Comedic Relief – Funniest College Prank Ever

My college roommates in our apartment in 2005/2006. Pot-luck roommates and ended up living together until we graduated. Love these girls.

One night my sophomore year of college I came home from a long shift at Buffalo Wild Wings to find my room had been toilet papered by my friends and roommates. I remember being mad for some ridiculous reason (maybe because I paid for the toilet paper??), but looking back it was quite hilarious. However, nothing quite approaches the level of hilariousness presented in this video.

A group of BYU students has taken the cake with a recent Easter prank they pulled on their neighbors…you must watch this:

Original Story Here – Via KSL.com

Medical School in Indonesia

Today I’m excited to introduce to you Anna, a 22 year old medical student from Bogor, West Java province in India. She is in her last year of clinical clerkships at Universitas Pelita Harapan medical school, a bilingual (Indonesian and English) open to both local and foreign students.

Currently, Anna is undecided on a specialty, but is interested in both Neurology and Emergency Medicine. She has five more rotations before she finishes, so it will be interesting to see what she decides on! She blogs at Surreal Hours and you can catch her on Twitter @a_elissa.

She contacted me a few weeks ago asking if I was still open to having more posts in the Medical Education Monday series. I’m so thrilled that y’all find medical education in various countries as interesting as I do…it’s certainly been great to hear about all the different systems.

If you are (or someone you know is) a medical student or physician in a country not yet covered, please have them contact me! Here’s what Anna had to say about Medical School in Indonesia:

Getting In:

How old is one when they begin medical school?

We begin medical school directly after high school. However, some schools are open for students who already have an undergraduate degree, this is usually the case for foreign graduates.

What exams does one have to take to get in?

  • Public Schools: National exam called SPMB that is designed for a specific major, but is valid for any universities. This exam is not the actual entrance exam, it’s only for filtering out students who are academically eligible for a certain major, in this case for medical school. A prospective student sitting the medical school SPMB also needs to fill out a list of schools of their choice. The result of the exam is then sent out to those schools, and he will receive a notification about his acceptance. There is then another exam and an interview from each school that he has to complete and pass before being formally enrolled.
  • Private Schools: Each school has its own entrance exam, usually consisting of basic science focusing on human biology and chemistry, and an interview. Students applying for scholarship may be required to sit an additional exam.

Is there any required pre-requisite coursework?

The national high school system divides the curriculum into two major programs: Ilmu Pengetahuan Alam or IPA (Natural Sciences), and Ilmu Pengetahuan Sosial or IPS (Social Sciences). One has to do the IPA / Natural Sciences program to be eligible for medical school. If a student graduates from a foreign curriculum, like Cambridge or the International Baccalaureate (as in my case), then he must have taken at least biology, chemistry, and maths.

Is it a competitive occupation?

Very.

What are you called at this stage of training?

A high school graduate.

Being In:

How long is it?

5 years.

How are the years broken down?

  • The first 3 – 3.5 years are pre-clinical years. Using the new block system, we learn basic anatomy, physiology, biochemistry, and immunology for the first year, then system-based approach for the remaining pre-clinical years. The actual division of the organ systems depends on each school. In my school, it is musculoskeletal, cardiology, pulmonology, gastroenterology, genitourinary, endocrinology, neurology, obstetrics and gynecology, dermatology and venereology, tropical medicine, hemato-oncology, and emergency medicine.
  • Students who have completed the first 3.5 years are considered graduates already, and are granted the title “Sarjana Kedokteran” (Bachelor of Medicine). They can quit at this time and start working non-clinical jobs.
  • The last 1 to 1.5 years are clinical/clerkship years. We do 9 minor rotations and 5 major ones. They differ by duration: minors last 4-5 weeks, majors last for 10-12 weeks. Minor Rotations: Neurology, radiology, psychiatry, ophthalmology, ENT, oral medicine, dermato-venereology, anesthesiology (including critical care), and forensic medicine. Major Rotations: Surgery (including emergency medicine), internal medicine, obs/gyn, pediatrics, and public health. Upon completing the clerkship, we then graduate as Medical Doctors.

Describe your typical day.

  • Pre-clinical: Class starts at 7:30 AM. Some days start with lectures, some with PBL discussions. Labs are usually in the midday. On the last period every Friday, there is a plenary session where the PBL case study that week is discussed with an expert. The day usually ends at 3:00 PM.
  • Clinical: In my hospital, office hours start at 7:00 AM and end at 2:00 PM, while outpatient clinic starts at 9:00 AM. The first thing we do in the morning is write SOAP notes of ward patients, then wait for the attending physicians to come for the morning round. After rounds, activities vary according to department. We may have academic activities, like tutorials or case study presentations, or we may go to outpatient clinic and have academic stuff later in the day. For surgical specialties, most operations commence at around 10:00 AM, depending on the number and difficulty of the cases that day.

