Category: Priority Managment

Gap-Year: You Can’t Afford Not To…

Gap-Year: You Can’t Afford Not To…

In my  attempt to become the living personification of Instagram, I’m going to share a cliché: I don’t believe in regret. Don’t get me wrong, there are decisions that I think would’ve made my life easier. But for the most part, I’m happy with who I am. I know that’s a small minority of people who enjoy that peace, and I’m eternally grateful for it, so don’t think me un-gracious or despondent with life.

Having said that, I have one regret about medical school- I should’ve taken a Gap Year, or two. Today, I want to tell you why.

When I was an undergrad, and before I got accepted to medical school, I thought of a gap year as a consolation prize, a participation trophy. You tried, but just missed the mark, better luck next time sport. I furrowed and bit my tongue when I heard of friends talking about “taking some time off” before applying to medical school, or even after being accepted (deferring as it were). Either a, lying to themselves and they were never going to become physicians-secretly giving up, or b, didn’t value the gift that they had received.

I was wrong. They were the smart ones-they saw something I didn’t. I should’ve listened.

Taking a Gap Year before medical school is arguably the best decision anyone can make after graduation day. Because you’re not ready. I wasn’t ready. Intellectually, sure, you can handle the work, but emotionally, relationally, experientially, identity-wise, and financially you are not ready for the challenge and burden of medical school.

I want to help you with the cost-benefit analysis of taking or not taking a Gap Year, to share with you my experience as best as I can. Hopefully, you’ll learn from my mistakes. I’m not sharing “how to tips” to make the most of your Gap Year. I’m probably not going to go into long diatribes about my own time in medical school. Heck, I’m not even advocating a blanket statement that everyone should take a Gap Year. I just want to help you count the cost of taking a Gap Year, because quite honestly, you can’t afford not to.

This week, I just wanted to introduce where I was coming from. Next time, I hope to share with you a little more specifically about why taking a Gap Year is a great idea, both for your mental and relational health.

Stay tuned for part 2…

Why Most Medical Students and Doctors are Hypocrites (And How We Can Change)

Why Most Medical Students and Doctors are Hypocrites (And How We Can Change)

Social Histories

If you were to sit in on any routine doctor’s visit, you are bound to hear a few common questions. “Do you smoke? How much alcohol do you drink, if any? What is your diet like? How much exercise do you get weekly?” These are questions we are trained to ask as early as the first week of medical school. We are taught to treat not just the conditions a patient presents with, but also inquire about their overall health and instruct them on ways to improve it.

Addressing negative social habits that can impact patient’s health is a recurring theme throughout medical school.

My classmates and I have learned how to recognize drug addiction and drug-seeking behavior, how to determine if our patients were alcoholics, and effective ways to counsel people on healthier diets. As much as we future doctors know what qualifies as “good” health, and how to attain it, I wonder how closely we follow our own advice.

Medical students work incredibly hard, studying for hours on end for very difficult exams, as well as spending long days in the hospital without pay. With this amount of dedication, certain things are almost automatically erased from our lives. Sleep deprivation is the first thing that comes to mind, and I am constantly aware that this will only get worse when I start residency. Though the field of medicine has made great strides in ensuring that residents have work hour limitations, and the days of sleeping in the hospital all weekend are largely behind us, the amount of work still leaves many constantly fatigued. We counsel our patients to have good sleep hygiene, and often attribute lack of sleep to problems with mood, concentration, and general quality of life. But what about us? We set ourselves up for failure in these areas when six hours of sleep is a good night’s rest.

Doctor Non-Compliance

This lack of good sleep directly leads to an increase in the amount of stress we put on our bodies and minds as students and physicians. Let’s face it: medical school is stressful. This is a point that needs no clarification. Passing exams, getting honors on clerkships, and resting all of our hopes on a few board exams is pressure nobody enjoys. The stresses that come along with a career in medicine are certainly matched in other fields, but most other professionals do not spend their days advising their clients to avoid stress. How ironic is that? I have seen the effects stress can have on people, including my classmates: dissolution of relationships, family strife, and depression, to name a few. While we tell our patients to go easy on themselves when they are having trouble in their personal life or at work, we do not afford ourselves the same luxury.

