oxford-handbooks

anonymous asked:

Hi, just wondering if you recommend the mini editions of the oxford handbooks or the full size? Is there a difference (content cut out, etc)? Which titles do you recommend? Thanks! :)

Oh are those those really tiny ones?? I’ve never tried them because I find the size of the normal ones small enough already really! The normal ones are still small enough to easily shove in your bag and they’re soooooo good.

The ones I recommend are - 

- the oxford handbook of clinical medicine - this has pretty much most of the stuff you need to know, from like the main specialties like cardio, rheum. It doesn’t go into massive detail but it has the basics of everything you need to know, and it’s laid out really nicely.

- oxford handbook of clinical specialties - I’ve only just bought this one so I can’t say much, but it seems really good. It basically has all the specialties not included in the clinical medicine one, e.g. things like ophthal, derm, paeds.

- oxford handbook of clinical diagnosis - this one is soooo helpful, especially for revising for OSCEs! It basically has everything split up by sign or symptom, and goes through the differentials for each one and what investigations to get, etc. So for example, there’s a page on chest pain, acute abdominal pain, jaundice, etc. 

Anti-epileptics/Anti-convulsants Made Incredibly Easy

TREATMENT STRATEGIES:

  • Start therapy after the second seizure; first ONLY if recurrence is high = MRI abnormal, EEG abnormal, or status epilepticus.
  • Monotherapy until seizures are controlled.
  • If failed: titrate up to maximum tolerated dose –> shift to alternative drug –> use drug combination –> VNS, DBS.
  • Full drug therapy for 2 – 3 years after the last fit.
  • Gradual withdrawal over at least 6 months.

Rx Profile:

(Drawings are courtesy of @mynotes4usmle​)

Carbamazepine

  • Mainly for generalized tonic-clonic seizures
  • Trigeminal neuralgia
  • Bipolar disorders (with depressive predomince) - mood stabelizier
  • NEVER in abscence seizures
  • SE:

Lamotrigine

  • Safer profile, with minimal interactions.
  • Bipolar disorders (with depressive predominance) - mood stabilizer  
  • SE: maculopapular rash; SJS

Topiramate

  • Broad spectrum anti-seizure; used in migraine.
  • SE of TopIRamate: enzyme Inhibitor + Renal stones.

TREATMENT PROTOCOL:

Green: first line; Yellow: second line; Orange: third line; Red: contraindications. (Graph reproduced from Oxford Handbook of Clinical Medicine)

Epilepsy & Pregnancy:

  • Non-enzyme-inducing AEDS have no effect on the pill. Enzyme inhibitors prolong the half life of OCP (=Valproate) so better for birth control , and vice versa.
  • Most of AEDs are teratogenic; Category D
  • Therapy not stopped; uncontrolled seizure is risky to fetus & mother. Give lowest effective dose.
  • Avoid phenytoin, valproate and barbiturates (use Lamotrigine)
  • Most AEDs cause folate deficiency …. Folic acid (prior to or early in conception)
  • Most AEDs are competitive inhibitors of vit. K-dependent clotting factor: Vit. K to mother 10 days before labor & to newborn.
  • Most except carbamazepine and valproate are present in breast milk. Lamotrigine is safe on infants.

Status Epilepticus:

  • WHAT? Seizures lasting for >30min, OR repeated seizures without intervening consciousness.
  • Things to be done:
  1. Bedside glucose, the following tests can be done once Rx has started: lab glucose, ABG, U&E, Ca2+, FBC, ECG.
  2. Consider anticonvulsant levels, toxicology screen, LP, cultures, EEG, CT, CO level.
  3. Pulse oximetry, cardiac monitor.
  • How to treat?

THE END

Originally posted by disneypixar

silver-pastel-stars  asked:

Hi! I'm writing a report for on the Baltic deportations, the Forest Brothers, etc, using many of the resources from your blog. Do you have any sources I could use that I can cite (I can't exactly site posts from Tumblr without getting questioned)?

paging @official-latvia and @official-lithuania to give their sources as well

anonymous asked:

Hello! Do you know of any interesting books or essays on Sufism?

This is far from my area of expertise and I’m afraid my recommendations will mostly revolve around Sufi poetry. But if you’re interested in these, here you go:

Preface and Annotations by Coleman Barks, in Rumi and the Book of Love
Hafez and the Sufic Ghazal, Iraj Bashiri
Preface and Annotations by Peter Avery, in Angels knocking on the Tavern Door
Weaving with needles and pens: Sufism, self-affirmation, and women’s poetry in the Indian sub-continent, Anna Vanzan
Rumi - Past and Present, East and West: The Life, Teachings, and Poetry of Jalâl al-Din Rumi,
Franklin D. Lewis (I can only vouch from excerpts for this one)
Sufism, in the Oxford Handbook of World Philosophy, Erik S. Ohlander
Sufi: Expressions of the Mystic Quest, Laleh Bakhtiar

I have also had my eye on:

Sufism, The Essentials, Mark J. Sedgwick
Islamic Mysticism, A Short History, Alexander D. Knysh

I hope this helps!

anonymous asked:

Any tips on how to study for a GP rotation? :)

Hello! So we don’t really have a GP rotation, we sorta have it mixed in with everything else, but I just did my elective mainly in GP so hopefully I have some good tips.

