MED4190: Specialty clinical practices

- Paediatrics: tutor assessments (11%), written case report (4.6%), oral case report (4.6%), contemporary issues in health group oral presentation (2.8%), logbook tasks (hurdle)
- Women's health: written case report (4.6%), oral case report (4.6%), observed clinical encounters (2.2% x 5), contemporary issues in health group oral presentation (2.8%), logbook tasks (hurdle)
- Psychiatry: written case report (23%)
- General practice: chronic disease assignment (23%)
- Other: attendance of 80% for all rotations (hurdle), evidence-based clinical practice quizzes (1% x 8 ) and forum posts (hurdle), health services management forum posts (hurdle, semester 1), health economics forum posts (hurdle, semester 2)

This is a very challenging year and unit. It is essentially one big unit divided into four topics: paediatrics, women's health (obstetrics and gynaecology), psychiatry, and general practice. I'll keep this general given that every student will have their own unique experience depending on their site, their rotations, their group, and how keen they are to get what they can out of it.

Basically the sites Monash have are (I may be missing some!):
- Central: Alfred (psychiatry), Cabrini (paediatrics), Peninsula (paediatrics, women's health, psychiatry)
- Monash: Monash Medical Center (paediatrics, women's health, psychiatry), Dandenong (paediatrics, women's health,psychiatry), Casey (paediatrics, women's health,psychiatry)
- Eastern: Box Hill (paediatrics, women's health), Maroondah (paediatrics, psychiatry), Angliss (paediatrics, women's health)
- A bunch of rural sites such as Bendigo, Mildura, Bairnsdale, Traralgon, etc
- Hundreds of GPs, although the teaching home base is in Notting Hill

Basically how rotations are allocated is that after giving preferences, the cohort is divided into three groups: metro, rural, Peninsula. Metro students have access to rotations in all metro hospitals other than Peninsula, rural students have access to rotations in the rural hospitals, and Peninsula students are at Peninsula for the year. I was a metro student who had rotations at MMC, Angliss, and Casey. Each site has their ups and downs in terms of a balance between practical skills and teaching and it's probably not up to me to make a comment on this for each site, but I think I was pretty lucky in getting good rotations.

The year is divided into two 18 week semesters, followed by one week SWOTVAC and then 5 exams in 5 days (more on that hell-hole in my MED4200 review!). Each semester you do two rotations, either paediatrics and women's health, or psychiatry and GP, each of 9 weeks duration. Some people may be in multiple hospitals during a rotation (especially psychiatry at MMC, or metro paediatrics), others might be at just the one (more-so in women's health), really depends.

From the outset, I want to make it clear that this unit is bloody hard work and it's really important to study smart and keep on top of your study to make sure you don't fall behind. This sounds obvious, but this unit has a lot of assignments and Moodle tasks, and if you get caught up in them then it's very easy to lose track of your study. Personally, I made notes for my rotation before it started, and then added to them once I was in the rotation. So how my study went:
- Summer holidays: make paediatrics notes, also decided to make notes on ophthalmology, dermatology, and ENT because I knew GP was my last rotation and I wanted to ease off pressure as it was so close to exams
- Paediatrics: refine paediatrics notes, make women's health notes
- Women's health: refine women's health notes, make psychiatry notes
- Mid-year holiday: refine all notes thus far and start to revise third year material for MED4200
- Psychiatry: refine psychiatry notes, make general practice notes, continue revising third year material
- General practice: refine general practice notes, revise all notes from this and last year
- SWOTVAC: cram everything like there's no tomorrow, maybe consider revising clinically-relevant things year 1 and 2 if you have time for MED4200

To aid with the study, the Faculty provides you with a matrix, similar to the one in third year except about double in size. However, as I'll touch on later, I think that's the bare minimum to know. To enhance your knowledge, I'd strongly recommend a purchase of some sort of online MCQ/EMQ question bank. Some of the ones I have used over the years include:
- http://my.onexamination.com/Login.aspx (probably the best one)
- https://www.pastest.co.uk/product/medical-student-online?rbc=true&pnpid=915
- http://www.passmedicine.com/index.php

Here are some properties from my combined years 3 and 4 notes, the study is very much real this year:

Many, depending on the series of lecture

N/A, exams fall under MED4200, but I'll be discussing some exam study in this review too

5/5

No.

