Panacea Vol 47 Issue 2 (December 2013)

panacea the official magazine of the australian medical students’ association

december 2013 volume 47 issue 2

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the australian medical students’ association would like to thank its major sponsors of 2013 for their ongoing support

contents panacea volume 47 issue 2 december 2013

editorial 5 letter from the president 6 articles being well rounded lucy_haynes 8 seventeen again nikhil_autar 10 a mirror on timor amy_millicent_cao 14 surefire ways to make friends in PBL claire_meaton 16 a country to practice kai_chaivannacoopt 18 the guiding light katie_roberts 20 a right to employment sanj_mudaliar 22 a DREaded opportunity anonymous 24 postcards a la suva matthew_bray 26 book reviews half the sky emily_whitelaw 12 obstetrics and gynaecology: an evidence-based guide andrew_duckworth 30 emergency medicine: the principles of practice arghya_gupta 31 poetry internship blessing brooke_ah_shay 28 xxxx brooke_ah_shay 41 medsoc reports anumss 34 fmss 34 gums 35 msand 35 medusa 37 mumus 37 sums 38 unms 38 unsw 39 uwsms 39 wumss 40

arghya_gupta

amsa publications officer

I recently read an article that mentioned that medical students have an eye for entrepreneurship.

I have heard that if you want something done, get a busy person to do it. I know that in the future, my medical colleagues will not only be at the forefront of medical research, but also my go to for how to touch up a car, which opera to go see, and how to do a proper deadlift.

Medical students are an amazing bunch of people, and next time you look in the mirror and worry about an internship crisis or the trainng pathway bottleneck, take a deep breath and give yourself a pat on the back. Many of you have succeeded at the UMAT and had an incredibly high tertiarty entrance score, on top of an interview to get through. Others, who have done GAMSAT, have had to come in the top 10 per cent of candidates - that is, a high calibre of people who have completed degrees and have a desire to do medicine. To even get in is an amazing acheivement.

To those reading this who are not doing medicine, this is not to suggest that medical students are some sort of race of Renaissance men and women,

but rather, that there is more to them than the person you say hello to at a party when you develop a rash or a headache.

This edition of Panacea has articles that will inspire you, articles that will make you laugh, and articles that will make you think again. But what they all do is show the breadth of the abilities of medical students. This whole year, I have been inundated by great articles from medical students nationwide.

If I can ask one thing of you as I leave the role of Publications Officer of AMSA for this year, it’s to continue contributing. To Panacea if you have an article, to Embolus if you have some news, or to the wider world in general f you have something to say.

You never know who you’ll end up inspiring to go onto bigger and better things.

So from myself, I thank the whole AMSA family; Ben and the National Executive, the Presidents and Representatives, and every medical student I’ve met along the way. I hope to meet more of you over the years, and to see you all soon.

panacea volume 47 issue 2 editor arghya_gupta executive junior vice-president of editing john_farey cover kreg_steppe (flickr: spyndle) australian medical students’ association 42 macquarie st, barton ACT 2600 |po box 6099, kingston ACT 2604 p 02 6140 5446 | f 02 6270 5499 |e publications@amsa.org.au | w www.amsa.org.au all images in this publication have been used under Creative Commons / Fair Use policies printed 10 december 2013

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benjamin_veness

amsa president While contemplating a career in medicine, I read a lot of paperbacks by doctors. One of my favourite authors was Atul Gawande, who also writes excellent long form pieces for The New Yorker. At the end of one of his books, Professor Gawande implored other doctors to write, too.

So as I sit here in Sydney’s early December heat, grateful for the invention of the pedestal fan, I’m also grateful for my wonderful colleagues who have contributed to this second and final edition of Panacea for 2013. Its editor, Arghya Gupta, has compiled a fascinating collection of varied personal reflections on what it is like to enter, study and finish medical school.

Inside, Katie Roberts (Newcastle) pays tribute to Ngiare Brown, who solidified Ms Roberts’ dream of caring for others and showed her how an Indigenous woman can succeed in medicine.

With Australia’s intake of Indigenous medical students finally at population parity, we all share Ms Roberts’ gratefulness for role models like Dr Brown, and hope that completion rates can be similarly improved so that we maintain population parity through to graduation.

There are other inspiring stories, too. Nikhil Autar (UWS) was diagnosed with leukaemia at age 17, bravely asked for his chances, and cried, for ages, at the doctor’s reply. Demonstrating somewhat of a natural aptitude for mindfulness, Mr Autar eventually realised that he could choose to respond differently to his thoughts, and assumed control over his emotions. He reframed the bad news into good, and by writing about it in Panacea, offers his precocious wisdom to both us and our patients.

Other Australian medical students have written stories about providing care internationally: Amy Millicent Cao (Monash) on East Timor and Matthew Bray (Monash) on Fiji. Did you know that our near neighbour Fiji has one of the world’s highest rates of suicide and that our density of doctors is nearly eight times theirs? As thousands of medical students head off on their elective in the coming months, Ms Cao and Mr Bray’s insights warrant reading. Ms Cao’s experience reminded me of my own ophthalmology elective in Myanmar, where I saw presentations – adult and paediatric – that were shockingly late by Australian norms and served to inspire in me a greater interest in public and global health.

Also waiting for you are political pieces, a poem, book reviews, reports of all the amazing work being done by MedSocs across the country, and more. Put up your feet and relax into this great edition of Panacea. Have a fun and safe summer holiday, and best wishes for Christmas and the New Year. It’s been an absolute pleasure to serve you as AMSA President, and I look forward to working together throughout our careers. Thank you very much for your support, and an especially big thank you to my wonderful NSW National Executive team.

Yours,

Benjamin Veness President

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being well rounded

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lucy_haynes flinders

I am often asked how, at my age (a mere 31 years old), I came to be a medical student. I have given about one hundred different answers to this question, none of which seem to satisfy the listener.

As a graduate entry student, the question is commonly pre-empted by the obligatory ‘what did you do before med?’ that all graduate entry students ask one another and undergrad students ask us ‘oldies’. The asker often seems perplexed when I reply that I have a zero science background and that I used to work in in the Arts, at music festivals and for circuses. They seem even more confused when I confess that I loved my jobs and what I refer to as ‘my previous life’. Some even appear to be a little affronted that I could love something other than medicine. They often ask ‘well, why are you studying medicine if you loved what you did before?’ and I try in vain to explain myself.

The truth is, though, that it’s very hard to explain to someone whose sole focus has been medicine that it’s possible to focus on and to love many careers in one lifetime. As I try to clarify, having job satisfaction in my old career does not preclude me from being passionate about medicine. The knowledge and fervour of the students I meet is overwhelming and delightful. I admire people who have always known their vocation and have followed it through with determination and enthusiasm. That was how I came into my old life and it’s how I try to approach my new life. In all honesty, I am studying medicine because I have always wanted to – I just didn’t realise it until a little later in life.

I have been very fortunate that my past has allowed me to travel widely and to have a plethora of experiences that I would not have had had I discovered medicine sooner and I will always be grateful for the

opportunities I have been given and for and to the people I have encountered along the way. All of this has shaped me into the person I was when I entered medical school. The person I am now is a product of the old me and all the wonderful, frightening, stressful and sometimes just plain disgusting experiences I have had since commencing studying.

I have come from literature to music to circus to medicine to AMSA ranger to AMSA rep and I have loved every minute of it.

All I can do is implore you to remember that you are more than just a medical student – you are a person, made up of everything you have experienced and learned and that is a truly wonderful thing to be. Try hard not to become just another ‘medical student’.

