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Tuesday, January 13, 2015

Cold Medicine for Adults



Over-the-counter cold medicines won’t cure your cold, but they might make you more comfortable, so you can rest as it runs its course. Here's a look at some common products and what they can do for you.

Stuffy Nose

Decongestants can curb swelling inside your nose and sinuses and help you breathe more easily. There are two types:
  • Pills or syrups. If you see the letter "D" at the end of a medicine's name, it means it includes a decongestant. Look for products with phenylephrine or pseudoephedrine. (You may have to ask for these; they're still considered over-the-counter but are often stored behind the counter.)
  • Nasal sprays. Products with oxymetazoline and phenylephrine may work faster than pills or syrups. But you shouldn't use them for more than 2-3 days in a row, or your congestion could get worse.
Don't take both types of decongestant at the same time. Start with a nasal spray for the first couple of days, and switch to a pill or syrup if you still need it.

Runny Nose, Watery Eyes, and Sneezing

When you have a cold, your body makes chemicals called histamines. That leads to sneezing, a runny nose, and watery eyes.
Over-the-counter antihistamines such as chlorpheniramine and diphenhydramine block this process and can relieve those symptoms. They can also make you sleepy and dry out your eyes, nose, and mouth.

Cough

Can’t stop coughing? You have two main choices in the cold-and-flu aisle:
  • Cough suppressants, like dextromethorphan, can stop your cough for a short time. They work on the part of the brain that controls coughing.
  • Expectorants, like guaifenesin, can break up congestion in your chest by thinning the mucus in your airways. This way, when you do cough, you can get rid of phlegm more easily. Drink plenty of water if you take this medicine.

Fever, Aches, and Sore Throat

These symptoms are usually mild with a cold compared to a more serious illness, like the flu. Still, if you feel bad and can’t rest, most experts agree it’s OK to take something to ease pain and lower a fever, like acetaminophen or ibuprofen.
Always check drug labels for side effects, and follow the instructions for taking the medicine. Make sure it won't interact with any other medications you're taking or health problems you have. If you’re not sure, ask your doctor or pharmacist.

Natural Cold Remedies

Maybe you've heard that vitamin C, echinacea, and zinc are good for a cold.
These don't cure a cold, but vitamin C and zinc may shorten the length of one. Research on echinacea has been mixed. Before trying these products, check with your doctor to make sure they’ll work well with other medicines you’re taking.
Nasal strips can also help you breathe easier, since they can enlarge nasal passages while you wear them.
Other more traditional remedies might help relieve common cold discomfort, too.
  • Drink plenty of liquids, including chicken soup. It can make you feel better when you have a cold, research shows.
  • To relieve a sore throat, gargle with warm salt water, use throat sprays, and suck on ice or lozenges.
  • Try a saltwater nasal rinse. These can help with a stuffy or runny nose, studies show.
  • Use petroleum jelly on your nose if it’s irritated from constant blowing. Facial tissue with added lotions can help prevent, and heal, redness and soreness.
  • Use a humidifier to help break up phlegm.
When you have a cold, do what you can to make yourself as comfortable as possible, and rest while your body fights the virus.

Details about Premature ejaculation diseases



Definition
Premature ejaculation occurs when a man ejaculates sooner during sexual intercourse than he or his partner would like. Premature ejaculation is a common sexual complaint. Estimates vary, but as many as 1 out of 3 men say they experience this problem at some time. As long as it happens infrequently, it's not cause for concern.
However, you may meet the diagnostic criteria for premature ejaculation if you:
  • Always or nearly always ejaculate within one minute of penetration
  • Are unable to delay ejaculation during intercourse all or nearly all of the time
  • Feel distressed and frustrated, and tend to avoid sexual intimacy as a result
Both psychological and biological factors can play a role in premature ejaculation. Although many men feel embarrassed to talk about it, premature ejaculation is a common and treatable condition. Medications, counseling and sexual techniques that delay ejaculation — or a combination of these — can help improve sex for you and your partner.

Symptoms

The primary symptom of premature ejaculation is the inability to delay ejaculation for more than one minute after penetration. However, the problem may occur in all sexual situations, even during masturbation.
Premature ejaculation can be classified as lifelong (primary) or acquired (secondary). Lifelong premature ejaculation occurs all or nearly all of the time beginning with your first sexual encounters. Acquired premature ejaculation has the same symptoms but develops after you've had previous sexual experiences without ejaculatory problems.
Many men feel that they have symptoms of premature ejaculation, but the symptoms do not meet the diagnostic criteria for premature ejaculation. Instead these may have natural variable premature ejaculation, which is characterized by periods of rapid ejaculation as well as periods of normal ejaculation.

When to see a doctor

Talk with your doctor if you ejaculate sooner than you wish during most sexual encounters. It's common for men to feel embarrassed about discussing sexual health concerns, but don't let that keep you from talking to your doctor. Premature ejaculation is a common and treatable problem.
For some men, a conversation with their doctor may help alleviate concerns about premature ejaculation. For example, it may be reassuring to hear that occasional premature ejaculation is normal and that the average time from the beginning of intercourse to ejaculation is about five minutes.

Causes

The exact cause of premature ejaculation isn't known. While it was once thought to be only psychological, doctors now know premature ejaculation is more complicated and involves a complex interaction of psychological and biological factors.

Psychological causes

Some doctors believe that early sexual experiences may establish a pattern that can be difficult to change later in life, such as:
  • Situations in which you may have hurried to reach climax in order to avoid being discovered
  • Guilty feelings that increase your tendency to rush through sexual encounters
Other factors that can play a role in causing premature ejaculation include:
  • Erectile dysfunction. Men who are anxious about obtaining or maintaining an erection during sexual intercourse may form a pattern of rushing to ejaculate, which can be difficult to change.
  • Anxiety. Many men with premature ejaculation also have problems with anxiety — either specifically about sexual performance or related to other issues.
  • Relationship problems. If you have had satisfying sexual relationships with other partners in which premature ejaculation happened infrequently or not at all, it's possible that interpersonal issues between you and your current partner are contributing to the problem.

Biological causes

A number of biological factors may contribute to premature ejaculation, including:
  • Abnormal hormone levels
  • Abnormal levels of brain chemicals called neurotransmitters
  • Abnormal reflex activity of the ejaculatory system
  • Certain thyroid problems
  • Inflammation and infection of the prostate or urethra
  • Inherited traits
  • Nerve damage from surgery or trauma (rare)

Risk factors

Various factors can increase your risk of premature ejaculation, including:
  • Erectile dysfunction. You may be at increased risk of premature ejaculation if you occasionally or consistently have trouble getting or maintaining an erection. Fear of losing your erection may cause you to consciously or unconsciously hurry through sexual encounters.
  • Health problems. If you have a serious or chronic medical condition, such as heart disease, you may feel anxious during sex and may unknowingly rush to ejaculate.
  • Stress. Emotional or mental strain in any area of your life can play a role in premature ejaculation, often limiting your ability to relax and focus during sexual encounters.

Complications

While premature ejaculation alone doesn't increase your risk of health problems, it can cause significant problems in your personal life, including:
  • Stress and relationship problems. A common complication of premature ejaculation is relationship stress.
  • Fertility problems. Premature ejaculation can occasionally make fertilization difficult or impossible for couples who are trying to have a baby.

Preparing for your appointment

It's normal to feel embarrassed when talking about sexual problems, but you can trust that your doctor has had similar conversations with many other men. Premature ejaculation is a very common — and treatable — condition.
Being ready to talk about premature ejaculation will help you get the treatment you need to get your sex life back on track. The information below should help you prepare to make the most of your appointment.

Information to write down in advance

  • Pre-appointment restrictions. At the time you make your appointment, ask if there are any restrictions you need tgo follow in the time leading up to your visit.
  • Symptoms. How often do you ejaculate before you or your partner would wish? How long after you begin having intercourse do you typically ejaculate?
  • Sexual history. Think back on your relationships and sexual encounters since you became sexually active. Have you had problems with premature ejaculation before? With whom, and under what circumstances?
  • Medical history. Write down any other medical conditions with which you've been diagnosed, including mental health conditions. Also note the names and strengths of all medications you're currently taking or have recently taken, including prescription and over-the-counter drugs.
  • Questions to ask your doctor. Write down questions in advance so that you make the most of your time with your doctor.

Basic questions to ask your doctor

The list below suggests questions to ask your doctor about premature ejaculation. Don't hesitate to ask more questions during your appointment.
  • What may be causing my premature ejaculation?
  • What tests do you recommend?
  • What treatment approach do you recommend?
  • How soon after I begin treatment can I expect improvement?
  • How much improvement can I reasonably expect?
  • Am I at risk of this problem recurring?
  • Is there a generic alternative to the medicine you're prescribing?
  • Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

What to expect from your doctor

Your doctor may ask a number of very personal questions and may also want to talk to your partner. To help your doctor determine the cause of your problem and the best course of treatment, be ready to answer questions such as:
  • How often do you have premature ejaculation?
  • Has this problem developed gradually or suddenly?
  • Do you have premature ejaculation only with a specific partner or partners?
  • Do you experience premature ejaculation when you masturbate?
  • Do you have premature ejaculation every time you have sex?
  • How often do you have sex?
  • How much are you bothered by premature ejaculation?
  • How much is your partner bothered by premature ejaculation?
  • How satisfied are you with your current relationship?
  • Are you also having trouble getting and maintaining an erection (erectile dysfunction)?
  • Do you take prescription medications? If so, what medications have you recently started or stopped taking?
  • Do you use recreational drugs?

What you can do in the meantime

Deciding to talk with your doctor is the most important step you can take. In the meantime, consider exploring other ways in which you and your partner can connect with one another. Although premature ejaculation can cause considerable strain and anxiety in a relationship, it is a treatable condition.

Tests and diagnosis

In addition to asking about your sex life, your doctor will ask about your health history and may perform a general physical exam. Your doctor may order a urine test to rule out possible infection. If you have both premature ejaculation and trouble getting or maintaining an erection, your doctor may order blood tests to check your male hormone (testosterone) levels or other tests.
In some cases, your doctor may suggest that you go to a urologist or a mental health professional who specializes in sexual dysfunction.

Treatments of Premature ejaculation

Common treatment options for premature ejaculation include behavioral techniques, topical anesthetics, oral medications and counseling. Keep in mind that it may take a little time to find the treatment or combination of treatments that will work for you.

Behavioral techniques

In some cases, therapy for premature ejaculation may involve taking simple steps, such as masturbating an hour or two before intercourse so that you're able to delay ejaculation during sex. Your doctor also may recommend avoiding intercourse for a period of time and focusing on other types of sexual play so that pressure is removed from your sexual encounters.

The pause-squeeze technique

Your doctor may instruct you and your partner in the use of a method called the pause-squeeze technique. This method works as follows:
  1. Begin sexual activity as usual, including stimulation of the penis, until you feel almost ready to ejaculate.
  2. Have your partner squeeze the end of your penis, at the point where the head (glans) joins the shaft, and maintain the squeeze for several seconds, until the urge to ejaculate passes.
  3. After the squeeze is released, wait for about 30 seconds, then go back to foreplay. You may notice that squeezing the penis causes it to become less erect, but when sexual stimulation is resumed, it soon regains full erection.
  4. If you again feel you're about to ejaculate, have your partner repeat the squeeze process.
By repeating this as many times as necessary, you can reach the point of entering your partner without ejaculating. After a few practice sessions, the feeling of knowing how to delay ejaculation may become a habit that no longer requires the pause-squeeze technique.

Topical anesthetics

Anesthetic creams and sprays that contain a numbing agent, such as lidocaine or prilocaine, are sometimes used to treat premature ejaculation. These products are applied to the penis a short time before sex to reduce sensation and thus help delay ejaculation. A lidocaine spray for premature ejaculation (Promescent) is available over-the-counter.
Although topical anesthetic agents are effective and well-tolerated, they have potential side effects. For example, some men report temporary loss of sensitivity and decreased sexual pleasure. In some cases, female partners also have reported these effects. In rare cases, lidocaine or prilocaine can cause an allergic reaction.

Oral medications

Many medications may delay orgasm. Although none of these drugs is specifically approved by the Food and Drug Administration to treat premature ejaculation, some are used for this purpose, including antidepressants, analgesics and phosphodiesterase-5 inhibitors. These medications may be prescribed for either on-demand or daily use, and may be prescribed alone or in combination with other treatments.
  • Antidepressants. A side effect of certain antideph3essants is delayed orgasm. For this reason, selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft), paroxetine (Paxil) or fluoxetine (Prozac, Sarafem), are used to help delay ejaculation. If SSRIs don't improve the timing of your ejaculation, your doctor may prescribe the tricyclic antidepressant clomipramine (Anafranil). Unwanted side effects of antidepressants may include nausea, dry mouth, drowsiness and decreased libido.
  • Analgesics. Tramadol (Ultram) is a medication commonly used to treat pain. It also has side effects that delay ejaculation. It may be prescribed when SSRIs haven't been effective. Unwanted side effects may include nausea, headache and dizziness.
  • Phosphodiesterase-5 inhibitors. Some medications used to treat erectile dysfunction, such as sildenafil (Viagra, Revatio), tadalafil (Cialis, Adcirca) or vardenafil (Levitra, Staxyn), also may help premature ejaculation. Unwanted side effects may include headache, facial flushing, temporary visual changes and nasal congestion.

Counseling

This approach, also known as talk therapy, involves talking with a mental health provider about your relationships and experiences. These sessions can help you reduce performance anxiety and find better ways of coping with stress. Counseling is most likely to help when it's used in combination with drug therapy.

Saturday, December 27, 2014

How Do You Get Lymphoma Cancer?

Lymphoma cancer is the cancer of the Lymph cells and lymph nodes, which is the most common type of blood cancers. Lymph cells are also called as lymphocytes, and are present along the blood vessels.  Lymphocytes or the lymph cells are carried throughout the body through fluid, lymph. Lymphoma cancer occurs when the two types of lymphocytes: B cells and T cells multiply or grow abnormally. Seldom any significant cause, is understood for lymphoma cancer, but a few risk factors are identified to have association with the disease. These risk factors can explain howyou get lymphoma cancer. Treatment of this type of cancer can be
promising at the initial stage, while for metastasized cancer, radiation and chemotherapy can be best solutions.


Causes of Lymphoma
No causes are known for this cancer. Genetics may be a prominent cause for the disease, which causes abnormal cell growth in the lymph nodes. Following are some causes and risk factors related to lymphoma.
Genetics
As said earlier, genetics or mutation in the genes can be responsible for cancer. This mutation will not necessarily develop cancerous cells in the body, but certainly make a person more prone to develop cancer.
Carcinogens
Carcinogens are certain types of substances such as solvents, pesticides, insecticides, herbicides, and benzene can be responsible to damage the DNA and its ability to function normally. Hence, it can lead to lymphoma
cancer.
Immune Suppressing Drugs
A person may be recommended to have certain immune suppressing drugs, after an organ replacement surgery. Suppressing the immune system is a high risk of suffering from lymphoma cancer.
Viral Infections
HPV (human papilloma virus) infection is closely associated risk factor for many types of cancers and lymphoma is one of them. Viral infections with a few viruses such as Epstein-Barr virus, human T-lymphocytic virus type 1 (HTLV-1), Hepatitis B or C virus, and HIV virus is also a
risk factor for lymphoma cancer.
Bacterial Infection
A bacterium, with the name, Helicobacter pylori, is responsible for causing ulcers of stomach or gastritis. Such bacterial infections can also be risk factor to lymphoma.
Other Types of Cancers
Other types of cancers may also be related to triggering lymphoma cancer. Any person who has taken treatment for lymphoma earlier should also be alert for its recurrence.
Cancer of lymphocytes or white blood cells is called as lymphoma cancer and is a common type of blood cancer. Lymphoma cancer causes are not clearly understood, but the above given risk factors have been studied and confirmed to have association with this type of cancer. Avoiding such risk factors can be a preventive measure for this cancer.



Visit http://www.thecorrect.com/ for more medical question and answers

The unwritten rules of being a junior doctor/ 25+things you wished you knew before becoming a doctor

1. (And this is the most important) Never say the "q" word. The q word is the dirtiest swear word of the medical world. In the rare event your day is "Quiet" DO NOT SAY IT!! If you do utter the word then be  prepared to be blamed by all staff when seemingly every patient on the
ward becomes deeply unwell.

2. When referring a patient you can prepare your referral as much as you like and still guarantee the senior you are discussing with will ask that one aspect you forgot to look up such as the all important serum-rhubarb level.

3. Crash bleeps like to go off when you are in the middle of a procedure or breaking bad news

4. Crash bleeps like to get cancelled as soon as you arrive at the correct location having run from the opposite end of the hospital.

5. As per above "crash call cardio" is an excellent way of getting your recommended exercise.

6. The patients you get called to see with low urine outputs/ poor oral intake will probably have drunk and/or peed substantially more than you have during your on call shift.

7. You will have to make some truely awful referrals/ investigation requests at the recommendation of senior doctors (surgeons I'm looking at you) and by the end of your fy1 year you could probably make a decent second hand car salesman after the amount of shit you have been peddling to other specialities all year.

8. For the above the words "my consultant would like" absolves you from blame for crap referrals.

9. You will get blamed and/or shouted at for the crap referrals anyway.

10. A great ward sister/ charge nurse who likes you will make your rotation survivable. Doubly so if said nurse is also an avid ward baker.

11. You will just be finding your feet in a speciality when you rotate to the next one. Return to go, do not pick up 200.

12. The most difficult to bleed patient will also be the one who needs daily/ twice daily bloods.

13. You won't have to do a female catheter until there's a patient that none of the nurses can catheterised and then suddenly you are expected to be the expert...

14. If you are a female doctor then in spite of your stethoscope neck adornment and totally different dress code you will get called nurse by patients 85% of the time.

15. To misquote pirates of the Caribbean: Your finish times are more like a guideline...







16. However late after your shift it is if you are on the ward you will still be considered fair game by other staff for more jobs.

17. As soon as you have qualified (if not as soon as you have started medical school) be prepared to be accosted by nurses/HCAs/cleaners/catering staff/ friends/ family/ the cousin of the great great granddaughter the lady who lives 3 houses away requested you look at and instantly treat their rash.

18. All rashes look the same to an FY1

19. The treatment for most rashes is emollients and/or steroids anyway.

20. You will develop a robust stomach that cannot be touched by indigestion. This is because you will strengthen it by consuming a lot of your lunches either whilst fast walking between wards or while typing a discharge summary with one hand and eating with the other.

21. If you start reviewing a patient whilst eating lunch however you may have gone too far.

22. Most of your friends will be doctors.

23. You will spend a lot of your social time discussing medicine with other doctors.

24. On the rare occasion you manage to venture away from the medical crowd for socialising please see point 17. You will still find yourself discussing medicine...

25. Scrubs are lifesavers when laundry day came and went about a month ago.

26.  You will find a pair of comfy shoes and wear them to pieces as the thought of breaking in new shoes on the wards is unthinkable.  (In my case I wore my shoes until there was decent sized holes in the soles.  I only threw them away when I stepped in a patients vomit...)

27.  You will develop a creepy habit of staring at people with bulging veins and thinking "phwoarrr how easy would it be to cannulate that!"

28. Your patients will rarely have such veins.

80 + Things you wish you knew before you started medical school

So I've been looking at this site http://www.medschoolhell.com/2007/04/24/101-things-you-wish-you-knew-before-starting-medical-school/ , which is great but very american and not always applicable to the english medical school system, so I've decided to slowly completely
plagiarise/alter/ add my own bits to this (I'll keep updating this post as I think of things. I think I'm a bit more optimistic than the original poster perhaps tho, so some have had a positive slant added to them!)