The last, and possibly most important, area that I notice physicians and other healthcare professionals not taking their own advice is in our indulgences.

Long hours, high student debt, and a relatively low salary can restrict medical students and residents from having the healthiest habits in terms of diet and exercise. When you have to round quickly on patients and get to the OR by 7 am, it is not uncommon that all you have the chance to eat is a light snack or coffee. Throughout the day the demands of the patient wards may prevent you from having a real meal, and the vending machine seems like it may as well be a Michelin star restaurant. In spite of this, I am constantly impressed by a small subset of my peers who manage to make exercise a focal point of their day, whether it be at 5 in the morning or 10 at night. Many of us—and our patients—do not have this will power or motivation, and will collapse into our beds the second we have a minute to do so.

Other indulgences include drugs and alcohol, the unspoken hidden addictions many doctors struggle to control. The House of God provides anecdotal evidence:

“the classic novel where residents take swigs out of a flask at work and aim to be inebriated as often as possible when off the clock. This is a work of fiction, but it is based in reality.”

Physicians are often incredibly vulnerable to addiction when it comes to alcohol and drugs. It may be because we self-medicate, thinking we can recognize a problem more easily since that is what we were trained to do. Hence, we quickly and easily enter the world of self-denial. It is not uncommon to hear stories of physicians overdosing on prescription drugs or attending AA meetings. This is nothing to be ashamed of, and it is always good to get help when it is needed. However, the pressure placed on us not to have such problems—and to hide them if we do—makes it harder to identify and treat addictions when they do exist.

Some Of Our Own Medicine

We should strive to be the best versions of ourselves always, but also recognize that we are not above the maladies that may afflict our patients. If a patient states they are struggling with work and feel they need to drink more lately, it is okay to recognize that you as a doctor have experienced that problem too. When you advise your patient to cut back on the booze, take a day off work, and get better, remember that can be an option for you as well. The next time you ask your patient if they are downplaying a problem, ask yourself the same question. It is just as important to care for yourself as it is to care for others. Remember, just because there’s no lecture on it in med school, doesn’t make the problem any less real.

 

Jessica Celine Morgan
MD Candidate  |  Class of 2017
New York University School of Medicine
Is Medical School Right For Me?

Is Medical School Right For Me?

Guest post by Jay from Med School Insiders.  Med School Insiders seeks to inform and empower aspiring doctors through videos and articles, ultimately help you realize your career aspirations in the medical field. 

Medicine is a great field, but I’m obviously biased. While I do love medicine, it is not something I would recommend for everyone. It is very important that you are aware of the pros and cons and carefully decide if it is the right profession for you.

The Path to Becoming a Doctor

  1. First, you complete 4 years of college. You can have any major, but must complete 2 years of pre-reqs which are mostly science courses. For this reason most students choose a life science major, but again you study anything from mechanical engineering to english to political science. After college you go to medical school, which is another 4 years. After medical school you go to residency which is at least 3 years, but can be up to 7. Fellowship allows you to specialize further, which can be one or more years in addition to residency.
  2. Assuming you don’t take any years off in between all of that, you’ll be around your late twenties to early thirties when you finish training. Lots of people take time off, though, so it is not uncommon to be a few years older than that
  3. Financial aspects: The average debt for graduating medical students is currently $180,000. In residency, you will make about $50k/year, so you will barely make a dent in your debt and interest will accrue to a value much larger than $180,000. Your salary will rise after finishing training to a comfortable 6 figure income, but that varies depending on your specialty.

Deal Breakers

These are reasons you should NOT pursue a career in medicine. Be as honest with yourself as possible – do any of these apply to you?