1. Psychosocial. So firstly, bear in mind that there is a LOT of psych and social stuff in GP land. It’s not just diagnosing and treating, it goes beyond that. A patient might not come in because they have a symptom; they might come in because they’ve just got a divorce and don’t know what to do. Or they might come in because they are elderly and socially isolated, and want someone to talk to. 

So it’s really important to brush up on your consultation skills, especially for psych, and also know that there isn’t always going to be a simple answer.

2. Practicalities. Another thing that GPs have to deal that you don’t really learn much about in med school are things like fitness to drive, fitness to fly, time off work. We learn tons about diseases and symptoms in med school, but what do you do when a patient with COPD comes in asking if they can fly to Mexico next week? Or someone with depression says they can’t bear the thought of going to work tomorrow? There’s a lot of this in primary care, and it’s important to know about the rules and regulations of things like this. 

There’s also more serious, legal stuff GPs have to deal with - for example, what do you do if you suspect your patient is being domestically abused? So it might be good to look up guidelines about that sort of stuff.

3. Dealing with uncertainty. In med school, we learn that firstly, the patient comes in with symptoms. Then we investigate the patient thoroughly, until we reach the diagnosis. Then, we treat the patient. Well, that really doesn’t happen all the time in primary care. GP’s will often have to consider the differentials and go with what they think is most likely, even though it hasn’t been confirmed. You can’t just send every single patient off for all the investigations - you have to learn how to assess the risk of a patient and the chances that something actually serious is wrong. This is the main thing about being a GP - is it serious? Does this patient need to be referred or not? 

4. Following on from that, know your red flags!! This is so important for GPs - after all, they are the gateway to medicine, and it’s important not to miss worrying signs. Learn your red flags for back pain, for cough, etc. 

5. Differentials. This is probably obvious, but GPs need to be REALLY good at differential diagnoses for different symptoms! And especially focus on the more common ones. Common things happen commonly.

6. Brush up on your knowledge of common things seen in primary care and how to approach them. From what I’ve learnt and from experience, these are things like: Back pain, depression, MUS (medically unexplained symptoms), anxiety, asthma, hypertension. All the common stuff! 

7. Oh and knowing stuff about screening and prevention of disease is really important, as it’s usually GPs who deal with that. E.g. cervical cancer screening, checking things like blood pressure and doing risk scores (like QRISK) etc. Smoking and alcohol problems, and help with quitting, is also another huge thing.

I’ve probably still missed out loads of stuff but I hope that gives you an idea of what sortof stuff to study anyway! Also, I recommend the chapter on primary care in the Oxford handbook of Clinical Specialties, if you’ve got that. Good luck! x

A half-proud half-guilty brotherhood. Proud because we hold the reins of life and death in our hands, and guilty because we are all dragged down by the unstated fear that our cures have never fully evolved from our ancient past of quackery and charlatanism. This is the reason we are so pathologically loyal to each other and our jargon has the role of binding us into an unbreakable magic circle that ensures what is unsayable remains unsaid
—  Oxford Handbook Clinical Medicine (on the encrypted way doctors present patient histories in front of the patient themselves, and its exclusive nature)

medicine-student-blog  asked:

Do you know of any good resources or books that would be beneficial for a medical-student-to-be-in-September? I've heard that Oxford Handbook of Clinical Medicine is wonderful so I will be purchasing it. Is there any other books or resources or even things that I'll need in clinical settings? My university has said they won't give any information to us till we start but I really don't want to be waiting till then. I want to start now. I'm so hyped for Medicine and it's ups and downs!

First of all hearty congratulations in getting a place!

Hmmm, the first couple of years are always pretty non-clinical and are generally focused on harnessing all the theory and then the latter (clinical) years are where you translate all that into actual practice. 

Don’t be fooled with the massive reading lists med schools love issuing. They are notoriously long and a lot of the books you may never have to use! 

Word of advice, DO NOT BUY any books without having tried them out first. You’ll find out people are buying tons of books in the first few weeks, a lot of is ‘cause of peer pressure, being new etc. You have to bear in mind the reading material is not exactly cheap (average of £50-80 per book). I didn’t buy anything for the first couple of weeks…and instead borrowed books from the library, and if I liked them I would later buy them. Nothing worse than shelling out for an expensive book and realising it’s not actually for you. 

I’ll break it down into:

(disclaimer these were my gen favourites.) 

Physiology 

 - My favourite was Martini. Easy to use, just the right balance of detail. Plenty of pictures so ideal for anatomy. Marieb & Hoehn is also really good. 

- Guyton - infamously detailed with very wordy prose, although very useful if you want more in depth explanations. 

Anatomy 

Gray’s anatomy - my favourite. Right amount of text, loads of pictures, sections on surface anatomy. Just all round great. Probably the most popular anatomy book. 

Moore and Dalley - another great go to anatomy book. Awesome pics, nicely colour-coded. Good when in combo with Gray’s. 

Netter’s anatomy flash cards - if you’re a visual person, this is a great tool also. Really handy during the revision period when you want to practice in a group or pairs. 

Pathology / Pharmacology

Robbins Pathology - the mother of all pathology books. Incredibly heavy but incredibly useful.

Rang & Dale - probably the best pharmacology aid. Had always been my go to for all things drugs. 

Clinical

KUMAR AND CLARKE!!- the bible of medical school. You gotta have one. You’ll be referring to this one during your clinical years quite a bit. 

