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Finding Your Focal Point(s)

Finding Your Focal Point(s)

  • Author: temp-admin

Finding Your Focal Point(s)

how to get into medical school, medical school acceptance,

The modern world is ripe with opportunity, however, pursuing every bit of it can leave you stretched too thin. This is the classic conundrum faced by medical students. You spend years building your application, but have the joy of building it all over for your next stepping stone: residency. Don’t worry though, this simple, reflective exercise, inspired by Brian Tracy’s book Focal Point, will provide perspective and allow for optimization. Essentially, he proposes: highlighting the high-yield activities you do on a daily basis, and eliminating the low-yield activities, which exponentially increases your happiness and success (however you define it). Now, let’s find your focal point(s)!

Step 1: Define Yourself

Who are you? If you were to categorize your life into the things you work at, interact with, or think about on a daily basis, what would they be. Then, rank them, beginning with the most important. My list looks like this:

  1. Faith
  2. Family (includes Fiancee and kitties)
  3. Friends
  4. Mental and physical well-being
    1. Mindfulness
    2. Exercise
    3. Diet
  5. School
    1. Class
    2. Extra-curricular activities
      1. Student Surgical Society
      2. Volunteering
      3. Research

In my experience, if the previous item is not in order, then the latter suffers. For instance, if my mental and physical well-being are in shambles, then my performance in school deteriorates.

Step 2: Create Short-Term Goals

By short-term, I mean less than a year. If you want to think in terms of a shorter timeline, be my guest. Some of my short term goals revolving around the 1st item above, family, include the following:

  • Talk on the phone/facetime my Fiancee at least every other day
  • Text her during my spare moments
  • Spend as much time as possible in Minneapolis (where she is a medical student herself)
  • Plan affordable dates while there
  • Make time for a honeymoon after we get married this summer
My list ranges from daily occurrences to things on the horizon in the coming year. (Side note, making time for dates, even on a shoestring medical student budget, is vital to a relationship and the mental health of any medical student. It allows you to escape the books and feel like a real person for at least a little while haha.)
 
Step 3: Create Long-Term Goals
 

These are the goals that look beyond 1 year, or whatever corresponds to beyond your short-term goal timeline. Some of mine, again for item 1 (family), are listed here:

  • Live with fiancee after 1st year and during 3rd year
  • Match in the same city as fiancee (even if through transitional year)
  • Take 4 affordable trips each year
  • Start having kids at the end of her residency

I am in an accelerated, 3 year program, so I will actually begin my clerkships the summer after my 1st year of course work. My fiancee will be a 4th year med student in Minneapolis, so if I am able to get placed in Eau Claire, WI (roughly an hour and a half drive), this may be a possibility. Keep your fingers crossed for me! Hopefully then we could live together during her intern year, which would be my final year of clerkships. Thereafter, I intend to match in the same city as her, even if it is just a 1-year transitional spot. This is where your priorities come into play. I have family at the top of my list and school down lower at 4. Therefore, I would gladly do a transitional year, even if it meant reapplying for the match, just to be with her. Just as dates are important to a relationship, I feel trips are as well. Your flexibility definitely depends on your specialty choice, but regardless 4 seemed like a reasonable goal. Maybe the kiddo goal is a bit ambitious, but time will tell!

Step 4: Identify Your Focal Points

This is the most important step. Critically look at your goals and figure out what is needed to accomplish them. This is your focal point. It may require more of certain activities, less of certain activities, initiating new behaviors, cutting behaviors out altogether, or some combination of this. For instance, when I looked at my goals, 3 themes emerged: mindfulness, awareness, and strategy. The mindfulness applies most to items 1 and 2, Family and friends. Being mindful encompasses interacting with them often, whether in person or through electronics, and being truly present during those interactions, not having my head buried in thoughts of pharmacology. The awareness also applies to these relationships because it involves recognizing how the relationship is doing thanks to my efforts. For instance, am I taking my fiancee on enough dates or am I texting my sister enough. Last, the strategic element largely incorporates items 3 through 5. There are a myriad of things I want to accomplish and unfortunately not enough time. To combat this, I decided that every night I will map out my schedule for the ensuing date, prioritizing these elements to slowly chip away at the high priority targets.

Step 5: Keep Your Focal Points Close
 
I did this entire exercise on a white board that I keep in my room (see the picture to the right)! That way, every morning I wake up I will be reminded of my goals and the focal points through which to accomplish them. Not that those in medicine could be characterized as wanderers, but this truly gives me a purpose every single day. I feel as if every day is an invigorating and inspiring mission now.
 
Now it’s your turn!
Go out and get what is yours!
5 things you must do before starting a new semester

5 things you must do before starting a new semester

In college, each semester offers the opportunity for a fresh start; a chance to learn from past semester mistakes; a chance to reach new goals. Being aware of this opportunity and successfully acting on it are two different things. While it’s easy to desire change, it is much more difficult to make it happen. How do you get the most out of a new semester and accomplish your goals? In this post, I am going to talk about a few key things I learned in undergrad that helped me turn a new semester into a successful one.

1.  Define your Goals 

I cannot tell you how many times I have wandered into a new semester like I was in La La Land (editors note: go see La La Land). I would take each day at face value and had no idea what to expect, or what I wanted.  At the beginning of each new semester, ask yourself what you want to get out of this semester. Is it to get all A’s in your classes? Do you want a letter of recommendation from a certain professor? Or maybe you want a new research position. To achieve new goals, you must define what you want. There is no finish line if you don’t create one.

