Internal Medicine: Keys to Understanding with Prof Boyd Jones and Dr Darren Merrett

• Introduction
• Timetable for Modules
• Content of Modules
• Program and Reading List
• Technical Requirements for Online Study
• Register for this Course

By the Tutors: Prof Boyd Jones and Dr Darren Merrett

Welcome to our Internal Medicine course!

What this course is not

This course cannot teach you all there is to know about medicine. There is simply not the space (nor inclination) to provide laborious detail on specific diseases, ECG interpretation, performing neurological examinations, etc... All these topics are already covered in immense detail and clarity in the recommended texts.

What this course is

The aim of the course is to illustrate the mental approach to problems in internal medicine, mainly by stepping back and getting an overview or big picture of the topic. This overview serves as a framework of understanding that we might be able to flesh out a little with brief information in the text, and with the various assignments and reading material. Once you have a clear understanding of a topic, your future reading and experience can be slotted into this framework of understanding.

What if I fall behind?

By undertaking any distance education course you are committing yourself to a considerable workload. Various work and personal factors may arise that do not allow you to dedicate as much time as is required to complete all the assignments in each module. Rather than risk "giving it all away", there is still value to be gained and considerable material for later reference to be enjoyed. To ease the burden we will provide:

• Annotated reading lists

In each module you are presented with a wide range of articles to provide further information on the topic. A few short words on the list of references gives you a guideline to the 'value' of the references. Remember there is still value even if you just read the abstract.

• The various questions in the monthly assignment will be colour coded to nominate 'core' and 'additional' material. If pressed for time, try and get the core part of the assignment completed. For maximal benefit we would suggest you try and complete as much of the additional material as possible.

Case reports

Occasionally the module assignments ask you to describe how you have handled a particular problem in your practice. This letter allows us to give you advance warning to be on the lookout for specific types of problems to ease the rush of having to find a particular case that month. You will require a case report on:

• a coughing dog
• a dyspnoeic cat
• a patient with icterus
• an anaemic animal
• two animals with haemostatic disorders
• an animal with monoparesis/monoplegia
• two animals with an endocrine disease involving the pituitary and/or thyroid and /or parathyroid
• two patients with endocrine disease involving the adrenal and/or pancreas

Your cases should not be documentary! You must discuss the work-up and diagnosis, and justify your decisions, diagnostic tests and treatment. You must be specific eg. include dose rates, fluid administration rates etc. A case where 'the owner can’t afford any tests' is unsuitable. You are trying to expand your knowledge in medicine - full data is required.

Problem Based Medicine

The course is problem based and you will receive an introduction to problem-based medicine and its application. You may have been taught problem-based medicine, but if you haven’t we will help you to understand the methodology and to put it into practice with the case studies provided. We expect you to use a problem-based approach with your own case studies.

What can the tutors do for you?

We are not here simply to make life difficult by setting lots of questions. If you are having problems understanding a section of text or a particular concept, if you have a problem case in your practice, etc. - contact us. You will have details of our phone/fax/email numbers - so get in touch (email/website is probably the preferred medium).

What can’t the tutors do for you?

As tutors we will make ourselves available over the duration of the year. However, at the end of the year we need time to prepare for the next group and to recharge our own batteries. Our aim is to help as many of you as we can but we are not available after July 2008. So write this in your diary now and work with this deadline in mind.

Assignments

Assignments consist of varied activities primarily based on problem-solving exercises that may take the form of case studies, short answer questions, case reports from animals you have treated, completing or constructing tables and algorithms, etc.

You may need to be prepared to provide financial support to investigate cases seen in your own practice if the animal’s owners are unable to pay for full investigation. In fact, this is a great idea at all times; allocate a certain annual budget to allow you to run some further tests on selected cases for your own education and for the purposes of the module. If you are employed, it is worth asking your employer for a budgeted sum for case support for the year (e.g. $500-$1000) which you can utilise as you see fit during the duration of the course (and beyond).

Workshops

There will be two workshops during the year. One in August 2007, and the other in June 2008. The workshops are an opportunity to meet the tutors and fellow course participants and they provide a forum to discuss individual problems, cases, study guides etc. You will be required to bring some case studies or discussion items to these sessions to present to the group. These 'in person' seminars are very valuable and you should attempt to attend. The first workshop is especially important and participation will ensure you are on the 'right track' for the rest of the year.

