10 Blogging Rules To Follow

I used to resist referring to myself as a “blogger,” it just seemeds like such a large shoe to fill with people out there who write so much more graciously (and humorously) than I…and often about more important things. I guess after this much time I can start to embrace being called a blogger, even though I still feel a bit like a fraud saying that. Occasionally, people will ask me how to start a blog or if I have any tips for them as they work towards creating a space for their thoughts. Here’s a few rules I try to follow for myself, most of which are based more on my experiences as a reader than as a writer – the things I appreciate in blogs I look up to and enjoy.

Wordy Version:

The beauty of blogging is that if someone doesn’t like what you’re writing about, they don’t have to read it. So, own your material, whether boring, hilarious, informative or crazy, it is yours and you created it. No matter how your blog evolves, and it should be allowed to evolve, it needs to always be yours. I started this blog as a mostly personal blog and it has evolved into a conglomeration of medical school, personal stories and general information. Write about what you want and be open to your blog growing and changing along the way.

If you are happy with what you’re writing, that is all that matters. Always write posts that are worth reading, but remember that a post worth reading is one that you think is worth reading. This is your space and you get to decide what does or does not belong, what is or is not worth reading. You may not think reading about my crazy dogs or life timeline is interesting, but I love those posts and having them recorded here is more than worth it to me.

So often I see people not write for three days…or three weeks…or three months…and come back apologizing. Unless you are Frank of PostSecret, it’s highly unlikely people are sitting around fretting over the fact that you took a blogging break…in fact they may have not even noticed you went on hiatus. Sometimes life (or a surgery rotation) happens and you can’t write. It’s okay…don’t come back apologizing, just come back. Pick up where you left off – you have nothing to apologize for. In that same vein, take some time off for crying out loud! The internet isn’t going anywhere, we’ll all be here when you come back.

This is especially important if you’re just starting out with your writing – set goals for how often you want to write, how long your posts should be, etc. When I first started blogging my goal was to write one post per week, because any more than that seemed overwhelming at the time. Now I really just write when I feel like I have something to say that’s more than 140 characters, but at first I wasn’t always sure I had something to say until I just sat down and started saying it.

Your readers deserve your attention – they are visiting your blog and reading your content, the least you can do is listen! If a reader disagrees with your opinion, welcome it…accept it…discuss it. The only way to grow in this life is be open-minded and you can’t do that by immediately discounting opinions other than your own. If a reader emails you, respond. If someone poses an interesting view or question in a comment, write back to them or create a post in response. Find ways to engage and interact, it will serve you well in the future.

Post a link to your blog on your Twitter or Facebook if it seems appropriate, but don’t only post links to your blog. Nobody likes a spammer. If the only thing you ever tweet is “HEY CHECK OUT MY NEW BLOG” your only followers are going to be that naked girl who tweets links to diet pills and her friend who has the miracle acne cure.

The Golden Rule of blogging – link your references. If you reference an article or another blog or a person or a tweet – link it! It’s common courtesy, you’d want your work linked back. And please don’t steal photos, use a creative commons-type source for your pictures and link back to their photographer. Don’t Google Image search and include those pics in your post, this is not only basic courtesy…it’s avoidance of plagiarism, which we all learned about in 2nd grade. Cut & Copy = Plagiarism.  Sometimes you simply can’t remember where you read something you reference and that’s fine, but cite your sources if at all possible.

If you are posting 4 times per day you are overloading your readers. Once per day is fine, less is great, more is definitely overkill. Others may disagree with this one, but I delete any blog that regularly has more than once per day out of my reader (barring the occasional blog with multiple authors or which aggregates info & posts from other sources). Almost universally anyone who has that much to say rarely has anything to say that is really worth reading.

This may be the most important rule of them all – posts need a format. Use bullet points, headings, numbering and formatting. Break up your post with images if relevant. Make your writing look pretty – remember in junior high when you’d have to write papers and make them double-spaced? Same principle. It is no lie when I say I will often spend an hour writing and 2 hours formatting a post…it’s just that important.

Barring the rare exception, posts should not be extremely long. I typically write a post and come back to it the next day to whittle it down to the important stuff. Fluff is not your friend in blog-land.