  1. Going into medicine for the money is not a good idea. While you will be making well into the six figures after finishing training, you will be significantly behind the curve due to debt and opportunity cost. If money is your main concern, look elsewhere. In case this doesn’t sound so bad to you, consider opportunity cost. If you started working after college and didn’t have to take on the additional debt of medical school (where you are not earning any money), you would be in a much better situation financially. 
  2. If you hate school and hate learning, again look elsewhere. I’m not saying you need to love every subject or love the annoying parts of being a student. But if you don’t enjoy science or learning about the human body, then a career in medicine will be significantly more challenging for you. A big part of being a physician is being a life long learner. This means you have to continually educate yourself even after finishing training to stay up to date.
  3. If you don’t like working with people, I again urge you to look elsewhere. There are certain specialties that have limited contact with patients such as radiology or pathology. However, you still need to regularly communicate with your colleagues. For example in radiology you’ll be reading scans for surgeons, emergency physicians, hospitalists, etc. and in pathology you also need to communicate with your colleagues.

It’s easier to tell you the reasons you should not go into medicine than the reasons you should go into medicine, as those reasons vary wildly from person to person.

One thing I hear commonly from premeds and med students is the desire to help people. That’s a noble cause that I fully support and think should almost be a requirement to pursue a career as a physician. But at the same time, that’s not enough. You can help people in a variety of professions. Why not be a nurse instead? Firefighters help people, as do paramedics, etc.. so there needs to be something else there.

 

Qualities of a Physician

  1. First, they are leaders of the healthcare team. You don’t have to be a leader already as it is a skill you can develop – but is it something that is appealing to you?
  2. Second, being a physician is a very intellectually challenging profession. Do you have an inquisitive mind? Do you like problem solving? Or would you rather be following protocols and not having to think too hard?
  3. Do you like working with your hands? There’s a broad range of specialties. Some have little or no procedures, like psychiatry, and others are very heavy on procedures like orthopedic surgery.
  4. Are you a hard worker? This is one of the most important factors to being successful as a physician. I believe that most soon-to-be physicians, current physicians, and most of the public believe that physicians are much smarter than they really are. While you definitely have to be intelligent to be a physician, its much more important that you are a hard worker. Diligence, discipline, and persistence will overpower smarts.

 

I have a friend who went to a top college and was known at my high school for being a genius. He never studied, often fell asleep in class, and still crushed all his tests. He went to college and did more of the same.

But when he went to medical school, he struggled.

From being in the top 5% of his class, he was now in the lower third. And it’s because he never developed the proper study skills and habits. The medical profession requires some critical thinking and understanding of complex concepts, but its mostly memorizing vast quantities of information. That’s why hard work trumps intelligence.

Shadowing and Gaining Exposure

One of the most important things for you to do before starting medical school is shadow. Don’t just shadow one doctor, either. Check out different specialties in different settings. Learn what it means to be a primary care physician in the community clinic, check out the operating room at an academic center, and get some exposure to inpatient medicine in the hospital. Medicine is an incredibly diverse field and you will likely gravitate towards only a few select specialties within it that are suited to your personality and interests.

Before starting medical school, I was in love with the idea of being a Gastroenterologist, motivated by a family history of GI illnesses. I thought it would be a great fit because I loved nutrition and the science behind it, wanted continuity with my patients (meaning building a relationship with them over time), and have always found satisfaction from working with my hands, and the specialty has multiple procedures. But once I got exposure to GI during my second year of medical school, I realized that it was not the field for me. While I love procedures, I didn’t find the procedure types stimulating or challenging enough. While I loved learning about certain diseases and pathologies of GI, there was much of it that didn’t excite me.

Luckily, after gaining exposure to multiple specialties, I found a surgical subspecialty that is a perfect fit for my personality and interests.

I consider myself very lucky for finding something that was such a good fit. In hindsight, I wish I would have started shadowing and getting exposure before medical school started. I did do volunteer research in the emergency department, worked with some neurologists, and did some basic science research, but that only gave me a tiny glimpse of what it meant to be a physician.

Knowing your areas of interest sooner than later will only help you in the long run. At the same time, don’t feel the pressure to decide early, but be sure to gain exposure and understand the different parts of medicine.

