Tuesday, September 2, 2014

Med school sanity tip #1

On rotations, don't stress about your schedule. More effort is put into making the schedule for residents and attendings, students are sort of left by the wayside sometimes. 

If no one tells you where or when to report, show up at 6 or earlier and introduce yourself to the team once you find them.  I never really bothered paging the resident or fellow because they have so much going on already.

In medical training, life is easier if you just surrender and take your schedule the way it's served.  There's not too much you can do to change things so just hang in there and remember it's temporary

Monday, August 25, 2014

General Surgery: Common Procedures

A lot of young people in medicine and just the population don't really understand what a general surgeon really does.  Here are common things you will see a general surgeon in residency do depending on the institution/volume:

1. Laparoscopic cholecystectomy
2. Laparoscopic appendectomy
3. Abscess draining on extremities
4. Colon irrigation
5. Whipple procedure
6. Distal pancreatectomy
7. Fem-pop bypass
8. Perirectal abscess drainage
9. Abdominal trauma surgery
10. Colostomy
11. Jejunostomy
12. Different procedures in plastic surgery (you can do a fellowship in plastics after gen surg)
13. A lot of similar procedures in pediatric patients
14. Checking on floor patients every morning, usually around 5-6am
15. Laparoscopic hernia repair with mesh
16. Open hernia repair

But when you're on the general surgery rotation, it starts to look like this:

  1. Cholecystectomy
  2. Cholecystectomy
  3. Cholecystectomy
  4. Abscess drainage
  5. Abscess
  6. Abscess
  7. Abscess
  8. Cholecystectomy
  9. Cholecystectomy
  10. Appendectomy
  11. Hernia
  12. Hernia
  13. Abscess
  14. Cholecystectomy
  15. Abscess
  16. Hernia
  17. Appendectomy
  18. Hernia
  19. Abscess
  20. Chronic draining wound/abcess
  21. Abscess
  22. Pilonidal cyst
  23. Debridement
  24. Abscess
  25. Debridement

And so on.  Throw in poor wound healing due to chronic diabetes and things start smelling and looking terrible.  Surgery isn't for complainers or people who dislike abscesses and the colon/fecal matter.  You have to love operating like a robot case after case after case and you need to do things exactly the same way every single time.  Any wonder why attrition rate in the US for surgery residents is 20%?

Remember: specialist surgeons don't live off of their specialty procedures alone.  You will keep doing laparascopic cholecystectomies and draining perirectal abscesses.

Residency app tips

Seek out the program director of your school and work with them to get a LOR if you're interested in staying at your home program or even if you're not, it'll help.

Make sure the chair knows your name at least and make sure they see you active and working hard. 

There might be people who are assistant program directors and you don't end up finding out until later, so work hard all the time! 

Surgery entry coming up soon, everyone!

Saturday, August 16, 2014

How many people fail out of medical school?

I've been asked this a few times as an upperclassman.   At my institution, I'd say probably 2 people dropped out in my class.  About 3 took a leave of absence due to grades and came back as a repeat MS1.  Failing happens but it's not the end. Med school is hard but there are a lot of people watching out for you if you're at a good school.  If you're struggling, get advice right away, because there's no time to fall behind.   Let me know if you need any help

Monday, August 11, 2014

The surefire mcat prep

Examkrackers MCAT study set, and Kaplan's MCAT online study prep with Qbanks and book helped me get the score I needed to interview everywhere I wanted to go.  Got accepted everywhere except for a place that waitlisted me, but that's just the way it goes.  Take dedicated study time and work hard.  Take as much time as you need and treat it like you only have one chance to take it

Sunday, August 3, 2014

The Medical Student Budget and Saving Money II

So here are more real-life examples of budgeting and money saving during my medical school journey.

1. I bought a lot of music on iTunes but it was getting to be so expensive that I switched over to Spotify's $10 a month plan.  Saved me a ton of money and it was the most reasonable thing to do because I love discovering new music.

2. I cancelled my cable television and just use internet.

3.  When looking for apartments, I went for the best balance of safe, affordable, and close to school.  Being on a public transport route saved me a lot of money too.  Some med students with more money than sense decide to live in luxury condos.  Brilliant.