 

Bottom Line:

  1. Own your space & teach it about Darwinian Theory.
  2. Be proud of work you create and create work you are proud of.
  3. Never apologize for time off, nobody even noticed you were gone.
  4. Set goals for yourself, especially in the beginning.
  5. Interact with readers and embrace opposing opinions as opportunities to grow.
  6. Don’t be an annoying spambot or annoying spambots will be your only followers.
  7. Follow the Golden Rule: Link back to others as you’d want others to link back to you.
  8. Don’t flood your readers…nobody can write 5 great posts every day, not even you.
  9. Make posts easy to read, formatting can make or break your writing.
  10. Fluff is for Build-A-Bears, Moon Pies and school essays, not blogs.

 

What rules do blog authors that you appreciate and look up to consistently follow? What would you add or subtract from my list?

 

Image: Michal Marcol | FreeDigitalPhotos.net

Mind On Med Ultimate Guide to Studying for USMLE Step 1 and COMLEX

A couple of months ago I asked a few of my favorite online medical students to answer a few questions about their experiences preparing for Step 1 and COMLEX. They gave me some very insightful answers, so I wanted to share them with you. This post is simply to create a comprehensive answer to the question we all have as second year med students, holymaterialexcessiveness how do I even begin to prepare for this? Believe me when I tell you that these 4 students have amazing advice & guidance. I’ll answer the same questions from my point of view in another post. For today, though, let me introduce you to my guests:

            

Step 1: June 14            Step 1: June 24             Step 1: Early June         COMLEX 1: May 27

Blog: APM                   Blog: MD2B                  Blog: Lancet                 Tw: @endlessrant

Tw: @astupple             Tw: @grecoa3               Tw: @michaelbmoore

 

I’m ecstatic with my score.

 

I am very happy with my score. I originally set my goal around average – which is 220 or so. After taking a few practice tests, I realized I could aim a little higher and ended up surpassing the new goal as well. I used this score calculator online. It factors in UWorld, NBME, and practice questions to give a score estimate and I found it very helpful for setting my goals.

In general, I am very happy with my score. It wasn’t perfect, but it wasn’t ugly either and really, unless you are shooting for something super-competitive, that should be your goal. The test is a reflection of how serious you are and the effort you are willing to put into a task, but it is also a measure of your ability to answer arbitrary arcane of standardized multiple choice questions on a specific day in May, June or July. For me, it’s like running a marathon in under 4 hours – not going to get you into the Olympics. It’s my best. In retrospect, that sounds like a total rationalization, but hey…it’s my rationalization.

Yes & No. Going into the exam I had determined a score range that I would be happy with. My actual score ended up being the literal bottom of that range. When I got my score, I started laughing. One point less & I would have been in tears. So yes – I’m happy, but (as always) I would have liked to done better.

 

No formal prep classes. My school had a week of formal review in late May provided by one of the prep companies with a wonderful live lecturer. I was happy with it and the videos provided with it were good, but if you hadn’t done a lot of prior prep-work it wouldn’t have saved you.

Doctors in Training. I highly recommend it. I was reluctant to use it, because it’s essentially a guided tour through First Aid, but it really keeps you going at a fast pace for 15 days (the length of the program).

 

I used two books: Goljan Pathology and First Aid, and supplemented with the classic textbooks from each supporting discipline. Goljan Pathology is not for everyone, but it is worth taking a serious look to see if it suits you. I found it ideal because it was clinically applied pathology, written with STEP 1 in mind. I did all of USMLE World, taking time to read through the explanations. Also, I listened to the Goljan audio recordings of his STEP 1 review several times through during the year to learn pathology in general.

I predominantly used First Aid for Step 1 and UWorld question bank. I also used specific books for weak areas – Rapid Review Biochemistry, BRS physio (super high-yield) and Microbiology Made Ridiculously Simple.

Book: First Aid for USMLE Step 1 Resource: Kaplan Q-Bank (on PC/Android/iPad). A note on Qbanks, your choice of Qbank is not as important as your discipline in using them. If you are a MSII you should be deep into a Qbank – start as soon as you can and use it often. A month with the best Qbank is not going to make up for lost prep time.

First Aid for Step 1 + Saverese OMT Review = The complete COMLEX study package. Practice Questions – COMBank & COMSAE

 

I studied non-stop for five straight weeks after second year was over. Prior to that I thoroughly read through Goljan and First Aid once with friends as a study group before the end of second year classes. We started this before Christmas break, meeting roughly once a week. The group wasn’t a huge time investment and it paid off tremendously because, when full-time studying came, I knew where to look to sharpen areas that I’d become rusty on.

