Toronto Notes, now in its 29th edition for 2013, is a concise and comprehensive medical review revised annually by the University of Toronto graduating medical class under the guidance of the Faculty of Medicine. This valuable resource is now availabe for consultation in the Library, just ask at the Library Desk. The accompanying StatNotes and Clinical Handbook are also available.
Considered THE resource for studying for the MCCQE 1 (the Canadian Medical Licensing Exam) and a must have for all medical students preparing for the USMLE Step 2 as well.
"This reference text started as a compilation of notes written by and shared among University of Toronto students to study for their medical licensing exams. After 29 years, it has become a reputable study guide used by medical students across Canada and around the world."
Caribbean Medical Education: Experience of a UMHS Graduate
We are pleased to announce that UMHS graduate, Dr. Larry McMann will hold a special presentation on Friday, April 12thfrom 3:00 – 4:00 PM, in the Auditorium.
The title of the presentation is “Offshore Medical Education”. Dr. McMann will walk you through his journey which includes clinical rotations and securing a residency spot.
Please join us for another session of the Dean's Grand Rounds. UMHS is pleased to have Phil Klassen, MD, FRCPC deliver a special session of Grand Rounds today, March 14, 2013, at 4:30 pm in the Campus Auditorium.
Professor Terence Stephenson, a paediatrician and Chair of the Academy, said:
“As health professionals, we see it across all our disciplines – from the GP’s surgery to the operating table and everything in between. So it is no exaggeration to say that it is the biggest public health crisis facing the UK today."
The report recognises that some clinicians are ‘insensitive, ineffective, and lack confidence’ when dealing with patients with weight problems, but goes on to point out that part of the problem is doctors do not have the services to refer patients to. Many of the recommendations in the report in fact seem to be calling for external changes directed at the fast food industry and media advertising. This is all well and good but it brings to mind those two most popular words in the english language, "you should".
The BMA comments on the point that doctors themselves need to measure up. The other consideration is that doctors may not want to be seen as 'insulting' their patients, as highlighted by Brian Regan in his comedy sketch below of a visit to the doctor. A stronger emphasis on patient communication skills training for physicians and medical students, would be a good thing! Enjoy the video!
Now when you need to take a break from the books to run around and kick some ball ~ you can ~ and without leaving campus!
Come to the library and check out one of the 3 new UMHS sports balls (a volleyball, football and soccer ball) now available for students to use ~ thanks to a generous donation by your fellow student and Sports Club President for the past two semesters, Alexandru Cojanu.
The game that used to be reserved for politicians; the game that parents are not supposed to play; the game that Google rankings depend on, celeb's slave for, teens die for, and medical school professors pretend to ignore; namely, the 'popularity contest'.
Now consider the effects of this game on the medical profession and its consequences for the rising cost of health care. Surprised? Just consider how you would rate your doctor in a patient satisfaction survey if he/she told you that you needed to lose 30 pounds?
"You can tell people to eat their vegetables all you want; they’re still going to remember more fondly the person who gave them a slice of cake."
Were you aware that the growing trend in the United States is to tie a physician's compensation to their performance - not in the operating room - not in providing quality evidence-based care - but on their rating on the patient satisfaction survey?
Catering to Patients Can be Harmful to Their Health
The BMC Cases Database is a freely-accessible and up-to-date data base of over 11,000 medical case reports from publishers such as Springer, BMJ and PubMed Central. Bio-Med Central has aggregated these case reports together into one searchable database to facilitating comparison and provide clinicians, researchers, regulators and patients a simple resource to explore content, and identify emerging trends. An advanced search and alerts feature is also provided.
The first in a new video series from the Health Council of Canada will answer this question for you and help you to understand Clinical Practice Guidelines (CPG's); how they are used, how they are disseminated and implemented, and what impact they can have. This video series was developed by the professionals who design, disseminate, and use CPG's in Canada.
"CPGs are evidence-based recommendations that help health care professionals make better clinical decisions. When designed and used properly, CPGs can play an important role in the Canadian health care system."
