Premed Resources – Guest Post

The following is a guest post from www.zencollegelife.com The links are more catered towards American students, but hopefully you will find them useful.

Update: Clerkship is going great so far. I’m enjoying it greatly despite having much less sleep than before. I’ll try to blog about my experiences when I have time to.

Five Best Online Resources for Premed Students

Being a premed student is definitely one of the hardest academic paths that one can choose for themselves, which is why it’s good to know about these five online resources for premed students. These sites have everything from MCAT studying techniques, to pointers on how to nail an interview for a hospital. With all of the pressures that come with taking premed classes, studying for the MCAT, and applying to medical school, these online resources specially tailored for premed students are definitely necessary to survive in the harshly-competitive world of medical education.

Premed Guide

If you’re a medical student who is confused about the different sectors of the medical profession, then this is the online resource for you. This website contains a multitude of articles about everything in the world of medicine, from entering medical school to the pros and cons of becoming a nurse practitioner. More than just an online resource for premed students, this is one of the best web-based collections of articles that offer complete instruction to those who are curious about entering the realm of professional medicine.

Old Medicine

Despite its name, this website has a very modern take on medicine and medical education. Written for premed students who have certain concerns regarding furthering their education, this blog offers advice on everything from what classes to take to what online research sites are best for what kind of project. An indispensable resource for anyone in the medical field, this blog is an independently-researched project with the sole purpose of shedding more light on the vast amount of knowledge that premed students need to know.

OldPreMeds

This grouping of message boards is one of the most personal online resources tailored especially for premed students. Each board connects practicing physicians with current or prospective premed students in order to provide a much-needed back and forth dialog about classes, trends in professional medicine, and other such topics. The “Diaries” section is particularly interesting用roviding interested parties with a completely introspective look into the deeper sections of medicine, from a doctor’s first all-night call to a first week as a surgical intern.

Student Doctor

This is easily one of the most comprehensive resources for premed students online. With articles based on discipline neatly listed across the top of the front page, navigating between dentistry and audiology is a breeze. The forums allow past and current practitioners to connect with students in order to give them the best advice about their prospective education, while the articles offer an insightful look into many aspects of medicine that, until now, seem to have gone unexplored.

MomMD: Premed Resources

Despite its name, this site isn’t just for mothers, or even exclusively for women. The premed section of the site offers thoughtful articles on subjects such as how to pick a good med school, how to study for the MCATs, and even what classes you should take once you’re admitted to your school of choice. Plus, there’s a fantastic variety of articles for nurses, physicians, or even just people who are interested in the medical craft. A highly comprehensive yet casual approach to the medical world, this site is a great way to ease unfamiliar people into many of the ideas and issues that premed students need to deal with on a daily basis.

Louise Baker writes about online degrees for Zen College Life. She has recently also wrote about the best schools online.

Bias

Today, I saw a young female who was 35 weeks pregnant. She was also a crack cocaine user.

When I see a patient like that, it’s hard not to be biased. Her clothes were unkempt, she smelled, her eyes had dark bags hanging underneath and strange mannerisms. Yet deep down, I know she was a person that deserved my help and respect, just like everyone else.

So why when I first saw her did it take several seconds to get over my prejudices? Was it because here was a women who was harming her body and baby with drugs, while so many other people desperately want a child but can’t have one due to miscarriages and infertility?

I’m confident that I’ll encounter many unpleasant people in my rotations, some downright nasty. It’s so hard to be empathetic to people who purposely harm themselves or try to use you. I can see why lots of doctors get jaded and become mistrusting. It’s part of the hidden curriculum no one ever teaches you.

I don’t really have a specific train of thought or conclusion to this post. Just a pondering from today.

The Shortlist – Year Two

About a year ago, I made a list of specialties that I was considering.

Now at the start of third year, I am writing down the top five specialties currently in the considering. I’ve had more time to shadow and do electives in a variety of fields. So here they are, my shortlist at the end of M-2, with explanations below.

Top 5

Internal Medicine – Still tops the list, especially since my favorite subjects so far has been in internal (cardiology, pulmonary, GI, oncology). The diversity along with the chance to further subspecialize appeals to me a lot. I like problem solving, working on complex cases, team environments and interacting with patients.
Family Medicine – Diverse, flexible, wide variety of practice. Can never rule out primary care.
Gen Surg / Ortho - Unfortunately or fortunately? I haven’t ruled out surgery yet. Although I am pretty confident I am more for medicine, I like working with my hands, working on teams and seeing positive results. The satisfaction knowing that you made a difference, that your hands fixed something, makes surgery highly appealing. Though I don’t think I am focused enough to do a sub-specialty surgery that has a narrow scope like ENT, Ophtho, Urology, etc. Though I think plastics is super cool.
Neurology / Physical Med & Rehab – A different pace of medicine, often more focused on management instead of cure. Similarities to internal perhaps?
Emergency Medicine – Things I like: Quick, fast-paced, great learning experiences in past, wide scope of practice and skillset. Dislike: Shift work, no continuity of care (not having “your” patients, following up after admission)

Bottom 5 - (no particular order)

Pathology – No interests at looking at slides, cells and cadavers. It doesn’t make pathologists any less of a doctor. It just wasn’t meant for me.
Anesthesiology – Puts me to sleep, just like it does for patients undergoing surgery.
Psychiatry – After learning about it in class, I found it fascinating. A super important field that often goes neglected but again just not for me. Psych is part of every field of medicine, hopefully I’ll see my share of psych patients in another field and do a good job caring for these under-served patients.
Cardiac / Neurosurgery – I don’t have enough passion in these two fields to give up the rest of my life
Medical Biochem / Genetics / Microbiology & Lab Med – Had enough research experiences to know I can’t spend the rest of my life doing lab work. Would much rather be at the bedside than the bench.

Changes

Decrease

Ophthalmology – The eye is still pretty cool topic and restoring vision is still admirable work. But it’s narrow focus and few procedures makes it less appealing to me. I enjoyed studying Ophthalmology (spelled with two H’s!) a lot this year but I didn’t have any special interest to pursue a surgical career in eye care. Still an important topic to know no matter what you end up in.
Radiology - I thought long and hard about this one and after multiple electives, I can happily say, it’s not for me I liked my experiences in interventional radiology and ultrasound. Learned a lot reading Xrays and CTS. Was bored to sleep in nuclear imaging. Reading radiology accurately is an essential skill that all clinicians should have. I feel like if I go into Internal, I’ll get my fair share of radiological interpretation to satisfy me. As for interventional, I can’t bear the thought of going through a five-year residency program reading films just to get the chance to do procedures.

Increase

Dermatology – I was actually quite engaged and interested when we learned about dermatological problems in class. Not all just acne and botox. Though I feel like what they showed us in class (all the interesting rare stuff) is quite different from real life practice.
OBSGYN – Not a bottom 5 specialty but nowhere near the top either. I was lucky enough to scrub in on a few C-sections this year. The miracle of life is unlike anything else, it really is beautiful. Though the frequency of malpractice/lawsuits and preference for females in this specialty are enough to rule it out for me.

Still Here

Just with nothing to write about… I apologize. I remember when I started this website, I wanted to make it a complete resource for medical school applicants. But then medical school started, and after a while, you sort of just move on to new challenges and things to learn.

I have a lot of thoughts on the MCAT, Interview Process and admissions in general, but I am either (1) bored of writing about the stuff (2) too busy with non-medicine stuff.

I wish I had the motivation to write articles about how to study for the MCAT, but I feel like I would just be rehashing advice given by many other people. I don’t have a particular unique perspective or knowledgeable experience with it, after all, I only wrote the test once.

It’s strange how much a person can change in just two years. My my my, how my goals have changed since.

The Dreadful Truth

During the school year, my life is often one thing followed by another thing. If it’s not studying, it’s helping someone with their medical school applications. If it’s not volunteering, it’s exercising and playing intramurals.

And throughout the year, I would often say, “I can’t wait for the summer to arrive so I can just kick back and relax, and take a break before the school year starts again.”

Now I’ve come to realize… school isn’t what makes me busy. I am the problem. I think I have a natural habit of taking on stuff to do and once again, I am juggling activities left, right and centre.

At least the summer’s not boring… I wonder what it would like to take a few months off to do absolutely nothing?

Not Much To Do

I can totally understand now why so many of my favorite med blogs often lack updates. When I was still a premed, I read medblogs fairly often. I must have gone through ten or twenty medical student blogs from start to finish, from when they started posting to when they stopped writing. I was always sad when their adventures ended or they discontinued writing because they had moved on. I didn’t understand why they stopped then, but I can empathize with them now.

