Looking for a CoBlogger for PreMed, MCAT, Med School Topics

As long time readers may know, I am pretty far out from the premed life. It’s been six years since I wrote the MCAT and applied to medical school. I don’t really know what it’s like to be a pre-med today in 2013. I you asked me right now about the MCAT, I can’t give you up to date answers. Even though I an extensive experience with the medical school process, my experience is starting to be outdated. Since residency, I am focused on my clinical duties more than ever, and I don’t really want to write about topics I used to write about (MCAT, admissions, interviews, etc)

This has lead me to the conclusion that I am really out of touch with the readers of medaholic. According to this poll I ran last year, 50% of readers are premeds and 30% are medical students. I fall into the 5% that identifies themselves as residents. I am a minority on my own blog. There’s a disconnect with what I want to write about and what readers want.

The Solution – a Co-Blogger

I love blogging – I love writing posts that are helpful, I love the discussion generated in the comments and I love replying to emails from readers. This has been a refuge for my thoughts over the last four years and I really believe blogging and regular self reflection has benefited me.

At the same time, I don’t think it’s fair that people who visit this blog – often looking for the premed, MCAT, medschool material- often find a blog that no longer focuses on these topics.

After much thought, I believe finding someone to help out medaholic.com will be the best solution and I hope I can find the right person for the job.

What I am Looking For

Authenticity – I’m looking for a person who is interested in a career in medicine and are actively pursuing it. Someone genuine. I’m looking for real people with dreams and aspirations.

An Appreciation for Writing – You don’t have to be an expert writer for this job, but I do want you to enjoy the process and aim to improve in it. I was not the best writer when I started out and I know I’m still not that good. But I enjoy the process and strive to write better. I appreciate how words can make a difference and impact others.

Similar Demographic to Readers – The ideal candidate would be a student in their undergraduate studies or someone who is in medical school. They will be going through the whole medical school process. They will be one and the same with the average reader of this blog. Age and gender is not a factor.

I don’t discriminate against nationality, in fact, being American might help as there are a lot of readers from the States that you could reach out too.

However, if you think you can offer something to this blog and you fit in some other category (resident, physician, health care worker) – I’m open to ideas.

Creativity – I want you to bring something to his position. This is not a position where I just tell you what to do. I want someone who I can challenge and be challenged by. Someone who will not only make this blog better but do it in big meaningful ways.

Basic Internet Knowledge – Running a blog will require a bare minimum understanding of how internet webpages work. Simple tasks like linking pages, finding images, formatting. I will take care of the server hosting and technical stuff. Obviously the more skills you have – coding, social media use, site analytics – the better equipped you will be.

Passion – I’m looking for another me, sort of, not really. I want to find someone who is obsessed with medicine in a way that I was. Someone who takes their time in figuring out how to be the best doctor. Someone who is fascinated with medicine and can’t stop thinking about it.

What I am NOT Looking For

No Guest Posts – I am not looking for a person to write an occasional guest post that than links back to their website. Please if you’re an “internet freelancer” that writes highly targeted articles, please don’t bother. Again, I am looking for longer-term applicant, someone who is committed and passionate about being a doctor and the many topics that go with it.

A Short Term Stint – If you think you would only have time for a month or two, I don’t think this position is for you. When I first started this blog, I didn’t think it would go on for so long – almost 5 years – and find such success. I didn’t have the vision back then to see what this site could become. I want someone who has that imagination that can see what this blog can become!

Spam / Scam Artists – I pretty good at sniffing out bad apples. Don’t even bother if all you want to do is hijack this site and flip a profit.

Benefits

There are perks you should consider if you are interested in this position.

Readership – One of the challenges you face when you first start writing is finding an audience. Becoming a writer at Medaholic offers you the chance to have your content reach thousands of readers immediately. More importantly, you are directly targeting a highly focused group of people who will be naturally interested in your content. To back it up, according to Google Analytics, visitors have been growing steadily and this blog is on its way to a thousand unique visitors a day in addition to the hundreds of subscribed readers and twitter followers.

Mentorship - Running a successful blog requires a lot of effort. There are a lots of blogs that start out strong for a few months but fade a away, few that truly last. Joining medaholic offers a win-win situation. It’s a head start to learning how to run a successful blog. Furthermore, it takes a long time figuring out how to grow a blog, how to make it sustainable, how to build a readership. I will provide as much guidance as needed to make sure you will be successful with your posts and if you want to, starting your own website or project.

Autonomy - I always believed that people need to have autonomy to enjoy their jobs. In this position, I won’t dictate your schedule nor will I tell you what you have to write. There will be suggestions at first. You are free to write whatever you want as long as it’s relevant to readers and fits with the overall theme of the medaholic blog. Of course, I willprovide guidance and you can always ask me for any ideas. This should be something that’s fun for you. I know it certainly was fun for me – writing out my ideas and sharing with others, summarizing and providing useful content and growing a website.

At first, you will start out as a contributor where I can review and edit your posts. If things go well, there will be more autonomy including becoming an author and having the ability to post without supervision. If things go really well, we can talk about co-running the whole site, including expanding and taking part-ownership. Similarly, I am open to ideas about how to make this website even better and as hire #1, you’ll have that chance.

Income – Although it shouldn’t be your primary motivation, it’s always nice to be paid for your work and becoming a writer at medaholic offers that opportunity. After experimenting with different revenue models, this website now generates a comfortable amount of cash that more than covers all costs. Best of all, once the initial work has been done it’s all becomes passive income. Last year, medaholic.com brought in more than $1000 in referral (Amazon) and advertising revenue (Adsense), and I hope I can continue this growth in near future by expanding the site.

Instead of paying a flat-rate per article, I  offer you the same chance to earn directly from the posts you write. Any affiliate links or adsense profits in each post would profit you directly. It might not seen like a lot at first, a few dollars here and there, but if you write a home-run article like How to Self Study for the MCAT which is listed as a top hit Google, a few hours of work can pay off in the long run.

Free Stuff! – I didn’t know running a blog could result in so much free stuff! Publishers regularly send me material (books, audio books, apps) to review and promote. I have already turned down many offers because I don’t have the time to try everything out. Similarly, I don’t really have a need for MCAT materials or some introductory texts anymore, but if you’re a premed/med student that does, this job has that perk.

Room for Advancement – If this partnership works out, there will be opportunity to have a greater input at medaholic. Ideally, I’m looking for someone who I can trust to steward medaholic.com to be a relevant resource for premeds and medical students in the years to come. A passing of the torch if you will. Similarly, if you’re ambitious and have a project you are interested in, I would love to figure out how to get it done. If you are interested in putting together an ebook, distributing and profiting from it, we can make it happen.

How to Apply

Send me an email at medaholic@gmail.com with the subject “Interested in Coblogging Medaholic” or something that will catch my attention.

I don’t want to make this too formal, but please introduce yourself – specifically what stage you’re at in your life – “premed, applying to med school, medical student, etc”, some geographical information (Canadian, U.S, International) and why you want to co-blog at medaholic. 

Eg. I’m medaholic and I’m an Internal Medicine resident in Canada. I want to write for medaholic because I love creating useful content that others find helpful!

Just keep it short. Think of it as a meet and greet. If you want to say more you are certainly welcome to. I will email back everyone who sends something in. I will probably ask more questions like what skills do you bring to the table, or what ideas do you have for medaholic.com to be even better!

Hopefully through emails, I can get a sense of which candidate would be best. If I think you have potential, I’ll probably arrange a more formal interview (phone/skype/something) where I can get to know you a bit better and vice versa.

Deadline

Please send me an email as soon as possible. I will leave this open for 6 weeks and will stop looking at the end of April, 2013. I hope there is someone out there that will be a good fit for this blog that I can get to know and trust. I think there will be a lot of value to having another voice at medaholic.

In many ways, Joshua from medhopeful.com was my informal co-blogger. Although we blogged at different sites, it was often about similar topics and we bounced ideas back and forth between us.

This is a new step for me. I can’t know for sure that this venture will work out but I’ll try my best because I think in the long-run, readers will benefit from having another passionate blogger at medaholic.com

As always – Comments, emails and discussions are welcome!

Pre-Call

Creative Commons – dskley

You would think being on call for the last two and a half years would make this easier, a little more tolerable. Especially after doing 1 in 4 nights for the last six months, I should be used to it. Yet here I am again, getting this sense of anxiety the night before my call shift. This is my pre-call dread.

This pre-call dread gives me a sense of impending doom, as if my call day will be the worst day of my life. I get worried, I get keyed up, I complain in protest of not wanting to be on call. People often talk about their post-call days and how wonderful they are. Few people talk about pre-call.

I’ve spoken to my colleagues about this phenomenon and they agree it’s a real thing. It manifests itself differently for each person. Some people get fatigued more easily and decide to sleep earlier in preparation for their call day. Others distract themselves by doing something fun like watching a movie or having a nice dinner. For me, I don’t sleep very well when I’m pre-call. Instead, I often get a last minute ambition to tackle the multiple undone items on my to-do-list as a final effort to delay the inevitable.

The silly thing is I don’t even find call that bad. When I’m on call, time goes by quite quickly, I learn a lot and I enjoy the independent decision making. Most nights, I get enough rest so that my post-call days are decently productive. I’ve learned to cope with being on call well so it’s bearable. Pre-call on the other hand, I handle poorly. I feel uneasy. I feel tension.

