How I Became a Patient

Four weeks ago I was riding my normal route to the hospital, a ten minute trip on my bicycle most days. It was cold and windy but there was no snow or ice on the roads. There is one spot along the way where I make a left and then an immediate right turn.

I make the left turn.

Then nothing. Darkness.

The next memories I have are cloudy and dreamlike. I remember handing my school ID and health insurance card to someone at a desk. I vaguely realize I am at the hospital but I don’t know why. My face hurts. A young guy tells me I was in an accident and he brought me to the hospital. He is using my phone to call my wife, I stumble through some expression of gratitude and then he is gone.

That is how I ended up a patient at my own hospital. I was on my surgery rotation, so I had been working with the residents and physicians that were seeing me. It was… a little weird. I remember apologizing to the trauma resident for creating more work for him. I was a little out of it but I legitimately felt bad. Ha.

Overall, the experience has lead to some positive things. Before I get to that, let me just say that I am fine. I was wearing my helmet. I stayed in the hospital one night as they wanted to repeat my head CT the following morning. I have a nice scar from a gash on the right cheek (see below). I had headaches for about a week, but returned to work after a few days off. I still can’t remember exactly what happened. I think my bike just slipped as I made that turn. I seem to have about 15 minutes of memory I’ll never get back. As far as I can tell there are no other residual effects, but if I failed my surgery shelf I am blaming the traumatic brain injury.

My experience with the hospital was very good. I hope I wasn’t treated very differently, but I have no way to know for sure. I did learn how overwhelming it felt to be surrounded by a team of physicians and students. It’s amazing how quickly your mind can go blank when the doctor asks “Do you have any questions?”

This whole thing has lead to a lot of jokes. It’s funny how many people will ask me what happened and before I even respond they’ll say, “I should see the other guy, right?” I wasn’t even going to say that! I also had a few fellow students accuse me of crashing on purpose so I could get out of my surgery rotation. Surgery was rough but it wasn’t that bad!

My favorite so far was a patient I had this week in clinic. She asked about the scar and I told her the story. Later we were talking about her quitting smoking, and she said “Everyone has bad habits. For you, it’s falling.” Touché.

Some other upsides: I have always been a big proponent of helmets and now I have a personal story to use when I implore people to always ride with one. Also, a random stranger helped me out of the street and brought me (and my bike!) to the hospital. Faith in humanity restored!

Today I swapped bike crashing stories with a elderly gentleman. He said that into his fifties he was riding 40-50 miles a day. I was so inspired I had to get back on the bike. He I am four weeks to the day after my accident:

photo (26)

It’s good to be back!

Need somewhere to Stay During an Away Rotation? Trying to Sublet your Place? Check out RotatingRoom.com

RotatingRoom is a great idea that solves two common problems for medical students.

First, where do you stay during externships or away rotations? If you don’t have a family or friend in the area and the away institution isn’t helping, you may be stuck with an expensive hotel stay or a sketchy place found through craigslist. RotatingRoom allows you to find available sublets from other medical students.

It also allows you to sublet your own place, giving you an opportunity to cover rent while you are away on your own rotation.

The site is simple and well designed. And free. Find or list your room here.

USMLEWorld QBank App now available for Kindle Fire

The USMLE World App is now available for the Kindle Fire. I know this may not seem like a big deal to some of you, but I spent too much time hacking my Fire so I could put the Android app on it and use it to study for Step 1. I wasn’t savvy enough to modify it the way I wanted, so I’ve since reverted back to the original software.

Now when I start using UWorld to study for Step 2, I can use this app. The app is free and works great. I cannot seem to find an app for the Kaplan Qbank.

Anyway, I love my Kindle Fire, and now you can get the new ones!

Obstetrics Abroad

Tomorrow I take my OB-Gyn shelf exam, marking the end of my first clerkship this year.

Today I stumbled across this photo from National Geographic. The caption reads:

  Asia, a 14-year-old mother, washes her new baby girl at home in Hajjah while her 2-year-old daughter plays. Asia is still bleeding and ill from childbirth yet has no education or access to information on how to care for herself.