Website

Another innovation this year will be the opportunity to communicate via the List Serv. All the courses will have individual List Servs where various queries regarding the course or assignments can be posted. Boyd and Darren DO NOT want the List Serv to be a passive exercise for participants!! Where possible they would much prefer to see two or three participants voice their opinion BEFORE they express an opinion. As you may gather, we consider the aim of the List Serv is to facilitate discourse regarding the contents of the modules and general issues in medicine. The Post Graduate Foundation will forward you the necessary information regarding computer requirements and using the List Serv at the beginning of the year.

You can help us!

We need your feedback on the course, individual modules, problems, difficult questions or cases, etc. Anything you think might make the course better for you, your colleagues and next year’s students! Don’t be shy, tell us your concerns or tell us if we are 'doing it right' for you.

Good luck and happy studying.
Boyd Jones and Darren Merrett

Timetable for Modules

Please note: All modules are sent to students via standard mail, or airmail when applicable. It is important for international students to be aware that the unsettled international climate means that mail can be held up for long periods of time at customs, or for other reasons. We can arrange to have material couriered to international students, so if you would like further details on this option, please contact your course coordinator, Giselle Alegria on +61 2 9351 7979 or email: galegria@usyd.edu.au.

Internal medicine is an incredibly diverse field and it is well beyond the bounds of possibility for a space and time constrained distance education course to totally illuminate the whole field. However, what we can achieve is to help you build a 'framework of understanding' (i.e. the 'big picture') - for particular topics or areas of study. This framework is then available to be fleshed out with specific disease and case examples in the modules to provide:

a) a short term goal of immediate insight into a topic, and

b) a long term goal of providing a foundation for future study and experience.

By way of example, in the first neurology module, rather than teaching how to perform a neurological examination (many textbooks already cover this topic in excellent detail and clarity), our aim is to teach you how to interpret the information to localise lesions and generate differential lists and appropriate future case management plans.

Recommended Reading

Selected Companion Texts
1. Canine and Feline Endocrinology and Reproduction. RW Nelson ED Feldman, WB Saunders, Philadelphia, 2nd edition
'Excellent and all-encompassing endocrinology text'

2. Essentials of Small Animal Internal Medicine. RW Nelson G Couto, 2nd Ed., Mosby 1998
'Good, practical, easy to read, general medical text'

3. Textbook of Veterinary Internal Medicine. 5th edition. SJ Ettinger and EC Feldman, 2000, WB Saunders, Philadelphia
'Excellent general reference in medicine (the 'bible'), but heavy going'

4. Essentials of Canine and Feline Electrocardiography. LP Tilley, Lea & Febiger 1992, 3rd edition
'Excellent ECG reference - if you have an ECG in your practice you need this book'

5. Manual of Small Animal Neurology. SJ Wheeler ed, BSAVA
'Good general overview on neurology'

6. Clinical Syndromes in Veterinary Neurology. KG Braund, Mosby 1994
'Discusses lesion localisation well and brief summary on almost all neurological diseases
Somewhat dated but good basic text'

7. Strombeck's Small Animal Gastroenterology. WG Guilford SA Center DR Strombeck, DA Williams DJ
Meyer, WB Saunders Philadelphia 1996 3rd edition
'Excellent, comprehensive text that covers all aspects of gastroenterology'

Selected Journals
1. Journal of Small Animal Practice
2. Australian Veterinary Practitioner
3. Journal of the American Animal Hospital Association
4. Journal of Feline Medicine & Surgery

Technical requirements for online study WebCT is a software program developed in Canada which provides a platform and a set of web course teaching tools for online learning. As an introduction to the online learning environment The Post Graduate Foundation in Veterinary Science is using this platform to give you access to your course online. This medium will allow you to access your course and participate in online discussions with other participants and your tutor via a computer, a modem and a web browser, such as Netscape or Internet Explorer.

To optimise your use of WebCT for online learning we recommend the following specifications: http://www.pgf.edu.au/disted/index.cfm#technical

• Read your Online Course Requirements?
  
  
• Read the General Information page?
  
  
• Read the How Much Does it Cost page?
  
  
• Become a Member of the Post Graduate Foundation?