Try to always be you. p

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nikhil_autur western sydney “The good news is you’re 17 and you have leukemia, but the bad news is you’re 17 and you have leukemia.”

That’s how I was told I had cancer.

It’s news thousands have to hear every day. And so I asked that one question all cancer patients dread.

“What are my chances?”

A man I’d met only 12 hours ago pulled down his glasses and sighed.

“10 - 20% chance that you’ll live beyond 5 years.”

I cried. For ages.

Everyone kept telling me not to give in, that I should keep my head up, that I could do it.

But how could they understand? I’d just been told I would probably not live to see 22!

I couldn’t stop asking myself WHY ME? I hadn’t done anything wrong to anyone.

I was fit, healthy, and was doing well at school. For God’s sake, I was only 17! Wasn’t cancer for old people? Or those who smoked, or been exposed to radiation or something?

I spent days clinging to that pillow in the same clothes and sheets, asking those questions.

But after a while, I started to hate that feeling. The deep, dark hole I’d dug myself into. The fear of what was to come. The wet pillows from all the crying.

And so I took a step back and looked at what had happened to me again - as if it had had all happened to someone else.

It was then that I realised that I had the cancer now. No matter how much I wanted to, I couldn’t go back in time and change that.

And I realised that it was me - MY brain that was making me feel that way.

And I realised that going forward, I had a choice.

I could either stay down and depressed and harm only myself - or I could try to see what had happened to me in another, more positive way.

At that time, though, only days before chemotherapy, it wasn’t easy to see anything but the pain and tears to come.

But that changed after I started thinking about others’ reactions to this sort of news and asking one simple question: why?

Why were they acting as if cancer was a death sentence? As if they were already goners?

Why were they getting down over something they couldn’t control?

Why were they fearing the chemotherapy when it was the thing that could cure them?

Why was I thinking like them?

From that point onwards I realised that I would always have a second way of looking at things. If I just asked why, I could always manage to see the alternative view.

My doctor’s diagnosis still loomed over me, however. He was the one I trusted, the one who knew most about the disease and I couldn’t get past my horrible prognosis. His words mattered most.

And so I asked myself why, once more.

Why had I been seeing my diagnosis at such a young age as a curse, when in truth, it was a blessing?

So maybe the bad news was that I was seventeen and I had cancer. But the good news was, I was seventeen and I had cancer.

Being young and healthy meant I could take the hardest treatments possible and recover from them. I wouldn’t have to worry about a family or a job while going through treatment; hell - my family would be there every step along the way!

And in the end, I could get back to living a normal life after all this was done.

And you know what? After five rounds of

chemotherapy, a fatal dose of radiation, a relapse and two bone marrow transplants - I’m almost there!

I’m not saying that you can cheat death by changing someone’s attitude. What I am saying is that you will always have a second way of looking at things. That you and your mind is what decides whether you’re happy or not.

And that you, and those under your care, no matter how hard your battles may seem, will always have something on your side to see things differently with.

It doesn’t have to be your age - it could be your family, faith, friends or simply the fact that just by living in Australia, you’ve been afforded the best chances of success.

You won’t be able to get them, or yourself, to just become happy overnight.

It’ll take time.

You may doubt that you’ll be able to do it all. Or you may think that I did something extraordinary or brave.

All I did was 3 simple things.

1) I took a step back and examined myself from another perspective; 2) I asked why of all my doubts; until, 3) I realised that going forward, and that I had the power to choose how I viewed and took my life.

If you, your patients and your loved ones can do this in the face of any obstacle you may be facing, I guarantee you that you’ll give yourself the best chance of succeeding, and the best chance of being happy in life.

To read my whole story and for more inspiration - check out my blog at nikhilthegrizzlybear.blogspot.com.au p

seventeen again

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book review emily_whitelaw wollongong Half The Sky Nicholas Kristof, Sheryl WuDunn Vintage, 2010 Half the Sky was named with reference to Chairman Mao’s proclamation that “women hold up half the sky”. Perhaps just used for its lyricism, the phrase is fairly controversial in the context of his Great Leap Forward resulting in the genocide of more than 45 million. In doing so he banned female foot binding, reduced fertility with the one child policy and allowed (read: made) women to enter the workforce - all essential features in China’s unsurpassed economic rise over the past 100 years. If human rights are not an incentive for the empowerment of women (as it seems in many cultures today) then economics may provide one such incentive.

This book is full of cases and anecdotes from such cultures, documented during the years of travelling by foreign correspondents Nicholas Kristof and Sheryl Wudunn thoroughout the developing world. From the rural corners of Pakistan to Mexico, Kenya to Cambodia, they uncover that the main challenges keeping women disenfranchised are the same ones keeping their communities stricken

with poverty and violence.

The approaches of governments and NGOs are scrutinised in detail for both their successes and failures.

2. Iodise salt in poor countries to prevent children losing approximately 10 IQ points each through deficiency inutero.

The authors work their way towards a central thesis on empowerment through analysing the successes and failures of governments and NGOs alike.

3. Eradicate obstetric fistula and train more people to provide better maternal care generally to reduce maternal mortality.

1. Reduce the gender gap in education by finding the most cost effective way for each community from those that have worked before – providing school uniforms to girls from poor families, deworming communities, providing scholarships to the best-performing girls, helping girls manage menstruation, or supporting school meals.

Luckily it concludes with some sustained hope. This book is for people with a global conscience to enjoy stoking the fire in their belly and for everyone else to read and experience the warmth. p

The humanity brought Success, they argue, through the individual stories requires a world where of women from across there is no preventable the developing world has maternal mortality, no a solid base in facts and human trafficking, no sexual pragmatism. You almost feel violence, and no routine physically knocked around daily discrimination against or a touch cyclothymic females. The essential such are the highs and lows ingredients include universal in rapid succession. Take a access for girls to education, breather then you’re torn family planning, microfinance back down to look at the and general ‘empowerment’. tragedy of obstetric fistula (‘A walk to beautiful’ for those at The first steps towards GC2013 Academic), then fire achieving such a vision are up in anger at the appalling shockingly simple, and inspire statistics on sexual violence in optimism: conflict areas.

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panacea

author name university

mirror on timor

amy_millicent_cao monash

Eye-opening. Rewarding.

Overwhelming. Fulfilling. Mindblown. Helplessness. Gratitude.

These are the words that come to mind when I think back to this extraordinary trip. As part of the Alison Kearney East Timor Eye Scholarship, I had the privileged opportunity of joining a wonderful team of eight amazing medical professionals: ophthalmologists Dr John Kearney, Dr Ross Littlewood, Dr Sue Wan, optometrists Ms Kate Doherty, Mr Bob Lees, nurse Ms Cheryl Doran, paramedic Mr Emiel Van De Kar and volunteer Mrs Elena Kearney on their seven day trip to Timor-Leste in August 2013. This was part of the well-established East Timor Eye Program run by the Royal

Australasian College of Surgeons (RACS).

The team was lead by Dr John Kearney (ophthalmologist & associate professor in Ophthalmology at Bond & Griffith Universities).

Timor-Leste is one of the poorest countries in the world with a ranking of 134 on the Human Development Index by the United Nations Development Reports in 2012. I had been cautioned to expect the unexpected but nothing could have prepared me for this trip.

