Monday 30 January 2012

Improving Fluid Intelligence

http://www.emergencyone.com.au/

Researchers at the University of Michigan published a truly revoluvtionary paper in 2008. They determined that training using something called the Dual N-Back Test could be used to improve fluid intelligence (the thing that helps you solve unique problems that you've never encountered before-like a rat in a maze).

Why is it revolutionary? Well firstly, fluid intelligence has long been held to be the heritable component of intelligence (it's always been figured you were only ever as good as what you were born with). What's even more remarkable is that it has never previously been demonstrated that any activity was able to improve this kind of intelligence (ie; you couldn't train yourself to be more intelligent in this domain).

These researchers tested measures of fluid intelligence then subjected 4 different groups to training using the Dual N-Back test for different lengths of time while a control group received no training. Upon retesting, the control group showed a modest improvement attributable to the retest effect; however the training groups showed massive improvement. What was even more impressive is that the longer you trained, the smarter it seemed you got (ie; there was a dose dependent relationship).

The idea is that this test improves working memory (the short term second to second memory) while forcing the student to process visual and auditory stimuli under significant time pressure......it's HARD! You can have a look at the test here:

http://dual-n-back.com/

If you're so inclined, check out the original article, it's excellent!

http://www.pnas.org/content/105/19/6829.full.pdf+html

Jaeggi, Buschkuehl, Jonides & Perrig 2008 'Improving Fluid Intelligence with Training on Working Memory', Proceedings of the National Accademy of Science, 105 (19)

The only down side is that after having a crack at the Dual N-Back Test, you may find your head is ready to explode. But persevere, it will help with your GAMSAT preparation....or just make you a little sharper if that's what you fancy!

Good luck y'all

http://www.emergencyone.com.au/

Friday 20 January 2012

Dissection of a GAMSAT question


Hi again to everyone

Ok it's time to put my money where my mouth is with respect to the whole "reasoning skills" thing. As you may or may not know, my wife and I run a company that offers training in reasoning skills for the GAMSAT. Here's the proof in the pudding as it were.

I'll be referring to examples in the ACER GAMSAT test materials published on their website. I cannot reproduce them here for copyright reasons. Hence I'll list the book, section and question with a description of the question, but I'm afraid you will have to refer to your own copy of the book. It is kind of essential for preparation and you can get a copy at the ACER website here. FYI, I don't receive commisions for that link/book sales and ACER do not endorse any providers of GAMSAT preparation courses or materials (myslef included).

So here goes, I solved this one with my wife. I solved it very quickly and she was amazed; quick hint it has almost nothing to do with chemistry, it's just basic algebra......observe:

GAMSAT Test Book 1
Green Cover
Section III
Unit 10
Questions 32-35

This unit describes some fatty acids as well as some information about their bonds, their state (solid or liquid) at various temperatures and then a table of several fatty acids. So you must need to know heaps about organic chemisrty and fatty acids right......errrrrrr.....no. In fact you can answer it with year 12 chemistry and lots of good quality reasoning!

Firstly lets identify the key information contained in the vignette
(equivalent to year 12/ first year chimistry):
-fatty acids have a carboxylic acid group (COOH)
-saturated fatty acids have all single bonds
-unsaturated fatty acids have some combination of double bonds

Secondly lets identify what assumed knowledge you need:
-carbon atoms form 4 bonds (year 12)
-the ability to solve a basic algebreic equation (year 11)

Question 32 
You have to pick the set of 3 acids that are saturated. So here's the trick; go back to the vignette and look at palmitic acid. You KNOW that this is saturated (the vignette says so) now count the atoms to get the algebreic formula for a fatty acid; it goes C16, H32, O2. Hence the generic formula is (C8n, H16n, On). If an unsaturated fatty acid has one or more double bonds, then H will not follow the formula 16n; hence a saturated fatty acid has to have twice as much H as it does C. Now that you've identified your knowledge, defined the rules, you just need to solve the problem.