Davidson’s - lesser detailed compared to K & C but nonetheless, detailed enough to grasp health concepts. 

Oxford Handbook of Clinical medicine and arguably it’s counterpart OH of Clinical Specialties. Actually the former is the bible of med school. Had a pocket sized one that I got for free during freshers! Succinct, right amount of detail, a great section for abbreviations and logically set out. Can’t fault anything with OHCM. It’s a definitive must have. 

Anyway, hope that helps. Best of luck with your endeavours! :)  

people like to assume that Vocaloid and the Gorillaz are identical, varying only in their place of origin, because of their popular holographic performances. but the majority of those assumptions come from the sole fact that they both utilize the “virtual popstar” characteristic when really they’ve vastly different…in the west, the “hologram” part of Vocaloid creation gets all the credit and attention just because its something you can see up-front and because of the pretty high production value but that’s not even what Vocaloid’s all about..

the thing that really makes Vocaloid unique is that its success is based almost entirely in its community’s passionate contributions. honestly, i find the ability of a software combined with a character design to inspire genuine creative and participatory passion within people across the world a lot more revolutionary than the discovery of a way to project an image off of a transparent screen. holograms really aren’t THAT uncommon. they’re a slightly more advanced version of the pepper’s ghost trick. they’ve been used by Tupac (2012), the Gorillaz (2005?), even Splatoon’s Squid Sisters (2016). Hatsune Miku’s first live performance was in 2009 (her initial software release in the summer of 2007). but does the success of Tupac, the Gorillaz, and Splatoon come from a global anti-hierarchical community of collaborative artists? no. Tupac is a rapper/actor, the Gorillaz is a band, and Splatoon is a video game.

now, all of these things are different in their own right. neither is “better” or “worse” than the other, they’re all different, and have different histories, are based in different media types, and messages to their respective fanbases. they all have different places in the entertainment industry, and people have their own preferences and “tastes” in entertainment media. that’s fine, to each their own. i’m sure Tupac is a fantastic rapper, i’m sure the Gorillaz is an amazing band, i’m sure Splatoon is a really fun game. Vocaloid, too, is a phenomenal culture. but none of these things are identical just because holograms were utilized by them at some point, and if their holographic performances happen to be the initiating event of further interest, let it be understood that they are merely the tip of the iceberg that is the rest of the franchise. 

(furthermore, is anybody is interested in getting a much more in-depth look on the history and success of the modern “virtual popstar” in musical, visual, and performing art, i suggest Chapters 7 (”Hatsune Miku and Japanese Virtual Idols” by Rafal Zaborowski), 8 (”Hatsune Miku, 2.0Pac, and Beyond: Rewinding and Fast-Forwarding the Virtual Pop Star” by Thomas Conner), and 9 (”’Feel Good’ with Gorillaz and ‘Reject False Icons’: The Fantasy Worlds of the Virtual Group and Their Creators” by Shara Rambarran) in the Oxford Handbook of Music and Virtuality by Sheila Whiteley and Shara Rambarran. )

Update + Survival Strategies for Medschool

Today a few people came crying to me and a few more expressed their low mood. This is one of the days when medschool really sucks :/ Keep reading to see how I stay sane myself.

On the bright side, I felt much more confident doing prehospital care scenarios tonight and learned a lot so I’m glad I went and didn’t follow the lazy minion in my head.

I was quite curious about the feedback I’ve been getting from tutors and doctors in hospital so I peeked into my feedback and some of it is so positive I thought they must’ve confused my name with someone else’s. Either that or I managed to fool everyone into thinking I know a lot when I don’t feel that way at all. If I did, it must be my new life attitude working - I decided I would:

- show up (unless really unnecessary)
- put on a poker face if feeling nervous, smile a lot
- fake it till you make it, including dressing the part
- not take criticism to heart - seriously throw that negativity out the window, you don’t need someone to tell you you don’t know something and make you feel bad for it if you already know you don’t and you’re working on it
- remember the consultant/attending only knows more because they’ve had more practice, they are not better, just further down the line
- strategically answer questions when 100% sure
- reason through the ones where not 100% sure
- talk around the answer when I really don’t know (only because when I say I don’t know, doctors keep pressing me more and saying that I probably do - annoying habit!)
- ask questions
- ask more questions to avoid getting asked questions or in response to a question if I don’t know the answer (they forget they were the ones to ask)
- joke with the doctors & make friends with them, they’re mostly nice people
- befriend the junior doctors and final year students, they’ll help without even being asked
- carry a massive notebook everywhere and take down every single case or piece of information I hear - helps you learn + makes you look like you’re on it
- never trust them when they say they’ll send you the slides because they never do
- Google, Wikipedia and YouTube are my best friends
- the Oxford handbooks and the BNF are my second best friends
- learning outcomes: use ‘em, you’ll feel like a genius if you read around them in advance
- ask to do things on wards/theatre/clinic, take bloods, do ECG, calculate & prescribe meds, clerk, examine, assist in surgeries, suture
- go to conferences, learn more about the specialties you enjoy, it’ll fuel your studying
- feign interest even if really disinterested, it works and you learn
- buy a cheap whiteboard and draw complex pathways on it so they’re ingrained in your mind forever, look at it as you come and go