Paediatrics:
- Clinical Paediatrics for Post Graduate Examinations 3rd - Stephenson, Thomas and Wallace
- Illustrated Textbook of Paediatrics 4th - Graham and Lissauer
- Jones' Clinical Paediatric Surgery 7th - Beasley, Hutson, King, O'Brien and Teague
- Toronto Notes 2015 31st - Hall and Premji
- http://www.health.vic.gov.au/neonatalhandbook/conditions/
- http://www.rch.org.au/clinicalguide/
- http://muppits.mumus.org/clinical-cases/
- http://www.health.gov.au/internet/immunise/publishing.nsf/content/handbook10-home
- http://www.asthmaaustralia.org.au/Inhaler_technique_videos_for_HPs.aspx
- http://www.asthmahandbook.org.au/

Women's health:
- Gynaecology by Ten Teachers 19th - Monga
- Lectures in Obstetrics, Gynaecology and Women's Health 1st - Kovacs
- Obstetrics by Ten Teachers 19th - Baker and Kenny
- Practice OSCEs in Obstetrics and Gynaecology - McNeilage, Vollenhoven and Weston
- Toronto Notes 2015 31st - Hall and Premji
- https://system.prompt.org.au/login.aspx
- http://geekymedics.com/how-to-read-a-ctg/
- https://www.thewomens.org.au/health-professionals/clinical-resources/clinical-guidelines-gps/
- http://medilinks.blogspot.com.au/2012/05/instruments-used-in-gynecology-and.html
- http://www.menopause.org.au/health-professionals/management

Psychiatry:
- Diagnostic and Statistical Manual of Mental Disorders 5th - American Psychiatric Association
- DSM-5 Guidebook - Black and Grant
- Kaplan and Sadock's Synopsis of Psychiatry – Behavioral Sciences - Clinical Psychiatry 11th - Ruiz, Sadock and Sadock
- Toronto Notes 2015 31st - Hall and Premji
- https://masteringpsychiatry.wordpress.com/ (there is a textbook in here too which is excellent)
- http://www.trickcyclists.co.uk/
- https://www.youtube.com/playlist?list=PLBF6D1605733BAACB

General practice:
- Clinical Examination A Systematic Guide 7th - O'Connor and Talley
- Clinical Orthopaedic Examination 5th - McRae
- Eye Emergency Manual 1st - NSW Department of Health
- Murtagh's General Practice 5th - Murtagh
- OphthoBook 1st - Root
- The ECG Made Easy 7th - Hampton
- Toronto Notes 2015 31st - Hall and Premji
- http://www.racgp.org.au/your-practice/guidelines/redbook/
- http://www.dermnetnz.org/
- http://elearning.dermcoll.asn.au/login/index.php
- http://lifeinthefastlane.com/ecg-library/
- http://www.ranzco.edu/index.php/ophthalmology-and-eye-health/eye-conditions-information
- http://www.ophthobook.com/ or https://www.youtube.com/channel/UCSfq-96NwFRpmEZXxI7WIEw
- http://www.racgp.org.au/afp/
- http://copdx.org.au/copd-x-plan/
- http://www.dhhs.tas.gov.au/palliativecare/health_professionals/symptom_management_guidelines
- http://www.eyeandear.org.au/page/Health_Professionals/Education_and_Training/Lecture_series/

I'd also recommend utilising UpToDate, eTG, and http://radiopaedia.org/ as much as possible.

per week: varies between rotations and sites
- Paediatrics (perspective from MMC and Casey): get there at 8.30am for ward rounds and you can probably leave at around 2pm
- Women's health (perspective from Angliss): depends what you're doing, days can be long (including night shifts for delivering babies!), days can start early (for surgery), days can be short; highly variable
- Psychiatry (perspective from MMC and Kingston): get there at 8.30am for ward rounds and you can probably leave at around 12pm
- General practice: expected to do two full days of GP a week, there is 9-5 teaching two days a week, and one day off

Semester 1 and 2, 2015