Archive for November, 2008
Why Travel – New Perspectives of Old Scenery
Like most people, I enjoy traveling and as of lately, I’ve been flying everywhere for conferences. As a result, I’ve had some time to do some much-needed self reflections. Seeing a change of environment and exploring new places always excites me. I’ve always felt blessed that I’ve been to so many places at such a young age and as a result, a large part of my identity is the product of my travels.
I always thought the value of traveling was seeing new things: meeting different people, learning about other cultures, being exposed to new ideas. Traveling would broaden your scope of the world and help you think differently. After each trip, I feel like I’ve learnt something new and understood something more about the world. Recently though, I’ve noticed that traveling is as much about seeing new things as it is about seeing familiar things with new eyes.
Whenever humans inhabit a place for a long time, we end up creating a set of habits and daily routines. As a result of being creatures of habits, we like to do certain things the same way every day. We designate a place to study, a place to eat, and a place to relax. We establish bathroom rituals, whether it’s brushing your teeth after breakfast or flossing only at night. These daily habits are so ingrained to our everyday living that we don’t think about them. Eventually, we don’t think about what we are doing, we do it out of familiarity.
Traveling shakes things up. It is a break from our daily routines. Being in a new place removes us from our accustomed lifestyles, and forces us to think over actions. Our brain’s auto-pilot becomes obsolete. If in a new city, you will have to figure out where things are, how to get around and things you want to do. When looking for lunch, you have to actively think, look for and evaluate places to eat. Through removing yourself from your usual surrounding, you give thought to decisions that would normally would not.
By stepping away from your everyday routine life, traveling gives you a chance to see your own life more clearly. You notice the little habits, preferences and mindless actions you do each day. From a distance, you can see the bigger picture of your life. What directions you are heading in, what you spend your time doing, how your actions impact you. From traveling, you get to know more about the world while getting to know thyself. Therein lies the value of traveling; it is both a journey of the external, and internal world.
How Smart are Medical Doctors?
Posted by medaholic in Health Care, Thoughts on November 26, 2008
Medical Doctors Ranked First with Highest IQ amongst job professions
How Smart are Medical Doctors? An interesting study published by the University of Wisconsin suggests that doctors (M.D or equiv O.D, dents, etc) have the highest IQ on average.
Though I’m not a huge supporter of IQ tests but I would say that most doctors are somewhat smart. However, I would further add that, having a high IQ does NOT make good doctor.
Being a good doctor requires more than just book smarts. It requires strong work ethics, commitment and clear communication skills. Understanding basic science and pathology requires you to be smart. Facing death and the sickness of others requires human compassion.
A often neglected, but perhaps more important measurement is Emotional intelligence. Doctors with high EQ care for their patients better.
Medicine is both a science and an art. Doctors have to understand bio-mechanisms and lab tests as well as human emotions and feelings. People who are aware of their own emotions and can empathize with others will be more likely to give excellent patient care.
Unfortunately, the ever increasing emphasis on test scores (GPA, MCAT, USMLE) may be a bad sign for our future doctors. We are increasing our IQ statistics but consistently neglecting our EQ measurements. Medical schools have acknowledged these problems and have begun pushing for more arts and humanities in medicine.
People don’t care how much you know–until they know how much you care.
A higher EQ is beneficial for doctors too. A patient is more likely to trust their physician and disclose information if they know their thoughts and ideas will be respected. Even though medical knowledge is growing exponentially and as physicians, we will continually learn medicine, we must not neglect our emotional education either. Doctors treat patients, not diseases.
The Medical Student Syndrome Online: Cyberchondria
Posted by medaholic in Health Care on November 25, 2008
Today on the New York Times, there is an interesting article on the use of the internet to find medical and health information. The term Cyberchondria comes from the root words of cyber (internet) and 
hypochondria (an excessive preoccupation with one’s health). A cyberchondriac is then a person who uses the internet to gather health information for themselves or for people in their care.
This “cyberchondria” is not a new phenomenon. People have been using Dr. Google since the publication of medical literature on the internet. For many cases, the search engine diagnosis can be fairly accurate and empowers patients with an understanding of their illness. However, as stated in the article, people who use search engines for health care knowledge tend to focus on more serious and rare conditions, diseases that they most likely don’t have. And since the internet is a series of connected hyperlinks, after several clicks, the patient’s supposed disease has escalated into the most lethal incurable case possible. The web can be misleading.
The classic “medical student syndrome” is no longer confined to students in the walls of medical school. Anyone with an internet connection can start becoming paranoid about potential health risks with only some cursory reading. Hypochondria is affecting everybody. People are suffering from sleepless nights and loss of appetite over misconceived ideas and false conclusions can cause severe emotional harm. Furthermore, “self-diagnosising” often breeds mistrust between the doctor and the patient. The patient begins second-guessing the doctor’s assessment. They are willing to distort their symptoms and exaggerate the ones that support their hypothesis. This impairs a doctor’s ability to find the real source of the problem.
Despite the setbacks, accessible and public medical and health information is a good thing for patients. But in this age of information overload and non-reviewed online publications, doctors are just as needed as ever. They are experienced guides to navigate through the medical jargon jungle. They have years of proper education and real life experiences that have been tested and true. There is an old joke in medicine that asks, “What do Doctors do to exercise?” And the answer is exactly the same thing that plagues patients and cyberchondriacs, jumping to conclusions.
So next time you feel inclined to go online to look up your symptoms and select a potential explanation to your illness, take some extra time, and call your doctor to discuss with them your symptoms. Afterall, that’s what they are trained to do.
Adcom Advice #1 – Don't Lie
Posted by medaholic in Admissions, Application on November 24, 2008
If there is one cardinal sin of applications, it is lying (false information, overexaggerate, half-truths)
Nothing gets your application thrown out faster than lying: about your qualifications, extracurricular activities, personal achievements. There are no benefits from lying on your medical school application. It is dishonest and unforgiveable in the eyes of adcoms. You gain nothing and risk everything. Typos and late submissions are bad, but lying is inexcusable.
Even with the dire consequences, each year, a small number of students take their chances and lie on their applications. Although only a few commit this crime, it is common enough that several applicants will be straight out rejected every cycle. A single lie will make adcoms doubt the rest of your application, even your honest achievements.
Fortunately, the majority of applicants send in honest applications, so if you are one of the few considering fabricating some part of your application, here are the Top 5 reasons Why you should not Lie on your Med School Apps.
- Adcoms can tell - Despite how cleverly crafted your application is, or how dumb you think adcom members are, we can tell when applicants are making things up. After going through hundreds of applications, we can detect when something is inconsistent. When we read a profile, we get a good “feel” for each applicant’s character and we can pick up when something doesn’t fit.
- Adcoms check – When we do find inconsistencies, we check. That’s why we ask for referrers and contacts. Furthermore, med schools will randomly call contact numbers as extra precaution. If you “are” a national award winner, a simple google search will tell us. The same goes with all other parts of your application. The power of modern day telecommunications is on our side.
- You need a big lie – If you are going to stretch the truth, you need a tall tale to make a difference. Exaggerating that you volunteered 4 hours a week, instead of 2 hours, won’t give your application any significant advantage. You would probably get the same score, but now, you run the risk of being caught and in turn, having your entire application discredited. If you want any competitive edge, you need to go big; captain of a varsity team, international volunteering, published papers. And with any big achievements, adcoms can tell if it’s consistent with your character and they will definitely check.
- Lowers Self Esteem – Lying does not significantly increase your chances. However, it will significantly increase your personal struggles. You will feel guilty about lying and paranoid that adcoms will find out. If you do get in from large exaggerations, you will be someone who had to cheat their way in and you will feel like an imposter.
- Integrity – Lastly, a large part of being a good doctor is integrity. Would you would want a dishonest doctor who takes unfair shortcuts to care for you and your family? If you do want to become a doctor, please be a good one. If you need to sacrifice your morals and identity to get into medical school, you should choose another profession.
Lying on your application is a fatal mistake. Do not pretend to be someone you are not. If you don’t have any significant leadership roles or scholarships, that’s ok. Adcoms understand that not every applicant will be a superstar. Every year they will admit dozens of less than perfect applicants. Your job is to present who you are in the best way possible. I will write more on how to do this in subsequent posts. But please, please, please, do not lie or overexaggerate. Don’t report false grades, MCAT scores, fake activities, etc. We (adcoms) want to know the real you. And more often than not, the people who are honest and sincere are the ones admitted.
Adcom Advice – Series
Posted by medaholic in Admissions on November 23, 2008
I am starting a new series titled: “Adcom Advice.” This year, I have the opportunity to be involved with my school’s admission committee and an integral part of selecting future medical students. Looking back on my own application process, I now see so many things I could have done to make my application better. I also feel very lucky that I inadvertantly avoided the most common mistakes and pitfalls that applicants commit every cycle. Having this first-hand opportunity to see and understand how the medical school admissions process works from the “other” side, I want to give back some of the lessons I have learned to the community. The intent of my posts is to help students send in their best application, how to market their strengths, not to undersell themselves, or commit any fatal errors. That is why I am starting this adcom advice blog series.
Disclaimer: In no way am I trying to leak private information belonging to any medical school onto the internet. I will not be revealing any specific school weighting formulas or actual admissions logistics, all posts will have no relationships with any particular medical school. I respect the privacy of the admissions process and all applicants and I will protect this confidentiality. All examples used in my posts will be fictional, and any resemblance to real-life applicants will be purely coincidence.
Advice in my posts will not be anything new… you will have heard this advice frequently from professors, medical students, parents and friends. In fact, if you pick up a typical medical school admissions guide from any bookstore, they say EXACTLY the same thing. So what do I offer that’s new? What I believe I can give is a different and fresh perspective to the admissions process. I can offer both the viewpoints of an admissions committee member and a starting medical student. Furthermore, as a student who has very recently gone through the system, I understand the challenges and difficulties facing students today.
But the reason I hope this series will offer value to you, is YOU. I am just one person, I only have a finite amount of experiences to share. However, each of you have stories to share and advice that has worked for you. Why pay hundreds of dollars to admission consultants for information that people are willing to share for FREE. So I encourage readers to comment, to start a discussion and to help me understand how the admissions can be better. And together, maybe we can make sense of this whole process.
Why You Shouldn't Volunteer
Many med school applicants volunteer for the sake of volunteering. They do it to write on their CV. They do it because everyone else is doing it. They volunteer because they believe it is what they should be doing. To all the volunteers with this mentality, “You’re wasting your time.”
When I use the term volunteering in this post, I am describing the many extracurricular activities people pursue. It can be helping out at the soup kitchen, spending time with residents at a nursing home, tutoring ESL students. Any item on a typical premed laundry list. Now I understand that there are many instances where volunteering has a tremendous impact – running into a burning house to save a life, performing the Heimlich maneuver, forming a search party for missing individuals. I am not talking about these brave acts of volunteerism. I am talking about plain old, “I volunteer at a hospital, giving directions, providing drinks and warm blankets to patients, handling paper work.”
The main criteria of volunteering is that one offers an act of service without pay. So whether you’re a big brother/sister, a child care volunteer, doing data entry, coach of a sports team, playing piano for your church, communicating with dialysis patients, helping out in an African orphanage, you’re all doing this free of charge. The problem with the majority of volunteering activities is that they do not offer any valuable service. The easiest way to determine if you’re volunteering is worth anything, ask yourself, “how much would someone pay for me to do my job?” For the majority of cases: absolutely nothing.
There would be no difference if a volunteer disappeared, most organizations would still be functional. The hospitals would run just fine, perhaps maybe even better without all the confusion, training and interruptions of volunteers. Some will argue that teaching English to third-world children is valuable, English tutors are expensive! I would agree with you too, except for the fact that you cannot teach someone English in a week, a month, a summer or even a year. When you decide to give up several years of your life teaching English for free in a foreign country, I will change my mind. If you were a cardiovascular surgeon volunteering to do heart transplants for free, you are making a difference. For the majority of people who volunteer for the sake of doing it, the volunteering you do has no value.
Money is power. It allows people to buy useful goods and services. Volunteering does not generate any money, which leads to the point that volunteering is not self-sustaining. People cannot work for free forever, we all have bills to pay, necessities to buy. Eventually, funding will have to be brought in from somewhere. Even charity staff are paid for their work. Furthermore, if you’re motivation for volunteering is to put it on your CV, as a resume padder, you will hate your job. You will be emotionally drained. You are better off not volunteering at all.
So am I against volunteering? Absolutely not. Volunteering has a lot of good merits and I believe people should volunteer. Medical schools will look favourable on volunteer experiences. What I want to get across is to volunteer for the right reasons. Volunteering won’t change the world, but volunteering will change you. You will learn and grow with your experiences and hopefully, you can go on afterwards to change the world.
[Article coming soon: How to make the most of your Volunteering]
The Three Roads Ahead – Medical Career Paths
Posted by medaholic in Uncategorized on November 18, 2008
Usually medical students are busy deciding what residency or specialty they will end up in after their medical school years, for me I have a different question on my mind. What kind of medical career do I want to have? Medicine is flexible discipline, broad enough to have interests for everyone. For me, I just seem to be interested in too many fields. After much consideration, I’ve come to see three distinct paths ahead that I can see myself doing, each with their pro, cons and other considerations.
1) Academic / Research / Education / Industry
Pros:
- Intellectually stimulating / rewarding
- Opportunity to positively impact large population
- Able to pursue self academic interests / curiosity
- Furthering of human scientific knowledge
- Flexible, Job Security (after tenure)
- Less on-call frequency
- Teaching, Giving back
- Chance for $$$ – large research grants / business opportunities
Cons
- Low patient contact
- Dealing with administration / bureaucracy / politics
- Tied down to an academic institution / company
- $$$ – dependent on finding grants / funding / profits
- Need patience – years before fruits of labor realized
- Uncertainty in research / discovery
Other Considerations
- Several more years of scientific training, most likely needing a PhD
- Need to find good mentors / research experiences
- Emphasis on publications / teaching
2) Social Equality / Public Health / Relief Work / Third-world countries
Pros:
- Serving people who need it the most – poor, needy, vulnerable, sick
- High intrinsic satisfaction from helping others
- Sense of justice and doing the right thing
- Meaningful patient contact – Saving lives
- Seeing and knowing that your efforts are making a difference
- Wider exposure to the world
Cons
- Emotionally draining – facing insurmountable challenges
- Not as comfortable a lifestyle
- Possibly live in different country – away from home
- May strain family life – traveling, may be gone for months, raising kids
- $$$ – considerably less
- Fixing the underlying causes / system is hard and lengthy in time
Other Considerations
- Additional training, MPH (epidemiology, statistics, environmental)
- May need to pick up additional language(s)
- Understand health related economics, policies, government, organizations
3) Private Practice / Clinical Work / Health Care Team
Pros:
- Valuable patient contact
- Training and development of clinical skills
- Medical practice autonomy – how you run your clinic, manage patients
- Ability to influence your community positively
- $$$ – higher, have control over income
- Family friendly – settled down location, routine in your lifestyle
- Outside interests – control of time, pursue hobbies (specialty dependant)
- Comfortable lifestyle – will be able to buy a house / nice car / raise kids
- Job stability and certainty – high demand for primary care
Cons
- Regular routine – may become boring / tedious
- On-call frequency higher if in hospital / shared practice setting
- High volume of patients / long work hours – may be stressful
- Not as far impacting as breakthrough research
- Treating patients and disease only – Less likely to change health care system
- Overhead costs, malpractice fees?
- Aging population – puts a strain on healthcare workers
Other Considerations
- Can sub-specialize, focus on specific groups or niche fields
- Able to work anywhere, anytime (dependent on your preferences)
- Short training period
These are factors that I have given much thought too. Ideally, I would like to do all three; realistically I would most likely pick just one. The reason is that it’s very difficult to excel in more than one area. I am a finite person with a finite amount of time, and each of these paths can be a separate career on their own. The large amounts of training and energy needed to get good at any one leaves you with little to contribute to other ones. Obviously, the pros and cons are specific to me. Some might see low patient contact as a pro and other people might hate research.
So this will be the question I will be thinking of for a while. I have at least four years of medical school and 3-5 more years of residency to think this over with. If anyone has faced this question before and has experiences they can share or advice they can give, please leave a comment below. It will be much appreciated.
The Specific Language of Medicine
Posted by medaholic in Medical School on November 16, 2008
Learning medicine is like learning a foreign language. Clindamycin, Mycoplasmas, Otitis Media… All these words have no meaning until you give them one. For most of medicine, this foreign language you are learning is Latin. Almost all medical terminology – certainly anatomical and pathogenic terms – has roots in Latin. The big exception to the rule is drug naming.
When it comes to giving medication, it seems like their naming convention is random. However, after giving it some thought, drug names are no different from the random nature of human names. Take the example of the United States 43rd president.
If I originally say Bush – you may have images of George Bush, a burning bush, pubic hair, thick forests. However, if I add the first name George Bush, there is more information available. You now know I am referring to an American president. To further differentiate between George Bush Sr and Jr, I can add in the middle name so you now know I am referring to George W. Bush.
The key piece of information that was the “w” in his name. It helped differentiate two presidents and provide specificity. To further shorten down this whole process, I can just refer to George W. Bush as “dubya.” In one short word, I created a unique name that has low ambiguity.
Much in the same way, drugs get their hard to memorize names in a random process. We go from antibiotics > beta lactam > cephalosporins > third generation > “drug name.” The final drug name seems arbitrary but it is only through these random words that highly specific information can be given. Only by creating these unique words is there a 1:1 term to definition, where every term describes only one thing.
So even though the random medical jargon – of anatomy, physiology, pathogens, drugs, treatments – is incomprehendable to the general public. Amongst physicians, this highly esoteric language provides painstakingly precise information, that makes our communication amongst health care workers, highly effective.
Learn Using What Works For You
A big change in medical school is to be surrounded by the same classmates, day in and day out, everyday for at least the next two years. Naturally, you begin to observe their studying habits. Some print out their notes and follow the lectures in class, coloring them with six shades of highlighters. Others, open up their laptops and follow the presentation on their own screen while chatting away on facebook.
A lot of people like to study in groups; much time is spent “pimping” each other on obscure facts from lectures. Some use group study time to learn from others or as an opportunity to teach. Most student-made notes and study cheat sheets are shared with each other.
I’ve tried many different learning methods since starting medical school, changing it up to see if I can become a better student. I’ve tried copying what other people do, maybe by imitating their study styles, I’ll become more effective. After two months, I’ve come to realize I must do what my instinct has been telling me all along.
Study the way that fits you. I should be true to my own learning methods and continue to do them. I’m a visual learner who does most of my education outside of the classroom. For me, nothing is more effective than a big chunk of time in front of class notes, textbooks and making my own notes. Lectures aren’t effective for me, I retain absolutely nothing. Flashcards are nice, but whenever I make them, I don’t use them. I don’t listen to podcasts and reading notes over and over again doesn’t do it for me.
And for the past two weeks I’ve gone back to my old and time-tested methods. And I have never felt more confident with my choice. I am beginning to grasp the concepts taught quicker and in more depth. I use less time to study more topics. I skip class occassionally and I don’t feel guilty. Use what works for you. Learn the way you are most comfortable with. Knowing how you best study is important. Don’t be intimidated by people who learn differently from you. Do what you do best. After all, it got you through undergrad and into medical school and I guarantee it will get you through pre-clinical years.
I’ve heard clinical learning though is completely different.
Famous Poems by Physicians
In Flanders Fields
In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.
We are the dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved, and were loved, and now we lie
In Flanders fields.
Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.
— Lt.-Col. John McCrae
Lest we forget…