HOLISTIC TIPS:
- chew gum discreetly, always
- wear monochrome and smell good but not overpowering
- make time for fun with friends every day
- speak to family everyday
- do a few good things for others everyday
- gym a couple times per week
- eat well (not too “healthy” and not too unhealthy - balance is key!)
- tidy up room (& life) every once in a while
- memes (can’t stress this one enough)
- allow self to wallow in self-pity for a day or two but make sure to reset and get back on track after the specified time frame
- learn about the world and not lose touch with what it is to be human, watch documentaries, read articles, communicate with old friends and stay in touch
- hot showers before bed, face scrub, chill in dressing gown and spa slippers
- change bed linen every week
- keep window open at night
- spray air freshener or light candles
- decorate walls, have books on the shelf
- never drink coffee, always drink water
- eat any and all free food to avoid cooking
- not take self too seriously and take every opportunity to have some banter

Second, instead of the state and nation being real essentialized objects, feminist theories tend to explore them as relational entities that need to be perpetually reproduced through discourses, practices, or material circuits. Feminist scholars explore the power relations behind these constructions, the femininities and masculinities they rely on and reproduce, and their differentiated gender impacts. State processes, policies, institutions, discourses, practices, and norms are shown to be gendered and gendering and constitutive of gender orders. States and nations are also racialized and sexualized in that they use norms around heterosexuality to reproduce the state and nation.
—  Johanna Kantola, “State/Nation,” in Oxford Handbook of Feminist Theory, ed. Disch and Hawkesworth, pp. 915-6 

anonymous asked:

Hi! I have a question, as a female junior doctor, white coats aren't allowed but how do you keep your oxford handbook on you? Or your phone, bleep, bottle of water? And are they allowed non-ripped loose jeans? And can one wear black nondescript trainers if they have foot problems and need arch support? Thank you! I'm worried about starting F1...

Hello!

You’re right. They were outlawed for infection control reasons a long time ago (around 2003?) so I only have the most vague distant memory of doctors wearing white coats. It was before I was even in med school!  Personally, I kind of feel white coats would be too warm for most people; after all, we’d still have to wear smart clothes underneath. And hospitals are warmed so that patients wearing nothing more than a gown don’t feel chilly. I’m someone who always feels cold, but even I’m not sure I’d want a white coat.

My ‘little ward bag’ is juust big enough to fit my handbook, pens, money, and assorted other items. I’ve actually drawn it in a comic here. It fits a surprising amount, it turns out. I only take it off when I have to for procedures, or if I’m having a rest on nights. Otherwise, it’s become almost a physical part of me.  And the stuff that goes on my lanyard or gets carried around has been featured in the follow up comic here. I don’t carry a bottle of water with me, though I’m thinking of bringing a flask to work to get myself to drink more water. So I definitely recommend that, but there’s the challenge of not losing it if you’re on call.

In terms of how we dress as doctors, I try to draw my comics as close to real life as possible. We all have our own styles and comfort zones on the smart/scruffy continuum, so there’s no one answer that fits everyone. But in general, most junior doctors tend on the smarter end of smart-casual. I’ve explained it in this post here, because coincidentally I’ve had a few asks about shoes and dress codes recently. I also recommend this post on shoes for tips.

The NHS dress code as it stands, specifically forbids jeans and trainers. This means that your employers, and your seniors would be within their rights to ask you to dress differently if you turn up wearing either of these. Because it’s in the rules, and they can start citing vague but old-fashioned GMC guidance on ‘dressing like doctors’ and the like. I have complex feelings about dress codes, and feel that we as doctors are sometimes our own worst enemies when it comes to imposing old-fashioned rules on our peer group. Do I feel a doctor having blue hair or tattoos makes them less professional? No. I feel that we are too quick to assume what our patients would or would not accept to be appropriate dress for doctors.

But although I support my more outlandish colleagues, I personally dress smartly.  Because I’m a short woman who keeps getting asked if she’s a med student or a nurse (If I’m lucky), and I need to look like an experienced, reasoned adult that patients and their relatives feel is competent. And because it’s a kind of uniform that makes me feel more confident to be assertive. I feel it’s like a costume that helps us to take on the doctor persona, and it’s a visual signifier to our patients and our fellow colleagues that we are at work and we mean business. I would suggest that erring on the side of smart is sometimes a necessary evil in order to be taken seriously.  When you start as an FY1, you’re the lowest in the pecking order, and you’re working with doctors and nurses who are decades older than you. It’s hard not to feel like a bumbling kid, in some ways. Most of your patients are elderly, and many will tell you that you look far too young to be a doctor.

There’s another risk, If you wear trainers or jeans on the wards, your seniors might take you aside and tell you it’s inappropriate. It’s the kind of thing that people can remark on. I used to think nobody would be that petty, then one of the surgical consultants gave one of my fellow FY1s a public dressing down for wearing scrubs outside of theatre. Because apparently surgeons should always dress smartly +++ outside of theatre. I think that’s an overreaction, but I personally don’t want to risk extra grief at work from colleagues or patients. Bearing in mind that we rely on feedback from colleagues and seniors to pass every year, and rely on their assessing our competence.