I ended up studying for 4 weeks and a few days. After formal lectures ended the school gave us a maximum of 6 weeks to study for the test. I tend to get distracted very easily when I’m studying, so I knew that a schedule would be important to keep me on track. I would wake up around 7 and get to the library by 8. I would study until lunchtime, when I would walk back to my apartment and grab some food and take care of other errands. I’d get back to the library around 1 and study until 5 or so, when I usually took a class at the gym. At night I’d eat dinner and do a set of practice questions out of UWorld, and get to bed around 11 or so. I used a systems-based approach to studying. Our curriculum was systems-based, so it made sense to me to review the material the same way I learned it in the first place. I didn’t even start studying for the USMLE until our last class ended in May. Instead, I focused on the coursework and doing well on my tests, since these covered each topic more in depth than Step 1. You only have a few weeks to study before the exam, which isn’t nearly enough time to re-learn everything from the start of 1st year, so learning the material well the first time through is key.

 My school did not give me time to prep – our classes ended a week before our mandatory live prep course. I tried to get 2-3 hours of prep a day regardless of my class schedule. I would use the review materials/Qbank pertinent to the organ system/specialty we were studying at that point. It’s not as hard as it sounds.

I started studying concurrently with classes in January 2011. This might seem early, but I consider myself a slow reader & my weakest subjects were biochem & micro (2 BIG subjects & sections of FA). I used the Taus Method where you annotate each section of FA using a review book. Study time varied by week & topic I needed to cover, but I aimed to put in 4 hours/week of board prep on weekdays & at least 4 on the weekends. I then studied for 2 weeks after classes ended. During that time I’m guessing I studied 10-12 hours/day.

 

The day before the test, I broke the rules and did some reading. Personally, I feel more relaxed just reading stuff. That way, I don’t have to convince myself that it’s okay not to do any preparation. I’m not a hyper-focused person who’s too neurotic to relax, it’s just that I prefer to read over material rather than not.

I still had some questions left to do in UWorld, so I finished them early in the day. I spent the day packing to go home for a few days, cleaned my apartment, hit the gym, and went to bed early.

I reviewed my ultra-high-yield/most commonly asked questions…Brachial Plexus, Dermatomes, Cranial Nerve Exams, Characteristic Drug Side Effects/Reactions. Mainly for nerves and to give me something to do.

I got a massage, ate a great lunch, watched Inglorious Basterds & reviewed FA. Everyone says “Don’t study!” I disagree. Don’t try to learn anything new, but do set a cut off time – mine was 6pm. I went to bed at 11pm.

 

Take some time preparing a lunch that will be tasty, you’ll actually want to eat, and that’s easy to store in a 1 cubic foot nonrefigerated locker. Figure your lunch out the day before and don’t forget napkins and all that. Also, pay attention to what foods make you tired an hour after eating and avoid those.

I took the exam early in the morning (it’s an 8 hour exam). I recommend taking lots of sugary snack and caffeinated drinks, because it’s a marathon of a day. The exam has a tutorial section and a lunch break built in, but you can skip both. I wouldn’t skip the tutorial, because there are a few ways that the test software differs from the practice tests. Also, the lunch break can be split up. I took breaks in between each of my exam blocks to stay fresh.

Bring snacks, one for each break and your own water. Sounds dumb, but make sure you do it. Make it tasty, but not too tasty, with a good mix of complex and simple carbs (Power Bar). If you need caffeine, re-caffeinate at lunch. A day long test is as much a physical challenge as a mental one.

Make sure to have a snack during your breaks. You won’t be hungry during your break, but you will be 15 minutes after it ends.

 

The one thing that I regret is not taking more full-length practice tests. I don’t think I ever sat for 8 hours straight during my preparation and the fatigue definitely got to me on tst day. I consider myself kind of tough, used to working 8 hour days and longer, but I was surprised at how my focus was off. If I were to do it again, I would have done two or three 8-hour practice sessions, just like the regular test day; get up at 6AM, make a quick breakfast, and then go to a room and do nothing but questions for 8 hours. It sounds awful just writing it, but considering all the work invested, this time developing test stamina might have had a big impact. Last comment: I would seriously consider not taking ANY notes or doing ANY highlighting. Just read and do questions. Your brain is amazing, and trying to force it to remember stuff with notes and highlighting just gets in the way.

