medschool

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...

5 Essential Tips to Get a Research Job

I think this topic is one that can never be discussed enough in pre-med circles, particularly when it comes to non-traditional students. Working in research and getting published are two of the most desirable accomplishments you can boast on your medical school application. Unfortunately, especially for someone who may not come from a very science-heavy background, breaking into the field of scientific research can be a daunting prospect. If this is your situation, have no fear! Having been there and experienced this exact obstacle I have a few tips that will help you land a job working in medical/clinical/scientific research. 1. Utilize your school: many universities have a job board where they list open positions on campus and these often include research or lab assistant positions. These are tailored for students and are often part-time, which will allow you to get some experience while still being able to log long hours in the library for Orgo. As a bonus, you will probably be learning about certain lab techniques in class while perfecting these techniques at work which will definitely help you come exam time! 2. If you’ve already graduated, browse the openings on local hospital and university career job websites: these tend to require a little more experience as they are usually looking for someone with a B.A. but there are often entry-level positions in labs or on research projects that...

The Real Issue with the Match

Imagine for a second that you really want to be a doctor. Like really, really want to be a doctor (and if you’re reading this, I’m guessing you probably don’t really need to imagine). But anyways, imagine that you take the general path to becoming a doctor. You go to college, pick a major, complete medical school pre-requisites, get clinical experience, volunteer, go through the difficult medical school admissions process (all while building up debt from tuition and living expenses), and luckily you are one of the 42% of medical school applicants each year that gets accepted (as of 2013). You think that you’ve just surpassed the largest hurdle toward becoming a doctor and while the coursework and clinical experience that lies in your future will be challenging, as long as you excel, the next opportunity will be available for you. Then you actually go to medical school. You make it through with good enough grades, USMLE score, and recommendations to be competitive for your choice of specialty (again while building up debt – this time up to hundreds of thousands of dollars). In your fourth year, you apply to residency, the next step in your journey to becoming a physician. You spend money on application fees. You take time away from your fourth year clinical rotations while spending money to travel the country and interview. You eagerly wait...

9 Thoughts You Have When You Graduate From Medical School

1. Did 4 years just go by that quickly? It may be that med school is usually split up into pre-clinical and clinical years, but the time just flew by! When did you get grey hair? When did you gain 25 pounds? Did you really hook up with 25% if the females in your class? It’s like you lived a lifetime in just 4 years. The upside: if you did it right, you probably learned a lot, met lifelong friends, and were introduced to some really inspiring professors and scientists.   2. I’m gonna need a solid 2 year vacation now. You mean I only get a month? I call bulls*it!   3. Crap, that “debt” stuff they talked about really wasn’t a joke. Congrats!! You got your top residency choice in ______ (insert one of the most expensive cities to live in in the United States). They funny thing about top-ranked residency programs is that they are usually located in areas with heavy and diverse populations – metropolitan cities. Funny things about metropolitan locations? Lots of demand for living space and, thus, lots of rent.   4. I’m going to die alone. So, you pretty much blew every relationship that had potential in both undergrad and medical school because you were “so dedicated to your studies.” Now you’re about to start your residency where the time you aren’t in the hospital will...

How Are You Going to Spend Your “Last Summer” of Medical School?

The summer between first year and second year of medical school is sometimes referred to as the “last summer” since it is the last time students can travel or take off before they start the journey towards USMLE Step 1 and then their third year clerkships. With the angst building, first year medical students are actively deciding in the dead of winter what they will do over the summer. One popular decision is to do research – this is not uncommon since residency programs are increasingly competitive and look for students who have a commitment to scholarly work. However, there are a plethora of other things students could do as well. As tonight is our “Intro to our Summer Research Program” for Pritzker medical students, I thought I would share some of the most common questions I get about the “Last Summer”: 1. Should I do research in a competitive field? The answer here is to do substantive research that you are interested in with a “CAPE” mentor (Capable, Available, Project interests you, Easy to get along with). As my pre-med advisor once told me, “Mickey Mouse” research is not going to look good to anyone (no offense Mickey). The key is to find something you are passionate about – after all you have to tell this story on your interview trail of why you chose to do this...

5 High-Yield Gastroenterology Pearls for the ABIM Board and Medical Clerkship Exams

As we mentioned in a previous blog post this week, Gastroenterology and Hepatology comprises about 9% of the ABIM Internal Medicine exam, making it one of the more critical subjects on the boards. Below, we review 5 High Yield Gastroenterology/Hepatology Pearls that may help you score a few extra points on your ABIM or Internal Medicine shelf examination.   1. Interpreting Hepatitis B markers seems like a pain but is worth remembering Start with these key points: o Hepatitis B surface Antigen (HbsAg) → active infection o Hepatitis B surface Antibody (HbsAb) → past infection or vaccination against hepatitis B o Hepatitis Be Antigen (HbeAg) → active replication of the virus o Anti Hepatitis B core IgM Antibody (Anti-HBc IgM) → acute infection o Anti Hepatitis B core IgG Antibody (Anti-HBc IgG) → chronic infection This table helps reinforce these rules: (Click above image to view larger size) As you see above: Along with the Cleared state, both Chronic and Carrier Hepatitis B patients will have positive HBsAg and Anti-HBc IgG. How can these two conditions be differentiated? Easily. Just look at the Liver function tests (LFTs) o Chronic → Increased LFTs o Carrier → Normal LFTs What about that Hepatitis D virus? o Hepatitis D can’t exist on its own. It requires Hepatitis B infection to be present o Anti-Hbc IgM + Hepatitis D virus → acute co-infection...

Reddit Users Weigh In: What To Do During Your ‘Last Summer’

First year is coming to a close and it’s hard to believe you’ve already finished 1/2 of your pre-clinical time. It was harder than you could have possible imagined but now approaches glorious, beautiful summer. Since you’ve been on the med-track since 6th grade, you can’t remember the last time your summer wasn’t devoted to strengthening your resume. So now that you have one last shot at it, what should you do? Reddit users speak up… 1.” Two friends and I got a summer internship at a few family practice clinics: They were federally qualified health centers. We got nearly $5k in stipends/scholarships to show up to the clinic for 4 days a week and do some weekend community projects occasionally. Best part was they paid for a 2/2 about a block away from a huge beach/tourist area in Florida. So naturally, after a half day at work Thursday, we would walk to the beach with a case of beer in hand. Rinse and repeat all weekend. Throw in happy hour/ladies night on the weekend at a local bar, and that would make for a tough recovery come Sunday. My MS1 summer consisted of a lot of beer, beach, working out, hanging with friends, and some learning in an outpatient rural clinic. It was the best summer of my life.”   2. “Just take the summer off. Go to a beach, take a sweet...