For me, there are a still a lot of topics I know I can write about. Subjects that are helpful like studying for the MCAT, how to write a better application, how to prepare for interviews. But after writing about these things for the last two years, I find a lot of these topics boring. Important to a lot of people, but boring to me.

I’ve answered the same questions so many times over that it just becomes a routine. How Do I Prepare for the MCAT. What Interview Strategies should I use. However, despite it being so mundane it’s surprising how fast things change. The application is a continually evolving process and everyday I’m becoming less in tune with what it’s like to apply to medical school.

These days, I’d rather spend my time learning medicine or preparing for clerkship. It’s not like I’m looking down on the people who are still in the application process or undergrad. I just feel like I have to keep moving forward to keep growing. It’s too easy and too comfortable to get stuck in the past.

So after 2 years of blogging, I again find myself asking “Why Do I Blog?” I’ve enjoyed the process so far and definitely learned a lot about myself, but is there a greater purpose? And although I’m not sure what will happen in the future, I’m excited to see what happens as this blog officially enters its third year.

Five Charities You Should Know About

As a medical or university student, you probably have more debt than money. However having said that, I still believe donating money to worthy causes is still one of the best things you can do with your finances. I am quite skeptical about a lot of charities out there especially when it comes to their overall effectiveness and overhead. However, there are still lots of great organizations out there and I would like use this post to promote some of my favorite and most effective organizations. If you have wanted to donate to help change the world for a while, please consider one of the following below. As always, if you want to find out more about certain organizations, websites like www.charitynavigator.org/ or http://www.givewell.net/ will help you rate and determine how well organizations measure up.

So in hoping to help make the world a better place, I encourage all my readers to donate to one of these great organizations, or just donate. Because although your contribution seems insignificant, every little bit counts and if enough people believe that they can make a difference, collectively we will make a difference.

1. KIVA

www.Kiva.org is one of many micro-finance organizations. If you haven’t heard of micro-finance before, it is the provision of financial services including loans and credit to people with low incomes. The eventual aim is to provide the initial capital for these populations to eventually break free from poverty.

Kiva is linked to many Field Partner organizations around the world who help approve entrepreneurs for loans. When you donate to Kiva, you lend money to these people (often groups) to help fund their start-ups. Over time, these entrepreneurs repay their loans to YOU! Eventually you can decide if you want to withdraw these funds or re-lend to other entrepreneurs. I have been a huge fan of micro-finance ever I read about Grameen Bank founder Muhammad Yunus (Nobel Peace Prize Recipient 2006) and his book “Banker to the Poor”.

If you don’t have much knowledge about the economics of poverty, reading about micro-finance is one of the best ways to start. There are many other micro-finance charities out there, so do your research before you donate to each of them. Kiva

2. MÉDECINS SANS FRONTIÈRES (MSF)

You would have inevitably heard of www.msf.org/ or more commonly known as Doctors Without Borders. As described on their website,

Médecins Sans Frontières is an international, independent, medical humanitarian organisation that delivers emergency aid to people affected by armed conflict, epidemics, healthcare exclusion and natural or man-made disasters.

They are amongst the first and front line response to medical emergencies and humanitarian relief all across the world and their organizational effectiveness is one of the best. I highly recommend reading MSF’s past president James Orbinski’s book “An Imperfect Offering” to get a better sense of the kind of work MSF is involved with.

3. PARTNERS IN HEALTH (PIH)

Not enough good things can be said about Partner’s In Health, which is an organization that has been working in Haiti for over 20 years. They have been a world-leader in providing health care in resource limited settings along with groundbreaking practices in treating Malaria, TB and HIV. If you’ve never heard of Dr. Paul Farmer who founded PIH with his classmate Dr. Jim Kim when they were still students at Harvard Medical School, I highly recommend Tracy Kidder’s “Mountains Beyond Mountains”

If you want to help out with the Haiti Earthquake Relief, there is no better organization than Partners In Health who have established an extensive health network in Haiti. They are currently running a campaign called “Stand With Haiti” so please consider donating!

4. WORLD FOOD PROGRAMME (WFP)

We all need food everyday. Perhaps you have tried fasting before or one of those “30 hour famines.” Despite the bad rep UN Organizations get sometimes, the World Food Programme is a legitimate program that provides essential nutrients to tens of millions of people every year.
Furthermore, they are always in need of more funds, and money spent goes directly to saving lives! Remember that no amount of money spent in infrastructure, education, and even essential medicines will be helpful if the basic needs of food, water and shelter are not met.

5. Room To Read

I’ll admit that this charity may not be as life saving as the other ones I have mentioned but that doesn’t make it any less of an admirable and well run organization. Founded by John Wood (an ex Microsoft executive), Room to Read is covered extensively in his book “Leaving Microsoft to Change the World” is an inspirational read about how we can all make a positive impact if we put our hearts and mind to it.

Starting after a trip to Nepal, where he saw a school with an empty Library, John Wood set out to raise enough funds to build a library. And after that first school, Room to Read has expanded into nine countries while building hundreds of schools and libraries.

I have personally donated to all these causes and have no links affiliated with them. Although my reasons to donate to many of them can be linked to personal stories, books or articles I read, I believe that everyone should have worthy causes they are willing to support.

There are still so many other organizations out there doing importing work in underprivileged areas that need financial support. So I encourage everyone, to start with just one subject they feel strongly about and learn about it and then support it. Whether it be an environmental or social justice cause, taking that first step and deciding to take an active role – instead of a passive spectator – is the an important and life changing step.

It is in my best hopes that this post will encourage people to donate more. There are a lot of poorly run organizations out there and many reasons to be cynical about charity. But don’t let a few rotten apples spoil the good works of many people out there. Thanks for reading and I am looking forward to comments about what type of charities or causes you support!

The End of the Beginning

Nothing like final exams of your preclinical years to realize just how little you know about real medicine. Although I’m currently full of head knowledge, who knows how much of it will actually translate to clinical knowledge.

I’m starting to grow dreary of classroom learning. It’s been almost two decades of traditional teaching, I look forward to moving on.

At the same time, I think I’ll miss the classroom setting. The joys of being a student who’s only true responsibility is to learn. And learning is fun.

A bittersweet beginning perhaps.

Not Quite a Medical Student

Even as I am finishing up my 2nd out of 4 years of medical school, I often don’t feel like a true medical student. Although we may have learned about all the systems, dissected the entire human body and built a good foundation of medical knowledge, we have truly yet to experience what it means to be a doctor.

Next year is the start of clerkship and it is both exciting and frightening. Exciting because we will finally see patients daily, care for them, write up orders and learn the practice of medicine. Frightening because all our shortcomings and incompetency will reveal themselves.

So even as I pass the halfway mark on my undergraduate medical education, I feel as if I have yet to begin. I guess I’ll find out what kind of a person and a doctor I will become next year. Exciting. Frightening.

See One, Do One, Teach One

To learn medicine, they say you need to see it done once, do it yourself once and finally teach someone else how to do it.

This has always been the way it was taught. But despite being such a classic didactic model, I wonder if this is the best and right way to learn?

I remember the first time I heard about the hidden curriculum of medical school. It was the story of medical students performing pelvic exams on unconscious patients who had not given their consent. The argument was where else would students get the chance to practice, no patient would want a inexperienced student doing an unnecessary and invasive exam, all in the name of learning. And I’ve talked to some senior doctors about this, and even though they are very ethical and caring doctors, they shared their experience about going along and not questioning it, even when they knew it was wrong. I’m afraid I will be in similar situations in the future, and I am scared that I will not know what to do.

Today, I stumbled across a report on “Providing a strategic vision for improving patient safety” and came across the following quote.

“The old approach to teaching procedures—See one, Do one, Teach one—
is antithetical to safe, patient-centered care. Simulation provides the
opportunity for one to see as many as one would like, do as many as
are necessary to demonstrate procedural competence, and leave the
teaching to experts.”

In one sense, I agree completely that simulation can be a perfect way to hone your skills so you can be competent when you finally see your patients. On the other hand, I also think that you can’t learn and understand the complete practice of medicine in the classroom or simulation room in this case. You learn medicine by interacting with human beings, real patients with real diseases. You remember faces and emotions associated with diseases. You get the real deal, not just a fictitious rigid simulation. I don’t know what my complete thoughts are about medical school training, but I just want to leave you all with this quote by one of the greatest physicians of the 20th century.

He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients does not go to sea at all.

- William Osler