So here I am again, the night before I’m on call, trying to tidy up all the unfinished tasks from the week. My room’s usually in disarray, my bags are not packed and I don’t want to go to bed. I’m writing a post about this dread. I feel anxious and I’m usually not anxious about anything. Presentations, projects and exams don’t even cause the same sense of distress for me as pre-call.

It’s a strange feeling. I guess people with generalized anxiety must feel this way all the time. I sympathize for them.

But alas, my time’s up. My pre-call day is over! On to the real call and then that blessed post-call day. Such is the life of a resident.

Deciding on a CaRMS Residency Rank List

I have been chatting with some friends who are going through CaRMS residency match. They’ve finished interviewing at various programs and now they are in the process of coming up with a Rank List. In short, your rank list is the order of programs where you would like to do your residency. However, where you ultimately end up is decided by a match algorithm. In many ways, applying for a residency program can be more daunting than applying to medical school.

First there’s the uncertainty of where you might end up. When you apply to medical school, you at least have a choice a which school you would like to attend when you receive your acceptances. For the residency match, you are instead “matched” and that’s the end of the discussion. There’s no backing out of it, you are legally contracted to your residency program once you have been matched.

Secondly, for applicants who have not made up their minds on what specialty they would like to pursue, the rank list can be a difficult to finalize. They may have interviewed for two or three specialties and now face the difficult decision on choosing a career, even if they haven’t quite made up their mind yet. At least when there was a rotating intern year in the 90’s, graduates had more time and exposure to help them make that decision.  Now-a-days, if you want to do a competitive specialty (derm, ophtho, ENT), you almost have to know even before your clinical years to be competitive.

Coming up with a Rank List can be difficult task. But it doesn’t have to be.

Deciding on a Specialty

For those who have applied to more than one specialty, figuring out which specialty you want to do is the first step. I’ve written about my thought process in choosing a specialty before (Part 1, Part 2), it’s a topic I frequently talk about on this blog, and there are a lot of good resources available to help you out. Here’s one I reviewed on The Successful Match. (Amazon)

Hopefully, if you’ve been thinking about this throughout medical school – figuring out what type of medicine you want to do won’t be too hard.

If you are just starting medical school, I highly recommend writing down your thoughts on specialties on a regular basis. I made a shortlist of programs I was interested in after Year 1, Year 2, and Year 3. During clerkship, take some time to reflect on each rotation you go through and write down what you like and dislike about each specialty. As you can see, my initial impressions changed quite a bit by the time I had to apply to residency.

If you really can’t decide on a specialty, you can take some solace in knowing you can switch programs even during residency. It’s uncommon but definitely doable and I know people who have done so successfully.

Deciding on a Location

Apart from specialty (easy for those who are only applying to one), the next biggest factor is deciding where you want to do your residency. There are so many things that make location such a big deal. Family members, significant others, children, outside-work commitments. Picking up and relocating your life should be taken seriously. I honestly believe choosing where you will be doing residency has such a large influence on your personal wellness during your post-graduate years.

If you’re settled down, have deep-ties to a city and foreseeable see yourself living there for a long time, it would be crazy to consider doing residency anywhere else. On the flipside, there are applicants who have spent their entire education and life in one city and want to experience something different. Residency is a perfect time to try someplace new. Residency eventually ends and if you do want to come back to your hometown or Alma mater, the diversity of experience you will have is often viewed favorably.

Factors to consider when deciding on location

  • Urban vs Rural
  • Large city or small city
  • Family, Partners, Children, Friends
  • Commitments outside of clinical medicine – research, volunteer, church, etc.

Ranking Specialty or Location?

In some instances, especially for competitive specialties, people are left to decide whether the should weight specialty or location more important.

In general, I would choose specialty over location. Although location is an important factor, it is the more flexible of the two options. After residency, you are more than welcome to move to your preferred location. The same can’t be said for specialty. There’s no guarantee you can change specialty after you match. Furthermore, specialty choices influences how you will practice medicine for the rest of your career. Residency on the other hand eventually ends and if it means toughing it for a few years, it’s bearable.

Understanding the Algorithm – Rank What You Want

If you read the official CaRMS website, there’s no secret to the matching process. You don’t have to worry about how programs rank you. The process is always weighted favorably for applicants. Applicants should rank programs in order of preference.

You can be sure a lot of thought has been put into this algorithm. In fact, the 2012 Nobel Prize in Economics was awarded to Lloyd Shapley and Alvin Roth for their work on market design and matching theory. Shapley and Roth were personally involved in designing the algorithm that they use in residency matching, and since it’s implementation in 1997, residency matching is as fair as it can be. This algorithm also applies to couples ranking.

I won’t go into the mathematical aspects of the algorithm, you can read more about the matching algorithm and the NRMP (US Match) on the Nobel Prize Page (pdf). It’s pretty cool math.

Never Rank a Program You Do Not Want to Attend

Because the CaRMS match is finalized, you should never rank a program that would not want to attend. because if a program is on your list, there is a chance that you could match there. Some people say it’s better to go unmatched than to match to a place you don’t want to go to, I’m still undecided about this. Being unmatched puts you in a difficult spot, it’s a mark on your record that can be hard to overcome. My advice to people is to apply broadly during the CaRMS process so you have options to choose from. Remember that practically everybody gets their top choices. Only a few percentage of applicants run into trouble and those are usually with competitive specialties.

Other Factors to Consider when Making a Rank List

There are many other things to consider when picking programs. After specialty and location, I would say these things shouldn’t be weighted as much. Remember that every accredited program will give you good training, and how good of a physician you will become depends more on what you do than the program you attend. Here’s a list of other things to think about

  • Faculty/Mentorship relations
  • Resident happiness, collegiality
  • Opportunities for fellowship, research, jobs
  • Funding for well being, projects, conferences

Making a List, Checking It Twice

When you finally come up with an order that you are happy with, sleep on it and check it again later. If you are still pretty content with your list – check it once more to ensure the order is correct and submit it. Whether you decide a week before or minutes before the deadline doesn’t make a difference to the final result. Submitting it as soon as you’re ready gives you a peace of mind. At that point, you would have done everything on your part and the rest is out of your hands.

Trusting Your Gut, Choosing Happiness

My final advice would be to trust your heart and gut in choosing a residency program. There are a lot of intangible elements that can’t be easily entered into a a pros and cons list. Talk to people who are important to you to see what their input is. Don’t get caught up with other applicants and their ranking strategies. Find what works for you. It all works out in the end for the majority of people, so there’s no need to stress out. Ultimately, choose the place where you will be the happiest. Even if you a program is very prestigious but you are miserable, it can make residency a very tough few years. You’ll be a trained adequately as a doctor wherever you go. You might as well be happy.

Taking Ownership of Your Patients

In many ways, residency is not too different clerkship. You rotate through different specialties, you try to learn how to take care of patients from your teachers. Sometimes, I feel like I knew more medical knowledge when I was a medical student than I do now. During clerkship, I saw fewer patients, read more and spent a lot of time in my studies. As a resident, educational activities take a second seat to clinical duties, often consists of a lot of scut work.

However, the biggest difference you face as a resident is the responsibilities  you are given and how you handle them.

I remember in medical school I had several preceptors tell me to “take ownership of your patients.” At the time, I thought this meant I should see my patients daily, know their medical history inside out, have all their lab work and investigations checked obsessively and write comprehensive daily notes. To me, taking ownership was knowing everything about my patients..

But looking back now after being a resident for half a year, I think taking ownership is more than just good patient care, it’s a philosophy where you learn to be the most responsible person to your patients.

Last week’s NEJM had an excellent perspective on medical hierarchy and how when we don’t take responsibility and ownership, patients get harmed.

We realize that, each of us unsure, we gained confidence from the perceived assurance and expertise of the other. We unearth the other specialists who participated in the patient’s care. The oncologist had wanted the infected effusion drained so he could safely commence chemotherapy. The respiratory physician had recommended referral to a larger center for drainage. The infectious diseases physician had no more antibiotics to offer. The general internist bowed to the others, and the surgeon was approached as the next service provider in line. Tragically, no one person looked beyond the effusion to the whole patient. Although he saw myriad specialists in his last week of life, he died lacking holistic care.

It’s hard to really understand this concept until you are on your own, on call in the middle of the night looking after sick patients. As a medical student, you were always supervised either by your resident or attending. Whenever patients got sick or there was some obstacle, there was always someone you could defer to.

To me now, taking ownership means assuming you are the most responsible physician looking after this patient. Although as a resident I am still supervised by a staff doctor, I think having this mentality of being the most responsible person will ultimately make me a better doctor and provide better patient care. It means not assuming that other people will order proper investigations or check lab results. It means advocating on behalf of your patients. It means doing that DRE that everybody has avoided doing or taking extra time to talk with family members.

However, assuming responsibility comes with a cost. It can be emotionally draining. You become invested in your patients. You experience their joys but also their sorrows. You end up working more and your efforts are not always appreciated.

And as I head into the second half of my intern year, finding this balance between being your patient’s doctor and personal wellness will be a continued challenge. But Residency is exciting. If medical school was learning how to be a doctor, residency will determine what kind of a doctor you will become.