I could say so much, but is it really necessary? Ultimately these are the sort of health inequalities I hope to be working toward solving in the near future.

Interview on Accepted.com and other Links

Accepted.com is interviewing various med school bloggers and I was featured a little while back. Here’s a preview:

Accepted: What is your favorite class so far?

Steven: My favorite class so far was probably Anatomy. I loved the hands-on aspect of the course. Plus anatomy lab allows you to build a unique camaraderie with classmates. It would be hard to go through medical school alone; anatomy seems to bring people together in a way that makes sure that doesn’t happen.

Check out the rest of the interview here!

In light of the recent decision on health care reform (AKA the Affordable Care Act) I am really curious to read this e-book about our health care system written by two medical students. Here is a quote from the New York Times review:

In their unpretentious voice, Ms. Askin and Mr. Moore make clear from the beginning that their explanations are neither in-depth nor definitive. But given their evenhanded and highly organized prose, it’s hard not to put their book in the same revered category as a medical textbook or dictionary. In a mere 175 pages, and with an impressive roster of references and well-placed graphics, “The Health Care Handbook” illuminates the maddeningly opaque terms, acronyms, organizations, personages and policies that abound in health care. The authors do so not by expounding on the minutiae, but by jettisoning the jargon and gobbledygook and presenting only the core ideas.

Sounds worth the read to me.

Speaking of worthy reads, one of my favorite bloggers Cal Newport (if you are not reading his blog Study Hacks, you should be) is releasing a new book in September titled “So Good They Can’t Ignore You”. It’s one of the few books I have ever pre-ordered. I am looking forward to seeing how the ideas in this book can be applied to the medical profession.

Affiliate links are present in this post.

Saving Money While in Medical School

Note: This is a guest post from Elsevier Health.

Medical school is expensive. It is a time where being thrifty and more conscious of how you spend your money can pay off in the long run. You may have to prepare yourself for this lifestyle change. The median tuition at public medical institution was $28,685 and $46,899 at a private institution in 2011-2012, according to the Association of American Medical Colleges. Keep in mind that this does not include textbooks, lab fees, food and housing.

Student Discounts and Renting Textbooks

First and foremost, you can use your student status for discounts. Your student ID card might come in handy at museums, movie theaters or restaurants. Check business websites to see if they offer student discounts. Student Rate offers local and national student discounts that can aid in saving money on computers to clothes. You can research online and take advantage of daily deals you come across on Groupon or Living Social.

Using coupons and online discount codes can also save you tons of money. From food and house cleaning needs to school supplies and books. Taking the time to cut out coupons and researching for discount codes for online ordering is a smart and easy money saving technique.

You also have the option today to rent textbooks through the new e-readers that are available, such as the Kindle or iPad. Books can be easily purchased and downloaded through Amazon and the iTunes store. You only pay for the amount of time you need the textbooks, such as a semester or two. However, when you are in the medical profession, it is often helpful to have textbooks handy for future reference. Purchasing hard copies of textbooks are often the best option for medical students. Looking up promotional codes online and comparing various textbook sites for the best prices is very helpful.

Take Advantage of Campus Resources

Using resources available on your campus is a great start to saving money during the school year. For example, take advantage and utilize the campus library. The library is filled with free books for studying or reference materials. Free Wi-Fi and computers are also available to you. It is also full of space for you to study quietly and effectively.

You may also want to see if your campus has a gym that is free for students. Staying healthy and fit will help relieve stress and focus better on your work.

If you live off campus, doing away with a TV will also help in lowering your living costs. Between schoolwork, rotations at the hospital and studying, you will most likely find that you have very little down time to watch TV anyway. Full episodes of your favorite show are most likely streaming on the internet, or if you’re a sports fan, head to a friend’s house to catch the game.

To save on food, perhaps there is a discount for employees at the hospital in which you are working? Making coffee at home and cutting out cups of coffee from Dunkin Donuts or Starbucks can save significant money as well. Eating healthy on a budget may not be easy, and as medical professional, you
know high sodium foods such as Ramen Noodles or Campbell’s soups, while affordable are not exactly healthy. Finding healthy foods on a budget may be hard but worth the investment.

