Easter

AMC exam
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17th march
Went to AMC clinical exam last sat to become SP (simulated pt)
AMC exam is the entrance exam for foreign docs who wanna work in OZ, be it you are a lowly intern or a highly consultant overseas.
actually the exam consists of a MCQ and the clinical exam. how far infront of the Q for clinical exam will depend on how will u do in MCQ.
it's really interesting to be at another end of table
the scenarios were mostly based on GP setting. so beware consultant.....cuz they can be easily outta touch of the community needs :P

i was SP as a mother with a kid with septic arthritis (paeds) (morning session)and also a young lady with psychotic disorder >_< (psych) (afternoon session). These 2 are basically quite straight forward and hard to fail. heard that there are other killer stations such as secondary post partum hemorrhage and oso the infective endocarditis. there are 16 stn altogether and doc has to pass 12. and oso pass at least 1 paeds and 1 ONG . most docs are very knowledgeable, the diff lies in their approach to the patients. in order words, it's like customer servicing. cuz everytime the doc leave the room, the examiner will ask me how do i feel. it's so interesting to see different doctors with different approach.

Mom & kid with septic arthritis

1. a doc who act like he's a big doc..... he is physically big as well. can see the sweat mark on his armpit. he's the kind who sit heavily on the chair and then merge with the chair and qiao his leg ( cross his leg) and start his conversation" OK, today i'm goin to...." he told me wat to do most of the time. This is a classic example of doc that don't give me a chance to talk. well if they cover all areas then it's good. if they don't, too bad....but they definitely get mark down on the pt approach part.as SP, we were told wat to answer and what to ask if the doc hasn't address the issue yet.
some of the doc i wanna help them oso cannot cuz they juz keep talking. i juz find it hard to input some questions to them as a concerning patient

2. a lost doc
he looked lost, i didn't know why i got lost with him too..... mayb he's cute(part of the reason) LOL. anyways, he was not very focussed and didn't seem to know what's goin on. so i'm lost in the sense that i don't know when can i find the right chance to input my question to help him to score his content point.

3.shy doc
a middle age lady who look all nice, smily, slow and shy. and not too confident and oso not too sure as well.

4. a super prim and proper doc
a thin small size russian looking guy, with long and stern face. put both of this hands on the table and straighten his back when he ask u qn with a monotonous tone.....
oh my....i so feel like laughing....but i ctrl myself lah.

5. of course there were those good one,
even the good ones they will miss out some points. each good one managed to cover some points that other good ones didn't managed to.

in this stn, to be perfectly good, some minor points to cover like remember to take a brief full overall hx even u already know its septic arthritis fr the presenting complaint. try to ask whether they can go to ED if not, arrange some kind of tpt for them (ambulance). there are lot more details to cover.juz one trick, even if you know wat will their concern be...there is no harm asking.

i wonder whether is it becuz of the exam setting that render the above doc half of wat they normally are.

for the morning session: it was all nice. as i can be a nice pt and try to prompt them with my questions. and my answers were mostly repetitive...
most docs were great that the examiner ( the Albury clinical school incharged) had a strong urge to give them his name card & ask them to work for him.

Critical Error for this stn (critical error is the error that will fail u str away no matter how well u did) : did not admit the kid immediately to hospital

Pscyho patient who has strong paranoia

in the afternoon, as i was reading thru the instruction sheet to be a psycho, i was confused as well. no clear hx given, hahha that's the point right !!!!
well, we are not encouraged to be aggressive psycho cuz it can be very tiring after acting over and over again for 16 times!!!

i wasn't very familiar with what i should do initially so i was a pretty reserved psycho but i slowly warmed up. basically i was a calm psycho. i'm supposed to have some self harm intention too...
i find it hard to help the doc in this stn as compared to the previous one. but later i found something such as kept telling them that i'm worried about my work so i can't sleep....which most of them fail to address anyway ..... (waste my effort)

1. the anxious doc (stuttering)
i guess everyone is anxious.(including me, cuz i have to be really concentrated in listening to the doc and try to ask them necessary qn to bring them back to the point). but this one is so hilarious. he stuttered every 2 words. but luckily he still managed to cover the content points before the buzzer rang. this one i actually pity him and be nicer abit to him :D

2. the consultant looking doc
he looked like he has a certain age and calibre with his white hair, consultant body shape ( not very slim >_<) and also his coat but he didn't do really well. i think partly becuz this stn requires knowledge of OZ psych system (something as " Mental Health Act") 3. the very happy doc a china guy.... oh my...he look so happy & relac. keep smiling when asking me qn. haha i'm supposed to be depressed but .... i'm not that depressed in his case. i actually smile and shake his hand on his way. usually i don't cuz i'm supposed to be Acting !!! i'm such a dedicated actress 4. the fierce looking doc i'm not very happy with this one personally, she gave me a fierce look. COME ON, I'M SUPPOSED TO BE PSYCHO.... YOU CANNOT BLAME ME. after i refused to be admitted, she ignored me straight away and turn to the examiner ..... -_- as compared to this, another doc handled my unreasonability pretty well when i ask her not to be sucha busybody when she ask me how i hurt my hand. she is the best candidate for this stn.

5. The good ones
address my concern : which is my work issues. bonus: offer a solution: counseling (instead of juz hospital admission) but it's abit unfair as well cuz the instructions already contain most of my hx so most pple didn't go back to it again but went straight in telling me about my prob and that i need to be admitted.

6. Doc who gave me a label !!!
most of the doc said" Ms Lina, i think you have psychosis based on your hx and clinical examination". Even i'm SP, i felt damn OFFENDED wuay!!!. i would be either like " huh? what's that" or " i know wat's hallucination but i 'm pretty sure that i don't have that". but there this one doc i can see he is trying very hard to not to call me psychotic. only went i kept kacauing him then he tell me nicely that i have psychosis and explain it pretty well to me.

Critical Error: didn't admit me straight away or let me go home and take my stuff....

most doc will juz kept repeating that i need hospitalisation but none of them actually convinced me......
as a bad pt i will try ways to buy some time & trick them in not hospitalised me immediatly
1. simply just refused to be hospitalised
2. said that i can't skipped work cuz it's goin to make my workplace problem worse
3. said that i need to feed my cat first
4. said that i need to go home to take some stuff first
5. said that i will admit myself and ask for hosptial address

but luckily none of them fall for that. so becuz of the way the marking scheme is drawn out....it is actually very hard for the candidate to fail this stn as long as they don't fall for the critical error and manage to explain mental health act and management well..... the pt approach is not a major component under this marking scheme. according to the examiner, this qn was not drawn out suitably cuz knowledge on mental health act and psycho mx could well be tested in MCQ, not in clinical exam.

lilian was doing the same stn as me at another stream. her examiner focussed more on the scientific part such as mental health act blah blah blah. while mine is more towards pt approach: have they addressed my absence from work (MC), do i need company to go hospital, is my cat being fed at home while i'm away....

heard that they r goin to abolish the exam for those coming from UK and NZ

most doc look Arabish or South Americanish. but language wise so far so good....haha they can understand my asianish english :D

Bondi Hurricanes
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Tuesday
try out free wifi in uni
and then met up juniors at bondi Hurricanes for dinner.