However, plenty of people wear trainers when they are on nights, or if they are on placements like ITU or paeds or A&E where they are expected to wear scrubs every day. That said, if you are on the wards or in clinic, then the expectation remains to wear smart shoes and smart clothes. I’ve seen ladies get away with fitted dark ‘jeans’ that basically look like fitted trousers, but proper denim would definitely be noted.  Unfortunately, my advice would be: dress down at your risk. Perhaps if you have medical problems, they might let you get away with the trainers. I hope so, personally. I had to wear canvas trainers to clinical rotations in med school for a few months due to foot problems, because everything else was agony. Then again, I was probably limping around everywhere, so perhaps they just felt it best not to comment. However, the rules are a little stricter if we are working, so I wonder if they would be as lenient. We’d have no excuse to wear jeans, though, because there are plenty of options for comfortable smart-looking clothes (as opposed to shoes).

As for shoes, I can empathise with your struggles. I’ve had chronic foot problems since med school, and it’s been a real struggle to find shoes that don’t cause me agony. I’ve bought (then had to get rid of) so many shoes that seemed comfortable only to cause agony after a few hours. Many of my friends can wear just about any shoe. I’m so envious, I’d give anything to be able to do that, even just for a night. Unfortunately, I’m stuck with torture feet. Even with problem feet, it’s not impossible to find smart shoes that are comfortable; you can and will find ones that work for you eventually. It’s just hard, and it takes a long time because what works for each of us is a little different. I now have brogues that I genuinely love to wear on 13h on-calls, that feel comfier than my canvas trainers. Comfy smart shoes do exist. And we have to seek them out, because as a professional doctor it probably won’t be possible to wear trainers the whole time.

My Advice would be:

  • explore stores and ranges that offer half sizes or wide/narrow fit. sometimes that makes all the difference.
  • Look at orthopaedic ranges. Yes, I know some of them are designed for grannies. Not all of them are; I have some pretty nice shoes from the footglove range from M&S, and I love Clarks. Both are perhaps more expensive than I’d like, but hardly in ‘designer shoe’ range.
  • Oxfords, brogues and loafers can all be really comfy when you have worn them in.
  • Plimsolls, Toms and shoes that don’t look like trainers but still offer support.
  • Consider trainers that don’t obviously look like trainers? Maybe some of the nicer ones from Sketchers or something?
  • Stay away from pumps. Nobody gets out of them without bloody feet. Pumps are a trap.
  • Consider insoles, if they have helped in the past. That might help to adapt
  • Podiatrists may be able to help advise what kind of insoles you might need if you have high arches or need special support.
  • Google shoe recommendations by nurses and other doctors. Nurses are on their feet a lot and know all the best shoes.I’m personally collecting recommendations to try out. 

Good luck in FY1, and let me know how you get on. At the end of the day, what we do when we are at work is far more important than how we dress. So this shouldn’t have to be a massive source of stress for you. You absolutely don’t have to be dressed like the smartest, fanciest person out there, just look vaguely presentable and you’ll be OK.

cynicalmstudent  asked:

Hi, I'm going to be starting FY1 pretty soon, and getting pretty nervous so was wondering whether you have any tips or advice for a newbie like me. Thanks!


Hey, not a problem :)

Congrats on finishing first of all. I’ll try and be as useful as possible.

Starting as a junior can be really daunting but you’ll join a supportive team and meet some really great people along the way.

These are the things that stuck with me.

Be organised. Make sure to have a blanks of paper, pens, your name stamp if your trust gives out any. Maybe a pocket oxford handbook just to use as reference or just as a safety blanket ha.

Do. Not piss off the nurses. They are your best friends. They’ve been working on these wards a lot longer than you. They’re a fountain of knowledge and have seen the cycle of new docs countless of times. They know where the request forms are kept, where the nearest pod to send off bloods is, what the extension for xray is. Trust me, you’ll be brought down to earth very quickly. There’s nothing worse than an over-confident cocky doctor. The most dangerous combination is sometimes who doesn’t know their limitations. You’re dealing with people’s lives, there’s no place for that kind of attitude.

You will become an expert at taking bloods, cannulating and doing ABGs. It’s a given.

Be prepared to stay behind if necessary. I’m not saying hours, but there’s nothing more crappy than the day team handing over a cannula or some other menial job that’ll take a few mins to complete but more likely hours for the night/ on call team.

Before you’re asked to discuss with specialities about your patient, have everything on hand. I can’t tell you how embarrassing it is when you can’t answer half the questions about your patient because you didn’t bother swotting up.

You will feel overwhelmed, stressed, cry and feel like quitting.

It’s normal. You’re not the only one. There are thousands of others like you in the exact same situation. I remember I had a good cry on my first medical ward cover. It was cathartic and needed. Remember, it’s a steep learning curve that at times will make you feel inadequate, but you will learn quick.

ASK FOR HELP/ ADVICE

You’re not expected to know everything despite what you might think.

I cannot overstate this enough, make use of the nurses, the HCAs, other colleagues.

Do not try and make stuff up. I don’t know why but we doctor breed have this thing of appearing weak if you can’t answer a question. We’re not encyclopaedias. Even the consultant who’s worked for 20+ years, still has to look up guidelines. Remember you are training! Asking questions is how you develop.

Prioritisation,  Prioritisation,  Prioritisation,  

By the time the ward round is done, you’ll have a job list as long as your arm, and yes, time is never on your side. So start with the most important things, request all the investigations you’ve been told to order, take any bloods that are needed, and then any urgent discharges that need doing etc. It’ll be difficult at first, having to decide what’s important and I can guarantee you, the nurses will tell you to do things now. Everything needs to happen now now now. Clinical urgency will always trump an ‘urgent discharge’  Be prepared to use your own judgment, and not be pressured into neglecting more urgent things.  

This insanely helpful guide REALLY helped me during the first few on calls and I still use it from time to time.

There’s a LOT of admin and PAPERWORK. You’ll become an expert at faxing, emailing, writing referral letters, filing etc

TAKE YOUR BREAKS  and don’t forget to pee!) Especially when you’re on call. No one will tell you to go on a break. So look after yourself.  

Reflect.

You will see the good, the bad and the ugly of humanity.. You will see death, illness, people being diagnosed with incurable conditions. It’s easy to forget that you’re human too. Don’t bottle stuff up that’s shaken you up. Talk about it to someone.

WORK LIFE BALANCE. Have a life outside of medicine! The job is really stressful, pressured etc and it can be so easy to lose perspective to life and neglect the stuff you enjoyed doing outside of it. So make sure that you still make time for your hobbies, mindless internet surfing and binging your fave shows.

Anyway, got a little bit carried away ha.

Best of luck!

@dxmedstudent is an abundance of tips and advice also! ( feel free to add anything I’ve missed out!) 

First year med school

Ok so this will be a post about what med school is actually like, and how you can prepare for it and what to expect, and general tips! Hope at least someone finds it useful.

FIrstly, the general stuff:

1. First year is for fun! Don’t be one of those people who just works all the time - you need to go out and meet people, make friends! And the people on your course you’ll be with for at least 5 years, so make a good first impression! Don’t be fooled into the stereotype that ‘med students don’t have time to have a social life’ um yes we do. So don’t panic. 

2. But don’t go TOO crazy. I probably didn’t work hard enough especially in my first term. All med schools do exams differently in first year, but make sure you do some work for them, even if they don’t count for much.

3. You will be overwhelmed at times, and that’s ok. Especially if your med school is integrated, you may be faced with upsetting patients at just 18 years old, as I was. It’s ok if you don’t deal with it well at first - it’s part of the learning process. Remember that everyone else is finding it tough too.

4. Make sure you don’t become one of ‘those’ medics. You know who I mean. It’s fine to be proud to be a medical student, but that doesn’t mean you’re better than other courses. And when you’re on placement, remember that the nurses, porters, etc, are just as important as the doctors. 

5. Be outgoing - especially on placement, it is what you make of it. Meaning, you’ll learn a lot more if you go out of your way to see patients and go on the wards. Ask questions, ask the doctors (if they’re not too busy) if they could watch you do a history or examination, ask them if there’s any bloods that need doing, etc. You’ll learn a lot more that way! AND DON’T SKIP ANYTHING EVEN IF IT’S SOMETHING YOU HATE BECAUSE YOU NEVER KNOW WHAT YOU MIGHT LEARN!

Ok, so now more work-related things!

6. There is a LOT of work. You will have to learn far more information in small amounts of time than you have ever done before, and the way to get around this is BE ORGANISED. Even if you’re having fun in your first term, make sure you still go to lectures, make sure you cover at least the bare minimum. Buy notebooks, folders for different subjects. An important thing is to know WHAT you need to know. Your uni should have some sort of learning outcomes or specification (hopefully). Keep a note of that and tick things off.

7. MAKE NOTES AS YOU GO ALONG. YOU WILL THANK YOURSELF LATER WHEN YOU HAVE YEARS OF MATERIAL TO REVISE! It doesn’t matter how pretty they are, just try to keep them organised and with the key material you need to know.

8. DON’T IGNORE ANATOMY. Ok yeah it’s long and it’s boring, but try and keep up with it or you’ll find it harder to understand the diseases.

9. In practical exams it’s all about how you present yourself. Be confident, smile (but not when the actor/patient is telling you they’re terminally ill) and act like you know it, even if you’re not sure. And practise makes perfect! Practise with your friends and help each other perfect your technique.

10. And also, especially for British students, I’d recommend getting the Oxford Clinical handbook because it’s such a dinky little book with pretty much the basics of everything you need to know. I always have it in my handbag! (When I’m at placement and stuff. Not on a night out, that would be weird.)

If anyone else has questions about this, let me know and I’ll answer and update this! Love you all and good luck xxx

anonymous asked:

How did you find medical school? Any advice??

It was fun, it was a rollercoaster, and for something that is pretty long, it felt like it passed really, really quickly. Each year is pretty different, so I’ve divided my tips based on the year:

First and second year:
You’ll be mostly in lectures. Perhaps you’ll have PBL. Don’t buy too many textbooks too early in the year; borrow them first and work out which ones you really like, and which ones your uni actually uses. Don’t leave covering your material til the end of the year, try to revisit the things that you struggle with as you go along. These years are mainly about the theory, rest assured that clinical medical years are a lot more interesting and representative of life as a doctor, so hang in there!

Intercalated degree: pick something you honestly think you will like. It doesn’t have to be competitive, or all that medical. But use this year out to enrich yourself. Perhaps you could try research, or even just explore the medical humanities. Essays aren’t as hard as you fear they are, and lab work is straightforward if you get help and follow the protocol. This year tends to make people nervous because they get used to the ‘med school’ way of studying, but there’s no need. If every other student in the UK can deal with conventional degree formats, you can survive them, tooo. Don’t be ashamed to ask questions.