You can find more posts like this at MedSchoolInsiders.com.

 

Could Short-term Memory be More Important than Long-term Memory for Premed and Med Student Success?

Could Short-term Memory be More Important than Long-term Memory for Premed and Med Student Success?

 

The beauty of success is that only one person can define it for you: you. If your idea of success is being the best damn Mom in the world, then pursue that wholeheartedly. If you desire to revolutionize the pharmaceutical industry, then by all means, do it! Whatever it is you want in this life, be it x, y or z, aim for perfection. Of course, no one is perfect (with the exception of my cats), so we will all inevitably fail. Because of this inevitability, most people are afraid to shoot for perfection. Naturally, they set the bar a bit lower, still high, but not quite at the level of perfection. Maybe they achieve their goal, maybe they don’t. Regardless of the outcome though, they have created a ceiling for themselves. They have put a limit on their potential. Because of this, I counter that we should all aim for perfection, with one caveat: utilize short-term memory.

Continue reading

7 Hacks for Pre-Med Success

7 Hacks for Pre-Med Success

Hello nerds and nerdettes, I’m here today to give you 7 lifehacks that will make your years and a pre-med infinitely easier. To be perfectly honest, these aren’t the sorts of lifehacks that you might learn from mentalfloss or /r/lifehack, but simple, little tricks I believe saved me time, money, and a whole-lot of stress during my years as a pre-med. To be honest, these first hacks aren’t particularly specific to pre-meds, but in the future, I promise that I’ll have a stronger focus on those specific needs.

1. Live with People Who Will Help Move You Forward

Let’s face it, pre-med life has a set of unique challenges few understand (except maybe our friends in the engineering and physics departments). Compound this with the fact that you are likely living on your own for the first time ever and “learning to adult” at this same time is a recipe for endless stress. In order to minimize these struggles, I encourage you NOT to live with your best friend(s) unless they too are pursuing a career in medicine. I made the mistake of living in a house with 13 other guys my 3rd and 4th year, and while more good than I can share came of it, the fear of having clean dishes, or enough hot water for a shower, or my non-medical friends wanting to grab a beer or play video games or have people over when I needed to study was a source of endless anxiety. Instead, find other similarly studious people who you might not be best friends with, but can get along with just fine, and set ground rules right away.

2. Abebooks.com

It’s witchcraft I tell ya. After being an idiot and buying my textbooks from the school bookstore first semester, I never looked back. Abebooks is arguably the best website I’ve ever used to find textbooks I’ve needed or wanted at reasonable prices, including all of those expensive science textbooks. And what’s more is that a lot of what they sell are the international editions (which, despite what your professors say, are exactly the same as their American counterparts), which are already cheaper. In fact, I managed to make money off selling my textbooks back to students and/or the bookstore once I was done with them. Also, don’t trust your professor about needing the textbook or not-ask other students instead.

3. Social Media is the Enemy

Okay, yes, digital natives, blah, blah, blah. I understand that we all have social media at this point, but the reality is that you will spend way too much time on it if you aren’t careful. It is easy to try to justify it by saying “That’s how I stay connected or hear about school stuff/events on campus,” but at the end of the day, social media sucks up more time than we realize. I love it too, but I had to come to terms with my passive use of social media to fill my brain (I could talk about the negative health and intellectual impact of this for days), and so these days, I only use social media, and even check email, and very specific times during the day. That way, I control it, and it does not control me.

4. Pack Heavy

I cannot tell you how much time I’ve wasted going to my apartment in the middle of the day to go get my books for afternoon class, or to make lunch, or even to take a nap. I end up just wasting time screwing around-cleaning, or talking to a roommate, or what have you. When you set out in the morning, go out with the intent of not returning until the evening once classes are over. This has the dual purpose of forcing you to stay in “class mode” as long as you are on campus, with no excuse not to sit down and get some work done when you have an odd 15-20 minutes between class.

