New Year 2017

Happy New Years to all! The holidays are now slowly winding down. Back to work tomorrow. Back to life in less than 24 hours. I picked up a few extra shifts Christmas Day and Boxing Day but kept my NYE work-free. It felt good.

But I can’t wait to get back to the grind.

Can you?

8 More Sleeps Until Christmas

christmas_holly_iconChristmas is now just around the corner! I’ve also started my new post and am now driving to work each day. To be honest, I was dreading driving on the wrong side of the road, but it’s really not so bad. I think having lived in the country for a while, you get used to looking right instead of left when crossing the road and driving comes with that same instinct.

Vince and I have started our fair share of buying Christmas gifts for one another as well. We always agree on nothing extreme, but small things we’ve been wanting here and there.

christmas_jumper_sweaterIn other news, we are joining the ugly Christmas sweater (or jumper as they call it her) bandwagon. Only I quite like the sweaters we bought. I’ll have to remember to take some pictures to post on here later on.

I’ve just renewed this website for another two years. I feel bad for constantly pummeling money into hosting and domain names, but I really can’t bear to part with this. And I’m also hopeful that I will eventually find a blogging niche. I don’t even think anyone pops by to read anything I write currently, so this really is just my own little space on the interwebz at the moment.

Anyway, I’m on nights this weekend, so I’m off to nap before work!

Hello there

I’m really awful at updating, I know. Since my last post in July, I’ve moved up the ladder at work and am now a GP trainee. One of my closest friends from medical school works with me in the same program and in the same hospital. I bought a car. I upgraded my iPhone (finally). And I’ve probably gained a good 20lbs.

I’ve also applied for the MCCQE1, which I will be tackling in April/May. Studying starts now (just spent a lovely $200 on a Q-bank).

I continue to toy with the idea of writing the Canadian exams to give it a shot to apply to Canadian residency. On the other hand, I finish all my training here in less than 3 years now and I can look towards a fellowship in EM in Canada instead (with a part time role as a surgical assistant)… So many opportunities.

My Experience with the MCCEE

It was a humid and cloudy day in mid-May. I was stressed out because I misjudged how long it would take me to get to the Prometric center. Luckily, I made it with plenty of time to spare. This was my first attempt taking the MCCEE (Medical Council of Canada Evaluating Exam).

My mark: 313

mccee-exam-result-medical-council-canada-evaluating-usmle-medicine

The exam: You start with a tutorial. There was a highlighting function that worked very, very poorly and was rather distracting/time-wasting. Once the tutorial was over, there it was. 1 out of 180 questions in the top left corner. A timer counting down from 4:00:00 on the right. There was no blocks, just question after question. There was a calculator function. No labs button (but the questions gave you normal values in the stem). 4 hours is plenty of time to get through the exam. The questions were fair. Nothing to abstract or out of the ordinary. There was something that annoyed me and I don’t know if it’s because I wrote the exam in the UK, but every time there was any mention of acetaminophen, there was paracetamol in parenthesis right next to it – each time. I don’t know if that’s because I was writing the test in Europe, where Tylenol is known as paracetamol, or whether I would have come across the same thing had I been doing the exam in Canada. Another thing that annoyed me was the highlighter function – you weren’t able to highlight a word without highlighting ALL of the text that came before it. And forget about trying to highlight two different words in a stem – disaster. Anyway, after the exam, you have time for a survey, where I would have mentioned all of the above – but my keyboard wasn’t working! I ended up clicking through it to exit out just to get it over and done with at the end.

My study prep: I bought the CanadaQBank in September for 6 months, with the initial intent on writing the exam in March. However, I wasn’t really studying and work got in the way. Before I knew it, it was February – my exam hadn’t been booked yet and I didn’t feel anywhere near ready. I decided then that I would book it for May, extend my QBank subscription, and really get cracking on it. I went through all the questions in 50Q blocks by topic in tutor mode. I started with my easiest subject (surgery) and saved my worst (medicine) for last. It took me until May to get through everything once. I made flashcards and used Dr Google (Medscape and Wikipedia) to fill in any gaps on my weaker subjects. Finally, I went through a few question sets using only the difficult questions on an untimed mode. The day before the exam, I did four sets of 45 questions in a timed mode – only to practice going through 180 questions in a test-like scenario. I’d like to say I used another resource, but I didn’t. I do think almost two years of clinical work does help though.

My advice: Think back to previous exams you’ve written and those you did well on. Some people like to read books to study. Others like to watch videos or listen to audio files. Others like to learn from question banks. I’ve always found that I learn best by doing questions. The easy ones are those I can apply to patients and medical conditions I’ve seen and treated previously. My one successful strategy is being able to apply medical knowledge to real-world scenarios. That’s where my strength came in. Also, be fluid and adaptable to what’s going on in your life. My plan to write the exam in March didn’t happen as planned, so I had to re-work a few things and re-plan my schedule because life was getting in the way. If you’re in med school, it’s a lot easier to create a study schedule and stick with it. But if you’re working or have a family or other priorities, you need to be able to adjust for them.

Everything is about trial-and-error. I’ve read through dozens of message boards and forums to try to find that one successful strategy. It’s different for everyone. I’ve previously done all of Kaplan. I’ve tried Goljan, DIT, the Pass Program – you name it. I’ve studied for school exams by reading chapter after chapter – I didn’t retain much. I’ve listened to audio files – didn’t retain much either. Most of my knowledge has come from being able to apply what I’m studying to real life scenarios. If I had understood this whilst a student, I would have put in a much greater effort during my clinical years to learn as much as I could from the patients I was seeing.

What’s next: MCCQE1 (approx $1000) and the NAC OSCE (approx $2500). I need to have done (and passed) the NAC OSCE in order to apply to CaRMS in October/November 2017. But I also want to write the QE1 around the same time to have it over and done with; and so I can stick it on my CV. It’s too late to write the NAC OSCE in November, so I will try to get the exams booked for Spring 2017. In the meantime, I’ll have a look around to develop a study schedule and see if there are any study resources that may be useful over the coming months.

Family Medicine to Emergency Medicine

So I’m due to start a family medicine residency in August – but I’m currently working in the emergency department and I LOVE this job. The hours are awful, other specialties can give me shit when referring patients, and patients often want more than what I can offer them, but I love the pace of the job and the work I do.

I’ve abandoned the thought of training in a surgical specialty because it requires a minimum of 5 more years of training (and most train for 7 years before becoming attendings). And speaking to my senior colleagues makes me realize that training is not as simple as keeping a surgical logbook and attaining specific surgical skills at different levels of training. In this country, it’s all about your tick-boxes: audits, audits, and more audits; research and publications, but not just in any journal – it must be a peer-reviewed journal; teaching, with “evidence” that you’ve taught; conference presentations and poster presentations. And you’re strewn all over the country at times. And they have almost the same requirements to get into the surgical training post as well – those who meet the tick-box requirements get in. There are no reference letters highlighting whether you’ve got the surgical skills to make it in the job. You don’t get “points” for being able to be a proficient first-assist in a laparotomy. The structure of the system is flawed.

I am now at the point where I’ll be entering general practice, and this also comes with its own set of requirements during training, one of which I’m particularly not looking forward to – reflections. Every week, a requirement is to two at least two reflections either about a patients encounter or on something you’ve learned from. Personally, I’m not one to reflect – in a blog, yes. But in a portfolio – no. Especially since I know it will be read and assessed by my supervisor. In that sense, I feel my reflections will be very superficial and I won’t be as honest as I truly feel. But, whatevs.

My other thought is what if I abandon general practice and try to jump into emergency medicine training. I’d be more satisfied with my job. But training would again be another ¬†years. The option I’m set on now is to endure the three years of general practice and then get a fellowship in emergency medicine and remain there. The options are endless. My career path is not a fluid one. The only path that’s certain for me with work is my return to Canada. My aim: return in a maximum of 3 years, if not earlier.