ĨŽƌ ŐůŽďĂů ŚĞĂůƚŚ͕ ƚŚĞ 'ůŽďĂů ,ĞĂůƚŚ EĞƚǁŽƌŬ͖ ĂŶ ĂŶŶƵĂů 'ůŽďĂů ,ĞĂůƚŚ ŽŶĨĞƌĞŶĐĞ͖ ĂŶĚ ŐůŽďĂů ŚĞĂůƚŚ ŐƌŽƵƉƐ Ăƚ Ăůů ŵĞĚŝĐĂů ƐĐŚŽŽůƐ͘ tĞ ŚĂǀĞ ƚŚŝƐ ƉƵďůŝĐĂƟŽŶ͕ ĚĞǀŽƚĞĚ ƐŽůĞůǇ ƚŽ ĂĚǀŽĐĂƚĞ ĨŽƌ ŐůŽďĂů ŚĞĂůƚŚ ŝƐƐƵĞƐ͕ ĂŶĚ ǁĞ ŚĂǀĞ ĂŶ ĞŶĐŽƵƌĂŐŝŶŐ ĚƌŝǀĞ ƚŽ ŝŶĐŽƌƉŽƌĂƚĞ ŐůŽďĂů ŚĞĂůƚŚ ǁŝƚŚŝŶ ƚŚĞ ŵĞĚŝĐĂů ĐƵƌƌŝĐƵůƵŵ͘ ZĞĐĞŶƚůǇ͕ Ă ŐƌŽƵƉ ŽĨ ǇŽƵŶŐ ĚĞǀŽƚĞĚ ĚŽĐƚŽƌƐ ŚĂǀĞ ĞǆƚĞŶĚĞĚ ƚŚĞƐĞ ŝŶŝƟĂƟǀĞƐ ƚŽ ƚŚĞ ũƵŶŝŽƌ ĚŽĐƚŽƌ ĐŝƌĐůĞƐ ƚŚƌŽƵŐŚ ƚŚĞ 'ůŽďĂů ,ĞĂůƚŚ 'ĂƚĞǁĂǇ͘ dŚĞ ƐƚĂƚĞ ŽĨ ƚŚĞ ǁŽƌůĚ͛Ɛ ŚĞĂůƚŚ ĐŽŶƟŶƵĞƐ ƚŽ ďĞ ƵŶĂĐĐĞƉƚĂďůǇ ƵŶũƵƐƚ͕ ďƵƚ ƐƟůů ŵƵĐŚ ŵŽƌĞ ĞƋƵŝƚĂďůĞ ƚŚĂŶ ϱϬ ǇĞĂƌƐ ĂŐŽ͘ /Ĩ ǁĞ ĨŽĐƵƐ ŽŶ ƚŚĞ ĞǆĐŝƟŶŐ ƉŽƚĞŶƟĂů ĨŽƌ ĐŚĂŶŐĞ͕ ǁĞ ǁŝůů ƚŚŝŶŬ ƚŚĞ ƐĂŵĞ ŝŶ ϱϬ ǇĞĂƌƐ͛ ƟŵĞ͘

2 VECTOR august 2010 072 Panacea Vol 44 No 2

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ƌƌĞƐƉĞĐƟǀĞ ŽĨ ƚŚĞ ƌĞĂƐŽŶƐ ĨŽƌ ƚŚŝƐ ŽƉƟŵŝƐŵ ΀ϭϯ΁ ƚŚĞ ŚĞĂůƚŚ ĐŽŶƐĞƋƵĞŶĐĞƐ ŽĨ ĨƵƚƵƌĞ ŐůŽďĂů ĐůŝŵĂƚĞ ĐŚĂŶŐĞ ĂƌĞ ůŝŬĞůǇ ƚŽ ďĞ ƐĞǀĞƌĞůǇ ƵŶĚĞƌĞƐƟŵĂƚĞĚ͕ ǁŝƚŚŽƵƚ ĐŽŶƐŝĚĞƌĂƟŽŶ ŽĨ ƚĞƌƟĂƌǇ ĞīĞĐƚƐ͘ ^ƵĐŚ ĞīĞĐƚƐ ĂƌĞ ůŝŬĞůǇ ƚŽ ĞǆĐĞĞĚ ƚŚĞ ŽƚŚĞƌ ŝŵƉĂĐƚƐ͕ ĞǀĞŶ ŝĨ ĐŽŵďŝŶĞĚ͕ ƉĞƌŚĂƉƐ ďǇ ŽŶĞ Žƌ ĞǀĞŶ ƚǁŽ ŽƌĚĞƌƐ ŽĨ ŵĂŐŶŝƚƵĚĞ͘ ƉƉƌĞŚĞŶƐŝŽŶ ŽĨ ƚŚĞƐĞ ƚĞƌƟĂƌǇ ĞīĞĐƚƐ͕ ƚŚŽƵŐŚ ƉŽŽƌůǇ ĂƌƟĐƵůĂƚĞĚ͕ ĂƉƉĞĂƌƐ ƚŽ ďĞ Ă ƌĂƟŽŶĂů ĞǆƉůĂŶĂƟŽŶ ŶŽƚ ŽŶůǇ ĨŽƌ ŵĂŶǇ ĐŽŶĐĞƌŶƐ ĞǆƉƌĞƐƐĞĚ ďǇ ǇŽƵƚŚ ĂďŽƵƚ ƚŚĞ ĨƵƚƵƌĞ ΀ϭϲ΁͕ ďƵƚ ĂůƐŽ ĨŽƌ ƚŚĞ ůĞǀĞů ŽĨ ĐŽŶĐĞƌŶ ĂďŽƵƚ ĐůŝŵĂƚĞ ĐŚĂŶŐĞ ŝŶ ďŽƚŚ ƚŚĞ ŚĞĂůƚŚ ĂŶĚ ǁŝĚĞƌ ůŝƚĞƌĂƚƵƌĞ͘