The trip started off with a two hour train ride from Gold Coast to Brisbane, a four hour flight from Brisbane to Darwin and an ironically short one hour flight

from Darwin to Dili. Within Dili, the markets hustled and bustled with pedestrians, children, cars, weaving motor bikes and the stray runaway chook. After a bumpy four hour bus trip winding precariously through mountainous terrain on narrow strips of bitumen with multiple potholes, we finally reached our destination, Baucau, the second largest city in Timor-Leste.

Our days started with an outpatient clinic to assess eye conditions and to identify those that could be improved with surgeries such as cataracts and pterygiums. As part of the assessment, our experienced optometrists, Kate and Bob would assess the patients’ vision

15 and eye pressures before they were seen by one of our ophthalmologists who would ensure that their eye pathology was one that could be improved by surgery. My role in Timor-Leste was to perform the pre-operative tests for our cataract patients, including keratometric readings to measure the curvature of the cornea and using ultrasound to measure the axial length of the eye (A-scan).

These measurements would determine the correct artificial lens that will replace the patient’s own cataract-ridden lens for their surgery later that day.

Most of our patients had travelled long distances on well-worn roads from their remote villages to come to see us. During our week in Baucau, our team assessed over 200 patients and performed around 50 surgeries.

abdomen was distended to that of a near term pregnant woman. After hacking away at the fascia and peritoneum with a pair of blunted tissue scissors well past its lifespan, the surgeon was able to suction more than one litre of mixed peritoneal and faecal fluid. The patient had perforated her ileum. Almost the entire small bowel from the root of the root of the jejunum to the ileum had infarcted—it was dark maroon.

Unfortunately given the severity of the condition, it was inoperable. The surgeon and I closed her abdominal wound and she was wheeled out of the operating theatres moaning in pain. She died later that night on the surgical ward without any family nearby. There had been five similar cases in the previous week.

It was truly amazing and heart-warming to see patients who would come to our clinic blind or virtually blind and be able to walk unaided after their eye patch was removed the day after their operation. The glint in their eyes and the smiles on the faces of their family members were the happiest I have ever seen. The phenomenal satisfaction in knowing that we made a major difference to these patents’ lives was indescribable. Never in my life have I felt so fulfilled and fortunate that I was joining a profession that could contribute so much to peoples’ lives and to humanity.

It is seeing patients like these that make me feel incredible heartache and injustice in the world and at the same time, feeling extremely fortunate to be living in Australia. However, despite the poor health care standards, and appalling living conditions, the Timorese were happy and welcoming people. They were very grateful and appreciative of the help and service we were delivering. As Frederick Keonig once said: “we tend to forget that happiness doesn’t come as a result of something we don’t have, but rather of recognising and appreciating what we do have”.

It was not without cause for reflection on the nature of life in a third world country. One particular patient I remember vividly. A middle aged man presented with poor vision in one eye and near blindness in the other. To patients, all eye pathologies that make them blind are the same. However to our team, blindness from cataracts was reversible, but blindness from macular degeneration was not. Through the interpreter we explained to the patient that his vision could not be improved through surgery. No combination of eye drops or surgeries could restore his vision. The disappointment on his face as this was explained to him was gutwrenching. I still have the image of him getting out his chair and the dark shadow that his back cast as he walked slowly out of our clinic.

As part of this trip I also had the opportunity of seeing third world medicine on the wards and assisting in emergency surgeries. Another patient’s story was just as unforgettable. She was a 48 year old woman who presented with severe abdominal pain and worsening nausea and vomiting for six days. She was brought in by ambulance from a remote village over 125 kilometres out of Baucau following days of traditional herbal remedies without improvement. She was a thin lady but her

I would like to express my sincere gratitude to Mrs Alison Kearney for her generosity of this scholarship and to Dr John Kearney for his incessant support and guidance, both of whom made this unforgettable trip a reality for me. It was the most humbling, fulfilling and overwhelming experience. I would also like to thank our wonderful team: Dr Ross Littlewood, Cheryl, Kate, Bob, Emiel and Elena for putting up with me. A special thank you to Sue for being my amazing mentor. This trip has sparked my interest in third world medicine and consolidated my enthusiasm to pursue a career in ophthalmology. Thanks also to Bond University for their support. p

surefire ways to make friends in pbl

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claire_meaton deakin Ah, PBL. The rite of passage for many budding young doctors.

Where respect can be gained and lost within a single session or even a single sentence. We spend an extraordinary amount of time with classmates trying to nut out the details of cases, but the real intrigue lies in the group dynamics. Here are some tips on escaping the process unscathed, or at least without everyone in the room thinking you’re a dickhead.

1. Tim Tams, pringles and grapes. Yawn fest. Your originality and effort are blowing me away. This is not a great first impression. Bob brought these exact same items in last week. As did Jane the week before. Do you really want to be known as the person without an ounce of pizzazz when it comes to catering for the hungry hordes?

Just remember, judgments on your food choices can be quickly extrapolated to your personality.

2. The food extravaganza.

Uninspired food choices should not be overcompensated for by whipping up soufflés and trifles during class time. Cool your jets. Let’s not let things escalate. Instead I recommend opting for a simple baked good accompanied by some fruit for example. This can highlight your cooking prowess while not screaming “please be my friend!”

3. Coffee detox. What’s that?

You’re giving up coffee? You could have at least waited until I was sitting down before you delivered such shocking news.

No PLEASE tell me more, you’re the first overly anxious and risk averse medical student to have roped anyone within earshot into your inner struggle over whether the one or sometimes two cups of coffee you have a day is overdoing it. Concerned and deadpan facial expressions always make me reconsider my assumption that this is a rhetorical question.

4. “According to Boron”. Don’t be that person who prefaces every contribution with these words. Don’t get me wrong, this is indeed a good textbook, but classmates do not care for regurgitated paragraphs to be recited to them in class.

Summarise and synthesise people. Summarise and synthesise.

5. Interrupting. If you ignore every other point on this list, please take heed to this one. I know you think what you have to say cannot wait another single second to be vocalised, but we do not all necessarily agree with this view. If you think no one interrupts in your group, you are most likely to be the primary offender. I was once stopped mid sentence with the question “Is that a man eating an icecream outside?”

6. Saying something someone else has just said again in a different way. Or paraphrasing what your classmate said just moments ago. See what I mean? This is a highly time consuming and irritating phenomenon. I know you probably have an amazing way to explain a concept someone else has just gone through, and you’re probably a bit peeved you missed your chance, but save us all a headache and just give yourself a quiet pat on the back. Good on you.

7. Suggesting tangential learning goals at 4.45pm on a Friday. Are you stark raving mad? Sure, if you want to go home and learn about the prevalence of Multiple Sclerosis in women aged between 30 and 31 living in Norway then be my guest. Just don’t drag me down with you. These are the sorts of “interesting” ideas you lock away to help you feel superior about the extent of your knowledge; don’t share these gems with your classmates.

Finally, paying too much attention to this list may unnecessarily reduce you to a sweaty mess. I should know, I compiled it and break each rule on a regular basis.

I recommend immediately forgetting everything you just learnt and going forth with wild abandon. Haters gonna hate. p

a country to practice

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kai_chaivannacoopt flinders I’ve always wanted to work rurally. I can’t quite pin it down… perhaps it is from the 80s and 90s television shows like “A Country Practice”, or because I really enjoyed bushwalking and camping, or perhaps it’s because I hate being in a large city. Either way, I can’t seem to point that one particular thing that attracts me to work rurally – they all do.

My mother is a General Practitioner and I remember growing up around her medical practice, often having to rely on my father’s cooking when she ran late, or annoying the medical administration staff when I was on school holidays resulting in a few stern words from my mother later.

Something obviously rubbed off on me and unlike my siblings, I became interested in medicine and to work as a doctor.

So, this is how I became a medical student. Like so many others, I completed my undergraduate studies then was accepted into a graduate entry medical school. I was fortunate to have received my preference – to enter Flinders University under the Northern Territory Medical Program. This was newest medical program in Australia having just received the first cohort the year before in 2011; it was the most isolated medical program in Australia; it featured a unique focus on rural, remote and Indigenous health; and it piggybacked the well-established Flinders University graduate entry medical program based in Adelaide.

So the choice was clear, given that I was interested in rural, remote and Indigenous medicine.

So why would I choose to do a rural placement? How does experiencing the challenges and lifestyle of rural health affect my drive to work rurally?

To me, that’s simple. Rural communities have a life and soul that large cities doesn’t. It’s not about the

CWA or the stereotypical country fairs (although they are lots of fun!).

It’s about the people’s ownership of the town; the way that the town is a community and not just a place to live; the fact that when something happens in a town, everyone knows about but also rallies behind to support or resolve the issue; it’s for standing up for what they believe in; and it’s for supporting their own. We don’t see that in large cities. How many people would know their own next door neighbour? I want to live in a community where I knew my next door neighbour, or the people down the street.

Granted, rural communities are not homogenous. Every community is different. Some communities are AFL lovers, others are rugby league supporters. But it is this uniqueness that makes each community special. This is something that I want to be part of.

But not everything is all rosy either.

Rural communities have their own problems. Patient confidentiality and the boundaries of a doctor is extremely grey; when does your job stop if you bump into a patient (and often friend) in the shops and you see they’re buying all the unhealthy “junk” foods? What happens if the mother of a patient asks you about their child’s recent consultation? In large cities, we just blend in. However, in rural communities, it’s very difficult to do that. Plus, we’ve got the difficulties of referral or specialist care, especially if they’re hundreds of kilometres away. Finally, what about professional support, or your own mental health?

I feel that experiencing the challenges and lifestyle of a rural medical practitioner will help answer some of these questions and many more. Yes, I’ve got some ideas as to how I could tackle these challenges, but I’m sure I can learn a lot more from my mentor and clinicians during the rural placement. Perhaps they

approach things in a totally different manner from how I would approach the issues. Being armed with these different approaches, I feel, makes for a more successful and resilient doctor.

But with these challenges also comes the joys of a rural practice. It’s multidisciplinary team work where the doctor is more of a team member rather than isolated silos of health care. I feel that I’ll learn to work with and respect nurses and allied health professionals because we are forced to rely on each other. Often, we forget that nurses and allied health members are subject matter experts in their own right and we’re all there for the same common goal – to provide the best possible care to our patients. I feel that working rurally may also result in increased exposure to a wide variety of cases; more so than an urban placement. The opportunity to upskill and gain a wide understanding of a cross section of health conditions would be an added advantage to my medical student career.

So, it’s hard to predict the future, but I’m optimistic and enthusiastic about my upcoming rural placement. It’s where I do genuinely want to be. The medical skills, the people skills and the soft skills I will gain will be of significant benefit to my medical student and future medical career. The networks and bonds I’ll make from the rural experience, I hope, will inspire me to continue with my passion and interests. A place is what you make it to be and while I’m realistic in my expectations that it’s not all roses, I will put in the effort to make it the best possible academic, clinical and social time.

Like the catch line of the Northern Territory advertisement from years ago, “You’ll never never know if you never never go!” Here’s my never never now. p

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katie_roberts newcastle I am Wiradjuri girl from central New South Wales. I grew up on the land on various properties throughout the Central West.

I was the first of anyone in our extended family to complete my HSC, it was always assumed the family would stay on the land and academics were never a high priority. I enjoyed school and had a passion for the sciences and sport.

As a young girl I was always pulling things apart, finding out how they worked and fixing them. When it came to an injury of a family member, friend or animal, I was always first on scene ready to patch up. I was fortunate to represent NSW in Hockey in my final years of school, but after a serious knee injury I required physiotherapy treatment. My physiotherapist was an amazing Indigenous man who sparked my interest in health care. I never dreamed that I could combine my passion of science, and for lack of a better description, “fixing things!”. I performed work experience with the physio and went on to study Physiotherapy at the University of Sydney.

Throughout my physiotherapy degree I would volunteer at various sports events and was also lucky to be employed with a sports team. I saw a call out for physio students to volunteer at the David Peachey Indigenous Rugby Carnival in Dubbo – I immediately put my hand up. I thought how good is this, I get to combine my love of rugby and what I study and do for work together. Topped off with the added bonus of having my brothers and cousins playing at the Carnival.

Here I met the most pivotal person who directed my dream

towards medicine and proved it was possibility for me. Dr Ngiare Brown, an Indigenous woman from Southern New South Wales. Ngiare was in charge of the medical and first aid components at the carnival. We worked side-by-side over several days and I learnt about her journey into medicine, her roles in Indigenous health and she encouraged me to follow mine.

I returned to my placements in physio with a new injection of motivation. I stepped into the hospital system for placements where I craved more than what I felt physio could offer me as a career. I longed to be involved in whole patient care from the beginning to the end. Not just being a link in the chain, I wanted to be involved in the whole chain!

So with the guidance and support of Ngiare, I followed her footsteps and was accepted into Medicine at the University of Newcastle.

My overall career goal is in primary care and emergency medicine with focus on Indigenous and rural health. This is where my family is, where I grew up, where I belong and where I can make a difference. I hope to return to the Central West to continue my career.

My motivation for doing my placement at Maari Ma in Broken Hill is that this health organisation is dedicated to improving the health outcomes of communities in the far West of NSW with special focus on Aboriginal health.

The health services here are multidisciplinary and holistic and work closely with mainstream agencies to provide access to a broad range of services. The organization has

strong affiliations with various government agencies and departments and has been awarded many awards for their programs and strategies, particularly their strong focus on developing the indigenous workforce and closing the gap through effective health care.

I also have a strong interest in human rights law and health and how we can utilise these rights, principles and frameworks to improve Aboriginal health and social justice outcomes. I believe it is important for communities and individuals to participate in decision making and the accountability of governments around health care. I believe this placement at Maari Ma will allow me to explore how we can use the principles to support and develop our most disadvantaged, as this is pivotal to their vision and strategy.

If it wasn’t for my Indigenous physiotherapist, who ignited my passion and confidence to step into health care, the meeting of Dr Brown and her subsequent guidance into the medicine pathway I would not be the person I am today and developing into the Indigenous doctor I hope to be in the future.

This is what I hope I can do for my family, my cousins, for all rural and Indigenous people. That chasing your dreams and following your passions is a possibility; I can do it, and so can you. p

the guiding light

the right to employment

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sanj_mudaliar flinders Employment is not an implicit right of graduation, but everyone should have the right to seek employment in their field of training.

The national shortage of internships is at the forefront of every medical student’s mind. Under the current priority ranking system, those most likely to not secure an internship are international students studying in Australia as non-permanent residents. While this system is understandably unpopular amongst this cohort, it is hard to construct a solid argument against its central tenet: an Australian citizen should be preferentially employed above an equally qualified non-permanent resident. However, while the legal argument for providing these students with internships is weak there is a strong ethical argument to the contrary.

