Never Bored
Posted by medaholic in Medical School, Thoughts on February 4, 2010
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Although I was busy during my undergraduate studies, I can still remember days or weeks where I would be bored with school. If I was particularly on top of my school work, I would often take the weekend off and do absolutely nothing productive and instead something fun. I would slack for weeks at a time and know that I could catch up. I remember studying for chemistry intensely until I knew the periodic table and each element’s properties down cold. There were tests where I could recite dozens of physic formulas without the need for a cheat sheet. I remember having to find extra work to do to challenge myself, get involved in clubs, and push myself to go beyond class expectations.
On the contrary, nowadays it seems like work always has a way finding me. It’s rare to have a spare moment just to read leisurely or contemplate about life’s big mysteries. There’s always more diseases to study, new terms to look up, clinical opportunities to be involved with. And I know as soon as clerkship starts and residency, it’s only going to get busier.
Medicine is challenging. Compounded with my initial dislike for rote memorization – though it has improved a lot – I often find learning everything overwhelming. When I peruse the titles on the library shelves, there seems to be a textbook for every imaginable disease possible, irregardless of how obscure they may be. There’s such a variety of subjects to learn, ranging from anatomy to epidemiology to each specific specialty. For a curious person like myself who likes to know everything about anything, I find it hard to have the same confidence of knowledge as I did in undergrad. Even for common conditions such as hypertension or diabetes, there is a wealth of knowledge out there that keeps changing.
I knew what I was signing up for when I decided to go to medical school. Long hours, grunt work and a whole lot to learn. It can get draining, mentally, emotionally and physically. There will be days where going to the washroom and taking a nice hot shower will become a luxury. Sleepless nights, angry patients, grieving families. Life long learning until the day you stop practicing.
Medicine can be pretty tough, but boring? There’s rarely a dull moment. There’s always something to do, something to learn, something to challenge you. It’s a trade-off I can live with.
The Difficult Patient
Posted by medaholic in Medical School on February 3, 2010
I was doing an ER shift today when I came across my first difficult patient. Mr. K was a 50 year old divorced man who came in irritably on a stretcher having passed out from COPD exacerbation. He was shaking all over and showed a distrust for the medical system: the paramedics that brought him in, the nurses, the entire system.
Nothing destroys a relationship with a patient faster than distrust and I realized it was going to be a tough situation as soon as I took his history. “Jesus ****ing Christ, Why are you asking me again! I’ve already told you guys ten times what my medical history is like! Just do what you need to do and get me out of here.”
It was uncomfortable, after discussing with my preceptor, to go ask more follow-up questions and do a physical exam. I felt defeated and flustered. What knowledge and competence I had about his condition evaporated once his bitter criticism hit me. For the most part, the limited patient encounters I had before were generally positive with them being encouraging and understanding that I was still a medical student. There’s always two sides to a coin.
After the shift while walking home, this difficult patient encounter lingered in my mind. I guess sooner or later, every medical student becomes a bit more cynical and pessimistic. Their young idealism and optimism is replaced with harsh reality, death and disease. And although I remain positive about medicine, there are hard lessons and growing pains to be experienced. Even though it is difficult, I will continue to respect and treat my patients with dignity, irregardless of religion, race, age, disease or attitude.
Medicine is interesting in this respect. It not only builds knowledge, but also character. You slowly begin to realize what kind of a person and eventually what kind of a doctor you will become with each patient encounter. I hope I can become a doctor my patients trust.
A Typical Day in Medical School
Posted by medaholic in Medical School on January 23, 2010
Disclaimer: I have not yet begun my clinical rotations so this is just one student’s brief summary on a typical medical school day in the preclinical years.
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7:00 AM – My alarm clock rings. I quickly turn it off. 5 minutes later my second alarm which I always have as back up goes off. Going to class is too important to be left to chances; having two alarms is much safer. I brush my teeth, eat breakfast and pack all my notes, textbooks and laptops, which have been sprawled over my desk from yesterday’s late-night studying, into my trusty backpack.
7:45 AM – I make the quick walk to school. Living on campus is a luxury, the time you save from commuting is worth the higher prices you pay on rent. If you don’t live at home and have the option of choosing a place, live by the university. You won’t regret it.
8:00 AM – The first lecture of the day is beginning and the classroom is only 70% full. Stragglers and latecomers slowly file into the lecture theater, while the rest of us are just waking up. The smell of coffee and breakfast snacks fill the room. Thank God for caffeine.
8:30 AM – It’s halfway through the lecture and at this crucial point, depending on how good or bad the lectures has been going, I will either increase my concentration and focus for the remaining slides left or… begin checking my email.
8:45 AM - The daily newsfeeds and listserv messages begin flooding my inbox: faculty emails, student group event announcements and people looking for rent or pawning their old textbooks. If I’m lucky, there might be some personal emails from friends and family.
9:00 AM - Break time. Get up, stretch, go to the washroom. Only a few more minutes before the next lecture begins.
10:00 AM – Students in scrubs fill the hallway to the anatomy lab. The smell of formaldehyde is one that you don’t forget easily. Time always passes by quickly in the lab as we dissect our cadavers. Our group rotates responsibilities of cutting, reading the dissector and referencing our anatomy atlas. Tip: learn to use all your tools, not just the scalpel. The blunt scissors, probe and your fingers are often times better than the blade when it comes to dissecting.
12:00 PM - The combination of anatomy lab chemically induced hunger and classes all morning really work up your appetite. If there’s a lunch-time talk with free food I try to attend. If not, the lunch hour is a great time to hang out with friends, make necessary phone calls (banks, utilities, etc) and catch up on some studying.
1:00 PM - On alternating days, we either have small group learning or clinical skills teaching. If it is a small group session, ten or so medical students along with a preceptor begin discussing the case prepared for that week. After each session, we set out our learning objectives created for next time’s discussion.
3:00 PM – If it is a clinical teaching day, my group follows a preceptor to see patients. We practice our history taking and physical examination skills, while learning about different medical conditions. Clinical teaching is definitely an enjoyable time for me. It’s just a small taste of what is to come.
5:00 PM - My day at school officially ends, but the real work is about to begin.
5:30 PM - I usually head to the gym for a quick workout or relax a bit. Balance is key to a healthy lifestyle in medical school.
6:00 PM – Study. Study. Study
7:00 PM – Cook dinner. Whatever is most convenient is usually eaten first. Groceries are usually only done on weekends when there is time. Often, eating dinner is either in the company of friends or school notes. I also like to cook my meals in bigger portions and back the leftovers for lunch.
8:00PM – 10:00PM – Study. Study some more. There’s an awful lot of stuff to learn in medicine.
10:00 PM – Dedicated instant messaging / facebook / answering email time. Showers are nice too.
11:00 PM – An hour is lost from being unproductive and/or procrastinating.
12:00 PM - I usually get solid studying done at these wee hours. My circadian rhythm just happens to coincide with the midnight hour to be a productive one. I like to study and work until I feel tired and head to bed. But lately, I’ve been trying to keep a more regular routine. I often feel like sleep is a nice bonus for people in medicine, it’s nice to have but isn’t always required or permitted.
Summary
The day I have described to you is probably one of the busier days of the week. There are probably 2-3 of those days and another 2 more relaxed days with less class and responsibilities. Apart from class time and basic necessities, a lot of time is spent studying or doing other school related work. For the most part, medicine is not a 9-5 job, especially as a student when there is so much to learn. I feel like I could study 12 hours a day for several months (I wish I could) and still have lots to learn. I guess that is why the time it takes to train a doctor is so long (6-10 years).
If you have any questions about what a typical day for a medical student is like or want to contribute your experiences too, please leave a comment. Thanks!
Anatomy Lab Munchies
Posted by medaholic in Medical School on January 12, 2010
There’s something strange about the embalming chemicals in the anatomy lab. I’m always starving when I come out of the anatomy lab. And it seems that this is a common experience amongst medical students. It’s kind of disturbing that you would feel hungry after cutting human tissue for the last hour or so.
I guess just another peculiarity of med school.
The Taste of Failure
Posted by medaholic in Medical School, Thoughts on January 7, 2010
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Failing is a bitter medicine to swallow but like medicine, it is ultimately good for you. And even though I’ve accumulated my share of mistakes over the years and I am not really affected too much by it these days, there are still incidents and failed attempts that bruise my ego and leave me questioning my abilities.
I was recently reminded of these feelings of frustration and self doubt when I received a series of rejection letters from a few jobs and scholarships. It has been a while since I last ran into such “bad luck.” Sometimes the competition is just too fierce and sometimes it’s just the luck of the draw.
I can still remember being denied admissions to my top choices for university programs, all seven of them. And I still remember the countless hours I spent filling out applications for scholarships I never did win or jobs that never got back to me. I vividly remember getting rejected from medical school the first time I applied; I was devastated. Or being rejected the second time the next year, it wasn’t any easier.
Failing is a part of life. It’s easy to forget that sometimes, especially when you compare yourself to people around you. As humans, we often choose to see only what we want to see. While we often praise the success of others, we rarely focus on our own strengths and tend to focus on our own shortcomings. We tend to ignore the importance of making mistakes and how our successes often arises from tough situations.
It’s good to be reminded once in a while what failure tastes like. It’s like a strong smelling ginger that awakens your sense of complacency. And although not everything will always go my way, I remain optimistic. Because looking back now, my current achievements and success was built on overcoming my own failures. I became a more responsible student after my rejection letters. I became a more patient person as I waited to enter the medical profession. I will be a better person because of my failures.
As a wise personality from my childhood once said, “Take chances, make mistakes, get messy!”
Learning to Learn in Med School
Posted by medaholic in Medical School, Pre-med, Studying, Thoughts on December 31, 2009
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Learning in medical school is quite different from learning in a undergraduate setting. The concepts of medicine themselves aren’t that hard to grasp or different from the biochemistry, physiology and general biology in a typical premed course.
Simply put, each individual concept in medicine is easy to understand; connecting all the ideas and knowledge together is the more challenging part and is what makes a doctor. The increased volume of knowledge, need for long term retention and integration with clinical skills is what makes learning in medical school different, but not necessarily more difficult. Although, I have only studied medicine for a short time, I have begun to notice what works for me and what doesn’t and would like to share my own lessons on learning medicine.
1. Be an Active Learner, not a Passive Student
Learning is fun! As a medical student in preclinical and clinical years, your main responsibility is to learn, doing so in a respectful and enjoyable manner. No one is as responsible for your education than yourself. It’s your job to make sure you acquire the knowledge and clinical skills needed to become a competent doctor, not your school, not the licensing board, but YOU!
Do you still remember your transition from high school to university and how nobody was there to hold your hand anymore when it came to learning? Same goes in medical school. Luckily, there is no shortage of things to learn and do in medicine. Don’t feel obliged to just stick to just whatever the professor or lecturer says in the classroom, medicine is a far broader field than most know. Shadow, get clinical exposure, talk to physicians and learn outside of the classroom. Don’t spend all your time just focusing on material that you will be tested on, take time to learn what is important and essential to the practice of medicine! You would be surprised how poorly what is tested and what is important correlate, just ask a practicing doctor.
Remember that you are not in medical school to get good grades so you can get into the residency of your choice. That may have been true in your undergraduate studies, but it shouldn’t be in medical school. You are studying to become a doctor and you should ensure that you take the necessary steps to become a good one. Never let school get in the way of your education.
2. Nobody Remembers Everything their First Time Around
There is a lot of memorization in medicine, there is no avoiding it. But even the brightest students don’t remember everything their first time through. Spaced and constant exposure to the material is needed for any long term memory to be created.
Cramming may work to pass an exam but I highly doubt you will learn anything in the end. That is why I have found frequent reading and continual exposure critical to acquiring and retaining large amounts of knowledge. You may not remember all your antibiotics and bugs the first time through, but the more you repeat it, the better it sticks.
However, I must caution against repeating a lecture over and over again. Many schools record their lectures for student convenience and I think it is a waste of time to attend a lecture and then to go home replay the same lecture. Not only are you spending twice the time to cover the content, you are also becoming a passive learner who is hoping to absorb all the information by osmosis. It is the same as glazing over lecture notes repetitively but never taking the time to grasp the concepts. That is why focused and active learning must always take place.
3. Build a Basic Skeleton, then Fill in the Details
With the vast amount of knowledge to be learned, it’s quite common to get caught up with memorizing minutiae. After all, most exam questions tend to be focused on specific nitpicky facts. However, if a skeleton of knowledge isn’t built for each topic before these details are learned, it becomes hard to keep track of all the information floating around.
For any disease, I try to approach it in a systematic and consistent way. I like to start with a good definition or summary sentence for each new term. Using a good medical dictionary (and acronym and abbreviation dictionary) can make a big difference. Mondofacto, MedTerms, Medline, MediLexicon, Taber’s or even a dictionary or wikipedia are good sources.
Always start with the basics if you do not know them. Normal human physiology, anatomy, biochemistry, etc should be understood first before learning about the abnormal pathophysiology and disease states.
Apart from Etiology, Epidemiology, Clinical Signs, Diagnostic Tests, Treatment, Prognosis, etc I try to summarize the main points for each disease on one page of paper. Often a review book such as Toronto Notes or First Aid can be an excellent resource to learn the key and essential facts. Once you have the main points down, feel free to fill in any additional details.
4. Learn from Multiple Perspectives – Peers included
It would be a shame if your entire medical education was based on just your class lectures and recommended readings. Sure, the material you will be tested on will be from these notes but there is also a lot of material that will be left out that is important! Furthermore, class notes are often poorly organized and sometimes even incorrect.
Better yet, once you begin learning from multiples sources (and not just wikipedia) you will be able to differentiate what is important and what is not. The key concepts and facts will be repeated in multiple books because … they are important! Even comparing your class notes with a textbook will help you organize the information better and in turn you will spend less time with irrelevant material.
This applies to more than just textbooks. Learn from different teachers, learn on the wards and learn from your peers. There are a lot of nifty learning aids and tools that you may be unaware of.
5. Make the Knowledge Your Own
Take ownership of the things you learn about. If that means rearranging lecture slides into something you can understand, do it! Mark up your textbook with multi-colored highlighters and side notes if it will help you learn. If you want to learn the difference between multiple diseases, creating a comparison table is an excellent exercise and quick visual aid you can use.
Similarly, creating your own mnemonics or finding ones you will remember can make dry material more interesting. Create songs, rhymes and dances when possible.
Every time you create your own notes, you are reorganizing the information in a way that you can understand and digest. However, I would caution against just copying out notes mindlessly. You must organize the information to suit how you learn.
6. Ask Questions
There is no quicker and effective way to find your gaps of knowledge than by asking questions. That is why tests are such a practical tools in learning and that is why pimping (pdf) by attendings can be beneficial to you.
The pursuit of knowledge begins with a good question. After going over a topic, I like to turn over my notes and ask myself some questions. What did I just learn? Why is such and such important? How does this relate to this other condition? How can I differentiate between this and that? In doing so, not only do I come to realize what I don’t know, but I also create links between different concepts which further solidify my base of knowledge.
7. See one, Do one, Teach one
The old adage of seeing one, doing one and teaching one holds true when practicing clinical skills. It combines the best of repetition, active learning, different perspectives and taking ownership to help you learn and remember.
All students will observe, proactive learners will do, few will teach. I guarantee that if you take the time to teach somebody else a topic or a technique, you will end up benefiting from the experience. Even though I am not a big fan of group studying, one type of group work I do enjoy is when every group member first does their own reading and studying and then comes together for a review session. Every member is assigned a topic to go over and teach; they are to be the expert. By teaching in front of your peers, you get to know your topic inside and out because you will need to outline and explain all the concepts clearly. Furthermore, your peers will ask questions that can identify your weaknesses and similarly, they can contribute to the discussion if details were left out.
8. Practice Makes Perfect
Finally, I’ve come to realize that the journey I am on is a long one and everything doesn’t always come easy the first time around. I often forget my anatomy or confuse two different things for each other. I mispronounce drug names and many times I just don’t know. But luckily, I am still in the early stages and there is much more to go and with dedicated practice, I will improve. It’s important to set high standards but not to be too hard on yourself. Rome wasn’t built in a day and neither were doctors in days, weeks or even a year. It takes 10,000 hours to become an expert in a field (Outliers, Gladwell) which roughly works out to be somewhere after medical school and in residency. And even though I feel as if I have learned a lot, I know that there is still much more to learn ahead of me. So I look forward with optimism and excitement because I am slowly getting better at learning and I find learning medicine fun. =)
If you have any tips on how to learn, please leave a comment. I would love to hear how other people approach their learning!
I’m Back
Posted by medaholic in Uncategorized on December 24, 2009
Finally have some time to reinstall the website and add in some new features. It should be all done by the end of the week.
A scary thought crossed my mind tonight. I know how to get into medical school. I understand how the system works. I played the game and succeeded.
What happens if I don’t succeed in becoming a good doctor? What if I am inadequate?
A New Beginning
So starts my second year in the long arduous journey of medicine. In the last year, I feel as if I’ve definitely changed as a person; to what extent I still do not know. But I also find myself more focused now and a bit more certain about the kind of future I want to make possible.
And as usual with the start of the school year, I will be getting back into a routine and running this blog/website will definitely be a part of my schedule. Many changes to come including adding ads and sponsored links. I hope my readers won’t mind. It’s still a pretty big experiment for me but the whole idea came from a book I have just finished reading called Free: The Future of a Radical Price
Basically, the premise is in order for things to be “Free” – especially for web content – there should be a model that ensures it is possible. And for digital information, the advertising model is one of the best and most effective ways to do so. In fact, to a point where customers (readers) actually prefer to have them on websites as it helps bring relevant information to them.
I don’t know if what I’m doing is the right move or readership-suicide, but it’s something that I’m going to try and if it doesn’t work out, I can always revert back.
More updates to come!
Why the MCAT is Necessary
Posted by medaholic in MCAT, Medical School on August 2, 2009
A lot of people complain about the MCAT. I know I wasn’t too keen to study for it. I hated grueling through long verbal passages and needing to practice writing “MCAT-styled” essays. But in the back of my mind, I always thought of the MCAT as an essential and important test to have taken regardless of your score.
The Journey, not just the destination – I’m a firm believer that the process matters just as much as the results in anything we do. There is always such a strong emphasis of getting a good score in the MCAT and needing to meet cut-offs and school requirements that not many pay attention to how they study for the MCAT.
I can only speak from personal experience but I know that studying for the MCAT definitely made me a better student. And it wasn’t because I got a “good” score. Instead, it was during the process of preparing for the MCAT that I was able to develop effective study habits and disciplined time management.
More than another hoop to jump through – Many people see the MCAT as just another obstacle between them and medical school. It’s a thing you just do to get it over with. I urge you to take this opportunity to improve yourself and become a better student and hopefully one day a better doctor. With every challenge and difficult circumstance we face in life, there is also an opportunity for change and growth.
Really analyze how you study, how you learn and what peaks your interest. Find your strengths and weaknesses and nurture and compensate for them. If you were never the type of student to have a focused time-schedule, now may be the best opportunity to try it out. I know I played around with several different learning styles before I settled down on the best one for me.
Life-long Skills - Build your stamina and endurance. Practice learning and reading for fun. Learn something new each day. Learn how to tolerate stressful situations and doing things in a limited amount of time. One practical habit I acquired after writing the MCAT was to read the news everyday. I started out reading the news to get ideas for the MCAT essay. I now read it to learn more about our world.
A lot of premeds always ask me how to get into medical school. And when I tell them about the MCAT and what type of a test it is, the majority fear or dread writing the exam. They wish they would rather not have to write it. I disagree.
The MCAT is as much of a discovery process as it is a proof of your critical thinking abilities and test readiness. It’s the type of test where you CAN study for and prepare yourself accordingly. It’s not just testing your inherent intelligence but also how much you prepared to take it. If you haven’t taken the MCAT, I’m not sure if you are ready for the rigors of medical school.
Up to that point, how many 5 hour exams would you have written? Would you know how to study effectively and efficiently? Would you have the endurance and persistence that medicine requires?
That’s why I think the MCAT is not only necessary for standardizing scores, it is an essential part of the medical school admissions process. It’s a badge of honor, a reward for your hard work. Work hard for the MCAT and I guarantee that you will learn more than just physical sciences and biology. In partaking in this exam, one of which thousands have gone before, you are completing another rite of passage of medicine. Cause face it, there will be many more exams after this one, you might as well get the most out of it.