Most of my classmates took about 5 weeks to study, and began Monday after our last final exam; this gave them a week or so afterward to travel and relax before third year began. Hands down, the best decision I made was taking a week off to go on a trip BEFORE I started studying. Most of my classmates thought I was crazy, but when I came back I was fresh and relaxed. My other biggest strength when it came to studying was that from the beginning I wouldn’t let myself get freaked out by what everyone else was doing – some friends would literally do nothing but eat, sleep, and study. I didn’t get bent out of shape about it, because I just can’t study that way. I made sure to take time for the gym, and my favorite TV shows. I took weekends off from studying and did fun things. I think it helped keep my mind clear and stress level down.

Great question. I waited until January before my test to make a freaked out OCD schedule for my prep. I wish I had done that sooner.

QBanks – if you are only taking the COMLEX, a 3 month subscription to COMBank is all you need. The questions are indicative of what’s on the actual test. If you think you want to take the USMLE as well, then stick with UWorld & get a 1 month subscription to COMBank. Take a practice test. There are several available on the NBME website for $50 each and they are definitely worth it. They are made of retired questions and it is exactly how the actual test will be (but only 200 questions instead of 400). My suggestion is to take one about 2 months before your exam so you have a baseline & then another 1 month before so you can see how you would do on a real exam. The downside to the COMSAE is that you don’t get an answer key. They score it for you & give you a breakdown, but not explanations so they aren’t really helpful for learning – just assessment. I took 2 & my actual COMLEX score was 60 points more than what COMSAE predicted.

Night People Smart, Morning People Happy?

I remember as a kid staying overnight at my grandparents’ house during the summers – the days always seemed to start out with the two of them getting up at (what seemed to me) a ridiculously early hour. They’d sip black coffee and chat and my grandma would fry up some bacon and scramble an egg for my cousin and I when we finally rolled out of bed well after the sun had said it’s good mornings and roosters had crowed their songs.

“The early bird gets the worm!”

they’d say…or

“Early to bed early to rise, makes a man healthy, wealthy and wise.”

As intelligent as the two of them were and as much as I wish it was a joy for me to get up at 5:00am, this study researching circadian type or “diurnal preference” has left me feeling vindicated, to a degree, regarding my tendency towards late nights and mornings. Indicating the contrary of the old adage, the article seems to say that people who stay up late and sleep in are, in fact, a bit more intelligent. Did you really need proof in the form of a scientific study to show that you that night-owls are smarter? Yah, neither did I.

However, this study does say that “morningness” has a significant positive correlation with life satisfaction and I can definitely agree that I feel better and more productive when I get up early and get my day started with the sun (and a cup of caffeine).

So, what does all that tell us? Not much other than there are lots of studies out there looking into all sorts of things you’d never have expected. Interesting, to be sure – helpful, maybe not?

So, life satisfaction and intelligence-wise, who do you think wins? Night owls or morning glories?

I’d love to stick around and see what you all have to say, but none of your answers will change the fact that it’s 10pm and my alarm is set for 4:45am tomorrow. Wonder what forced early-rising is correlated with? I’m speculating a positive correlation with amount of caffeine consumed prior to 10am.

Image 1: photostock | FreeDigitalPhotos.net

Red Hair

A Little Red Change

Do you ever feel like you just need to make a change?

Not a big change. I never get the urge to auction my life off on Ebay (all yours for one low price – a Mazda, stressful medical exams, & crazy dogs! BUY NOW)…that’s going too far…especially for someone who gets palpitations thinking about changing blog headers and profile pictures.

Just little things.

I’m pretty good at neglecting my hair – last year I went a full 11 months without so much as a trim (I know…stop judging me…). Usually this is because I’m too lazy to get an appointment, lately it’s been because I’m ridiculously busy on my Ob/Gyn rotation.

But, today we got out of lecture unusually early and I decided I would make a change.

Red Hair

I’m still “processing” the new hair color, so please refrain from asking me to change my email address or Twitter icon for at least the next 6 weeks. I can only handle so much, people.

Now excuse me…the landline is ringing and I need to balance my check book.

 
 

Medical School in Canada

I was recently contacted by Jessica, a 21-year old 2nd year medical student at the University of Alberta in Canada, offering to teach us about Medical Education in Canada! She complete 3 years of undergrad in Vancouver, BC – her focus of study was Microbiology. Jessica runs the blog Atalanta’s Antics and also tells me she’s a film nut, choir director, hockey pseudo-player, actor, pianist and BBC fan. This chick is the dictionary definition of well-rounded, y’all.

