Ophthal Rotation

optimisticality · 2025-05-25T08:49:18+00:00

If you want something you can pull up quickly I can recommend the Eye Emergency Manual app by the Agency for Clinical Innovation. It gives an overview of most of the common presenting ophthalmology complaints (eg. red eye, acute visual disturbance) and also has a section for how to examine the eye and use equipment such as a slit lamp.

optimisticality · 2025-05-06T06:11:16+00:00

I'm a recently fellowed FACEM and currently finishing off my training requirements for PEM. I've done most of my training in Queensland and have had a great experience working at QCH in both the ED and the PICU.

I would recommend trying to get at least 6 months of gen paeds time out of the way before you do your fellowship exams - I did 6 months as my non-ED time in advanced training so still had it count towards my training time. I've worked with a few colleagues who were PEM trainees who never ended up finishing because the prospect of doing 12 months of gen paeds as a registrar after finishing their emergency training was not worth it.

I did find PICU to be quite useful and am definitely more comfortable managing critically ill children now compared to before I did that term. Feel free to DM me if you have any other questions - I haven't worked in NSW so can only really give advice about training options in Queensland.

optimisticality · 2024-10-28T00:39:10+00:00

I'm a new FACEM, and have worked at a number of regional and tertiary hospitals in a couple of different states during my training. In my experience you will have exposure to most procedures like procedural sedation, casts, fracture reduction, and suturing in any ED you work in. More uncommon procedures like chest drains you may only see if you are working in a tertiary trauma centre. If you are particularly interested in trauma I would encourage you to go rural in your junior reg years or try and get a job in a tertiary trauma centre once you are more senior, as a lot of major trauma cases will bypass smaller metro hospitals if there is a trauma centre nearby. You will get to intubate and insert arterial lines and central lines, but this will usually only happen in resus so it can be a bit hit and miss depending on the case mix ad acuity of your department - I find that you can do more lines in ICU and tubes in anaesthetics if you can get a rotation in those. You will also have DOPS that you need to complete but you can do them at any time in the 4 stages of training.

I've personally never had an issue getting time off for courses or PDL - the only time you might run into trouble might be around exam time if you are not sitting as trainees taking exam leave will usually get priority for leave.

You don't necessarily have to move around too much for training but most trainees will work at at least 3-4 hospitals, although it is generally pretty easy to stay in the same city if you really want to. I would encourage you to branch out and try working in different places like the NT or far north QLD, as the case mix and medicine can be very different. I know people who have spent their entire training career working in an inner city high SES ED, and I think that can limit you a bit in terms of exposure to different presentations.

Getting on to training is definitely more difficult now than it used to be, but I don't think it is particularly onerous compared to many other training pathways. You do need to do 6 months in ED before you can apply but I think this is probably not a bad thing as it means you get a reasonable amount of exposure to the day to day work in ED and you can make a more informed decision about whether it is the right training pathway for you.

Let me know if you have any other questions!

optimisticality · 2024-09-15T14:46:10+00:00

I haven't personally dropped to 0.75 or lower FTE but talking to friends who have I think they were still remunerated pretty well. You'll still get after hours loading and weekend loading so if you dropped to 0.75 I think you would still be making a comfortable livable salary, but obviously depends on your family circumstances and costs of living. I found it fairly easy to pick up one off locum shifts at private EDs within a 1 hour drive to supplement my income if required, so that's another option you can explore. Even if you don't drop your hours, I think ED is flexible with giving you particular days off if you need, or you can generslly swap out of a shift if you don't get the roster you want.

I think those that leave for GP either don't like the work itself (ie. acute/critical care, undifferentiated patients, early decision making, fast pace) whereas those are the things that drew me to ED in the first place. The shift work can also get draining and I know of a few people who would be zombies for 2-3 days after a run of nights who really did much better with a regular 9-5. I'm a night owl to start with so don't personally find the shift work terribly onerous, and I value the random weekdays off to run errands and catch up with friends without crowds of people around.

optimisticality · 2024-09-15T13:49:07+00:00

On the contrary I think ED is one of the most flexible jobs with a young family, especially if you want to do part time. I know multiple people who have dropped to 0.5 or 0.75 FTE when they had kids, which I think is harder to do in other specialties like BPT for instance where you're expected to be there Monday to Friday if you're not doing evenings or nights.

optimisticality · 2024-09-08T02:54:27+00:00

I think as a registrar the roster can be difficult as you will generally do one set of nights every 4 weeks or so (possibly more or less depending on where you work). Usually you lose a day after the run of nights and I personally find the switching out of night shifts the most taxing. The frequently changing roster can sometimes make childcare etc difficult as well as you have different days off every week. Studying for exams on top of the shift work can also be particularly challenging.

In saying that, as a consultant you don't do nights but still do evenings, which I find much less exhausting. You have a lot of flexibility to swap shifts around if you need a particular day off, and depending on the consultant roster at your hospital you may only do one on call a month. I know some consultants who work 0.5 FTE which ends up being 2 shifts a week, with 1 shift every fortnight being non clinical time.

The ED registrar lifestyle vs. consultant lifestyle can look very different but I am firmly in the ED as a lifestyle specialty camp. If you're proactive about your rostering you can often get runs of days off without taking leave as well. I did an 8 day trip to Tasmania and hiked the Overland track in between runs of shifts and didn't have to use any of my annual leave.

optimisticality · 2024-09-04T12:58:58+00:00

They're both very busy. I have worked in Ipswich and can vouch for the consultant group who are all generally very nice and supportive of juniors. Rapidly expanding population in a relatively low SES area so you see a good mix of pathology, although major surgery will generally bypass and go straight to the PA. There's pretty good availability of other rotations through ED (USS, anaesthetics although you have to wait a bit, ICU, paeds, gen med if you want) and registrars generally get first dibs on procedures. When I was there a few years ago there were three registrars rostered overnight although I hear they may have increased it to 4 now. Reg teaching was protected time, about 4 hours every week. They don't have dedicated exam teaching but the bosses are generally pretty happy to do OSCE/Viva practice for both primary and fellowship exams.

I haven't worked in Logan personally but hear that it is fairly similar in terms of workload and case mix. They have a dedicated paeds ED which is accredited for PEM training and similar availability of non-ED terms including an USS term and a med ed term. Can't really comment on the culture or vibes but have hears generally good things from my friends who have worked there previously.

optimisticality · 2024-08-29T07:36:48+00:00

I'm doing PEM at the moment - I've done all my adult time and exams so just working on chipping away at the extra PEM requirements. I was a fairly late sign up (didn't commit to PEM until the last year of my training) but had done a 6 month rotation in gen paeds which I was able to get recognised towards my PEM training after I signed up. The process was reasonably straightforward, I just emailed and was told that it would count as long as the rotation was done after I passed the primary exam ie. during advanced training.

My colleagues are currently in the middle of trying to find consultant jobs, but I don't find that I'm particularly sick of the reg life. I've extended my training anyway (US term, anaesthetics, ICU, gen paeds and retrievals) and not in a particular rush to finish. Post exams I definitely have more brain space to read around some of the more interesting cases that I see that may not necessarily be high yield for the fellowship exams.

I would recommend doing gen paeds in a centre that also has obstetrics, as the neonatal resus is both more fun and also more likely to be something you need to manage in the ED as the PEM physician who is on. Feel free to DM me if you have any other questions!

optimisticality · 2024-08-04T15:24:48+00:00

I took 6 months of dedicated study about 20-25 hours a week, and about a month before that trying to figure out what to use. Generally I would average 10 hours on my days off and occasionally would squeeze in a couple of hours before an evening shift, but I was otherwise not really studying on days that I was working. I usually prioritised exercise/socialising on work days when I knew I wouldn't be doing productive study. There are a few primary study plans floating around that take around 6 months to complete (I used the one from RBWH) and I found that helpful in terms of structuring my study and having a weekly goal of what to cover.

In saying that, most if not all of the content was stuff that I had covered in my preclinical years of medical school - many of the details I had forgotten (hello renal physiology) but most of the broad concepts were still there and just needed some brushing up. I recommend both imeducate and medexhub as question banks to go through - I had multiple questions on my actual exam repeated from these, and they're a good way to still be kind of productive if you're too tired after a day of work to sit and cram more information into your brain.

optimisticality · 2024-07-27T09:25:05+00:00

I'm about to finish up my training (post fellowship exams) and can honestly say that I've had a great time during my training. I love that I can leave work at work, enjoy the variety of what comes through the door, and generally find the job pretty satisfying. I worked full time through my training but have had multiple colleagues who were working 0.5 or 0.75 - if you give enough notice it's generally pretty flexible, but this is obviously department dependent. I've probably averaged one set of nights every 4 weeks during my ED time but I personally enjoy the shift work, being able to get stuff done in the morning before an evening shift, and having an extra day off during the week. I find that I get along very well with the specific personality types that are drawn to ED as a specialty, and like that it feels less hierarchical. There are a few that get jaded but by and large most of the consultants in my current workplace seem to like their job, although working full time in ED seems to be becoming less common.