2.  Be Realistic

After defining your goals, look at your other responsibilities and ask if the goals you set forward are realistic. If you work 40 hours a week and are taking 21 credits of all upper division science classes this semester, getting a 4.0 and being president of two clubs while conducting research is probably not in your future. I’m not saying it’s impossible- maybe you are superhuman with amazing multitasking skills. In that case, I am super jealous. But regardless, it’s definitely important to be realistic with yourself and understand your limits. That said, any goal is achievable if you are able to break it up into smaller attainable ones.

3. Break Your Goal into Smaller Ones and Schedule Everything

Take some time to organize a schedule. This includes class time, commute time, office hours, hours spent at any job you may have, sleeping, eating, getting ready, etc. I know this may sound trivial, but trust me it changes everything when you lay it all out on paper and visualize it.  Once this is done, look at the amount of time you have left each day and set aside a certain amount of time for studying, extra-curricular activities, research, and anything else you may want to include. This way, you know how much time you can realistically dedicate. If you stick to tiny goals of studying for X amount of hours and conducting research for X amount of hours, while working X amount of hours and accounting for class time, you may just achieve that 4.0 and become president of your club. And even if you don’t, you know you will be working as hard as you can with your current situation. And that is an achievement within itself. One that you’re bound to reap rewards from. If you set goals that are in your control and are attainable, you are more likely to achieve them.

4. Anticipate Obstacles

Everything in life does not always go according to plan. This semester is probably not going to go perfectly.  Plan for obstacles. Think of ways to overcome them.  Let’s say you don’t get the test score you wanted, what are you going to do differently? Attend more office hours? Study more? If you have a plan, you are less likely to get discouraged and more likely to plow onward towards your end goal.

5. Find an Effective Method of Stress Relief

Let’s face it. We’re not robots. The majority of us cannot work hours on end without feeling fatigue. We are humans and we are all vulnerable to stress, so you need to be prepared with at least one method you know will help you to recharge your battery. This is where you can take advantage of your passions. You should make time for the things you enjoy in order to help alleviate stress. For me, yoga, running, and meditation all helped me to effectively deal with stressful weeks. Everyone is different and you should find something that works for you. Trust me, you will be happier. Your mind will be clearer. Your focus will be better. Your motivation will be stronger. All of which are important in achieving your goals.

I elaborate more on these topics in my YouTube video, “Start The New Semester Off Right- College Advice and Motivation-Organization Tips for School,” (http://tinyurl.com/glkvzev) so feel free to check that out. I also found that creating Study To-Do Lists and preparing for lectures beforehand were both really helpful in maximizing my time. More info on that can be found in my video, “How to Study Effectively- Study Tips for High School and College- Premed Advice” (http://tinyurl.com/jk2h97d).

Hopefully you guys found this helpful! If you guys have any questions for us, feel free to contact us at amandaandrichshow@gmail.com and we would be happy to respond. Now go make your next semester the best one yet!

My USMLE Step 1 Study Strategy

My USMLE Step 1 Study Strategy

I’ve been busy traveling for residency interviews, but I figured I should take some time to talk about my own strategy for studying for USMLE Step 1. While others have already posted study guides, I figured I would add my own two cents in, not because I have any revolutionary new ideas on how to study for the Step, but rather because I think there are a few suggestions I have that could make things a bit more efficient for you. Although I took the exam in early 2008, I feel this advice will be quite applicable for those of you taking USMLE Step 1 for years to come (haha, until they change the exam structure up, as they always do about every 10 years)…

Before I get into this, I should note that I am simply describing my own experience and what worked and did not work for me. I hope you take away something useful from it, but do not feel that there is only one way to study successfully for the Step. Everyone comes into this with different strengths and weaknesses, depending on their medical school’s basic science education as well as their own aptitude and experiences. Everyone also has their own learning style: some people are visual learners; others, aural. Another thing that people are less likely to admit, but is clearly true: while we all want to score well on the Step, not everyone shares the exact same goal as far as their score goes. Read as much advice as you feel necessary, but do what feels right for you, first and foremost. As for general advice on what subjects to study and how to budget your time, I feel these have been discussed quite well elsewhere, so check out 21+ Online Resources for USMLE Step 1.

My Daily USMLE Step 1 Study Schedule

If you do look at other sites, you’ll see there are various study guides for people who have 4, 6, or 8 weeks to study for the exam. What some sites don’t mention though is that the hours you’re willing to study per day matter as well. Some people can go 8 hours straight; others can only be highly productive for an hour or two. Personally, I aimed to do three 3-hour chunks per day. I’d study one topic from roughly 9am to noon, take an hour break for lunch, study from 1 to 4pm, take 2-3 hrs break to exercise and eat dinner, then do practice questions from 7 or 8pm until I felt tired. Some days were better than others, but I think I averaged around 9 hrs a day, which seemed appropriate to me. I also took a half day or whole day off each week to catch up with friends and family. It is key to schedule in breaks in order to maintain your health and sanity. Jam-packing your schedule with unrealistic study expectations will only demoralize you later on when you cannot keep up.

My Six Week Strategy For USMLE Step 1

Due to the structure of my school’s curriculum, in theory I had up to 10 weeks to study for the Step. However, in reality I probably spent about 7.5 weeks studying, and really peaked around the 6th week and plateaued after that. Sometimes I wonder if my score actually went down due to that extra 1-2 weeks of studying just because of burnout! Anyway, based on the general advice for Step 1 I found online as well as talking to upperclassmen friends who had recently taken the test, my basic strategy was to read through First Aid for the USMLE Step 1 in order to get comfortable with all the general topics covered in the exam. Some students try to start studying by picking a topic area and delving into it.
I understand the rationale behind this, but the reason I avoided it is that there is so much information out there, you easily start to feel overwhelmed as you study one area, which leads you to become demoralized. By studying First Aid initially, not only did I get a general refreshed on all the major topics covered on the exam, but I also felt more comfortable in judging the depth to which I needed to study particular subject areas. Since the questions on the exam are integrative, having reviewed all the subjects was often helpful when I took practice tests, as I got more questions right as compared to studying one subject alone, which helped build my confidence. I budgeted about a week for this, which was sufficient for me.

After going through First Aid, I prioritized each major subject area covered in Step 1, and covered them week to week, starting with the subject I was least comfortable with, biochemistry. As I mentioned above, I’d spend about 6 hours per day studying the subjects, and then spend the rest of the time doing practice from Kaplan Qbank and then later on, USMLE World. While I do not want to belabor what subjects to study and how much they appear on the exam, I feel that in general, memorizing First Aid in its ENTIRETY and doing LOTS of practice questions from one of the qbanks is sufficient to get a great score on the Step. You don’t need any fancy combination of books or vast detailed knowledge about esoteric zebra diseases. Just know the basics really really really well. That’s it! But, of course, no one would feel comfortable studying just one book and doing questions so we all use other resources. If you’re interested in the books I found useful, check out Books For USMLE Step 1.

I repeated this pattern of studying for particular subjects for about 6 weeks, but I made sure to reserve the last week before the exam to go through First Aid again. Doing so really helped solidify all the material in my mind. Also, as I had been taking notes in First Aid as I did review questions, I had a much richer resource to study from during that last week, and did not have to waste time hunting for notes in other resources. The day before the test itself, you really should try to just relax, watch a movie, hang out with friends. If you really feel the urge to study, just do some light review in order to calm your nerves and build your confidence. Do NOT try learning tons of new things. The rapid review section at the back of First Aid is good for this in my opinion.

The USMLE Step 1 Aftermath

After taking the test, I felt pretty good about my strategy and I think it prepared me well to answer most of the questions on the exam. There is no perfect strategy out there, and the test will always throw some real curveballs at you. But, don’t worry, many of these questions are experimental and will not affect your actual score. Focus on answering the questions you know you should be able to answer and you’ll sail through. The best part about taking the Step is that no matter how the test went, you have a great reason to CELEBRATE afterwards! All those weeks of hard work will have paid off. Go out and reconnect with all those parts of your life you put on hold!

By Scrub Notes
(click to see original post here)
My Pre-Med Story – Ellen

My Pre-Med Story – Ellen

“‘My pre-med story’ is a new series that lets you get a glimpse into the lives of fellow pre-meds… If you would like to share your own story, email it to: Editor@motivatemd.com”  Enjoy…

 

As the end of 2016 approaches, I know there are still some medical school applicants, like me, anxiously waiting to hear back from schools. This is my first year applying and the best way I can sum up my experiences so far is by comparing it to traveling abroad. Before you begin on your trip, you’ve meticulously planned out which countries you want to visit, chosen which cities you would like to see and also which sites you just HAVE to experience, calculated the cost of transportation, hotels, food, entertainment, etc., and created a day-to-day itinerary of your entire trip. But once you start traveling, you come to realize that not everything may go according to the plans you’ve set…

 

Comparing a new chapter in your life to embarking on an adventure may sound like one big cliché metaphor, but this whole process IS one long journey. Every person has a different story on why they decided to go on this “journey” to become a physician. For example, I knew I wanted to become a doctor when I was 16 years old. I had just started my first job as a lifeguard at the YMCA. Most of the time at work, nothing significant happened- until one day, I found an unconscious man in the middle of the YMCA parking lot. My Red Cross training kicked in instinctively and I rushed to help him. For what seemed like an eternity, I performed CPR until the ambulances came. When they finally arrived to take him to the hospital, one EMT looked at me and said, “If you weren’t here, he would’ve been dead.” Those words of finality resonated in me and that moment was when I knew I would do whatever it took to become a doctor.

The following years in high school I knew what I needed to do in order to get into the college of my dreams, and I did it. From then on, I thought I had my life together and everything would just fall into place. What I didn’t know was that I could never have been 100% prepared, especially since I had never embarked on a journey of this magnitude before.

During my sophomore year at Emory University, my grades suffered due to the unexpected deaths of my grandparents. This was a turbulent phase in life because I had never lost anyone so close to me. I didn’t know how to deal with grief so I blamed myself for allowing my grandparents to die. I blamed myself for being an ungrateful granddaughter who was too self-absorbed with her own ambitions to help others. The irony of my thoughts and actions consumed me and I hit an academic slump. After some time, I finally agreed to take a semester off during my junior year to seek counseling.

Looking back, taking a semester off was a blessing in disguise- I learned that I can’t control everything that happens and no matter how much pre-planning I do, life is naturally disordered. But if you have enough willpower to keep going, then the next step is to look for alternative routes. Which is what I did after I graduated from Emory. I completed a Pre-med post bac program, where I met some of the most inspiring and compassionate people. The following summer, I studied for the MCATs with another student I met during my post-bacc program. We couldn’t afford a prep course so we bought MCAT prep books and spend three months in the library together, for eight hours a day. It was a grueling summer of nonstop prepping and countless practice tests. It didn’t end there- then, there was the AMCAS process, followed by the countless secondary applications essays. (Not to mention how broke I was by the end of this process). But I did it. We all did it. And now, we wait.

I look back at all the time and effort I put into my dreams of becoming a physician. I know that my journey is incomplete and there is still a long way to go. But what drives me to keep going is in knowing that I tried and gave a shit…and I still do. My biggest fear was and is still failure. But I’ve come to learn that failure plays a humbling role in our lives. I’ve had a lot of setbacks in my life, but each time I overcome them, I gain a little more insight and self-awareness. It would be easy to breeze by life and get everything you want in an instant. But I believe that fighting to get to where you are makes you learn about ambition, determination, passion, empathy, patience, diligence, intuition, and other attributes that define a great physician.

What I want to ultimately say is that we cannot give up. Sure, medical schools initially filter applicants by grades and MCAT scores but what they also look for is personal growth and strong willpower. Nothing is more powerful, more reputable, than someone who does not stop at the first sign of failure. So, if you get rejected this year and are planning to re-apply, you are definitely more prepared than last time! We made it this far and if we can do it once, we can do it again. There may still be bumps in the road but each escapade is a learning process. And now you also know there is more than one way of getting to your destination. So rather than to “sit back and enjoy the ride,” embrace yourself for one helluva ride.

 

My Pre-Med Story By Ellen Kim (guest post)
Undergrad – Emory University
Post-Baccalaureate – Rosemont College
Research, Mentorship, and a Broken Liquid Nitrogen Container

Research, Mentorship, and a Broken Liquid Nitrogen Container

Research. Most premeds do it—some to check a box, others to learn, or challenge themselves, explore academia, or even add knowledge to the world. While just doing research to fulfill a requirement can lead to bitterness, and even burnout, the latter can give rise to a life-long passion and skill sets that can benefit a wide range of people.

I did it because I had to….

Now you may brush me off as a stereotypical cutthroat premed, I’ll tell you that it’s no longer the case. I have exceeded my requirement for box-checking and am now in a research fellowship, pursuing my own project. I feel fulfilled and I’m fully invested in my project and the potential it has to add to the knowledge of an under-studied phenomenon. I’m finally doing it for the right reasons and it feels refreshing.

Through a long process of mistakes, unhappiness, and stress, in which I almost dropped my hopes and desires of becoming a physician, I went from box-checking to pursuing a passion. Towards the end of my first research experience, I questioned whether I wanted a medical career. But I did some soul-searching (corny? yes; true? also yes), and gained some wisdom in the process.

It was my freshman year at university, and I was nervous about fulfilling the long list of requirements and recommended activities before I applied to medical school, especially research. When I applied for a research fellowship through and introductory research course and was placed into the lab of my choice, I was ecstatic—I felt I was going to make it.

During our first meeting, my PI seemed like the perfect mentor—he was a big name in transplant science, he offered opportunities of publications, shadowing and research conferences. I can still clearly remember his words at the end of the meeting: “Mentorship is one of the key components in any success story, and is the best way to help the next generation. I want you to promise me that you too will do the same for another student when you too are a physician.”

I promised, of course, and thanked my lucky stars for the opportunity.

Reality hit quickly. Naïve freshman me thought that I’d be working directly under his supervision. So it came as a surprise when he introduced me to the graduate student, “V”, I’d be working under. V was a pharmacy PhD candidate, who was a foreigner that had been in the US for two years and had quite recently started on the project that would be her thesis. She seemed extremely nice, so my surprise was not tinged with disappointment.

After completing endless research safety modules, I was finally in the lab with V, ready to cure cancer, end hunger, and find an answer to the age old question: Coke or Pepsi?

I figured the first few weeks would be spent familiarizing myself with the lab, safety protocols, and methods of the study. However, V jumped right in to teaching me how to do a long and seemingly dangerous tissue processing method involving liquid nitrogen. After two weeks, I was alone and unsupervised in the lab, working away at processing rodent tissues.

A pattern was soon established: V would tell me to be in the lab at some time, I would wait for an hour, then she would answer her phone and text back a to do list for that day, often with a protocol modification with which I was unfamiliar. My day would be spent trying to deduce exactly what I was supposed to do, sometimes having to text her back multiple questions, which were not answered in a timely manner.

I began feeling uncomfortable. I didn’t actually know what it was I was doing half of the time, and spent most of my time figuring out how to get that to do list accomplished without burning down the lab. I was also worried what the post-docs in the adjacent labs thought. I realized some would steal curious glances toward my section of the lab. What if I was exposed for the clueless undergrad I was?

One day soon after, I was pipetting a solvent and a research fellow that shared the lab stopped as he was passing by. To my shock, he looked concerned as he told me that the chemical I was pipetting was a carcinogen and should only be handled under a fume hood. This was how V showed me to do it.

I was upset and finally decided to take it up with V. She told me, “I’ve been doing it for years, and if you want to do it your way you can.” She also let me know that if I felt uncomfortable, then she could simply talk to the PI and have me placed on another project.  This frightened me. I feared becoming the incompetent, ever-complaining undergrad. That was not a label I wanted.

So I told her no, and that I would try my best. Meanwhile, I had not seen the PI in weeks, outside of routine lab meetings, despite my unceasing efforts.

The last straw came as the course was ending. I was transferring a mortar into a liquid nitrogen container to cool it down, when some liquid nitrogen splashed on my ungloved hand (V said we didn’t have the grant money to get the proper gloves), and I reflexively dropped the marble mortar into the glass liquid nitrogen container. It made a huge boom, and liquid nitrogen spilled all onto the floor. The same fellow from before came running over, eyes wide, and asked me what the f*ck was going on.

Not surprisingly, I was doing it the wrong way—the way V showed me how. The whole incident could have been avoided by simply poring the liquid nitrogen into a Styrofoam container.

I called immediately and explained what happened. She was nowhere near campus, but after screaming at me, she told me to wait for her. Two hours later, she arrived with further yelling and told me that I would have to pay a few hundred dollars for the broken container.

