www.ezralimm.com
Wednesday, March 30, 2022
Ezradamus: Australian Inflation Will Be 20% for 2020-2023.
Sunday, October 17, 2021
Project Magnum Opus
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.
PERMALINK
https://www.ezralimm.com/p/pmo.html
Saturday, July 03, 2021
The Goblin War Buggy
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.