PRELUDE I am writing this to become a better
doctor. To be able to function at the level of a consultant. There is no
fixed syllabus. There are only outlines of topics that a consultant
kinda needs to know about. It seems like an impossible task, but
medicine is ultimately based on real life, and it cannot deviate from
that. Medicine changes, but human beings do not evolve that quickly. I
have 10 years of experience behind me, along with studying for the
exams, which are based on real life, and will stay true to reality.
This project is an integration of all previous study documents for
consultant level exams, namely my collection of clinical decision making
tools and copypastable templates, ECG archives, ABG archives, and
collections of structured assessments and multiple choice questions.
This aims to be the final set of notes in my career. It will be
updated as appropriate and once complete I will look into versioning and
QI.
APPROACH The topics are wide, and the
knowledge required could be extremely focused at times. Remembering
lists is meaningless. Everything has to be in working memory, well
understood and structured to allow for rapid access on the floor. Quick.
Intuitive. Practical. To achieve the required amount of practical
working knowledge, basic principles are to be employed. The structure is
similar to that of the International Baccalaureate diploma, in that
each theme is broken up into chunks with a progression of concepts and
logical themes.
The separation of themes differ from
traditional textbooks and references as they are oriented around
clinical relevance and application. Compartmentalizing information in
clinically relevant areas of working memory is a key goal of this
project.
As this project focuses on real life, many topics
are deliberately superficial and to the point. There are also some
topics that end up being oddly specific and detailed as they are
relevant to clinical practice.
Chunking.
Breaking up each topic in to bite sized pieces that could be integrated
into working memory. Each topic should be reviewable in about 1 hour.
Minimising cognitive load.
Pictures / diagrams / illustrations / questions*
Each topic has to flow in a logical progression of thinking – from fundamental concepts to complex themes.
Each topic starts with a question or clinical scenario – because that’s how real life works.
Cutting out the noise: Information relevant to practical real life clinical decision making is to be included.
Portability – if a presentation needs to be done on one of the themes, easily copy-pastable into a powerpoint.
VERSIONING / PROOF READING
I hope to enlist some colleagues to help proof read the topics prior to publishing. Versions are identified by a date appended to each file.
It costs two mana. One colorless, one red. It is cast with haste, and can attack the turn it is played. It deals two damage on turn two.
I have not played Magic The Gathering since 2002.
Why do I remember these cards with such vividness? More importantly, why do I understand the function and role of cards in the meta of a game i have not played in over a decade?
The Goblin War Buggy is not the only card that I have taken to heart. I could list at least two dozen cards in vivid detail, along with their function and role, and how they integrate into a deck, so many years after last playing with them. In retrospect, playing Magic The Gathering was a perfect combination of a few factors. I
spent my casual free time thinking about cards. The game made you think
hard long before it was actually played. Building a deck meant fussing
over card counts and how each card fit in grand strategy of the deck. I
spent so much time studying the cards, and thinking about them on my
spare time, that I developed a keen understanding of each card. I then
played with them, and that reinforced the knowledge I had about those
cards.
Why do we remember what we learn? How can I integrate what I learn into working, functional memory?
Step 1: Priming Mental Function
- Sleep enough.
- Cardio Exercise 3 times a week (~20 mins at ~80% HR, or about 160bpm).
- Meditate to wipe out distracting thoughts.
The ultimate goal of the above is to increase levels of Brain Derived Neurotrophic Factor that greatly aids in learning and memory. Meditation reduces distracting thoughts, and improves focus on the now... as the default mode of the brain is to think about things past and future, but not the present. Exercise increases BDNF, improves sleep, and lifts mood.
Step 2: Study in a Flow State
There must be no distractions. No checking facebook / instagram / reddit
/ email. You have one task: To study XYZ. Nothing more. Study while not stressed, in one's casual free time, out of one's own volition, with
no pressures or distracting thoughts. Once in a flow state, focus and read intently. Reading for the sake of reading, while incessantly checking facebook or reddit, does not achieve anything. The whole idea of reading is that it allows you to think. It is the act of thinking about something that will integrate it into working
memory.
Step 3: Visualize.
Practicing what has been read, will solidify that knowledge and make it easily reproducible/verbalized (for exams!). Performance artists (eg dancers / gymnasts ) will often go through the motions in their mind when not actively practicing physically. The same reason why professional guitarists play the air guitar on the bus. The mind has the ability to visualize scenarios - and it is linked very strongly to the formation of new memories
Step 4: Marinate / Practice
Thoughts need time to marinate. Studying and visualizing require time to marinate and be integrated into one's mind. Seeing things happen in practice will make it stick even more.
How does this relate to studying for Consultant level Exams?
1) The Flow Protocol
- clean up workspace
- exercise
- shower and brush teeth
- meditate for 5 minutes.
2) Study a topic from the syllabus.
- Read various sources regarding a topic.
- Textbooks,
- and yes, google (FOAMED) is my friend.
3) Ruminate about the topic. Scribble some notes
- What questions can they ask me about this topic? - There is only so much they can reasonably ask!
4) Visualize the topic
- So, a medical student comes and asks you about it. what will you say?
- A patient turns up with this condition. How would you approach it? - Can I make a first year, first-rotation, intern "autopilot" the management of a patient presenting with XYZ? If so, what clear instructions do I need to give?
5) Consolidate knowledge in to formal notes.
- Structured and consistent with the syllabus.
- Allows rapid recollection / rumination / visualization.
