MS-III
Saturday, August 28, 2004
Donnie Darko
I watched this movie the other day, and Oh My God! It is hilarious. If you haven't seen it, they now have it at blockbuster and you MUST RENT IT!
Basic synopsis: Donnie Darko (yes, that's his real name) is a paranoid schizophrenic teenager (aren't they all?) who is led on various adventures by his "imaginary" friend, Frank-the-6-foot-tall-rabbit. The whole movie is about the hijinx he gets into. Its somewhat dark, but is still very funny. For mature audiences only, please. No 10 year olds...
Otherwise, this weekend has been completely relaxing. Took the departmental exam on thursday (which was exactly what I expected it to be - since they gave us the questions) and then the medicine shelf on friday. We'll see about that one - I had a pretty good feeling about it, though. Hopefully I'll score well and not trash all my hopes.
Now, I'm in the process of re-vamping my curriculum vitae and writing a personal statement so I can start to get letters of recommendation from my clinical preceptors. I know, I know.. it's too damn early for that, but I think getting them early is better. Especially since medicine is one of the big-hitters as far as letters go. Hopefully I did well enough to get a decent letter.
For EM, it is recommended that you have two letters in the S.L.O.R. (Standard letter of recommendation) format - ingenious name, isn't it from clinical EM faculty (preferably someone like Rosen or Tintinalli, but anyone from a residency program would do) and then at least another from another "relevant" clinical discipline. The problem is, what discipline isn't relevant to EM? I haven't found one yet - nor can I think of one off the top of my head.
So, I'm spending hours in front of my computer, trying to remember everything I've ever done in my life that might pertain to residency applications (or medicine in general) so I can put together a C.V. The next task is to try to figure out what I want to say for my personal statement. I hate writing those stupid things - but supposedly they are OH SO IMPORTANT when it comes to residency applications. How ridiculous. I thought this was about medicine, not journalism. Maybe someone can clear that up for me. And don't tell me that "a well written and poignant personal statement can catch a program directors eye." That's a cop-out, and this is about realism. So, what exactly is the purpose of a personal statement?
I suppose it is to tell your story. But what if your story is boring: You've worked in the ED for 5 years and you know you like it and you know that EM is a good fit for your personality type.
That's it. I guess my personal statement will be pretty short. You've seen it here first, folks!!
Oh well, I guess I'll need to come up with something more lengthy than that. Besides, I don't know how much residency committees will like me telling about my experiences in the ED as a nurse. I guess we'll have to see, eh, since that's all I have right now. ¶ 4:46 PM 1 comments
Basic synopsis: Donnie Darko (yes, that's his real name) is a paranoid schizophrenic teenager (aren't they all?) who is led on various adventures by his "imaginary" friend, Frank-the-6-foot-tall-rabbit. The whole movie is about the hijinx he gets into. Its somewhat dark, but is still very funny. For mature audiences only, please. No 10 year olds...
Otherwise, this weekend has been completely relaxing. Took the departmental exam on thursday (which was exactly what I expected it to be - since they gave us the questions) and then the medicine shelf on friday. We'll see about that one - I had a pretty good feeling about it, though. Hopefully I'll score well and not trash all my hopes.
Now, I'm in the process of re-vamping my curriculum vitae and writing a personal statement so I can start to get letters of recommendation from my clinical preceptors. I know, I know.. it's too damn early for that, but I think getting them early is better. Especially since medicine is one of the big-hitters as far as letters go. Hopefully I did well enough to get a decent letter.
For EM, it is recommended that you have two letters in the S.L.O.R. (Standard letter of recommendation) format - ingenious name, isn't it from clinical EM faculty (preferably someone like Rosen or Tintinalli, but anyone from a residency program would do) and then at least another from another "relevant" clinical discipline. The problem is, what discipline isn't relevant to EM? I haven't found one yet - nor can I think of one off the top of my head.
So, I'm spending hours in front of my computer, trying to remember everything I've ever done in my life that might pertain to residency applications (or medicine in general) so I can put together a C.V. The next task is to try to figure out what I want to say for my personal statement. I hate writing those stupid things - but supposedly they are OH SO IMPORTANT when it comes to residency applications. How ridiculous. I thought this was about medicine, not journalism. Maybe someone can clear that up for me. And don't tell me that "a well written and poignant personal statement can catch a program directors eye." That's a cop-out, and this is about realism. So, what exactly is the purpose of a personal statement?
I suppose it is to tell your story. But what if your story is boring: You've worked in the ED for 5 years and you know you like it and you know that EM is a good fit for your personality type.
That's it. I guess my personal statement will be pretty short. You've seen it here first, folks!!
Oh well, I guess I'll need to come up with something more lengthy than that. Besides, I don't know how much residency committees will like me telling about my experiences in the ED as a nurse. I guess we'll have to see, eh, since that's all I have right now. ¶ 4:46 PM 1 comments
Thursday, August 26, 2004
All Good Things Must Come to an End
Well, today is the last day I'll be on an Internal Medicine rotation and I'd like to give some thoughts on the whole process...
First of all, the mileage varies widely from preceptor to preceptor. Some people have really long days filled with scut and rounding, while others have really long days filled with teaching, rounding, and fun. The common denominator seems to be really long days. This isn't too bad, however, since you are busy the whole time and (as a student) when the day is over noone pages or calls you for patient problems. This is why being a student rocks. The reason being a student sucks is 1) the same reason above - noone calls you, so you are always the last to know; 2) You can't technically make any treatment decisions, order any tests, or give orders for your patient that is in excruciating pain. You still have to call the intern/resident/attending or wait until rounds later in the day; 3) Everyone looks at you and calls you "that student" behind your back. I've heard it - it really happens; 4) The nurses always try to show you up. This really bothers me - why do they do this? I never did this when I worked in a teaching hospital. Of course, I worked in the ED where the view of physicians in general is a little different. Oh well.. whatever.
Overall, I was pretty surprised at this past month. I thought it was going to royally hoover, but all-in-all, it's been a pretty good time. Of course, it doesn't hurt when you have a great preceptor that takes time out every morning to teach for an hour. Hopefully, that'll help when it comes to the shelf exam tomorrow. Another reason I was surprised is that for a tiny hospital, they see a fair amount of pathology. Nothing like at the county hospital, which probably only beats it because of sheer volume, but we still had some pretty interesting cases.
Now for the downsides:
* Not enough pathology. This is a common complaint at smaller institutions. All the super-sick people go to the larger hospitals in town. Of course, it doesn't help that those huge hospitals are like a 3 minute ambulance drive away - pulls alot of stuff away from us. As I said above, they see some just not enough for what I would like as a resident-in-training.
* Too many consults. Ohmigod! How is it that at the county hospital, where there are at least 6 times the number of patients, the surgical services can manage their own medical issues but here they can't? It's very frustrating to be called at all hours for another consult on a surgical patient for management of their "medical issues" which amount to hypertension and diabetes - things even a 3rd year medical student can manage (can anyone say "continue home medications?")... Oh yeah.. we're talking surgeons here.... :) Of course, if it weren't for the consults our census would have been only about 12 patients.
* Patients stay too long. The beautiful thing about team call is you play the "who can we get out" game. The point of this came is to drop your census as low as possible before the next call (which occurs 3 days after you get off your previous call). Patient turnover is much more rapid than when everything is run by a private physician who really has no incentive to move patients along. For instance, I have had a patient with CHF for 4 days now - she is fine and she probably could have been discharged back to her nursing home 2 days ago. However, since we are not playing the game, we are waiting for her to ask to go home - which she finally did - today. I'm not saying this is a bad system - this is routinely how hospital admissions worked years ago and it is a viable option. However, for a hospital that continually complains that it is going bankrupt, it may not be a financially viable option. We need to work a bit more on what (in the ED) is called throughput - getting patients in and out.
Despite these few things, I really enjoyed this rotation - aside from dictations. Which is why I'm going into EM. You don't dictate crap. You see your patients, scribble orders, circle some words and check some boxes and you're done (god, I love the T-system). Then you look for placement - out the door or in the hospital. Lickety-split. None of this "you may now begin your dictation" crap.
My team was great, as was my team at county hospital. Thus far, I have been very fortunate. Even the other students that were with me on this rotation were cool - which is fortunate, since I didn't really talk with any of them prior to this month and had no clue what to expect. Thanks you all for making the month fun!
You too, Drs. C, B, and M!!
What's next for me? Family medicine: the final frontier. I'm getting all the medicine out of the way, so I can work on my sewing (surgery), catching (OB/GYN), and corralling (pediatrics) later. Of course then there's the pitchfork (Psych) and yoga class (OMMMMMMM....). But it's off to the West side for family medicine, where the monkey suits will reign supreme. Have I told you I hate monkey suits? ¶ 2:46 PM 0 comments
First of all, the mileage varies widely from preceptor to preceptor. Some people have really long days filled with scut and rounding, while others have really long days filled with teaching, rounding, and fun. The common denominator seems to be really long days. This isn't too bad, however, since you are busy the whole time and (as a student) when the day is over noone pages or calls you for patient problems. This is why being a student rocks. The reason being a student sucks is 1) the same reason above - noone calls you, so you are always the last to know; 2) You can't technically make any treatment decisions, order any tests, or give orders for your patient that is in excruciating pain. You still have to call the intern/resident/attending or wait until rounds later in the day; 3) Everyone looks at you and calls you "that student" behind your back. I've heard it - it really happens; 4) The nurses always try to show you up. This really bothers me - why do they do this? I never did this when I worked in a teaching hospital. Of course, I worked in the ED where the view of physicians in general is a little different. Oh well.. whatever.
Overall, I was pretty surprised at this past month. I thought it was going to royally hoover, but all-in-all, it's been a pretty good time. Of course, it doesn't hurt when you have a great preceptor that takes time out every morning to teach for an hour. Hopefully, that'll help when it comes to the shelf exam tomorrow. Another reason I was surprised is that for a tiny hospital, they see a fair amount of pathology. Nothing like at the county hospital, which probably only beats it because of sheer volume, but we still had some pretty interesting cases.
Now for the downsides:
* Not enough pathology. This is a common complaint at smaller institutions. All the super-sick people go to the larger hospitals in town. Of course, it doesn't help that those huge hospitals are like a 3 minute ambulance drive away - pulls alot of stuff away from us. As I said above, they see some just not enough for what I would like as a resident-in-training.
* Too many consults. Ohmigod! How is it that at the county hospital, where there are at least 6 times the number of patients, the surgical services can manage their own medical issues but here they can't? It's very frustrating to be called at all hours for another consult on a surgical patient for management of their "medical issues" which amount to hypertension and diabetes - things even a 3rd year medical student can manage (can anyone say "continue home medications?")... Oh yeah.. we're talking surgeons here.... :) Of course, if it weren't for the consults our census would have been only about 12 patients.