Third year:
your first clinical placement year. ask the juniors to show you all the skills you are expected to know; nobody will be mad if they watch you take blood etc, and the sooner you get comfortable with things, the better. Just practice
Get a stethoscope and an Oxford Clinical Handbook of Medicine. Try to go over the topic before the placement in that specialty. Don’t be ashamed to ask questions.

Fourth year: usually specialities year.
Borrow lots of short, succinct books on your specialities, because there are too many to cover in huge detail. Focus on covering the most common conditions. No matter how little some specialities interest you, don’t stop yourself from getting involved. Throw yourself into every speciality, because this could be your last time to witness something really exciting in that field. You really, REALLY don’t know which speciality you will end up in, no matter how firmly you believe you love one particular speciality as a student. Don’t be ashamed to ask questions.

Final year:
Make sure you know the curruculum breakdown. If not, don’t worry. It’s usually all of medicine and surgery you’ve covered. And now they’ve added most of the specialities to a smaller degree. So it’s practically everything. But the core topics will be the most common, and the most serious things.
Don’t let medical final year OSCEs throw you; real medicine is a lot less scary than exam conditions. Get a hold of OSCE books that have mock station mark schemes and just keep practicing the stations. Practice with your friends. Practice on a pillow by yourself. Practice until “Hello,my name is [your name] and I’m a final year medical student, would it be OK if I examine your [whatever]” is so ingrained in your psyche that you practically say it in your sleep.
Your prescribing exam won’t be that hard, as long as you have a basic idea of how the BNF works.
Your SJT exam is trickier, but just remember that your responses should be proportional to the scenario.
Shadow junior doctors. You’ll be doing their job very soon, so take care to see just how they do it. There are many knacks that will make your life easier. Don’t be ashamed to ask questions.

In general:
make time to rest
eating and basic bodily functions are important
it is absolutely not necessary to live on caffeine or pull all nighters to do well; doing so is a sign you left it late, not a mark of dedication to your craft.
look after yourself
look after each other
forgive yourself your limitations and your mistakes
you’re better than you give yourself credit for
everyone feels like an imposter.
You WILL make friends, no matter how weird or shy you are.
Being an introvert, nerd, shy, having anxiety etc in no way disqualifies you from being able to complete your degree or be a good doctor.
No matter who you are and what you are like, there is space in medicine for someone like you.

I hope that helps :)

inevitable events, vulnerable, failure to launch ..

فيه كذا موضوع بيطاردني مهما حاولت اتهرب منه، ولما يتفرض الأمر الواقع واتعامل معاه لحد ميبقاش مشكلة .. يظهر بشكل تاني ويجدد المشكلة تاني !

في مرحلتي دلوقتي .. معدتش فاهم نفسي، بفتح على نفسي كل الجبهات وعاوز أحقق كل حاجة في نفس الوقت .. وبتأثر بكل الكلام..
كنت بقول لصحبي امبارح، إن عدم استقراري المكاني بيضعف قدرتي، وإن الحاجة اللي محتاجة طاقة وتخلص بقت محتاجة طاقتين، الكلام اللي بكتبه دلوقتي بيخرج صعب ومش عارف أعبّر عن شعوري صح .. بس عاوز أكتب ..

وأنا ف امتياز - اللي هو مش بعيد .. السنة اللي فاتت، بس الواحد بيحب يكبّر نفسه - عجبني الإهداء بتاع كتاب الهاندبوك اللي أكسفورد عملاه لطلبة الامتياز -  Oxford Handbook for the Foundation Programme

وكاتبين :

ومازال نفس الشعور دا بيمتلكني .. هو أنا بعمل إيه في حياتي دلوقتي ؟ وليه بعمل كدا ؟ وهستمر في الحالة دي لحد امته ؟

كنت بقول : 

أنا عارف إيه الحل ؟! الحل هو صدمة كبيرة جداً .. غير متوقعة إطلاقاً، عشان الصدمات اللي مش قوية كفاية وأقدر أتجاوزها مش جايبة همها ومبتأثرش بيها .. بالعكس تأثيرها السلبي أكبر ! هو دا الواقع ، المفروض منكرش كدا !

بس هل دا الحل ؟ ولو فرضاً فانت مش عارف قد إيه الصدمة الكبيرة دي ممكن تكسر إيه ؟ بس لأ .. دا مجرد حل يائس ..

كنت قرأت عن نموذج اسمه  نموذج كيوبلر روس .. بيتكلم عن مراحل الصدمة النفسية :

The 5 Stages of Grief: Denial - Anger - Bargaining - Depression - Acceptance.

بس هو اللي أنا فيه دا صدمة نفسية؟ وهل يعني إني مريت بشوية مشاكل يبقى دي صدمة ؟ ولا أنا لسه في مرحلة الإنكار ولا إيه ؟!