5. Amazon Prime is your Friend

Amazon Prime is only $50 for students, and it is worth every penny. Whether it’s a charger for your computer, new ear buds, goggles for class, pens and notebooks, or even toiletries, Amazon Prime has saved me more time than I can even begin to imagine. This is especially true if you’re like me and didn’t have a care during your undergraduate years, and couldn’t just pop off to the store every time you needed something. You can even set up regular shipments of things like razors, shampoo, toothpaste, or certain foods (Amazon Pantry) that will free up more time for you to work hard and enjoy undergraduate life.

6. Take Advantage of Free

Whether this is free Friday screenings of movies on campus, or the kindness of your friend with a meal plan, take every opportunity to cash in on the free opportunities in undergrad. Let’s face it, your tuition is really paying for these “free opportunities” anyway. And more than simply freeing up cash for a Kaplan Class or the MCAT (two major expenses not to be overlooked), these free experiences are often opportunities to exposure yourself to new ideas and chances. For example, had I never attended a free physics symposium, I never would have heard of the new biophysics class being offered, and I would’ve missed out on an excellent opportunity.

7. Meal Prep

This is my biggest regret in undergrad-I simply did not eat healthily, and it bit me in the butt on many occasions. The trick was that I didn’t believe I had time to cook-which is entirely true when you’re a pre-med. My advice- take an afternoon-3 hours or so- once a week and make meals for the rest of the week, especially breakfast. Even if it’s just sandwiches or mac and cheese, or maybe something fancier like a casserole, make yourself something healthy and nutritious that will last you throughout the week.

Bonus: Have a Daily Schedule

I’ll talk about this more in a later installment, but suffice it to say that learning to plan out a single day is the number one skill a pre-med can develop. Lay out the gameplan the night before, and if you’re anal like me, even prep for the next day that night by laying out your clothes and packing lunch ahead of time.

By Matthew Wright
Medical College of Wisconsin
Motivate MD

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The 80/20 Rule – from Peas to USMLEs

The 80/20 Rule – from Peas to USMLEs

The Pareto Principle originated in 1896, when the esteemed Italian economist Vilfredo Pareto demonstrated how 80% of his peas were derived from 20% of his peapods.  This since has been widely investigated; with mathematicians proving that this principle follows a power law distribution applicable to many natural phenomena.  Currently, the most prevalent and proven applications of this principle take place in the business world, following the rule of thumb that, “80% of a company’s sales, come from 20% of their clients”.  So how would a doctor or medical student use this natural principle to their benefit? To answer this question, one needs to re-evaluate their effectiveness on a daily basis….

During undergrad, my main method for studying material was to re-write the content several times, so that by the end of my studying, I could recall and write down most of the testable content.  This technique carried over into to medical school, and surprisingly enough, got me through a successful first year.  That being said, I was fed up with hand cramps, fear of the infamous “2nd year”, and the monotony of arduous writing, I explored more efficient methods outside of the realm of typical studying techniques.  This led me to the 80/20 rule, which I thought I could steal from the business world and use to my advantage.

First, I had to ask myself, what aspects of my studying contribute the most to retaining the material I was attempting to master?  Upon self-reflection, I concluded that most of my recall came from simple, made-up mnemonics (mostly converting acronyms into visual representations), which I only utilized during my later rounds of re-writing the material. The light bulb went off; this is my 20%!  Now focusing on the 20% of studying that contributes to 80% of my retention (and cutting out the rest), I have saved countless hours of study time (and healthcare costs by avoiding my inevitable treatment of focal dystonia from handwriting), ultimately creating more time to live a happy and balanced life.

This principle can be applied to any aspect of your life, including relationships. For example, try to identify the 20% of meaningful conversations/activities that contribute the most to building a successful relationship and work towards increasing the frequency of those moments.  So whether it be growing peas in your backyard or studying for the USMLE steps, applying the 80/20 rule can dramatically increase your effectiveness; leaving you more time to devote to things that matter the most.

photocredit: https://eatingrules.com/the-80-20-rule/

Drew Porter

University of Wisconsin School of Medicine and Public Health – Class of 2019