Multitasking

See: I'm already making no effort with my pics (the one above is the first that comes up on a Google image search for 'multitasking').

Crap, isn't it?

Anyway, this year, now that I'm a bit settled / stuck in a rut, and what with the economy improving and all, I've started to take on a bit of work based on my previous experience. A bit of cash will be nice and it makes me feel like a grown up again. I've snagged a chunk of research work as a visiting fellow in the local university and am working with a professional services firm (as it were) to help out with a few management consulting projects in the CBD. Not sure whether this work will detract from my strict flash card-based exam technique, but so far I've gone well enough and frankly I quite like having a CV without a four / five year medical school-shaped gap in it.

I've also had conversations regarding going back to the bench for some wet science. I'm in two minds about this. On the one hand, it would be nice to maintain a bit of momentum on the (hard) science side: may help my clinical career although I have published ok over the years so I'm not sure what that would prove. On the other, it was my dislike for bench science (or rather, the crap career structure surrounding bench science) that led me to leave altogether ten or more years ago.

The clincher may be how much time I can spare. There's also a financial consideration of what is the best use of time plus the fact that I would like to use this highly unusual career break to see as much of my family as possible.

We'll see... perhaps the two small roles are fine as they stand.

Deja Ecoute

A Facebook friend was tagged in a photo last week, looking all proud in his A&E gear having spent his NYE rotation there. Thing is, he started med school 18 months after my first go in the UK and he now seems to be racing ahead which triggered a bit of (yay) reflection.

Some of the delay in my training is clearly my fault for messing around changing countries after my first year, deferring my Australian start date due to commitments made prior to receiving the offer etc. However, some of it is due to the structure of this course, which is beginning to get me down a tad.

On this course, the first two years are combined which means that, save for some exams and, of course, the actual content, the second year is largely a carbon copy of the first. Although it's nice to be in a routine, it's taking all of my gumption to maintain a high level of enthusiasm for undertaking ten or so more reflective paragraphs, five more examinations with the same format, working in groups doing largely interchangeable tasks with the same people, etc.

I'm not looking for endless variety, but this next year is going to lack the novelty of the last which probably was last year's saving grace given the other hassles associated. On the other hand, there is a degree of comfort to be gained from not having to go through all the same crap with a new bunch of people, explaining why I'm so old etc.

So perhaps, on balance, yr 2 will be less uncomfortable than yr 1.

Changing views

Worryingly, and from what I can see, typically for a med student, I'm having people asking my opinion on medical matters a task for which I am singly not qualified and tell them so, pointing them in the direction of Wikipedia (joke). Here are some of the complaints I've had to avoid professing an opinion on so far other than go to the doc's ASAP (there are more but I forget):

- Any number of rashes. Nowhere embarrassing yet, though.
- Whether a US based relative should ditch his expensive heart pills and buy some generics. Different formulations, not quite the bioequivalent formulation. Crikey - it's your heart for God's sake, why are you cutting costs there! Buy one fewer watches or go skiing less or something.
- Chest pains (chest pains!).
- Rectal bleeding (proper blood in the water, not the tissue) lasting for a couple of years (years!). I did have a clear recommendation this time: get to the bloody doctor; why are you sat here in a pub quiz night when you could be having this problem looked at?!
- Something that looked like a BCC.

Some if not all of these could well be serious - go to the GP if you have these problems rather than relying on some part qualified idiot like me. Goes to show, perhaps, the importance of trust between the advisor and advisee in a clinical relationship I suppose.

Sad and obsessive behaviour

I must admit to being a bit of a Joy Division tragic. Although I was very young when they turned into New Order, the re-release of their albums in the late 80s found me at an impressionable age and an indie kid to boot. The only JD you would hear typically came at an "alternative" dance night when you'd badgered the DJ for hours to put some on then yo'd be treated to Love Will Tear Us Apart... and a largely empty dance floor.

The sad and frustrating story of the lead singer Ian Curtis' suicide is part of popular culture now having been turned into a film on at least two occasions quite recently (C0ntrol, 24 Hour Party People) but when I started listening to JD it was all very confusing adding to the mystique of the band (give me a break, I was an adolescent...) Living within driving distance of Manchester meant that I could head over to visit the town regularly which cemented a love of the city's music that began with the Smiths and continues to this day. It was an odd experience to walk through Afleck's Palace, loading up with JD posters and a copy of the Komakino flexi disc to take off to college and stick on the walls (the posters, not the disc) . Felt like proximity to the band. Hard to explain but strongly remembered times for me. Probably due to me being 17.