If you’re new around here, let me explain. This post is an extension of the Medical Education Mondays series I started a while back. In addition to random Med Ed information, I’ve had an array of fabulous guest bloggers share info on medical school in the United States, Belgium, United Kingdom, Spain, Egypt, Australia, Saudi Arabia, Greece, South Africa and the Dominican Republic. You can see these cool posts, as well as the rest of the Med Ed Monday series, here.

Jessica’s Talks Medical School in Canada (frank additions by me are in orange):

Getting In:

At what age does one typically begin medical school?
It varies. I started when I was 20, but I’m a bit young for my class since I got in after only 3 years of university. Technically, you only have to finish 2 years of undergrad to apply for the University of Alberta, but it’s extremely competitive at that point. Most people get in after finishing their Bachelor’s degree, so that makes them about 22-23 years old. There’s also a lot of Master’s and PhD students, as well as people who had a career before applying, so ages can range anywhere from 21 to 40. Other schools are different – some require a finished degree, while others essentially require a Master’s to be competitive.

What exams does one have to take to get in?
The big one is the MCAT, just like in the United States. It’s a 5-hour with 4 components:

  1. Physical Science (ex. physics, inorganic chem).
  2. Biological Science (ex. biology, organic chem).
  3. Verbal Reasoning (i.e. reading comprehension).
  4. Writing Sample.

The first 3 are multiple choice and each are bell-curved and scored out of 15 (i.e. one year, getting 49/52 may be a 14, another year may be a 12). The writing sample is ranked from J (lowest) to T (highest), so you end up with something like 10-9-10 R (29R). For the year I wrote it, I got a 11-11-11 Q (33Q), which was about the 86th percentile.

In addition to the MCAT, you also have to interview at each school you’re invited to, usually using the Multiple Mini-Interview (MMI) format. This consists of a series of stations, each with a different topic or ethical dilemma to discuss with an interviewer. So, you’re not judged solely on one interview by one panel, but rather on multiple topics by multiple people.

Is there any required pre-requisite coursework?
This also depends on the school. The U of Alberta requires some general chemistry, organic chem, biology, physics, English, statistics, and biochemistry. Other schools like the University of Calgary don’t have a set list of courses. That being said, you don’t have to be a science major to get in – in our class we’ve even got a photography major and a carpenter!

Is it a competitive occupation?
Yes. The acceptance rate is about 10% across the country, with about 50% of those getting interviews being accepted. Doctors are in extremely high demand right now, so they can make excellent money. It’s not uncommon for people to apply for several years before getting in. I applied to 3 schools and got interviews for all of them. However, I think due to my age, I was rejected from 2 and waitlisted for the school I’m in now. A few weeks later I was accepted, but there are a lot of excellent, intelligent people rejected each year.

What are you called at this stage of training?
Before getting in, you’re just an undergrad student. Some people identify themselves as “pre-med,” but given the 10% acceptance rate, I think it’s a bit presumptuous.

Being In:

How long is it?
Four years.

How are the years broken down?

  • Pre-Clinical: The first two years include mostly classwork, labs, and some clinical skills and patient interaction. The year is broken down into system “Blocks” that vary by school. In first year my school has Infection Inflammation Immunology (Triple I), Endocrine, Cardiology, Pulmonary, and Renal blocks. In second year, we do Gastrointestinal, Reproduction and Urology, Musculoskeletal (MSK), Neurology, and Oncology. Throughout the year, we also have Patient-Centered Care (PCC) classes, cadaver lab, an elective, and clinical skills.
  • Clinical: 3rd and 4th years are “clinical” years, where you do rotations in all the major fields: Pediatrics, General Surgery, Anaesthesiology, Internal Medicine, Psychiatry, Obstetrics & Gynecology, Urban and Rural Family Medicine, Emergency Medicine, Specialty Surgery, and Geriatrics. There’s also elective time and a bit of mandatory lecture.

If you opt for the Integrated Community Clerkship (ICC) option, you spend your entire 3rd year in a rural community with no rotations, just learning everything at once and getting lots of hands-on experience.

Describe your typical day.
Applicable to pre-clinical years: Class usually starts at 8:00 with lecture for a few hours, followed by Discovery Learning (DL) where we get into small groups and work our way through some cases relevant to the block from diagnosis to treatment to prognosis. After lunch may be more lectures or clinical skills, depending on the week. Cadaver lab is Friday mornings with PCC on Tuesday and Thursday afternoons – right now, being in repro block, we’re practicing how to take a sexual history. There’s a quiz every Friday, so we really have to keep on top of our studying!