Linking the global climate and global health inequality crises

ŚĂƚ ŚƵŵĂŶŝƚǇ ĂƉƉĞĂƌƐ ƚŽ ďĞ ŶĞĂƌŝŶŐ ĂŶ ĂďǇƐƐ ŵŝŐŚƚ ƐƵƌƉƌŝƐĞ ƐŽŵĞ ƌĞĂĚĞƌƐ͘ ,ŽǁĞǀĞƌ͕ ĂŶŽƚŚĞƌ ŝŵŵĞŶƐĞ ƉƌŽďůĞŵ ŚĂƐ ĐŽͲĞǆŝƐƚĞĚ ǁŝƚŚ ŽƵƌ ŝŶĐƌĞĂƐŝŶŐ ƉƌŽƐƉĞƌŝƚǇ͕ ƐŝŶĐĞ Ăƚ ůĞĂƐƚ tŽƌůĚ tĂƌ // ΀ϭϳ΁͘ dŚŝƐ ŝƐ ƚŚĞ ƉƌŽďůĞŵ ŽĨ ĂƉƉĂƌĞŶƚůǇ ŝŶƚƌĂĐƚĂďůĞ dŚŝƌĚ tŽƌůĚ ƉŽǀĞƌƚǇ͕ ĂŶĚ ŽĨ ƚŚĞ ƌĞƐƵůƚĂŶƚ ŚĞĂůƚŚ ŐĂƉ ďĞƚǁĞĞŶ ƉƌŝǀŝůĞŐĞĚ ĂŶĚ ƉŽŽƌ ƉŽƉƵůĂƟŽŶƐ͘ /Ŷ ĨĂĐƚ͕ ƚŚĞ ƉĂƌĂůůĞů ƉƌŽďůĞŵƐ ŽĨ ŐůŽďĂů ŚĞĂůƚŚ ŝŶĞƋƵĂůŝƚǇ ĂŶĚ ŽĨ ŽƵƌ ƚƌĂũĞĐƚŽƌǇ ƚŽǁĂƌĚƐ ĚĂŶŐĞƌŽƵƐ ĐůŝŵĂƚĞ ĐŚĂŶŐĞ ĐĂŶ ĞĂĐŚ ďĞ ĐŽŶƐŝĚĞƌĞĚ ĂƐ ŵĂŶŝĨĞƐƚĂƟŽŶƐ ŽĨ ĂŶ ŝŶƚĞůůŝŐĞŶƚ ƐƉĞĐŝĞƐ͕ Ă ĐůŽƚŚĞƐͲǁĞĂƌŝŶŐ ƉƌŝŵĂƚĞ͕ ǁŚŽ ŝƐ ŶŽƚ ƋƵŝƚĞ ĂƐ ƐŵĂƌƚ ĂƐ ƐͬŚĞ ƚŚŝŶŬƐ͘ ,ŝƐƚŽƌǇ ŝƐ ƌĞƉůĞƚĞ ǁŝƚŚ ĐŝǀŝůŝƐĂƟŽŶƐ ƚŚĂƚ ŚĂǀĞ ĐŽůůĂƉƐĞĚ ΀ϭϴ͕ ϭϵ΁͘ ǀĞŶ ďĞĨŽƌĞ ŚƵŵĂŶƐ ŚĂĚ ĚĞǀĞůŽƉĞĚ ĐŝƟĞƐ ǀŝŽůĞŶƚ ĐŽŶŇŝĐƚ ĂŵŽŶŐ ŚƵŵĂŶƐ ŚĂƐ ďĞĞŶ ĚŽĐƵŵĞŶƚĞĚ͕ ĨƌŽŵ ƚŚĞ ĞŶĚ ŽĨ ƚŚĞ WůĞŝƐƚŽĐĞŶĞ ΀ϮϬ΁͘

ǇŽƵŶŐ ĐŚŝůĚ ŝŶ ƚŚŝŽƉŝĂ ĂƐƉŝƌĞƐ ƚŽ ďĞĐŽŵĞ Ă ĚŽĐƚŽƌ͕ ĞŶŐŝŶĞĞƌ͕ Žƌ ƚĞĂĐŚĞƌ ŽŶĞ ĚĂǇ͘ ^ŚĞ ĚƌĞĂŵƐ ŽĨ ĞĂƌŶŝŶŐ ĂŶ ŝŶĐŽŵĞ͕ ŽǁŶŝŶŐ Ă ŚŽƵƐĞ ĂŶĚ ƉƌŽǀŝĚŝŶŐ ŚĞƌ ĐŚŝůĚƌĞŶ ǁŝƚŚ Ă ůŝĨĞ ƐŚĞ ĐŽƵůĚ ŶĞǀĞƌ ŚĂǀĞ͘ Ƶƚ ƚŚŝƐ ƐĞĞŵƐ ůŝŬĞ Ă ĨƵƟůĞ ĚƌĞĂŵ͘ ,Ğƌ ĨĂŵŝůǇ ŝƐ ƵŶĂďůĞ ƚŽ ƉƌŽǀŝĚĞ ŚĞƌ ǁŝƚŚ ĂŶ ĞĚƵĐĂƟŽŶ͕ ĂƐ ƐĐŚŽŽů ĨĞĞƐ ĐŽŶƐƵŵĞ ŵŽƌĞ ƚŚĂŶ ŽŶĞ ƋƵĂƌƚĞƌ ŽĨ ŚĞƌ ĨĂŵŝůǇ͛Ɛ ŝŶĐŽŵĞ͘ ĞƐƉŝƚĞ ŚĞƌ ƉĂƌĞŶƚƐ͛ ǁŚŽůĞͲŚĞĂƌƚĞĚ ĞīŽƌƚƐ ƚŽ ƐĞŶĚ ŚĞƌ ƚŽ ƐĐŚŽŽů͕ ƚŚĞ ƌĞĂůŝƚǇ ŽĨ ƚŚĞŝƌ ƐŝƚƵĂƟŽŶ ŵĞĂŶƐ ƚŚĂƚ ƐŚĞ ǁŝůů ďĞ ĞŶƚƌĞŶĐŚĞĚ ŝŶ ƚŚĞ ƉĞƌƉĞƚƵĂů ĐǇĐůĞ ƚŚĂƚ ŚĂƐ ĞŶĐŽŵƉĂƐƐĞĚ ŚĞƌ ĨĂŵŝůǇ͖ Ă ŶŽŵĂĚŝĐ ůŝĨĞ ƵŶĚĞƌƉŝŶŶĞĚ ďǇ ƚŚĞ ĚĂŝůǇ ƐƚƌƵŐŐůĞ ƚŽ ƐƵƌǀŝǀĞ͘

