Lifecourse assignment marks

We got our marks back from the dreaded lifecourse assignment: 24/40 (60%). Not bad considering how seriously I took it.

We had interviewed my father (who lives in WA) and there was an odd reference on the marking sheet to the fact that our interviewee wasn't a resident of Brisbane "as required".

This "requirement" wasn't mentioned in either the assignment guide or the briefing lecture; in fact, both explicitly stated that the interviewee had to be a resident of Australia. It doesn't look like we lost marks for failing to meeting this "requirement" but I am checking.

Update: The population health person has confirmed that the requirement was only that the interviewee live in Australia and that no marks were deducted

Med Revue 2008

I went to the annual UQ med revue Monday night.

Described as "the traditional annual homage to the highly refined procrastination skills of medical students". Lots of singing, dancing and skits and some video presentations featuring the school's academics. I expect the videos will turn up on YouTube and will post links when they do.

Some of my fellow medical students have some serious talent. Liam McCollow (on the right of this picture, as Jake Poos in the three "Poos Brothers, proctologist" songs) in particular; medicine's gain
is comic opera's loss.

I especially enjoyed his solo "Empty Chairs in Empty Tute Rooms" about a student losing all his classmates to a harsh exam but that may be because the lyrics strike a chord:

Here we learned about anatomy
Here we dreamed of future wealth
We said one day we will be surgeons
But they asked us public health

Med school exams

Someone which way too much time on their hands has created a joke exam paper. It is a little depressing just how close to the real thing it is.

First they present a case

Mr. Walloper, a 75 year old who has smoked like a bastard all his life, presents with an 18 minute history of progressive stillness without exertion. There is no past history of respiratory disease. He has a resting respiratory rate approaching 0 min^-1, a reduced expiratory phase, powerful shoulders that are not moving as much as you would like, decreasing antero-posterior diameter of the chest, and is not using any accessory muscles for breathing. Breath sounds are diminishing in intensity over both lungs. Diaphragm percussion levels are being displaced superiorly. There are no wheezes, crackles or rubs. You suspect that he is having trouble breathing.

then they ask a series of questions which in no way depend on the facts of that case

(a) What muscles are normally used during quiet breathing?
(b) What muscles are normally used during forced expiration?

then we learn some more about the case

A little while later, on closer inspection, Mr. Walloper is noted to be quite dead.

followed by more questions which only tangentially refer to the facts of the case

Death is most likely to be the result of (choose one):

A	decreased cardiac output.
B	hypoxic vasoconstriction.
C	a low arterial PO2.
D	a low haemoglobin concentration.
E	both C and D above.
F	A with elements of C and perhaps B but definitely not D.
G	probably K if it went down that far.
H	you spending 15 minutes or so trying to remember what muscles are used for quiet breathing.

(the correct answer incidentally is G)

Joke from the "family grieving" lecture

Q: Why do they have nails on coffins?
A: To keep the oncologists out

I have a nasty feeling

Each week we get presented with a fictional patient whom we attempt to diagnose and who's condition we use as the basis for our study. Most of the week's lectures and labs are also (more or less) connected to the case.

Three of our lectures this week are:

The family grieving process
Pain management in terminal disease
Terminal Illness

I have a nasty feeling that this not going to go well for our patient.

Suspending doctors

Some doctors should be suspended by their thumbs but no doctors should ever be suspended from practice.

The issue was raised in my mind by a "moot court" based on a real medical negligence case run jointly by the law and medical schools last week.

The bench, pretending Health Practitioners Tribunal, ordered that the doctor be supervised by another doctor for a period. One of the members (the doctor on the panel) thought that the doctor's registration should be canceled. It was mentioned afterwards that another possibility was suspending the doctor's registration for a period.

In my view either supervised practice or cancellation of registration might be valid punishments for clinical malpractice depending on the severity of the infraction. What is not ever a valid punishment is suspension of practice. Medicine is critically dependant on experience and remaining current. Responding to a clinical error by stopping a doctor from working is putting a fire out with petrol. Just plain silly.

Going through old exam papers

A group of us are going through old exam papers. We are each allocated a set of questions from past papers which relate to material covered in the current week or the corresponding week in first semester. During the week we produce model answers and then get together on the weekend to discuss them.

The process is not conducive to equanimity.

Slightly frightening is the amount of stuff I realize I once knew (way back in first semester) but can't answer off the top of my head now.

Really, really frightening are the questions I can't produce good model answers to even with access to the library and the Internet.

I had one this week on the neural control of micturition (urination). I knew I didn't understand it, I now suspect that the physiologists don't understand it either. Certainly the four physiology textbooks in our PBL room all give subtly different answers. You can get another n opinions by visiting n websites.

The exam, of course, has a marking guide and exactly one correct answer. No, we can't see it; not for past papers, not for the exam we have just done and don't know why we lost marks for particular answers we thought were perfectly good.

Deep calming breaths.