* Patients stay too long. The beautiful thing about team call is you play the "who can we get out" game. The point of this came is to drop your census as low as possible before the next call (which occurs 3 days after you get off your previous call). Patient turnover is much more rapid than when everything is run by a private physician who really has no incentive to move patients along. For instance, I have had a patient with CHF for 4 days now - she is fine and she probably could have been discharged back to her nursing home 2 days ago. However, since we are not playing the game, we are waiting for her to ask to go home - which she finally did - today. I'm not saying this is a bad system - this is routinely how hospital admissions worked years ago and it is a viable option. However, for a hospital that continually complains that it is going bankrupt, it may not be a financially viable option. We need to work a bit more on what (in the ED) is called throughput - getting patients in and out.
Despite these few things, I really enjoyed this rotation - aside from dictations. Which is why I'm going into EM. You don't dictate crap. You see your patients, scribble orders, circle some words and check some boxes and you're done (god, I love the T-system). Then you look for placement - out the door or in the hospital. Lickety-split. None of this "you may now begin your dictation" crap.
My team was great, as was my team at county hospital. Thus far, I have been very fortunate. Even the other students that were with me on this rotation were cool - which is fortunate, since I didn't really talk with any of them prior to this month and had no clue what to expect. Thanks you all for making the month fun!
You too, Drs. C, B, and M!!
What's next for me? Family medicine: the final frontier. I'm getting all the medicine out of the way, so I can work on my sewing (surgery), catching (OB/GYN), and corralling (pediatrics) later. Of course then there's the pitchfork (Psych) and yoga class (OMMMMMMM....). But it's off to the West side for family medicine, where the monkey suits will reign supreme. Have I told you I hate monkey suits? ¶ 2:46 PM 0 comments
Sunday, August 22, 2004
Political BS
While I love this country (The USA, for those of you in Internet Land that don't know), one of my biggest gripes is our electoral process. While I feel that the public-at-large should have a say in who gets to represent our country, I usually find the campaign process to be wanting - badly.
Why, oh why do all politicians (who also happen to be lawyers) always promise things they never intend on doing? "No new taxes," anyone? The list of unfulfilled campaign promises (which I like to call "Pillow-talk) could go on for days.
And then there are the advertisements: "George Bush Jr., The one you want if your kids are sluts and coke addicts. Just look at his kids! - Paid for by the coalition of sluts and coke addicts" or "John Kerry: Was he really shot in Vietnam? - Paid for by the coalition for accusing people of not being injured in vietnam." Come on, people! Why can't politicians stop lying (because they're lawyers) and just say what they mean. Instead of promising "No new taxes," why don't they just say "No new taxes, so long as you make over 1 million a year and you can afford to put your money in tax shelters." Or, "Vote for me so I can ruin this country by going to war and finishing my daddy's agenda." At least, then when we vote a person in (or he buys the vote by getting his brother to falsify ballots - what was it they called those little pieces of paper? Chads? Or was it Jebs?) to the White House, we'll know what he really stands for.
I'm really tired of reading the news and every day it is one person bashing another in order to try to gain an edge. Lets talk about issues, people, and really mean it. What are you going to do about the mess that has become our involvement in Iraq and the middle east? What about healthcare? What about the malpractice crisis? What about the national debt, for crying out loud? When are we going to put some real money into alternative power research? Greenhouse gasses, overcrowding, crime, capital punishment? What are your views - and what are YOU going to do to fix the problems that we, as a country, are facing?
When are the constituents of this fine country going to stand up and shout, "WE'RE TIRED OF THIS POLITICAL BULLSHIT!" and demand some truth from our leaders. I'm tired of being fed the crap they think I want to hear, I'm tired of them catering to minorities just to get their vote and then shitting on them like all their predecessors, I'm tired of getting shat upon because I'm not a minority (although white male is quickly becoming the newest minority, and intelligent has always been a minority - I should file for minority status), I'm tired of the whole process. The electoral process needs to get thrown out the window and we need to rethink it.
Don't get me started on the impotence of the Presidency in general - even if we vote in the most thoughtful, intelligent president that actually has a conscience (i.e. is not a lawyer) and means to do what he promised on the campaign trail, you can bet Congress will not pass any bill proposed or the courts will find it unconstitutional. It seems everyone wants a piece of the legislation pie.
Now, from the above it might seem that I'm unhappy with this country - I'm not. I just don't think our government is run in the most efficient manner possible. We have aides to the aides of secretaries. Why do we need 3 people doing a secretary's job? Why do we need to spend 450 dollars on a hammer, 75 dollars on a pen and 50 dollars on a roll single-ply toilet paper? Our BUREAUCRACY needs a major overhaul - starting with the campaign trail. Just cut it out, ok? Let's stand up for our rights.
more to come.... ¶ 3:59 PM 0 comments
Why, oh why do all politicians (who also happen to be lawyers) always promise things they never intend on doing? "No new taxes," anyone? The list of unfulfilled campaign promises (which I like to call "Pillow-talk) could go on for days.
And then there are the advertisements: "George Bush Jr., The one you want if your kids are sluts and coke addicts. Just look at his kids! - Paid for by the coalition of sluts and coke addicts" or "John Kerry: Was he really shot in Vietnam? - Paid for by the coalition for accusing people of not being injured in vietnam." Come on, people! Why can't politicians stop lying (because they're lawyers) and just say what they mean. Instead of promising "No new taxes," why don't they just say "No new taxes, so long as you make over 1 million a year and you can afford to put your money in tax shelters." Or, "Vote for me so I can ruin this country by going to war and finishing my daddy's agenda." At least, then when we vote a person in (or he buys the vote by getting his brother to falsify ballots - what was it they called those little pieces of paper? Chads? Or was it Jebs?) to the White House, we'll know what he really stands for.
I'm really tired of reading the news and every day it is one person bashing another in order to try to gain an edge. Lets talk about issues, people, and really mean it. What are you going to do about the mess that has become our involvement in Iraq and the middle east? What about healthcare? What about the malpractice crisis? What about the national debt, for crying out loud? When are we going to put some real money into alternative power research? Greenhouse gasses, overcrowding, crime, capital punishment? What are your views - and what are YOU going to do to fix the problems that we, as a country, are facing?
When are the constituents of this fine country going to stand up and shout, "WE'RE TIRED OF THIS POLITICAL BULLSHIT!" and demand some truth from our leaders. I'm tired of being fed the crap they think I want to hear, I'm tired of them catering to minorities just to get their vote and then shitting on them like all their predecessors, I'm tired of getting shat upon because I'm not a minority (although white male is quickly becoming the newest minority, and intelligent has always been a minority - I should file for minority status), I'm tired of the whole process. The electoral process needs to get thrown out the window and we need to rethink it.
Don't get me started on the impotence of the Presidency in general - even if we vote in the most thoughtful, intelligent president that actually has a conscience (i.e. is not a lawyer) and means to do what he promised on the campaign trail, you can bet Congress will not pass any bill proposed or the courts will find it unconstitutional. It seems everyone wants a piece of the legislation pie.
Now, from the above it might seem that I'm unhappy with this country - I'm not. I just don't think our government is run in the most efficient manner possible. We have aides to the aides of secretaries. Why do we need 3 people doing a secretary's job? Why do we need to spend 450 dollars on a hammer, 75 dollars on a pen and 50 dollars on a roll single-ply toilet paper? Our BUREAUCRACY needs a major overhaul - starting with the campaign trail. Just cut it out, ok? Let's stand up for our rights.
more to come.... ¶ 3:59 PM 0 comments
Friday, August 20, 2004
Errata
Holy Cow, how did I get so busy so fast? It seems like only 2 days ago our service had 12 patients and now it has 26. Oh wait - that is because it WAS two days ago. My gosh, what a change.
I went from comfortably completing all my tasks with plenty of time to spare to now only getting finished with a few minutes before lecture. I really need to get faster at writing notes. I can see and examine a patient in about 5 minutes, but then it takes me 15 to write down everything I did - maybe my notes are just too long and detailed. It must come from all the time spent working as a nurse - we notoriously make overly detailed notes, while doctors frequently make under-detailed notes. I need to find a happy medium in there somewhere. I'm sure it will come with time. Any ideas for ways to pare down?
I saw this article today and thought it was kind of interesting. It goes against everything we were taught in physical education classes. Maybe the new paradigm will be just warm-up without stretching to help prevent injuries. I know that this spring, while volunteering at football games in a women's league, I saw lots of ligamentous and muscle sprain/strain type injuries. And what did the team doctor always say? "You need to stretch more before games!" Maybe now, he'll have to tell the players to stretch less before the games and perform more warm up exercises. I never would have thought to study something like this. I wonder what gets into people's heads to make them think to study these simple "truths" that we've been fed all our lives. I just don't think that way, I guess.
More about the physician-scientist role: I think some people are just born with it and are interested in furthering the body of medical knowledge. I see myself as more of a people-person: I would rather use that body of knowledge and my own interpersonal skills to help the masses. Unfortunately for me, a "scholarly project" is required of every resident in Emergency Medicine. I have long feared the day when I would be forced to do research, and that day is rapidly approaching.
Not that I think doing research is inherently bad - in fact, a lot of good things have come from research. We (the human race) would never have eradicated smallpox if it weren't for the experiments that found that vaccinia (cowpox) injections could prevent smallpox. Nevermind the suffering eased by the secretions of a lowly mold: Penicillin was perhaps the most fortuitous discovery ever. After all these wonderful discoveries (and the millions that have been made since), I just don't see what I possibly have to offer the world. No, just let me take what has been found and put it to good use, thank you very much.
Now, I'm sure there are those of you that could give me a million reasons why every physician should be a physician-scientist. And I would answer back to you that, in a way, every physician is a scientist, and an artist, teacher, healer, and friend. Yes, friend. When all else has failed you, when all your art and science has left you behind and your patient is dying, all that is left is the relationship you have built with your patient, your friend. And you won't have that if you are too busy with the science to let yourself shine through.
Wow, that was macabre. But food for thought, nonetheless.
And now, for something COMPLETELY different (in the words of the infamous Monty Python)...
I just returned from watching, Exorcist, the Beginning, and it wasn't half bad. It wasn't nearly as good as the original (don't you just hate it when people compare something to the original? I'm sorry....), but I didn't expect it to be. The original was a once in a lifetime, luck of the draw kind of movie. I don't think even if they remade the whole thing over again with today's technology that it would be the same as the old black and white. The chemistry just isn't there, the mood, the fear rampant in the community at large. We (as a society) are too used to seeing gore, blood, death and mayhem that it is commonplace now. Is it any wonder that a kid took a gun to school today here in the metroplex? Our society has made it ok for everyone to carry guns without a thought as to the ramifications of such an act. If guns are readily available, of course people are going to use them. We're weak - we are ruled by our emotions and we do things in a moment of passion we might later regret. So, let's take away the temptation.
