Otago MBChB Class of 2016

[hogan390]

Clinical staff you're following in the hospital are paid by the DHB, not your uni fees (I don't know the exact financial deals in place between the hospitals and the medical schools, but it certainly doesn't involve the university paying clinicians to have students tail them). I'd imagine that people taking specific tutorials through the med school are probably the ones getting paid with your fees.

Yeah, I definitely wouldn't think the med school directly pays anyone, but I would have thought the med school would pay the DHB something? Otherwise why would they take on students?
And seriously, if they don't pay the DHB something where on earth do our fees go! We get less teaching/labs/tutorials etc than anyone doing a regular degree and yet we pay like 3x the price? They just dump us in hospital with no formal teaching, how can that cost so much?

 

[frootloop]

Yeah, I definitely wouldn't think the med school directly pays anyone, but I would have thought the med school would pay the DHB something? Otherwise why would they take on students?
And seriously, if they don't pay the DHB something where on earth do our fees go! We get less teaching/labs/tutorials etc than anyone doing a regular degree and yet we pay like 3x the price? They just dump us in hospital with no formal teaching, how can that cost so much?

I don't really know if the uni pays the DHB, or if they do, how much. But it's a pretty mutually-beneficial arrangement, the university being there means that a lot of 'big name' types start working there, and there are a lot more research opportunities for DHB staff. Then there's things like the university library/computer lab, which the DHB staff have access to, which they wouldn't if the uni wasn't there.

I too, have always wondered how it can cost upwards of $70,000 per year (remember that your contribution isn't even close to the full amount, the government foots most of the bill) to train a medical student. But I guess the money to upkeep buildings, pay teaching and support (eg: cleaning) staff, and all of the other vast expenses of running a university, have to come from somewhere.
I definitely agree with you that it's ridiculous that we pay ~3x the fees of most other students, no doubt the logic there (as with all finance logic related to medical students) is 'You'll be able to pay it off later because Drs are so rich blah blah blah'.
Personally I suspect/my crazy conspiracy theory is that an awful lot of our fees get siphoned off for research funding.
Edit: Also, I can't comment on your experiences in terms of clinical work (since as a research student, every time I'm tailing someone/in theatre/in clinic, nobody expects anything from me haha), but I can relate to feeling like cr*p, wanting to give up, feeling sad all the time, etc. Your counsellor sounds like they were a touch useless if all they said was 'stick it out', so I'd go with finding another one, or talking to Jill Tourelle (or her equivalent if you're not in Dunedin), because she certainly helped me a lot last year.

 

[greenglacier]

The med school has formal agreements with every DHB that students are sent to, and I'm almost certain that there's money involved. Hospital consultants may not be directly paid to teach, but it's definitely a core part of their job (and most do genuinely enjoy it, even if they don't show it).

 

[Ben]

Another year down... Grats everyone!

EDIT: [MENTION=6896]SaxGuy[/MENTION] - any chance of an overview of 5th year in Chch?

 

[GoldenGarlic]

Hey Ben, any chance of a 4th year overview for chch?

 

[frootloop]

[MENTION=20536]GoldenGarlic[/MENTION]

Haven't been on MSO in ages! Looks like I also came on at a convenient time to give some info about CHCH ALM


Basically, the year is broken up into 4X 8 week blocks, which are then split into 2.


You are put into a group of ~12 people, and you will have a sister group also of ~12. You and your sister group will both be on the opposite half of each 8 week block (I.e. You swap at 4 weeks) and after that you move onto the next 8 week block.


The runs for 2014 are due to change, so I'll provide information about what I've done over the year, with some info of what I know is changing next year.


Healthcare of Elderly:
4 week attachment which is based at Princess Margaret Hospital. This is a medical run, with a focus on rehabilitation. Many patients are transferred here from Christchurch Public Hospital for ongoing support after a particular admission, however stroke patients may be admitted directly to PMH. Issues that most often need dealing with at PMH include things such as deconditioning after a hospital stay, stroke rehabilitation and then particular things that geriatricians have specialized knowledge of, e.g. cognitive impairment, Parkinson's, incontinence.
There is a heavy focus on neurological examination (one of the OSCEs is a neuro exam), rehabilitation (one assessment is a written case report with a rehabilitation focus) and psychogeriatrics (there is a psych OSCE, either a cognitive assessment or discussion with a family member re: potential family member's dementia).
In terms of what you do throughout the run, you're attached to a team and can go round with them, however there is not a strong focus that you keep up with the team activities). What's really cool is that you can really get to know patients really well by the end of the run which is really rewarding.
i remember thinking that this run seems like it might be boring - I can't honestly say that it was one of my favourites.


Otolaryngology, Ophthalmology and Addiction Med:
This is the sister run of Healthcare of Elderly, but is being changed so that it moves into 5th year, so I won't bother writing about it


GP:
This is an 8 week run, with both sister teams doing the same thing for the whole 8 weeks. Pretty cool run, very chilled. A minimum of zero hours of work each day, a maximum of ~6 hours.
Most days of the week have a 2 hour tutorial in the morning, which cover common presentations in GP.
You are placed with a maximum of 3 GPs, and you go to each one, one afternoon of the week (e.g. a maximum of 3 afternoons in GP). This depends on how many GPs are available, and with the 2014 class size due to increase, there may be less placements. Some people this year had only 2 afternoons a week.
Assessment is really chilled - a musculoskeletal OSCE on your classmates, a researched clinical question, and a SAQ exam.


Cardiorespiratory:
Awesome run. You're attached to either a cardiology team, or a respiratory team for 4 weeks. There is the option of swapping with each other throughout. There is a lot of learning on the ward, and lots of good clinical signs to elicit. Often the best learning is done on acute presentations - ideally you go to the ED with your registrar and potentially see patients by yourself. Aside from doing team activities, there are some activities you need to schedule yourself to see (e.g. Watch an exercise ECG).
One of the assessments at the end is a written case report. You are encouraged to submit multiple practise case reports throughout the run. There is a lot of work that can go into this, but there are really good for learning.
Other assessment is a presentation on either a cardiology or respiratory research paper. The CR OSCE is part of the CVPD (see below) OSCE.


Cardio/Vascular/Plastics/Derm (CVPD):
*This may be changing next year*
Basically you are scheduled to see a variety of vascular surgery, plastic surgery and you still have cardio bedside teaching over 4 weeks. Dermatology is essentially non-existent, there are very few dermatologists in CHCH. You are not attached to a team. What is very cool about this run is that there is possibility of doing minor plastic surgery procedures yourself (e.g. Removing moles).
The OSCE for this is combined with CR. There are 3 stations, one history, one examination and one education on either a respiratory, cardiology or vascular topic. There is also a combined MCQ.
CVPD also has an E-poster assessment on any topic in CVPD.


Surgery/Emergency/Gastroenterology/Oncology (SEGO):
You are attached to one surgical team over the whole eight weeks, but have additional activities scheduled throughout the 8 weeks - gastro for 4, and oncology for 4 (urology used to be part of this, but I understand is being taken into 5th year). You schedule 6 shifts in the ED over the 8 weeks.
There is lots to do on surgery (surgery in definitely the main component of the run), which is important as one of the assessments in basically how much your team/consultant see you getting involved. You can't really slack off on this run. In general, you schedule is what your consultants are doing - common things are scopes (gastroscopy and colonoscopy) and theatre. In theatre there is the opportunity to assist, but don't count on doing a lot in theatre, you may get to close the skin. Acutes is an important part of surgery - that is where you see all the acute surgical admission. Opportunity to practise lines, histories, etc. also may get to do lots in theatre as it's often just you and the registrar.
ED is really cool, you get to see pretty much any patient that comes in, there is the opportunity to practise cannulation and suturing, etc.
Gastro and oncology are fairly simple, basically clinics and bedside teaching.
Assessment for SEGO is as follows: 3 surgery case reports, consultant assessment, ED shift log, oncology case report, oncology log book, surgery log book, OSCE (abdo exam, gastro history, ED and oncology questions - from a consultant, and written urology - may not be included next year). This sounds like a lot but they are evenly spaced out, so not so bad, but you can't let yourself get behind.




LOL this was intended to be a brief overview but actually took me ages! If you want me to elaborate on anything, let me know.

Edit: forgot to add that Monday afternoons or Thursday mornings (depending on what run you're on) + Thursday afternoons are dedicated for vertical modules, which for 4th year are path/biochem/haem/micro, quality and safety, Maori, professional development, ethics, and clinical skills (I think there might be more)

 

[Cathay]

I'll add a bit about Public Health and Addiction Medicine (which replaced Otolaryngology, Ophthalmology and Addiction Med):
This run is 3 weeks of public health and 1 week of addiction med.

Public Health
The Public Health component is relatively relaxed, with mostly half-days of classes, but one day a week you'll have off-site visits in the morning, and classes at the med school building in the afternoon.

Fair warning: if you start on public health you may find yourself thinking "I thought we left ELM!", whereas most of the class will go there after the SEGO run and will find it a much-needed holiday after the surgical run)
Assessments for public health include a SAQ test on the third Friday, a group assignment (more on this below), and the main lecturer will assess your professional attitude based on participation in (her) tutorials, so make sure you get a bit of contribution in - but don't talk for the sake of talking, and if you're about to say something inflammatory/controversial try to phrase it in a gentle academic debate kind of way

Now, for the group assignment, the entire group (12-14 of you) will have to work on it together (which is inherently difficult) to produce a 4,500-word report. The project (at least this year) is about 'Burden of Disease', so your group will be allocated a disease (COPD, prostate cancer, breast cancer etc), and there will be three parts to the project. Part I is a description of the epidemiology and the current burden of disease, Part II is a rundown of preventive measures currently undertaken, and Part III is an evaluation/appraisal of a specific preventive measure.

The groups generally split into three subgroups; each sub-group is meant to contribute 1,500 words towards the main written report, and in addition, Parts I and II have a presentation each, at the end of week 1 and 2 respectively. From what the staff said to us in emails it seems like they think sub-group 3 should be putting the main report together, but most groups have an editor or two that are dedicated to writing the main report, doing the referencing (you'll rack up >50 references easily, so using EndNote is highly recommended - the library has tutorials about this), and keeping an eye on the big picture (so they can write the Executive Summary).

Important: DO NOT be the editor - it increases your workload dramatically, and you have to try and please everyone while trying to get them to do their parts, so it's exhausting and it sucks (note the highly biased views there). This is especially true if you go through public health at a time when the pathology exams are happening (August-September).

Addiction Medicine
Once the holiday (or hell, for editors) that is public health is over, you have a week of Addiction Medicine, a branch of psychiatry (I think). For this you'll have a solid 9-5 week (except Thursday which is vertical module teaching). There will be classes, and the most important classes are the Brief Intervention Workshop and the Alcoholism: Assessment & Treatment tutorial, which basically teach you how to sit the Addiction Med OSCE (which will either be taking an addiction history or performing brief intervention) - I would avoid missing either of these two classes, as that would make your life much harder.

Also required are attendance at a recovery group (such as Alcoholics Anonymous) and writing a report about it; an afternoon clinical placement in a rehabilitation facility and doing a presentation about it; and writing a Letter to the Editor on a topical issue, which you have to read to the group, who will vote on the best ones to submit to the local newspaper (if the winners of this contest are comfortable doing so).

For the OSCE: as long as you revise how to take an addiction history and how to do a brief intervention, and practice a couple of times beforehand, you should nail it. It'll probably be an alcohol scenario, and a common scenario is "this is their drinking history on a sheet, read it, and perform a brief alcohol intervention".

Thoughts
I personally found Public Health / Addiction Medicine to be a rather... mind-broadening four weeks. Much was learned (and much was forgotten as we visited the local pub too many times at lunch time) and a greater appreciation of the world (and the amazing alcoholic ginger beer at the pub) was gained.

But on a serious note, it was eye-opening to see what public health physicians do (which I don't think is for me), and addiction medicine gave me a whole new way to conceptualise addiction and addicts, as well as some completely different views on cannabis. (Yes, you're allowed to use the word "addict", unlike what they say in the overly-PC HIC classrooms.)

If you're one of the six groups to have this some time after the surgical run, you'll enjoy the relaxing change; if you're the one group starting on it, you'll probably get frustrated at the lack of clinical environment; and if you're the one group to have this after the Healthcare of the Elderly run, you'll probably feel something completely different which I won't be able to predict

EDIT: Good lord, did I really write that much? I didn't mean to. Guess I should have another round of the amazing alcoholic ginger beer and go home (on the bus... and fall asleep and end up at Hornby Mall then decide to take a different bus to explore the city and not end up going home until 5 hours later - true story)

EDIT2: Formatted a little to make it more readable, necessary since I've unintentionally written an essay.

 

[Cathay]

The UMAT discussion posts that were here have now been moved to http://www.medstudentsonline.com.au/f115/otago-hsfy-class-2015-a-29083/index11.html#post283432