Check the first fatty acid listed in each option to exclude some answers. B is instantly wrong as gaidic acid follows the rule C8n, H15n, On. Then move on to the second fatty acid. D is now wrong as linoleic acid follows the rule C9n, H16n, On. Finally move on to the last fatty acid, we've already established that gaidic acid does not meet the rules; hence C cannot be correct. That leaves us with A. Check it, you'll find that for all three fatty acids, tehre is always twice as much hydrogen as there is carbon.....hence it follows the rules and hence A is the right answer....you've proven it by inclusion and exclusion. That's 1 point....now you just have to do it in 100 seconds and multiplied by 110!!

Question 33
So now look at the drawing of palmitic acid and add a mental double bond. We know that adding a double bond will obligate the removal of two hydrogen atoms since carbon can only accomodate 4 bonds. Look at arachidonic acid, it follows C10n, H 16n, On. We can see that it needs 8 hydrogen atoms to meet the 'saturated rule' above, or more to the point it must have discarded 8 hydrogen atoms in exchange for double bonds. Hence there must be 4 double bonds (ie 4 double bonds multiplied by 2 hydrogens). Hence D is correct.

Question 34
This is an interesting question from a knowledge vs reasoning perspective. Your choices are to know everything there is to know about marganrine (it's really not worth your time or energy) or to recognise that they're really just testing your reading comprehension, logic skills and that you established the above mentioned rules.

We know that saturated fatty acids form semi-solids at room temperature (the vignette says so) and the question implies that multiple double bonds reduces the melting temperature. We also know that the point of margarine is to turn an liquid fat into solid fat (again year 12 chemistry). Now lets look at reasoning. Do we know what effect changing pH will have? No. Do we know what adding an alkyl group will achieve? No (well actually we know that a side chain will lower the melting point, the vignette says so). Do we know what effect shortening the chain will have? No. Finally, do we know what effect removing the double bonds will have? Yes. Removing the double bonds will make the molecule saturated....and the vignette tells us that this will make it a semi-solid at room temperature....and our amazing knowledge of margarine tells us that its nicer to spread than it is to pour!! Hence C is correct.

Question 35
When I first looked at this, I thought I was boned because I couldn't remember the molar mass of iodine.....then I realised that I'm an idiot :) This is really just the love child of Q32 and Q33. More double bonds = more iodine reacting with them = higher iodine value. All you have to do is disprove 3 sets of 3 fatty acids. Option A, capric acid is saturated, hence no iodine will react, hence its iodine number is not greater than arachidonic acid, hence A and C are wrong. Using the aforementioned rules, gaidic acid has 2 double bonds and arachidonic acid has 4 double bonds. Hence the iodine value will be higher for arachidonic acid. Hence B cannot be correct and D can be correct. You can take a punt and leave it at this, or you can check the final fatty acid in D to confirm your hypothesis.

Voila! I scored 100%, within 6 minutes (although it took ages to write this post!!). All it took was very basic high school chemistry and algebra. The moral to this story and the only lesson I'll ever ask you to learn is that;

GAMSAT is a reasoning based exam and not a knowledge based exam!

Don't exhaust yourself learning doctorate level chem, org chem, bio and physics. The required knowledge is relatively simple. Instead invest a LOT of time in puzzles, problem solving and reasoning based materials. Check out MENSA, they publish a lot of this stuff, it's DIFFICULT and great practice.

Better still come to our course, we will spend a whole day running through reasoning (aka fluid intelligence), what it is, how to improve it and how to apply it to the GAMSAT. It works and if you get it right, it WILL improve your score. You can book online here:

www.emergencyone.com.au

All the best with your prep folks!!

**PS: If you're freaking out about how much the GAMSAT and associated prep is costing I have this sage advice. You are well advised to put the cost into the context of $100-400k for a medical school education and the potnetial cost of having to sit GAMSAT multiple times. By all means don't get ripped off, but do ask what it is you hope to learn from any particular prep activity**

Sunday 15 January 2012

Back online

Again, thanks to all for their patience.

www.emergencyone.com.au

is once again back online.