If you choose a specialty, when do you have to decide by?

There’s no requirement for that. Age-wise, residency programs only require applicants to be less than 30 years old by the time of entrance.

What are you called at this stage of training?

  • Pre-Clinicals Years: Medical Students.
  • Clerkship Years: Our formal name is “dokter muda” or junior physicians, but we are more often called with our colloquial names, “co-ass”, from the Dutch word co-assistant. We still use a lot of Dutch medical terms in spoken conversations.

Getting Out:

What exams do you have to take?

The law is changing as I’m typing this. There used to be no exam getting out, as each rotation in clerkship already has its own exam. However, the new bill proposes for a national board exam. It is still undecided whether the exam will be a test for theory or clinical skills, or both.

Do most people graduate?

Yes.

When are you finally considered a “doctor?”

When we have taken our Hippocratic Oath at the end of clerkship (and after the board exam, if the new bill passes).

Do you have additional training after MS or do you start working immediately?

Again, the law is under some changes. The new law requires an unpaid 1-year internship in a hospital chosen by the government. After that year, doctors can work independently.

What’s the average debt for attendance?

There is no debt, except for scholarship students. Regular students pay the full fee. Scholarship students will pay back by working for their universities or teaching hospitals immediately upon graduation for a certain period of time, usually 2n + 1.

What are you called at this stage of training?

A doctor. More formally, a general physician.

Being Out:

What’s the average salary?

Depends on where you work. The general rule is the same everywhere: it’s higher in private institutions than public ones, and is also higher in bigger cities than in rural communities.

Is the job security good?

Yes. There is a high demand for doctors throughout the country, especially outside the main islands of Java and Bali.

Can you switch specialties?

Yes, but people rarely do this.

Can you go back and choose a different specialty?

Technically, yes, as long as one has not reached the age of 30 by the time of entrance. However, I have never heard of anybody doing that.

What are you called at this stage of training?

A specialist.

Breaking The Rules

A recent article called “To Tweet, or Not To Tweet: Physicians Misusing the Internet” discussed a new JAMA study which apparently found that…

“92 percent of state medical boards in the United States have received reports of [online] violations ranging from inappropriate contact with patients to misrepresentation of credentials.”

I guess this is supposed to be shocking, but I was really somewhat underwhelmed with the information (I was actually more shocked it wasn’t 100% – which state has had none…because that’s awesome). It’s exceedingly easy to report a violation that occurs online, since it’s permanently etched in the history of the internet, so of course there’s a large number of state boards receiving reports on violations that occur online.

The discussion is relevant and interesting, but clearly written with a negative attitude and watch-your-mouth, paternalistic tone (like many of the recent articles and research publications on social media in medicine, unfortunately). A quick search finds that the doctor on the answering end of this Q&A session has a rarely used Twitter account (@RyanGreysen) and no blog (that I could find, anyway)…clearly making him one of the least effective people to be discussing these issues unless his only advice is going to be to avoid a presence in social media all together.

However, that’s not exactly the point. What irks me so much about the recent onslaught of negative-nancy articles on physicians in social media is that they pretend that the internet is some delinquent hangout for the physicians who can’t seem to conduct themselves professionally. The tone of these articles comes across like Twitter is where we gather to join in HIPAA-violating hippie parties and have inappropriate contact with patients.

The tone implies that these things don’t happen on the elevator, at the football game or in the corner bar. The article (and many others like it) repeatedly discusses the need for educating physicians on the “rules” of online behavior and “how to conduct yourself online.”

That is not the problem.

The fact that the online world documents breaches is the problem.

Venture into any hospital hallway and you will be bombarded with far more private information in a circle around one ward than you will in a full days Twitter stream.

The issue is not that we’re gathering online and violating HIPAA because we don’t know how to conduct ourselves online, the issue is that it’s recorded here.

By saying we should educate physicians on how to act online we imply that either:

A) Unprofessional conduct is not occurring off-line.         OR

B) It’s more important to watch what you say here because it’s documented.

 

Is it important to watch what you say here because it’s documented?

Absolutely. Unequivocally. Yes.

Is it more important than it would be in your local Chili’s?

I sure hope not.

 

Sure, you’re less likely to get caught if you’re talking about private patient details in Chili’s, since it’s not being recorded and all, but that doesn’t make it ok. As a kid my mama would tell me,

“Doing something bad when you know you won’t get caught doesn’t make it any less bad.”

Doesn’t that rule still hold true?

What I’m saying is that these are not separate entities. Just because reports aren’t getting filed about physicians discussing private patient details in elevators as often as they are about physicians discussing private patient details online does not mean it’s happening less. It means it’s recorded less. That is not to say that there is no room for guidelines or advice about conduct in social media, just that online behavior is not inherently different than offline behavior. @SeattleMamaDoc really said it best,

“We are worse in the elevator than we are online.”

We don’t need to educate physicians on behavior online, because this problem is not unique to the internet. We need to educate physicians on keeping private patient information to themselves. On using some common sense and respecting co-workers and patients alike. Not just on the internet…everywhere…including on the internet. The physicians who are violating privacy and acting unprofessionally in the elevator are the ones who will talk about their patients online. This is not a problem inherent to an information medium, it’s a problem inherent to a person. And I’m not sure it’s one that can just be “educated” out of someone.

Thus, this is not about our online conduct, it’s about our conduct…and as soon as we make it about online conduct we imply that it’s only important to follow the rules if there’s a really good chance you’ll be caught if you break them.

 

Image 1: Pixomar | FreeDigitalPhotos.net

I Love My Job – Medical Educator Edition

As a first year I began working alongside a Pediatrician who would become pivotal in shaping my view of doctors and specialty choice. The way she loved her job shined through every single day (and still does as I work with her in third year) and the example she was to me became key in my discovery of the importance pursuing a career in a field you love holds. She showed me how important it was to choose a specialty you are truly passionate about…partly because it benefits you, but mostly because it benefits your patients.

As I mentioned a few days ago, residency applications are looming on the horizon and, with that, comes the promise of graduation (uhh…I hope, anyway) and “the real world.” As I struggle to decide what I want to be when I grow up I find that speaking with people who truly love their job is not only incredibly eye-opening, but exceedingly inspiring to me. Last semester I began asking around to find some healthcare professionals who love what they do and are willing to tell y’all about it. I hope to build a resource here so medical students struggling with post-graduation planning can get a look into the day-to-day life of various areas of medicine and, hopefully, find a piece of themselves in one of these inspiring stories.

I started by asking Dr. Michael McKenna, pediatrician and pediatric program director at Indiana University, what he loves about his job as a medical educator and how he ended up in the position.

Here’s what he had to say…

J. Lo in The Wedding Planner, when asked why she is a wedding planner:
“Y’know, ‘Those who can’t do, teach?’ Well, those who can’t wed, plan!”

While the above quote is a common phrase, I wholeheartedly disagree. People who teach don’t do so because they can’t hack it otherwise. They do it because their passion for their field is so great they can’t help but spread their knowledge, experience and passion to others.

I am a pediatrician, but the reason that I have been asked to write for Mind on Medicine’s “I Love My Job” series is because I teach newly minted doctors how to be pediatricians.

I am a Medical Educator.

I initially thought I was going to be a Pediatric Endocrinologist because it was the only organ system that made sense to me.

But before I had a chance to go on to fellowship, I had to pay my time to the State of Indiana.

No, I wasn’t making license plates in a minimum-security correctional facility. In medical school, I participated in a tuition payment program to serve in a medically underserved area. After residency participants needed to payback their time before doing any kind of fellowship. So, Endocrinology would have to wait.

Luckily, this did not preclude me from receiving the greatest honor of my career, serving as a Chief Resident of my residency program. Most residencies have one or more Chief Residents leading during their last year. In our program, Chiefs are expected to create the schedule and call schedules for the year. They also do a great deal of problem solving. Most importantly, Chief Residents teach residents and medical students. It was this aspect of my Chief year that changed the direction of my career.

Ever since I was a kid, I considered being a teacher, but being young and foolish, I didn’t consider it “cool enough”. These thoughts came flooding back during my time as Chief, as I realized medicine and teaching could be combined into one career. Ever since, I’ve had one all-encompassing (albeit cheesy-sounding) goal… helping residents become the best pediatricians they can be.

You don’t have to be Chief or take special classes to become a medical educator. The main quality needed is passion. I encourage everyone to incorporate medical education into every career path. 

The best medical educators I know, just like the best doctors, are always adding to their knowledge base. For educators, this means attending workshops about giving feedback or creating curricula. You can even get a Master’s Degree in Medical Education.