Anyway, this Christmas I received a copy of Who Killed Martin Hannett? , a painfully complete description of the relationship between the man who produced their albums and the band seen by his "best friend" (it says here). The full story of Martin Hannett would take a book to go through (as you can see from the fact that someone has written one) but suffice to say he was credited with the band developing a unique sound, of being a control freak / perfectionist and being increasingly fond of heroin as the albums progressed. Martin H died in 1991 and his story reads like Wired, the John Belushi biography where, even if you didn't know the Belushi story and question the veracity of Woodward's account, you just know the guy has to die soon the way he's going on. I had the same vibe about the author of the Hannett book whilst reading it... imagine my lack of surprise when I found that he had passed away in September last year, poor guy.

Leaving this ghoulish aspect of the Factory story, this brings me to the album of Martin Hannett's Personal Mixes, the cover of which is at the top of this piece. Browsing through a vinyl shop in the CBD, I came this vinyl (mmm... 180g) and having heard about it elsewhere, I laid out the frankly painful $39.98 to buy it. The music here falls into three categories: different mixes, some sound effect recordings (interesting.... having heard them so often as part of a JD song) and a couple of interview snatches (not worth discussing). This album has had mixed reviews, but for a sad man like me it's been an insight.

Basically, it looks like Hannett's reputation for a love of delay and treble is well founded. What is more surprising is the amount of bass that is in the front of the mix. Almost capable of causing nausea. The top end hiss on the recordings of Autosuggestion plays from left to right and causes more disorientation. Two of my favorite tracks on Closer, The Eternal and Decades (which I used to listen to so much as a teenager it still causes my father conniptions) are provided in mixes which only show their differences if you've heard them a thousand times before. The sounds seems comprised of only top and bottom end (bass drum and snare, bass guitar and strange trebly jangling guitar parts) which may have been the idea: to let the singer's voice stand alone in the middle ground with only the sibilants venturng out of this territory.

At the end of side four comes a probably intentional piece of iconoclasm added to provide some contrast: someone telling Ian Curtis to "F*ck off".

Summer is a bummer

Halfway through the summer break here. I have to say, I wasn't looking forward to it a much as my younger colleagues were. I can't help but see these two big breaks in the first two years as being two three month delays in getting through the course. Due to having Christmas away from home, it's tricky to get a chunk of work during this time too so probably the best thing to do is to sort out the odd jobs around the house.

Not sure I have six more weeks of them left in me, though.

Big return

Things that stopped my blogging:

- having to find a relevant image to illustrate a posting
- excessive quality control re referencing my posts
- general busyness

Well, I can rectify the first two and we'll see how the third goes.

Odd goings on in the Guardian

Rather than write the whole thing out again, here's what I posted on the Bad Science forum:

++++++++
First post. Sorry if I appear pedantic but the Guardian's grasp of basic science facts irritates me in the face of their positioning in the market as being the clever clever paper.

Thing is, the Guardian's health correspondent has had a confusing weekend struggling with what E. coli is. Bug, virus or bacteria.

He plumped for virus in the first iteration of the article on which he was the sole author. I posted a link on my blog which now connects to a different article:

http://www.guardian.co.uk/uk/2009/sep/1 ... urrey-farm

This now has two authors, one of whom is, bizarrely, an economics writer. The avoids all mention of viruses or bugs, just "E coli". Confusingly, the article history indicates only a single revision 27 minutes after the first posting which I think is strange given that I had time to read the original article, work myself up into a whirlwind of pedantry, draft my blog bit with a photo (finding one always takes five minutes or so) so it looks like I lucked into a small window there.

Thing is, I think that this was the original piece which has also been edited:

http://www.guardian.co.uk/uk/2009/sep/1 ... urrey-farm

From a different author (Ben Quinn rather than David Batty) but the timing fits with when my blog was updated: http://methuselahmedstudent.blogspot.com/ and it has the requisite "vomiting bug" reference missing from the new piece.