Keep in mind that you are doing a noble thing. You are educating yourself to become a physician someday. Soon you will be saving lives and helping people stay healthy and live longer. Keep in mind that this point in your life will be a distant memory someday. Embrace your time in medical school and enjoy your experience while it lasts! Saving money is helpful, but remember to treat yourself as well! If you score high on a test, go out to dinner or to a movie with friends. If you find you have some extra down time, attend a party, or hang out with some close friends. Keeping sane and staying true to you is very important – to you and your patients!

Elsevier Health was generous enough to provide the http://mdjourney.com/ readers with a 10%promotional code! See below for savings.

Elsevier is a publisher of popular book titles such as The Harriet Lane Handbook and Goldman’s Cecil Medicine. For 10% off your next purchase from http://www.us.elsevierhealth.com you can use the discount code 04357 in the promotion code box at checkout. Valid for unlimited use. Offer expires 1/1/13.

Affiliate links are present in this post.

Physician Assistant (PA) Programs / Schools in California

There are 10 physician assistant programs in the state of California. They are located in various cities spread around the statePA school including Los Angeles, Sacramento, Oakland, and Pomona among others.

Looking for some help applying to PA schools? Check out this book!

Learn about each program by clicking on these links about each PA program in California:

Charles R. Drew University of Medicine and Science Physician Assistant Program

Keck School of Medicine of the University of Southern California Physician Assistant Program

Loma Linda University Master of Physician Assistant Program

Riverside County Regional Medical enter/Riverside Community College Physician Assistant Program

Samuel Merritt College Physician Assistant Program

San Joaquin Valley College Physician Assistant Program


Stanford University School of Medicine Primary Care Associate Program

Touro University California College of Health Sciences Physician Assistant MPH Program

University of California Davis Physician Assistant Program

Western University of Health Sciences Physician Assistant Program

Click here for an index of all the PA programs in the United States.

Good Luck!

Can Blogging Help You Get Into Medical School?

This guest post is from Ryan Nguyen, a medical student who blogs at WhiteCoatDO.

“So tell me about PracticalPremed…”

It had only been two minutes into a medical school interview when the physician sitting across from me asked me about the blog I had started as a third-year undergrad. Her face showed a slight smile, conveying her curiousness on a topic that deviated from the usual questions on volunteering, ethics, and academics. For the next few minutes, I discussed why I started PracticalPremed and what I hoped to get out of it. The confidence and connection built with my interviewers from these talking points lasted throughout the interview. Two weeks later, a call came in from the Dean of Admissions, offering me a spot in their class.

Among all the decisions I made during college, starting a blog easily ranks among the top five (right besides playing innertube waterpolo, that game is friggin’ awesome). Blogging became a creative outlet, giving me the sanity to keep memorizing the steps of TCA cycle and pushing through those brutal five and a half hour practice MCATs. When filling out primaries, I listed blogging as one of my activities, but had no idea how much it could help me with the application process. By the end of the application season, blogging had played a key role in helping fill out secondaries, acquiring interview invites, tackling interviews, and even securing acceptances.

How Can Blogging Help Premeds Get Into Medical School?

Talking Points For Interviews

For each of my five interviews, blogging and social media were topics of discussion for at least 5-10 minutes (most interviews lasted around 30 minutes). As a topic I probably knew a little more about than my interviewer, blogging was something I could discuss with relative ease. From a strategic standpoint, this meant there was less “dead time” for me to squirm during ethical scenarios or for off-the-wall interview questions such as “which kitchen appliance would you say you are?” Yes, that is a real medical school interview question.

Displaying Initiative and Creativity

In early November, a guest post I wrote was featured on HackCollege, one of the most visited college blogs on the internet. The post became pretty popular, as it was shared over 140 times on facebook and 60 times on twitter, and so I put it into one of my update letters I sent to schools in November. Just a week and a half later, an interview invite came from one of those schools.

In the sea of tens of thousands of applicants (the AMCAS twitter reports 21,732 applications submitted as of July 17th), blogging provided a unique way for my application to stick out beyond the usual GPA/MCAT/extracurriculars criteria. The website for my medical school states they desire an applicant who “demonstrates excellent verbal and written communication skills,” and so blogging became a natural way to display such skills.