Medical graduates differ from many other professionals in that they are required to complete a year of internship in order to gain full registration with the Medical Board of Australia. This is a great strength of our healthcare system, cultivating a safe pre-vocational learning environment which produces wellequipped, undifferentiated medical graduates. It is a consequence of the way in which our medical education system developed that this year of provisional registration also serves as the first year of full time medical employment, employment which is provided by the state healthcare system. State

budgets are not infinite, and the health department’s control over internship numbers and accreditation is reasonable, given its financial and managerial stake in delivering them. It is equally valid that universities control the number of international students they accept, based on the training they deem themselves capable of delivering.

What does not make sense is how little these two organisations communicate with one another, considering that the number of university students directly dictates the number of graduates who will be seeking internship. If you accept the premise that internship is the final year of basic medical education then this disconnect, while not directly the fault of either party, is nevertheless perplexing and can have a profound impact on people’s lives. It is hard to imagine a situation in which a university student finishes the penultimate year of their degree to then be told that there is no room for them in the final year of their course.

This is essentially what happens to students who miss out on an internship. They have completed their medical degree, but without a final year of internship that degree does not allow them to seek professional employment in the area in which they were trained.

Employment in itself it not implicit in being a graduate and it is unreasonable for graduating students,

local or international, to assume guaranteed employment once they graduate. However, it is implicit that graduates are able to reasonably seek wide employment in their field of training. The disconnect between student numbers and internship positions denies this implicit right to those who miss out on the final year of their basic training. More communication is needed between the universities and health departments to ensure that into the future all graduates of Australian medical programs have the right to at least seek employment in the country of their training.

As a local student, I will soon receive an offer for an internship. Some of my international colleagues will not.

These students will face an agonising wait for second and third round offers to see whether their qualification actually gives them the right to practice clinically in the country in which it was obtained. With one of the central recommendations of the HWA workforce 2025 report being that Australia must reduce its dependence on foreign trained doctors. Surely we can all agree that this group of students, who have mortgaged house and home, travelled across the world and funnel millions of dollars into the local economy deserve the right to stay and contribute to improving the health of the country that has trained them. p

a dreaded opportunity

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anonymous Originally, I thought I’d spare you the nasties on performing my first digital rectal examination. But where would the fun in that be?

Enter: Roger, our volunteer patient. Male, mid-60’s, and typical of the patient demographic needing regular screening for prostate cancer.

Prof. Cinna commenced the proceedings with much gusto, performing the genital examination sans protection, donning our stock latex gloves prior to executing a masterful DRE. It was just another anus, and these were just another group of students staring at it like a clowder of cats watching a fish tank.

“For the cardiothoracic surgeon, the index finger is for dilating the mitral valve,” he said, turning to us whilst still metacarpal deep.

“But for the general surgeon, ah yes, the index finger is solely for examining the prostate.”

A twitch of the eyebrow, and a jig of the wrist.

“Roger, am I on the prostate?”

Prof. Cinna said.

“Spot on doc, you’re in the central furrow right now,” Roger said.

I wondered how many digital rectal examinations it took for a member of the public to become adept in the anatomy of the prostate. I had no patient notes to refer to.

As the smoke settled, our hero, the mighty general surgeon, removed the glove and re-holstered his index finger. Legend has it that he sleeps with it under his pillow – loaded and safety off. I’m too afraid to ask.

My turn. I’d seen the doyen of the DRE do his thing. I tried to incorporate some rudimentary sports psychology in an attempt to calm my nerves.

Be the index finger. Be the index finger. Be the index finger.

Nope, if I continue like this I’ll be sick on the patient. There is no alternative but to just jump right in.

Game face activated. Gloves on. Adequate lubrication. Time to enter the dragon’s lair.

“Roger, am I on the prostate?”

I asked, just like the Professor.

“Yeah mate you’re on main street right now,” he said.

Great, I thought, I’d been looking for some directions. I couldn’t make out the postoffice from the town hall without a set of eyes in there.

Time for the withdrawal.

“Squeeze down on my finger, Roger. I’m just assessing for anal tone,” I said, thanking the anatomy fairies the dentate line didn’t actually have teeth.

A positive KitKat sign upon inspection of the gloved finger.

Sensitivity 95%, Specificity 95%.

Clinical significance: patient forgot to empty bowels prior to attending clinic.

And with that, it was time to have a break, I’d had enough chocolate fingers for one day. p

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postcards a la suva

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matthew_bray monash The Pacific region doesn’t get a great deal of airtime in discussions surrounding global health, next to the abject poverty and conflict of Africa or the huge population growth of Asia.

However, our neighbours in Oceanic countries such as Fiji face a number of challenges to the provision of healthcare including: • A tremendous burden of noncommunicable diseases owing to urban drift, Westernising dietary patterns and transition to sedentary labour and leisure, including high adult prevalence of diabetes mellitus1 (16% with many undiagnosed) in a system ill-equipped to manage its countless complications • The world’s highest prevalence of paediatric rheumatic heart disease (55.2 per 1000)2 and numerous other preventable childhood infectious diseases such as scabies pointing to poor hygiene and health literacy

The frontline in the fight for Fiji’s health and wellbeing is its medical workforce of brilliant, compassionate, hard-working and probably overstretched doctors. Fiji has 4.3 doctors per 10,000 population4, as compared to Australia which boasts 32.65, and so against the backdrop of a hospital system crying out for more reinforcements, the Umanand Prasad School of Medicine opened as part of the new University of Fiji in 2008. Set among the hills of Saweni, on the outskirts of the western sugar industry capital of Lautoka, the school was founded with the express vision of “producing graduates who are dedicated, effective and compassionate community leaders, committed to fulfilling the healthcare needs of rural and underserved communities in Fiji”; a noble and courageous endeavour in light of the challenges that lay ahead.

• The constant threat of natural disasters accelerated and magnified by the changing climate, including more frequent cyclones and tsunamis, and an encroaching sea level threatening to reclaim whole countries,

Being a medical student is a hard task, no matter where in the world you study. To undertake medical studies at an un-tested, underfunded rural medical school demands a leap of faith that is testament to the students’ unwavering commitment to the aim of serving their communities through the art and science of medicine. Not only were the six years of study laden with concerns about the University’s administrative and fiscal position and difficulty in finding staff, but a new medical school requires clinical training placements and supervision be made available in what was previously a one-school country, prompting opposition from an establishment wary of competition and change.

• A climate of political and economic instability that has stimulated brain drain of local doctors making mass exodus to Australia and New Zealand

Despite these and many more obstacles, such as the chronic shortage of learning materials and medical equipment, the first ever cohort to graduate from

• Among the world’s highest suicide rates3 in a nation hampered by stigma towards mental ill-health and low investment in psychiatric services

UPSM will don their mortarboards this December, eager to be set loose and play their part in the improvement of Fijian lives. From their first year these students volunteered as helpers with a medical team that travels the countryside to run free clinics in remote communities, thus honing their skills in communication while reminding them of many future patients who await them and the need for more passionate and compassionate clinicians in Fiji.

Driven by this thirst for success and to prove their detractors wrong, these Fijian medical students put their Australian colleagues to shame not only in terms of hours of study, but the calibre of their clinical prowess, refined in a crucible of criticism and disadvantage.