So: either the bylines have been switched, or there has been some unreferenced changes, or I'm a huge idiot missing something (which is always possible). Perhaps I should have archived the original page but I"m not that anal (I didn't even italicise E. coli above, I'm sure you've noticed).

Cheers

Meths
+++++

Science literacy in the media

The Guardian, the paper of the British undergraduate (and me when I lived there), likes consider itself somewhat a cut above other newspapers. It provides a platform to the excellent Bad Science columnist Ben Goldacre (although his recent article on drug patents left a bit to be desired) which is to be applauded.

However, despite all this it still seems to favour the art graduate stepping sideways school of training health correspondents and because of this makes regular, irritating (to me) mistakes in the most basic facts of science stories. There was an article which conflated influence vaccines with therapeutics quite recently etc etc.

Here's a classic. As I clicked on the link, I knew what I would find:

- Story about an E. coli outbreak.
- Covered by David Batty, "Health Correspondent"
- He thinks it's a virus. He's clearly not sure, so starts off with the classic "bug" gambit at the start of the article to avoid committing.
- He even quotes a bacteriologist.

How long does it take to search Wikipedia? I suppose if you don't know what you don't know, you don't know you need to search.

Maybe I could be the Guardian's Australian chess correspondent. After all, I know shag all about that.

Exam time again

It's that time again: exam next week so little time to post.

Share and choose

Working in a small team can be tricky at times. One of the first issues to arise is task allocation. The most intuitive approach understood by most people was codified by Hywell Dda in the laws of Wales and is known to most people as the principle of "one to share, the other to choose".

If you have never come across this approach, it's a treat and is particularly useful if you have children. Here's the deal: the first party allocates the tasks into two groups (or cuts the cake into two bits...); the second party then choses which group of tasks they want to do (or which slice of cake they want: bigger, more smarties on top etc).

This splitting puts a natural fairness control into the process. If the first party splits the work unfairly, they get lumbered with the worst / most work.

If there are more than two parties, then the work is allocated between groups in a iterative process until individuals are choosing.

Bags of fun.

UK universities

I read the most strange statement today regarding the UK GCSE results from the Times'John O'Leary, who apparently writes for their Good University Guide:

"Today’s results are vitally important, especially for those who are aiming for a selective university - whatever those universities might think about GCSE as a measure of academic potential" [my bold]



I'm not going to wade into the dumbing down of A levels / too many people going to university debate, but it's a bit depressing to think there are non-selective universities out there.

Medical literature 3

I actually quite like this book. Although it covers similar ground to the other junior doctor memoirs and is also pre-EWTD, for some reason it doesn't read quite so artificial, probably because it's a collection of short articles written for the Guardian over a period of time, which also makes it a good toilet book.

The author comes over as likeable and self-deprecating in the right measures. He covers the usual topics of sleep deprivation and the rest but offers some personal insights. Unlike other books ("Trust me, I'm a ...") it doesn't read like it could've been set in any workplace.

And, surprise, he chooses to specialise in psych.

A journalist's perspective

Here's grim.

The splash page of the SMH had a nice picture of Marlene Dietrich with the accompanying uplifting by-line letting us know that intersex patients can now be "fixed" by their doctors, which is nice:

"

When the answer to girl or boy is: 'I don't know'

They've been called hermaphrodites and intersex children - but doctors can often fix them. "

Looks like the front page has been changed.

Oh, no: it's back now.

The article itself was unimpressive and looked like an excuse to show glamorous photos with nice titillating hermaphrodite plays on words. Mmm... sexual healing. No sign of the athlete in question, nota bene. Guess she looked a bit, erm, "mannish" for the tone of the article. Nothing as off-putting as an unglamorous intersex person.

Thing is, there's no mention of "fixing" intersex children in the article. Nor should there be, given that many of the generation of intersex children who were surgically "fixed" are a bit (a lot) upset about not being given much choice in the matter what with them being infants at the time. The Intersex Society of North America may not speak for all those born somewhere along the sex continuum, but they represent a large body and have very definite and reasonable opinions on this matter which you would have thought would be taken into account before putting a nice big picture with link on your front page.

Particularly given that the article originated in the right on, intellectual as Guardian newspaper in the UK. Despite being the paper of the discerning, earnest under- and post-grad, it still took their Health Editor, who seems to have been in the job for long enough to pick up a bit of science by osmosis at the least, several goes to get the number of human chromosomes right.

