What Is The Best Way To Get The Most Out Of Clinical Clerkships?

It’s been a mere 4 weeks since I started my third year of medical school. I was one of the few brave (or foolish, whichever you prefer) souls to start on internal medicine. I’ll be honest, clinical clerkships are no walk in the park. I’m in the hospital 6 days a week, waking up at 5:30 AM and hoping to trudge back home by 7 PM, grab a little bite to eat, and pass out on the couch. But don’t get me wrong, I would never trade this for the first two years of medical school. The fatigue definitely hits you everyday, but the reward of finally learning what I came to medical school to do in the first place is unparalleled. So now that you are finally a third year, what is the best way to get the most out of rotations? In my opinion, it comes down to three simple rules: 1. Know your patients AND know other people’s patients I know what you’re going to say. I can already see you nodding your head from side to side and judging me. Let me be clear, I’m not that guy who tries to know everything about everything in order to show off, because honestly, I have the attention span of a squirrel. I am, however, a proponent of the principle that you learn by doing. I still...

Listen to Your Gut: The Microbiome Might Be Your Disease’s Foundation

Growing evidence supports the idea that the gut microbiome is the foundation of most illness and disease. A bacterial imbalance or pathogen in the gastrointestinal (GI) tract can lead to irritation and inflammation, increasing the risk for leaky gut and inflammation in other body systems. Not good. Recent studies suggest that gut microbiota influence communication between the GI tract’s very own nervous system— the enteric nervous system (ENS)— and central nervous system. The ENS is commonly referred to as the “brain in your gut” which communicates back and forth with the brain in your skull. To overcome physiological stressors, dysbiosis, and to promote an overall healthy gut, the enteric nervous system fires signals to the brain for support from the rest of the body by means of the nervous, endocrine, and immune systems. It is when these gut-brain and brain-gut interactions are prompted too often and subsequently put into overdrive when problems occur, specifically in the brain. More simply, a healthy, diverse, and balanced gut is an important factor for a normal, healthy brain. However, an impaired microbiota is believed to increase the risk of mood disorders such as anxiety and depression, and even neurodegeneration. It is not yet known whether the bacterial imbalance is the source or outcome of these disorders. Dr. Michael Zasloff conducts research on the gut-brain axis where he targets the enteric nervous system to potentially treat...

How I Learned to Stop Worrying and Love Step 2

First of all, you know how everyone says Step 2 is much easier than Step 1? They are correct. If you were conscious during your 3rd year clerkships and you spend a reasonable amount of time studying, you will be able to get a better score than you did on Step 1. Many people have asked me how I studied for Step 2, so I decided to write a quick blog about. (Disclaimer: If you’re applying to Ortho, Neurosurg, Derm, or Ophtho, none of this applies to you. You just need to talk to one of your people.) I chose not to take any time off to prepare for Step 2 because I had a six-week Psychiatry rotation at the end of 3rd year.  This rotation is lovingly referred to as “Psych-cation” because the hours are pretty amazing (usually 8:30-ish to lunchtime). In other words, I knew I would have time to study. So I scheduled Step 2 for June 29th, which was three days after my Psych shelf, and two days before the first day of 4th year.  (Yay! One day of vacation!) I ordered First Aid for Step 2 CK and Step 2 Secrets. (I didn’t use the latter very much, although it is a good resource and has great derm pictures.) Because I had used UWorld for my 3rd year clerkships, I reset the Qbank and started over. The Step 2 Qbank has ~2,200 questions...

Why I Took A Gap Year

Should you do a gap year before applying to med school? In this post, we’ll go over some of the benefits of doing a gap year. I’ll also share my own experience. That’s right – I did a gap year! Really quickly I’ll give you my experience and then I’ll provide you a general perspective on gap years. My Own Experience Taking A Gap Year Before Med School: People often forget that I took a gap year. But my gap year has been one of the most influential in my life. I graduated with my bachelors in 3 years. I didn’t have the financial capability to afford a 4-year education without requiring loans. But I also didn’t feel prepared to jump straight into medical school. I still felt mentally immature and inexperienced. So I made it a decision to take a gap year and apply to med school during my “4th year of college”. What did I do during my time off? I worked part-time a behavioral therapist one-on-one with autistic children. It’s by far the best job I’ve ever had! I had a light schedule, had a great salary, and developed my interpersonal communication skills with one of the toughest crowds out there. Working with my kiddos (clients) was a life-altering experience. But it also helped me on my med school interview. On every interview I went on, they...

Virtual Reality Could Replace Anesthesia

While the idea of using virtual reality (VR) tools in medical training and patient treatment has been around since the inception of the technology, Dr. José Luis Mosso Vazquez, research professor at the Universidad Panamericana and accomplished surgeon, has been actively using VR in surgery for over a decade already. After purchasing his son a low-tech VR game featuring Spiderman back in 2004, Dr. Vasquez realized the tech’s potential for immersion and distraction. Since many areas of Mexico lack access to the latest medical technology and professionals, ailments requiring surgery can be prohibitively expensive for patients. Even in Mexico City the hospitals are considered to be largely underfunded, so surgical suites may be under-equipped or understaffed. Dr. Vasquez’s virtual reality solution allows surgery to be performed using only local anesthetics while the patient’s attention is focused on an immersive digital experience. In geographically difficult to reach areas, this innovative surgical approach has helped many hundreds of patients to date. VR is already being used in medical schools for surgical training. Read more about it: What does it really feel like to manage an emergency in the operating room? The Cleveland Clinic Department of Thoracic and Cardiovascular Surgery is using virtual reality (VR) simulations of OR cardiac emergencies to replicate the experience as closely as possible and train cardiac surgery residents. “The two-minute video shows how Cleveland Clinic is using virtual reality scenarios to teach cardiac surgery...

Should I Go On A Medical Mission Trip?

Hearing the word medical mission trip on your resume or CV sounds interesting and impressive. You get to make a short trip to some third-world country and offer some of the much-needed healthcare services which the people there really need. These trips (according to the advocates) are much more valuable than serving a volunteer program in the US at some clinic. Many also think of these medical mission trips as very enticing and perhaps, life changing. However, there are two sides to everything. There are some who are not in favor of these medical mission trips as they think they serve no meaningful purpose. This dual point of view makes it difficult for the medical students to make up their mind whether or not they should be going on a medical mission trip to a third-world country or not. There are a number of questions that need to be addressed before you plan to go on a medical mission trip. The most important question being, will it actually have any long-term benefit for the people of that small country? Are you also facing the same situation and are unsure whether or not you should be traveling to an under-developed or a developing country on a medical mission trip? Here are some pros and cons that will help you make the decision. Pros of Going on a Medical Mission Trip It...

Taking Sick Days in Medicine

As my regular readers may have noticed, I tend to write about what I know. I think it’s the best way for me to choose what to write about because then I don’t feel like a phony, which is something I sometimes feel just as a by-product of being a student of medicine. Another way in which I feel like a bit of a phony is when I get sick and have to miss school. It’s especially tough on rotations because you feel like you’re letting everyone down, as if the whole team is somehow there for you when in reality they would function completely the same without you (although they may miss your positive attitude/humor/white coat pocket snack stash). For example, I get migraines often and they are only partially managed with medication. Sometimes the meds just don’t work or I’m not able to take them in time. Once I went a whole month without them because there was a snafu with the pharmacy and I couldn’t refill them. During that time I was so nervous I would get a migraine and have to call in sick that the whole time I was filled with anxiety over the mere possibility. Even if I do actually take the sick day I just sit at home feeling nauseas and ill, arguing with myself over whether I am sick “enough” for...