Understanding Clinical Practice Guidelines: A Video Series Primer Video 1:What are CPGs? Video 2:Challenges for CPGs. Video 3:Integration of CPGs at the system level. Video 4:Opportunities and future considerations for CPGs.
Dr. John Hall, author of the Guyton and Hall Textbook of Medical Physiology, was interviewed at the EB 2012 Conference held in San Diego, California in April.
"Dr. Hall discusses how he became involved with "Guyton and Hall Textbook of Medical Physiology," [published by Elsevier] now in its 12th edition. He also chats about some hot trends in the field, including the greater demand for digital media and how students are hungry for digestible online information. Finally, Dr. Hall shares some advice to medical students and reveals his 3 'defining moments.' "
Brandon Smaglo, MD, and Sameh E. Mikhail, MD from the Lombardi Cancer Center at Georgetown University attempt to stump John L. Marshall, MD, director of the Ruesch Center for the Cure of Gastrointestinal Cancers, with this unique case study:
While we applaud the hard fought gains against poliomyelitis, new infectious diseases are continuing to emerge around the world and old ones are appearing in new locations. Statistics reveal that 25% of global deaths are attributed to infectious organisms. What’s behind this trend? Has human behavior amplified the problem?
The National Academies, advisers to the government of the United States in science, engineering, and medicine, has created a new website to provide you with dependable, objective, and authoritative information to further understand and answer your questions about infectious diseases. Highlighted are topics related to infection, threats, challenges, and prevention.
"The Institute of Medicine (IOM) and the National Research Council (NRC) have conducted numerous studies and workshops on the topic of infectious disease. The information on this site draws from that body of material and on other sources, offering a basic toolkit of facts and concepts to help people understand this complex topic."
Also access more resources from the National Academies, including this companion ebook, as well as other ebooks on important health topics.
Nick Shockey and Jonathan Eisen take us through the world of open access publishingand explain just what it's all about. Make sure to watch it in HD and Fullscreen!
Thank you PhD Comics for your great explanation of 'What is Open Access?'
Join us for another great series of Dean's Grand Rounds for our Fall 2012 Semester at UMHS St. Kitts:
Beginnning on Thursday, September 20th at 12:30pm in the Auditorium come, listen, and ask questions: A Visiting Professor of Pathology will be presenting on:
"How to Apply for a Residency in the US."
Then on Thursday, October 11th at12:00pm in the Auditorium
Joel Amidon, Med4 Student will be presenting on:
"How Well is St. Kitts and Nevis Handling Epidemiologic Transition."
Next on Thursday, November 1st at 12:30pm in the Auditorium there will be panel discussion moderated by Dr. Girish Kotwal on:
"The Impact of the United States Presidential Election on the Medical Profession"
Keep watching on this blog for updates as new topics are scheduled.
No doubt many of you have heard the odd 'ghost story' involving nail scratch marks discovered on the inside lids of long occupied coffins. It seems when you are dead, you still may not have died yet? Now you can look to BBC's Health reporter, Anna-Marie Lever for incite into what may seem to those outside the medical profession or to even our novice medical students at UMHS, as probably the simplest diagnosis for a physician to make ~ diagnosing death. The article entitled "How easy is it to diagnose death?" (BBC-Health column) questions that assumption.
The report cites various cases where patients were mistakenly declared dead or appear to have regained life, sometimes referred to as the "Lazarus Syndrome". The question warrants further examination, especial by those students studying medical ethics this semester, as one quickly realizes the enormity of the medical, ethical and legal implications of a misdiagnosis of death!
"Dr Daniel Sokol, a barrister and medical ethicist at Imperial College London, said: "The implications of confirming a person dead are enormous, and hence doctors have an ethical obligation to ensure that they 'diagnose' death with due care and skill."
Note the Uniform Determination of Death Act (UDDA) provides this definition:
§ 1. [Determination of Death]. An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.
Read the full article posted this morning (October 17, 2012) online at BBC News - Health.
Time to Reassess your Study Habits? Nine Points to Consider.
Are you beating yourself up after Block One? Saying, “should ‘a, could ‘a, would ‘a done better …BUT … if only _________(fill in the blank)”. What is your excuse? Maybe it is time to reassess your study habits?
