Hi All,
I'm a 30y/o Australian Medical Student from Sydney, have also studied Medical Science.
Happy to answer questions as best I can about Medical Practice / Medical School from the perspective of a Medical Student.
Just to be 100% clear Med Student - Not a Doctor incase you missed it the last three times.
GP training is typically 3 or 4 years as a minimum on top of medical school. Not 2. But yes GPs often have particular special interests. Its particularly common in rural practice to spend a year training in another speciality field (obstetrics, surgery, anaesthetics, ED for example), so that you can provide some of these services in a rural setting.
I had my moles checked a few days ago by 2 female doctors, then one removed by a female doctor (ouch). So of course it isn't normal at all. What a strange statement for your doctor to make. You might want to question it, and report it if you don't like the answer.
hope you didnt pay them via medicare and reported them for this nonsense. Religion has no place in medicine.
My friend has this weird growth and itch in the groin region. What could it be?
asking for a friend
no yes
if left untreated, username might check out
Do you believe in God?
Do you believe in an immortal soul?
Do you believe in freedom of the will?
I am an atheist to the common perception of what "God" is seen to be.
I went to catholic schools my entire schooling career
Genuine question: why are you asking?
Just curiousity
Interesting you use the word believe … you should check what the word means. Only idiots believe in things, we should all be reasonable and only accepts proofs not stories without evidence.
Well that’s your belief
NO its a fact. Go check a dictionary what belief means and then return and show or tell me that anything i have said isnt true.
Excellent work on doing medicine! I see that you work and run a small business. How do you balance uni work and keeping a regular/stable income? Especially during the final 2 years of medicine where it's all FT worth of placement.
I'm planning to take the route you're taking too in the near future. i.e Do medicine closer towards 30 years of age. With the workload of med students, I'm just worried there isn't enough time left over at the end of the day for a job and to make enough to support yourself. Please share your secrets :D
I don't even know where to start. To make matters worse my wife and I also built a house in the middle of my studies and my marks did suffer during this time although the university is really helpful, they want you to pass so they offer you a lot of assistance when times get tough for whatever reason.
I am lucky now that my business is at a point where there is very little work I need to do on my end to ensure that it runs smoothly, my wife has also picked up some of the work to lighten my load although she could be doing more IMO haha. The course is essentially Mon-Fri with the odd day off where I only have lectures, I watch them from home or if i'm working I try to catch up on them before bed.
I said in an earlier post I am lucky that my current employment is quite flexible where I can attend virtually all classes, I was offered the opportunity to work weekends instead which would mean I wouldn't have to swap shifts with people during the week although then I would then be sacrificing my only real free time so as it stands I shift swap and make it back up to them during my uni holidays.
So as for uni work and employment balance - it works with minimal impact on my income, I receive my full salary. In final years it will become much more difficult because as you said it will be as though I am working full-time in the hospitals. I do have long service leave and annual leave I can use to get the time off I need but I will still fall short so still working on that one.
Thanks for the insight! It does seems rather hard to balance and you lose out on all your spare time on the weekend :(
All the best for your studies mate, you'll make an amazing doctor.
Thanks mate, I hope so.
Are you going to sell the business or keep the business and hire a full time manager while you're working/on placement?
What industry is your business?
I will keep the business as it's very low maintenance, it isn't my primary source of income so if I were to hire someone to manage the business it would take a significant proportion of my profit. My wife is slowly taking on more responsibilities with the business to the point where I just maintain relationships with suppliers and order stock when required.
The business is medical related I sell therapeutic goods and medical consumables online.
Don't worry. If they don't take attendance, a textbook, paper or even youtube video can often teach you the subject more comprehensively and with fewer errors than the lectures of most medical schools.
It's all about smart study and finding the right mediums for you to learn for life because at the end of the day medical school is just a barrier to medical practice rather than an institution of education for the medicine you will start to practice in 6-10 years.
