Showing posts with label youtube. Show all posts
Showing posts with label youtube. Show all posts

Monday, 15 May 2017

An Incredibly Trippy History of the World

I actually learnt so much from this video! Although unbearably trippy it is actually really entertaining and surprisingly accurate. hats off to Bill Wurtz for this creation.

Thursday, 1 December 2016

What Did I Learn Today 2

Thursday morning in sunny Brighton, I'm getting ready for the SJT exam tomorrow and getting a little sidetracked:

Thursday, 24 November 2016

What did I learn today




Friday, 18 November 2016

How do I study for this?

Studying in my final year of medicine, there is one question I get asked by the years below me all the time. "how do you study for this? what should I study from, the books, pubmed or the internet?"
Compared to twenty-thirty years ago and with the boom of the internet we have a huge amount of resources at our disposal. And its this huge variety in educational resources makes this question an increasingly common one. Here is my answer:

Disclaimer: First of all, everyone has their own best method, some people learn best from videos, others from quizzes and case studies, this is an important disclaimer when considering study methods.

What is there?:
  • Fundamental textbooks
  • Wikipedia
  • Pubmed
  • Uptodate
  • Lectures and lecture notes
  • Clinical case and question books/sites
  • Revision books
  • Senior and classmate notes
  • Group sessions
  • Youtube
  • The ward
  • medical blogs
  • FOAMed/MEDed and twitter
(SKIP TO SUMMARY/ANSWER AT THE END IF YOU LIKE)


Textbooks:
The bread and butter of medical study. Often huge, boring and full of what some may consider unnecessary detail. Older doctors will swear by them and the younger doctors may completely avoid them. Use your textbooks as reference! No one has time to read the entire Goodman and Gilmans pharmacology or Kandels textbook of neuroscience. Textbooks are becoming increasingly thicker and thicker and the level of information can terrify first and second year students. When it comes to the fundamentals however, use them! but look for concise or targeted student versions:
Anatomy - Greys anatomy for students
Physiology- Berne and levys physiology
Pharmacology- Rang and Dales
These kind of books for the basic sciences are a must read in their entirety, try and find a smaller concise version for each core subject afterwards. Its in the clinical subjects where you should only use textbooks for reference, Harrison Cecils etc.

Read them, make brief notes, highlight important concepts, bookmark pages, the fundamental textbooks need to look like they have survived a train-wreck after the first couple years of medicine.
moving to the clinical years is where things get tricky...


Wikipedia:
Whenever you google a clinical condition the first post is most likely to be wikipedia post. Hugely informative and structured perfectly with sections for diagnosis, presentation, prognosis and related diseases etc. Take it with a grain of salt. Wikipedia is created by hardworking freelance contributors, many the posts are accurate and uptodate but you never know, they may not be! Until wikipedia has more efficient controls in place, its best used as a quick refresher and definition search tool 

Pubmed:
The centre of all that is EBM (eveidence based medicine), you can effectively answer any clinical question here for free. however, its hard work! often you have to search  hundreds of articles, and even if you find a nice review, it will probably contain many pages of information that you just arn't ready for yet as a medical student. which brings me to Uptodate

UptoDate:
Requiring a login or at least a registered institution, its not free! However this is the best place hands down to answer any clinical question you may have. The information is reviewed regularly and all the relevant clinical information that is interspersed through articles on pubmed is concentrated here. Again there is the issue of perhaps being a little too advanced for the average medical student. Best used a reference to clinical questions especially patient and disease management questions. 

Lectures:
Tedious, time consuming and highly dependant on the skill of the lecturer. We have all sat through a lecture so boring that you struggle to keep your eyes open, it can be a waste of time. On the contrary we have all been to that amazing lecture that kept us on the edge of our seat and full of curiosity at the end. Sometimes I feel I learn more from certain lectures than I ever could in a day reading through the relevant textbook. As much as we moan and and groan about them, lectures are important! attend them, drink coffee, and make notes! lectures will form the backbone of your study and are an important place to cement the core concepts you will need to study in revision. The medical exams are often about what you were lectured on remember.