1. Time:“But I don’t have enough time!” Take the test and see where your time really goes? How much time do you spend on your cell phone, texting, and checking your email? How motivated are you to study? “Deep motive correlated with time on assignments. Students who were less certain they wanted to work as a doctor undertook less study activity and spent less time with patients.” Yet, more time studying is not better if your problem is inefficient study habits! (Wilkinson, 2007) Which leads to the next issue …
2. Focusing:"But there is so much going on, I have trouble blocking out the distractions?" Use ear plugs, try the study carrels in the library, close out Facebook, turn off you cell phone, do what it takes! To quote KevinMD from his blog article “9 Essential Tips for new Medical Students” ~ “When you study, focus on studying.”
3. Location: Research shows that studying a certain piece of information repeatedly is good, but that studying it repeatedly in different surroundings is even better (Sasanow, 2010). So review that lecture power point in the LRC , then read it over again while studying in the library, then of course learn it during the lecture, then review it again at home. The research shows that if you learn something in multiple settings it will stick with you better as your mind is not connecting that piece of information with only one particular location or environment (Carey, 2010).
4. Multitasking:“But I went to all the lectures!” That is very good because research has shown those who attend live lectures score 3% higher than those who rely on even recorded lectures. (Wenger, 2012) BUT what were you doing during the lectures? Research shows that only 5% of people can multitask effectively (Weimer, 2012). Do you honestly believe you are in that 5%? Note the following quotes: “…students who did not text (during the lecture) scored significantly higher (on a post-lecture quiz) (Ellis, 2010).” “Students who tried to listen to the lecture while using … distractive windows (on their laptops ~ such as games, pictures, email, instant messaging, and web surfing) had significantly lower scores … (Kraushaar, 2010).” “The level of laptop use negatively correlated with how much attention students paid to lectures, the clarity of the lectures and how well they understood the lecture material (Fried, 2008).” “Their multitasking was significantly related to lower GPA … (Barak. 2012).”
5. Practice Review:“But I read the textbook!” But you didn’t really get it did you? While you were reading did you periodically stop and think about what you just learned? How did it relate to what you already know? Write down the key points and concepts you managed to extract from what you just read and then try to explain them, teach them, to yourself. Then go back and re-read the section again, refine your notes then meditate some more on the points. “…high-achievers spent significantly more hours/week on self-study (…and) scored higher on 3 factors which measured aspects of deliberate practice – planning, study style and motivation.” (Moulaert, 2004) The Moulaert study also showed that high achieving students owned more books and read more articles! So make good use of our library resources and our online medical literature databases.
6. Concept mapping:“But I memorized all the facts!” So after you have done your reading, got your notes, got your points, try ‘concept mapping’. In other words draw a diagram of what you just learned. Generally speaking, most educators are big on this as they believe “…having students draw detailed diagrams documenting what they are learning …forces students to make connections among facts.” However according to recent research you need to take this a step further…
7. Practice questions:“I am sure I got that now, I will remember that!” Now you need to test yourself so you are sure you own the material! Research reports that students who stop at point #5 can harbor “the illusion that they know the material better than they do” (Belluck, 2011). It also shows a further significant benefit to learning through testing, and the use of practice questions, even when students get the questions wrong. Note this reader’s comments: “During medical school we were also encouraged to "do questions" to prepare for both our institutional exams, as well as for the national licensing exams. In fact, there are large on-line 'question banks' and 'question books' that are available for purchase and everyone knows you need to do those to pass. The conventional wisdom is that if you do all the questions from the past 5 years of books, you'll pass the exam. I don't know why it works, but it does. These are NOT questions that you will see again on the exam so it's not a case of just memorizing the right answer.““While students have many different ways to study, which includes reading the text book, students can perform well on examinations using high yield review books and practice exam questions as resources. Students who used practice clinical vignette-type questions on average scored 5 points higher than the class average.” (Wenger, 2012) Have you started using Exam Master yet, or the many review books available to you in the library?