Learning Responsible Social Media Usage

Between facebook, twitter, and the epatient movement, the rise of social media holds unforseen implications for the future of healthcare. A 2006 paper states that 18% of adult internet users go online to find healthcare information for themselves or others and that health searches are one of the more popular uses of the internet. And as not everything on the internet is 100% true (someone would really lie on the internet???), physicians have the unique positions of combating misinformation with their knowledge of evidence-based medicine. One such example is Dr. Howard Luks, an orthopedic surgeon who has embraced social media and posts informative medically-related articles on topics such as degenerative joint disease. Thus, an underlying theme I employed throughout my application is that I would use my skills in social media and blogging to meet patients where they were at (i.e. searching for health information online) in order to advocate for evidence-based medicine in the online world.

At the same time, many of today’s health care leaders are also wary of the dangers of social media and HIPAA violations. KevinMD features a great post on steps physicians are taking to stay careful on social media. Blogging as a medical school applicant was also a challenge in constantly being aware of the nature of published content. The knowledge that an admissions committee member could be looking at my site at any moment pushed me to maintain a sense of professionalism. Developing these skills as a premed will hopefully give future doctors the time to develop effective and professional writing skills by the time they are healthcare professionals.

Offsetting Costs Through Side Income.

With application fees, flight tickets, hotel fees, and acceptance deposits, applying to medical school is a costly endeavor. And I don’t want to even get into the six-figure average indebtedness that medical school graduates are facing in the US. In this post, Steve details how his total costs during the application year totaled $6,024 (and that’s with the $4,290 he was able to save). One of the beautiful things about blogging is the ability to convert website traffic into side income. In the past two weeks, PracticalPremed has generated $53.44 through a combination of affiliate programs and Google Adsense. While not a ton of money compared to my student loans (sigh…), it still is income that will be coming in when I’m eating, studying, sleeping, and studying some more. Now if only I could get some sponsor to pay for all of my tuition for the next four years…

For the past two years, Ryan has been blogging over at PracticalPremed. Now an upcoming first-year medical student at WesternU COMP, he runs WhiteCoatDO to document his perilous attempt at navigating medical school and beyond. Get in touch if you’re interested in starting your own blog!

Relief, Disappointment and Fun–Yep I’m in Med School

I received my Step 1 score yesterday. I was relieved to find out that I passed! This is a huge step (ha ha) towards becoming a physician.

At the same time, my score was well below what I desired. It was not a complete shock as I struggled with some practice tests before the exam. I hoped to have a similar experience to the MCAT, where I scored 2 points higher than any practice test I had taken. That was a foolish hope.

I don’t need to get into exact numbers, but I will say that my score was below the national average. This is not the end of the world. Obviously 50% of test takers are in the same boat. But I am a little worried about it limiting options for my future. I have never had much desire to enter a hyper competitive specialty but I would like to end up on the west coast and have heard that residencies there can be more competitive in general.

So relief… and disappointment. I know that Step 1 will be just one aspect of my application programs will look at. I know a higher Step 2 score can help. I know I will still have many options. But a higher Step 1 scored would have relieved some pressure, and honestly any way to take a little pressure off in med school is welcome.

I can’t change my score now. What I can do is continue to take every opportunity in my training to make sure I’m the best physician I can be.

And that brings me to fun. I have been in third year for about a week and it already is so much better than the first two years of school. Delivering babies, assisting on surgeries, talking to real live patients – it’s all fun! I am actually doing something, and learning a ton at the same time.

So goes the roller coaster that is medical school.

Congratulations to all the new MDs and DOs!

Several med student bloggers that I follow recently graduated from medical school! I want to take the time to acknowledge their hard work and perseverance. I appreciated this post by JeffreyMD, where he notes “In the grand scheme of things, I am still at the beginning. I have ‘leveled up,’ but I’m still at a very low level.”

You may be still at a low level, but you’ve still accomplished something great. Congratulations!

Here are a few other new physicians who just “leveled up.”

Medaholic

Off-White Coat

Adjacent Possible Medicine

Doctor Fishypants

Medical-School-Insider