I went back to my dorm after with a million thoughts racing through my mind a minute. I laid on the hard, unforgiving bed that night, unable to get more than a few hours of sleep. What was I going to do? Is this what research is like? Am I doing something wrong?

Soon after, I told a biology lab teaching assistant whom I trusted. In her shock, she told me I was in no way responsible for paying anything and that I should talk to my seeming-absent PI.

This was easy enough—I just had to talk to the PI after a lab meeting. But what if he wouldn’t trust me and kick me out of the lab? What if I got a bad grade? What if that affected my GPA? Thoughts continued to run through my head during busy days and now sleepless nights.

I never ended up telling the PI. I left the lab, vowing never to do basic science research again. I was bitter, disappointed, and unsure of my aptitude for medicine. Actually, I was unsure whether I really even wanted to be a doctor. It took me a while before I even thought of doing any type of research again.

Not telling the PI is one of my biggest regrets to this day. If I were more upfront, this whole situation may have been avoided. Even if he’d kicked me out of the lab, it would have been for the better. However, I learned many important things that will help me throughout my life and career.

Fast forward to today (about a year and a half later). I am now working on my own project in the field of health economics, under a faculty mentor whom I met through a former professor and have a good relationship with. While his reputation is not as large as my former PI, he is fairly well-known in public health and, most importantly, finds time to invest in me.

Realize that research is not just checking a box. Many get into medical school without it, and if you don’t enjoy it, it can truly sap all the energy from you. There are plenty of not-so-great stories out there. However, most experiences (in fact few) aren’t as bad as my first and I attribute that to lack of experience, maturity, and foresight on my part.

BUT DON’T GET DISCOURAGED! It’s not all bad! If you find an interesting field, and find a good fit in terms of a lab, graduate student, and PI, go for it. You may just find your passion. And it’s okay to explore until you find the right fit.

And regarding the promise I made to my first PI? I plan on fulfilling and exceeding it. It’s now my goal to become a clinician-educator: to practice clinical medicine in an academic teaching hospital and teach residents and medical students. I also plan to take on a few mentees, invest my time in them, and help them grow personally and professionally.

By @Premed_Wisdom

Guest Post

Should You Consider Primary Care?

Should You Consider Primary Care?

 

As the growing burden of medical education increases, many ask the question, can I still be a primary care doc? This essay outlines a few possible solutions for pursuing a passion in primary care…

Are you considering primary care?  Or perhaps proctology?…

That is the late, great Richard Jeni.

How about family medicine or internal medicine/primary care practice?  If your parents were in Primary Care, the chances are, they would not suggest you follow in their footsteps.

You probably have heard other complaints such as low pay (you have loans to pay off), burdensome Insurance hurdles, EMR costs, ICD-10 headaches etc.  These problems are real, but can be overcome.

Independent Practice
Opening your own Fee for Service practice can be expensive, and expensive to run.  If this is your dream, start looking to underserved areas, so you reach a full panel quickly.  Joining an existing Independent practice is another option.  An older Physician may take you on and offer equity.  One caveat, the Independent practice is going the way of the millstone.  Hospitals are buying up practices.

Employed by a Hospital
The benefits are a steady income, relative job security, and the software and office staff costs are covered.  Disadvantages may include up to 30 patients/day, rushed appointments were you options are, write a script, order a test, or refer to a Specialist.

Membership Medicine
These are Independent practices that require a fee so the Physician can offer longer appointments, 24/7 access via email, text, phone, etc.  The definitions in this Industry are not in stone, but in general:

  • Concierge Medicine.  This form typically still accepts Insurance, but charges an additional fee to compensate the Physician for their additional time, that is not reimbursed by Insurance.  The downside is the additional office costs to still process Insurance claims.
  • Direct Primary Care (DPC).  In this model the Physician does not accept any Insurance.  All revenue is derived from the Membership fee’s, and the Physician is free to practice medicine without 3rd party payer interference.

I have been contacted by many Medical Students about how to move from Residency directly into DPC.  This is tough, but not impossible.  I call this a “cold-start”, and we are working on a way to help build a panel from scratch.  Just hanging a shingle and taking out a newspaper ad does not work.

In the mean time my suggestion is Network, Network, Network.  Find a DPC who may take you on post Residency.  Call them now.  You will find the vast majority are fantastic people who truly care about their patients and promoting DPC.  What can you do for them now?  Can you refer patients to them?  If you can help a DPC Practice to grow now, you may be creating your own position.

Do you know any employers?  Start telling them about DPC.  A self-insured 200 employee company is ideal.  They will have approximately 600 dependents, and that is a fantastic panel start.

Education of the public is the hardest part.  With rising deductibles and co-pays, DPC makes more sense every day.  Be sure to stress that DPC is not an alternative for Health Insurance.  The patient should of course still have Catastrophic coverage.

DPC can help you practice medicine the way you envisioned it.  Start planning your future now.

Guest Post: by Bill Cossart
-Contact Bill here
4 Secrets for a Successful Career after Medical School

4 Secrets for a Successful Career after Medical School

Dear students:


Please go to medical school, finish medical school and become a doctor. This is a personal request from a 47-year-old future patient of yours. By the time I reach my elder years I’m going to need access to some medical professionals with at least a couple of decades’ worth of experience under their belts. Mathematically speaking, that means you. I confess that my advice to you may be self-serving, but at least you know I’m honest…

I’m not going to pretend to understand the intellectual, physical, and emotional challenges that you will have to manage in medical school. Others can comment more informatively about that than I. I’m not a clinician. I’m a career health care consultant. I have been practicing in, observing and writing about our health care system since the mid-1990s. The best doctors I know are more than great practitioners. They have thoughtful perspectives on a variety of issues that impact your profession. You might want to develop some of these opinions too.
With this in mind, I wish to pass on some insights on a few topics that will impact you as your career unfolds. If you start thinking about these issues now, you will begin to develop your own ideas which will help you to proactively manage your professional life.