Cheers
David

Saturday 14 January 2012

I unlike VistaPrint

Well amid much pomp and celebration, the EmergencyOne website was relaunched last night. It looked nice, it was more user friendly and had our expanded services on offer.....but VistaPrint have decided to melt down and it seems I can't access my own website via the internet, not can I properly modify it via the dashboard!

My apologies to any of our customers who have been inconvenienced by this, I have backed the website up and as soon as I hear from VistaPrint, I will reload and relaunch it. Thanks for your patience and any communication can be done via this blog if needed.

Cheers
David

1000th birthday for EmergencyOne

Heelllloooo to all out followers! Well after our post earlier today, we made it, nay we smashed it!

www.emergencyone.com.au has now had 1025 visitors with over 2500 page views.

To celebrate we've released our new website and the second phase of our business development. Why medical consultancy services you may ask?! Well that's exactly what we do. We have generalised expertise in the field of medical information services. Stop by and check out the new website!

As such, from today EmergencyOne now offers a range of health promotion activities and first aid training for schools, children's services providers and families.

We teach age appropraite and play based learning for kids aged 3 up to 18 on the basics of good health and good nutrition as well as junior first aid skills in the following programs:
  • HealthyTots
  • EmergencyTots
  • HealthyKids
  • EmergencyKids
  • EmergencyTeens
We also offer family specific health promotion and first aid training in the form of:
  • NewFamilies: first aid training for the 10 leading causes of childhood illness and injury. Specifically targeted at new parents and grand-parents
  • Baby Boot Camp: short sessions about the nuances and troubles of parenthood including sleeping and feeding difficulties, colds and fevers, colic and child saftey
  • Bubs and Blikes: short sessions designed for blokes to get together and chat about their hopes and fears regarding parenthood. Sessions include discussions about being a good dad and a good bloke, surviving the delivery room, sex after babies and keeping your cool
So if you have kids, work with kids, know kids, are having kids or know someone who's having kids and you think they might be interested in what we have to offer, pass on our details, we'd be thrilled to work with them.

www.emergencyone.com.au

Thanks to all of our family, friends and metors for their support thus far on our business journey. We are eternally indebted for your help, love and support.

Cheers
Dave

Friday 13 January 2012

We've nearly hit 1000

A friendly hellooooo to all our followers

Great news, as of today this blog has had nearly 600 hits since it was launched on 15th of December 2011....not bad for just under a month. Even better, our parent site http://www.emergencyone.com.au/ needs just 10 more hits to reach it's 1000th birthday!!

So while we'll continue to provide free, high quality advice and support for all of you medical hopefuls, feel free to return the favour. Post replies and questions on our blog (we WANT to hear from you), like/follow us on Facebook, show our sponsors some love or better still, sign up for one of our courses. The greater our fanbase and the more love (read money to feed our family) we get, the more time and energy we can devote to getting our word out and making EmergencyOne a truly excellent service to our customers and the community.

Stay tuned for
-The realities of being a doctor today
-Why you shouldn't sewat the cost of GAMSAT
-Uber debate for section II

Good luck to all of you, I wish you the very best for your preparations!

David

Thursday 12 January 2012

Section II...the dreaded essays (insert ominous soundtrack here)

www.emergencyone.com.au

Section II of the GAMSAT is an often under looked facet of the exam. So today I'm writing about the essay: what it's about, what it's testing and how to smash it.

To start with, the essay section falls between the social sciences and physical sciences sections, usually just before lunch. You're allocated 60 minutes plus 5 minutes reading time (very important for good technique!). Two essays are expected, one argumentative and the other discursive (again very important)

There will be a selection of quotes used as the foundation for each question, often similar in theme. The candidate is free to select one or more as the basis for the essay. You can usually pick which is the argumentative and which is the discursive by the way the quotes are presented, though sometimes this can be a bit blurry.

The argumentative essay quote will be put forward as a strong assertion and the other quotes will either be similar or diametric opposites. The goal here is to adopt a stance on the issue being raised and form a logical, structured and persuasive argument as to why this view is correct. This is essentially what is done in a debate and this is a good way to prepare for writing these essays.

The discursive essay is much less clear cut. The quotes will often be from authors, anecdotes or sections of stories designed to provoke conversation. It aims to draw out of the candidate a broader discussion of the topic including arguments for and against and the use of anecdote and analogy. There need not be a clear cut stance issued in this section and in my mind I often likened it to the stereotypical 'old timer' who rambles on a bit. While your thought pattern needs to be clear, logical and concise, you need not argue your point as in the argumentative.

To prepare for this, I read a lot of fiction, biography and philosophy, became adept at identifying the argumentative and discursive topics and practise writing a few essays to perfect my timing. I got 62 (I think) which is probably a little on the low side compared to the rest of my paper, but better than a poke in the eye with a blunt stick. I'll post again soon on ways to maximise your performance and improve your score, but in the mean time, read a lot and read outside of your comfort zone.

Biographies, editorials and talk back radio....I can't stand them but they are good sources of practise. Rather than changing the station or hurling abuse at the knob who's talking rubbish on the airwaves, spend some time analysing why you disagree, why you're right and he/she is wrong and how you would convince a judge that you were correct...if you get bored, ring up and put your case forth...or better still join a debating team (I have to confess I'm a massive debate nerd and seem to have a penchant for it....it's funsies).

Good luck y'all! The book is coming along nicely and should be ready in the next 2-3 weeks, keep an eye on the EmergencyOne website and this blog and support your local friendly GAMSAT blogger.

Cheers
David

www.emergencyone.com.au

Wednesday 11 January 2012

Not a bad offer!!

http://www.emergencyone.com.au/

Since late last year I have been doing freelance GAMSAT style question writing, proof reading and report writing for a group called PrepGenie.

They have invested large amounts of time and money into developing what is quite a good set of GAMSAT tests. Some of them will be appearing in EmergencyOne's book in a chapter entitled "Dissection of a GAMSAT question", look out for it.

They are offering a preview package containing one full legth GAMSAT practice test and a set of sectional tests in humanities (75 questions), chemistry (40 questions), biology (40 questions). There is a flat fee of $25 to cover postage and handling. Worth a look if you need more question fodder to practice with.

Good luck and all the best with your preparations

http://prepgenie.com/free-preview-copy/

Tuesday 10 January 2012

5 ways to be better than everyone else in the exam hall


So let's forego why you want to study medicine; suffice to say that if you're willing to pay $400 to sit the exam with less than a 20% chance of success then you must want it for some reason. Instead let's look at getting better value for your money....ie; if you've already paid $400, you might as well pass right?!

If you've decided that this is path for you, you need to find a way to be better than 8 out every 10 people around you in the exam hall. The reality is that it's a competition. I'm afraid I can't condone violence, incapacitation, cheating or mischief; you can only win by lifting yourself up, not by dragging the competition down.

 5 Ways to be better than everyone else:
  1. What is the exam testing? This seems obvious, but I hear of so many candidates who seem to omit this fundamental idea in their preparation (there are a lot of you who are franatically trying to learn biology, physics and chemistry to a post-doc level......please stop). Read the ACER website carefully, understand what the exam is testing and then do just a handful of questions to get a feel for what this means.
  2. Practice what you're supposed to: As I keeping harping on....it's a reasoning exam....not a knowledge exam. You can acquire as much knowledge as you'd like, but without developing your reasoning skills you're wasting your energy. You're not going to study architecture because it's not necessary, nor are you going to study ancient Greek. Learn uni level chem, organic chem and biology and year 12 physics, then learn to solve a problem (it's called problem based learning for a reason).
  3. Have immaculate exam technique: As I've said, it's a tough competition. World records rarely get broken by wide margins....in reality, one point may be the difference between an interview and no interview. Good technique will help you juice every possible mark out of the exam.
  4. If it ain't working, do something else: If you've sat the exam and your score wasn't great, it's time to change something. The definition of insanity is doing the same thing over and over and expecting a different result. Maybe you have to work harder, develop your physics, read more fiction or work on your problem solving. Just make sure you do something different
  5. Go with the crowd or stand out? This is an interesting concept and it's entirely statistical. In the exam your chances of success are about 20%. In the interview your chances are 66.6%. In the exam you have to stand out if you want to succeed. In the interview, the goal is to be as much like everyone else as possible.
Ultimately you can and must be better than everyone else if you want to make it, just make sure you're a gracious winner. Good luck with your preparations.

What are the odds?!

http://www.emergencyone.com.au/

The other day I asked my wife what she'd like me to write about on this blog as an aspiring medical student, she suggested I talk about the reality (and sadly the difficulty) of getting into medicine. So here goes...

So what are the chances of becoming a medical student, successfully completing the course and becoming a doctor?.....Sadly not great. When I sat in 2005, I did a quick tally of width by length and worked out there were about 400 applicants in the hall with me. With about 100 places for Flinders and assuming all states held roughly the same ratios, that gave me about a 1 in 4 chance of gaining entry. The cutoff at that time was about 62 for Flinders.

In the 2-3 years after I started medicine there was a large increase in the number of places offered as part of a variety of responses to terrible indigenous health status, major shortages of rural GPs and shortages of GPs in general. Hence the cutoff dropped as low as 54 or so (these were often rural bonded places and domestic full fee places); obviously being Flinders, an immaculate GPA could offset this score. However the number of applicants quickly increased to counteract this trend.

In the ensuing years, I'm now advised that the odds of gaining a place are now under 20%. That is to say out of an exam hall of 1000 people, 800 will walk away empty handed......Better than Master Chef but still pretty terrible. From this there will be an attrition rate anywhere as high as 10-20% prior to and during the degree. Then maybe 5% in the first 1-2 years of being a doctor. So our cohort of 1000 people is now whittled down to about 175 doctors. 

Why are the odds so bad?

Like any market place there is supply and demand:

The demand for doctors is tightly regulated by government expenditure on health care, employment places for doctors and the community's need for their services. Bear in mind there are few thoughts scarier for a new doctor than having spent 4-7 years training and roughly $100-500k and not having any means to feed your family at the end. A quick tally of the ACER website shows that there are about 1500 domestic places at Australian universities. Hence out of maybe 10,000 applicants each year 2,250 will be offered an interview and 1500 will win a golden ticket.

As for supply, why are there so many people keen to chase this dream? At the end of the day, medicine is a sexy career. The prospect of money, power, prestige, knowledge, social mobility, being your own boss, being THE boss, improving humanity and improving science all loom large on the minds of GAMSAT applicants. I'll write a post on the reality of being a doctor soon.....it's a bit depressing and I don't want to get off topic.

Ultimately, the odds of success are pretty poor. But someone's gotta do it, it might as well be you!! All the best for your preparations.

http://www.emergencyone.com.au/

Wednesday 4 January 2012

Timing is everything...as is technique

http://www.emergencyone.com.au/

So imagine it's GAMSAT day. You have an exam lasting just shy of 7 hours ahead of you. Here's the breakdown.

Section I: 100 + 10 minutes for 75 questions
Section II: 60 + 5 minutes for 2 essays
Lunch: 60 minutes
Section III: 170 + 10 minutes for 110 questions

The average attention span in most adults is 15-20 minutes......you need to sustain it for nearly 7 hours!! The difference between good and bad technique can very realistically be the difference between an interview and having to repeat the whole process the following year. You will have to work smarter and harder than the average bear :)

You have about 90 seconds per question for section I (including your reading time) and just under 100 seconds per question for section III.

Here's some handy hints:

1-) Use your reading time! You can't mark the answer book, but you can read the questions and answer on your scrap paper. It takes about 2 seconds per question to transcribe an answer and it gives you the ability to answer an extra 6-7 questions more in the alloted time. It's not against the rules.....use the time!!

2-) Develop a system. Good technique can be make or break.I used a system that quickly sorted questions into 3 categories:
  • Questions you can answer within 90 seconds: solve them immediately
  • Questions you could solve if you had more than 90 seconds: flag them on your scrap paper and come back to them after you've done a FULL lap of the paper
  • Questions you can't answer: you have to guess and you won't be penalised for doing so, but save these questions for last. You have a 25% chance of getting the right answer. Once you've gotten all of the points you can get by skill, it's time to get all of the points you can by chance!!
3-) Practice!! You WILL drift off during the exam whilst contemplating your navel. Develop strategies to deal with your inherent human-ness.
  • Practice sustaining your attention for prolonged periods
  • Learn to identify when you're distracted and tune back in quickly
  • Allow yourself a few strategic seconds to stretch and refocus; do this every 1-2 vignettes and you'll find you're more efficient overall
4-) Learn to identify the key information quickly and efficiently. Each vignette will have a key piece of information that the subsequent question will test. The exam is full of "trick" questions whereby you will give the worng answer (but think you got it right) if you missed a key word or sentence in the vignette. Learn to identify these nuggets of information and develop the habit of putting mental 'post it notes' on them so that you can refer to them quickly and easily. This is particularly true for section I where there are often long vignettes and several questions to answer. Missing the word no or not in a long stretch of prose is the difference between getting the answer exactly right and exactly wrong!!

5-) Read quickly and efficiently!! If you're a slow reader, practice. If you're a quick reader, good, just don't miss anything important.

Good luck y'all

 http://www.emergencyone.com.au/

Sunday 1 January 2012

Happy New Year and the problem with scarlet fever

http://www.emergencyone.com.au/

Hello to all of our followers

We trust that you had a fantastic Christmas and a Happy New Year. We wish you all the very best for your personal and professional endeavours in 2012.

In answer to our "What's the Diagnosis?" post, the answer is, scarlet fever! The give-away is the sand paper like rash and as predicted, putting this single search term into Google gives the answer.

To recap:
-4 year old child
-febrile
-sand-papery rash confined to torso
-flushed face with pale mouth
-complained of sore throat 2 days prior

What is your leading diagnosis/diagnoses?
Based on this information, the leading diagnosis is scarlet fever. Differential diagnoses include erythema infectiosum (slapped cheek), rubella and measles. The distribution of the rash and lack of rash on the face tend to refute rubella and measles.

In/on which body part might your expect to see a sign to help confirm your diagnosis?In the mouth.

What sign would you expect to see?In this case the child had mild pharyngitis and a desquamating white coating on the tongue. Over the following days this coating shed to reveal the 'strawberry tongue' (a red tongue with prominent papillae) typical of scarlet fever.

The child recovered uneventfully with a brief course of penicillin. While the study of xanthems is standard medical school education, scarlet fever has become relatively rare. It's not uncommon for clinicians to spend an entire career having never seen a case. It remains highly prevalent in developing nations and indigenous Australian communities.

Rather what makes it an ideal case study for our purposes is its analogy to the GAMSAT.

Read the question=take a history
Identify the keywords=identify the key features of the disease
Discriminate=discard irrelevant information
Identify the most likely answer=formulate a hypothesis
Exclude other answers=exclude differentials
Pick the answer=test the diagnosis

While the GAMSAT may seem like a set of irrelevant questions, it aims to test the skills (as opposed to the knowledge) necessary in doctors. Interestingly it has been demonstrated that good performance in the GAMSAT does not correlate with good performance in medical school, 1, 2. So as to whether or not the GAMSAT is a GOOD test of the qualities needed in doctors I won't speculate. Because ultimately, GAMSAT is the reality of admission into graduate medicine in Australia and as an aspiring medical student, the mastery of this exam is your goal.

Good luck for your preparations people!!

http://www.emergencyone.com.au/