ĚƵĐĂƟŽŶ ŝŶ ^ƵďͲ^ĂŚĂƌĂŶ ĨƌŝĐĂ ŚĂƐ ƉƌĞǀĂŝůĞĚ ĂƐ Ă ƌĂǇ ŽĨ ŚŽƉĞ͕ ŝŶ ƚŚĞ ŵŝĚƐƚ ŽĨ ƉƌŽůŝĨĞƌĂƟŶŐ ƉŽůŝƟĐĂů ǁĂƌĨĂƌĞ͕ ĂŶĚ ƚŚĞ ƚƌƵĐƵůĞŶĐĞ ŽĨ ĚŝƐĞĂƐĞ ĂŶĚ ŝŶĞƋƵĂůŝƚǇ͘ dŚĞ ϮŶĚ DŝůůĞŶŶŝƵŵ ĞǀĞůŽƉŵĞŶƚ 'ŽĂů Ͳ ƚŽ ĞŶƐƵƌĞ ƚŚĂƚ͕ ďǇ ϮϬϭϱ͕ ĐŚŝůĚƌĞŶ ĞǀĞƌǇǁŚĞƌĞ͕ ďŽǇƐ ĂŶĚ ŐŝƌůƐ ĂůŝŬĞ͕ ǁŝůů ďĞ ĂďůĞ ƚŽ ĐŽŵƉůĞƚĞ Ă ĨƵůů ĐŽƵƌƐĞ ŽĨ ƉƌŝŵĂƌǇ ƐĐŚŽŽůŝŶŐ Ͳ ŚĂƐ ďĞĞŶ Ă ŬĞǇ ĨŽĐƵƐ ŝŶ ƚŚĞ ĐŽƵŶƚƌŝĞƐ ŽĨ ^ƵďͲ^ĂŚĂƌĂŶ ĨƌŝĐĂ ĂŶĚ ^ŽƵƚŚĞƌŶ ƐŝĂ͘ ĚƵĐĂƟŽŶ ŚĂƐ ďĞĞŶ ŝĚĞŶƟĮĞĚ ďǇ ĞǆƉĞƌƚƐ ĂƐ ƚŚĞ ŵŽƐƚ ƐƵƐƚĂŝŶĂďůĞ ĂŶĚ ĞǆƉĞĚŝƟŽƵƐ ŵĞĂŶƐ ŽĨ ĞĐŽŶŽŵŝĐ ĂŶĚ ƐŽĐŝĂů ĚĞǀĞůŽƉŵĞŶƚ ĂŶĚ ƚŽ ĂůůĞǀŝĂƚĞ ƉŽǀĞƌƚǇ͘ tŝƚŚ ĞĚƵĐĂƟŽŶ͕ ĞŵƉůŽǇŵĞŶƚ ŽƉƉŽƌƚƵŶŝƟĞƐ ĂƌĞ ďƌŽĂĚĞŶĞĚ͕ ŝŶĐŽŵĞ ůĞǀĞůƐ ĂƌĞ ŝŶĐƌĞĂƐĞĚ ĂŶĚ ŵĂƚĞƌŶĂů ĂŶĚ ĐŚŝůĚ ŚĞĂůƚŚ ŝƐ ŝŵƉƌŽǀĞĚ͘

ŽƵŶƚƌŝĞƐ ƐƵĐŚ ĂƐ ƵƌƵŶĚŝ͕ ƚŚĞ ĞŵŽĐƌĂƟĐ ZĞƉƵďůŝĐ ŽĨ ƚŚĞ ŽŶŐŽ͕ ƚŚŝŽƉŝĂ͕ 'ŚĂŶĂ͕ <ĞŶǇĂ͕ DĂůĂǁŝ͕ DŽǌĂŵďŝƋƵĞ͕ dĂŶǌĂŶŝĂ ĂŶĚ hŐĂŶĚĂ ŚĂǀĞ ĂďŽůŝƐŚĞĚ ƐĐŚŽŽů ĨĞĞƐ͕ ǁŚŝĐŚ ŚĂƐ ůĞĚ ƚŽ Ă ƐƵƌŐĞ ŝŶ ĞŶƌŽůŵĞŶƚ͗ ŝŶ 'ŚĂŶĂ͕