We need to seriously look at where we are going as a society and make changes now, while we still can. Stop war for the sake of war. Sure as hell stop war for the sake of getting re-elected to a freaking office. We need to take care of our own country before we go sticking our nose in other people's business. We have a horrid educational system, crime is rampant, the healthcare system is a joke, and 60% of our population is overweight and the other 40% is starving and on welfare, drugs or both. We need to take care of our own for awhile. The US is entering a midlife crisis right now - we're big enough to throw our weight around, and like the playground bully, we've started doing it. But just like the bully, we only do it because we feel bad about ourselves - we don't know where we're going, and the only thing we know to do is to strike out at others. We need to get our heads on straight and take care of our own problems for a few decades. Today, Kobe Bryant made more than I'll make in my entire life. And I can guarantee he never went to graduate school - and his entire school career probably wasn't as long as my college, medical school, and residency career will be. Our priorities are in the wrong place. We spend $8 on a movie ticket and $10 more on a soda and popcorn or candy, but then bitch when we have to lay down a $20 co-pay at our physician's office. What is more important - your health or the latest Tom Cruise movie? I think it made 24.4 million it's opening weekend or something. That's more than the GDP of several small countries. Come on, people, get your priorities straight.
Ok.. I'm sorry for the rant. I'm going to count to ten and stop now before I do something I might regret.
more to come... ¶ 7:41 PM 0 comments
I went from comfortably completing all my tasks with plenty of time to spare to now only getting finished with a few minutes before lecture. I really need to get faster at writing notes. I can see and examine a patient in about 5 minutes, but then it takes me 15 to write down everything I did - maybe my notes are just too long and detailed. It must come from all the time spent working as a nurse - we notoriously make overly detailed notes, while doctors frequently make under-detailed notes. I need to find a happy medium in there somewhere. I'm sure it will come with time. Any ideas for ways to pare down?
I saw this article today and thought it was kind of interesting. It goes against everything we were taught in physical education classes. Maybe the new paradigm will be just warm-up without stretching to help prevent injuries. I know that this spring, while volunteering at football games in a women's league, I saw lots of ligamentous and muscle sprain/strain type injuries. And what did the team doctor always say? "You need to stretch more before games!" Maybe now, he'll have to tell the players to stretch less before the games and perform more warm up exercises. I never would have thought to study something like this. I wonder what gets into people's heads to make them think to study these simple "truths" that we've been fed all our lives. I just don't think that way, I guess.
More about the physician-scientist role: I think some people are just born with it and are interested in furthering the body of medical knowledge. I see myself as more of a people-person: I would rather use that body of knowledge and my own interpersonal skills to help the masses. Unfortunately for me, a "scholarly project" is required of every resident in Emergency Medicine. I have long feared the day when I would be forced to do research, and that day is rapidly approaching.
Not that I think doing research is inherently bad - in fact, a lot of good things have come from research. We (the human race) would never have eradicated smallpox if it weren't for the experiments that found that vaccinia (cowpox) injections could prevent smallpox. Nevermind the suffering eased by the secretions of a lowly mold: Penicillin was perhaps the most fortuitous discovery ever. After all these wonderful discoveries (and the millions that have been made since), I just don't see what I possibly have to offer the world. No, just let me take what has been found and put it to good use, thank you very much.
Now, I'm sure there are those of you that could give me a million reasons why every physician should be a physician-scientist. And I would answer back to you that, in a way, every physician is a scientist, and an artist, teacher, healer, and friend. Yes, friend. When all else has failed you, when all your art and science has left you behind and your patient is dying, all that is left is the relationship you have built with your patient, your friend. And you won't have that if you are too busy with the science to let yourself shine through.
Wow, that was macabre. But food for thought, nonetheless.
And now, for something COMPLETELY different (in the words of the infamous Monty Python)...
I just returned from watching, Exorcist, the Beginning, and it wasn't half bad. It wasn't nearly as good as the original (don't you just hate it when people compare something to the original? I'm sorry....), but I didn't expect it to be. The original was a once in a lifetime, luck of the draw kind of movie. I don't think even if they remade the whole thing over again with today's technology that it would be the same as the old black and white. The chemistry just isn't there, the mood, the fear rampant in the community at large. We (as a society) are too used to seeing gore, blood, death and mayhem that it is commonplace now. Is it any wonder that a kid took a gun to school today here in the metroplex? Our society has made it ok for everyone to carry guns without a thought as to the ramifications of such an act. If guns are readily available, of course people are going to use them. We're weak - we are ruled by our emotions and we do things in a moment of passion we might later regret. So, let's take away the temptation.
We need to seriously look at where we are going as a society and make changes now, while we still can. Stop war for the sake of war. Sure as hell stop war for the sake of getting re-elected to a freaking office. We need to take care of our own country before we go sticking our nose in other people's business. We have a horrid educational system, crime is rampant, the healthcare system is a joke, and 60% of our population is overweight and the other 40% is starving and on welfare, drugs or both. We need to take care of our own for awhile. The US is entering a midlife crisis right now - we're big enough to throw our weight around, and like the playground bully, we've started doing it. But just like the bully, we only do it because we feel bad about ourselves - we don't know where we're going, and the only thing we know to do is to strike out at others. We need to get our heads on straight and take care of our own problems for a few decades. Today, Kobe Bryant made more than I'll make in my entire life. And I can guarantee he never went to graduate school - and his entire school career probably wasn't as long as my college, medical school, and residency career will be. Our priorities are in the wrong place. We spend $8 on a movie ticket and $10 more on a soda and popcorn or candy, but then bitch when we have to lay down a $20 co-pay at our physician's office. What is more important - your health or the latest Tom Cruise movie? I think it made 24.4 million it's opening weekend or something. That's more than the GDP of several small countries. Come on, people, get your priorities straight.
Ok.. I'm sorry for the rant. I'm going to count to ten and stop now before I do something I might regret.
more to come... ¶ 7:41 PM 0 comments
Monday, August 16, 2004
Getting Into Medical School - Part 2
Ok, so I've finally gotten around to finishing this little project. Sorry for the delay:
Step 6: Interview
* You've filled out all the mountains of paperwork and paid your money, filled out your secondaries and turned them all back in. Hopefully you're now getting offers for interviews.
* What happens during an interview and what is expected? First, dress up. For men, this always means suit and tie. For women, this is much more variable. You all know "professional dress" much better than I do, so I won't offer too many opinions here - I'll only remark that women are incredibly lucky not to have to wear choking shirts and ties. Show up at the school (at the designated spot) at around 0730-0800. There will be a few medical students from the school there to help show you around and make you feel "comfortable," as if that is a state of being one could find oneself in such a situation... yeah right. Anyway, there is generally a packet you must collect which will contain a schedule for the day, the names of the people with which you will be interviewing and some other information about the school/interview day you may/ may not already know. Read this over quickly - this could come in handy during the actual interviews. Next, there is frequently a short presentation about the school and a Q&A session. If you ask questions here, make them general questions about the curriculum or the school - nothing too specific. These questions are best handled in person. Lunch usually occurs around this time - frequently in small groups with one or more of the current medical students or faculty. Now you can ask these specific questions - feel out the student/faculty member first, though. For students, ask about student life, curriculum, the daily life as a medical student, etc. Remember, these will be 2nd years, so don't ask too much about clinical stuff - they won't really know. In the afternoon is usually when the real business occurs: the interviews.
* There are several types of "interviews." There is the standard one-on-one interview (probably the most prevalent and lowest stress) and then there are the "committee" interviews (highest stress). Fortunately, I never had any of the latter. My interviews were all one-on-one and very low stress almost to the point of feeling informal. The person with which you are talking will generally ask about your life, what draws you to medicine, any specific experiences you may have that you feel will help you in medical school or influenced you to pursue medicine as a career. Be sure to know about current events and current trends in medicine - ethics, malpractice, etc. Generally, they have not seen anything in your file aside from your personal statement (although each school varies in this) and so grades, MCAT scores, etc do not really matter here. The assumption is that since you were invited for the interview, you are good enough from a numbers standpoint to be accepted and the point of the interview is to separate the "wheat from the chaff," so to speak - to see which applicants would make a good fit for the school.
* A final point - remember, you are not only auditioning for a position in the entering class of this school, but you are also on a mission to discover if you even want the position at all. Be sure to ask questions of all the interviewers - ask about accreditation status/financial viability (you don't want your school to close down in your 3rd year, do you?), shifts in curriculum (and the reasons for the changes), recent board performance (and what is being done to improve them if <95% passing and if all recent classes have not beat the mean), where recent grads have gone for residency (ask specifically about your field(s) of interest - if you know).
* Hopefully after one or two interviews, you'll get the hang of it and any stress you experienced will be gone and you'll reach your stride. No worries.
* Be sure to send thank you cards to each person you interviewed with - the schedules I referenced above are good for reminding you of who they were - especially if you scratched notes out after each interview. This puts your name in front of the admissions committees again and reminds them of what a good applicant you are... and it shows that you have manners and you're interested in the program.
Step 7: Wait for "match" day
* After your interviews are over, next comes the most excruciating part of all - the wait for acceptances, rejection, or more waiting (wait-list). Hopefully, you'll have lots of acceptances and you won't have to worry about the other two.
* If you get accepted, CONGRATULATIONS. If you want to take the spot, place your deposit and get ready to move.
* If you get rejected, don't worry about it. A lot of people don't get accepted - generally schools interview at least 10 people for each spot they have open. So as long as you interviewed at more than 10 schools, you're pretty much guaranteed an acceptance SOMEWHERE just by playing the numbers. :) It's good to be optimistic!
* If you get wait-listed, congratulations - you still have a shot to go there. There is generally some pretty good movement on the wait-lists as the season goes on - it just depends on which people accept which places. There may be significant movement or almost none at all. I can't really give you much advice as far as this is concerned. Keep calling and writing the admissions office of your favorite school and remind them that you're incredibly interested - hopefully everything will come out in your favor.
Ok, this is a brief overview. If there are any specific questions or anything anyone would like me to cover more in-depth, leave a comment and I'll try to address it (if I can - I don't know everything, you know). Otherwise, best of luck and hope to see you among our ranks soon!
more to come... ¶ 10:00 PM 0 comments
Step 6: Interview
* You've filled out all the mountains of paperwork and paid your money, filled out your secondaries and turned them all back in. Hopefully you're now getting offers for interviews.
