medschool

Eating Chocolate and other lessons from the ABIM Forum

Every year, the ABIM Foundation convenes a set of thought leaders on American health care to answer the tough questions.   At first glance, this year’s meeting  had the same standard agenda –  talks and discussions followed by networking and informal activities. However, for some reason, this Forum was more exhausting. Perhaps trying to solve the nation’s vexing problems facing health care is fatiguing! So, what were some of the themes that we came away with? • Intrinsic motivation is powerful, so can we create it? We heard about the potential dangers of extrinsic motivation through financial reward. Pay-for-performance, after all, is a tool that is only as good as the system is designed, and many designs have not been very effective. I was reminded of an unusual medical education experiment when they started paying residents in pediatrics on a fee-for-service model (yes, residents). The residents saw more patients, and their outcomes even improved with fewer ER visits! But, closer inspection yielded that these residents stacked their clinics with well child visits, who were healthier and did not need to visit the ER. So fee-for-service residency was abandoned. While everyone agreed it was time to move away from fee-for-service medicine, do we really think a change in the payment system creates intrinsic motivation? One health system offered their solution: recruit those that are intrinsically motivated. But, that still leaves us with how does one become intrinsically motivated? The...

What Nelson Mandela’s Words of Wisdom Mean to Almost Docs

I am fundamentally an optimist. Whether that comes from nature or nurture, I cannot say. Part of being optimistic is keeping one’s head pointed toward the sun, one’s feet moving forward. There were many dark moments when my faith in humanity was sorely tested, but I would not and could not give myself up to despair. That way lays defeat and death. Optimism is one of the greatest qualities a person can possess in life, and often, especially in medical school and as a doctor, it is tested. Life is full of challenges, and part of what makes life exciting is overcoming these obstacles. Remember that no matter what you face, the only way you can conquer difficulties is to be positive and have faith. When a difficult exam is approaching, remind yourself of your achievements and accept the challenge with enthusiasm. When you’re treating a patient and you think they might not make it, do your best and have confidence in your ability, no matter what the outcome. I learned that courage was not the absence of fear, but the triumph over it. The brave man is not he who does not feel afraid, but he who conquers that fear. The responsibility of taking care of someone’s health and having their life in your hands is frightening. For medical students, it is especially frightening to take part in...

SketchyMicro Aims To Make Medical Micro Really Easy (And Even Fun)

Medical microbiology is a tough subject. For any given bacteria, virus, or fungus, medical students must memorize how it clinically presents, the specific pathogenic mechanism, treatment options, and relevant laboratory tests. Taking Vibrio cholera for example, medical students learn to associate the buzzwords of “rice-water stool” and “comma-shaped” all while understanding the increase in cAMP production due to activation of a Gs protein. Three UC Irvine medical students figured there had to be a better way to learn these associations than through brute memorization, and born out of this frustration came SketchyMicro, a “learning modality that utilizes visual learning as its primary form of teaching” according to Andrew Berg, one of the co-founders. The approach capitalizes on the Baker/baker principle in order to increase recall and learning efficiency for students preparing for their USMLE Step 1 and COMLEX Level 1 exams. “We draw cool pictures to teach microbiology” -Andrew Berg, co-founder of SketchyMicro SketchyMicro is now accepting pre-orders at $39.99, which includes instant access to 21 of their videos and 6 months of additional rolling access when the program officially launches with 44 videos in late 2013. Read the full interview with SketchyMicro co-founder Andrew Berg at...

How Alcoholics Anonymous Can Help Doctors Too

Samuel Shem, author of The House of God, explains his motivations for writing a play about the founding of Alcoholics Anonymous. Shem describes the success of his patients that entered the program. The play, Bill W. and Dr. Bob, is currently playing at The Soho Playhouse in New York City. For tickets go...

Identity, Expectations and Choice: Asian Americans on the Premedical Track

Now that I am a college senior, the most pressing question on anyone’s mind seems to be, “What are you planning to do after graduation?” Many people are visibly unsurprised to hear that I have set my sights on medicine. Their eyes thank me for confirmation of what they guessed I would want. From people who know me well, this is a compliment—that if I keep working hard, I might make a good doctor someday—or, if not a compliment, at least a seal of approval, encouragement to fight the long fight in pursuit of my dream. From people who hardly know me, though, I start to wonder how much the Asian American stereotype affects their perception of me and other Asian premeds like me. And for a second, I start to wonder how our stories and our identities, shaped by the assumptions of others, might affect our own self-perceptions. When I told my parents that I wanted to pursue a career in medicine, they were supportive, but not too supportive, because they knew how difficult the path would be, and told me they didn’t want to influence my decision-making process. My maternal grandmother, on the other hand, kissed me on the cheek and thanked me. When I asked her why, she said it was because she never had a doctor she really trusted, and she wasn’t getting any younger....

Top 10 Mnemonics to Get You Through Med School

Sometimes even after reading over the same paragraph multiple times, the material just doesn’t stick. These mnemonics will help you effortlessly master important concepts that are high yield on the boards and guarantee your succes. 1) 5 parameters of the HPI (history of present illness): 2) Encapsulated organisms: 3) Inhibitors of Cytochrome P450: 4) To remember that the right lung is tri-lobed and the right side of the heart contains the tricuspid valve while the left lung is bi-lobed and the left side of the heart contains the bicuspid valve: 5) 12 Cranial Nerves (in consecutive order): 6) Branches of the Brachial Plexus: 7) X-linked Immunodeficiencies: 8) Most Common Symptoms and Bacterial Causes of Meningitis: 9) Anterior pituitary hormones: 10) Precursors in neurotransmitter synthesis (steps in order):     Featured image from Flickr / digiart2001 jason.kuffer   Correction: July 19, 2013 An earlier version of this post used incorrect wording for the third cranial nerve. This error has been...

When Treating Chronic Pain Syndrome, Family Matters

Bruce Singer, Psy.D., Program Director, Chronic Pain and Recovery Center, Silver Hill Hospital, evaluates the large social impact of chronic pain syndrome. He urges families to avoid enabling certain behaviors and to be an integral part of chronic pain...