For their diligence and excellence against all odds, they are a source of much inspiration to myself and many colleagues at Friends4Fiji (a global health group at Monash) who have sought to partner with them as we take parallel journeys in medicine. For our part, it has been a privilege to get to know and work with them through providing material aid, sponsoring study tours and facilitating volunteer trips. In an increasingly globalised world, the friendship we’ve forged through sharing resources, cultures and experiences will hopefully bear long-term fruit as we work in tandem to tackle the shared global health challenges of our Pacific region. p

References 1. Fiji Non-Communicable Diseases (NCD) STEPS Report, 2005 2. Reeves BM, Kado J, Brook M. High prevalence of rheumatic heart disease in Fiji detected by echocardiography screening. J Paediatr Child Health 2011;47:473 – 8 3. Booth, H. Pacific Islands suicide in comparative perspective. J Biosoc Sci 1999; 31(2), 433 448 4. WHO Global Health Observatory, 2009 5. OECD Health Survey, 2013

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poetry brooke_ah_shay james cook Internship Blessing May the successful cannulations be plentiful May the needlestick injuries be few May our first stabs at procedures go well May the patients decide not to sue

May the food at grand rounds be delicious May our education sessions be of use May we have ample chances to attend them May our pagers and ourselves form a truce!

May the med students not know more than us May our long-term memories serve us well May interrogations by superiors be minimal May the feelings of shame be easy to quell

May the opportunities ahead be bounteous May blue be the skies above May our supervisor reports be glowing May we all find specialties we love!

May the single male registrars be hot The physiotherapists too May the consultants be more Clooney than Laurie And may said talent only accrue

May we not fear what lay ahead As we commence a new chapter of our lives May we march into the future confidently And find that, happily, we thrive

May medical admin be agreeable May the nurses be our ally and friend May the demands on us be reasonable May the sticklers be willing to bend

May we form genuine bonds with our patients May we adhere to our Hippocratic vow May we make the most of the moolah we’re (finally) making And celebrate: after all, we’re doctors now!

May our colleagues be a source of support May our friends be there as our saviour May our venting sessions be productive And prevent most unsavoury behaviour!

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book review andrew_duckworth sydney Obstetrics & Gynaecology: An Evidence-Based Guide Jason Abbott, Lucy Bowyer, Martha Finn Elsevier Health, 2013 Having just finished my 3rd year obstetrics and gynaecology term, I’m glad to have had this book as my main reference for the rotation. Written by a distinguished team of authors from around Australia, everything it contains is relevant to Australian practice; which means you won’t be tripped up by subtle differences between Australian and UK or US practice in examinable areas such as cervical cancer screening. As the subtitle suggests, it has been updated to reflect evidencebased practice as of 2013.

Starting an O&G term can be a little daunting, as it uses jargon largely not shared by the rest of medicine. Helpfully, each chapter of this book begins with a set of key points and definitions that summarise the chapter’s contents. These are the basic things to learn to be able to speak the lingo while in clinics or on the labour ward. For example, Chapter 15: Labour and delivery starts with a summary of the stages of labour and the grading of perineal tears - assumed knowledge for shifts on the labour ward.

The chapters are arranged

by age; from the newborn, through puberty, pregnancy, the menopause and beyond. There are chapters on the underlying physiology of pregnancy, the menstrual cycle, and of fetal growth and development.

Obstetric clinical topics such as medical disorders in pregnancy, labour and delivery, and obstetric emergencies are complemented by common gynaecological topics including contraception, sexually-transmitted infections, and fertility. Some of the more specialised areas such as gynaeoncology are well covered too, with ovarian, cervical, and uterine cancer getting a thorough treatment.

The chapters themselves are written in easy-to-read prose, which, thankfully for my short attention span, is broken up on most pages by tables, flow charts and figures. These boxes cover plenty of examinable details.

For instance, you’ll find boxes on how to read a cardiotocograph (CTG), the normal ranges for scalp and cord blood sampling and how Rhesus isoimmunisation actually works in Chapter 12. The book is pitched at a medical student/intern/resident level, but would remain a useful reference for anyone who has contact with the field.

At the end of each chapter there are a set of multiple choice

questions (MCQs) and mock objective structured clinical examination (OSCE) stations that help to cement the key points and to help you integrate what you’ve learned into practice.

Complementing these is a set of example answers for the OSCEs (and MCQs) that explain the relevant history, examination, investigations and management for each station. Each scenario ends with tips on what ‘the best students’ do, to help you impress during viva voce exams.

One of the weaknesses of the book is its index, which omits topics like premature rupture of membranes (PROM) or the use of magnesium sulfate, though you’ll find these areas covered briefly in the book if you search hard enough (see preterm birth and pre-eclampsia, if you’re interested). If you, like me, are used to the instant answers of a Google search, you might find hunting through the book a bit frustrating.

In sum, I’d seriously consider picking up a copy of this book for your O&G rotation.

You’ll have up-to-date info on Australian practice all in the one reference, as well as the background physiology of O&G. The mock OSCE sections are great preparation for anyone doing medical student level O&G exams. p

31 Emergency Medicine: The Principles of Practice (6e) Gordian Fulde, Sascha Fulde Elsevier Health, 2013 I came across this wonderful little gem (will fit in a satchel or handbag) when I was doing my paediatrics term, and having a cirriculum which assessed a lot of paediatric emergency presentations, this book became one of my staples.

Like many emegency books, the first few pages are dominated by flow charts, tables, and dot points on how to handle certain presentations in short time.

Unlike many emergency textbooks, after you get to the inner title page (only 115 pages in!), you are presented with good explanations with regards

to history, examination, and management for your common emergency presentations. And this is done thoroughly, which for me was a blessing as you can put everything in context. The content is written from an Australian and New Zealand perspective, bypassing the confusion often encountered when translating the admin of foreign systems read in textbooks into clinical situations on the wards.

The chapters for the most part are designated by presenting symptom systems, but has enough reference chapters for specialty cases such as geriatrics, paediatrics, and masscasualty events. While this means some things might be placed in a chapter you would not expect, an

articulate index lets you know exactly where you should be.

The book doubles up as both an emegency reference in the first hundred pages, and a thorough textbook for the non-emergency physician, which is reason enough to get it. However, the Fulde team manage to squeeze in somewhat heartfelt chapters addressed to JMOs and medical students, with things such as how to get the best outcomes in a real hospital when there is a busy nurse or a self-absorbed registrar.

The poetic licence, the thorough content, and the Australasian context make me recommend this book a necessity for every student doing a critical care term and beyond. p

book review arghya_gupta sydney

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The RACGP’s highly interactive online education platform – ideal for developing clinical knowledge and practising for examinations.

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33

amsa medsoc reports

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It’s been a big year for ANUMSS in the AMSA department – we’ve represented proudly at GC2013, where we enjoyed participating in a successful world record attempt, featuring a world record number of ANU attendees.

We’re already looking forward to an unConventional experience in Adelaide 2014. We also sent a strong (both physically and in terms of numbers) delegation to the inspiring Global Health Conference in Hobart.

Closer to home in the sunny ACT, we’ve had a year packed with events of a high calibre. Our revamped, ‘Vegas’ themed, Winter Formal was a huge success (obviously what happens in Vegas stays in Vegas). We’ve also held inspiring and thought provoking medical and surgical symposia, and concluded our inter-year sporting cup - a crushing victory to the powerfully built first years. In slightly less

fmss lucy_haynes amsa rep

It’s been a busy and engaging year for the FMSS. We kicked off with an exciting orientation week and a sold out an hilarious med camp. We were excited to welcome our new students in both the MD program and the combined Bachelor of Clinical Science/MD program. At the FMSS we now accept our Bachelor of Clinical Science/MD students as full members of our society and consequently members of AMSA, so we’re engaging them and enjoying having them as members from day one!