* What happens during an interview and what is expected? First, dress up. For men, this always means suit and tie. For women, this is much more variable. You all know "professional dress" much better than I do, so I won't offer too many opinions here - I'll only remark that women are incredibly lucky not to have to wear choking shirts and ties. Show up at the school (at the designated spot) at around 0730-0800. There will be a few medical students from the school there to help show you around and make you feel "comfortable," as if that is a state of being one could find oneself in such a situation... yeah right. Anyway, there is generally a packet you must collect which will contain a schedule for the day, the names of the people with which you will be interviewing and some other information about the school/interview day you may/ may not already know. Read this over quickly - this could come in handy during the actual interviews. Next, there is frequently a short presentation about the school and a Q&A session. If you ask questions here, make them general questions about the curriculum or the school - nothing too specific. These questions are best handled in person. Lunch usually occurs around this time - frequently in small groups with one or more of the current medical students or faculty. Now you can ask these specific questions - feel out the student/faculty member first, though. For students, ask about student life, curriculum, the daily life as a medical student, etc. Remember, these will be 2nd years, so don't ask too much about clinical stuff - they won't really know. In the afternoon is usually when the real business occurs: the interviews.
* There are several types of "interviews." There is the standard one-on-one interview (probably the most prevalent and lowest stress) and then there are the "committee" interviews (highest stress). Fortunately, I never had any of the latter. My interviews were all one-on-one and very low stress almost to the point of feeling informal. The person with which you are talking will generally ask about your life, what draws you to medicine, any specific experiences you may have that you feel will help you in medical school or influenced you to pursue medicine as a career. Be sure to know about current events and current trends in medicine - ethics, malpractice, etc. Generally, they have not seen anything in your file aside from your personal statement (although each school varies in this) and so grades, MCAT scores, etc do not really matter here. The assumption is that since you were invited for the interview, you are good enough from a numbers standpoint to be accepted and the point of the interview is to separate the "wheat from the chaff," so to speak - to see which applicants would make a good fit for the school.
* A final point - remember, you are not only auditioning for a position in the entering class of this school, but you are also on a mission to discover if you even want the position at all. Be sure to ask questions of all the interviewers - ask about accreditation status/financial viability (you don't want your school to close down in your 3rd year, do you?), shifts in curriculum (and the reasons for the changes), recent board performance (and what is being done to improve them if <95% passing and if all recent classes have not beat the mean), where recent grads have gone for residency (ask specifically about your field(s) of interest - if you know).
* Hopefully after one or two interviews, you'll get the hang of it and any stress you experienced will be gone and you'll reach your stride. No worries.
* Be sure to send thank you cards to each person you interviewed with - the schedules I referenced above are good for reminding you of who they were - especially if you scratched notes out after each interview. This puts your name in front of the admissions committees again and reminds them of what a good applicant you are... and it shows that you have manners and you're interested in the program.
Step 7: Wait for "match" day
* After your interviews are over, next comes the most excruciating part of all - the wait for acceptances, rejection, or more waiting (wait-list). Hopefully, you'll have lots of acceptances and you won't have to worry about the other two.
* If you get accepted, CONGRATULATIONS. If you want to take the spot, place your deposit and get ready to move.
* If you get rejected, don't worry about it. A lot of people don't get accepted - generally schools interview at least 10 people for each spot they have open. So as long as you interviewed at more than 10 schools, you're pretty much guaranteed an acceptance SOMEWHERE just by playing the numbers. :) It's good to be optimistic!
* If you get wait-listed, congratulations - you still have a shot to go there. There is generally some pretty good movement on the wait-lists as the season goes on - it just depends on which people accept which places. There may be significant movement or almost none at all. I can't really give you much advice as far as this is concerned. Keep calling and writing the admissions office of your favorite school and remind them that you're incredibly interested - hopefully everything will come out in your favor.
Ok, this is a brief overview. If there are any specific questions or anything anyone would like me to cover more in-depth, leave a comment and I'll try to address it (if I can - I don't know everything, you know). Otherwise, best of luck and hope to see you among our ranks soon!
more to come... ¶ 10:00 PM 0 comments
Sunday, August 15, 2004
Back from the Luau
I think I spelled that correctly. Wait a second, let me check the dictionary.... Awesome, I got it right. Who ever would have thought that a word in English would actually be spelled like it sounds. Oh, wait. That's not English.
Did you miss me? I was out of town for the weekend. My mother was celebrating the 15th anniversary of her 29th birthday and I was invited (or is the word OBLIGATED? Just kidding).
So, on saturday morning I went up to the hospital EARLY and checked on my patients and made sure there were no more admissions overnight that needed to be seen (which there weren't, thank goodness) and then I skipped town for a weekend of fun in the sun (well, shade actually), fruity drinks, and family and friends.
My mother has this obsession with all things tropical. If you ever want to buy her a gift, anything with a flamingo or tropical fish would be just great. The problem is, I'm starting to run out of tropical-type stuff to buy for her. It's really quite frustrating.
So I'm headed back to my home-town for this anniversary party, but I have to make a quick side-stop and pick up my girlfriend. She has spent the past 6 weeks in a small west-texas town doing rural family medicine. She is also (unfortunately for her) living in a hospital room. Yeah, suck, right? I decided to grab her and rescue her from her torture for a weekend.
After I pick her up, we head to my parents' house, where the luau is taking place. We're several hours early, so we get recruited to help set it up (I should have known better than to get there early... promptness, dammit!). Oh well.. I have a little fun anyway.
Finally, the shin-dig (small-town speak for "event") gets under way and people begin arriving. After awhile, about 20-30 people are there and we're all hanging out and talking.. and talking.. and they're drinking fruity drinks or beer or their drink of choice. I'm drinking coke because I didn't feel like fruity drink or beer. But we're talking.
Finally, it gets to be about midnight and I go inside to go to bed (remember, I was at the hospital around 0530, so I've been up for a long time by this point). I felt like a wuss, but after 20 hours (with the last 10 outside in the heat and mosquitos) you get really worn out. Maybe I should have been drinking water with DEET or something :) My H/H is probably 8/25 today after all the blood I've lost. I think I need a transfusion. I just hope none of those little suckers (literally) gave me West Nile...
Anyway, this morning, I wanted absolutely nothing to do with consciousness. I think I finally woke up at 1100 and even then I could have slept for about 4 more hours, easily. I've been so tired lately. I think I might have a sleep disorder - I have way too much daytime sleepiness to be getting proper sleep at night.. of course, now it's 0130 and I have to be up in 5 hours.. But that couldn't have anything to do with my fatigue, could it? hehehe... this site is a bad influence on me.
Anyway.. so now I'm back. You can quit missing me, since I'll be posting again after my short reprieve over the weekend. I'm going to finish my post for pre-meds tomorrow and then I'll post a bit more on EM and maybe critical care (which I've been contemplating for quite some time now...), so stay tuned and don't touch that dial. Because (if you remember this, you're a real champ), after these messages we'll be right back!
more to come (I promise - because you can't stop me!!)... ¶ 10:32 PM 0 comments
Did you miss me? I was out of town for the weekend. My mother was celebrating the 15th anniversary of her 29th birthday and I was invited (or is the word OBLIGATED? Just kidding).
So, on saturday morning I went up to the hospital EARLY and checked on my patients and made sure there were no more admissions overnight that needed to be seen (which there weren't, thank goodness) and then I skipped town for a weekend of fun in the sun (well, shade actually), fruity drinks, and family and friends.
My mother has this obsession with all things tropical. If you ever want to buy her a gift, anything with a flamingo or tropical fish would be just great. The problem is, I'm starting to run out of tropical-type stuff to buy for her. It's really quite frustrating.
So I'm headed back to my home-town for this anniversary party, but I have to make a quick side-stop and pick up my girlfriend. She has spent the past 6 weeks in a small west-texas town doing rural family medicine. She is also (unfortunately for her) living in a hospital room. Yeah, suck, right? I decided to grab her and rescue her from her torture for a weekend.
After I pick her up, we head to my parents' house, where the luau is taking place. We're several hours early, so we get recruited to help set it up (I should have known better than to get there early... promptness, dammit!). Oh well.. I have a little fun anyway.
Finally, the shin-dig (small-town speak for "event") gets under way and people begin arriving. After awhile, about 20-30 people are there and we're all hanging out and talking.. and talking.. and they're drinking fruity drinks or beer or their drink of choice. I'm drinking coke because I didn't feel like fruity drink or beer. But we're talking.
Finally, it gets to be about midnight and I go inside to go to bed (remember, I was at the hospital around 0530, so I've been up for a long time by this point). I felt like a wuss, but after 20 hours (with the last 10 outside in the heat and mosquitos) you get really worn out. Maybe I should have been drinking water with DEET or something :) My H/H is probably 8/25 today after all the blood I've lost. I think I need a transfusion. I just hope none of those little suckers (literally) gave me West Nile...
Anyway, this morning, I wanted absolutely nothing to do with consciousness. I think I finally woke up at 1100 and even then I could have slept for about 4 more hours, easily. I've been so tired lately. I think I might have a sleep disorder - I have way too much daytime sleepiness to be getting proper sleep at night.. of course, now it's 0130 and I have to be up in 5 hours.. But that couldn't have anything to do with my fatigue, could it? hehehe... this site is a bad influence on me.
Anyway.. so now I'm back. You can quit missing me, since I'll be posting again after my short reprieve over the weekend. I'm going to finish my post for pre-meds tomorrow and then I'll post a bit more on EM and maybe critical care (which I've been contemplating for quite some time now...), so stay tuned and don't touch that dial. Because (if you remember this, you're a real champ), after these messages we'll be right back!
more to come (I promise - because you can't stop me!!)... ¶ 10:32 PM 0 comments
Thursday, August 12, 2004
Getting Into Medical School - Part 1
For all you pre-med types out there - we're not forgetting about you here! At least, I'm not.
I remember when I was a premed - all 8 miserable years of it - all I wanted was information. I never could seem to get enough of it. I read as much as I could about medicine, medical school, medical students. Believe me, publishers bank on that and make a lot of money because of it. I bought several books about medicine - "First, Do No Harm," "The House of God," "Mount Misery" to name a few.. all of them very good books, by the way. Another good one is, "Kill as few patients as possible." It's hilarious. Written by an internist of a certain background that I am not allowed to mention. You might be able to figure it out (inside joke).
Anyway, back on track here.
As I was saying, back then, all I wanted was information. That is still true, actually. I'm always asking "what's next?" So I thought I'd lay out a little timeline for you and try to explain some of the things that happen along the way. If I leave anything out, or you have more questions, please feel free to mail me any questions you may have.
Step 1: Go to college
* All medical schools require at least SOME college credit. Gone are the days when you could just follow a doctor around for a few years, ask some questions and strike out on your own. There is actually an educational process involved now (supposedly). The requirement is at LEAST 90 hours, most prefer a degree of some sort. Ivy league-type schools require a bachelors, most others you can get away with less, so long as you've taken the required courses and present a good package. The particular college doesn't matter. Go to your state college if you'd like and save yourself some money.
* Speaking of required courses, what are they? Biology - 8 hours* Chemistry - 8 hours* Physics - 8 hours* Organic Chemistry - 8 hours* English - 6 hours Calculus/Statistics - 3 hours (* = lab required)
* As you can see, there isn't really that much actually required for medical school - some 41 hours. Nothing you couldn't comfortably finish in a year and a summer session if you put your mind to it. The problem comes when you start looking at getting a degree.. that is more of a time investment. Most schools no longer have a "Premed" major. Now you must major in something else, like business, philosophy, engineering, biology, music, or theatre - you name it, and there has been someone with that degree go to medical school . They even let lawyers into medical school - the really sado-masochistic ones.
Step 2: Talk to your Pre-medical advisor
* Hopefully you've chosen an undergraduate institution that has a pre-medical advisory committee. If not, choose again. Just kidding, you can do it without a committee. That's the way they did it before there were committees. Everything was probably much easier back then too - no bureaucratic red tape that always comes with committees. Yuck. red tape. So much less tasteful than blue or green tape. Anyways, somewhere near the beginning of your undergraduate career, you need to speak with someone on this committee. If you don't have one, talk with your major advisor about who usually performs this duty at your institution.
* What to talk about: At first, you just want to introduce yourself and find out what is available. Some schools have very established programs with meetings and informative sessions. They will bring in speakers from different schools to talk about admissions, medical school life, etc. Some schools will have next to nothing besides a person sitting in a office playing the voice of authority - much like the Wizard of Oz: You never see him/her, but you know he/she is there...
* As your undergraduate career advances, you will need to stay in close contact with the above-mentioned person. Talk with him/her frequently about how your classes are going, what you're experiencing, ask any new questions you may have. At the end of every year or so, sit down for a formal session and talk seriously about how you've done and what you need to do to be a competitive applicant. This is a pain in the butt, but very worthwhile. The better you know your pre-med advisor, the better off you are in the long-run. Why? 1)They are your school's authority on medical school admissions. Presumptively, this person is keeping up with all the latest trends in the field. 2)This person will likely be contributing to a letter that will be sent to all the schools to which you apply. Wouldn't you rather have a friend writing about you than some schmoe you just met last week? Yeah, I thought so.
Step 3: Volunteer
* Please, oh please, oh please, oh please do something besides take classes and go to frat parties. Medicine is a very serious undertaking. You need to know what you are getting yourself into - the educational process alone will take at LEAST 7 years after you graduate from college. Of course, the educational process never really ends, but that's another topic altogether.
* Talk to your doctor - can you shadow him/her?
* Go to the ER and talk to the physicians there - can you shadow one or more of them? Maybe you could get a job as a tech
* Take an EMT course - that is great experience and will open some doors to you as far as employment opportunities...
* Have you met any other physicians while doing any of the above? Can you talk with them or perhaps shadow them as well?
* If you don't get the point I'm trying to make here, you need to have some sort of idea of what medicine is before you ever dream of applying. You may shadow a half dozen physicians and decide it's not for you at all.. and right there you've saved yourself about $120,000 (at least). What a bargain for a couple saturdays a month, huh?
Step 4: Take the MCAT
* All the courses listed above are only to prepare you for your worst nightmare - the Medical College Admission Test, or for those of us who know it well - the MCAT.
* As has been stated oh so eloquenly elsewhere, the MCAT does not test anything in the least bit relevant to medicine. Basically, it is a barrier exam to keep those not-at-all capable out of medical school. Most schools use 24 as their lower limit, but it varies widely from school to school.
* In a word, the MCAT is horrible. I've seen nothing worse - until the COMLEX, that is. The MCAT is an 8 hour exam that you usually have to take in a town about 80 miles away from your own on one of your 2 days off during the week, so you waste the other day driving the 80 miles so you can be there at 0700 to register without having to get up and be in the car by 0500. Yeah, what a pain. All this just to see whether you should even bother to apply this season.
Step 5: Apply
* So, provided you've done everything in the first 4 steps and have completed all the requirements for your pre-medical committee, you're ready to apply to medical school. This has recently been made quite easy by the incorporation of all the applications into a centralized program - AAMCAS (for Allopathic schools), AACOMAS (for Osteopathic schools), or TMDSAS (for Texas Schools) - ok, well only pseudo-centralized.
* What they will want is all your information regarding your undergraduate education, extracurricular activities, organizations to which you belong, leadership positions you have held, and any volunteer/publications/etc... You'll fill out endless forms and write endless essays, but in the end, it's all worth it.
* Hopefully, you have an idea of where you would like to apply.
stay tuned.. next time we'll talk about interviews and acceptance.... or not. ¶ 8:55 PM 0 comments
I remember when I was a premed - all 8 miserable years of it - all I wanted was information. I never could seem to get enough of it. I read as much as I could about medicine, medical school, medical students. Believe me, publishers bank on that and make a lot of money because of it. I bought several books about medicine - "First, Do No Harm," "The House of God," "Mount Misery" to name a few.. all of them very good books, by the way. Another good one is, "Kill as few patients as possible." It's hilarious. Written by an internist of a certain background that I am not allowed to mention. You might be able to figure it out (inside joke).
Anyway, back on track here.
As I was saying, back then, all I wanted was information. That is still true, actually. I'm always asking "what's next?" So I thought I'd lay out a little timeline for you and try to explain some of the things that happen along the way. If I leave anything out, or you have more questions, please feel free to mail me any questions you may have.
Step 1: Go to college
* All medical schools require at least SOME college credit. Gone are the days when you could just follow a doctor around for a few years, ask some questions and strike out on your own. There is actually an educational process involved now (supposedly). The requirement is at LEAST 90 hours, most prefer a degree of some sort. Ivy league-type schools require a bachelors, most others you can get away with less, so long as you've taken the required courses and present a good package. The particular college doesn't matter. Go to your state college if you'd like and save yourself some money.
* Speaking of required courses, what are they? Biology - 8 hours* Chemistry - 8 hours* Physics - 8 hours* Organic Chemistry - 8 hours* English - 6 hours Calculus/Statistics - 3 hours (* = lab required)
* As you can see, there isn't really that much actually required for medical school - some 41 hours. Nothing you couldn't comfortably finish in a year and a summer session if you put your mind to it. The problem comes when you start looking at getting a degree.. that is more of a time investment. Most schools no longer have a "Premed" major. Now you must major in something else, like business, philosophy, engineering, biology, music, or theatre - you name it, and there has been someone with that degree go to medical school . They even let lawyers into medical school - the really sado-masochistic ones.
Step 2: Talk to your Pre-medical advisor
* Hopefully you've chosen an undergraduate institution that has a pre-medical advisory committee. If not, choose again. Just kidding, you can do it without a committee. That's the way they did it before there were committees. Everything was probably much easier back then too - no bureaucratic red tape that always comes with committees. Yuck. red tape. So much less tasteful than blue or green tape. Anyways, somewhere near the beginning of your undergraduate career, you need to speak with someone on this committee. If you don't have one, talk with your major advisor about who usually performs this duty at your institution.
* What to talk about: At first, you just want to introduce yourself and find out what is available. Some schools have very established programs with meetings and informative sessions. They will bring in speakers from different schools to talk about admissions, medical school life, etc. Some schools will have next to nothing besides a person sitting in a office playing the voice of authority - much like the Wizard of Oz: You never see him/her, but you know he/she is there...
* As your undergraduate career advances, you will need to stay in close contact with the above-mentioned person. Talk with him/her frequently about how your classes are going, what you're experiencing, ask any new questions you may have. At the end of every year or so, sit down for a formal session and talk seriously about how you've done and what you need to do to be a competitive applicant. This is a pain in the butt, but very worthwhile. The better you know your pre-med advisor, the better off you are in the long-run. Why? 1)They are your school's authority on medical school admissions. Presumptively, this person is keeping up with all the latest trends in the field. 2)This person will likely be contributing to a letter that will be sent to all the schools to which you apply. Wouldn't you rather have a friend writing about you than some schmoe you just met last week? Yeah, I thought so.
Step 3: Volunteer
* Please, oh please, oh please, oh please do something besides take classes and go to frat parties. Medicine is a very serious undertaking. You need to know what you are getting yourself into - the educational process alone will take at LEAST 7 years after you graduate from college. Of course, the educational process never really ends, but that's another topic altogether.
* Talk to your doctor - can you shadow him/her?
* Go to the ER and talk to the physicians there - can you shadow one or more of them? Maybe you could get a job as a tech
* Take an EMT course - that is great experience and will open some doors to you as far as employment opportunities...
* Have you met any other physicians while doing any of the above? Can you talk with them or perhaps shadow them as well?
* If you don't get the point I'm trying to make here, you need to have some sort of idea of what medicine is before you ever dream of applying. You may shadow a half dozen physicians and decide it's not for you at all.. and right there you've saved yourself about $120,000 (at least). What a bargain for a couple saturdays a month, huh?
Step 4: Take the MCAT
* All the courses listed above are only to prepare you for your worst nightmare - the Medical College Admission Test, or for those of us who know it well - the MCAT.
* As has been stated oh so eloquenly elsewhere, the MCAT does not test anything in the least bit relevant to medicine. Basically, it is a barrier exam to keep those not-at-all capable out of medical school. Most schools use 24 as their lower limit, but it varies widely from school to school.
* In a word, the MCAT is horrible. I've seen nothing worse - until the COMLEX, that is. The MCAT is an 8 hour exam that you usually have to take in a town about 80 miles away from your own on one of your 2 days off during the week, so you waste the other day driving the 80 miles so you can be there at 0700 to register without having to get up and be in the car by 0500. Yeah, what a pain. All this just to see whether you should even bother to apply this season.
Step 5: Apply
* So, provided you've done everything in the first 4 steps and have completed all the requirements for your pre-medical committee, you're ready to apply to medical school. This has recently been made quite easy by the incorporation of all the applications into a centralized program - AAMCAS (for Allopathic schools), AACOMAS (for Osteopathic schools), or TMDSAS (for Texas Schools) - ok, well only pseudo-centralized.