Who needs sleep when you can think about things like…

1. REIMBURSEMENT: Advocate for direct consumer-to-provider pay models of reimbursement.
In this time of policy flux, lots of ideas about how to transform the health insurance system are being proposed. To many, a European-style, single payer system sounds attractive because of its simplicity and egalitarianism. Unfortunately, it will likely never work in America. I believe our country is too large, too diverse and too unhealthy to be managed centrally by the federal government. We’re also a capitalistic nation. We simply will not tolerate socialized medicine. Instead, we might consider an American-style single payer system where the single payer is the patient. Rather than routing money through the government and/or insurance companies for a service delivered by you, the doctor, the patient would just pay you directly. This is true consumer-driven health care. This model has already gained traction in low-acuity service environments (“minute-clinics”) and has started to gain a foothold in more acute care settings like ambulatory surgery centers. If you need any convincing that this direct pay model is a good idea, I encourage you to visit the business office of your hospital or clinic. Then go have a beer.
This model will not replace the way that all health care is reimbursed for every single patient. But it can start to simplify the payment system and move pricing towards figures that are set by the market – not by the government or an insurance company. Please re-read this section after you get your license and start thinking about employment options. When you’re a partner in a medical practice, you’ll appreciate the phrase “cash is king.”

2. CLINICAL STUDIES: Engage in useful studies that can offer low cost, high quality results.
A few years ago I spoke with an individual who was conducting a study on cancer rates in women in Sub-Saharan Africa. If a study existed that had a flawed data set, this was it. The notion that any woman in Sub-Saharan Africa would live long enough to develop cancer meant that she had already cheated death from a whole host of mortality factors including but not limited to complications during childbirth, dysentery, HIV, and violence. I am not saying that the study was “bad”, just that there are bigger fish to fry. Think long and hard about the usefulness of what you’re studying. In contrast, consider a recent report that recommended a protocol that dramatically improves outcomes for patients that present in the ER with a hip fracture. Expediting surgery within hours rather than waiting several days reduced patient discomfort, rehabilitation time and mortality rates. Costs associated with these issues were reduced or eliminated. Most importantly, lives were saved. Win-win!

3. TECHNOLOGY: Embrace technologies that transform care rather than solutions that automate processes.
A September 2005 Health Affairs article cautiously stated that “The adoption of interoperable EMR systems could produce efficiency and safety savings of $142–$371 billion.” In case any of you were wondering, that didn’t happen. Analysts under-estimated the costs of implementation as well as the challenges of collecting and connecting a comprehensive data set. Many EMRs include scanned PDF files. The data on those files cannot be analyzed through the EMR, although it is considered “electronic.” Here are some departments that love scanned PDFs: legal and compliance. There have also been high hopes that wearables will transform health care. The problem is that most wearables simply capture data. It’s up to the user to do something with the information. The individuals that will be influenced to take action based on wearable data are the people who buy these products in the first place. It’s the individual’s motivation, not the device, which drives change. In other words, just giving people Fit-Bits isn’t going to help them with their obesity problems.
Telemedicine is a different story. Here’s a great low-cost way to broaden access to care, engage with patients on a more regular basis, and reduce costs. To be sure, telemedicine has yet to be fully regulated. As doctors, I encourage you to view telemedicine as an effective care delivery tool rather than a job-killing threat.

4. Ethics: Read philosophy.
Your generation of doctors will face an unprecedented number of ethical situations where the cost for treatment and the need for care will come into intense conflict. A current concern is how costly hepatitis c drugs, which can run $1,000 per pill, are covered. Depending on patients’ insurance and financial situations, they may or may not be able to afford treatment. And when it comes to certain public health outlets, such as prisons, care is rationed; some inmates don’t get treatment at all. Wrap your brain around that. Advances in genetic studies and precision medicine will generate wonderful treatment options in the coming years. As with any new technology, be it an iPhone or a custom-tailored pharmaceutical, the early adapters of these cutting-edge products will be the wealthy. This inequity in care access is not strictly an American problem. Folks from all around the world come to America to get the treatments they want because they can afford to pay for them. (Some of you doctors are pretty amazing too!)
The American health care system has its issues. But know that many people are working to close the gap in care access and quality so that together, we can improve the health and wellness of all Americans.

Thank you for your commitment to such an important profession. Best of luck!

Guest post by Janis Powers
@janis_powers

Janis Powers is a health care consultant, adviser and writer. Her articles have appeared in The Huffington Post, Hospitals & Health Networks, Healthcare Financial Management and Becker’s Healthcare. Her work-in-progress book Health Care: Meet the American Dream outlines a redesign of the American health care payment system. You can learn more about Janis on her site http://janispowers.com

7 Key Factors for Choosing the RIGHT Location for Your Medical Practice

7 Key Factors for Choosing the RIGHT Location for Your Medical Practice

 

Becoming a physician is a long, arduous journey. After many years of hard work, you finally reach the point of completion and begin your career as a physician. As you embark on the next steps of your vocation, one important factor must be determined… Where to locate your practice?

Choosing your location is an important decision and one that should not be made solely based on the clinical nature of the job. Due to my years of experience, both working directly for hospitals and as a third-party physician recruiter, I would suggest the following factors to consider:

1) Geographic Location

When choosing to relocate, there are many geographical factors that can sway your decision such as optimal climate and desirable neighbourhoods. It’s important to keep in mind that although these factors can be very tempting, there are future life changes that may also be important to consider such as career opportunities for your spouse, proximity to desirable schools and the growing needs of a family that may come your way.

