medschool

The One Major Mistake That Medical Schools Are Making

As I prepare to matriculate in medical school in August, I have had some time to reflect back on this past year which I have spent at The “Almost” Doctor’s Channel. As I witness other friends happily celebrating their acceptances, while others struggle to make alternative plans due to not-as-happy outcomes, I can’t help but wonder, “why did they choose me?” I had a decent/good MCAT score (depending who you ask). I went to a good undergraduate school and had a good/decent GPA. I was in an a cappella group because I love to sing, played on a few intramural sports teams because I loved to play sports and held a position on the board of my sorority because…well, I like having a voice within a large group. That about ends the list of extra-curricular activities that I participated in because of my own desires and interests. As pre-meds, medical students, and residents, we train from a young age to be the physicians we hope to one day be. We go to “DNA Camp” in high school (uh, was that only me?) and finagle together a sad excuse for a Siemens or Intel paper (again…any others out there who did this?), and then when we finally get into our dream college, the cycle starts all over again. We hound heads of labs in the hope of being a (unpaid)...

5 Crucial Lessons I Learned From Working at a Hospital

I took a year off before going to medical school. It was less of a decision than I would have liked it to be, considering I was rejected from medical school my first time applying, but all’s well that ends well. In the meantime, I got a job working as a nurse assistant on a medical/surgical floor, and the experience provided me a very in depth look at a field I had only imagined myself getting involved in – a career I had only seen in episodes of Scrubs and Greys Anatomy as well as random, superficial stints in the hospital via volunteering and shadowing. What I would quickly come to find is that I really didn’t know what I was getting into. Here are some of the things I found most surprising.   1. Medicine is at best a dirty science. For all the davincis, google glasses, and cutting edge research that people love to think about when they think of medicine, at the end of the day there needs to be someone to wipe off the poop. For every one patient that is helped by a davinci, there are hundreds that require their bowels disimpacted, straight catheterizations, or wound and bed sore treatment.  It is smelly, dirty, and wholly underappreciated, but constitutes the bulk of what it takes to treat a patient every day.   2. Being...

Morgue Mistakingly Sends Body to Einstein for Dissection

Overworked and multitasking morgue workers made a grave mistake this week in the Bronx. According to NBC News, Aura Ballesteros died in her sleep at the age of 85 on May 16th, 2014 due to long-term heart problems and dementia. Her body was taken from the Kings Harbor Nursing Home to a morgue in the Bronx, where morgue workers told Aura’s family they would keep the body until the planned funeral on June 16th. But on June 3rd, Aura’s son, Hector, received a phone call that his mother’s body was no longer in their possession – that it had been sent to Albert Einstein College of Medicine for use by their students in anatomy lab. According to the morgue policy, if a body is not claimed within 2 weeks of death, it is discharged for medical teaching use. When Hector called the school, he was told he would need to wait 2 days before he could claim the body. Though the body had not been dissected, it had been embalmed. “The office’s chief of staff, Barbara Butcher, said that a staffer at an office in Manhattan called the morgue in the Bronx to tell them about the arrangements, but the person on the other end of the line didn’t make a note of it.” Aura’s family plans to file an emotional stress lawsuit against New York...

5 Ways We Can Reduce “The July Effect”

July is just around the corner and with it, freshly minted med school grads are flooding internship programs. Many are familiar with the old adage about not getting sick in July because of new interns. But the truth is that new interns start this week! Yet, you don’t hear much about the “late June effect.”  So is the July effect overblown or true? Well, there have been many studies – so many so that there was a recent systematic review co-authored by one of my own co-interns a long time ago. While I am sure it was hard to synthesize the studies of often sub-par quality, the review does state “studies with higher-quality designs and larger sample sizes more often showed increased mortality and decreased efficiency at time of changeover.” The study I recall best examined over 25 years worth of death records and found a pattern. Of the 240,000 deaths due to medication errors, mortality rates were higher in July, especially in counties with teaching hospitals. I’m not sure death certificates are an accurate way of diagnosing cause of death…but that’s another story. The question, thus, becomes: what can be done to ensure July is as safe as possible? While it’s not possible for patients to time their illnesses, there may be other ways to do so. Though there is scant literature on this topic, over the last several years, I have had...

You Never Forget Your Med School Firsts

Congrats! You’re starting medical school soon! You’ve worked hard to get here and now you have tons of things to look forward to… Like the first time you get your syllabus. Source: tpwwforums.com   And then it hits you – that’s just all of the stuff you have to memorize in the first two weeks. Source: bestgifreaction.tumblr.com   The first time you sit through more than four hours of lectures. Source: miscgifs.tumblr.com   Your brain after the first 6+ hour study sesh. Source: heyveronica.tumblr.com The first time you don your white coat.   > Source: totalfilm.tumblr.com The first time you try and get a medical history.   Source: timmytitwank.tumblr.com   The first time you meet your cadaver in anatomy lab. Source: miscgifs.tumblr.com   The night before your your first exam. Source: seinfeldgifs.tumblr.com   Your first exam. Source: living-to-inspire-and-dream.tumblr.com   Seeing the letter “P”(Pass) for the first time next to your name on aforementioned exam. Source: gifloop.tumblr.com   Realizing, for the first time, it may just work out in the end. Source:...

Why Surgical Residents Are So Vastly Underprepared – Part 2

As far as I know, most medical schools are teaching surgery just like they did 40 years ago. What is Hesselbach’s triangle? What is Charcot’s triad? Second assist on a bunch of cases. Get the lab results from the computer so they can be re-entered in the computer in a progress note. And so on. Now that an entire surgical textbook can be carried in your cell phone, why don’t we change the paradigm? Rather than forcing you to memorize information, we should be teaching you how analyze and synthesize information as it relates to your patient. The third-year surgery rotation in medical school is not a necessarily a good simulation of what it’s like to be a surgical resident. I can’t say what goes on in every school, but the last school I was affiliated with allowed students to take off the day after call. I never could figure out why since we only woke them for major cases at night and they usually slept most of the time. All I could say was, “It’s your tuition [$45K/year] and if you want to go home, it’s OK with me.” By the way, we at the affiliated hospitals never saw a penny of that tuition money. I’m not sure exactly where it was spent. I think that the way students are coddled on surgery rotations might be a factor...

Why Surgical Residents Are So Vastly Underprepared – Part 1

A rising second year medical student read some of my posts and wrote me a kind note asking if I would write something for students. I taught students and ran surgical clerkships at community teaching hospitals for my entire career until about 6 years ago. I also was prompted to address this subject after reading a New York Times story about a new admissions policy at Mt. Sinai Medical School. The school is accepting some students who are majoring in the humanities and are not required to take the usual science courses or the MCAT. In the words of one of the participants in the program: “I didn’t want to waste a class on physics, or waste a class on orgo [organic chemistry]. The social determinants of health are so much more pervasive than the immediate biology of it.” I agree that possibly “orgo” and probably physics are not necessarily essential for medical school applicants. But I think these courses are still relevant because they assess one’s ability to think. According to the article, these humanities students are faring as well as traditional students as far as grades and class rankings are concerned. Is this because science doesn’t really matter or could there be another reason? Grades in medical schools are a joke. Let’s talk about the third year. If you look at the explanation of grades that comes with a...