Clincal cases and question books/sites:
Use these after you have studied, prior to exams. The best way to really test if you really know a subject is to test yourself. Often through testing yourself you find the holes in your knowledge base. it really works! Clinical case books are excellent, a little tedious but are probably the best way to test yourself in a way that will prove to be useful when you start work as a doctor (that special way of thinking when you approach a patient). Multiple choice question books and similar quiz books have now been surpassed by websites with endless question banks. The BMJ on examination site (which I use regularly) is just fantastic. One of my colleagues swears by the Firecracker app, where he answers about 50 quick questions a day on the metro/underground on the way and back from university. Unfortunately there is a catch, these questions banks can be incredibly expensive, so maybe its best to use these resources only before the big exams such as finals or end of phases.

Senior and classmates notes:
Forget it, the source isnt always reliable and most of the learning is in producing the notes yourself. One of my colleagues makes a killing selling his anatomy notes to first years, perhaps a good buisness solution, dont fall for it. On the plus side, notes may be targeted to an exam well and help when you have missed lectures. My advice, avoid if possible.

Group sessions:
Moving a bit away from the topic of resources, group studying is a real preference for some people. I think I will address the debate 'group vs solo studying' in another post. It depends a lot of the group itself and the study method, tackling clinical cases together is a good method.

Youtube:
What a resource, there are hundreds of videos on youtube and many of them are fantastic. I mentioned in a previous post Paul Bolin lectures and how they are brilliant for students preparing for the USMLE. Youtube is probably the best place for people interested in surgery and procedural medicine. Intubation, inserting catheters, chest drains and surgical approaches its all there (although can take some searching to find decent videos and in the correct language). Its incredibly difficult to learn a procedure from reading a book or passage, they are best learnt visually in a step by step matter, or better yet on the ward!!

The ward:
A must for all students. Spending time on the wards presents potential learning opportunities in areas which are favoured by in examinations, particularly practical assessments. Remember that medical school is a precursor for life as a doctor and thus, adequate exposure is necessary to assimilate the abilities expected of new doctor when they start. Although tempting to spend less time on the wards, especially near exams, try not to skip these session. Take a pen and note pad, note down everything you learn or new drug/disease/concept you hear. Try and take at least one history every time you are on the ward.

Medical blogs (like me :)):
There are some incredible medical blogs out there, life in the fast lane and emergency anatomy to name a couple that I usually use. It can be difficult to keep track of the variety in posts and to stay on track when studying a particular subject. You have to be careful with the accuracy of the information and sometimes it best to use the references in the post and read the original material before even reading the main post. I kind of feel that blogs are actually best for gaining an insight into the world of medicine, for opinions on the latest research and methods and for all that humanitarian stuff that forms much more of medicine than most of us are aware about. Patient care and professionalism are fundamental to a great doctor, it can be hard to find a good understanding about some of these issues from textbooks, blogs are invaluable! (not many textbooks will have a part about how to study like this will they ha).

Twitter:
There is an amazing movement happening in medical education at the moment, the hashtag or FOAMed movement. Hashtags like #FOAMed and #MEDed are attached to various things from the internet (videos, blogs, websites) to form this huge collection of medical education resources. More specific hashtags can be used to focus on the subject at hand #FOAMcc for crtical care for example or even summarize the findings from important conferences like #AHA16. Its a wonderful movement and its keeping medicine uptodate almost instantaneously and completely for free. Watch this space!

Ok I have rambled on a bit now and my lunch break is ending. Here is my best answer to the question above:

Attend lectures, make notes and read through them briefly that same day. Use the lectures to form a kind of back bone of core topics. Use the text book to cover these core topics by subject. And use the entire textbooks when addressing core fundamentals like anatomy and physiology. 
When you start clinical modules, use smaller review books with a more concise approach (I'm thinking Kumar and clarks vs Harrisons for example or Surgical talks vs Sabistons surgery). Whenever you have a clinical question use Uptodate and Pubmed. If you feel you need to understand something better use the fundamental textbooks. Try and explore the topics with twitter and blogs. When you are close to exams use clinical case books and online question banks, referring to the textbooks when you find a hole in your knowledge. 

