Archive for December, 2008
A Break in Routine, A Good Thing
One of the pleasant aspect of holidays is the break from the daily routine. You can sleep in, lounge around in your pajamas, stay out all night, and spend your time in any way you please.
Although I do enjoy the rest, I have spent much of my holiday doing things I wanted to do but never had the time to do before. In the past week, I have gratefully read four non-medically related books, seen old friends that are outside the bubble that is medical school and done much of the simple and appreciated things of life. Write, sing, laugh, study.
It is in these calm moments, when the bustle of a busy schedule slows down, that I find motivation to re-energize myself. A time when I can step back and reevaluate the directions of my life and make adjustments and lasting changes. Every year at this time, I think and write a summary and reflection of the year. I’m looking forward it.
Some questions I think about are
- What were my goals that I set for myself last year?
- How many of those goals did I accomplish? What went right and wrong?
- Is there something I could have done differently? How could I have improved?
- Were there any changes and deviations to my goals?
- What did I learn? How have I grown as a person?
- What am I looking forward to in the New Year? Is there anything I am going to do differently?
- What are my goals for the next 6 months, 12 months, 18 months and 5-10 years
I find it strange to have an inbox not flooded with emails each day. I have more free time than scheduled appointments. The change of pace is gladly welcomed. It is these different moments of irregular routines that we can pursue new things and experiment. That is why I think summers, especially the last few that I have left, will be very valuable. A large block of free time is increasingly harder to find as we grow up. We get more responsibilities, commitments and “grown-up” things to do.
Sometimes we just need some free time to travel, discover, grow and enjoy.
Merry Christmas 2008
Posted by medaholic in Uncategorized on December 25, 2008
It’s been an eventful year 2008. New city, new school and a journey into medicine. Next year looks promising and I”ll be sure to update often.
Have a happy holiday season, a Merry Christmas and a Happy New Year. I hope all your new year’s dreams and goals go well.
The Taboo of Medicine and Money
Posted by medaholic in Health Care on December 17, 2008
I stumbled upon a blog post today asking the question “Do Doctors Make Too Much Money?”
As I read on, what started out as a simple question soon ballooned to over 100+ comments from patients, doctors, residents and spouses all with their strongly voiced opinion.
On one side, there are overworked doctors who see nothing wrong with the current billing system and in fact suggest that more compensation is necessary, especially for the primary care providers. Other patients complain about how little doctors know and how little “actual work” they do for their big pay cheques. There are quite a few comments that blast doctors for doing it only for the money, nice cars and long vacations.
There are examples of neurosurgeons who are working their butts off to get by. Others counter with stories of dermatologists with 40 hour work weeks clearing half a million.
The answer to such a question of physician pay is quite complex. When considering how much physicians are paid it’s not simply enough to look at hours worked. There are also lots of hidden costs and intangible factors to consider. Overheard costs and malpractice fees are paid by physicians out of their own pockets.
Or consider the opportunity cost of becoming a physician. Education is long and strenuous, easily taking a decade before students become licensed doctors. How can you put a price tag on youth? The interruption a medical profession has on family, the loss of relationships, the physical and emotional hardships endured is hard to count in dollars.
A doctor also faces a lot of unique job circumstances that are hard to quantify and put in numbers. How much can you pay someone to to face death and illness day after day? To have the blame of a patient’s death? There is also a lot of stress and physical toll working a job that require long shifts of 24-30 hours every few days.
Government and health insurance companies also have their own agenda. They want to implement policies and billing procedures that may not be to the best interests of the patient. Patients also have their own preferences. Some will demand the most expensive treatment while others will not buy beneficial medication because of the hefty price.
Medicine is a tough job but it still attracts the brightest. These are people who most likely would have succeeded (however you define that) in almost any job. Yet they have chosen to pursue medicine, and almost all (there are a few exceptions) will have done it for reasons other than money.
Yet there is still a taboo that doctors aren’t allowed to talk about money and salaries. Whenever a doctor brings up the topic of money, they are accused of doing medicine just for the money. That you see medicine as a way to make a living and that they don’t take it seriously and as a calling to serve others. They are branded and told if they don’t like their current pay, than maybe they should leave the profession and leave it to people who are more altruistic and actually care about healing others.
But money is a part of medicine. As much as you don’t like that idea, money affects medical decisions. To NOT talk about money and the economic choices in health care is actually harmful for everyone, especially the patients. Talking about the money medicine is an important aspect that should be discussed more openly. We need our medical students, residents and physicians to be know about basic health economics. Patients need to understand medical finances too.
There is nothing wrong with medical doctors talking about money. Just like there’s nothing wrong with patients, politicians, and even charities talking about money. There is a problem though when your underlying motivation for becoming a doctor is money. The patient should always come first. Money can be a good and bad thing, but we shouldn’t criticize doctors or health care workers as greedy salary earners just because they suggest higher pay. Similarly, doctors need to start looking at things from a patient’s point of view and why they believe physicians are paid too much. Obviously there is truth to both sides of the argument of whether doctors are making too much money.
So whether you’re a RN, health professional, doctor, patient, insurer: we need to stop accusing each other of greedy motivations and being such cynics and critics and we should get talking. We’ve ignored for too long the elephant in the room that is money and medicine.
Better use of our money will lead to more effective and efficient health care. If we are open to talking about money, more people will have their input which will hopefully lead to creative and innovative solutions. At the end of the day we shouldn’t be too worked up over physician salaries. Instead we should be measuring the quality of health care provided to patients. If talking about money can get us there, I don’t see why we shouldn’t start thinking and asking questions about it.
Adcom Advice #5 – Quality Over Quantity
Posted by medaholic in Admissions, Application on December 16, 2008
When it comes to giving marks for extracurricular activities , quality wins over quantity.
A fruitful summer of research with a publication is better than three summers being a lab assistant/tech. A long term commitment to a volunteer organization with significant responsibilities is better than volunteering at three different hospitals.
The same goes for personal activities. Do you play several instruments at an intermediate level, or can you play one instrument with high caliber? Are you good at several non-competitive sports or are you a varsity athlete representing your school?
Don’t think that spreading yourself over several similar activities represent diversity. Whether you volunteer at one hospital or five, your diversity of experiences remains relatively the same. Diversity is doing something different from the status quo. It is exploring options you haven’t previously considered. A competitive athlete that also helps out at a homeless shelter is diverse. An athlete that plays two different sports, not so much.
So if you’re deciding what extracurricular activities / interests to pursue, here are three good guidelines to follow.
1) Commit to something that you enjoy doing / are interested in
2) Commit to it whole-heartedly, give it your all
3) Find something you’re good at – and do it better
Abraham Lincoln said it best,
“Whatever you are, be a good one”
Comparing Yourself With Others
It’s application season again. Premeds are looking for summer research positions. Med students are applying for scholarships and grants to fund their education. And medical school admission committees are processing and reviewing hundreds of files.
Naturally as a consequence of seeing the profiles of so many talented people, you begin to compare yourself to others. You size up your accomplishments to others to see how you have done in comparison. While browsing through all these amazing applicants, I still wonder how it was possible that I was ever admitted to medical school.
I am not a captain of a varsity sports team. I haven’t backpacked across Asia, volunteered in Africa or ran a marathon. I’m not a gifted musician in any instrument and I can’t speak three languages. Yet there are dozens of applicants that have such experiences. They have had endured life-changing hardships and have overcome poverty and prejudice. I feel like there are so many more deserving applicants than me.
If you hang around internet medical forums, you would have experienced this insecurity. Almost all the posters seem to have a 4.0 GPA, MCAT 36+, hundreds of hours of volunteering and great leadership roles. If you go to www.mdapplicants.com it’s so easy to feel down when comparing yourself to others.
If you haven’t had this experience before, just look up the winners of some big scholarships. Rhode scholars, Fulbright, Gates Scholars, Golden Key recipients. I feel small and insignificant in comparison when I read the winner’s bios. What have I done?
Comparing yourself to others can be a boost to your ego but for the most part it will be a blow to your self-esteem. You will feel as if your best isn’t enough. You will have no confidence in your own abilities.
When I am down and out, I just remind myself that it’s all about doing YOUR best. The only person I should be comparing my achievements with, is myself. Am I a better person today than I was yesterday?
Everyone has their own strengths and weaknesses. And when I think about it, when I look at highly accomplished people, I know I probably do certain things better than them. I might be a better friend, a better listener, someone who can keeps secrets well. The point is everyone has good and bad points and it would be foolish not to realize that we will always be learning from and teaching each other.
So next time that you find yourself comparing your accomplishments with others, step back and look at what really matters. Don’t do things because other people are doing it.
If you compare yourself only to yourself, in the long run, you’ll be much more satisfied with your achievements.
Adcom Advice #4 – Grades Come First
Posted by medaholic in Admissions, Application on December 11, 2008
There are so many factors to consider when reviewing medical school applicants. You may have heard that volunteering overseas will get you big points, that you must do research, or that a good MCAT score will go a long way. All of these things do play a significant role in the admissions process, but if you had to pick one area to focus on, good grades come first.
Just today, while reviewing applications, I noticed a lot of applicants would try to explain their poor grades. Not only does this go against my advice of not making excuses, there is absolutely nothing I can do to fix your grades.
All successful medical school applicants have good grades.Despite how impersonal viewing a person as a GPA can be, it is one of the few objective criteria admissions can use to evaluate applicants (another being the MCAT). It shows you are intelligent. You are hardworking. You have been dedicated and disciplined enough to achieve a respectable GPA. There are the qualities we want in our future doctors. It’s the bare minimum.
A GPA is NOT the only thing that matters. When we mark your applications, your essays, reference letters, personal statement, extracurricular activities also receive scores. Theoretically, good diverse life experiences can make up for poor grades, but here’s why it’s unlikely to happen in real life.
Your grades are the entry point of your application. They are the first item we see. They get your feet in the door. Without them, the rest of your application might not be seen and just thrown out. Almost all schools do a first round screening, with computers, to eliminate applicants with low grades and shorten the applicant pool.
Your GPA is permanent. So by the time adcoms mark your application, we have no power to change your grades. Your explanation about how you were sick on your exam date or how personal circumstances lead to a poor semester become irrelevant. Your grades are set in stone. We can’t omit courses you have taken and readjust your GPA. Adcoms can’t give you more points for it if they like you and less if they don’t. It’s objective.
So if you had to pick one thing to focus on first, let it be grades. Grades alone won’t get you into medical school, but without them, there is no chance.
That is why I am saying grades must come first. You first must have good marks before you begin the MCAT, volunteering, reference letters and research. If other committments cause your grades to suffer, drop those activities and refocus on your grades. After you have your GPA covered, then you can begin to build the rest of your application.
Adcom Advice #3 – Don't Make Excuses
Posted by medaholic in Admissions on December 9, 2008
When you fill out your application, you want to put your best foot forward. You want your file to be flawless, free of typos and grammatical mistakes. That is why you must avoid making excuses!
You should never make excuses of try to explain your shortcomings. A lot of people try to justify their weaknesses on their application. Their grades are poor because they didn’t have the right mindset in freshmen year. I had a course overload along with a full time job, so I performed poorly on the MCAT. My mark in English class may seem low, but I was one of the top students in the class. Other than medical reasons and drastic life altering circumstances – which should require a separate letter to explain – on your application, never shoot yourself in the foot.
Doing so is not beneficial to you. Your application won’t be marked any more leniently because of your rant. You are not the only applicant with flaws. We have to be fair (you want us to be right?) and so we mark applicants the same, regardless of their circumstances (save for those exceptions mentioned above – but that should be an extra letter). Instead, the effect is quite the contrary. When you try to defend yourself, it sounds desperate. You are drawing my attention (as an admission committee member) to your flaws and I might mark you negatively for it.
You would be better off if you did not mention your shortcomings at all. I’m not saying you should lie, again, rule #1 is that you should never lie! If you have a criminal record, you will have to disclose it to medical schools. You cannot fabricate your GPA and MCAT scores. Don’t even try creating phony extracurricular activities.
Always think positively. Trying to rationalize your shortcomings is pointless. If you don’t have any research background, don’t feel obligated to explain yourself. Show me what you HAVE done instead and despite your setbacks. If your grades are low because you had to work part-time during school to finance your education, highlight the positive aspects of your work and turn it into a positive factor. Explain what responsibilities you were given and how you grew from the experience.
Don’t make excuses! So when you are asked if there is anything else relevant the admission committee should know, if you don’t have anything good to say, say nothing.
Worth Memorizing
Posted by medaholic in Medical School, Thoughts on December 8, 2008
As a medical student, my chief responsibility is to learn, unfortunately this often translates to large amounts rote memorization. As medical students, we memorize everything: science concepts, medical terminology, classic presentations of diseases, lists of common illnesses, names of famous dead men who discovered such and such disease… some days all we do is sit and put things in our brain, drinking from the proverbial fire hose of knowledge…
Endless memorization naturally leads to boredom and the question, what is worth memorizing? How do we decide what we want to put in our brains? Will this content be on the test? Will these facts be useful to know in the future? How relevant is this material?
Each day we can only remember a limited amount of things. To cope with and balance the never-ending medical memory marathon, I have started committing to heart non-medical things worth remembering.
I’m a person that dislikes memorizing and I used to think it a waste of time to memorize poems, verses and speeches. If I wanted to know that stuff, I could always just look it up. I was wrong.
When your days degrade into medical fact after fact, being able to recite and ponder over some poetry becomes a breath of fresh air for your mind. It gives you a balanced perspective on life. You remember that there is whole world outside your knowledge bubble. It can be as simple as singing a few lines from your favorite song that can cheer you up. These short snippets and recollections of words make us human and experience emotion.
So take the time to memorize a few lines of Shakespeare. Imprint the words of Martin Luther King’s “I have a Dream” in your heart. Write out your favorite quotes. Select some Bible verses that will help you in troubled times. It is in these few words, that motivate and inspire us, that meaning and value is added into our lives.
Some Things I Have Memorized Recently
- When I Have Fears that I May Cease to Be – John Keats
- Stopping By Woods On A Snowy Evening – Robert Frost
- In Flanders Fields – John McCrae
- 1 Corinthians 13:4-8 - The Bible
How to be the Star of Your PBL Small Group
Posted by medaholic in Medical School on December 7, 2008
Photo By Rodrigobasure
You’ve just started medical school and your first PBL (Problem Based Learning) small group session. You are determined to amaze your preceptor with your amazing rhetoric and smarts. You want to be the shining group member that comes up with the correct answer to the case no one else could solve. You are going to impress and earn the respect of your peers with your awesome skills. If this is you, here are 5 easy steps to help you be the best group member you can be.
1. Listen
The first step is a simple one, listen to what others have to say. The point of having a small group is so you can be exposed to different ideas and opinions. Good group work requires discussion and listening is as important as speaking.
Being attentive will also make your meetings more efficient. If you hear things properly the first time, people will not have to repeat themselves and waste time. Your understanding of the case will be more comprehensive if you listen to everyone’s opinions.
2. Say only what is Necessary
Speak only when you have to, at all other times keep to yourself. Don’t interrupt when others are speaking. Wait your turn to speak. Simple manners adults often forget. Avoid engaging in small chit-chat that is out of context. Everyone’s time is valuable, so don’t waste theirs. If you can run an efficient meeting, your small group members will thank you for it.
When it is your turn to speak, limit yourself and say only what is needed. Don’t go on and on with information unrelated to the case. Don’t talk just to show off how much you know, cause your peers most likely know more than you and are irritated by your arrogance. Similarly, when there is an awkward silence in the discussion, and the group is stuck, take initiative to move the group in the right direction. Let your words be few and important.
3. Don’t Jump to Conclusions
Medical students have strong personalities and opinions. We like definitive answers and will quickly decide on what we think is right. However, jumping to conclusions poses a danger because it can get in the way of being objective and true learning. Many learning objectives will be missed if you keep downplaying details.
Similarly, when your peers propose far-out ideas, don’t be quick to dismiss them. They may have a valid point, and even if they don’t, you would have learned something. Doctors need to be able to come up with a good differential diagnosis, and that includes all plausible causes.
4. Be Understanding of Others
You will have members in your group that have strange personalities, quirky mannerisms and speech impediments. There will be things about them that annoy you. Accept them for who they are, and they will be more likely to accept you and what you say. Presenting in a group isn’t just about the accuracy of your facts and arguments.
The truth is, people will judge and evaluate your words along with your personality. How you act will influence how likely they are to listen to your findings. Group work requires teamwork. Treat others nice and they will be nice to you too.
People don’t care how much you know–until they know how much you care
5. Have Input from Everyone
The point of group work is so everyone can benefit and learn from each other. You can cover the material faster, more in depth and with more clarity if done properly. Furthermore, splitting up the research needed to be done can save you a lot of time too. Don’t try to steal the show by taking over the discussion. Make sure everyone is heard. Their differing opinions and perspectives will enrich your learning.
The secret to being the star of your PBL / small group is to not treat yourself like one. Be humble, eager to listen and slow to speak. As long as you remember that it’s not about you but a group effort, the better a group member you will be.
Adcom Advice #2 – Be Relevant, Specific and Concise
Posted by medaholic in Admissions, Application on December 4, 2008
When going through applications, nothing ruins a good application faster than ambiguous writing. Unclear statements make it hard for adcoms to review your application objectively and when in doubt, adcoms will tend to give lower scores as a precaution. Therefore, it is absolutely necessary that your application provides the most important, relevant, specific, wanted information and nothing more. Extra fluff or resume padding will not help you. Medical school admission committee members can tell when the listed activities are meaningful. By adding irrelevant and maybe even harmful to your application details, you diminish the impact of the true activities that are important.
The secret to a concise and well written application is to treat it like a resume. You want to cater your best and most relevant aspects of yourself to the medical school. You want to use Power-verbs to describe what you did. I managed, lead, coordinated, organized, taught, spoke, changed, etc. You want to include numbers, figures, specific roles. You want to sell your best and only your best and you always cater your resumes according to the job wanted.
Give the relevant information in a straightforward manner. For example, when it says to list awards / achievements, this section should be filled out in a direct way. Below is a sample template that you should follow.
Name of the scholarship – monetary amount $$$ – level of award (international, national, state/provincial, local, university-wide, high school) – basis of award (financial need, merit, etc) – Date Applicable
For example: “Medaholic Scholarship, $20000, National Award (one of ten), for leadership and community service in university” is much better than, “this Medaholic award was given to me by the Medaholic foundation for leadership and community service, from which I did blah blah blah activity and blah blah blah volunteering.” In this situation, they are asking for what awards you received, not why you received them. You will not get any extra points for the explanatory sentences because that’s not even what the question was looking for. Always address the prompts. They are clues to how we grade your applications. Follow instructions, answer the specific question and don’t go on tangents.
Cut out unneccessary fluff and give us the information adcoms are looking for! Adcoms burn through dozens if not hundreds of applications a day. Point form notes are OK! As long you make your shortened descriptions informative and specific, we will understand what you are saying.
Anyone should be able to read your application and understand it. If there are unique or local activities that aren’t that well known – explain it. When describing an activity, most applicants make the mistake of only thinking in terms of me, me, me. They talk about how these experiences shaped them to be a better person, how they discovered why they wanted to be a doctor through this, etc. But remember to include what you did for others too! I provided home care to eight elderly patients. I instructed five lower-income children math.
Use Numbers – as you can see in my previous examples, I specified the number of people involved. Adcoms love numbers. They are tangible and help us grasp the significance of your activities. I raised $30000 dollars for cancer research is much stronger than I did fundraising for breast cancer by doing a walkathon, singing contest and raffle. It’s good to know you can organize events, but it’s hard to understand the scale or magnitude if we weren’t there ourselves. Numbers help us see your contributions.
Similarly, for leadership activities, it’s not the activities you did that matter but the people you did them with. Use numbers to describe the number of people you worked with and managed. I worked with a group of twelve students, I was part of a six man team, I was in charge of recruiting 20 new members. When we ask about leadership, we want examples of how you interact and work with other people.
So when you are filling out the application, READ THE QUESTIONS PROPERLY. Give us what we want to hear (But Don’t Lie, that’s an even bigger mistake). Treat the primary or secondary as a serious job application and give us your best resume. Be clear, be precise, be concise.