If you choose a specialty, when do you have to decide by?
Residency matching (CaRMS) is late in 4th year, so most people have it figured out by the beginning/middle of 4th year.

What are you called at this stage of training?
The lowly Medical Student. 😉

Getting Out:

What exams do you have to take?

  • At the end of 2nd year there’s a comprehensive exam and Objective Structured Clinical Exam (OSCE, i.e. interviews, clinical skills, patient interaction…) on all the pre-clinical stuff.
  • At the end of 4th year, there’s the MCCQE Part I (Medical Counsel of Canada Qualifying Exam) – a multiple-choice and short-answer, all-day test on everything you’ve learned. You need to be able to draw on clinical experience and medical know-how to explain decision-making. This must be passed to move onto residency.
  • The MMC part II is basically a 3-hour OSCE that determines if you can move onto independent clinical practice.

Do most people graduate?
Absolutely. It’s extremely expensive to train a physician, so the faculty does everything in its power to make sure everyone graduates. People don’t usually drop out because of the difficulty, it’s almost always for financial or personal reasons. At my school we have a tradition that if everyone that enters 3rd year graduates, the dean of medicine wears white gloves to the convocation.

When are you finally considered a “doctor?”
Once you finish 4th year and pass your MCC part I, you’re considered a physician.

Do you have additional training after MS or do you start working immediately?
Yes – there’s residency for every field. Residents are paid, but it’s not nearly as much as when you’re finished with residency. You can also do a fellowship after completing residency, which is extra specialized training. Often these are done if the community where you plan to work needs a specific skill or if there are no jobs available in your specialty (currently common in cardiothoracic surgery) and you want something extra to put on your CV.

What’s the average debt for attendance?
It varies a bit by school, but tuition is around $13,000 per year, and many students expect to accumulate upwards of $60,000 in debt by the time they hit residency. Some students I know have $100,000 lines of credit that they use to condense living and academic expenses.

What are you called at this stage of training?
Once you pass the MCC part I and complete, 4th year, congrats! You’re now a physician!

Being Out:

What’s the average salary?
It varies by specialty and province and the numbers given by the College of Physicians and Surgeons aren’t very accurate, since a lot of people work part time in certain fields. On average, though, family physicians make around $200K, specialists make around $250K, and surgical specialists make around $350K.

Is the job security good?
Generally, yes. Once you have a job, you can keep it for as long as you want. The trick is finding the jobs, sometimes. For example, right now we’ve got an excess of cardiothoracic surgeons, so it’s difficult for them to find OR time.

Can you switch specialties?
Yes, it’s difficult, though. There are a lot of hoops to jump through since you basically have to be re-matched (into a new residency). However, about 80% of medical students across Canada get their first choice in residency matching, so it’s rare for someone to want to completely switch fields. You need an extremely good reason and must not be leaving a gap in your specialty for the College to allow you to re-specialize.

What are you called at this stage of training?
Resident Physician until residency training is complete, then fully-certified Physician.

 

Overall, medical training in Canada seems to be almost identical to medical training in the United States. If you look through the other Med Ed Monday posts you’ll see that this is a drastic difference from the layout of medical school in many other countries around the world.

Life, Anatomy & The Way We Were

I wish there was a way for me to tell this PostSecret author just how much her grandmother’s donation will be respected…a way to express to her just how much people like her grandmother have taught me…have taught all of us.

Rest assured that we recognize the sacredness of the anatomy lab…it’s palpable in those rooms. I recall long talks about the people willing to let us learn from them, thoughts of what their life was like and speculation on who might be missing them, what job they had, how big their family was.

We respect her, she gave us more than an anatomy lab…she gave us the opportunity to learn and help others. Her legacy lives on in the ones helped by everyone who learned from her. It’s impossible to count how many lives she will touch with her selfless donation.

Pregnancy & Infant Loss Remembrance Day

Today is an important day to a group of people I’ve expressed a deep gratitude to in the past. Sometimes it’s so easy to live life without remembering what the people around us go through and this is our opportunity to to be reminded of the struggles people have that we may not necessarily share.

October 15 is a day to remember families who have experienced the loss of a child through miscarriage, still birth or neonatal death.

Truth be told this day is really not necessary for those who have been directly affected by the loss of a child – they will never, ever forget. Today is to remind the rest of us how important it is to let them know that we recognize their loss and, more importantly, remember their child.

