medschool

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...

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...