* What they will want is all your information regarding your undergraduate education, extracurricular activities, organizations to which you belong, leadership positions you have held, and any volunteer/publications/etc... You'll fill out endless forms and write endless essays, but in the end, it's all worth it.
* Hopefully, you have an idea of where you would like to apply.
stay tuned.. next time we'll talk about interviews and acceptance.... or not. ¶ 8:55 PM 0 comments
Monday, August 09, 2004
If you're in the Class of 2006...
If you fall into the above group, or will be graduating with the above group (MD/PhD, DO/PhD, MD/MPH, DO/MPH, etc), please move on to another post. I don't want any added competition. Just kidding.
This post is about Emergency Medicine (EM). Yes, that's how you say it. It isn't the Emergency Room - it's the Emergency Department. It's not an ER doctor, it is an EM Physician. Would you call a surgeon an operating room doctor? Or a radiologist an x-ray room doctor? I didn't think so. The phraseology is very important here.
That said - I am interested in Emergency Medicine. If you go to my school, you would probably know this. If not, and I have met you at any of the several conferences I have gone to, you probably know this.
With my background being in Emergency Nursing, I've known for awhile that I am interested in EM. I'm almost 100% positive that I will be applying for an EM residency. So, now I have the daunting task of deciding which programs I might be interested in. The important factors for me include (but are not limited to) - in no particular order:
1. Is the ED an independent department, or a division of Surgery or Medicine? Independent is, of course, more desired.
2. Is it a 1-3, 1-4, or 2-4 program? Allopathic vs Osteopathic (yes, I have to decide this too...)?
3. How established is the program? I would rather go to a program that is established within the hospital and within the EM community.
4. What have graduates done after leaving the program? What fellowships are available in the area (I don't want to have to move around alot to get my training)?
5. How is the educational system within the program set up? What is the balance of clinical to didactic time?
6. Who are the clinical faculty? Are they known and active in the community?
7. What is the off-service rotation schedule like? I think that EM physicians are best trained in the ED; so I would like a program where the vast majority of the rotations are in the ED, or other critical care area.
8. What is the average amount of pathology seen in the department. What is the yearly census? What is the acuity (% of total that are admitted to floor/ICU)?
9. Will I be happy there?
10. Where is the program located? Large, tertiary hospital vs community hospital. I'll take large any day, if only for volume/acuity sake.
So, I've been looking around - and so far, I like Drexel's program. I think they have most of the above criteria. I've exchanged emails with Ms. Delgado there, and she said they have a new DO intern, so I know that matching there is a possibility. I've also emailed a 2nd year resident there, named Scrubbs (from SDN forums) and she said Drexel ROCKS! So, Drexel is #1 right now. If you're not a member of the class of 2006, I'd invite you to check out their web site - you might want to check out their program! Now, if only I could get a 4th year rotation set up there...:)
Other places I've looked at pretty seriously include Charity Hospital in N'awlins (web site down), Cook County in Chicago (new, cool web site), Scott & White in Temple, Tx (I've met a few of these guys - they are really cool and would be good to train with), and a few others that I don't feel like digging up their web sites right now. I'll talk more on that later.
For now, I'd like to tell you why EM -
When I first graduated from nursing school, I got a job on a med/surg floor. After about a year there, I couldn't stand it any longer. I was tired of picking up everyone else's slack because they didn't want to do something on their shift. [Now that I'm seeing things from the medical side - I realize that medicine isn't as bad as I thought it would be. I actually find it quite thought-provoking and really interesting. Of course, I've heard that EM docs LOVE every rotation they go through in med school...] I knew I had to get out.
So, after applying a few times, I got a job in an ED at a very small hospital (about 8 beds in the ED). I absolutely LOVED IT! I enjoyed the face time with the EM Docs (very nice for a premed), I loved the team spirit, even the frequent flyer patient's weren't so bad! I knew I'd found my calling. I started asking questions - what's it like being an EM doc, how long do you have to go to school, etc. Just trying to educate myself about this field. Pretty much everything I heard I liked. I remember one of the first docs I worked with, Dr. S.K. told me about why he went into EM: He lifted up his shirt and said, "See this, no beeper!" and then he walked out of the department on his way home. That is a powerful statement, and one I will never forget. What a testimony to the lifestyle an EM physician lives.
Of course, that's not the whole story... Everyone who has read for 2 minutes about EM realizes that it's not REALLY like all the TV shows depict it to be. Roughly 60-80% (or more) of the ED visits in a day are not trauma-related. They are medical cases: CHF, chest pain (from various causes), kids with fever, kids with rashes, adults with rashes, etc. You get the picture. The fun comes when you actually get to have that multiple trauma victim that jumped in front of a train (or a moving vehicle). It's the knowledge that something good could come in that keeps you going.
EM physicians are adrenaline junkies. They are looking for something fun to do. They work hard, but they play the entire time, and then they go home (without a pager or call) to play some more - hard.
There are downsides to all the fun and glory.
* Respect: a lot of other fields do not respect EM physicians. They call them "glorified triage nurses" and other such things. Believe me, I've heard it. Surgeons hate EM docs, Internists hate EM docs (because we admit patients to them at 0330 and call them before-hand to tell them about it).
* No follow-up. A major complaint I've heard from prospective EM physicians-to-be is that you never know what happens to your patient after they leave the department. My answer - someone else takes care of them. If you really want to know - while you have that doc on the phone at 3am to admit another patient to their service, ask, "hey, whatever happened to so-and-so?" They'll love you for it!!! :)
* The so-called "FISHBOWL" effect. They say that hind-sight is 20/20. This is especially true in Emergency Medicine. What a lot of clinicians do not understand is that an emergency physician is working under a time crunch with very limited information. They do not have time to sit down and talk with the patient for an hour to ask how they feel about the MI they are having. They have to do something about it right away, so maybe the patient will be alive so the internist and cardiologist can ask those questions tomorrow. The fishbowl effect comes in when, under the time crunch and limited information circumstances they must operate under, they miss something or forget to do something. Then, when the patient is admitted and the admitting physician comes in the next day, they find the missing test or diagnosis and then proceed to call down to the ED and gripe about how the EM doc should have caught this - even a 1st year medical student would know this, blah, blah, blah... Like I said, hind-sight is 20/20 (or maybe better when you have a full history and physical). It's the way we work - we don't know everything. We can't. Get over it. We do our best with what we have.
* Rotating schedules. Yes, EM physicians work shifts. They are 8 hours some places, 12 hours others. The rule is, however, that your schedule will change. There is no "Day shift" or "Night shift." Everyone gets to rotate to share all the wonderful night shifts. Too bad. I really like nights. The people that work nights are just more fun - I think it has something to do with lack of vitamin synthesis from the sun or something. Or maybe it's just sleep deprivation. Who knows. Now-a-days, places are making the schedules more "circadian rhythm friendly," so maybe this won't be such an issue anymore.
That's all the down-sides I can muster right now. I'm sure there are others - feel free to comment below to remind me. Heck, you might know some that I don't and make me re-think my position...:) Doubtful.
Yeah, so that's a "short" synopsis of the who, what, where, when, why, and how of EM and why I want to train in EM and a somewhat thought-out list of a few of the places I've researched so far. If you know of anymore really good ones (or for 4th year rotations) let me know. Time is running out. But I'm tired now and have to go to bed - I'm sure I'll ramble more about this later...
I just didn't want this entire site to be about family practice. I want my EM physicians to feel some love too! Just trying to throw some your way, guys and gals!!
good night, and more to come.... ¶ 9:04 PM 0 comments
This post is about Emergency Medicine (EM). Yes, that's how you say it. It isn't the Emergency Room - it's the Emergency Department. It's not an ER doctor, it is an EM Physician. Would you call a surgeon an operating room doctor? Or a radiologist an x-ray room doctor? I didn't think so. The phraseology is very important here.
That said - I am interested in Emergency Medicine. If you go to my school, you would probably know this. If not, and I have met you at any of the several conferences I have gone to, you probably know this.
With my background being in Emergency Nursing, I've known for awhile that I am interested in EM. I'm almost 100% positive that I will be applying for an EM residency. So, now I have the daunting task of deciding which programs I might be interested in. The important factors for me include (but are not limited to) - in no particular order:
1. Is the ED an independent department, or a division of Surgery or Medicine? Independent is, of course, more desired.
2. Is it a 1-3, 1-4, or 2-4 program? Allopathic vs Osteopathic (yes, I have to decide this too...)?
3. How established is the program? I would rather go to a program that is established within the hospital and within the EM community.
4. What have graduates done after leaving the program? What fellowships are available in the area (I don't want to have to move around alot to get my training)?
5. How is the educational system within the program set up? What is the balance of clinical to didactic time?
6. Who are the clinical faculty? Are they known and active in the community?
7. What is the off-service rotation schedule like? I think that EM physicians are best trained in the ED; so I would like a program where the vast majority of the rotations are in the ED, or other critical care area.
8. What is the average amount of pathology seen in the department. What is the yearly census? What is the acuity (% of total that are admitted to floor/ICU)?
9. Will I be happy there?
10. Where is the program located? Large, tertiary hospital vs community hospital. I'll take large any day, if only for volume/acuity sake.
So, I've been looking around - and so far, I like Drexel's program. I think they have most of the above criteria. I've exchanged emails with Ms. Delgado there, and she said they have a new DO intern, so I know that matching there is a possibility. I've also emailed a 2nd year resident there, named Scrubbs (from SDN forums) and she said Drexel ROCKS! So, Drexel is #1 right now. If you're not a member of the class of 2006, I'd invite you to check out their web site - you might want to check out their program! Now, if only I could get a 4th year rotation set up there...:)
Other places I've looked at pretty seriously include Charity Hospital in N'awlins (web site down), Cook County in Chicago (new, cool web site), Scott & White in Temple, Tx (I've met a few of these guys - they are really cool and would be good to train with), and a few others that I don't feel like digging up their web sites right now. I'll talk more on that later.
For now, I'd like to tell you why EM -
When I first graduated from nursing school, I got a job on a med/surg floor. After about a year there, I couldn't stand it any longer. I was tired of picking up everyone else's slack because they didn't want to do something on their shift. [Now that I'm seeing things from the medical side - I realize that medicine isn't as bad as I thought it would be. I actually find it quite thought-provoking and really interesting. Of course, I've heard that EM docs LOVE every rotation they go through in med school...] I knew I had to get out.