So, today I wanted to share this information with those of you who may not be familiar with the significance of this day. In honor of these women who have taught me so much I wanted to spread the word. If you know someone who has experienced the loss of a child, no matter the circumstances or how long ago it may have been, let them know today that you are thinking about them and their baby. Let them know their child has not been forgotten. I truly believe it would mean the world to them.

While there are more babies than I can count that I’m remembering today, I do want to share two names that represent so much for me:

 Evan & Micah

Their mom doesn’t know it, but the day she said goodbye to her second little one was the day I wrote this entry and her strength, faith and love of those babies in the coming months was a big factor in encouraging me to finally share it here. If you have a chance, let her know that her precious little ones, Evan & Micah, have not been forgotten. She is one of many, both real-life and online friends, who this blog post is dedicated to.

 

If you can’t directly contact someone you know who has experienced pregnancy or infant loss then leave a little note here – I promise someone will see it and I know it would mean the world to them.

 

High Five Wrigley

Compulsive Phone Checking?

Good Morning from California.
California Sunrise - Tuesday, 8/30

It’s 9:30am on a gorgeous, albeit scorching hot, morning in Rancho Mirage, California and I’m leaving a group lecture on the family dynamics of addiction at a world-renowned addiction treatment facility. As if it’s been magnetically cued I find my right hand patting the rear pocket of my jeans in search of an iPhone.

It’s not there.

After looking around to make sure no one watched me patting my own rear I am awe struck at the fact that, for no reason at all and without thinking about it, I compulsively reached for my cell phone.

As many of you know I just returned from a week long medical student program at The Betty Ford Center where I was taught about addiction from lectures by world-famous experts and through immersion into their patient treatment program. The center, with great reason, does not allow cell phones on campus and on Monday morning I suddenly found myself connection-less for the first time in years. I remembered an article I had read on CNN not long ago that discussed the addictive nature of smartphone checking.

So, there I am in the middle of a drug and alcohol addiction treatment center finding myself addicted to my phone. Or, as the article and this research paper suggest, addicted to checking – a repetitive behavior eerily similar to the training method I used to teach Wrigley to give me a high five.

High Five Wrigley

Behavior. TREAT! Behavior. TREAT! Behavior. TREAT! Behavior. Behavior. Behavior. TREAT! Behavior. Behavior. Behavior. TREAT! Behavior. TREAT! Behavior. Behavior. Behavior. Behavior. Behavior. Behavior. Behavior. Behavior. Behavior. TREAT!

An email essentially becomes a dog treat. Still with me?

It’s not hard to see how this could distracting enough to affect your real-life interactions and productivity.

“Dad said I can’t wear foil antennas and stick my fork in a socket while standing in that puddle of water. Can I pleeeeeeeease?”
…mustcheckphone-couldbeexciting*…
“Sure honey, eat your lunch first.”

So, how do we stop?

Cell PhoneNot unlike AA and other 12-Step programs the article suggests that the first step to stopping this behavior is recognizing that you’re doing it. Honestly, even after reading that article (before I was forced phone-less last week) I didn’t realize how often I was checking my phone in the course of a day. I think being aware of this has helped some, because it now seems I’m not mindlessly looking at it ad nauseum for no conscious reason. Now, I just check my phone somewhere in the vicinity of 40 times a day and think about checking it, but stop myself, an additional 35.

Baby steps, right?

Anyone else finding themselves checking their phone for no reason other than pure compulsive behavior? 

Image: Ambro / FreeDigitalPhotos.net

Quote from hilarious Oatmeal Comic.

Santo Domingo Children's Hospital

Medical School in the Dominican Republic

Medical School in the Dominican

Today I am honored to be continuing our Medical Education Monday series with Medical School in the Dominican Republic. Our Mind On Med guest blogger for today is Vera, a 21 year old medical student in the Dominican. She’s starting her 5th year of medicine and is still wide open on the specialty front, but has a special interest in Neurology. She loves blogging, snail mail, singing and coffee (would we even call her a med student if she didn’t love coffee? I think no, but that’s likely the addiction speaking). And, get this, Vera is a Latin dancer! How cool is that?! We should get her to do a vlog lesson for us. Feel free to contact myself or Vera with questions about Medical School in the Dominican! My additions are in orange.

Santo Domingo Children's Hospital
Children's Hospital in Santo Domingo, photo by RIGHT TO HEALTH.

Getting In:

How old is one when they begin medical school?
A regular student who never repeated courses in high school graduates of at the age of 18. You start pre-med after that – when I started pre-med was one year, but now it’s two, so you enter properly to med school at about 20 or 21 years old.

What exams does one have to take to get in?
We actually just have to take the general exam everyone takes to get into college, it consists of questions on Spanish, Maths, Logics, and English.

Is there any required pre-requisite coursework?
No, there isn’t (just the two years of pre-med course work described above).

Is it a competitive occupation?
No, there is a place for everyone interested; the only requisite is to maintain a scoring upon 2.5/4 while you are in premed in order to get in to the med faculty.

What are you called at this stage of training?
Premed Student.

Being In:

How long is it?
6 years

How are the years broken down?
When I started: One year premed, two years basic sciences and three years of clinical training.
Nowadays: Two years premed, two years basic science and two years of clinical training.

Describe your typical day.
Every semester is different. In the current unit I’m on classes begin at 7:00 am with a 2 hour theorical class. Everyday it’s a different subject, this semester includes Peds and childcare, Endocrinology, Gastroenterology, Imaging and Clinical Pathology, Family and Community Medicine and Preliminary Research. After that I go to the assigned hospital for that day and take a 2 hour practical class, again the subject is different each day. About 11:00 am we have a two hour break for lunch, I usually get the chance to go home and eat. At 1:00 pm we are back at the classroom and get out by 4:00 pm, which is when our college and hospital hours end and our duties begin. We are now working in our thesis, so we have about two or three meetings a week (an important amount of hours of work) and the rest is dedicated to study. Usually I stay in week nights (like a little kid =P  [nah! like any dedicated medical student, if you ask me :)]), I’ve learn to value my sleep and I know I’ll do it even more in a few months and years. Weekends are pretty diverse, depending on what’s going on.

If you choose a specialty, when do you have to decide by?
You can have an idea of what field you preferred, but it’s after you graduate that you can start a specialty. You have to take an exam and attend to an interview at the hospital when you are planning to get in; if you are accepted you are good to go. At the interview, besides your personality, the interviewers notice the points you have accumulated along your career as doctor (you win points by papers published, hours in hospital work, an internship year for the government, your graduation scoring, being part of the national medical association and, of course, the interview itself).

What are you called at this stage of training?
Medicine Student. In two semesters I’ll be called Medical Intern (middle of 5th year of med school).

Getting Out:

What exams do you have to take?
To be a doctor you don’t need to take any exam, but to opt for a residency spot you must take a national exam, it is based on a 100% and the minimum to pass it is 70%.

Do most people graduate?
Yes, most people certainly do.

When are you finally considered a “ doctor?”
Right after finishing the one year Internship required in med school and then get your diploma, which gives you the title of Doctor in Medicine (so, if I’m interpreting right, that would be about 7 years into your training including pre-med, medicine and intern year).

Do you have additional training after MS or do you start working immediately?
Doctors have to work a year for the government after graduation (another one year internship, now as a doctor and not a medical intern, in whichever hospital they require you to go to)* in order to get their exequatur (a written official recognition and authorization by the government to which one is accredited to work as a doctor in medicine).
*(The further the hospital, the greater the points you get).

What’s the average debt for attendance?
Well, the cost of medicine career here is about 500,000 RD$, that number into dollars must be around $13,158 USD.

What are you called at this stage of training?
Doctor

Being Out:

What’s the average salary?
The average salary of a resident is about 34,000 RD$ ($790 USD) per month.

Is the job security good?
Jobs have a great availability in our country, the opportunities are better for doctors who work in private clinics or hospitals, although private offices are kind of expensive. Doctors who want to work at a private level have to have the resources or help themselves by loans, which actually pay off when they get established and start working. Not everyone finds opportunities, though.

Can you switch specialties?
Yes you can, but only if it’s related to the field your currently on.

What are you called at this stage of training?
It depends on the years that the specialty you’ve chosen lasts. The word “Resident” adds an R to the name and later the year you are currently on. Ex.: R1, to the residents that are on their 1st year. R2, R3… you guys get the point =P. (This is quite similar to US residency training where we are called “physicians” or “doctors” during our residency training years and PGY1, PGY2, PGY3, etc. to denote our year of residency training. Although, in the US your intern year is equivalent to PGY1). 

Previous Medical Education Monday Posts

Medical School Around the World: