Pilyoship part 2

That went better than I expected..

I had an exam and interview a few days ago for a position in (yet another) fellowship training program. When I was way younger, I used to look with awe at those people who took training a few extra steps further. I mean, medicine by itself is already challenging, and residency is definitely not for the weak of heart. Sub-specialty training in is often a must among Internal Medicine residency grads who intend to practice in urban centers, and is no walk in the park either.

After I was done with fellowship training several years ago, the concept of going for further "sub-subspecialty" training seemed like such an abstract idea for me. Maybe its because I felt that I didn't have what it takes? Or perhaps after having been in training so long, I wanted to do things on my own terms? Or maybe because I was just tired of going through the entire process?

To give you an overview of the life of a person in medical training, here is a breakdown of the average years spent in education of someone who would eventually be a sub-specialist:

College degree - 3-5 years*

Medical School - 4 years

Postgraduate internship - 1 year

Residency (Specialty) Training - 3-5 years**

Fellowship (Subspecialty) Training - 2-3 years***

For the sake of simplicity, I chose not to include the INTARMED program popularized by UP Manila.

* College courses in the Philippines are 3 to 5 years in length depending on the university of enrollment and the coursework involved.

** Residency training ranges from 3 years for Internal Medicine and Pediatrics, to 5 years for General Surgery. Not included among these are the so-called "Straight programs" offered by some institutions wherein trainees have a lengthened residency period but are already qualified to take the sub-specialty examinations upon completion (common among the surgical sub-specs like Neurosurgery and Orthopedics).

*** Fellowship training for most sub-specialties like Pulmonology and Gastroenterology last around 2 years. Cardiology and Oncology fellowships are usually longer by a year. I have little idea about the subspecialities for other feilds, but I know Thoracic Surgeons have to take an extra 3 years after their General Surgery residency.

People may opt to take things one step further and pursue either a new sub-specialty (like one of my bosses who is BOTH a Pulmonologist and Oncologist), or delve further into the specialty by choosing a focused area of study to concentrate on (e.g. Interventional Cardiology, Hepatology (Gastroenterology), Sleep Medicine (Pulmonology). The length of this further training is variable, depending on the extent of training required.

From what I have seen, specialization can range from all-out fellowship programs lasting a year or two, to short trainings abroad (2 weeks to 6 months) for the emerging and newly-established fields of study.

Medical practice has been continuously evolving by leaps and bounds the past few decades, and the growth of specialization was inevitable, since it is necessary to keep up with the tremendous amount of new research and advanced techniques.

Having said all that, I made the decision to go and try for further training. Since my practice is in the highly competitive environment of the metropolis, its easy to get lost in the background noise and be considered irrelevant unless you have something that can help you stand out. ;)

I just hope everything eventually works out in the end.. :)

PHIVOLCS Earthquake Intensity Scale (PEIS)

With the recent distant rumbling of Taal volcano, I was a little curious as to how we graded seismic activity locally.. and here are the results of my research.. :P

*taken from the PHIVOLCS website

Intensity Scale and Description

I - Scarcely Perceptible - Perceptible to people under favorable circumstances. Delicately balanced objects are disturbed slightly. Still Water in containers oscillates slowly.

II - Slightly Felt - Felt by few individuals at rest indoors. Hanging objects swing slightly. Still Water in containers oscillates noticeably.

III - Weak - Felt by many people indoors especially in upper floors of buildings. Vibration is felt like one passing of a light truck. Dizziness and nausea are experienced by some people. Hanging objects swing moderately. Still water in containers oscillates moderately.

IV - Moderately Strong - Felt generally by people indoors and by some people outdoors. Light sleepers are awakened. Vibration is felt like a passing of heavy truck. Hanging objectsswing considerably. Dinner, plates, glasses, windows and doors rattle. Floors and walls of wood framed buildings creak. Standing motor cars may rock slightly. Liquids in containers are slightly disturbed. Water in containers oscillate strongly. Rumbling sound may sometimes be heard.

V - Strong - Generally felt by most people indoors and outdoors. Many sleeping people are awakened. Some are frightened, some run outdoors. Strong shaking and rocking felt throughout building. Hanging objects swing violently. Dining utensils clatter and clink; some are broken. Small, light and unstable objects may fall or overturn. Liquids spill from filled open containers. Standing vehicles rock noticeably. Shaking of leaves and twigs of trees are noticeable.

VI - Very Strong - Many people are frightened; many run outdoors. Some people lose their balance. motorists feel like driving in flat tires. Heavy objects or furniture move or may be shifted. Small church bells may ring. Wall plaster may crack. Very old or poorly built houses and man-made structures are slightly damaged though well-built structures are not affected. Limited rockfalls and rolling boulders occur in hilly to mountainous areas and escarpments. Trees are noticeably shaken.

VII - Destructive - Most people are frightened and run outdoors. People find it difficult to stand in upper floors. Heavy objects and furniture overturn or topple. Big church bells may ring. Old or poorly-built structures suffer considerably damage. Some well-built structures are slightly damaged. Some cracks may appear on dikes, fish ponds, road surface, or concrete hollow block walls. Limited liquefaction, lateral spreading and landslides are observed. Trees are shaken strongly. (Liquefaction is a process by which loose saturated sand lose strength during an earthquake and behave like liquid).

VIII - Very Destructive - People panicky. People find it difficult to stand even outdoors. Many well-built buildings are considerably damaged. Concrete dikes and foundation of bridges are destroyed by ground settling or toppling. Railway tracks are bent or broken. Tombstones may be displaced, twisted or overturned. Utility posts, towers and monuments mat tilt or topple. Water and sewer pipes may be bent, twisted or broken. Liquefaction and lateral spreading cause man-made structures to sink, tilt or topple. Numerous landslides and rockfalls occur in mountainous and hilly areas. Boulders are thrown out from their positions particularly near the epicenter. Fissures and faults rapture may be observed. Trees are violently shaken. Water splash or stop over dikes or banks of rivers.

IX - Devastating - People are forcibly thrown to ground. Many cry and shake with fear. Most buildings are totally damaged. bridges and elevated concrete structures are toppled or destroyed. Numerous utility posts, towers and monument are tilted, toppled or broken. Water sewer pipes are bent, twisted or broken. Landslides and liquefaction with lateral spreadings and sandboils are widespread. the ground is distorted into undulations. Trees are shaken very violently with some toppled or broken. Boulders are commonly thrown out. River water splashes violently on slops over dikes and banks.

X - Completely Devastating - Practically all man-made structures are destroyed. Massive landslides and liquefaction, large scale subsidence and uplifting of land forms and many ground fissures are observed. Changes in river courses and destructive seiches in large lakes occur. Many trees are toppled, broken and uprooted.

Impetus

*as defined by Dictionary.com

im·pe·tus

   [im-pi-tuhs] 

–noun, plural -tus·es.

1.

a moving force; impulse; stimulus: The grant for building the opera house gave impetus to the city's cultural life.

2.

(broadly) the momentum of a moving body, esp. with reference to the cause of motion

Everyone needs a little something to get going, whether it be a reward, a sought-after objective, or just a pretty darn good reason for doing so. In any case, receiving a little push never hurt, as long as it is towards a worthwhile goal

Especially if the goal happens to be SURVIVAL. :P

Fortunately, my need for stimulus is not as dire as the picture above. In a few weeks, I'll be starting over again (hopefully). It's not really starting from scratch as it involves going back towards a path I had previously mapped out before. Now that I've had my "time in the sun", I'm ready to get my life back on track. :D This time, things are gonna be different, as the years past have given me a sense of peace and a great deal of wisdom as compared to when I first attempted to follow this trail.

I hope.. no.. I KNOW that everything will go smoother this time around. ;).

Alate

I learned a new word today...

a⋅late

–adjective Also, a⋅lat⋅ed.
1. having wings; winged
2. having membranous expansions like wings
- noun
3. the winged form of an insect when both winged and wingless forms occur in the species

Remember all those flying ant-things that always fly around light sources usually before it rains? Well, we had an entire swarm of 'em here in the house!!

Yup, ganyan nga. Grabe, I never saw so many of them INDOORS! I'm saying probably a thousand or so! :P Mom told us to kill the lights for a while and hunkered down in our rooms, emerging later on to find that they had totally disappeared... Strange.. Well, not really. Apparently they all decided to drop down anf lose their wings, leaving behind a lot of debris on the staircase. As I helped mom sweep the wings (and the wingless creepy-crawlies), we discovered that we had a minor termite infestation going on! This was quickly remedied (I hope by well-placed sprays of Baygon insect killer, or would serve as a stopgap measure for the meantime.

During the time our staircase was abuzz with the sound of a thousand flying insects, I noted that the streetlights outside had no insect activity whatsoever, which was pretty strange since they are usually more on the outside than indoors. My curiosity was piqued, and I combed the internet for information regarding the famous "gamu-gamo" immortalized by the great Dr. Jose Rizal, and this is what I found out..

1) Apparently, the term "gamu-gamo" locally used for these flying things is acutally the Filipino term for Moth

2) Having discovered fact #1 and seeing that gamu-gamo was a dead end, I then looked up information on termites and ran into the term "alate", which referred to the winged form of the termites that are related to the propagation of their species. This info correlates with the presence of the newly-discovered termite infestation, but how come there were so many?... I guess we'll have to find out tomorrow...

Pirates of the Caribbean, in Fact and Fiction

http://blindkat.hegewisch.net/pirates/pirates.html
After watching "Pirates of the Caribbean: At Worlds End" a couple of days ago, my curiosity was piqued and I stumbled across this online resource on the facts about the piracy that went on in the olden days of yore, plus a few tidbits about how piracy still persists in the present day.