19 مارس السنة اللي فاتت مريت بصدمة، بس الحقيقة كنت متوقعها .. وجاريت الموضوع لآخره، أنا لا كنت فاكر إنه حصل 19 مارس ولا يحزنون بس افتكرته لما شفت الدرافتس بتاعتي هنا ولقتني كاتب عن مراحل الصدمة النفسية بردو ولقتني كاتب:  

حقيقي اليوم دا لازم يتوثق، ومعنديش أي حساسية أو إهتمام إطلاقاً لو حد قرأه وفهم ليه أنا بوثقه، أو دخل عشان يشوف ردة فعلي :D
الواحد لازم يواجه نفسه ويمتلك الشجاعة الكافية إنه يواجه كمان الناس ويوقّف طغيانهم وتأثيرهم على قرارته .. وإن مش أي حد يبهت على شخصيته ! ويمتلك مفهوم إنه “ إنسان “ ومفهوم “ لسنا ملائكة “ ! يعني إنه مش معصوم من الخطأ، وبالتالي لو أخطأ يمتلك شجاعة الإعتراف لنفسه أولاً بإنه أخطأ بدون تقديم أي مبرارات لخطأه .. ودا مش معناه إطلاقاً إنه مخطأ في كل حاجة على طول الخط، أو إن ثقته في نفسه تهتز شعرة !
ولو أخد قرار يتحمل مسئوليته ومسئولية عقباته وميخفش من تنكيت غيره ويقوله بكل ببساطة: “ انت مالك ! “، ولو فيه نقد محترم ياخد بيه لأنه على الأقل مش هيخسر حاجة ! بس لازم نفرّق بين الخطأ - ومش عارف كنت عاوز أفرق بين الخطأ وإيه تاني ساعتها ؟ - وأنا أخطأت مكنش في حق حد آه الحمد لله  بس في حق نفسي، بس فعلاً ودي حقيقة إن فيه “ عبأ “ كبير جداً اتشال من عليا، كنت شيّرت من فترة بوست للدكتور أحمد خالد توفيق على لسان شخصيته الخيالية “ د. علاء عبدالعظيم “ .. بيقول :

هناك عقدة لدى كل إنسان يُقدم على إختيار مصيري، هي أنه يتظاهر بالسعادة لأنه يخشى الشماتة أو أن يقال إن اختياره خطأ .. لا يمكن أن تسأل شخصاً عن صحة قراره المصيري .. سيؤكد لك أنه كان عبقرياً .. عندما يبتاع المرء سيارة جديدة يكلم كل الناس عن مزاياها، ثم يبيعها فيبدأ في ذكر مثالبها وكيف كانت خشنة القيادة تبدد الوقود .. إلخ !

_

امبارح بليل جالي حالة متحولة من المحلة، طفل عنده 3 سنين ونص، أمه كانت سيباه ف الشقة تقريباً لواحده وقافلة الباب، وقع من الدور الرابع، بس موقعش مباشرةً، وقع على سلك خفف الصدمة شوية، الجمجمة كانت مكسورة والمخ فيه كونتيوجنز بس مش لدرجة إنه محتاج تدخل جراحي، هيمجلوبينه كان 7,4 والأشعة بتقول إن مفيش أي نزيف داخلي تاني، المهم إن أبوه كان سواق نقل وكان حاصله زي حالة هستريا وإنه ملهوش إلا غيره وإننا لازم نعمله كل حاجة وبنحاول نطمنه وهو مرعوب ومسك مراته ويزعقلها وهي ساكتة بتعيّط ..
المشهد دا محستش بيه تماماً إمبارح ولا تأثرت بيه غير لما حكيته لأمي النهارده وشفتها قد إيه هي اتأثرت ! ومش عارف ليه فيه حاجات بتمر عليا كدا .. وبسيبها تُمّر ..
ومش عارف إزاي بقيت هادي جداً في مواقف مكنتش ببقى فيها هادي .. ودي حاجة بعتبرها كويسة، وإزاي عدّت بحس إني ضئيل جداً كل ما أعرّف وكل ما أكبر  ودا المفروض بردو كويس .. بس ليه الأساتذة الكبار عندي بيكونوا منفوخين أوي ومتكبرين أوي لدرجة إن لما تطلب من حد منهم إنه يسمعك يرد عليك ويقولك انت مين عشان أسمعك !
وتسكت .. وتحاول تسكت .. وتسكت .. وتنسى .. وتفتكر .. وتحس فيه حاجة تقيلة في قلبك وتغمض عينك .. وتبلع ريقك .. وتاخد أنفاسك ببطء .. وتتناسى .. وتسكت .. وتفتكر .. وتقول عادي ماتجلدش ذاتك ..  اتصالح مع نفسك .. ارفق بنفسك ساعة إني أراك وهنت ..طب حاول كدا تبقى أحسن .. انت طبيعي يابني ؟!  

Grad student bride WIN

Making a gorgeous kusudama-flower bridal bouquet (that doubles as a nice eco-friendly wedding favour) from cut-up pieces of incomprehensible scholarly articles that you were forced to print out for coursework research and now have no use for.

I feel like I would be a bad student if I didn’t properly cite my bouquet… So in case anyone’s interested:

Peter J. Pels, “The Spirit of Matter: On Fetish, Rarity, Fact and Fancy.” In Border Fetishisms: Material Objects in Unstable Spaces, ed. Patricia Spyer (New York: Routledge, 2001), 91-121.

Peter J. Pels, “Magical Things: On Fetishes, Commodities and Computers.” In The Oxford Handbook of Material Culture Studies, ed. D. Hicks and M.C. Beaudry (Oxford: Oxford University Press, 2010), 613-33.

Ming-Bao Yue, “Nostalgia for the Future: Cultural Revolution Memory in Two Transnational Chinese Narratives.” The China Review 5, no. 2 (Autumn 2005), 43-63.