2) Clinical

When considering the clinical aspect of the role, you need to take into account the following:
Are there enough patients to ensure both clinical competency as well as financial goals?

Is the patient population a group that would consistently need the clinical services you provide? Has the hospital invested in the needed equipment and budget for continued investments over time?

Have they completed a resources plan for the department in order to forecast future hiring and investment?

3) Relationship with Administration

What is the relationship like with the hospital or clinic administration? Given the interdependency with other healthcare providers and administration, these relationships will have a great impact on the environment you work in. The better the relationship the better the environment.

4) Market Share

The hospital or clinics reputation in the region and their market share is important and can potentially impact the clinical volumes and access to resources in the area.

5) Academic

Depending on personal preference, you will want to explore what opportunities exist for continued training as well as leadership development. Look into what affiliations they have with external academic organizations and teaching prospects.

6) Compensation

Compensation can be a key factor, however if you don’t have favourable responses to items 1 to 5, no amount of money will make it a great place to work. Keep in mind that a relocation allowance is not an incentive or bonus, but rather a resource that will make the process of relocation less daunting to tackle.

7) Recruiting Process

Lastly, I believe that the relationship you build during the recruitment process will be a good indication of the brand and culture of the organization and how helpful they will be as you go through the licensing and credentialing process.

Thankfully the process usually transpires over several months and thus allows the time to ask these questions and examine the fit. Physicians don’t move frequently so ensuring a thorough decision process at the start gives the best chance of a long-standing mutually beneficial environment.

Guest Post by:  Kevin Kirkpatrick, Managing Director of TMA Executive Search has worked recruiting physicians and planning for physician staffing for the last 12 years in Canada and the United States. He has worked with academic, urban and rural communities to recruit physicians.
Debunking the ‘Doctor Type’

Debunking the ‘Doctor Type’

 

Sometimes, your greatest obstacles can be in your own head.

Take resident physician Kyle Evers, MD. Throughout high school, he had a strong interest in the sciences and a natural desire to help people. Yet when thinking about his future career, medicine barely crossed his mind as a possibility.

Why? He didn’t fit his own notion of “the doctor type.”

“In my mind, doctors were people who never had to study—those kids who got straight A’s without even trying,” Dr. Evers explains. “That wasn’t me. So I didn’t really consider myself a future doctor.”

Today, Dr. Evers is a third-year resident in internal medicine at Memorial University Medical Center in Savannah, Georgia. It’s safe to say his views on who can be a doctor have expanded—along with his confidence in himself.

Discovering His Passion

When I ask Dr. Evers why he chose internal medicine, he says he loves the diversity of it—and begins ticking off all the different specialties he enjoys. Rheumatology. Nephrology. Gastroenterology. Cardiology. Endocrinology.

“My intern friends would joke that I wanted to specialize in everything, because when starting each new rotation, I would change my mind and decide that one was my favorite,” Dr. Evers says with a laugh. “I just wanted to do everything.”

It might seem hard to believe that someone with such an obvious affinity for medicine could have ever doubted his potential in the field. But Dr. Evers had discounted medicine since his teenage years, and it wouldn’t resurface until he was majoring in biology at LaGrange College. Recognizing his talent, a few of his professors encouraged him to reconsider the career he had long since dismissed.

“I kind of laughed it off at first, but then it became this recurring idea,” says Dr. Evers.

So he did an internship with a general surgeon in his college town. Then, he got a job as an orderly in the operating room, where he worked during his last year and a half at college. “That sealed it,” says Dr. Evers. “I knew I wanted to be a doctor.”

A Diverse Perspective

Dr. Evers decided to attend Ross University School of Medicine in the West Indies for a few reasons, including residency placement rates and overall reputation. In addition, he was intrigued by the option to choose either a single location for his clinical clerkships or experience multiple hospitals throughout the country.

“I love to travel and being able to experience new cultures, so being able to do that while getting a medical degree was a no-brainer,” says Dr. Evers.

Sure enough, during his clinical year, Dr. Evers took advantage of the option—getting a taste for medicine in Miami, New York, Cape Cod, Connecticut and Michigan.

His favorite? Miami. (“I love the culture and the bilingual nature of everything—and there’s amazing food.”)

“You can learn medicine anywhere if you’re willing to study. The real difference is the environment and the experiences,” says Dr. Evers. “That was the key benefit for me. If you work at only one place, you may think every hospital operates like that, but if you move around, you quickly realize how different hospital systems are. And each system has its strengths.”

Making a Home

His rich background across many hospitals helps him appreciate his residency hospital, Memorial Health, that much more.

In particular, Dr. Evers was struck by the “family atmosphere” he sensed at Memorial. During his interview, he was impressed by the interaction between residents and attending physicians. Not only did they stay after meetings to chat, they clearly made an effort to get together outside of work as well.

“It was very comfortable, very warm,” he says. “It’s a very personal environment.”

That environment is good not only for having friends outside of work—it’s also a key factor in helping the hospital run smoothly. Dr. Evers credits the friendly atmosphere with fostering open communication that’s led to great relationships across residency lines.

“Here, the staff is dedicated to patient care and diligent in their jobs,” says Dr. Evers. “It takes a lot of pressure off residents.”

And it’s clear that the feeling goes both ways.

“Dr. Evers is one of our most exceptional residents,” says Dr. Timothy Connelly, associate residency program director at Memorial Health. “I’m grateful for his awesome contributions to our program.”

The Real Doctor Type

Today, that high school student who thought he wasn’t the “doctor type” seems a world away from this dedicated physician who’s enamored with his work and singularly focused on patients.

Dr. Evers says he can’t imagine himself doing anything else.

“Even if I had a billion dollars and didn’t have to work, I’d still want to do this job. I can’t think of anything more perfect for me,” he says.

In fact, while some of his medical school classmates are earning their MBAs or have an eye towards management in the future, Dr. Evers couldn’t be happier exactly where he is.

“I don’t have administrative aspirations,” he says. “I just like taking care of people.”

Guest Post By Kristin Baresich – kristinbaresich@devrymedical.org

 

 

​9 Gift Ideas for Medical Students

​9 Gift Ideas for Medical Students

Happy Christmas-hannuka-kwanza-ramadan everyone! And if you’re just glad to be able to air your grievances and achieve some feats of strength, happy Festivus! (go watch Seinfeld my dear millennial classmates if this one goes over your head) Whatever holiday you celebrate this season, you can bet that your beloved medical student is probably exhausted from a well fought semester. Well friends, family, significant others, and other loved ones, I am writing today to you, yes you, to encourage you this season to think out of the box when it comes to gifts for your favorite future physician. That’s why I’ve attempted to come up with some atypical gift ideas that I believe would brighten any medical student’s holiday….

Note-I’m not going to be suggesting a gym membership-every medical student in my honest opinion should already be exercising regularly. If not, make a Gym Membership unofficial number 10 on this list.

1. Subscription Food Services 

At this point, you’ve probably been inundated with those aggressively innocuous commercials for services like Blue Apron, Plated, and HelloFresh. Despite that, these services are excellent, with quality, healthy ingredients. And most importantly, they taste incredible and are actually cheaper than going out to eat (which admittedly, every medical student does way too much). Your medical student will appreciate eating something other than the pasta bakes and gas station burritos more than you could know. If you’d rather send them away with some delicious snacks rather than meals, Naturebox and Graze (both stamped with the Matthew Wright Seal of Awesome) have got you covered. Prices range and vary greatly based on how often you want services to come.

2. This Adorable Guy

Your smarty pants medical student deserves a plushy brain. End of story. Or if they don’t like that, you can always buy them a giant microbe to remind them who’s really in charge. These guys make excellent stocking stuffers.

3. Subscriptions to Music and Audio Services 

The sad fact of the matter is, as much as we medical students love learning, and as good as reading is for your brain, most days, we’re all too exhausted to do it as much as we should, and far too often we sit in front of the computer screen and burn our eyeballs out, failing to get enough sleep. To fight this, I listen to a lot (try at least 30) different podcasts as well as audiobooks. I cannot recommend services like audible, pandora, and spotify (for music as well as podcasts) enough for the medical student-audiophiles out there. A personal favorite book to get started is “Quite: The Power of Introverts in a World that Can’t Stop Talking”

4. Office Supplies

Hear me out on this one. I’m not talking about low quality notebooks and pens. What I mean is that medical students spend so much time at a desk writing and taking notes, that creating the proper work environment is key. So,  that means finding quality lighting (especially if your med-student gets the winter blues), a quality chair, or even a standing desk. Maybe it means buying them a little bonsai tree, or some high-quality pens and notebooks to write or journal with. Your medical student might look at you with some eye rolls, but they’ll thank you for it in the long run.

5. Indulge Their Hobbies

Look, even med students need non-school hobbies. Maybe they like craft brewing, or excellent coffee. Maybe they’re a musician, or a botanist, or into building their own computer, or they love to ski. Whatever it is, nudge the student in your life to continue to enjoy their passions in whatever way you can. Heck, for me, it’s as simple as asking for a new board game for Christmas. So, whatever your student’s “thing” is, indulge them this Christmas season.

6. Peace of Mind

Maybe this is the introvert in me talking, but you know what sounds really great after an endless semester of studying and exams? Turning my brain off and starting at a wall for a few hours. Whatever the case is, one of the greatest gifts you can give your medical student is the gift of quietness. So please don’t ask too many questions about why we aren’t seeing anyone at the moment, or plan for us to visit relatives all break. Those things are good, make no mistake, but it will be important to learn to respect your student’s need for quietness and recovery this season. I especially encourage those looking for a “gift” in this area for their student to consider a pair of active noise cancelling headphones (I love mine), or even a bout in a sensory-deprivation chamber.

7. Self-Care Items

Be it comfy clothes, massages, bath bombs (still not really sure what that is), tea, coffee, suduko or crossword puzzles, coloring books (yes, coloring is for adults, and it’s awesome), favorite homemade foods, or a fancy haircut/mani/pedi, self-care items cannot be undervalued.

8. Experiences

Look, I’m not saying we can all afford a trip to Cabo for the holidays or anything (heaven knows I can’t), but some of the best gifts I have ever received have been those that allowed me to try something new. For example, Receiving concert tickets (tickets to Trans Siberian Orchestra is still my favorite Christmas surprise while I was growing up), gift cards to restaurants they love, lessons for a new hobby or skill, sky diving lessons, or if you can afford it, a vacation. Any opportunity to experience this beautiful world we live in is one of the most incredible gifts a medical student can receive.

9. Pay a Bill

Do I need to explain how poor we are right now? Please just pay our phone bill or make a car payment, or if you’re feeling especially generous-pay rent for a month. This is honestly one of the easiest, kindest things you can do for your student this season.

Most importantly, remember to love your medical student and meet them where they are at in this season of life. Hug them, listen to them, and care for them this holiday season. Happy Holidays from MotivateMD to all of you! Best of Luck!

By Matthew Wright
Medical College of Wisconsin