THE AURICLe volume 4 Edition 1
LETTER FROM THE EDITORS Welcome to 2015! We’re all still trying to shake off the holiday groove – after all, this is the first time in weeks that our alarms have gone off this early, our shirts have been ironed and our coffees have been cradled one-handed while driving down the Monash Freeway. This also marks the beginning of a very exciting year. The AMSA Convention is being held on our home turf, major events such as the Caduceus Cup and Annual Medical Ball are in the midst of being planned, the incredible Monash Med Revue is about to hold auditions and, of course, your favourite medical student publication is back in action. (Let us have that last one, please.) This edition features some amazing, inspiring and visionary medical students at Monash: from those who took the plunge to spend their BMedSc year at Oxford University, to champions of queer health in both medical students and the wider community, to an individual whose experiences with rural healthcare compelled her to run for Parliament. You read that right. So sit back and enjoy this, wherever you are reading this right now – in the common room of a hospital, in the Notting Hill kitchen wondering where to steal some biscuits or on birth suite night shift waiting for your lady to finally become fully dilated.
Your editors, Michelle Li (Clinical) Kai-Xing Goh (Pre-Clinical)
CONTENTS Girl In Oxford........................................................................................................................................................................4 Why We Marched At Pride............................................................................................................................................7 Election Time....................................................................................................................................................................11 An Internal Memo For All MBBS Teaching Staff............................................................................................13
GIRL IN OXFORD featuring Chavy Arora (Med V) Since my Year 10 philosophy teacher taught our class the principles of rationalism and empiricism – the conflict between whether we derive knowledge from reason or experience – I have found the subject of philosophy fascinating. In particular, I was captivated by the use of a system of logic to derive the answer to a philosophical question. I chose to apply to do my BMedSc in Bioethics at Oxford as I thought it would be a fantastic opportunity to develop my philosophical reasoning ability, while applying this philosophical thinking to an issue in medicine. I also saw it as a chance to be put outside my comfort zone, in a different and inspiring environment.
What was the application process like? The application process involved writing a cover letter on your motivation and interest areas in bioethics, as well as submitting a CV. As far as my understanding goes, if the selection team liked these things, and the applicant’s marks were satisfactory (I mean that in the loosest sense of the word!), then you were offered an interview. My experience of the interview was somewhat different to others. In September of 2013, I had just arrived in Hobart for AMSA’s annual Global Health Conference when I received an email stating I had been offered an interview in two days’ time. In a flurry of panic, I considered flying home for the interview. As I was looking up Hobart to Melbourne return flights, I remembered the invention of Skype; surely enough, the faculty confirmed that I could do my interview online. I have barely any recollection of the interview, except that I was confident that I stuttered more than I spoke, and there was no way I had expressed an eloquent thought. Two hours later, I sat in a lecture on foreign aid, listening to very little of what was being said, mindlessly refreshing my Monash email to provide some distraction from the terrible feeling in my stomach. To my surprise, an email appeared with the Subject “Bioethics BMedSc” and a preview reading “We would like to congratulate you on…” I was overcome with joy! Can you tell us about your project? My project was titled “The Ethics of Resource Allocation in the Neonatal Intensive Care Unit: An Empirical Perspective”. In the context of scarcity of resources in the NICU, it investigated the general public’s resource allocation inclinations and the underlying values associated with their decisions. This was done via an online questionnaire; this kind of empirical research is quite novel in the largely normative field of bioethics. What was it like when you finally got there? Describe a typical day. When I got there, I walked about twenty minutes through rain from the bus stop into town to pick up my keys from Exeter College proper. Although I was drenched, I was elated by the buzz of students in a university campus town, and the sight of the beautiful Oxford University buildings. A typical day involved cycling about 10 minutes to the Oxford Uehiro Research Centre where I had an office I shared with Kate and Chris (the other two Monash BMedSc students there with me) or to the old and wonderful Bodleian Library. I would work on my project (reading, writing or doing data analysis) until about 3pm, then attend afternoon lectures by visiting academics (I had the opportunity to hear the likes of Joseph Stiglitz and numerous others), often followed by college events such as formal hall or “BOPs” (Big Old Parties) in the evening. What are some of your favourite memories from Oxford? One of my favourite memories from Oxford was attending three days of lectures by Indian academics and policy advisors at the School of Interdisciplinary Studies during the lead-up to the Indian election; the biggest democracy in the world! Another was attending the 700th Anniversary Exeter College Ball, which was a black tie event that ran from 8pm-6am and involved the entire centre of Oxford town being shut down for festivities. Overall, my favourite part was the relationships I formed with wonderful and beautiful people from entirely different academic and cultural backgrounds to me. Did you have time to make trips to other places? Where did you go? I had the opportunity to attend a Global Health Ethics summer school in Geneva, along with the team that created the Global Burden of Disease measurement (funded by the Bill and Melinda Gates Foundation). I also got to travel around Europe for a month – Amsterdam, Berlin, Prague, Budapest, Madrid, Barcelona, Granada, Seville, Lisbon and Porto! Do you have any advice for people interested in applying this year? Past students who have done the Bioethics BMedSc seem to have been an extremely diverse bunch, so it seems there is no formulaic selection process, and therefore no particular advice I can offer. In terms of general advice, I would suggest reading widely on bioethics, or whatever interests you (there are ethical considerations to pretty much any topic), and writing about this in your cover letter and talking about it in the interview. If you have any specific questions though, I’d be happy to answer them (my email is caro1@student.monash.edu).
WHY WE MARCHED AT PRIDE Shaday Wheatley & Elizabeth Kindred On Sunday hundreds of people, queer and straight alike, mingled in a dizzying array of colour for the 20th annual Pride March. The event is a chance for the LGBTQI community to unite, both in celebration and in protest. Amongst the crowd were a group of students marching under the banners of MDQueer and the Queer Health Collective. These two groups are comprised of medical and other health students from universities across Victoria who have come together with the aim of helping to end the health disparity faced by the queer community.
For queer students, progressing through their health studies can be a jarring experience. In the midst of anatomy labs and radiology lectures they encounter the inevitable discord between their community and their new profession. Lived experiences of alienation and discrimination are suddenly put into the harsh context of population health tutorials full of statistics, diagnostic criteria and prognostic charts. The friend lost to suicide is suddenly part of a statistic on transgender youth. Outbursts of sadness, rage and frustration become unequivocally linked to studies on mental health in the LGBTQI community. The doctor’s lounge discussions reveal another side to the story. Students witness the broad spectrum of opinions, experiences and education that govern how the medical profession approaches these statistics in clinical practice. It was this mix of medicine and society that deemed homosexuality a mental illness, but also had it removed from the psychiatric diagnostic guidelines in 1973. It is this same system that still sees many doctors ill-equipped to meet the needs of transgender patients. This culture also helped shape the medical law that mandates gender assignment at birth and places massive restrictions on therapy to stop transgender youth going through puberty. It is the incredible, tireless struggle of queer activists that is responsible for the societal changes we have seen so far. Their work has created a generation of health students that have internalised this progress to become a more inclusive and socially conscious breed. The next step is for these sections of the profession to start creating change from within. They will have to strive to create a medical profession that is armed with the knowledge and sensitivity to provide better care to LGBTQI patients at their most vulnerable. It is vital to not only improve things in the health community but also to engage with the broader campaign and learn from its history. To create meaningful change it is important to fight the wider societal discrimination, treating the disease rather than merely the symptoms. On Sunday we marched to support a community that stills suffers due to discrimination. We marched to thank the activists of the past that gave up their safety, security and sometimes their lives to pave the way. We marched as a promise to do our part in this movement: to educate, support and advocate for the queer community in the health profession as well as wider society. This is why we marched at Pride.
“The next step is for these sections of the profession to start creating change from within.” “They will have to strive to create a medical profession that is armed with the knowledge and sensitivity to provide better care to LGBTQI patients at their most vulnerable.”
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ELECTION TIME Kate Maxfield (Med V) talks medicine, politics and that time she ran for Parliament
What made you decide to run as ALP candidate for Gippsland East? I have always had a passion for social justice and after having it lead me into medicine it was almost inevitable that it would lead me into politics. My passion for social justice is enlivened by what can be achieved in politics, whether it be improving health outcomes, increasing foreign aid or just improving peoples day to day lives. Being born and raised in rural communities with frustratingly unacceptable socio-economic outcomes, I was always drawn to what should be delivered for rural communities. How did this mesh in with what you were doing in medicine at the time? Standing for Parliament in country Victoria was a very natural extension of my medical studies. Being placed in rural areas across Victoria, I’ve witnessed first-hand the inequity in health outcomes faced by rural patients. Whilst I have been inspired by the commitment of rural GPs, nurses and other health practitioners in rural areas the sad reality is they need more support to do their jobs as best they can. These communities need greater funding, greater health education, greater mental health services, greater job opportunities and a wide array of other things to improve health outcomes. As a medical student I can hope to improve the lives and health outcomes of my patients and communities, but as a political activist I can help to improve the health system itself and therefore the lives of fellow country Victorians. How did it go? Despite the nerves, it was a really eye-opening experience. In the end I didn’t win, but I had a decent swing, with approximately 31% of the vote – but the highlight was most certainly being able to advocate for improved rural health, particularly emergency healthcare. Whilst having to debate ministers on live radio can be daunting, spending time with committed volunteers, activists and my campaign team ensured I was constantly inspired and confident that what I was doing was helping lead to the change that I know rural communities need. Do you see yourself running again or being politically involved in the future? Whilst I enjoyed running for Parliament and am very committed to achieving positive reform, I suspect I will have to let my study commitments take priority for the time being. That said I will always find time to speak out for what I believe in and get involved when I can – and I strongly encourage fellow students to take up the mantle and utilise their knowledge of the health system and advocate or get actively involved in improving it rather than just accepting it the way it is. It can be improved, and as health practitioners we need to be at the forefront of that drive to improve it. What is something that you think other medical students should take from your experience? For any other medical students interested in running for Parliament I’d recommend not doing it during the exam period! But on a serious note, I feel medical students need to appreciate how important politics is, particularly its influence on the medical world. As medical students we see a lot of confronting things, and I strongly believe that if you see something that can be changed, then stand up and change it. What are you up to in 2015? This year I’ll be completing my final year in rural and metro hospitals as well as continuing my involvement in the Labor party and an external leadership program. In the med student world I’m co-ordinating the MUMUS mentor program, Momentum, and am part of the AMSA Convention social team. I might also find a bit of time to debate politics with my friends and volunteer a little for the Labor party and other NGOs.
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Recent evidence-based studies published from Moodle survey databases demonstrate that Monash medical students are reporting levels of self-satisfaction that are unacceptably high.
1. Follow the Consultant This technique is for students in Years 3B to 5D of their training. Whilst leading them on ward rounds, ensure that you have your student’s attention. Be engaging and helpful! This will lure them into a false sense of involvement.
Ask yourself – are your students any of the following? – Well-rested? – Having too much fun? – Feeling human? – Proud of themselves or their achievements?
Whenever you get a page, start running. Run anywhere and everywhere. Run down corridors, weave in between patients and nurses, run up and down multiple flights of stairs. Be inhumanly fast!
Be assured! Utilising the latest research, our faculty is proud to present our patented Medical Student Workout – a complete solution that is guaranteed to crush their spirits!
Your students will have no idea what on earth is going on, but will still attempt to follow. It will be hilarious. When you have had your fun, turn around and say there was a stand down.
Implement just some of these sure-fire exercises and watch your students crumble by the time their VIA exams come around!
Repeat this process multiple times throughout the day to destroy their legs and psyches. 13
An Internal Memo For All MBBS Teaching Staff* *As perceived by the mind of a sleep-deprived medical student
2. Lecture Marathons
3. Rope-a-Dope
Best implemented in the second year of the program, lecture marathons are proven to instill sheer boredom in all but the most eager of medical students.
Identify a student that is overly enthusiastic. Offer, happily, to mark their MCRs or PIAs. Give the student some excellent feedback, ensuring to utilise one of the lines we’ve prepared foryou here:
Watch and laugh as their heads nod up and down. Watch them struggle to maintain waking consciousness.
– “That was flawless! You really showed great rapport with Patient X; I’m really impressed!” – “Your skills are at a higher level than some of the interns I know!” – “I have no criticisms.”
Consider some of these handy tips: – 7am to 5pm: maximum legal hours, ensure that you use them well! – An allotted break of 30 minutes is generous – Incorporate plenty of sociology and epidemiology for maximal effect – Schedule anatomy strategically in order to ensure attendance to all preceding lectures
Having pumped up their confidence, proceed to give them the most mediocre or average mark possible. For example, if it’s an MCR where marks range from 1-5, give them all 3s. Hand back the form and laugh inwardly. And there you have it – stay tuned for more advances in this growing field! 14
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