4.  I cooked my own meals and brought them with me.  Made my own coffee too.  Otherwise, I'd be spending $200 a month on  just lunch and coffee.

5.  I'd go to the liquor store to buy what I like to drink and then have gatherings with friends instead of going out to a bar to pay $7 for a beer when a six pack of that beer would be like $10-$12.

6.  Along that theme, I would get together with friends and we'd cook/do pot luck dinners.

7.  I've never gone on a vacation that involved airplanes in med school.  I just don't have that kind of money.  Probably missed some great memories, sure, but debt is terrible.  I'll go on vacation when I can afford it.

8.  I only bought clothes for clinic when they were on sale.  I wore scrubs to class or wore whatever I had around.

9.  I didn't buy a new computer just for med school.

10. Saved money by plugging my desktop into a TV.  Didn't have to shell out for a new monitor.

Basically, just live within your means.  Carpool, have roommates, don't throw lavish parties.

Also, lose your ego.  You're a med student, not a celebrity, so you don't need to be treating people to expensive dinners or show off this stereo or tv or whatever.  All my friends know I'm in serious debt and that's cool because that's just life.

As far as future income, who knows what it'll be.  Watch ortho's reimbursements get slashed, see primary care's get bumped up, or start seeing dermatologists get the shaft.

It's going to get harder and harder to hang up a shingle and run your own practice, honestly.  That's a thing of the past.  Health care has gotten to be so expensive that you should expect to practice in a hospital or a multispecialty kind of center.  Sorry if that was your dream, but let's be real here. Shadow a doc who has their own practice and you'll see them have their family members be the secretaries and billers and all this.  It's out of control.

Also, don't be a surgeon because that lifestyle is terrible (unless it's ophtho I guess.  ENT can be insane with facial reconstruction/neck dissections, but it's not as bad as ortho or trauma).

Just because you're in med school doesn't mean you're smart with your money!  Take care of your money and it'll take care of you.

The Medical Student Budget and Saving Money I

A reader of mine requested that I write an article on budgeting and living expenses as a medical student.  They were also concerned about the huge stack of debt US med students accrue and decreasing reimbursements when they start practicing as a physician.

How much does medical school really cost?

You've probably already submitted your applications to med school or are a college student looking at going to med school.  Congratulations.  All the financial aid information is on each school's website: easy.

There'll usually be a financial aid person to talk to on your med school interviews, and if not, get a card from someone or look them up on the website.

Tuition can be the biggest expense depending on where you go to school.  But there are costs you can help decrease like costs of living, eating, etc.

Here's what I recommend:
1. Get a roommate.  Med school isn't a time to live luxuriously on your own because you're borrowing all that money and it needs to get repaid.

2. Buy food/shower/bath/kitchen things in bulk.  Try either Amazon or bulk sales stores

3.  Minimize eating at restaurants and cook.  Cook enough for 3-7 days at a time, and make sure you cook multiple meals so you can eat something different everyday.  Bringing your own meal is great for morale on rotations.

4. Use public transport as much as you can

5. Go on Amazon or Google Play for textbooks instead of anywhere more expensive.  There are also some cool, inexpensive review books you can find on there.

6. Keep a fan on or put a sweater on to lower your heating/cooling bills.

7. Apply for financial aid early so you can benefit from institutional loans with lower interest rates (if offered).

8.  I avoided schools who had tuition of $60K+ a year..sure they were prestigious but expensive and I'm not sure I actually would've been happy in those cities.  That's also before factoring in cost of living.

9.  Avoid the thought of "well, I'm going to be a doctor, so I can buy this new stereo/tv/designer clothes now."  You're making "negative" money, so don't live beyond your means.  At most, treat yourself to a nice dinner within reason.

You hear debt ranging from anywhere to nothing (rich kids) to $300K or even $900K (due to extreme life events).  Managing your debt is a lot like eating healthy: you need to make wise decisions daily so it doesn't catch up with you and kill you in the end.

As far as residency goes: there are different repayment methods for your loans.  One is "pay as you earn," another is "income based repayment," then there's forebearance.

You can learn more at this AAMC website: