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23 October 2010

Tips for the D-day

I am pretty sure, you know everything what I am going to write here, however people tend to forget things easily and need reminder about important things.

This is really important day, as you are going to show off your all the hard work and skill in 3 and half hour. It is not only about expensive exam fees, it is also about a long waiting list and getting into job late. One of my school teacher told on one day that when you fail one year, do not think about salary you are going to earn on your first year of job, think about a year prior to your retirement.

As I mentioned in my previous blog, this is about presentation. If you know the stuff and cannot bring that out on the day, it is not helpful. Well rested and fresh mind work quicker and think better. I strongly recommend that you have enough sleep prior to your exam. Our biological clock is great. I recommend that you make your last few days schedule as same as your exam day. If your exam is in morning, do your practice in morning and vice versa. This will train your brain in that way and you will feel less stress on the day of your exam as it is your routine.

Make sure that you visit your exam centre prior to your day of your exam if you are not familiar with the centre, or at least ask someone who is going to come with you. Reach at your centre well prior to your exam time.

During your exam, when you are reading outside for 2 minutes try to concentrate on the topic and read carefully about what have they asked. Do not think too much what it will and I don't know this and those sort of stuff. If it is too hard, the expectation of examiner is low, so it is likely that you will pass easily. If your previous case went really bad, don't think about that otherwise you are going to perform badly on the new one. When you are inside, give your full attention to your patient and listen carefully. In examination, if you think something relevant say so, as examiners are not mind reader and won't give you any mark for not telling.

When you are consulting your patient, behave as a professional person. Don't be too unfamiliar or don't be too familiar. When you need to touch the patient, always ask for permission first (verbal consent). Warn them about what are you going to do and whether it will painful or uncomfortable. Wash you hand before and touching the patient.

When you are explaining something ask them about their understanding. It is possible that you might you few jargon without knowing, but if you ask them whether he/she has understand or not, then you are safe.

Just one sideline, when you are talking with patient in this exam, make sure you don't confront them in anyway (unless that's the case scenario). Most of them are 5th or 6th year medical students and they are being told that if the candidate is really sympathetic then help him. Use words like 'thank you' ' sorry' and 'please' freely. These words are not going to pass you, but if you don't use them, it is unlikely that you will pass. 

Keep in your mind that this exam is for an intern, not for a consultant. They are not going to ask you 'how to perform angiogram?', but they expect you to find out who is going to need them. They expect you to know how to take basic history and do examination. They expect you to know when and where to get help from. In other word, they want to make sure that you are safe doctor.

Please read disclaimer before using above information.

18 October 2010

Books you need to read for AMC exam

Reading in medicine is unlimited and there is no fix curriculum. Below is a guidance which book is more important for you to read for the exam. This is not official AMC guidelines, this is only from my experience. Also read AMC MCQ exam specification booklet (available through AMC website) and clinical exam specification booklet (link). There are few booklet and material available through various sources. If you need to purchase them there are various online  (usually cheaper) and offline bookstore available to purchase. These two bookstores will be nice to visit - Bookdepository and Fishpond. Another great online bookstore is obviously Amazon.com.
  • A must read books:
  1. Anthology of Medical Condition
  2. AMC Handbook for MCQs
  3. AMC Handbook of Clinical Assessment (for part 2, but should read for part 1 if you can)
  4. General Practice by Dr J. Murtagh
  5. Oxford Handbook of Clinical Medicine
  6. Oxford Handbook of Clinical Specialities
  7. The Australian Immunisation Handbook - freely available from  Australian Government websiteImmunisation Handbook 
  8. Assessing fitness to drive - freely available from website
  • You should read these books:
  1. Fundamentals of O & G by Llewellyn-Jones
  2. Essential Paediatrics by Hull
  3. Royal Children's Hospital - Paediatric Handbook
  4. Textbook of Surgery by Tjandra
  5. Practise tips by Dr J. Murtagh
  6. Patient Education by Dr J. Murtagh
  7. A Systemic Guide to Physical Diagnose by Talley and O'Connor - DVD comes with the book and that is really helpful for physical examination
  8. Diabetes management in general practice - freely available via RACGP website 
  • Use as a reference:
  1. Davidson's Principles and Practice of Medicine
  2. Harrison's Principles of Internal Medicine
  3. Ethics and the law for health professionals by Ian Kerridge
  4. Australian Family Physician - journal by RACGP - website , available free online, printed copy will need subscription.
  5. Medical Journal of Australia - website
  6. Therapeutic Guidelines - various available
Please read disclaimer before using this information.

16 October 2010

Clinical Exam preparation

Most of the people who prepare for AMC exam have question like 'how to prepare?', 'how much time should I give?","what should I read?", Is there any bridging course can I do?" and "where can I find more information?".

This exam is multi-station OSCE - Objective Structured Clinical Examination. In simple word, there will be multiple short cases. You have cleared AMC MCQ, so you have knowledge. Now you have to show that knowledge and clinical skill to your examiner and your patient. This exam is more sort of communication skill testing with your medical knowledge and skill.

When you want to prepare for this kind of exam, you should practice that in real life. If you are working in Australian system, it is much easier to do that, otherwise you can practice with your colleagues/friends. Practice is the only solution for this exam. Practice, practice and practice until you feel comfortable about that station.  When you are practicing, practice like you will do in real exam. Do not spend more than 8 minutes in any case. Now you will need mock cases, you can write by yourself or ask your friend or supervisor to do that for you. AMC Handbook of Clinical Assessment is great book to get idea about the cases. I recommend that you read and revise this book at least 3 times before your exam. There is also one DVD from AMC - Multi-station Structure Clinical Assessment out there, which gives you more idea about the exam procedure rather than cases.

How much time should you give for preparation? Answer of this question depends upon your clinical experience in your country and in Australia or similar system, whether you want to give full time or part time and what's your personal life circumstances. Ideally you should give 3-4 weeks of intense (full time) if you have Australian Clinical experience. You will require more time if you are out of the field or outside Australia, but 2-3 months is sufficient time according to my experience. If your speaking is poor and having difficulty in IELTS/OET speaking, then doing IELTS/OET during this time is also useful, as this exam will be in same language "English".

You should read above book and see DVD (if you can) for exam preparation. On the top of your AMC MCQ reading you should read following books/DVDs (Whole list is exhaustive and I will post in one blog together).
Talley and O'Connor's Clinical Examination: A Systematic Guide to Physical Diagnosis
John Murtagh's General Practice, Practice tips and Patient education

I come across this nice bookstore which is cheaper than other sites and it delivers books free worldwide. If you are in Australia and would like Australian website Fishpond is the anotherone to go.  

There are lots of bridging courses around by reputed source if you are in Australia. I am not aware of any good course outside Australia. Below are few institutions who run bridging courses for AMC candidates. They are costly, but I will recommend you to do at least one if you are not working in Australia. VMPF and RACGP (Sydney) are intense courses for lots of information and practice, but are really expensive.
  • VMPF - Victorian Medical Postgraduate Foundation
  • Monash University in Victoria
  • RACGP - In Melbourne, Adelaide (2 hours a week for 10 weeks) and Sydney (full day/week for 10 weeks)
  • Centre for International Medical Graduates, Queensland
  • Postgraduate Medical Education Council of Tasmania
  • Northern Territory General Practice Education
Clinical Exam tips and resume writing are coming soon!!

Please read disclaimer before using the above information.

AMC Clinical Examination

I have recently received few queries about clinical examination, so I thought I should write bit about clinical examination first and then go back to intial topics. Writing for AMC clinical exam requires more than one blog, you will need bit more patient to read me.

I will start with the exam procedure. Before you take clinical exam, you have to cleared AMC MCQ exam and according to new rule, that is the only requirement. You don't have to have any clinical experience in Australia before you take the exam, but clinical experience in Australian Health gives you more chance to pass.

There are 16 active stations and 4 rest stations.
16 active stations includes general medicine, general surgery, psychiatric, 3 X paediatrics and 3 X O&G cases.There are 4 rest stations and you don't have to do anything over there, it is just REST stations, and they are not marked.

Each station will be of 10 minutes duration, 2 minutes for reading (outside the room) and 8 minutes for actual case performance. Case can be anything but usually mixture of history, examination, differential diagnoses, investigation, management, counselling/education to patient or clinical procedure.

For passing the exam, you have to clear 12 out of 16 including 1 in paediatrics and 1 in O&G. If you passed 13/16, but failed either all 3 paediatrics or 3 O & G, they you are failed. If you passed 10 or 11 cases then you will have chance to do re-test (8 station exam without payment of fees). In re-test, you have to pass 6 out of 8 to pass the exam. If passed 9 or less cases then you have to appear for new exam and have to pay exam fee again.

For more information, please refer AMC exam specification booklet or visit website. Please read disclaimer before using the information.

Disclaimer

The information contained in this blog is for general information purposes only. The information is provided by authors and while we endeavour to keep the information up to date and correct, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the website or the information, products, services, or related graphics contained on the blog for any purpose. Any reliance you place on such information is therefore strictly at your own risk. In no event will we be liable for any loss or damage including without limitation, indirect or consequential loss or damage, or any loss or damage whatsoever arising from loss of data or profits arise out of, or in connection with, the use of this blog. Copyright of all work on this site remains with the author or copyright owner at all times and may not copied, reproduced, republished, downloaded, posted, broadcast or transmitted in any way except for your own personal, non-commercial use. All rights are reserved.

11 October 2010

Eligibility

Eligibility to get job and registration are two different things.  The main thing is to get job. If you are eligible for a job and secure one, it is most likely that you will be eligible for registration – at least limited registration. Then what are the eligibility criteria? It can be different for everyone, but still transparent. Minimum requirement is a below:
  • You have to have eligible medical degree from WHO listed medical university and your degree have to be verifiable through ECFMG. You don’t have to have degree verified, but you have to apply before you can get registration. Further information can be obtained from WHO website and ECFMG website.
  • You have done internship in your country.
  • You have done your OET/IELTS if you need that (i.e if you are not from English speaking country). You can clear either of these exams. At present you have to get at least overall 7 bands with 7 bands in each in IELTS academic. Further information for IELTS can be obtained from IELTS website. You have to get at least B grade in each for OET. Further information for OET can  be obtained from OET website
  • You have at least cleared your AMC MCQ. 
  • You have to obtain good standing certificate from your country, where your primary degree has been registered.
  • Other requirements for registration are minor and I believe almost all doctors would be able to fulfil those requirements like proof of identity, criminal check, registration history, 2 referees and professional indemnity insurance
Detail registration standards for medical practitioners can be obtained from APHRA website.

Disclaimer: The information contained in this blog is for general information purposes only. The information is provided by authors and while we endeavour to keep the information up to date and correct, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the website or the information, products, services, or related graphics contained on the blog for any purpose. Any reliance you place on such information is therefore strictly at your own risk. In no event will we be liable for any loss or damage including without limitation, indirect or consequential loss or damage, or any loss or damage whatsoever arising from loss of data or profits arising out of, or in connection with, the use of this blog.

Pathways to get entry

Along while ago, I put my contact detail on one forum, so someone who needs more information can contact me. None of them was from country who is eligible for competent pathway (see below). The common question they ask me is how can I get job as a doctor?  To answer this question, I have to start from the different AMC pathways.

There are main three pathways IMGs can enter in the Australian Health System at present. The fourth pathway – workbase assessment is under development at present. If you have AMC Certificate and done your English test (if you require to), you are eligible to get job. Often you get job prior to this (more on this later). 

1. Competent Authority Pathway
This pathway applies to IMGs who have studied in UK, US, Canada, NZ or Ireland or have passed equivalant examination in that country and have done their internship (usually 1 year except 2 years residency in US). In short, if IMG is eligible for full/unconditional registration in above countries then they can have advance standing certificate and have work-base assessment in Australia to get AMC certificate.

2. Standard Pathway
This pathway applies to IMGs who have done their MBBS or equivalant and wants to have general registration, but are not eligible for above pathway. Most of the doctors from Indian subcontinent (Indian, Pakistani, Sri Lankan, Bangalesh) and African countries will fall into this category. Few doctors from European countries can apply for competent pathway, but most of them will also fall into this category.  

3. Specialist Pathway
If  you have done specialist training in your country and thinks that your training is equivalant to Australian standard, then you can apply directly to relavant specialist college for consideration. All specialist colleges have their own criteria for application and they assess every application individually. If your specialist degree is recognised then you will get specialist registration which is different than general registration, as you will not be able to work in different speciality.

I am not in position to discuss 1st and 3rd pathway and I don’t think I need to either, as they have different requirement and they can find information easily. If someone would like more information on these pathway, I would be happy to provide my knowledge or will find more information to answer their question.
More information can be obtained for above options from AMC official website.        

Disclaimer: The information contained in this blog is for general information purposes only. The information is provided by authors and while we endeavour to keep the information up to date and correct, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the website or the information, products, services, or related graphics contained on the blog for any purpose. Any reliance you place on such information is therefore strictly at your own risk. In no event will we be liable for any loss or damage including without limitation, indirect or consequential loss or damage, or any loss or damage whatsoever arising from loss of data or profits arising out of, or in connection with, the use of this blog.

Abbreviation

I have made two  lists for abbreviation and will continue updating these. Please let me know if you think that should be in lists.
1. Medical terminology in Australian Hospital
APO – Acute Pulmonary Oedema
AR – Aortic Regurgitation (same apply for MR, TR, PR)
AS – Aortic Stenosis (same apply for MS, PS)
CBE – Complete Blood Examination
CCF – Congestive Cardiac Failure
EUC – Electrolytes
GBS – Group B Streptococcus
GDM - Gestational Diabetes Mellitus
HAV, HBV, HCV – Hepatitis A,B,C virus respectively
HOCM - Hereditary Obstructive Cardiomyopathy
HPV – Human Papilloma Virus
IDDM – Insulin Dependent Diabetes Mellitus
LFT – Liver Funtion Test
NIDDM – Non-Insulin Dependent Diabetes Mellitus
NSTEMI – Non-ST elevation Myocardial Infarction
STEMI- ST elevation Myocardial Infarction

2. Australian Health System Abbreviations
ABS – Australian Bureau of Statistics
ACEM – Australian College of Emergency Medicine
ACRR – Australian College of Rural and Remote Medicine
AMC – Australian Medical Council
AON – Area of Need
APHRA – Australian Health Practitioner Regulation Agency
GP – General Practitioner
IMG – International Medical Graduates
OTD – Overseas Trained Doctors
RACGP – Royal Australian College of General Practitioner
RACP – Royal Australasian College of Physician
RACS – Royal Australasian College of Surgeons
RANZCOG - Royal Australian and New Zealand College of Obstetricians and Gynaecologists
RCPA - Royal College of Pathologists of Australasia
RANZCR – Royal Australian and New Zealand College of Radiologists
RMO – Resident Medical Officer
SAIMET – South Australian Institute of Medical Education and Training

About me and my motive

I am currently working as a doctor in Adelaide, but I still remember those days when I arrived in Australia and it was really hard to find information about Australian Health System and how to get a job. Now I know basic about what is the procedure and how to get into the system. I thought I should start a blog about IMGs  and OTDs who are trying to move to Australia. There are lots of information available about this and those are useful, but either they provide too much information or provide confusing information. I will try to provide practical aspect of this from my experience. You will also find useful links from this blog. Please fell free to contact me about specific question and I will do my best to address that.
It is easy to get job if you have right direction, right support and you are eligible (more about this later), but it takes time. You need lots of patient, but you will get there if you are hardworking and motivated.
Now, lets talk about little bit about me, then move to the main discussion. I studied my medicine in India and graduated in 2005. I moved to Australia in February, 2010 on student visa. I took admission in University of Technology, Sydney. Initially, I wanted to do Master of Health Service Management, but end up doing Graduate Diploma due to personal reasons and time restrain. During that time, I cleared my English requirement and passed AMC part one exam. Now I was eligible for job as a medical practitioner in few states, but didn’t know the right pathway. I struggled for a while and then finally got entry as an Intern in 2008, since then I am working in same hospital and finished full registration requirement. Alright, this is enough.
I also encourage people to be proactive and contact me with their articles and I would be happy to publish their article with their name. I am from India and working in Adelaide. I know that different people have different requirement, so if you are from different country or working in different region, I would like you to invite as a mentor.  
In my next blog, I will list common abbreviation in relation to this blog site. Be first to get my next blog by joining this blog on upper right hand corner.

Disclaimer: The information contained in this blog is for general information purposes only. The information is provided by authors and while we endeavour to keep the information up to date and correct, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the website or the information, products, services, or related graphics contained on the blog for any purpose. Any reliance you place on such information is therefore strictly at your own risk. In no event will we be liable for any loss or damage including without limitation, indirect or consequential loss or damage, or any loss or damage whatsoever arising from loss of data or profits arising out of, or in connection with, the use of this blog.