So, after applying a few times, I got a job in an ED at a very small hospital (about 8 beds in the ED). I absolutely LOVED IT! I enjoyed the face time with the EM Docs (very nice for a premed), I loved the team spirit, even the frequent flyer patient's weren't so bad! I knew I'd found my calling. I started asking questions - what's it like being an EM doc, how long do you have to go to school, etc. Just trying to educate myself about this field. Pretty much everything I heard I liked. I remember one of the first docs I worked with, Dr. S.K. told me about why he went into EM: He lifted up his shirt and said, "See this, no beeper!" and then he walked out of the department on his way home. That is a powerful statement, and one I will never forget. What a testimony to the lifestyle an EM physician lives.
Of course, that's not the whole story... Everyone who has read for 2 minutes about EM realizes that it's not REALLY like all the TV shows depict it to be. Roughly 60-80% (or more) of the ED visits in a day are not trauma-related. They are medical cases: CHF, chest pain (from various causes), kids with fever, kids with rashes, adults with rashes, etc. You get the picture. The fun comes when you actually get to have that multiple trauma victim that jumped in front of a train (or a moving vehicle). It's the knowledge that something good could come in that keeps you going.
EM physicians are adrenaline junkies. They are looking for something fun to do. They work hard, but they play the entire time, and then they go home (without a pager or call) to play some more - hard.
There are downsides to all the fun and glory.
* Respect: a lot of other fields do not respect EM physicians. They call them "glorified triage nurses" and other such things. Believe me, I've heard it. Surgeons hate EM docs, Internists hate EM docs (because we admit patients to them at 0330 and call them before-hand to tell them about it).
* No follow-up. A major complaint I've heard from prospective EM physicians-to-be is that you never know what happens to your patient after they leave the department. My answer - someone else takes care of them. If you really want to know - while you have that doc on the phone at 3am to admit another patient to their service, ask, "hey, whatever happened to so-and-so?" They'll love you for it!!! :)
* The so-called "FISHBOWL" effect. They say that hind-sight is 20/20. This is especially true in Emergency Medicine. What a lot of clinicians do not understand is that an emergency physician is working under a time crunch with very limited information. They do not have time to sit down and talk with the patient for an hour to ask how they feel about the MI they are having. They have to do something about it right away, so maybe the patient will be alive so the internist and cardiologist can ask those questions tomorrow. The fishbowl effect comes in when, under the time crunch and limited information circumstances they must operate under, they miss something or forget to do something. Then, when the patient is admitted and the admitting physician comes in the next day, they find the missing test or diagnosis and then proceed to call down to the ED and gripe about how the EM doc should have caught this - even a 1st year medical student would know this, blah, blah, blah... Like I said, hind-sight is 20/20 (or maybe better when you have a full history and physical). It's the way we work - we don't know everything. We can't. Get over it. We do our best with what we have.
* Rotating schedules. Yes, EM physicians work shifts. They are 8 hours some places, 12 hours others. The rule is, however, that your schedule will change. There is no "Day shift" or "Night shift." Everyone gets to rotate to share all the wonderful night shifts. Too bad. I really like nights. The people that work nights are just more fun - I think it has something to do with lack of vitamin synthesis from the sun or something. Or maybe it's just sleep deprivation. Who knows. Now-a-days, places are making the schedules more "circadian rhythm friendly," so maybe this won't be such an issue anymore.
That's all the down-sides I can muster right now. I'm sure there are others - feel free to comment below to remind me. Heck, you might know some that I don't and make me re-think my position...:) Doubtful.
Yeah, so that's a "short" synopsis of the who, what, where, when, why, and how of EM and why I want to train in EM and a somewhat thought-out list of a few of the places I've researched so far. If you know of anymore really good ones (or for 4th year rotations) let me know. Time is running out. But I'm tired now and have to go to bed - I'm sure I'll ramble more about this later...
I just didn't want this entire site to be about family practice. I want my EM physicians to feel some love too! Just trying to throw some your way, guys and gals!!
good night, and more to come.... ¶ 9:04 PM 0 comments
Saturday, August 07, 2004
The "Doctor" Attitude
You know what I'm talking about - the expectation of respect from everyone you meet because you are a "doctor." The "I'm better than you" looks down their noses at everyone else in the hospital. The patronizing voice they use when you tell them there is a problem with their patient - the 'Doctor' attitude.
This is something I have made it my goal to dispel.
I was always taught that respect is earned, not given - and respecting someone for the fact that they went to school is just that, giving it to them.
I don't know how many doctors I used to want to smack right in the side of the head ("box their ears," if you're from the south) after encounters with them. They (some, not all) seem to expect everyone around them to wallow at their feet and kiss their rings or something if they are kind enough to come down off their thrones and speak with you. I HATE that. I'm tired of people being put on a pedestal because they went to school. Big whoop.. so did the manager at McDonalds (probably), doesn't make him better than any of his customers, why should a doctor be considered any better than any of his customers?
I am a person. I was a person before I went to school, I will be a person after I leave school. Nothing has changed except for the amount of debt I have collected and a couple letters after my name.
I still have to earn respect. It should not be given. It should not be given (repeated on purpose - I'm not schizophrenic).
That is why I have every intention of having my patients call me by my first name. Aside from the fact that they may not be able to say my last name, it makes it easier on me because that is what I am used to being called. It also reminds the patient and myself that we are equals.
I really don't much care for people that demand they be called "doctor x," because that is putting yourself above other people. If you are so unsure of yourself, don't go to medical school - that's not the place to try to raise your ego. You were given your name for a reason, use it. Be close to the patient, touch them, sit down next to them. They'll open up to you and it'll help build rapport. That's what medicine is all about - connecting with your patients and helping them to attain a better state of health. Not being adored by them because you went to medical school.
Besides, when did it become customary to call someone by their job? "Hey there, Cashier O'Donovan, how are you today?" "Pretty good, Customer DeLaughter. How about yourself?" How ridiculous. I think people that want to become a physician for the title should be caned.
Just my 0.02. Actual cash value: 0.00000000000001.
more to come.... ¶ 2:55 PM 0 comments
This is something I have made it my goal to dispel.
I was always taught that respect is earned, not given - and respecting someone for the fact that they went to school is just that, giving it to them.
I don't know how many doctors I used to want to smack right in the side of the head ("box their ears," if you're from the south) after encounters with them. They (some, not all) seem to expect everyone around them to wallow at their feet and kiss their rings or something if they are kind enough to come down off their thrones and speak with you. I HATE that. I'm tired of people being put on a pedestal because they went to school. Big whoop.. so did the manager at McDonalds (probably), doesn't make him better than any of his customers, why should a doctor be considered any better than any of his customers?
I am a person. I was a person before I went to school, I will be a person after I leave school. Nothing has changed except for the amount of debt I have collected and a couple letters after my name.
I still have to earn respect. It should not be given. It should not be given (repeated on purpose - I'm not schizophrenic).
That is why I have every intention of having my patients call me by my first name. Aside from the fact that they may not be able to say my last name, it makes it easier on me because that is what I am used to being called. It also reminds the patient and myself that we are equals.
I really don't much care for people that demand they be called "doctor x," because that is putting yourself above other people. If you are so unsure of yourself, don't go to medical school - that's not the place to try to raise your ego. You were given your name for a reason, use it. Be close to the patient, touch them, sit down next to them. They'll open up to you and it'll help build rapport. That's what medicine is all about - connecting with your patients and helping them to attain a better state of health. Not being adored by them because you went to medical school.
Besides, when did it become customary to call someone by their job? "Hey there, Cashier O'Donovan, how are you today?" "Pretty good, Customer DeLaughter. How about yourself?" How ridiculous. I think people that want to become a physician for the title should be caned.
Just my 0.02. Actual cash value: 0.00000000000001.
more to come.... ¶ 2:55 PM 0 comments
FUD
If you're at all familiar with computers and the Microsoft Anti-trust trial a few years back, the above line will no doubt rekindle fond and familiar memories.
It was said that during the years preceding the trial, and even more during the trial, Micro$oft had used FUD (fear, uncertainty, and doubt) to take over smaller companies, crowd those they couldn't take over out of the market, force users to utilize their products and gain an illegal edge in the marketplace, and hide it all from investigators.
* Fear because MicroShaft is a HUGE multizillion dollar company that (like it or not) has taken the majority of the marketplace - so if you don't do as they say (if you're a smaller business), they'll just buy you out or crush you in their wake. Also, there was the "fear factor" they laid forth saying that "if Internet Explorer isn't a central part of our operating system, the whole thing will crash." Like it doesn't on a daily basis anyway.
* Uncertainty was brought into the picture by never knowing what software would be compatible (Word 95 with WinXP, for example is no longer supported), never knowing whether your word document would be compatible with the latest Office Suite or wondering if you would be able to afford the software you needed.
* Doubt. Well, this was the most powerful tool of all. Ever heard of "Reasonable Doubt?" "We really didn't TRY to force xyz company out of the marketplace, that is just the way business works." Right, never mind the leaked internal memos from the committees devoted to studying these companies and destroying them - but they didn't try.
Why am I dredging up a years-old story? Because it is happening again. I opened up my web browser and my home page pops up with the top news story being: "Bush Warns Americans They Are 'Still Not Safe'"
Of course, when you read the article it is basically GW using the "war on t{rror" to try to get re-elected. He (and his co-conspirator, Cheney) tell the american people how the recent t{rror alert in NY, NJ, and DC proves that they need another term to 'make the world safe for democracy' (never mind the most recent alert was based on intelligence from 3 years ago). I have some questions - why is the world not safe for democracy? Oh yeah, because we try to shove it down everyone else's throat. Is it any surprise that people hate America? Why, when GW/Cheney have not been able to do anything about it in the past 3 years, would we want to give them another 4? So GW can institute his joke-of-a-plan for education? (Yeah, right) And why are we using intelligence 3 years old? If you quote a 3 year old medical study, you'll get laughed at (frequently) - that is ancient!
OK, count to 10... 1....2....3....4...5...6...7....8....9...10.... I feel better.
If you can't tell, I'm not really fond of our current president. I wasn't fond of him before he was president, and I'm not fond of his brother in Florida. I think they make really terrible leaders, they enact TERRIBLE policy (remember the brain-dead lady in Florida?), and they should be kept as far away from politics as possible.
Fear, uncertainty, doubt - fear of t{rrorism, uncertainty about our future, doubt that GW will be able to do anything about it.
FUD. I'm voting for mickey mouse this election.
more to come... ¶ 2:37 PM 0 comments
It was said that during the years preceding the trial, and even more during the trial, Micro$oft had used FUD (fear, uncertainty, and doubt) to take over smaller companies, crowd those they couldn't take over out of the market, force users to utilize their products and gain an illegal edge in the marketplace, and hide it all from investigators.