- Marinating thoughts (Step 3 and 4) while looking at notes
6) Examinology - 27 questions in 3 hours. 360 marks. Must finish. Must be concise. Must not give too little or too much information. - Like everything in life, this is a real skill that is not really taught anywhere.
*This article was originally written september 2020. I passed the exam July 2021.
This is my take on the Australian News Media Bargaining Code. A piece of legislation so unbelievably absurd I cant believe it exists in 2021. It is disturbing that private news media companies are skewed and extremely biased in their coverage. Here is what wasnt reported:
Summary:
Private News Companies lobbied the government to force facebook and google to pay them for having links to their websites. The idea of paying to post links is absurd - and breaks the basic functionality of the internet. No company/person should have to pay to link to another website. To make it even more absurd, FB is being made to pay for links it's users (not facebook) are sharing.
Media coverage of this issue has been unbelievably biased, and does not point out the basic fact above^.
Facebook/Google provide a free service in return for being able to provide targeted ads, which is very valuable. Traditional media is dying as advertisers are leaving them. In my opinion, if they could not adapt to an online world, they deserve to fail. This is the golden opportunity to break up the Murdoch Media Monopoly - which is a whole topic by itself.
Regarding the takedown of some government pages / emergency services: Using Facebook/Google is a privilege, not a right. The whole idea that a private company (FB/Google) must show your organization's website is absurd. If an emergency service relies on a free media platform run by a private company, it needs to take a hard look in the mirror.
Private News media companies are not reporting the simple
reality that they have lobbied for a law that gets them paid for having
links to their websites. Yup. Not the other way round. It is absurd.
What is the News Media Bargaining Code about?
TL;DR -
Facebook/Google has to pay PRIVATE news companies (ABC is excluded btw).
... by government mandated law in the private companies favour.
for sharing links. Not content. Links. FFS. This breaks the internet.
It's not how the internet works. Nobody should be forced to pay for
sharing links.
The private news media monopoly also will get access to the algorithm to give them an unfair advantage vs small and independant news sources.
Private news companies (Read: Murdoch's news
empire.) are bleeding because they no longer can profit from ads that
typically went into news papers. They failed to adapt to the online
shift in media consumption,... and despite 4+ billion hits to their
pages from Google, they are failing badly. They will die a natural death
if they cannot adapt.
Now they want google to pay them for having links to their websites. And lobbied the government to do so.Facebook took a stand. Google caved. The reason is simple. Facebook's profits dont rely on sharing links to news sites
The private news companies think too highly of themselves – their news is simply not worth much to Facebook. In fact, I would argue facebook is a much nicer place without the news
– stick to friends and family stuff. I dont mind seeing the occasional
targeted ad (which has led me to some nice purchases and things I use
every day). This in return for a place to share photos of my cat and dank memes. Im gonna go out and just say it: I like facebook.
At the end of the day: 1) Company ABCD should never have to pay company XYZ for sharing a link to company XYZ. 2) This fundamentally breaks the way the internet works. (free linking to different sites) 3)
I hope google and facebook boycott australian private news companies
and not get involved with australian news until this debacle of
legislation is over.
Free Speech? This has nothing to do with free
speech. Private companies (google/facebook/tumblr/twitter) can decide to show or
not show whatever they want. Even Donald Trump was banned from twitter. Free speech was never an issue then. Citizens still have the freedom of
speaking on other platforms and in public without reprisal. Similarly,
Murdoch's private media empire has the "freedom" to not report the
simple fact that they lobbied the government to get paid for having
their websites linked to. If you are upset about not being able to see
news on facebook – go somewhere else.
Stealing Content? No. There is no copyright
infringement. Google simply posts links to these news organizations. In
fact, google even gives the option of removing spiels and blurbs in
search results (if you dont want users to see snippets of your site). If you want an example of this in action: google your favourite crustacean on PrawnHUB.
What's this private news monopoly you keep talking about? Kevin Rudd talks about the news media bargaining code and the murdoch monopoly. He summarizes it nicely: https://www.youtube.com/watch?v=nL6XBJ5CoXo
How does it affect actual independant small news outlets? The
media giants also want insights into the algorithm for what is
essentially government mandated search result optimization. This removes
the advantage that the internet inherently gives to small publishers
and independant youtube creators – the type of people who need more
exposure. Over time, this means search results are more likely going to
be focused on private news media and their version of events. This
strengthens their monopoly, and prevents startups from finding a voice.
How does this affect me? Why should I care? Simple. Facebook will be showing you more ads. Advertisers will be charged more. You will pay more in the end as a consumer. Also, the murdoch media monopoly will be feeding you news that may not align with your interest, as independant/small news outlets will be suppressed. The private media monopoly will have access to Google's algorithm and essentially the best search engine optimization (SEO) which will make their news more visible by default.
========================================================= Dont get me wrong, Im not an ardent FB/Google fanboy. I believe that:
1) FB/Google/Corporations in general should be un-dodgebly taxed on REVENUE to high heaven.... to support public broadcasters like the ABC/PBS and public news services. And for grants to small/indie/independant news producers.
2) Private old school news companies that fail to adapt to changing times should be allowed to fail. This is a golden opportunity to break up the Murdoch media empire, and for Gen Y and Z to take over with small lean startups..
This is the opportunity to create a vibrant media landscape of lots of
small players with tons of potential due to the internet's scalability.
3) Despite all this drama, I still do believe private news companies are suitable
investments for a portfolio – heck I own shares in them. Never sold for
ages lol. Like all the other apes on r/asx_bets, If these companies die
i'll sink with the ship. Sometimes you just gotta stand for ya
principles. Never sell! I have DIAMOND HANDS.