But at least they didn't go for the glam angle, unlike the high brow SMH.

International students: the future

So, looks like after 2010, international students in our state will be at the mercy of the ballot / merit system, if, and it's a big if, the state decides that it needs more interns that can be provided in the shape of local grads.

I think it will take a lot of arm-twisting by the universities to get the state govt to do this: even though our uni in particular brings in A$20m+ pa (my back of an envelope estimate which may be very wrong), I don't that that's enough to sway their current position.

Although I have been wrong before. Not least in hepatology tutorials.

All done

Assignments all done for this term. I have to say I'm beginning to run out of reflections and TurnItIn is starting to get a bit suspicious.

Hope to get back to posting a bit more... just have to worry about this term's exam now.

That time of term again

Posting opportunities will be at a premium over the next couple of weeks whilst I engage in a number of repetitive tasks to complete my in-course assessment activities for this term. IMO, there's far too much of this sort of thing on this course: I'm not sure how much you learn from undertaking more than half a dozen group essays a year with the same group of chaps but I'm sure it's grounded in good educational theory.

Good news!

Here is the first bit of good news on the employment prospect front that I've seen for a long time.

"The number of empty jobs was measured on March 31 this year. Among hospital doctors and dentists, excluding trainees, the vacancy rate was 5.2 per cent, compared with 3.6 per cent in the same month last year. The long-term vacancy rates for this group jumped two thirds from 0.9 per cent to 1.5 per cent. Vacancy rates for GPs increased only slightly from 1.6 per cent to 1.9 per cent. "

Seems that there is a doctor shortage (again) in the UK. Workforce planning has always been a nightmare, particularly with changes to people's preferred working patterns (flexible, part time), the legal landscape (European Working Time Directive, other stuff here in Australia), the sex balance of the workforce (more women, more demand for part time work), etc.

Your big chance to work in a hopsital like the one above.

Despite training a lot more doctors, it looks like the effects of these reductions in productive hours per MBBS plus the attractiveness of the NHS pensions plus the generally admitted "it's not like it used to be" horribleness of the NHS working experience has accelerated the departure of older medics from the profession. Sounds like restriction on non-EU staff are also having an effect.

Given that Australia has a similar set of demographic and work practice changes imminent, it will be interesting to see whether we experience a similar effect here. IMO, given that many medics here retire self-funded, and given the hammering that asset values has taken in the last 12-18 months (esp. sthare and property), I envisage a hiatus in the rush for retirement of senior staff until the economy has picked up a bit.

Overseas students: short term salvation

Well, it looks like the international students who seemed to have missed out are going to be sorted for a training place... this year. Not sure how the state govt is going to find places for them to train given that one idea is to find interstate positions and all of the states are in the same boat. However, this is great news and must be a relief for those students who found themselves in this position.

This situation came as a surprise to most overseas students, but it's been in the wind implicitly for a couple of years and explicitly since the document I showed below entered the public domain months ago. Perhaps this change to scarcity of jobs is such a cultural shift that no one even considered checking to see what the actual situation was.

Whatever the case, I've spoken to some justifiably angry and upset people this week. For some students, by heading to Australia they have given up on their rights to be trained in their home country and so they fall between two stools.

Personally, I think the med student council should take more of an active role: it is at least their respsonsibility as much of that of the university to look after the interests of the student body and to make sure that students are aware of this sort of thing.

The next few years will see this problem get worse and for all students to be affected. This doesn't seem to be appreciated by the student council: I would say that at this time this body has a significant task ahead of it probably for the first time in memory (judging from my experience) and need to get active now.

For the time being, perhaps pub crawls and international student social nights may have to have a lower priority.

Weird looking photo and non-sequitor of the month

The poo continues quite rightly to hit the fan for these buffoons. Good to see that an absolute lack of contrition for acting like a twot doesn't get you very far these days.

In addition to providing a photo where the subject looks very weird around the jaw line (worse in the photo in the link), the article provides a quote from Jackie O's publicist:

"Jackie's a wonderful person so she's having a break [...]"

Not sure of the logic behind that statement. I'm a wonderful person too: where's my break?

News just in

This is interesting: looks like there's a presentation from our university's medical school office regarding the training issue.

I'll head along and see what's the go.