* Fear because MicroShaft is a HUGE multizillion dollar company that (like it or not) has taken the majority of the marketplace - so if you don't do as they say (if you're a smaller business), they'll just buy you out or crush you in their wake. Also, there was the "fear factor" they laid forth saying that "if Internet Explorer isn't a central part of our operating system, the whole thing will crash." Like it doesn't on a daily basis anyway.
* Uncertainty was brought into the picture by never knowing what software would be compatible (Word 95 with WinXP, for example is no longer supported), never knowing whether your word document would be compatible with the latest Office Suite or wondering if you would be able to afford the software you needed.
* Doubt. Well, this was the most powerful tool of all. Ever heard of "Reasonable Doubt?" "We really didn't TRY to force xyz company out of the marketplace, that is just the way business works." Right, never mind the leaked internal memos from the committees devoted to studying these companies and destroying them - but they didn't try.
Why am I dredging up a years-old story? Because it is happening again. I opened up my web browser and my home page pops up with the top news story being: "Bush Warns Americans They Are 'Still Not Safe'"
Of course, when you read the article it is basically GW using the "war on t{rror" to try to get re-elected. He (and his co-conspirator, Cheney) tell the american people how the recent t{rror alert in NY, NJ, and DC proves that they need another term to 'make the world safe for democracy' (never mind the most recent alert was based on intelligence from 3 years ago). I have some questions - why is the world not safe for democracy? Oh yeah, because we try to shove it down everyone else's throat. Is it any surprise that people hate America? Why, when GW/Cheney have not been able to do anything about it in the past 3 years, would we want to give them another 4? So GW can institute his joke-of-a-plan for education? (Yeah, right) And why are we using intelligence 3 years old? If you quote a 3 year old medical study, you'll get laughed at (frequently) - that is ancient!
OK, count to 10... 1....2....3....4...5...6...7....8....9...10.... I feel better.
If you can't tell, I'm not really fond of our current president. I wasn't fond of him before he was president, and I'm not fond of his brother in Florida. I think they make really terrible leaders, they enact TERRIBLE policy (remember the brain-dead lady in Florida?), and they should be kept as far away from politics as possible.
Fear, uncertainty, doubt - fear of t{rrorism, uncertainty about our future, doubt that GW will be able to do anything about it.
FUD. I'm voting for mickey mouse this election.
more to come... ¶ 2:37 PM 0 comments
Tuesday, August 03, 2004
Socratic Method
One of the things I enjoy most about Dr. C. is that he teaches via the Socratic method. If you don't know what that means, look it up. Just kidding.
The socratic method was developed in ancient greece by (guess who????) Socrates. Hah, I almost said egypt. Remember back to ancient history? Socrates taught aristotle taught alexander the great who killed a whole bunch of people in the name of - alexander the great.
Anyway, Socrates (pronounced So-crates if you're Bill and Ted) had this really bad habit of teaching by stopping a person on the street and asking a lot of questions. This got a lot of people to think - something we humans don't usually do on our own. For a long time, people were happy about it, he was popular, and life was good. For some reason, after many years, people turned on him and he was put to death for "heresy."
The truly interesting thing about socratic theory and the socratic teaching method is that you really learn alot because you tend to remember things when they are posed to you as questions, especially if you get them wrong. You never forget something you got wrong, right?
Anyway, Dr. C. likes to ask a lot of questions about different conditions - usually pertaining to the case at hand. If it's MI, he'll ask the top causes of MI (atherosclerosis, vasospasm, arteritis secondary to collagen vascular disease, trauma, inflammatory conditions, etc) or 5 complications after you have an MI (CHF, arrhythmia, pericarditis, papillary muscle dysfunction/rupture, extension of the MI). He also teaches alot about the cases, like what are the 5 F's of abdominal distention (flatulence, feces, fluid, fetus, and fatal tumor). He makes it fun, and you also get to learn alot.
He says he has been teaching for about 30 years and that he really enjoys it. It really shows in how he interacts with the students AND his patients. I don't know how many times in a day I've heard a patient say what a great doctor and teacher he is.
I'll second that.
more to come... ¶ 9:59 PM 0 comments
The socratic method was developed in ancient greece by (guess who????) Socrates. Hah, I almost said egypt. Remember back to ancient history? Socrates taught aristotle taught alexander the great who killed a whole bunch of people in the name of - alexander the great.
Anyway, Socrates (pronounced So-crates if you're Bill and Ted) had this really bad habit of teaching by stopping a person on the street and asking a lot of questions. This got a lot of people to think - something we humans don't usually do on our own. For a long time, people were happy about it, he was popular, and life was good. For some reason, after many years, people turned on him and he was put to death for "heresy."
The truly interesting thing about socratic theory and the socratic teaching method is that you really learn alot because you tend to remember things when they are posed to you as questions, especially if you get them wrong. You never forget something you got wrong, right?
Anyway, Dr. C. likes to ask a lot of questions about different conditions - usually pertaining to the case at hand. If it's MI, he'll ask the top causes of MI (atherosclerosis, vasospasm, arteritis secondary to collagen vascular disease, trauma, inflammatory conditions, etc) or 5 complications after you have an MI (CHF, arrhythmia, pericarditis, papillary muscle dysfunction/rupture, extension of the MI). He also teaches alot about the cases, like what are the 5 F's of abdominal distention (flatulence, feces, fluid, fetus, and fatal tumor). He makes it fun, and you also get to learn alot.
He says he has been teaching for about 30 years and that he really enjoys it. It really shows in how he interacts with the students AND his patients. I don't know how many times in a day I've heard a patient say what a great doctor and teacher he is.
I'll second that.
more to come... ¶ 9:59 PM 0 comments
Monday, August 02, 2004
A New Hospital, another Medicine Month
This post is about my first day on a new Internal Medicine rotation at a new hospital with a new attending.
The new month is August 2004.
The new hospital is lovingly referred to as the "O."
The new attending is Dr. P.C. (Names abbreviated for my protection...)
First, a little background. About 10 days ago, I received an email from the department of Internal Medicine about my second month IM rotation, reminding me that I would be rotating at the O and my attending would be Dr. C. and various and sundry other small niceties - like I would be required to attend rounds every morning at 0730, etc, etc.
As I was winding down from my last month of IM at JPS, I just tucked this information to the side and said I'd look at it later... much later if I had anything to do with it. But finally the day arrived, TODAY!!
So, this morning at 0600, I drag myself out of bed and put on my monkey suit (my words for dress slacks, shirt and tie) and bemoan the happy times at JPS when all would wear scrubs all day, every day. If you can't tell, I don't like monkey suits.
At 0700, I walk up to the hospital and ask a very nice lady how to get to the Jennings Pavilion. She gives me directions with a very nice smile. She was very nice.
I walk to the conference room in the Jennings pavilion and there wait for everyone else to arrive. Apparently, there was a bit of confusion about where morning rounds were supposed to be, since I received notification almost 2 weeks ago, apparently not everyone else did. Who am I to assume anything?
Finally, morning rounds begin. Not too exciting. I'm really not too sure what actually happened. An intern gave a presentation on a patient and then a bunch of people mumbled some stuff out and we moved on. I'm still kind of iffy on that one.
After morning rounds were over (consisted of 1 presentation - is that all that was admitted?), my group of students paged Dr. C. We met him in the cafeteria.
When he first walked in, I didn't know what to expect, but this was not it. He is very short, walks hunched over, but very jovial. He is skinny - he is always having to pull up his pants because they are too big for him. I've heard he spends all his time up at the hospital - this wouldn't surprise me. I think he is 55 or 56 years old.
He likes to talk. About everything. Not that this is necessarily bad, it just slows things down - alot. He spent 10 minutes talking about whether a patient thought Maury Povich or Jerry Springer is better today. Then he proceeded to ask each student's opinion. I wanted to say whichever one lets us drop this subject faster. Of course, he does a lot of bedside teaching as well - which will be nice for our shelf exams at the end of the month. Moderation is the key - and don't talk about the patient as if they are not lying 18 inches from you... not cool at all.
Overall, I get a good impression of him, though. He seems to care a lot for his patients, which is important, and I think he really knows his stuff - which is also very important. I just hope I don't go insane with him talking about daytime television shows for time on end each day.
I think I can learn alot, it'll just be self-motivated like everything else. ¶ 9:59 PM 0 comments
The new month is August 2004.
The new hospital is lovingly referred to as the "O."
The new attending is Dr. P.C. (Names abbreviated for my protection...)
First, a little background. About 10 days ago, I received an email from the department of Internal Medicine about my second month IM rotation, reminding me that I would be rotating at the O and my attending would be Dr. C. and various and sundry other small niceties - like I would be required to attend rounds every morning at 0730, etc, etc.
As I was winding down from my last month of IM at JPS, I just tucked this information to the side and said I'd look at it later... much later if I had anything to do with it. But finally the day arrived, TODAY!!
So, this morning at 0600, I drag myself out of bed and put on my monkey suit (my words for dress slacks, shirt and tie) and bemoan the happy times at JPS when all would wear scrubs all day, every day. If you can't tell, I don't like monkey suits.
At 0700, I walk up to the hospital and ask a very nice lady how to get to the Jennings Pavilion. She gives me directions with a very nice smile. She was very nice.
I walk to the conference room in the Jennings pavilion and there wait for everyone else to arrive. Apparently, there was a bit of confusion about where morning rounds were supposed to be, since I received notification almost 2 weeks ago, apparently not everyone else did. Who am I to assume anything?
Finally, morning rounds begin. Not too exciting. I'm really not too sure what actually happened. An intern gave a presentation on a patient and then a bunch of people mumbled some stuff out and we moved on. I'm still kind of iffy on that one.
After morning rounds were over (consisted of 1 presentation - is that all that was admitted?), my group of students paged Dr. C. We met him in the cafeteria.
When he first walked in, I didn't know what to expect, but this was not it. He is very short, walks hunched over, but very jovial. He is skinny - he is always having to pull up his pants because they are too big for him. I've heard he spends all his time up at the hospital - this wouldn't surprise me. I think he is 55 or 56 years old.
He likes to talk. About everything. Not that this is necessarily bad, it just slows things down - alot. He spent 10 minutes talking about whether a patient thought Maury Povich or Jerry Springer is better today. Then he proceeded to ask each student's opinion. I wanted to say whichever one lets us drop this subject faster. Of course, he does a lot of bedside teaching as well - which will be nice for our shelf exams at the end of the month. Moderation is the key - and don't talk about the patient as if they are not lying 18 inches from you... not cool at all.
Overall, I get a good impression of him, though. He seems to care a lot for his patients, which is important, and I think he really knows his stuff - which is also very important. I just hope I don't go insane with him talking about daytime television shows for time on end each day.
I think I can learn alot, it'll just be self-motivated like everything else. ¶ 9:59 PM 0 comments