NOTEs:
_The Eisenhower box to time management, works for studying too:
Remember you don't have to study everything in order, spaced repetition is the better way of learning in the long term.

Any questions feel free to comment and Ill get back to you, gotta runn..

Sunday, 4 September 2016

Junior Doctors Contract Dispute

So you have probably that junior doctors in England were striking earlier this year and that is some kind of contract dispute going on. So rather than write a long rant about it, here is great video by the well spoken Dr Lauren Gavaghan explaining the situation and a lovely rant by Dr Rant himself answering some of the popular questions.

"There is no funding, there is no plan, there is no model. You cannot stretch an already under-staffed NHS to seven days withou staff, without funding... and impose a contract"

Dear Reader. Here is a very quick guide to answer questions about the junior doctor pay dispute.
1) "The junior doctors are greedy and just want more pay". The junior doctors and the BMA were not insisting on a new contract. The old one works fairly well, but needed to be updated. The goverment are the ones who want to force a new contract through.
2) "They don't want to work weekends". They already do. Most junior doctors have worked every second or third weekend since qualifying. Like most of us, they'd prefer to be paid more at weekends. The new contract basically defines a weekend as 'Sunday evening'.
3) "They're all communist / Trotsky / lefty militants who want to bring down the Government". They're a bunch of A grade graduates who want to help people. In the 1980s, junior doctors didn't strike over 100+ hour weeks. In the 2000s, junior doctors didn't strike over the career-destroying MMC/MTAS. In fact, this is the first series of strikes in 40+ years. Compare this to tube drivers, who strike far more often. Not exactly militant behaviour by the juniors, is it?
4) "They're playing politics with the NHS". They will be losing a quarter of their monthly wages, and may need to repeat their training year as a result of these strikes. Meanwhile, multi-millionaire, Jeremy Hunt could end the industrial action in seconds.

Friday, 2 September 2016

September Round-Up (Medical Student gems)

Youtube Channel: Vsauce
It has to be the most interesting video channel on the internet. Michael Stevens the main host has become an internet personality and star as a result of his fascinating channel, in fact Vsauce now is spread over four channels on Youtube; Vsauce1 (linked above), Vsauce2 (hosted by Kevin Lieber), Vsauce3 (dedicated to virtual worlds and Wesauce. There are often videos about medical themes or ancient medical practises for those looking for most medically related content. I absolutely love this channel and it never fails to leave me in a completely pensive state about the universe or nature of things. 

Doctors dissected is an incredibly honest insight into the lives of Doctors. Jane Haynes (a psychotherapist) asks various British doctors (a few of them London based GP's) about the reasons they chose medicine and how they feel about the profession today. The answers are often incredibly heartfelt and you feel you really are experiencing a side of these doctors that very few people would get to see. I finished this book with a feeling that Medicine has changed dramatically over the last forty years both for the better and for the worse (its often mentioned the loss of continuity of care has been the worst loss to current medical practice). 

Twitter accounts: @NEJM @Qikipedia
The New England Journal of Medicine and The QI elves, the Kings/Queens of interesting facts (Not strictly medical account but very entertaining nonetheless). 

Webpage: Sporcle
This website, although its full of games, is a fantastic site for educational time killers. I found myself addicted to trying to name all the countries in Europe, Africa and eventually the world. So again not strictly medical, however, if you want something medical there are some medically related quizzes. For example try naming all the eponymous syndromes..

Film: The Doctor
Ok the choice is obvious and it may seem like a boring movie but this movie was the centre of my course on professionalism and there are some lessons to learn. The main character, an arrogant heart surgeon, gets laryngeal cancer and the movie follows his journey through the patient experience. 





Saturday, 27 August 2016

CPR It's easy actually


So continuing on from my last post on first aid although slightly on a tangent, I just want to drop some points on CPR (cardiopulmonary resuscitation). Its actually easy and could well help YOU save a life one day.
Vinnie Jones gives a breakdown in the video above;

Call an ambulance!*
120 compressions a minute (to the tune of 'staying alive' by 'the beegees')
If you are out on your own without a ventilator, no breaths
Compress the sternum (the bony middle of the chest)
About 5cm deep or 2inches
Two hands with arms straight and locked, use your back
Allow chest to fully recoil after each compression
Dont stop until the ambulance arrives

*(and get someone if available to find a public defibrillator and follow the instructions on the case)


Tuesday, 12 April 2016

Video: Why Did Mrs X Die, Retold



Powerful video about Maternal health in the developing world. 99% of maternal deaths happen in developing countries.
WHO factsheet for maternal mortality. 
Fortunately Maternal health is one of the United nations sustainable dvelopment goals, Hopefully will see some change of the next few years.

Sunday, 10 April 2016

April round-up (Medical student gems)

Youtube Channel: theedexitvideo
TheEDexitvideo channel run by Dr Carlo Oller gives great insight into life as an emergency department physician. It's a wonderful educational resource with the personal touch of a real down to earth honest doc.

Book: How Not to Die
Dr Michael Gregers book has been a long time in the works. Finally released last autumn, how not to die is a must read for anybody with an interest in nutrition. It even got me munching on plants more often.

Twitter accounts: @HansRosling @ShaunLintern 
Professor of global health at the Karolinska institute, creator of Gapminder.org and the Gapminder foundation, Hans Rosling. Sign up for his entirely free online introduction to global health course at eDX. Shaun Lintern a patient safety correspondent and a good one to follow to keep in touch with various issues with the UK health system.

Webpage: Global burden of disease
This interactive website run by the Institute for Health Metrics and Evaluation, is just fantastic. You can play around with the various graph styles, regions and income groups to have a really clear world view on the impact of diseases in the different groups. 

Film: Sicko
This famous Michael Moore documentary looks gives insight into the drawbacks and horrors of the American health system, although slow to start it is quite shocking. His latest documentary ‘where to invade next’ flopped, however Sicko is iconic Michael Moore at his best.

Friday, 25 March 2016

Bill Hicks

My favourite Bill Hicks quote, taken from 'Sane Man 1989';
“I was in Nashville, Tennessee last year. After the show I went to a Waffle House. I'm not proud of it, I was hungry. And I'm alone, I'm eating and I'm reading a book, right? Waitress walks over to me: 'Hey, whatcha readin' for?' Isn't that the weirdest fuckin' question you've ever heard? Not what am I reading, but what am I reading FOR? Well, goddamnit, ya stumped me! Why do I read? Well . . . hmmm...I dunno...I guess I read for a lot of reasons and the main one is so I don't end up being a fuckin' waffle waitress. Then this trucker in the booth next to me gets up, stands over me and says [mocks Southern drawl] 'Well, looks like we got ourselves a readah'"
I think everyone can learn from watching Bill Hicks, his comedy was intelligent and he often questioned 'the man', inspiring a generation of anti-establishment comedians. This article

Sunday, 28 February 2016

Nutrition 101: Dr Gregers annual nutrition summaries, How Not To Die

Dr Greger is an internationally recognized expert in the field of nutrition. He created the website and youtube channel Nutritionfacts.org and he wrote the New York Times bestseller 'How not to die'. Every year he gives a presentation summarizing the latest in nutrition research and current understanding of the effects of nutrition on medical diseases.
His talks are absolutely brilliant and eye-opening,  The common theme circles around the benefits of a plant-based diet and how it can reverse and be used in the prevention of many diseases. (heart disease and diabetes just to name a couple.)
I think physicians and future doctors everywhere should watch his videos.
Here are the videos for the annual talks below:
2012:
2013:
2014:
2015: