Archive for category Thoughts

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

  1. 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.
  2. Family Medicine – Diverse, flexible, wide variety of practice. Can never rule out primary care.
  3. 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.
  4. Neurology / Physical Med & Rehab – A different pace of medicine, often more focused on management instead of cure. Similarities to internal perhaps?
  5. 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)

  1. 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.
  2. Anesthesiology – Puts me to sleep, just like it does for patients undergoing surgery.
  3. 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.
  4. Cardiac / Neurosurgery – I don’t have enough passion in these two fields to give up the rest of my life :)
  5. 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.

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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?

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Five Charities Worth Donating To

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!

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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

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Change the World

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Often in the thick of studying for a final exam, when medicine seems to be reduced to just memorizing long lists of diseases, anatomy, drugs and information – I think and ask, why am I in medicine?

I remember before starting university and still was wondering what direction my life would take, I wrote out what I thought were the top 3 most pressing problems in the world. They were in no particular order

  1. Environmental Damage – including Global Warming, Pollution, Species Extinction.
  2. Extreme Poverty.
  3. Overpopulation and Intolerance to Others – including terrorism, peace conflicts, racism, etc.

When I look forward, I frequently question that difference a doctor can make. I acknowledge that you get to see the rewards of your efforts. Your actions have quick and direct results. But I wonder how much influence a doctor can have in large lasting changes? At most, a doctor will directly interact and help around ten thousand patients over his or her lifetime. A small drop in our global population.

Furthermore, for most doctors practicing in North America, they are treating people who have lived “privileged” lives. No war, no poverty, no famine or epidemics. Although we are helping people who have serious illnesses, there is always this guilt within me that tells me that there are people out there who are more deserving of help. People who live on less than a dollar a day, people who have never had an education, people who struggle everyday just to live.

I wonder how my studies in medicine are making the world a better place. Am I helping preserve our natural environment? How am I addressing the economic struggles of billions of people?

That’s why I think policy and research are so important. Passing a health care bill can instantly provide health care to millions who did not have access before. Vaccines have saved millions of children all around the world from debilitating diseases.  As just a primary care physician, although you are helping many people directly, there is a limit to your abilities.

Everyone wants to change the world, few have the chance to, and fewer actually do. And often I wonder was  studying medicine and becoming a doctor the right path to take. I guess my future is still ahead of me and it’s a bit too early to tell what’s in store down the road.

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Risk Averse

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Inspired by a post on Risk Taking and Failure written by a friend.

One of the most important skills everyone should learn is how to take risks. I’m not talking about foolish or rash decision making but of calculated and beneficial risks. For the most part, I credit a lot of my success to my willingness to take action in the face of uncertainty. Winning scholarships, getting job positions, finding opportunities, getting into medical school are all things I have benefited from taking good risks.

In many careers, calculated risk taking has many benefits. Business opportunities if coupled with entrepreneurial spirit and hard work can result in large financial gain. New artistic direction can be what separates you from the crowd. Having the courage to start a conversation with someone you don’t know may blossom into an important relationship. However, medicine often discourages risk taking, often to the point that erring on the side of caution is preferred.

Any risk will always have a chance of failure. You should only take risks if the odds are in your favor or if the reward far outweighs the cost. And that is exactly the problem in taking risks when it comes to medicine – the cost of failure is high.

A wrong mistake can lead to crippling disability.  An erroneous slip can lead to a malpractice lawsuit or a license suspension. One lab test missed or improper history can mean life or death. For example, even if the benefits of immediate treatment means a speedy recover, if a diagnosis is made and treatment started without confirming the diagnosis, the results may be disastrous.

That is why we are taught to be thorough in our history taking and physical examinations. That is why checking up on patients is so important, so that no alarm signs  slip go unmissed. That is why a differential diagnosis should be long and comprehensive, even if some items are highly unlikely. That is why extensive lab tests, imaging and consults are required. Don’t jump to conclusions. Be thorough even if it is going to cost you time and money. As a generalized rule, doctors err on the side of caution.

I think that is something I quite miss from my life before medical school. The chance to take risks and face the outcomes and consequences. I could aimed for all sorts of goals because I knew had the ability to rebound from my failures. I could push myself to my limits, be committed in several activities and try new endeavors. But now, I have a duty and a privilege to my future patients. To do well in my studies and become a good doctor. Instead of pursuing other interests, I have a job that I should do to the best of my abilities.

Perhaps I am over-exaggerating my situation to prove a point. It’s a bit like growing up. In yours twenties, you don’t have much to lose. If someone offered you one chance to win a million dollars on a 10:1 coin flip, would you take it? If you win, you get $1,000,000 but if you lose, you have to shell up $100,000. Mathematically, agreeing to the bet would be a no brainer. Now add twenty years to the same scenario, a house, a mortgage to pay, a car, a spouse, kids and bills that you are just scraping by with, your decision to take that bet drastically changes. If you win, a million dollars that could result in retirement but if you lose that money, how are you going to pay next month’s rent? Provide for your family? Would you still take that risk?

[I realize that the possibility of going into $100,000 of debt in your twenties is a great setback. You could even argue that when you're 40 and you have a stable job, you are more in a position to lose $100,000 than when you are just starting your career, but these numbers are just an arbitrary scenario and I hope you got the main point I was trying to make]

Possibility is traded away in return for stability. Predictable outcomes are favored when what you risk losing is  greater than the gain. When you become responsible for other people, especially in a job like medicine where a doctor-patient relationship is so important, I would feel really bad if I made a risky decision that negatively affected someone else.

So although risk-taking is a valuable trait to have, I often think being risk averse is also an equally important trait to have especially in medicine. Being paranoid and nit-picky, which is excessive at times, may one day save a life. Someone’s obsessive need for perfection or his insecure fear of failure can make a positive difference.

What are your thoughts on risk taking and risk aversion?

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Never Bored

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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.

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The Taste of Failure

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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!”

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Learning to Learn in Med School

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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!

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5 Simple Tips to Start Off the School Year Right

Whether you are just starting university or just beginning medical school, there are simple things every student can do to ensure their school year gets off on the right foot. Most of this advice is generic and old, but despite how many times you have heard it before in the past, it’s always good to take wise advice and put it into practice.

School is more than just getting good grades. It is a place where you can grow and mature as a person, pursue your interests and experience life. And by preparing yourself for an academic year, it is possible to have good marks and a good time at school. So here are just five tips that I always consider when September comes around. I hope you find them as useful for you as it has been for me.

  1. Set Goals

  2. If you don’t know where you are going, you will probably end up somewhere else.  ~Lawrence J. Peter

    One of the most important activities that anyone can benefit from is frequent goal setting. If you don’t have an end destination in mind, life often takes you whichever way it wants, often not to your liking. Do you want to achieve a certain grade point average? Do you want to get to know a few professors that could write you references in the future? Do you want to live healthier, socialize more or try something new? Without setting concrete goals down on paper, goals rarely actualize by themselves.

    If you’ve never picked up this habit of setting goals, one effective system to follow is the SMART Goal Setting. Goals should be Specific, Measurable, Attainable, Realistic and Timely. Success doesn’t happen by accident. It takes a focused and concerted effort to actualize your dreams.

    So if you haven’t so already, take a few minutes and a piece of paper to jot down your top three to five goals you want to accomplish this school year. Be realistic yet strive to do your best. You’ll find your goals will change from year to year, so I always have a few short-term, mid-term and long-term goals. I adjust them often. Goals act as a compass for our actions. Often when we’re lost or confused about what to do next, all you have to do is to look at the goals you have set out to do to realize where you should go next. Read the rest of this entry »

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