8. Test Taking Strategies: Learn key test-taking strategies and the anatomy of multiple choice exams, by attending the study skills lecture to be given by Sue Simon, in the UMHS Auditorium on Wednesday, October 24, 2012 at 12:30 pm . Also take note of these “Tips for Success: Mastering Multiple-Choice Tests”.
9. Manage Stress:“But I am feeling so tired!” Research demonstrates that “stress symptoms, such as fatigue, sleeping problems, anxiety, irritability and depression, were common (during undergraduate medical training).” Some other common symptoms of stress to watch out for are abdominal pain, nervousness, headache, dizziness, and pain in the neck, shoulders, or lower back. (Niemi, 2006) Learning to manage your stress early on will prevent more serious problems later, such as possible burnout. “Burnout is a psychological syndrome of emotional exhaustion, depersonalization, and impaired personal accomplishment induced by repeated workplace stressors. Current research suggests that physician burnout may have its origins in medical school.” (Mazurkiewicz, 2012) Don’t hold back from availing yourself of our campus counseling service for any extra support you may need to help get your stress level under control!
I hope you have been able to take something away from your read of these 9 points ~ and ‘all the best’ for an improved block 2 and your continued success at UMHS-St. Kitts! To quote Dean Camacho’s motto, “Never give up, never give up!”
Ellis, Y., Daniels, W. and Jauregui, A. (2010). The effect of multitasking on the grade performance of business students. Research in Higher Education Journal, 8 http://www.aabri.com/manuscripts/10498.pdf
Fried, C. B. (2008). In-class laptop use and its effects on student learning. Computers and Education, 50 (3), 906-914.
Karpicke, J.D., Blunt, J.R. (2011). Retrieval practice produces more learning than elaborative studying with concept mapping. Science, 11 February 2011: 331 (6018), 772-775.Published online 20 January 2011 [DOI:10.1126/science.1199327].
Kraushaar, J. M. and Novak, D. C. (2010). Examining the affects of student multitasking with laptops during lecture. Journal of Information Systems Education, 21 (2), 241-251.
Niemi, P.,Vainiomäki, P. (2006). Medical students' distress--quality, continuity and gender differences during a six-year medical programme. Medical Teacher, 28(2), 136-141.
Mazurkiewicz, R., Korenstein, D., Fallar, R., & Ripp, J. (2012). The prevalence and correlations of medical student burnout in the pre-clinical years: a cross-sectional study. Psychology, Health & Medicine, 17(2), 188-195.
Moulaert, V., Verwijnen, M. M., Rikers, R., & Scherpbier, A. A. (2004). The effects of deliberate practice in undergraduate medical education. Medical Education, 38(10), 1044-1052. doi:10.1111/j.1365-2929.2004.01954.x
Pugsley, L. (2009). Study effectively. Education for Primary Care, 20(3), 195-197.
Wenger, S.L., Hobbs, G.R., [et al]. (2012). Medical students study habits: Practice questions help exam scores. Journal of the International Association of Medical Science Educators, No. 4, n.d. Retrieved from the association’s website. http://www.iamse.org/artman/publish/printer_500.shtml .
Wilkinson, T. J., Wells, J., & Bushnell, J. A. (2007). Medical student characteristics associated with time in study: Is spending more time always a good thing?. Medical Teacher, 29(2/3), 106-110. doi:10.1080/01421590601175317
Improve your Study Skills & Win at Multiple Choice Exams
Sue Simon, Instructor of Medical Education and Student Counselor for UMHS-SK, extends an invitation to all UMHS medical students, who are interested in improving their study skills and performance on their block exams, to come out to her presentation entitled ~
"Winning at Multiple Choice Exams".
The focal points of the presentation will be:
Consistently turn the work you have done into great exam results.
Timing and review.
Getting to the answer.
The lecture will be held on Wednesday, October 24, 2012 at 12:30pmin theAuditorium. See you all there!
...facilitating communication between the Library and the Faculty, students, staff and community partners of the University of Medicine & Health Sciences (UMHS) & the International University of Nursing (IUON) ~ St. Kitts & Nevis WI ...