  1. People told you it would be hard, but at times you will feel they didn't emphasize this enough. At other times you will think that they (and me now!) are drama queens.
  2. You’ll study more than you ever have in your life.Only half of your class will be in the top 50%. You have a 50% chance of being in the top half of your class. Get used to it now.
  3. You don’t need to know anatomy before school starts. Or pathology. Or physiology.
  4. That Chemistry A level you had to take because it was "the most relevant a level for studying medicine"? Not relevant. At all.
  5. Third year rotations will suck the life out you. Fifth year ones might take your soul (so I hear, I'll let you know next year).
  6. Med-cest! Your year group will couple up, break up, and then re couple up differently. Gossip galore. Those with non medic partners are in a sad minority.
  7. You may discover early on that medicine isn’t for you.
  8. You will need to know how to make tea to order for GP rotations. That job in a cafe? Looking more useful now.
  9. You will become OCD about handwashing, if not you will be told off on many occasions by the nursing staff (rightfully).
  10. Despite all the early lectures you have about patients consent being clearly asked with regards to medical students sitting in on clinics, you will be in countless situations where you are pretty sure the consultant hasn't asked and you don't think the patient is comfortable with you being there
  11. You won’t be a medical student on the surgery rotation. You’ll be the retractor bitch.
  12. You often won't be a medical student on ANY rotation, you will be he/she who pulls the curtain.
  13. You will get really good at getting drug rep/ company free pens whenever you can but doctors are even better at "borrowing" them off you.
  14. If you added up all the time you waste waiting around for clinics/
    lectures/ ward rounds you could easily shorten the actual medical degree
    by a year.
  15. You will work with at least one smart arse senior that you want to
    argue with about the way they treat you and other medical students, but you will have to sit down and shut up.
  16. You will see staffs expressions of annoyance when you turn up and say you are a medical student.
  17. You’ll ask a stranger about the quality of their stools.
  18. You’ll ask post-op patients if they’ve farted within the last 24 hours.
  19. At some point during your stay, a stranger’s bodily fluids will most likely come into contact with your exposed skin.
  20. Somebody in your class will flunk out of medical school. Probably more than one.
  21. Several people in your year will date doctors during the course.
  22. After the first two years are over, your summer breaks scarcely exist. Enjoy them as much as you can.
  23. You’ll be sleep deprived.
  24. There will be times on certain rotations where you won’t be allowed to eat.
  25. The phrase "Reflective writing" will induce a pavlovs dog style response resulting in instant rage.
  26. There will be times throughout the course when you hate medicine and wonder why you are doing this.
  27. You’ll party a lot during the first two years, but that will reduce drastically once you start rotations....
  28. .... You will quickly learn than hangovers and ward rounds to not mix well at all.
  29. You’ll probably change your specialty of choice at least 4 times.
  30. You’ll spend a good deal of your time playing social worker.
  31. Nurses will treat you badly, simply because you are a medical student.
  32. Sometimes on ward rounds/ clinics you will start to seriously debate whether you have achieved the power of invisibility.
  33. You will develop a thick skin. If you fail to do this, you’ll cry often.
  34. Public humiliation is very commonplace in medical training.
  35. Surgeons are arseholes. Take my word for it now.
  36. It’s always the medical student’s fault.
  37. At least 5% of those in your year would happily push you over and walk on you on their way to try and get to the top.
  38. The woman at Lidl will give you a lecture about the medical risks of drinking too many energy drinks.
  39. Your house might go uncleaned for two weeks during an intensive exam block.
  40. As a medical student on rotations, you don’t matter. In fact, you get in the way and impede productivity.
  41. You’ll be competing against the best of the best, the cream of the crop. This isn’t school where half of your classmates are idiots. Everybody in medical school is smart.
  42. Don’t think that you own the world because you just got accepted into medical school. That kind of attitude will humble you faster than anything else.
  43. If you’re in it for the money, there are much better, more efficient ways to make a living. Medicine is not one of them.
  44. Anatomy sucks. All of the bone names sound the same.
  45. The competition doesn’t end after getting accepted to medical school. You’ll have to compete for decile ranking, awards, and f1 positions. When you specialise you will have to compete for that too.
  46. Close friends will claim they have done next to no work all year, you will be reasurred until you see their pages and pages of notes 1 week before exams start.
  47. Your fourth year in medical school will be like a vacation compared to the first three years. It’s a good thing too, because you’ll need one. (This depends on medical school however....)
  48. Somebody in your class will be known as the “highlighter whore.” Most often a female, she’ll carry around a backpack full of every highlighter color known to man. She’ll actually use them, too.
  49. Rumours surrounding members of your class will spread faster than they did in school.
  50. Rumours about the course will spread faster still - "haven't you heard the medical school HAS to fail 20% because the year is too big?!"
  51. You’ll meet a lot of cool people, many new friends, and maybe your husband or wife.
  52. No matter how bad your medical school experience was at times, you’ll still be able to think about the good times.
  53. Most questions at the end of lectures come from the post-grad students.
  54. There will be at least one person in your year who scarcely has the social skills to say his own name, no one knows how they got through the interview process.
  55. At the beginning of first year, everyone will talk about how cool it’s going to be to help patients. At the end of third year, everybody will talk about how cool it’s going to be to make a lot of money.
  56. By fourth year you are virtually having weekly conversations about how you will spend your first pay check.
  57. The attractiveness of being a GP with its good pay and short hours is positively correlated to your year at medical school
  58. Telling local boys/girls at the bar that you’re a medical student doesn’t mean shit. They’ve been hearing that for years. Be more unique.
  59. The money isn’t really that good in medicine. Not if you look at it in terms of hours worked.
  60. Don’t wear your hospital id badge into a petrol station, or any other business that has nothing to do with you wearing a white coat. You look like an ass, and people do make fun of you.
  61. Dont steal patients for presentations that you know other students are going to use and actually clerked! You will quickly be known as one of that 5% that would push their own gran in front of a bus if they thought it would help their career somehow.
  62. Stick to the back of the ward round parade unless offered to come forward and get a better view of the patient, we've not earnt a right to be at the front yet.
  63. If you piss off your F1, he or she can make your life hell.
  64. Make the most of all the opportunity universities have - don't forget you are at university rather than just medical school, don't be afraid to step out of that medical school bubble occasionally.
  65. Your family members will ask you for medical advice, even after your first week of first year. By your third year onwards they start to worry if you don't know the answer.
  66. Many of your friends will go onto great jobs and fantastic lifestyles. You’ll still be at university eating (asda smart price) pot noodles.
  67. It’s amazing how fast time flies on your days off. It’s equally amazing at how slow the days are on a rotation you hate.
  68. No matter what specialty you want to do, somebody on an unrelated rotation will hold it against you. You will probably starting lying to make your future career match your current rotation...
  69. Sitting around in a group and talking about ethical issues involving patients is not fun. But you will have to do it a lot.
  70. You will probably do more role play than the students studying drama do, and you will become adept at playing the role of a sick patient for ocse practice.
  71. Find new ways to study. The methods you used in college may or may not work. If something doesn’t work, adapt.
  72. Hospitals smell bad.
  73. Occasionally a doctor or nurse will offer you a cup of tea or coffee, that person will become your new god.
  74. Subjective evaluations are just that – subjective. They aren’t your end all, be all so don’t dwell on a poor evaluation. The person giving it was probably an asshole, anyway.
  75. Some physicians will tell you it’s better than it really is. Take what you hear (both positive and negative) with a grain of salt.
  76. 90% of surgeons are assholes, and 63% of statistics are made up. The former falls in the lucky 37%.
  77. During the summer before medical school starts, do not attempt to study or read anything remotely related to medicine. Take this time to travel and do things for you.
  78. Vaginal deliveries are messy. So are c-sections. It’s just an all-around blood fest if you like that sort of thing.
  79. Despite what the faculty tell you, you don’t need all of the fancy equipment that they suggest for you to buy. All you need is a stethoscope. The other equipment they say you “need” is standard in all clinic and hospital exam rooms. If it’s not standard, your training
    hospital and clinics suck.
  80. Don't buy textbooks before you start medical school, and don't buy everything on the reading list then, most librarys are perfectly adequate for textbooks you may only ever use a couple of times. Wait till you know what the core books you use are.
  81. There will be several people in your year who will seem to be doing some form of "gotta catch 'em all" for committee positions and extra curricular activities.
  82. There will be at least one person in your year who seems to be doing the same for STI's ...
  83. By fourth year suddenly everyone will be talking about publications they have got or presentations they are giving at national conferences. If you are not one of these people you simply won't understand how everyone has managed this.
  84. Don't let your decile ranking within the medical school affect your self worth!
  85. Avoid surgery like the plague.
  86. You may have gone into medicine "to help people" but sometimes the only way to do that is to carry out procedures which cause them pain and make you feel like an utter b**t**d, you'd better be prepared for that too.
  87. Reflection will now longer be just the thing you see in the mirror but a word that fills you with dread.
  88. Read this, and the linked american version, now, throughout medical school, and then after you’re done. Then come back and say how right all this is. (I read the american version early in medical school, and now again now as a fourth year, got to say, its definitely looking pretty right!).