The day-to-day flow of a medical educator varies depending on specialty and  interests. The main question of career medical educators is, “Who is paying for your time?”

In medicine, you pay for your time by seeing patients in order to bill and generate revenue. Teaching doesn’t generate any revenue. Instead, I have to convince the Chairman that I am worthy of receiving money from the budget to teach.

Medical education is a great way to keep your career exciting. Each day is different. I might be mentoring a resident, seeing patients, developing a new workshop or a myriad other tasks on my “to-do” list. More importantly, being around learners all of the time constantly exposes me to their thirst for knowledge, keeping me excited about medicine.

Many students and residents are paralyzed by the perceived gravity of choosing a career, believing that once they choose their path, they are committed to it FOREVER. That is not true. Your MD (or DO or MBBS) opens many doors. If you ever get stuck in a rut, you can always find a new adventure without up-ending your life with a new residency. Bring a learner into your practice, teach at a nearby medical center, be a mentor. Be a medical educator!

Because of the way my clinical time is set up, no one is ever going to say that Dr. McKenna is my doctor. I am sure this sounds like a sad statement. Isn’t that why most people go into medicine in the first place? Yes, on occasion I long for that, but I have something much better. If I do my job right, I will have hundreds of pediatricians that will proudly (at least I hope!) say, “Dr. McKenna taught me how to be a pediatrician.”

That is why I am a Medical Educator.

Michael McKenna is Associate Program Director of the Pediatrics Residency at Indiana University. He conducts scholarly work in the areas of social media and medicine as well as mentoring of chief residents. More importantly, he blogs about pop culture, academic medicine and history (occasionally all 3 together!) at Mamihlapinatapei (ironsalsa.wordpress.com). You can also follow him on Twitter @IronSalsa or email him at mpmckenn@ iupui.edu.

Image 1: sakhorn38 | FreeDigitalPhotos.net
Image 2: scottchan | FreeDigitalPhotos.net

Find Your Voice, Listen To Theirs

Rain drops trickle down the double-paned, ovoid window as my eyes jump from plane to plane watching for movement on the runway. The rainy weather in my connecting city has brought me back to the familiarity of muggy, hot Spring days that were so common place in my college years and I’m reminded of the excitement I felt of being in a new place, doing new things. As we taxi the runway for what seems like hours I reflect on the whirlwind weekend I’m making my way home from…

New city.

New people.

New ideas.

New Inspiration. 

I spent the weekend surrounded by what I can only describe as the most innovative and creative group of people I have ever encountered. The thirst for knowledge, aptitude for leadership, drive for entrepreneurship and innovation in the room was almost palpable. I found myself repeatedly standing just outside of conversations and listening – not wanting to join in too quickly because I was learning so much as an observer.

Amazed by everyone from medical students to physicians to marketers and computer programmers, I began wondering what I had missed…how I had become so complacent with doing the same things every day rather than innovating and advancing.

Being surrounded by people who harbor a thirst for knowledge and desire for advancement is contagious. The viral enthusiasm was quick to seep into my brain and I now find myself wondering how I spent so long in the dark about all the opportunities available for me…for my husband…for anyone who wants to seek them out.

I feel so blessed to have been a part of the Doximity Leadership Summit and I am so impressed with the ideas and information coming out of the group of physicians, students, supporters, developers and crew. My eyes have  been opened to an entirely different world of medicine that I never knew I was missing.

 

Doctor Vartabedian of 33 Charts wrote today on the future of Key Opinion Leaders – what does a physician influencer in the age of social media look like?

In my eyes they look like the people I was with this weekend – innovative, intelligent, well-spoken and … most importantly … just plain excited about all the things we will be accomplishing in the next 10, 15, 25 years.

 

As medical students and young doctors this is exceedingly important – we have this opportunity to use our voices and ideas to further not only our careers, but the entire field of medicine and how it’s practiced. I no longer feel like we have an option to be involved – this is an obligation…to ourselves, to our patients, to our educational experience. If you aren’t interacting with your tech-forward peers and mentors you are robbing yourself of an opportunity for personal advancement and missing out on inspiration and innovation coming from the mouths (and finger-tips) of people just like you.

Life is short, take this opportunity to find your voice and listen to the voices of others.

The digital age cannot be viewed as threatening for medical professionals any more – the longer we shy away due to scare tactics and unfounded concerns, the longer we lag behind in innovation. We can use this platform to change the world.

 

To be inspired…to create…to have a voice…this is a privilege.