1.Are you offered adequate lectures on nutrition? 'Food is thy medicine and medicine is thy food'
We are taught about nutrition through scenario based learning i.e patients with diabetes or obesity and are given lectures on the topic but not in great detail in my opinion, the teaching is more so aimed at recognising unhealthy eating and promoting healthy eating and lifestyles. There is also a strong focus on biochemistry, how our bodies handle the nutrients of food, how energy is produced from the food we eat, how our bodies process macro nutrients etc.
2.What are your thoughts on natural medicine? Are doctors becoming more accepting of natural medicine these days?
TBH I have heard alternate medicine being ridiculed by other medical students which I imagine would flow on after graduation, mostly because there is such a push toward evidence based medicine. In saying that I believe there are alternate therapies that are covered by Medicare, acupuncture for instance, so there is a level of acceptance. Although for serious illness and disease I think the gold standard will always be conventional treatment until such time as alternate therapies are proven over conventional. I am unsure of the view of practising doctors at this stage.
3.Do doctors receive kickbacks for prescribing certain meds?
I don't think kickbacks in the form of money are exchanged but I have heard stories of drug reps offering certain doctors expense paid trips to symposiums in order to promote their products. Apart from the free pens, mouse pads and coffee cups I'm unsure if doctors receive kickbacks so to speak.
The best thing my nurse relos ever got for free was a Viagra clock.
Yeah, my sister got one too. Had a dodgy base on and and would never stay upright
I managed to score a viagra stethascope (it was terrible) and blood pressure cuff. Sadly I've lost them.
Kickbacks are illegal/agains the very tight rules of Medicines Australia.
If a doctor is presenting a research/talk/paper related to a Drug company's product, they are allowed to have their trip paid for. I think this is fair enough. It is a requirement for any such financial involvement to be disclosed at the beginning of the presentation.
The rules from Medicines Australia is very strick thesedays:
https://medicinesaustralia.com.au/code-of-conduct/
Eg. Drug companies are not allowed to pay for a meal unless it is an educational seminar. I think if even this is disalloweed then it's a bit too strict.
They can provide us stuff for educational purposes. EG: can sponsor a lunch time teaching session. Can sponsor a night out where we have a lecturer or two come and speak on a particular topic. Can give us basic freebies like learning materials (I've scored a few free textbooks), teaching aids (I once got a simulated anus/rectum with different diseased prostates you could insert to examine, how fun!). Gone are the days when they just give us free shit. Even my mother as a pharmacist used to get given so much crap from drug reps. We got multiple iPods, a Sony PSP, gift vouchers.
Just to add to point 3 here, doctors/medical staff with free pens, etc. would have likely received them a long time ago or through other means, but not from the drug rep themselves as a gift, as this can be seen as a form of Direct to Consumer Advertising (DTCA) which is not allowed for prescription drugs.
Having said that, I know a lot of clinics that have a lot of Viagra and Pfizer merchandise from back when it was allowed haha
What are your thoughts on this diet: https://www.reddit.com/r/keto/ ?
(High Fat, medium (not excessive) protein, low carb, lots of green veggies)
Keto diet is essentially another fad diet, sure it works but most diets work if they are adhered to. The science behind it is basic and its factual (which is helpful), its how we loose weight but this diet is marketed around inducing ketosis and maintaining it for prolonged periods which is the tricky part and where the science gets a little fuzzy and professionals suggest all sorts of ways to do this. I found a webpage that gives a good rundown on how ketosis works, this will help people to understand exactly what your body is doing when you are inducing ketosis. https://ketogenic.com/overview/understanding-ketosis/
Early on in the course we explored all different diets and weightloss methods and learnt about healthy lifestyles and basically the approach is the same; it's recommended that you have a balanced diet based on moderate food portions in combination with an active lifestyle. If comorbities exist then a doctor may also suggest weight loss drugs in conjunction with the above.
Thanks for the detailed reply. Glad to hear that fad diets are studied by medical professionals.
Yeah I know it's another fad diet.
I usually jump on the fads for a few months, but can't maintain them (eg. the intermittent fasting).
This is the only one I've managed to stick to for > 1 year (who doesn't like eating bacon?).
who doesn't like eating bacon?
Vegetarians, vegans, devout Jews, swinophobes, people that don't like getting cancer,
@sparkanum: Don't know why you're being neg'd.
Your answer is mostly true and you did answer my question lol.
(thought I'm sure some people in that category secretly like eating bacon)
I know about the cancer thing, but I doubt I'll live long enough to die of cancer.
I like the way the swearing increases gradually as the video goes on lol.
I prefer whiskey to beer and wine anyway, and never liked biscuits or cups of tea so all good.
Are medical students 'taught' /trained how to connect / converse with patients ?
What I mean is that some medical professionals - whilst qualified and intelligent - have little or no interpersonal skills.
That's legit and nothing wrong with that. Doctors are suppose to see patients as puzzles to solve, not to see patients as people to help.
Have you been watching the good doctor?
Hart of Dixie :)
Come on bro!
I know exactly what you mean and this is incredibly frustrating for me as because it comes naturally. But yes we have clinical sessions and scenarios that are focused on interacting with patients, eliciting information, showing compassion etc. The teaching initially is more or less just conversing with patients getting to know their history etc, I notice some students overthink the situation and get stuck because they are running through flow charts and acronyms in their head trying to remember what comes next rather than just talking to the patients.
In NZ med school and probably in AU as well, we have practice sessions with actors pretending to be patients in the early stages of medical school. These are video taped as well. There are various scenarios including dealing with angry patients or relatives, breaking bad news etc. Obviously going forward from there our interactions are with real patients. Medical students and even jnr doctors also sit in on a lot consultations so are learning by example and modelling themselves on their mentors.
Hey kiwijunglist,
Where are you at with your studies? Any idea on what you want to do once you graduate?
I think this is a fallacy. Years ago it may have been the case, as the doctor/patient relationship was power based. It still maybe to some extent, as the doctor holds most of the knowledge and knowledge=power, but in my experience the vast majority of doctors in this country have excellent interpersonal skills. There is also a greater recognition that the patient holds the answer to their illness and it is incumbent on the doctor to extract the relevant information.
I think this situation is definitely improving with the ways medical schools are conducting intakes and interviewing potential candidates. I believe the problem also is that even though there may not be interpersonal skills issues to the extent as they were in the past but due to the amount of internationally trained doctors (almost 50%) leading to cultural differences and barriers to communication. It is known that patients will often seek out Doctors from similar cultures.
Also just to touch on something else you said about the doctor holding the power. This was recognised and we are taught to have a strong emphasis on patient centred care, starting from the first instance, things as subtle as sitting patients beside the consultation table rather than sitting across the table. Gaining consent is also very important and helps enforce the idea that the patient has control over the setting.
Most do in my experience. Certainly not all. I went through med school with a few chaps who while very bright have been politely nudged toward working in pathology due to their not so great interpersonal skills. (not a dig at pathology, I'm going to do haem myself)
There has been a lot more focus (away from scientific/academic based only) in the last 15 years in this area as this improves the doctor-patient relationship and overall satisfaction. However the problem is that this skill requires practice and experience plus doctors also have to be academically inclined, do extensive teaching, study hard and pass exams, research and publish, become proficiency in minor and major procedures, balance a large workload and work long hours. Thus sometimes interpersonal skills lose out.
What year are you in?
I am in year 2, I also studied medical science prior to medicine but I am in an undergraduate course so a lot of what we are learning about now is a re-work of what I have learnt in the past although I am enjoying the clinical aspect and relevancy which was not part of Med Science.
Also interested in this question
My daughter has just finished her 2 year out (Junior Dr/Senior Dr) as a Mature age student-had a nursing degree but also had to start from scratch and rehash some work. She took a year out at 4th year because (in her words) her brain was full! Went back with a new mindset and finished the degree. I wish you all the luck-not an easy course or path you've chosen!
Thanks :) Congrats to your daughter, it truly is a tough slog and I can complete relate with the "brain being full" comment I find it hard to remember things i've learnt prior to studying medicine as now my brain is just overloaded on medicine content. Hope your daughter has hit the ground running.
Am I going to die soon?
According to your usename, you're already living for 18 years longer than expected, so I wouldn't push your luck.
From a standing position sit down cross legged on the floor without using your hands. Now stand up again, again without using your hands. This is a fairly reliable indicator of life expectancy.
You're going to die in 10…..
Why are you 30 and a student?
Not sure if you read previous comments but I still work full-time so I don't consider myself to be a student when people ask "So what do you do with yourself?"
This was a decision I made with the long term in mind.
Why don't you read the posts before commenting?
It's tuzii. He needs a tl;dr for your question..
In your opinion at what stage do you consider people not allowed to learn?
Year 9
medicine is life long learning
so too is many other things in life
only fools think they know everything
ok, now all of your comments over the last year or so make sense
As in too old to study? Thats a good question and I think can only be truly answered by the people you're asking about, I suppose as long as you feel capable you should be allowed.
I think to disallow someone to learn / study is ethically questionable.
I'm 51 and a uni student
30 is most certainly not too old to be starting med school. Especially if you want to go into GP. He'll probably finish GP training before I do and I'm 5 years out.
How true is it there's an oversupply of doctors slowly occurring?
It's been a while since I have heard anything on this topic, from what I understand is that the issue wasn't so much an oversupply of doctors available to see patients it was an issue of an oversupply of doctors vs the available number of specialty training positions available. The issue was that they couldn't keep up with the amount of Australian and overseas trained doctors, there are still shortages of Doctors in certain specialities due mostly to an imbalance and the limited number of training positions available.
And are "they" creating new speciality training positions? If not… Sounds like an oversupply of graduates.
My understanding is that, not just in medicine, there is little incentive to train large number of new specialist as it would decrease the scarcity, and therefore the incomes, of existing specialists.
Big problem in clinical psychology at the moment. 1000 students start first year, masters placements for 20 of those.
I have no idea, this was something I was keeping an active finger on the pulse so to speak but have since stopped following the topic.
We will always need doctors and perhaps a better solution would be to limit the amount of 457's offered to internationally trained doctors which are close to 50-50 with locally trained.
Yes there will be an large oversupply of graduates/junior doctors compared to training positions which are highly protected. However even now, there is an oversupply of graduate specialists to available public consultant appointments so even getting on to training is no guarantee of getting a full time consultant job, especially in large metropolitan areas. The whole system is like a pyramid but I don't think it is any different to law firms (associates to equity partners).
My personal view is that perhaps we should train enough doctors that one can get a specialist appointment in less than 3 months, and these are affordable for people on lower incomes… these new places won't appear - Don't think specialist want to take a pay cut.
It is a pyramid, and the most unfortunate part is not that those at the base have trouble getting to the top, it's that so many resources are wasted in training doctors and teachers when full time places are so limited. Innefficient for society, but good for the people at the top of the pyramid I guess.
@ozbjunkie: I think there are many people who share your view and I am indeed one of them. I would hate to see Australia end up like the USA where people have to mortgage their houses in order to afford medical treatment.
@ozbjunkie:
allow me to cut in here
i'm a specialist who has been a dr for 23 years and qualified as a specialist 13 years ago.
The reason its difficult to increase the numbers of specialists is the amount of work available.
Trainees now are qualifying with about one quarter of the surgical experience I had when I qualified due to things like reduced hours and more doctors vying for training.
It creates difficulty with standards and only so much can be done with training on mannequins and cadavers etc.
Complaining about specialists protecting their patch is naive as you'll be the one whinging when the specialist-lite messes up your op.
The colleges have allowed lots of overseas specialists to come and that has improved supply.
The media are also complaining about bullying of juniors etc - this means that any useless trainee tends to hang around longer and even get through if they are brash and aggressive enough to beat the system.
My conclusions are training will need to be extended and already recommend this to my juniors.
The ones with insight comply and do fellowships.
The ones without come out to earn cash and practice on their early patients to get up to standard.
@TheCutter: Wow this was great insight into the current state of affairs within the profession.
did hear that there were not enough training positions for junior doctors, is this accurate? And if so are they dumbing down the training in order boost numbers or because they cannot handle the amount of graduates?
@TheCutter:
Thanks for the reply.
These overseas specialists, presumably well experienced, how do other countries have a surplus? What are they doing to produce an excess of well trained specialists. Can we learn something from them?
Or are they just able to make more money here than where they come from?
Importing experienced specialists doesn't seem to be a solution to the woes of recent grads - but you're right that I should think about quality of care before the cost (so long as the cost permits any care whatsoever).
@DrSyd:
There isn't enough training positions because there isn't enough work in public hospitals sometimes to get a doctor trained PROPERLY.
Not enough work = half trained doctor.
With 45% private uptake almost half the surgeries are in private hospitals - where I work with no trainee to observe.
Trainees want to come but they want to come in hospital / work hours where the public hospital will not cover them or pay them.
13 years of private operating = thousands of operations = no trainee ever has turned up.
Its a waste but a failing of the aussie system.
Good news is that in the private system - if you have an experienced dr they are the one looking after you.
Re - foreign doctors…. they are mainly working hard and saving you money - or stealing my job - like other immigrants ? You decide.
@DrSyd:
For you Dr Syd
GP is now very competitive and other specialities are going the same.
When I was an SR in 2002 my speciality was in such duress there were 21 applicants for 37 jobs in NSW.
Now thats long gone - hundreds of applicants.
But quality people will always shine - you may to do a few papers , extra presentations etc to look good on paper and you'll be on the program.
For speciality you may need to do pointless research for your CV.
Its just a game but you will go well i'm sure
@TheCutter: Thanks for the insight on getting the upper hand on GP applications, this is something I really had no idea about and is great to get some advice from someone in the know.
This might sound stupid as I know absolutely nothing about this, but are jmo's allowed to do rotations through private hospitals? Is there no facility to accomodate jmo's?
@DrSyd: Some private hospitals (e.g. SAH) now have limited JMO positions (intern, resident and registrar). I'm not sure how much they are allowed to do or the extent of decisions that they can make.
They also have a Usyd clinical school based there.
@DrSyd: This won't happen to Australia because we have a public system which all Australians are eligible for. Unlike America which are only available for certain population (Medicaid and Medicare) which results in large numbers of people being uninsured (i.e. no government funding because they are not poor or old enough and are not part of an employer paid scheme or rich enough to afford insurance (can be >$10,000 per year based on your risk). This was what Obamacare has attempted to reduce.
It's actually a lot more complicated than that. An adequate supply of doctors would mean not doing ridiculous hours of work — with extra hours being mostly unpaid. Yes, there are tons of junior doctors, and yes, there is not enough training spots for all of them. However, there is definitely a lot more room for junior doctors to be around, even if there are no specialist training spots for them down the line. I, for one, worked consistently 60-80hrs a week for most of my terms as an intern. This was in one of the largest metropolitan hospitals in Sydney.
Shortages of specialists are location, interest and training availability dependent. Rural and regional centres have a shortages of pretty much everything. Metropolitan areas? Not so much. There's no shortage of gastroenterologists or cardiologists, which are perhaps two of the most popular physician specialities — they're also very good generators of income.
Training positions are dependent on amount of supervision available. Specialities that are less popular and have a shortage are likely to have fewer training spots as there are not enough supervisors around.
The only caveat to sharing out the hours between more trainees/juniors is that people then finish their training with a lot less time on the job. Not that I'm advocating for 80 hour weeks - personally I don't enjoy them much!
Do your exams/tutes have actors portraying illnesses, much like Kramer on Seinfeld?
(reference: https://www.youtube.com/watch?v=JvCVg4MrhUE)
follow-up: do you get people with actual illnesses in for learning/pop-quiz/exams?
lol haha well I haven't seen that in a while!
We have objective structured clinical examination (OSCE) examinations which at an early stage of the course are portrayed by volunteers although whats cool is that they have pretty elaborate back stories (Like Kramer) and they even get special effects artists in to apply wounds / lumps and bumps etc. Some of the volunteers really put a lot of effort into the roles and really play the part well and others not so much. As you progress in the course you can get assessed bedside with real patients.
We also have 2 classes per week which run for 2 hours called "scenario groups", in each course we have a different scenario which is focussed around what we are learning. During the "scenario group" classes we go through the case studies, for instance we were learning about health maintenance and one of the scenarios was about a man with diabetes / obesity. Another learning about ageing - the scenario was about falls in the elderly etc.
Interactive manikins incorporating AI technology have taken over some of those tasks.
Yeah, I've heard some med schools have ($100,000+?) robotic babies (for example) that are controlled by teachers in another room.. they can burp/cry/vomit/breath/wet themselves/go into/out of cardiac arrest etc.. very exciting stuff, and obviously extremely valuable training for our future medical professionals.
(i assume this is what 4sure meant by interactive manikins)
About 5 years ago I was in Bond Medical School with a group of potential trainee doctors who were being shown these manikins. Suddenly the one in the bed next to the group sat up and said, "I'm thirsty, I want a drink!", in this really desperate, haunting voice. I wish I could have photographed their faces!
As an educator doing Basic CPR and Advanced CPR for rUral nurses mainly (and other uses) we used mannequins but not fully robotic. I could control them to answer questions with a yes, a groan etc. sometimes when 2 were doing their assessments, I would have the mannequin groan just as they were to check the carotid pulse (ie they had succeeded!). I always had it dressed, wearing thongs, and sunglasses in mock arrests for example.
I have seen a nursing lecturer in action at 3 conferences. She fools the audience every time. The program will lists a topic around advances in teaching clinical skills and the curtains open to a patient in any scenario (I have seen both men and women) with 2 or more of her actual student’s attending the patient in uniform. As they go through doing what they are supposed to be, the patient is telling them what they are doing wrong and why - all cleverly interspersed with general patient chit chat.
Then when it is the time, the patient takes off her carefully crafted and moulded head (which looks so real even up close) and underneath is the lecturer who then speaks for a short time about how it is used in their clinical laboratory. The first time I saw her, she spoke more about how the mask (for the sake of using some word) was developed. They aim to have real life clinical training. The technology has been sold to many universities And for varying purposes.
For nursing certainly this is much more effective than an6 robot and no programming required.
How much are you taught about physical exercise and its effectiveness in preventing and managing a wide range of illness and disease?
Yes, we are taught about the importance of physical exercise, the science behind it, and what medical conditions benefit from an increase in physical activity. For example; diabetes, CVD etc, . In the past if you had an illness it was common practice for Doctors to advise patients bed rest, now days if you have orthopaedic surgery for example they have you on your feet within 24 hours and strongly encourage physical activity.
But back on exercise, we are not so much taught how to exercise to the extent a personal trainer for physiotherapist would for instance but we are taught to understand the effectiveness of exercise as part of a well rounded treatment and management plan. We are also taught loads and loads of anatomy, personally I have a keen interest in sports and exercise science as I was once a regular gym go'er so the anatomy is great it helps me in the gym knowing exactly which muscles are affected by the movements I do and which exercises will target these areas the best.
My daughter had a T5-L1 spinal fusion and it was amazing to see her walk the next day. Family friends who had kids that had the same surgery 30 years ago nearly didn't believe me, as their kids were in roto-beds for a few months before even getting into a standing bed. Medicine is advancing so quickly.
This is a very rapidly growing area; for example there is a trial starting now into the effects of moderate/intense exercise on cancer patients. I predict that this and advances in anti-aging will be the big gains in the near future.
I believe Griffith (Gold Coast) takes in 180ish med students year 1. St Lucia UQ takes on around 540ish year 1.. DrSyd, how many in first year there?
p.s. try not to be too distracted by ozbargain.. stay focused!! :) :)
Thanks for all the detailed answered too.
WOW are you sure about UQ that seems like so many? I believe there are about 280 (i could be wrong) first years in my cohort spread across two campus' although years 1 and 2 combine in the second half of the first and second years of the course. So after 6 months the first and second years will combine so thats about 560 which is a fair amount perhaps the same as UQ?
@Mysterymeat: Yes I am a qualified specialist and I highly respect the work that GP do and the knowledge that they require. However a GP once told me that it took him 10 years of experience before he was very comfortable to treat the large variety of conditions that he encounters on a daily basis.