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Notes -
So, what are you reading?
I'm still on The Eternal Dissident.
The Oxford Handbook of Psychiatry, 4th edition:
The authors have made the bold artistic choice to employ what I call "narrative whiplash" as their primary technique. Patient vignettes follow a strict three-act structure: Act One (character introduction), Act Two (literally any psychiatric condition), Act Three (death/insanity/miraculous recovery). This eliminates any tedious middle section where character development might occur. It's rather like if War and Peace were rewritten as a series of Twitter threads, except instead of 280 characters you get exactly three sentences before Pierre either achieves enlightenment or develops catatonia.
Then again, the pacing might well be a stroke of genius when you consider the target audience: exhausted junior doctors who need to absorb maximum psychiatric knowledge while standing in a hospital corridor at 3 AM. Who has time for denouement? The patients certainly don't seem to.
The real mystery is why Oxford's handbook writers haven't applied this technique to other fields. Imagine: "A 67-year-old man presents with chest pain. He has a heart. He does not have a heart. The end."
(I don't actually think there any patient vignettes in it, it's too no-nonsense for that stuff)
I have previously complained that Fish's Clinical Psychopathology has very little to do with fish, nor was it written by one. A missed opportunity, I'd like to know what the SSRIs and cocaine in the water do for salmon facing the awareness of their inevitable mortality.
Verdict: False advertising, so I won't even read it.
Then there's Making Sense of the ICD-11. It always sets certain bells ringing when a book requires another to make sense of it. I hope the authors of 11 know that it should have just been a trilogy. The DSM guys are at least more restrained about milking the franchise (galactorrhea due to hyperprolactinemia).
The main takeaway, at least for me, is that the real mental illness was the classification systems we made along the way.
Ya'll don't have review books over there?
Dang.
Also medical classification systems are great. Fight me bro.
Something like:
I'm sure is a lot of fun to marvel at, but working with this system practically might be challenging... "So you say you were struck in the head by a falling object, my first medical question would be - were you per chance in a kayak at the time? How about a canoe?"
Comedy value on point though.
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Review books? Do you mean like targeted USMLE prep books and their equivalent?
Never heard of any for the MRCPsych, and I just looked on Google with no luck. There are some for other specialties, I can see results for the MRCP (no pancreas involved, usually), but apparently psychiatry residents get the shaft.
What most people do is sign up to a repository of notes and MCQs. I opted for one known as SPMM. In a way, the notes are a book, one that condenses a ton of scattered bullshit into something the mere human mind can grasp. Unfortunately, the overall quality leaves something to be desired, the study material I had for prior exams was better (clarity, content, presentation), but the more niche the exam the fewer people willing to spend money I guess.
Honesty, I'm done with like 75% of the coaching material, with just about a month to go. The problem is that psychiatry, when flattened into a series of bullet points for an exam, becomes uniquely soul-crushing.
In contrast, the other exams I've discussed actually require a bit of critical thinking. I didn't appreciate it at the time, but I do now.
I just find it hard to make all that information stick when it's so boring, and I do not relish the necessary revision ahead. Spaced repetition sounds great until you're actually doing it.
I attempted to channel my procrastination into going through some of the Royal College's suggested reading, and as you can see, I'm regretting it. The notes make them mostly redundant anyway. ChatGPT in combination makes them entirely so.
I cast F60.2
Wait, that's deprecated. Uh.. 6D10.1? Plus 6D11.3? For fuck's sake, in the most recent exams, they expect us to memorize ICD-11 and DSM-5 criteria, and the changes from ICD-10. When we still use 10 for all of our actual work and coding, with no plan to change before the current crop of consultants die of old age. And we don't even use the DSM, at least where I can see it. Is it there in our syllabus solely so we don't feel too embarrassed to attend American conferences? God knows.
You can see why this gives me a headache, though I will admit that classification systems are useful.
What about Anki decks for your boards?
Yeah F codes are a little silly at times cough cough struck by orca but automated tools help make them less of a pain in the ass.
The DSM is great though for kludging a million random phenomena into something that can be actually communicated between humans.
I haven't run into an any Anki decks specifically designed for this till date. I've made a few of my own, and I intend to go through them eventually.
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An interesting read, as long as it's not compulsory. I find it interesting that it has a new section 'to reflect changing cultural attitudes around gender dysphoria' but once you get into the more usual boring disorders it will tell you the gender incidence and relative ratio with bracing honesty.
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