ĨŽƌ ĞǆĂŵƉůĞ͕ ƉƵďůŝĐ ƐĐŚŽŽů ĞŶƌŽůŵĞŶƚ ŝŶ ƚŚĞ ŵŽƐƚ ĚĞƉƌŝǀĞĚ ĚŝƐƚƌŝĐƚƐ ĂŶĚ ŶĂƟŽŶǁŝĚĞ ƐŽĂƌĞĚ ĨƌŽŵ ϰ͘Ϯ ŵŝůůŝŽŶ ƚŽ ϱ͘ϰ ŵŝůůŝŽŶ ďĞƚǁĞĞŶ ϮϬϬϰ ĂŶĚ ϮϬϬϱ ΀ϭ΁͘ /Ŷ <ĞŶǇĂ͕ ĞŶƌŽůŵĞŶƚ ŽĨ ƉƌŝŵĂƌǇ ƐĐŚŽŽů ĐŚŝůĚƌĞŶ ŝŶĐƌĞĂƐĞĚ ĚƌĂŵĂƟĐĂůůǇ ǁŝƚŚ ϭ͘Ϯ ŵŝůůŝŽŶ ĞǆƚƌĂ ĐŚŝůĚƌĞŶ ŝŶ ƐĐŚŽŽů ŝŶ ϮϬϬϯ ĂůŽŶĞ͖ ďǇ ϮϬϬϰ͕ ƚŚĞ ŶƵŵďĞƌ ŚĂĚ ĐůŝŵďĞĚ ƚŽ ϳ͘Ϯ ŵŝůůŝŽŶ͕ ŽĨ ǁŚŝĐŚ ϴϰ ƉĞƌĐĞŶƚ ǁĞƌĞ ŽĨ ƉƌŝŵĂƌǇ ƐĐŚŽŽů ĂŐĞ ΀ϭ΁͘ ĞƐƉŝƚĞ ƚŚŝƐ͕ ƚŚĞ ϮŶĚ ŐŽĂů ŝƐ ŶŽƚ ŽŶ ĐŽƵƌƐĞ ƚŽ ƌĞĂĐŚ ŝƚƐ ƚĂƌŐĞƚ ŽĨ ƵŶŝǀĞƌƐĂů ƉƌŝŵĂƌǇ ĞĚƵĐĂƟŽŶ ďǇ ϮϬϭϱ͘ ƵƌƌĞŶƚůǇ͕ ϱϲ ŵŝůůŝŽŶ ĐŚŝůĚƌĞŶ ĐŽƵůĚ ƐƟůů ďĞ ŽƵƚ ŽĨ ƐĐŚŽŽů ŝŶ ϮϬϭϱ ĂŶĚ ŐŝƌůƐ ǁŝůů ƐƟůů ůĂŐ ďĞŚŝŶĚ ďŽǇƐ ŝŶ ƐĐŚŽŽů ĞŶƌŽůŵĞŶƚ ĂŶĚ ĂƩĞŶĚĂŶĐĞ ΀Ϯ΁͘ ŝƚŚ ƚŚĞ ϲϯƌĚ hE W/ͬE'K ĐŽŶĨĞƌĞŶĐĞ ďĞŝŶŐ ŚĞůĚ ŝŶ DĞůďŽƵƌŶĞ ůĂƚĞƌ ƚŚŝƐ ǇĞĂƌ͕ ƚŚĞ ƵƉĐŽŵŝŶŐ ŝƐƐƵĞ ŽĨ sĞĐƚŽƌ ǁŝůů ĚĞůǀĞ ŝŶƚŽ ƚŚĞ ƉƌŽŐƌĞƐƐ ŽĨ ƚŚĞ DŝůůĞŶŶŝƵŵ ĞǀĞůŽƉŵĞŶƚ 'ŽĂůƐ ;D 'ƐͿ͕ Ă ƌĞƐŽůƵƟŽŶ ƐĞƫŶŐ Ă ŚĂƌĚ ƚĂƌŐĞƚ ŽĨ ϮϬϭϱ ƚŽ ĂĐŚŝĞǀĞ Ă ƌĂŶŐĞ ŽĨ ƐƉĞĐŝĮĐ ƋƵĂůŝƚǇͲŽĨͲůŝĨĞ ďĞŶĐŚŵĂƌŬƐ ĂŐƌĞĞĚ ƚŽ ďǇ ϭϵϮ ĐŽƵŶƚƌŝĞƐ ĂŶĚ Ϯϯ ŝŶƚĞƌŶĂƟŽŶĂů ŽƌŐĂŶŝǌĂƟŽŶƐ͘ tŝƚŚ Ă ŶĞǁ ƚĞĂŵ ŐƵŝĚŝŶŐ sĞĐƚŽƌ͕ ǁĞ ǁŝůů ĐŽŶƟŶƵĞ ƚŽ ŚŝŐŚůŝŐŚƚ ƚŚĞ ĨƵůů ƐƉĞĐƚƌƵŵ ŽĨ ŐůŽďĂů ŚĞĂůƚŚ ŝƐƐƵĞƐ͘ tĞ ĂƌĞ ĂůƐŽ ŝŶƚƌŽĚƵĐŝŶŐ ĚĞĚŝĐĂƚĞĚ ƐĞĐƟŽŶƐ ƚŽ ĚĞůŝŶĞĂƚĞ ƐƚƵĚĞŶƚ ĞůĞĐƟǀĞ ĞǆƉĞƌŝĞŶĐĞƐ ĂŶĚ ƉƌŽǀŝĚĞ Ă ŐƵŝĚĞ ĨŽƌ ŐůŽďĂů ŚĞĂůƚŚ ŽƉƉŽƌƚƵŶŝƟĞƐ͘ tĞ ĐĂŶ Ăůů ƉůĂǇ ŽƵƌ ƉĂƌƚ ƚŽ ĂŵĞůŝŽƌĂƚĞ ŽƵƌ ŐůŽďĂůŝƐĞĚ ǁŽƌůĚ͕ ǁŚĞƚŚĞƌ ŝƚ ŝƐ ƚŚƌŽƵŐŚ ŐƌĂƐƐ ƌŽŽƚƐ ĂĐƟŽŶ͕ ƐƵƉƉŽƌƟŶŐ ŶŽŶͲ ŐŽǀĞƌŶŵĞŶƚĂů ŽƌŐĂŶŝƐĂƟŽŶƐ ƚŚŽƵŐŚ ĂĐƟǀŝƐŵ ĂŶĚ ƉĂƌƟĐŝƉĂƟŽŶ͕ Žƌ ŝŶŇƵĞŶĐŝŶŐ ŚĞĂůƚŚ ĐĂƌĞ ŝŶ ĚĞǀĞůŽƉŝŶŐ ŶĂƟŽŶƐ ǀŝĂ ƌĞƐĞĂƌĐŚ ĂŶĚ ƐƚƵĚĞŶƚ ƉůĂĐĞŵĞŶƚƐ͘ DĞĚŝĐĂů ƐƚƵĚĞŶƚƐ ŵƵƐƚ ƐŚŽǁ ůĞĂĚĞƌƐŚŝƉ ǁŚĞŶ ŝƚ ĐŽŵĞƐ ƚŽ ŝƐƐƵĞƐ ƐƵĐŚ ĂƐ ƵŶŝǀĞƌƐĂů ƉƌŝŵĂƌǇ ĞĚƵĐĂƟŽŶ͕ ĂƐ ĨĂĐƚŽƌƐ ůŝŬĞ ƚŚĞƐĞ ǁŝůů ŐƌĞĂƚůǇ ŝŶŇƵĞŶĐĞ ƚŚĞ ůĞǀĞů ŽĨ ďƵƌĚĞŶ ŽĨ ĚŝƐĞĂƐĞ ĂŶĚ ŽƚŚĞƌ ŚĞĂůƚŚ ƉƌĞĚŝĐĂŵĞŶƚƐ ŝŶ ƚŚĞ ĨƵƚƵƌĞ͘

ǁǁǁ͘ŐŚŶ͘ĂŵƐĂ͘ŽƌŐ͘ĂƵ

ůƚŚŽƵŐŚ ƚŚĞƌĞ ŝƚ ŝƐ ůĞŐŝƟŵĂƚĞ ƚŽ ďĞ ƚƌŽƵďůĞĚ ďǇ ƚŚĞ ĨƵƚƵƌĞ͕ ŚŽƉĞ ƐŚŽƵůĚ ŶŽƚ ďĞ ůŽƐƚ͘ ,ƵŵĂŶŝƚǇ ŚĂƐ ĨĂĐĞĚ ŐƌĞĂƚ ƐƚƌĞƐƐ ďĞĨŽƌĞ͘ ^ĞǀĞŶƚǇ ǇĞĂƌƐ ĂŐŽ ƚŚĞ ůůŝĞƐ ĨŽƵŐŚƚ Ă ďŝƩĞƌ ǁĂƌ ĂŐĂŝŶƐƚ ƚŚĞ :ĂƉĂŶĞƐĞ ĂŶĚ EĂǌŝ 'ĞƌŵĂŶǇ͘ ƋƵĂƌƚĞƌ ĐĞŶƚƵƌǇ ĂŌĞƌ ƚŚĂƚ͕ ŵĂŶǇ ĨĞĂƌƐ ǁĞƌĞ ĞǆƉƌĞƐƐĞĚ ĐŽŶĐĞƌŶŝŶŐ ŝŵƉĞŶĚŝŶŐ ĨĂŵŝŶĞ ŝŶ ƚŚĞ ϭϵϳϬƐ ΀Ϯϭ΁͘ /Ŷ ďŽƚŚ ƚŚĞ ĞĂƌůǇ ϭϵϲϬƐ ĂŶĚ ĂŐĂŝŶ ŝŶ ƚŚĞ ϭϵϴϬƐ͕ ŐƌĞĂƚ ĨĞĂƌ ǁĂƐ ŚĞůĚ ĂďŽƵƚ Ă ŶƵĐůĞĂƌ ǁĂƌ͘ ^Ž ĨĂƌ͕ ǁĞ ŚĂǀĞ ĞƐĐĂƉĞĚ ƚŚĞƐĞ ĨĂƚĞƐ͘ /Ĩ ŚƵŵĂŶŝƚǇ ŝƐ ƚŽ ƚƌĂǀĞƌƐĞ ƚŚŝƐ ĨƵƚƵƌĞ ŝƚ ǁŝůů ĚŽ ƐŽ ŝŶ ƉĂƌƚ ďĞĐĂƵƐĞ ŽĨ ƚŚĞ ĐŽŶƚƌŝďƵƟŽŶ ŽĨ ĚŽĐƚŽƌƐ͕ ƚŽŐĞƚŚĞƌ ǁŝƚŚ ŵĂŶǇ ŽƚŚĞƌ ĂĐƚŽƌƐ ĂŶĚ ŶĞǁ ǁĂǇƐ ŽĨ ƐŽĐŝĂů ŽƌŐĂŶŝƐĂƟŽŶ ΀ϮϮ΁͘

It was 1978

, ͙͛͜ ǡ Ǥ Ǯ ͚͘͘͘ǯǡ ǡ ǡ Ǯ ǡ ǡ ǯǤ Ǥ

͛͘ ǡ Ǯ ǯǡ Ǥ ͙͟͡͠ǫ ǫ

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ǁǁǁ͘ŐŚŶ͘ĂŵƐĂ͘ŽƌŐ͘ĂƵ

[1] Boyden S. The environment and human health. The Medical Journal of Australia. 1972;116:1229-34. [2] King M, editor. Medical Care in Developing Countries. A Primer on the Medicine of Poverty and a Symposium from Makerere. Nairobi: Oxford University Press; 1966. [3] McMichael AJ, Neira M, Heymann DL. World Health Assembly 2008: climate change and health. The Lancet. 2008;371:1895-6. [4] Lim V, Stubbs JW, Nahar N, Amarasena N, Chaudry ZU, Weng SCK, et al. Politicians must heed health effects of climate change. The Lancet. 2009;374:973. [5] Costello A, Abbas M, Allen A, Ball S, Bell S, Bellamy R, et al. Managing the health effects of climate change. The Lancet. 2009;373:1693–733. [6] Williams S. Parched Russia warns on harvest, wheat prices surge. Sydney Morning Herald. 2010. [7] McLaughlin JB, DePaola A, Bopp CA, Martinek KA, Napolilli NP, Allison CG, et al. Outbreak of Vibrio parahaemolyticus Gastroenteritis Associated with Alaskan Oysters. New England Journal of Medicine. 2005;353:1463-9. [8] Stenseth NC, Stenseth NC, Samia NI, Viljugrein H, Kausrud KL, Begon M, et al. Plague dynamics are driven by climate variation. Proceedings of the National Academy of Science (USA). 2006;103:13110-5. [9] Klempa B. Hantaviruses and climate change. Clinical Microbiology and Infection. 2009;15(6):518-23. [10] Butler CD, Harley D. Primary, secondary and tertiary effects of the eco-climate crisis: the medical response. Post Graduate Medical Journal. 2010;86:230-4.

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ǯ Ǥ ǡ

[11] Butler CD, Corvalán CF, Koren HS. Human health, well-being and global ecological scenarios. Ecosystems. 2005;8(2):153-62. [12] Tubiello FN, Fischer G. Reducing climate change impacts on agriculture: Global and regional effects of mitigation, 2000–2080. Technological Forecasting & Social Change. 2007;74:1030–56. [13] Butler CD. Peering into the fog: ecologic change, human affairs and the future (commentary). EcoHealth. 2005;2:17-21. [14] Kerr R. Splitting the Difference Between Oil Pessimists and Optimists. Science. 2009;326:1048. [15] Hall CAS, John W. Day J. Revisiting the limits to growth after peak oil. American Scientist. 2009;97:230-7. [16] (FNHUVOH\ 5 :KDW V ZURQJ ZLWK WKH RI¿FLDO IXWXUH" ,Q +DVVDQ * HGLWRU After Blair: Politics After the New Labour Decade. London: Wishart; 2006. p. 172-84. [17] Butler CD. Inequality, global change and the sustainability of civilisation. Global Change and Human Health. 2000;1(2):156-72. [18] Diamond J. Collapse: How Societies Choose to Fail or Succeed. London: Allen Lane; 2005. [19] Tainter JA. The Collapse of Complex Societies. Cambridge: Cambridge University Press; 1988. [20] Bowles S. Did Warfare Among Ancestral Hunter-Gatherers Affect the Evolution of Human Social Behaviors? Science. 2009;324:1293-8. [21] Ehrlich PR. The Population Bomb. London: Ballantyne; 1968. [22] Walker B, Barrett S, Polasky S, Galaz V, Folke C, Engström G, et al. Looming global-scale failures and missing institutions. Science. 2009;325:1345-6

ALMA ATA

30 YEARS ON ĆĒĎĘč ėĆčĆĒ ĆĊĉĎĆęėĎĈ ĔēĆĘč ĊĉĎĈĆđ ĊēęėĊ

Ǥ ǡ Ǥ ǡ Ǥ ǡ Ǥ ǡ Ǧ Ǥ ǡ ƪ Ǥ Ǥ

2010 august VECTOR Panacea Vol 44 No 2 073

H HOBART GFC

THE BIG PICTURE

đĊĝĆēĉėĆ ėĆĎē Ćēĉ ĚĐĊ ĆĒĎđęĔē ȋ ĔǦ ĔēěĊēĔėĘǡ

đĔćĆđ ĊĆđęč ĔēċĊėĊēĈĊ ĝĊĈĚęĎěĊĘȌ

ŚĞ ĞŶƚŚƵƐŝĂƐŵ ĂŶĚ ŝŶƐƉŝƌĂƟŽŶ ŽĨ ŽǀĞƌ ϰϯϬ ŵĞĚŝĐĂů ƐƚƵĚĞŶƚƐ ĨƌŽŵ ƵƐƚƌĂůŝĂ ĂŶĚ ƚŚĞ ƐŝĂͲWĂĐŝĮĐ ƌĞŐŝŽŶ ŝŶƚĞƌƐĞĐƚĞĚ ŝŶ ,ŽďĂƌƚ ĨƌŽŵ :ƵůǇ ϭ ʹ ϰƚŚ͕ ĨŽƌ ƚŚĞ ϲƚŚ ŶŶƵĂů ƵƐƚƌĂůŝĂŶ DĞĚŝĐĂů ^ƚƵĚĞŶƚƐ͛ ƐƐŽĐŝĂƟŽŶ 'ůŽďĂů ,ĞĂůƚŚ ŽŶĨĞƌĞŶĐĞ͘ dŚĞ ƚŚĞŵĞ ǁĂƐ ͚^ŵĂůů ^ƚĞƉƐ͕ ŝŐ WŝĐƚƵƌĞ͕͛ ǁŝƚŚ Ă ĨŽĐƵƐ ŽŶ ĞŵƉŽǁĞƌŝŶŐ ƐƚƵĚĞŶƚƐ ǁŝƚŚ ŬŶŽǁůĞĚŐĞ ĂďŽƵƚ ŝƐƐƵĞƐ ƚŚĂƚ ŝŵƉĂĐƚ ŽŶ ŚĞĂůƚŚ ĂƌŽƵŶĚ ƚŚĞ ǁŽƌůĚ͕ ǁŚŝůƐƚ ĞƋƵŝƉƉŝŶŐ ƚŚĞŵ ǁŝƚŚ ƉƌĂĐƟĐĂů ƐŬŝůůƐ ƚŽ ŐĞƚ ŝŶǀŽůǀĞĚ ŝŶ ĂĚǀŽĐĂĐǇ ĂŶĚ ĂĐƟǀŝƐŵ Ăƚ Ă ŐƌĂƐƐƌŽŽƚƐ ůĞǀĞů͘

ĞůĞŐĂƚĞƐ ǁĞƌĞ ĂĚĚƌĞƐƐĞĚ ďǇ ƌ ,ĞůĞŶ ĂůĚŝĐŽƩ ŽŶ ƚŚĞ ŵĞĚŝĐĂů ŝŵƉůŝĐĂƟŽŶƐ ŽĨ ŶƵĐůĞĂƌ ƉŽǁĞƌ͕ ďǇ ZĞǀ͘ dŝŵ ŽƐƚĞůůŽ ŽŶ ĐŚŝůĚ ĂŶĚ ŵĂƚĞƌŶĂů ŚĞĂůƚŚ͕ ĂŶĚ ďǇ WƌŽĨĞƐƐŽƌƐ dŽŶǇ DĐDŝĐŚĂĞů ĂŶĚ ŽůŝŶ ƵƚůĞƌ ŽŶ ůŝŵĂƚĞ ŚĂŶŐĞ ĂŶĚ ,ĞĂůƚŚ͕ ũƵƐƚ ƚŽ ŶĂŵĞ Ă ĨĞǁ͘ dŚĞ ƐƚƌĞĂŵ ƉƌŽŐƌĂŵ ƉƌŽǀŝĚĞĚ ĚĞůĞŐĂƚĞƐ ǁŝƚŚ ĂŶ ŽǀĞƌǀŝĞǁ ŽŶ ŝƐƐƵĞƐ ƐƵĐŚ ĂƐ ǁĂƚĞƌ ƋƵĂůŝƚǇ ĂŶĚ ĂĐĐĞƐƐ͕ ƌĞĨƵŐĞĞ ŚĞĂůƚŚ͕ ƐĞǆƵĂů ŚĞĂůƚŚ͕ /ŶĚŝŐĞŶŽƵƐ ŚĞĂůƚŚ ĂŶĚ ƌĞƐŽƵƌĐĞ ĂůůŽĐĂƟŽŶ͘ tŝƚŚ ŽǀĞƌ ϲϲ ƐƉĞĂŬĞƌƐ ĂŶĚ ƚƵƚŽƌƐ͕ ŝƚ ŝƐ ŝŵƉŽƐƐŝďůĞ ƚŽ ĐŽŶǀĞǇ ƚŚĞ ĂŵŽƵŶƚ ŽĨ ŝŶĨŽƌŵĂƟŽŶ ƚŚĂƚ ǁĂƐ ƉĂĐŬĞĚ ŝŶ ƚŽ ĨŽƵƌ ĚĂǇƐ Ăƚ ƚŚĞ hŶŝǀĞƌƐŝƚǇ ŽĨ dĂƐŵĂŶŝĂ͕ ĂŶĚ ĞǀĞŶ ŵŽƌĞ ŝŵƉŽƐƐŝďůĞ ƚŽ ĚĞƐĐƌŝďĞ ƚŚĞ ŝŶƚĂŶŐŝďůĞ ďĞŶĞĮƚƐ ŽĨ ŚĂǀŝŶŐ ϰϯϬ ŵŽƟǀĂƚĞĚ ƐƚƵĚĞŶƚƐ ŝŶ ŽŶĞ ƉůĂĐĞ͕ ǁŝƚŚ ŽŶĞ ŐƌŽǁŝŶŐ ŐůŽďĂů ĐŽŶƐĐŝĞŶĐĞ͘

“Small steps, big picture”

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4 VECTOR august 2010 074 Panacea Vol 44 No 2

Ɛ ǁĞůů ĂƐ ďĞŝŶŐ ĂĚĚƌĞƐƐĞĚ ďǇ ƐŽŵĞ ŽĨ ƚŚĞ ŵŽƐƚ ǁĞůů ƌĞƐƉĞĐƚĞĚ ĮŐƵƌĞƐ ŝŶ ŐůŽďĂů ŚĞĂůƚŚ ŝŶ ƵƐƚƌĂůŝĂ͕ ƐŽŵĞ ŽĨ ƚŚĞ ŵŽƐƚ ƉƌŽĨŽƵŶĚ ůĞĂƌŶŝŶŐ ĐĂŵĞ ĨƌŽŵ ŽƵƌ ƉĞĞƌƐ͘ dĞŶ ƐƚƵĚĞŶƚƐ ĨƌŽŵ ĚĞǀĞůŽƉŝŶŐ ŶĂƟŽŶƐ ũŽŝŶĞĚ ƵƐ ƚŚƌŽƵŐŚ ƚŚĞ ƵƐ / /ŶƚĞƌŶĂƟŽŶĂů ^ĞŵŝŶĂƌ ^ƵƉƉŽƌƚ ^ĐŚĞŵĞ͕ ĂŶĚ ǁĞ ǁĞƌĞ ĞŶůŝŐŚƚĞŶĞĚ ďǇ ǁŚĂƚ ƚŚĞǇ ĐŽƵůĚ ƐŚĂƌĞ ĂďŽƵƚ ŚĞĂůƚŚ ŝŶ ƚŚĞŝƌ ĐŽƵŶƚƌŝĞƐ͘ tŽƌŬƐŚŽƉƐ ǁĞƌĞ ĂůƐŽ ƌƵŶ ďǇ ƐƚƵĚĞŶƚƐ͕ ĨŽƌ ƐƚƵĚĞŶƚƐ͕ ƚŚƌŽƵŐŚ ƚŚĞ D^ dƌĂŝŶŝŶŐ EĞǁ dƌĂŝŶĞƌƐ ĂŶĚ dŚŝŶŬ 'ůŽďĂů ŝŶŝƟĂƟǀĞƐ͘ dŚĞƐĞ ƉƌŽŐƌĂŵƐ ĂůůŽǁĞĚ ĚĞůĞŐĂƚĞƐ ƚŽ ĚĞǀĞůŽƉ ƐŬŝůůƐ ŝŶ ůĞĂĚĞƌƐŚŝƉ͕ ĂĚǀŽĐĂĐǇ ĂŶĚ ƉƌŽũĞĐƚ ŵĂŶĂŐĞŵĞŶƚ͘

ŚĞ ĐŽŶĨĞƌĞŶĐĞ ǁĂƐ ĂůƐŽ ǀĞƌǇ ůƵĐŬǇ͕ ǁŝƚŚ ƚŚĞ ƐƵƉƉŽƌƚ ŽĨ ƚŚĞ hŶŝǀĞƌƐŝƚǇ ŽĨ dĂƐŵĂŶŝĂ͕ ^ĞĐŽŶĚ ŝƚĞ͕ ^ĐŽůŽƌĞƐƚ ĂŶĚ ƚŚĞ ^ĂůǀĂƟŽŶ ƌŵǇ͕ ƚŽ ďĞ ĂďůĞ ƚŽ ĐŽŶƚƌŝďƵƚĞ ƚŽ ƚŚĞ ůŽĐĂů ĐŽŵŵƵŶŝƚǇ ƚŚƌŽƵŐŚ Ă ĨŽŽĚ ƌĞƐĐƵĞ ĂŌĞƌ ůƵŶĐŚ ĞĂĐŚ ĚĂǇ͘ ĞůĞŐĂƚĞƐ ǁĞƌĞ ƐŽ ŝŶƐƉŝƌĞĚ ďǇ ƚŚŝƐ ƚŚĂƚ ŵĂŶǇ ŽĨ ƚŚĞŵ ƌĞƚƵƌŶĞĚ ďƌĞĂŬĨĂƐƚ ĨŽŽĚƐ ĨŽƌ ĚŝƐƚƌŝďƵƟŽŶ ĂŌĞƌ ƚŚĞ ĐŽŶĨĞƌĞŶĐĞ ĂƐ ǁĞůů͘

Ğ ĐĞƌƚĂŝŶůǇ ůĞĂƌŶĞĚ ƚŚĂƚ ƚŚĞ ŝƐƐƵĞƐ ĨĂĐŝŶŐ ƚŚĞ ŚĞĂůƚŚ ŽĨ ƚŚĞ ǁŽƌůĚ ĂƌĞ ƵŶĚŽƵďƚĞĚůǇ ŚƵŐĞ͕ ĂŶĚ ƌĞƋƵŝƌĞ ĂĐƟŽŶ ŽĨ Ă ƐŝŵŝůĂƌ ŵĂŐŶŝƚƵĚĞ͘ tĞ ǁĞƌĞ ƉŽǁĞƌĨƵůůǇ ƵƌŐĞĚ ďǇ EŝĐŬ ĞĂƌůŝŶͲ ůůĂƌĚŝĐĞ ŝŶ ƚŚĞ ĐůŽƐŝŶŐ ĂĚĚƌĞƐƐ ŽĨ ƚŚĞ D^ ', ƚŽ ƌĞŵĞŵďĞƌ ƚŚĂƚ ŝƚ ŝƐ ŶŽƚ ĞŶŽƵŐŚ ƚŽ ƐŝŵƉůǇ ĂƩĞŶĚ Ă ĐŽŶĨĞƌĞŶĐĞ͘ dŚĞƌĞ ŝƐ ƐŽ ŵƵĐŚ ǁŽƌŬ ƚŽ ďĞ ĚŽŶĞ ŝŶ ƚŚĞ ƌĞĂůŵ ŽĨ ŐůŽďĂů ŚĞĂůƚŚ͕ ĂƐ ĞǀŝĚĞŶĐĞĚ ďǇ ƚŚĞ ĂƌƌĂǇ ŽĨ ƚŽƉŝĐƐ ĐŽǀĞƌĞĚ ŽǀĞƌ ƚŚĞ ĨŽƵƌ ĚĂǇƐ ŽĨ ƚŚĞ ĐŽŶĨĞƌĞŶĐĞ͘ /Ĩ ǇŽƵ ĂƌĞ ŝŶƚĞƌĞƐƚĞĚ ŝŶ ƉƵƫŶŐ ƚŚĞ ƉĂƐƐŝŽŶ ĂŶĚ ĞǆĐŝƚĞŵĞŶƚ ŐĞŶĞƌĂƚĞĚ Ăƚ ƚŚĞ D^ ', ƚŽ ŐŽŽĚ ƵƐĞ͕ ƉůĞĂƐĞ ĐŽŶƐŝĚĞƌ ũŽŝŶŝŶŐ ƚŚĞ 'ůŽďĂů ,ĞĂůƚŚ 'ƌŽƵƉ Ăƚ ǇŽƵƌ ƵŶŝǀĞƌƐŝƚǇ͕ Žƌ ũŽŝŶŝŶŐ ĂŶ ĂĚǀŽĐĂĐǇ ŐƌŽƵƉ ůŝŬĞ tŽƌůĚ sŝƐŝŽŶ͕ KĂŬƚƌĞĞ͕ Z ^h>d^͕ ƚŚĞ 'ůŽďĂů WŽǀĞƌƚǇ WƌŽũĞĐƚ Žƌ ƚŚĞ ŽĐƚŽƌƐ ĨŽƌ ƚŚĞ ŶǀŝƌŽŶŵĞŶƚ ƵƐƚƌĂůŝĂ͘ tĞ ŚŽƉĞ ƚŚĂƚ ƚŚĞ D^ 'ůŽďĂů ,ĞĂůƚŚ ŽŶĨĞƌĞŶĐĞ ǁŝůů ďĞ ƚŚĞ ƐƉƌŝŶŐďŽĂƌĚ ĨŽƌ ŵĂŶǇ ƉĞŽƉůĞ͕ ŝŶĐůƵĚŝŶŐ ǇŽƵ͕ ŝŶƚŽ ŵĂŬŝŶŐ Ă ƌĞĂů͕ ƚĂŶŐŝďůĞ ĚŝīĞƌĞŶĐĞ ŝŶ ŐůŽďĂů ŚĞĂůƚŚ͘

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ǁǁǁ͘ŐŚŶ͘ĂŵƐĂ͘ŽƌŐ͘ĂƵ

How To: Complete your AMSA Student American Express® Gold Credit Card Application Just remember, by taking up a card, AMSA receives a financial benefit from member’s use of the AMSA Gold Credit Card to help fund member’s services. You can apply online, or fill in the form and send it in. Further special offers are available for members if they apply online! 1. Go online to www.amsa.org.au/content/member-benefits 2. Print the application form 3. Read the declaration 4. Fill in all fields on the application form 5. Attach the following to your application, signed by a Justice of the Peace (JP) - proof of income over $8,000 per annum. For example, two recent (not handwritten) payslips or a tax assessment - proof of Australian Citizenship. For example, copy of your passport 5. Sign the application form to acknowledge the information you have provided is true and correct, and that you have read the declaration 6. Return you completed application with documentation attached to: American Express® Reply Paid 5148 Sydney NSW 2001

This “How-To” Guide has been written and produced by the Australian Medical Students’ Association (ABN 67 079 544 513) in conjunction with American Express Australia Limited (ABN 92 108 952 085). ® Registered Trademark of American Express Company. For more information on the AMSA Gold Card visit www.amsa.org.au

Panacea The Official Magazine of the Australian Medical Students’ Association. ‘The Colour Edition’ Proudly Sponsored by American Express Volume 44, Edition 2, 2010

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GPYR MDFT3411/AMSA

NOT ALL PATIENTS REQUIRE AN APPOINTMENT.

As a Medical Officer in the Navy, Army or Air Force, you’ll have opportunities that you won’t get in the private sector. Such as providing humanitarian aid and the chance to specialise in primary care, occupational medicine, aviation, underwater, sports, trauma or tropical medicine. You’ll also get to lead a team of highly skilled professionals. As part of the Australian Defence Force (ADF) Sponsored Undergraduate Scheme we’ll pay you up to $40,500p.a. to study and pay your tuition fees. You’ll also receive subsidised accommodation and free medical & dental care. Upon graduation you’ll have the opportunity to further your career, 080 specialise and progress into senior roles. Along with adventure, you’ll also Panacea Vol 44 No 2 enjoy a favourable salary and a guaranteed job. For more information call 13 19 01