We’ve had a number of highly successful events across our Adelaide and Darwin campuses, including social, fundraising and advocacy related this year, including our highly competitive Sports Week, two Mental Health in Medicine Seminars, our ever popular Specialty Pathways Evening

anumss sam_harkin amsa rep

positive news - whilst our spirit was willing, we just couldn’t quite bleed enough to get over the line in the Vampire Cup – but we were very proud of our lifesaving efforts in snagging second though, and we’re coming back for the cup in 2014.

All the best for the rest of 2013 rangers!

with Professor Chris Baggoley AO (CMO for the Australian Government) as our keynote speaker, SALDS with Professor Michael Kidd as our keynote speaker, AMSA Blood Drive, Shave for a Cure, Live Below the Line and many more. Special thanks have to go to our Social, Health and Wellbeing and Community Activities Officers for their stellar work with these events. Our James Bond themed Med Ball smashed all previous records for FMSS and sold out quickly. We were thrilled with the attendance and enthusiasm of our students and even managed to persuade two of our Darwin cohort to come down.

We’ve also partnered with the Christies Downs Special School in SA (a local school for disabled and disadvantaged children) to implement a mentoring program between our students.

Our delegation at AMSA Convention was our largest yet, with our students excelling in the Emergency Medical Challenge (with a combined Adelaide/Darwin campus team who first met over Skype!) as well as enjoying the fantastic academic and social program that the GC team put together. We’re thrilled to have Convention 2014 in our town (especially with 3 of our students; Lucy, Toby and Tristan on the Convention committee) and look forward to welcoming all the interstaters to the lovely, crazy town that is rAdelaide!

All in all, it’s been a fulfilling year at the FMSS and with AMSA and we look forward to all the joys and challenges that 2014 is sure to bring!

2013 has been an exciting year for GUMS, with a focus on new initiatives while upholding and evolving our older traditions. This year, GUMS created the Pocket Guide, a tiny version of our GUMS Guide to Clinical Skills (now in its 2nd edition), packed full of useful information for history, examination, procedures and even interpreting results. After winning the AMSA award for best publication by a medical society at Council 2, the Pocket Guide is proof that good things can come in teeny-tiny packages. Along with the Pocket Guide, GUMS has been busy expanding academic support through the creation formative OSCEs for preclinical students. By working in collaboration with the School of Medicine, GUMS was able to ensure the student-written stations and marking criteria met the SoM’s OSCE standards. The formative OSCEs ran incredibly well and students have now received feedback and results to help guide their preparation for the real thing.

Along with these fantastic new initiatives, GUMS has been further evolving Med Revue and Coffeehouse, both of which commenced in 2012, into events that are now entrenched in the annual GUMS programme. Both Med Revue and Coffeehouse have significantly developed the

msand ghassan_zammar amsa rep

Post Convention (and multiple courses of antibiotics later), the MSAND crew have managed to wrap up another successful year, with our AGM concluding in early October and the new Committee recently announced. Congratulations to our incoming President Molly Kehoe, who will be spearheading a vibrant and dedicated MSAND 2014 Committee.

Our MSAND Gala Ball in August was a huge success and held at our hometown of Fremantle at the Esplanade hotel. The night was

gums

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felicity_mcivor amsa rep

creative side of GUMS, providing students with opportunities for dramatic, musical and artistic expression. Further, 2013 has also heralded second editions of both the GUMS Wellbeing Cookbook and the GUMS Guide to Clinical Skills, the continuation of clinical skills drop-in sessions, a reinvention of Noticeboard, and our largest delegation to AMSA Convention yet!

Throughout this evolutionary period, GUMS has upheld its traditions of strong advocacy and academics, emphasis on wellbeing, giving back to the community and fantastic social events.

After a such a fantastic year there are only two things left to say: thank you to the amazing GUMS 2013 executive and congratulations to the newly ratified GUMS 2014 executive, I look forward to seeing you make GUMS even bigger and better.

filled with glitz and glamour with a Gatsby themed extravaganza. Following that, we also held our annual half way dinner, a night for second year students to commemorate the halfway mark of their degree (any excuse to let loose really).

On the sports front, the second half of the year was host to the footy season. Our girls touch rugby team manage to thrash Notre Dame Law and Physio, but the highlight was our boys finally taking the cup back home and destroying the UWA footy team by 86 points. Whilst I’m still on my high horse, I would also like to note that after much trash talk, we beat Notre Dame Sydney for Vampire Cup donations.

And finally, our fourth year reps have been working hard to finalise the details of the graduation week program which will include three separate events held by MSAND; the graduation lunch, pre-intern seminar and of course the graduation gala dinner. We wish the class of 2013 the best in their new careers as doctors.

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medusa greg_evans amsa rep

Our annual med ball had 300 guests and was enjoyed by all; Alice In Wonderland theme.

We won the Vampire Cup for the third time in a row. Competition was absolutely intense and relentless right down to the wire!

A third year rural placement mentoring program has been created to increase support for these students and we will be holding a Grad Ball in December for our graduating 4th years.

For next year, the big question is; can we “ConMedSoc elections have been held, with a fresh nect Four” in the Vampire Cup? It’s a chalteam of Deakin students ready to tackle the lenge we look forward to, amongst all things small number of ongoing academic issues we AMSA; and Deakin is excited to have three stuface, and MeDUSA Merchandise (KeepCups, dents on the National Executive for 2014!

Jumpers) are selling well.

mumus harshan_jeyakumar president

MUMUS has enjoyed a number of busy months as the academic year nears its climax. In August, MUMUS hosted the second annual Monash Leadership Development Seminar – a daylong program for a select group of 120 students across the five years to learn more about the varying fields of leadership in medicine. Among the speakers who inspired on the day were The Honourable Dr. Michael Wooldridge (Former Federal Minister for Health), Professor Rob Moodie, and The

Honourable Dr. David Davis (Victorian Minister for Health and Ageing). A week later the famous Annual Medical Ball was held at the home of racing, Flemington Racecourse. In keeping with the Spring Carnival theme, the 2013 Melbourne Cup was on display throughout the night as 800 students and guests let their hair down into the wee hours of the morning. The Ball sold out in less than 5 hours; with tickets released across two days, and was a major success for all involved.

Finally, the inaugural MUMUS Caduceus Cup (yes, alliteration is more important than historical accuracy) took place in September with over 250 students taking part in a cohort-wide sports competition that pitted year level against year level. Each year was named after a much-loved Monash lecturer and competed in Quidditch, Soccer, Netball, Dodgeball, Tennis, Tug-of-War, Golf, Laser Force, Bowling and, of course, a boat race (with water) before the overall winner was decided. For an event in its first year, it was a major success for MUMUS that is sure to increase in popularity as the years progress.

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It has been a very busy couple of months at the Sydney University Medical Society.

sums

jonathan_sandeford amsa rep

In terms of our organisation, we recently created the SUMS fund which is a charitable fund administered by the University. We also recently became an MD program and our first year will be 2014. Our medsoc released a position statement to our faculty stating our concerns about the program particularly the introduction of domestic full fee places. tween our two universities. However, in the end SUMS was victorious!!!

In more exciting news, we had some fantastic events since the last panacea issue: Our 1st Finally, the Lambie Dew Oration held on the years performed this year’s Medicine Revue, 15th of October, was the premier SUMS event. entitled MED MEN. It was a slick performance Past speakers have included the late Profeswith beautifully choreographed dances, in- sor Hollows and Professor Ian Frazer to name cluding a pole dance, hilarious and witty hu- only two. Delivered in the Great Hall of the mour, the mandatory but highly risqué nude University of Sydney, the Oration is a celebrascene and sublime vocal performances. Over tion of the achievements of Medicine within $150,000 has been raised for charity over the the University and Australia. This year the oralast four years of Med Revue. This year pro- tion was delivered by Helen Clark current ceeds will go to the Milk Crate Theatre, Head- Administrator of the United Nations space and the Royal Flying Doctor Service.

Development Programme and the Former Prime Minister of New Zealand, speaking on The SUMS rugby team recently played a char- the virtues of how global health was a priority ity match against UNDS. It was a great qual- in the policies of all governments. ity game of rugby and strengthened ties be-

unms emma_cure amsa rep elect

UNMS recently scrubbed-in to ER party, to farewell our Year 3 students excitedly embarking on their end-of-semester HES placement. Most of these students are overseas or interstate to witness firsthand the health equity issues faced by different communities across the globe.

UNMS is now officially in the hands of the 2014 Committee, which began with President James Wayte and myself representing UNMS at Third Council. Team UNMS 2014 is teeming with excitement and innovation as we look to run more diverse events, redesign our corporate structure, and also change the way we interact with students: by embracing our website, mailouts, and online calendar, rather than relying merely on Facebook promotion!

In September UNMS fine-tuned its performing prowess with our biggest ever MedRevue cast and crew of over 50, and we tackled our way to victory in October at the annual Med vs Law Rugby match.

UNMS is proud that almost half of the Indigenous Doctors in Australia are University of Newcastle graduates, and we’re seeking to introduce an Indigenous Officer to our Committee. By creating this position we hope to better support and advocate for medical students identifying as Aboriginal and Torres Strait Islander.

‘AMSA@UNMS’ is the new face of our expanding AMSA culture, kicked off with our first AMSA@ UNMS Wellbeing Initiative: the ‘STUVAC Survival Station’. With over 400 free cupcakes, a quirky photo booth, and over 500 handouts from BeyondBlue, UNMS and RUOK, it was a simple and effective way to increase mental health and wellbeing awareness within our members and also the wider University student population.

With my energetic Junior AMSA Rep Jim Fann, next year AMSA is set to become more accessible to Newcastle’s medical students. In 2014 we’ll create an AMSA@UNMS subcommittee, an AMSA@UNMS blog, and regular thinktanks.

Watch out for UNMS at AMSA in 2014: We’re the dark (sea)horse you weren’t expecting…

39 It has been an amazing year for UNSW. From our major Medsoc constitutional changes in 2012, the current executive and council hit the ground running, putting on a myriad of exciting initiatives from wellbeing to academics to advocacy.

Some of the highlights include the first “Meet the Medics” event, connecting students with alumni, eminent clinicians and researchers; our first rural teddy bear hospital in Albury; our largest Medball (350!) to date; the first AMSA@ UNSW’s Welfare Week (raising awareness for student welfare in 5 different domains – mental, physical, academic, social and nutrition), a Presidential-elect QandA and a five-station surgical workshop taught by registrars and consultants! Phew!

From the faculty – an interesting development was our approval to allow us to offer a B.Med/ MD instead of MBBS with no curriculum changes: turns out that in our 6 year course (with a full year of research) we were already meeting the Masters level requirements!

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Once again, UWSMS has had an eventful and very successful semester. Since second council, we have been working hard on providing our members with social events that bring everyone out from their study shell, seminars that leave students incredibly inspired and student based tutorials that have made studying a breeze.

Our annual UWSMS Leadership Development Seminar saw some amazing speakers join around 100 UWS Medical Students at Campbelltown campus for a two hour seminar. Her Excellency, Professor Marie Bashir kicked off the evening with her inspiring

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On the AMSA@UNSW front, 2013 saw the rise of the AMSA@UNSW Subcommittee! With the power of this dream team combined, UNSW saw a 14 place jump in Vampire Cup stakes (Deakin watch out!), a 5 policies passed at a state and national level, and on the convention front, winning the Research Presentation Competition, 2nd place in Australia’s Brawniest Medical Student and tied 3rd place in Australia’s Brainiest Medical Student: a superhuman effort!

2013 has been a year of change, of progress, of unity. New South Supermen and Superwomen, I salute you, and I have no doubt that AMSA will be hearing from us louder than ever in 2014! words, followed by Dr Brendan Nelson and Professor Brad Frankum (OAM) discussing the opportunities and challenges that exist in healthcare.

The entertainment continued with the UWSMS MedRevue 2014, ‘The Intern Games’; a shockingly comedic and incredibly controversial show that as always left the audience crying with laughter. On top of this, UWSMS has prided itself on its traditional parties raising money for various charities; the annual Red Party in conjunction with UNSW (for African Aids Foundation), and our newest social event ‘Secret Soiree’ (for Macarthur Kids Foundation).

Then MedBall returned in fairytale proportions as UWSMS cruised across Sydney Harbour. Add in our Halfway Dinner, Yrs1-3 mOsce sessions, Inter-Year Sports Night, Student Mental Health Awareness Day, Our Surgical Associations’ Endomechanical Workshop, and soon to come post exam celebrations and GradBall, and UWS Medical Students have kept their academic and social calendars full!

Finally, a big congratulations to our 5th year students as their graduation ceremony draws nearer. Good luck in your internship year and well into the future!

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The greatest, most exciting, most……. inspirational activity to have occurred recently at Wollongong was our Inspiration Lecture!! Almost 300 people including students from every medical school in NSW and the ACT attended, as well as a number of Chancellors, Vice-Chancellors, and Deans.

The 3 speakers proved to be exceptional!

Particularly of note was Professor Rene Zellweger; a trauma surgeon that coupled his passion for his profession with his endearing personality to make a spectacular presentation. We hope to expand this event even further next year … watch out for the Inspiration Lecture in 2014!

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poetry brooke_ah_shay james cook I Know Why The Ranger Chants My days are done; my career has begun Convention now a thing of the past But mistake me not, my AMSA-loving lot For I have had a ball and a blast It was 2007, the political Year of Kevin I had not even turned eighteen I heard about a “Convention”, and without apprehension Ensured that my mouse was as fresh as my screen Adelaide was the city, but oh! what a pity My age was to be my enemy I thus attended academic, and missed the polemic Of the social nights’ fun and debauchery Yet still, I was sold: the event was pure gold!

I knew I would come back for more And back I surely came (this time with game) Keener than ever to shred the dance floor Over the years, alongside my peers I morphed from student to medical professional Though despite gradual maturity, it became quite the surety That my Convention love had become quite obsessional But apologies I won’t make! And beliefs I won’t shake!

It is a most justified and irrepressible passion Those who don’t understand, who think it has gotten out of hand Merely engender my sympathy and compassion

Now gone are the days, where in an alcoholfuelled haze I can chant, “Fuck. Off. Adelaide! Fuck-offAdelaide!”

Now, when I kiss a chap, there will be no goals of “lapping a map” Never again will my social events champion Rangers getting laid Convention has given me many ‘firsts’ (and satisfied a lot of thirsts!)

I’ve had ACRRM Award pride and hook-up regret But what can I say? For I love a body-painted Ranger, I love a tall and exotic stranger And I don’t feel ready to renounce such experiences just yet But lo! For life calls! Time to let go of the Gala Balls And move gracefully to my next life phase It is time to push on, and pass the baton And remember: the memories will be with me till my dying days So Rangers, here my cry: don’t let these precious days fly by!

Give these moments your fullest wonder and attention Because one day it will end, and heed these words my friend: You’ll be fucking glad you attended Convention

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copyright 2013, all rights reserved australian medical students’ association

pa n a c ea the official magazine of the australian medical students’ association volume 47 issue 2 december 2013