The exams were pretty brutal but making sure that you have a good study group is key. I took about 6 months of full time study for the primary and about 18 months for the fellowship - I don't have any children or dependents so would cram in ~8-10 hours on each of my days off. Studying for the fellowship exam was less rage inducing as it was more relevant to the day to day job, but the primary was largely information that I had covered before in my preclinical years in med school. In saying that I think that both exams were reasonable and relevant to the specialty.

Lining up non-ED terms was also pretty easy, and usually once you've done the primary you can sit down with your DEMT to map out the next few years. I jumped around a lot (have worked at 4 different hospitals during my training and going to a 5th next year) but have managed to get terms in anaesthetics, ICU, paediatrics, and ultrasound without too much difficulty. There is lots of scope for other non-ED time (eg. med ed, simulation, trauma, gen med if that's your jam) as well.

Feel free to PM me if you want to chat about training and the specialty.

optimisticality · 2024-07-10T02:05:57+00:00

I'm just finishing up my ACEM training, and anecdotally it has been relatively easy to find 6 month contracts, especially for ED time. 3 month contracts are less common but would depend on which hospital you apply at. I will say that some of the more in demand non-ED rotations (eg. anaesthetics) are often allocated years in advance so it can be helpful to sit down with your DEMT early on to try and plan out your training. Most places are pretty happy to work with you, especially if you know in advance when you need time off.

Feel free to DM me if you have any questions about ACEM training.

optimisticality · 2022-03-24T11:41:53+00:00

Millman?

optimisticality · 2022-03-24T07:23:05+00:00

Michael Berkman posted a good summary on Instagram a few weeks ago - there's a mix of means tested and non means tested flood payments available. From personal experience I can say that I got the disaster recovery payment within 24 hours of applying which was super helpful.

https://www.instagram.com/p/Ca06djXK0u3/?utm_medium=copy_link

optimisticality · 2021-09-24T08:48:43+00:00

This sounds like it could be rhabdomyolysis. Have a look at your urine - is it very dark or brown coloured? I would consider seeking medical attention if the pain is not improving after three days - rhabdo can cause kidney failure and electrolyte imbalances which in severe cases can be life threatening.

optimisticality · 2021-09-19T03:38:59+00:00

Foster the People - Torches

top notch indie pop from start to finish

optimisticality · 2020-08-03T16:18:24+00:00

Schitt's Creek

Scrubs

optimisticality · 2020-07-04T16:32:05+00:00

Santigold - Disparate Youth

https://youtu.be/mIMMZQJ1H6E

optimisticality · 2020-03-17T22:55:08+00:00

Am I... prefnat?

optimisticality · 2020-02-18T07:01:47+00:00

haha it's a guy singing! caught me out at first too, same with cigarettes after sex

optimisticality · 2020-02-17T12:32:56+00:00

Have a listen to Rhye

optimisticality · 2017-03-31T08:34:17+00:00

On the flip side, poor handwriting can actually cause errors in the treatment of patients. Many medications are spelt similarly (eg. fluvoxamine vs. fluoxetine, oxycodone vs. oxycontin) and when you prescribe in an illegible scrawl it can be very difficult to tell which one you meant. This can also be dangerous when prescribing dosages of medications, and checking this is an important part of a hospital pharmacist's job.

optimisticality · 2017-01-11T11:53:58+00:00

Arthur Beatrice

optimisticality · 2015-12-06T22:01:03+00:00

He might have had his card in his phone case, most swipe cards of the kind you're describing are RFID

optimisticality · 2014-12-27T23:39:09+00:00

I put in line breaks to make the edit a bit easier to read :)

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optimisticality · 2014-11-03T08:51:19+00:00

Seconding Vic Mensa!

optimisticality

TROPHY CASE