Wednesday, September 30, 2015
Friday, September 25, 2015
If I only knew then what I know now: A Primer for M2's
As I begin to write this article, generally unaware of the ultimate audience that it will reach, and reflect on the past year of my medical education, I can’t help but to appreciate the brevity of it all. You begin the first days of second year excited to learn “real medicine,” having paid your dues to the basic sciences. You tell yourself that you’re going to nail pathology, pharmacology, and microbiology. You go to class, you try new study techniques and strategies. You spend the entire second year with the inevitability of STEP 1 looming in the back of your mind, powerless to change the fact that “summer is coming.” And then, somewhere along the way, you stop and realize that it’s already over. You never really found the time to go back through your pharm-cards on weekends, and you never actually read that whole section of Harrison’s like you had intended. But now you’re past STEP 1, you’re on the wards, and none of that really seems to have made all that big of a difference.
I think that my point in all of this is that despite all of the advice that I’m about to humbly bestow upon my peers, the underlying message is that advice is great, but experience is better. By that I mean you’re going to collect the input of as many people as you can who’ve come before you, buy the recommended books and study aids, even emulate their study schedules, and in the end the only way that you will find what works for you is to live and do it for yourself. You’ll come out on the other side of STEP 1 with the knowledge and experience necessary for the wards, and most certainly your own formula for success to pass onto the next generation. All that being said, I’ve put together what I think are some of the most universally applicable pieces of advice for new M2 students.
1. Don’t let the dark cloud of STEP 1 interfere with what you’re learning now. Yes, that day will eventually come; and yes, you will (hopefully) be well prepared. But in my honest opinion, the most impactful studying that you can possibly do now and through January is to learn everything in the curriculum, and learn it well. Learn for understanding, to answer the why questions, not just the what questions. Go to class, and go to class prepared. If you read ahead, or at least read First Aid/Pathoma beforehand, you’ll be able to ask questions to solidify your knowledge. If you choose not to go to class, I would at least set aside those blocks of time for extra reading and review so that you don’t let yourself blow it off after the first pass. In all honesty, the better you learn it now (when there’s actually a reasonable amount of time to do so), the less you’ll have to work this summer. If you do feel compelled to do something, I would simply suggest annotating First Aid or your primary review resource as you go along with supplementary details.
2. If you start thinking about your curriculum vitae now, you won’t have to kick yourself later. This is mostly advice from the "what I wish I had done" file. As you begin third year, you soon realize that you need a current copy of your CV earlier than you think. Some competitive externships prefer students to apply up to 9-12 months before the actual clerkship start date, and many of those applications require you to attach a current CV. While it may not seem like a big deal (maybe you figure you can knock one out in a weekend or so), once you start to factor in the long hours you spend on clerkships (possibly on weekends too!) and the studying/sleeping you’ll fill your free time with, it quickly becomes very easy to blow off until the last minute. When that happens you’ll find yourself scrambling to remember when you did that one volunteer program, or what the title of that poster actually was; you might even forget something in the shuffle of it all. In an ideal world, I would strongly recommend that in your second year you begin to assemble a working CV as you go along. That way you can identify areas where you could use some beefing up while still allowing yourself time to actually do so. Given that I currently can name zero people who have done that in their second year, a more practical alternative would be to keep a running list of “have done” and “will do” items to eventually put into your CV. Keep track of it in Evernote or mac notes, so you can add things as they sporadically pop into your brain. That way, when you do sit down for that dedicated weekend, you’ll at least have a decent list to work off of, alleviating some of the work load from your long-term memory. All-in-all, so long as you have a mostly complete CV going into your third year, you’ll be in great shape.
3. If you haven’t found a hobby or other way to de-stress yet, now is time to find one. If you haven’t realized this yet, medical school can be stressful. It can be really stressful. STEP 1 will inevitably heap even more anxiety onto your psyche, and if you’re anything like me that can get uncomfortable overwhelming. That is why I make it a priority to take time dedicated to myself now and then to refocus and blow off steam. Currently, my outlets consist of exercise (mostly running/weight training) and cooking (teaching myself/experimenting, not just fixing grilled cheese). Those are just my personal examples, and frankly I don’t think it much matters what you do, so long as you give yourself an outlet to shut your brain off and not think about pharmacology or pathology for a while. This will become crucial in the summer when you take STEP study breaks; and you had better be taking some study breaks. Another benefit of having a “thing” is that it becomes a terrific topic of conversation when you get to residency interviews. I learned this from a recent graduate who shared with me how he came to be known as the “guy who has run every day for the last seven years.” While I’m not suggesting that you try and emulate this by doing yoga for 5 hours per day for the next two years, I am more so encouraging you to have “a thing.” By this I mean you can kill two birds with one stone by cultivating a hobby that both helps you relax and helps you to differentiate yourself from other candidates down the line. So whatever you decide to do, just make sure it brings you some kind of joy, and then own it for the next few years.
Ultimately, I cannot say with any certainty that these things will impact your second year whatsoever. To reiterate my opening thoughts, everyone has their own experiences, anecdotes, and advice that they accumulate along their personal path to becoming an MD. My hope in writing this article is that a few of these things will resonate, and make the second year of medical school just a little bit easier to manage. I wish all of the second year students the best of luck not only on the fledgling academic year, but also with STEP 1 and the ensuing transition to clinical education. Have a great year!
Kenneth Sack is a third year Athens student and graduate of LSU planning on training in Orthopedic Surgery. He is from Alpharetta, GA and spends whatever time he isn't studying on exercising, cooking, being outdoors, or binge-watching The Walking Dead.
Friday, September 18, 2015
What's your plan? Understanding Healthcare Policy Proposals
Standing in the aftermath of the second Republican Presidential debate, we as Americans now recognize that Presidential campaign season has officially begun. We also are in the wake of the controversial passage and rocky implementation of the Affordable Care Act—popularly known as Obamacare—and we will now hold our first national election in which the law’s advocate-in-chief will not be on the ballot. Republican and Democratic candidates alike will offer their perspectives on the law, its strengths, its weaknesses, and what should be done in response to them. As I talk with my friends in and out of medical school, several questions bubble to the surface: how should we as voters react when we hear candidates speak about Obamacare and their respective health plans? What would be helpful for us to remember in the midst of those conversations?
A few things will help us as citizens navigate these choppy campaign waters. First, do not expect a candidate to give a full plan with nuanced details during a speech, rally, or interview. Winning votes determines the success or failure of candidates, and therefore getting votes becomes the candidates’ ultimate focus. In order to do this, any candidate worth her or his salt simply must speak in language and ideas that as many voters as possible can understand.
While this political reality has the advantage of engaging many citizens regardless of background or education level in the political process, it has the inherent limitation of cutting short some of the more substantive policy discussions that many voters would like to see in a campaign. Health care is a great example of this. Health policy is a complicated field that candidates must boil down into digestible phrases we hear such as “repeal and replace Obamacare” or “universal health care.”
This leaves many voters wanting to know more. For example, repeal Obamacare and replace it with what exactly? What do you mean by universal health care? What is your plan?
For voters who find themselves asking these questions, a few things will be helpful to know. First, while every serious candidate will have a health policy proposal, the authors of those plans will be campaign advisors, not the candidates themselves. Many of these advisors are health policy scholars who work either in academia, at think tanks, or sometimes for the campaign itself. Whereas candidates spend their time trying to get votes, policymakers spend their careers focusing on ideas, such as the details of how to reform Medicare to make it more financially sustainable and improve reimbursement rates for health care providers. They write papers, publish studies, give speeches, and make friends with (prospective) candidates. When candidates make it to the point in the campaign where they need to offer a health policy proposal, they (and their campaign staffs) often turn to their friends and allies in the policy world.
If you really are interested in the details of a candidate’s plan, find out who is writing their health plan and then look at what that policy person has spent a career advocating. In the age of the Internet, any Google search will find you a list of publications, many of which will be electronic. Read those and read about the think tanks that employ or have employed those advisors. With a little research, you will gain a good understanding of some of the details in a plan and especially how the plan’s author thinks.
As you might imagine, in the same way that different candidates have different ideologies, different policymakers do, too. So Republican candidates turn to conservative health policy scholars and think tanks, and Democratic candidates look to progressive or liberal ones. For example, The Heritage Foundation (http://www.heritage.org) and American Enterprise Institute (https://www.aei.org) are both well-known conservative think tanks. The Center for American Progress (https://www.americanprogress.org) promotes progressive or liberal policies. Looking through publications on each of these sites will enable you to understand what types of policies a policymaker is likely to promote. It is important to remember that much of public policy is about priorities and means—what you want to achieve and how you plan to get there. As students training in health care fields, you will be able to use your clinical experiences to understand how you feel about whether a set of policy proposals will allow health care providers like you to provide better care to patients across the country.
Gaining a better understanding of a health policy advisor and her or his health policy preferences is critically important because any policy plan has to meet the political reality of governing. Plans can change as a candidate-turned-President looks at what she or he must put in a plan in order to get it passed by Congress. Many of the campaign advisors will remain advisors during the governing process, either formally or informally. These policy advisors will help Presidents navigate new political waters.
In summary, campaign season is here again, and many of us will want to know more about the health policy proposals of different candidates. In order to do this, focus not only on the candidate but also on the author of the candidate’s plan. Her or his track record along with her or his current and former employers are good markers for better understanding the thinking that will inform not only the candidate’s health policy proposal during campaign season but also the adjustments that she or he will need to make when confronted with the political realities of governing from the White House.
Jonathan Crowe is a second-year medical student in Augusta. His health care interests include caring for patients, health policy, global health, and medical technology innovation. When he is not at school, you can find him sleeping in, hunting for good barbeque, listening to music a little too loudly, spending time with friends, and loving most things either athletic or outdoors.
Thursday, September 17, 2015
Top Three Attending "Pearls" for Success
We’re lucky to have such great attendings at our school who
are more than willing to share what they know.
Here are three of my favorite attending “pearls”:
1. “Trust but verify.”
I heard this saying from multiple attendings, and for good
reason. The EMR is great for a lot of
things, but it can be full of incorrect information that gets copy and pasted
over time. I had a patient who had a
purportedly negative tobacco history.
Wrong – he had a 50 pack year history and was still smoking. Verify your patient’s histories. Make sure orders that are put in for your
patient have actually been done, especially medication orders (check the
MAR). Verify lab and radiology results -
don’t just take someone’s word for it. If
something feels off, verify.
2. “For us, we see
this all the time, every day. But for
you, it’s happening for the first time.”
I’ve loved this quote ever since I heard it early in my
third year. Once you’ve been in the
hospital for a while, things get very routine.
This quote reminds me to not become too nonchalant, especially when it
comes to informing patients about major treatment plans. Break the news slowly, don’t rush it, and
help the patient understand. This is
true for even the most common of things.
I underwent an endoscopy a few months ago. Although I knew it was a fairly routine
procedure, I was still nervous when they wheeled me into the endoscopy
suite. I realized then how grateful I
was to be told what was happening, even if it was just “we’re setting up the
meds.” Do your patients a favor – keep
them in the loop and explain what’s happening.
It’ll go a long way for patient comfort.
3. “You should stay
here 24 hours. You’re paying for your
education. The longer you stay, the
cheaper it is per hour.”
While nobody wants to maximize his or her price per hour
ratios by staying longer, you can maximize the quality of time that you are at school by being proactive. You’re paying to be wrong now before they pay
you to be right later. Get as involved
in your patient’s care as possible – ask why
you’re doing what you’re doing. Anybody
can follow an algorithm, but you’re in school to learn why the algorithm is the
way it is and what to do when the algorithm doesn’t work (which seems to be the
case more often than not). Don’t be
afraid to get your hands dirty, and take the initiative to ask to do
procedures. Your time in the OR is the best time to get signed off on a lot of procedures (especially foley
caths) as is your time on Labor and Delivery (ask to practice starting IVs). If your patient needs an EKG, ask the nurse
if you can do it (put on the leads yourself and learn how to work the
machine). You have to be at school for
several hours a day – might as well make it worth it!
Jennifer Simpliciano is a fourth-year medical student based out of the Augusta campus. She is currently applying for residency in Internal Medicine. Outside of school, she enjoys going ballroom dancing, eating too many desserts, and singing loudly in the car to 90s music.
Wednesday, September 16, 2015
Local Med Student Gets Out of the Way
Augusta, Georgia – A third-year medical student at Medical College of Georgia received overwhelming praise from administration last week for his unexpected capacity to not be in the way.
“We were just blown away by how naturally it came to him,” commented Dr. Zachary Greco. “At first we thought he was just a chair or table or something, but then we realized it was just because he was getting in our way so much less than his classmates.”
Ryan Johnson, an Augusta native, says that he is unsure how he developed the talent.
“I mean, I spent all summer really cramming basic science for the USMLE…but I guess little by little, the isolation was really teaching me how to blend into the background.”
Ryan’s surgical preceptor was especially vocal about his unique skill-set. “I wish all students would follow the lead of this young man. This is literally the first student that I have ever not hated. The first one! And I’ve been teaching students for over thirty years!” His excitement was palpable.
Ryan tells us that he never expected to be so good at something as a third-year student. When pressed for more details on how other students could work to be less in the way, he was genuinely at a loss. “I really can’t tell you how I keep coming into the hospital every day and be not in the way for fourteen to sixteen hours. I guess I’ll need to look a little deeper inside to find the answers.” He tells us that one day he hopes to teach future generations of medical students to be as little of an inconvenience as he has become.
Although the attention has been mostly positive, not everyone is particularly happy about the revelation. “I’m pretty convinced he’s cheating somehow”, said George Mint, a jealous classmate. “I’ve known him since first-year, and I’ve never seen him stay out of the way like he is this year. There’s something fishy about how good he’s gotten in such a short amount of time.”
Fishy or not, Ryan looks to be commended by faculty in the form of a kindly-worded email later this year. Naturally, he is modest about all of the recent acclaim.
“I don’t do it for the pats on the back. I do it because getting out of the way is my calling, and it helps me get yelled at less.”
Andrew J. Jones is a third-year medical student based out of the Augusta campus. His interests include history, science fiction, space travel, obscure television series, B movies, and playing musical instruments by ear.
Tuesday, September 15, 2015
Hidden in Augusta: Arts in the Heart of Augusta Festival
The festival is a fantastic excuse to get out of the classroom and hospital, soak up some sun, and support local artists and talent. Take a walk on the streets of downtown to admire the colorful and imaginative fine arts and crafts from the young and old. Perhaps you’ll be inspired to start your own project or find that one piece of artwork that completes your living room décor.
When you’ve worked up an appetite from all the walking, head over to the food stalls to satisfy your hunger. Here you can try foods from Cyprus, Greece, Nigeria, Philippines, Spain, Turkey, and more! Make sure you bring enough money so you can try everything. You’ll have so many mouth-watering options, you’ll probably have to come back on multiple days just to try a little bit of everything!
After you’ve had your fill from around the world, settle in for some live entertainment. There are multiple stages around the festival for you to choose from, so you’re bound to find something you like from jazz music to Irish dancing to indie rock.
Everyone deserves a break. Take some time off this weekend, and check out Arts in the Heart!
What: Arts in the Hearts of Augusta Festival
Where: Broad Street and the Augusta Common downtown
When:
Friday, September 18 from 5PM – 9PM
Saturday, September 19 from 11AM – 9PM
Sunday, September 20 from 12PM – 7PM
Cost: A limited amount of badges are on sale at SunTrust Bank locations across Augusta for $5. Gate price is $10 (badges are good for the whole weekend). Children 10 and under are free.
For menus and performance schedules, visit http://www.artsintheheartofaugusta.com/
Hidden in Augusta is a series featuring suggestions for events, restaurants, and activities in Augusta. If you have a suggestion, please email panacea.mcg@gmail.com.
Monday, September 14, 2015
How to Be an Anatomy Rockstar
Snapping on your gloves, you enter the cadaver lab for the
first time. The stench of formaldehyde hits you like a ton of bricks.
Undaunted, you walk through crowds of anxious medical students toward your table
and lab mates.
Are you pumped?
Check us out every day this week!
Welcome to Panacea, a blog run by MCG medical students that will feature content made to enhance (or possibly distract you from) your educational experience! We will be posting something every day this week to celebrate our opening week. After that, check us out every Friday for our feature blog posts and periodically throughout the week for other goodies we might post. Follow us on facebook and twitter for even more updates.