Wednesday, December 31, 2008
Sunday, December 28, 2008
5 Most Stressful Medical Specialties
1. General Surgery - perhaps I'm biased by the training, but I think given the career, it seems like a lot of stress, considering the income and hours down the road.
As for the least stressful medical specialty, I don't think you can wrong with the old "ROAD" mnemonic (radiology, ophthalmology, anesthesia, and dermatology). Some people would also throw pathology (heh, PATH / ROAD, get it?) and emergency medicine in there as well. While all are competitive to train for, I think the lifestyle down the road more than makes up for it, leading to less stress overall.
Saturday, December 27, 2008
Books For Surgery Core Clerkship / Rotation
For any rotation, I would suggest starting off by reading a clinical vignettes book initially, to get familiar with the cases seen most commonly by the specialty. Then, read a general textbook or review to learn more details about the patients and procedures. Finally, do practice questions in the weeks leading up to the test to solidify your knowledge. These principles are especially important during the surgery core clerkship, when your time is limited. Here are the books I used primarily:
Essentials of General Surgery
by Peter F. Lawrence
Case Files Surgery (Second Edition)
by Eugene Toy
NMS Surgery Casebook
by Bruce E. Jarrell
by Lorne H. Blackbourne
For me, these books either overlapped with the ones I listed above, or were too advanced for my tastes. However, if you are interested in surgery or want to honor the surgery clerkship, then it is worth considering whether you want to obtain these texts. Sorry to those of you who see the list twice; the images do not show up in some browsers.
Find other books useful on your surgery clerkship? What books helped you the most on the surgery shelf exam? Share your knowledge!
Friday, December 26, 2008
Thursday, December 25, 2008
Wednesday, December 24, 2008
Tuesday, December 23, 2008
Monday, December 22, 2008
Sunday, December 21, 2008
A recent post claims that Japanese scientists have discovered how to extract images directly from one's brain.
The scientists were able to reconstruct various images viewed by a person by analyzing changes in their cerebral blood flow. Using a functional magnetic resonance imaging (fMRI) machine, the researchers first mapped the blood flow changes that occurred in the cerebral visual cortex as subjects viewed various images held in front of their eyes. Subjects were shown 400 random 10 x 10 pixel black-and-white images for a period of 12 seconds each. While the fMRI machine monitored the changes in brain activity, a computer crunched the data and learned to associate the various changes in brain activity with the different image designs.
Sometimes I feel like everything important that needs to be developed has been already, but stories like this renew my hope in what lies ahead. Even if we understand how MRI works, we are still far away from understanding how the human brain functions. I can't imagine how such technology will develop over the next 10 - 20 years.
(Image Source: PinkTentacle)
He said their reaction was understandable, given that the museum’s collection includes abstract art, which he disdains. “I am a huge threat because what I have done renders everything they have junk,” he said beneath the glinting chandeliers in his great hall. “I hope that doesn’t sound arrogant but the reaction of people who come in here tells me the power of it.”
Saturday, December 20, 2008
Friday, December 19, 2008
- 12-13 years of primary education
- 4 years of college
- 4 years of medical school
- 1 year of internship
- 4 years of diagnostic radiology residency
- Possibly 1-2 years of radiology subspecialty fellowship
Thursday, December 18, 2008
Wednesday, December 17, 2008
- A Stethoscope - An excellent gift, especially for first or second year students who have yet to enter clinical rotations. Stethoscopes can be somewhat pricey on a student budget, but a nice one makes for a great investment. There's a wide selection of stethoscopes out there though, so shop around for one that makes the most sense for what your gift recepient is interested in. I personally have a Littmann Cardiology III (black) and think it's great. It's high quality, durable, and good for general use (which means, for most medical students). Plus, it looks quite professional.
- First Aid for the USMLE Step 1 2009 - Heh, to the person you'd rather see spend the holiday in the library. Still, I kind of wish I'd started looking at this earlier during medical school, so it really would be practical
- Palm TX Handheld - A nice tool to have around on rounds, especially with Epocrates loaded on it. Any time your patient is put on a new funny-sounding medicine, you can quickly look it up, as well as add notes about the drug. There is a lot of other medically-related software out there for the Palm as well, such as patient tracking software.
- Medically-Related Leisure Reading - Sometimes, when a medical student wonders "Why am I going through all this?" it's nice to read a regular book addressed to a general audience about medicine and why doctors do what they do. My favorites are:
- How Doctors Think by Jerome Groopman
- Complications: A Surgeon's Notes on an Imperfect Science by Atul Gawande
- Better: A Surgeon's Notes on Performance by Atul Gawande as well
- USMLE Step I Qbank - If you know your gift's recepient is a second year medical student and about to take USMLE Step I, consider paying for a QBank for them. There are several options out there, but Kaplan is one of the most popular. Have them try out the service before purchase with the Qbank Challenge, which lets them do a sample test of 10 or so questions (the full Qbank has 2000+ questions):
- Amazon.com Gift Card - The reality of medical school is that any medical student will have to study A LOT. To do so, this requires textbooks and review guides. An Amazon gift card will help any student easily purchase the texts and reviews they need, which can be a significant cost of medical education for a student, after tuition.
Tuesday, December 16, 2008
Monday, December 15, 2008
Sunday, December 14, 2008
- If the program has an agreement with a hotel for a special rate, try to utilize it. However, still shop around because you might actually be able to save more if you book it yourself via an online discount site like Hotwire.
- If someone in your family or you yourself has a AAA membership, use it! You can save 5-15% at many hotels with a AAA card.
- If you are a member of AMSA, they also offer savings up to 15% at select hotels.
Saturday, December 13, 2008
Well, two sites I would recommend are Kayak and TripAdvisor. Both sites let you quickly comparison shop between several discount sellers online. Nice features include searching around an address, which lets you enter the address of your interview location in, and then find hotels nearby. Kayak also has helpful mobile apps for iPhone/Android phone useres. Another suggestion would be to try to group your reservations so that you're booking from one site. For example, if you book 10 nights with Hotels.com, you get an 11th night free (with some restrictions, of course).
Anyone else have any good tips or website recommendations?
(Image Source: Airline-Discount-Fare.com)
Friday, December 12, 2008
Sounds like the blogger is a former 'poor' medical student who applied to a competitive field (radiology) and had to really watch every penny because (s)he has a family and three kids to take care of. Anyway, maybe some of you will find it helpful.
Thursday, December 11, 2008
Wednesday, December 10, 2008
In a good mood? Your neighbor, her friends and even her friends' friends should thank you – you're likely infecting them with your cheer. Happiness spreads through social networks about as easily as the flu, according to a new study.
The researchers analyzed data compiled from nearly 5,000 interconnected people over a 20-year period. After establishing a baseline mood for each participant, the team found that when one person became happier, it rippled through the network, increasing the likelihood that others would become happier too.
Sadness, thankfully, is not nearly as infectious. An attack of the blues creates a much smaller ripple than a case of giddiness, said head researcher James Fowler of the University of California, San Diego.
(Image Source: DesignFlute)
Tuesday, December 09, 2008
The sedated patient, his bullet wounds still fresh from a shootout the night before, was lying on a gurney in the intensive care unit of a prestigious private hospital here late last month with intravenous fluids dripping into his arm. Suddenly, steel-faced gunmen barged in and filled him with even more bullets. This time, he was dead for sure.
Hit men pursuing rivals into intensive care units and emergency rooms. Shootouts in lobbies and corridors. Doctors kidnapped and held for ransom, or threatened with death if a wounded gunman dies under their care. With alarming speed, Mexico’s violent drug war is finding its way into the seeming sanctuary of the nation’s hospitals, shaking the health care system and leaving workers fearing for their lives while trying to save the lives of others.
“Remember that hospital scene from ‘The Godfather?’ ” asked Dr. Héctor Rico, an otolaryngologist here, speaking about the part in which Michael Corleone saves his hospitalized father from a hit squad. “That’s how we live.”An explosion of violence connected with Mexico’s powerful drug cartels has left more than 5,000 people dead so far this year, nearly twice the figure from the year before, according to unofficial tallies by Mexican newspapers. The border region of the United States and Mexico, critical to the cartels’ trafficking operation, has been the most violent turf of all, with 60 percent of all killings in the country last month occurring in the states of Chihuahua and Baja California, the government says. And it has raised fears that violence could spill across the border, because dozens of victims of drug violence have been treated at an El Paso hospital in the last year.
I have not really followed the whole immigration / border security debate, but if we start drug wars in our hospitals, perhaps I should pay more attention. What was that talk about a wall again?
(Image Source: Art.com)
Monday, December 08, 2008
At any rate, I have a humble proposal: Interview Day(s). Initially, the idea was to mirror Match Day and have a single day on which all programs release their interview invitations. Since Dean's Letters go out on November 1, a date like November 15 would seem reasonable. However, one can imagine the chaos that would ensue on that day. Discussions with friends led to an evolution in the thought. Instead of having a single day, perhaps the 4 Mondays in November could each be a single wave of interviews. Each wave would represent a region of the country, and all the programs in that region would release their interview invites on that day. While this may stress some programs, I would imagine applicants would find this beneficial for two main reasons. First, it would remove some of the uncertainty regarding when one should expect to hear from a program. Second, if you hear from all the program in one region at the same time, it makes it MUCH easier to coordinate your travel plans so that you are not repeatedly traveling back and forth across the country. Of course, the region going last would be at a disadvantage but possible remedies include rotating which region goes last every year. While I'm sure programs would not be in favor of this system because of institutional inertia, I cannot see how it would significantly change how they decide who to initially interview. If applicants benefit, and the cost to programs in terms of effort is relatively minimal, such a change should be made. I'm sure I'm missing something here, but the idea seems like it is worth consideration.
(Image Source: AAMC)
Sunday, December 07, 2008
In a study recently accepted for publication by the Journal of Cognitive Neuroscience, scientists at UC Berkeley's Helen Wills Neuroscience Institute and the School of Public Health report that normal 9- and 10-year-olds differing only in socioeconomic status have detectable differences in the response of their prefrontal cortex, the part of the brain that is critical for problem solving and creativity.(Lee Michael Perry/UC Berkeley)Brain function was measured by means of an electroencephalograph (EEG) - basically, a cap fitted with electrodes to measure electrical activity in the brain - like that used to assess epilepsy, sleep disorders and brain tumors.
"Kids from lower socioeconomic levels show brain physiology patterns similar to someone who actually had damage in the frontal lobe as an adult," said Robert Knight, director of the institute and a UC Berkeley professor of psychology. "We found that kids are more likely to have a low response if they have low socioeconomic status, though not everyone who is poor has low frontal lobe response."
Saturday, December 06, 2008
For the skeptics:
Friday, December 05, 2008
Almost one-third of the world’s people don’t get enough iodine from food and water. The result in extreme cases is large goiters that swell their necks, or other obvious impairments such as dwarfism or cretinism. But far more common is mental slowness.When a pregnant woman doesn’t have enough iodine in her body, her child may suffer irreversible brain damage and could have an I.Q. that is 10 to 15 points lower than it would otherwise be. An educated guess is that iodine deficiency results in a needless loss of more than 1 billion I.Q. points around the world.
It's sad to think how so many things we take for granted, like iodized salt or chlorinated water, are luxuries in other parts of the world. It frustrates me when people knock government or public health initiatives and completely ignore all the benefits that such efforts have brought us. Hopefully articles like this one will spur philanthropic organizations like the Gates Foundation to pay more attention to this issue. As much as AIDS is a global health issue, one wishes that causes like potable water or adequate nutrition would receive equal attention.
(Image Source: Morton Salt)
Thursday, December 04, 2008
Wednesday, December 03, 2008
While reading random blogs online (Daily Dish, if you must know), I came across an interesting story about a woman with "perfect memory":
Price can rattle off, without hesitation, what she saw and heard on almost any given date. She remembers many early childhood experiences and most of the days between the ages of 9 and 15. After that, there are virtually no gaps in her memory. "Starting on Feb. 5, 1980, I remember everything. That was a Tuesday."
She can also date events that were reported in the media, provided she heard about them at the time. When and where did the Concorde crash? When was O.J. Simpson arrested? When did the second Gulf war begin? Price doesn't even have to stop and think. She can effortlessly recite the dates, numbers and entire stories.
"People say to me: Oh, how fascinating, it must be a treat to have a perfect memory," she says. Her lips twist into a thin smile. "But it's also agonizing."
In addition to good memories, every angry word, every mistake, every disappointment, every shock and every moment of pain goes unforgotten. Time heals no wounds for Price. "I don't look back at the past with any distance. It's more like experiencing everything over and over again, and those memories trigger exactly the same emotions in me. It's like an endless, chaotic film that can completely overpower me. And there's no stop button."
She's constantly bombarded with fragments of memories, exposed to an automatic and uncontrollable process that behaves like an infinite loop in a computer. Sometimes there are external triggers, like a certain smell, song or word. But often her memories return by themselves. Beautiful, horrific, important or banal scenes rush across her wildly chaotic "internal monitor," sometimes displacing the present. "All of this is incredibly exhausting," says Price.
Based on other research I have read casually, it seems that we evolved the ability to selectively remember items because it helped with learning. Having too much information was not beneficial. As the article notes, Price's episodic memory is nearly flawless, but her semantic memory (the memory associated with learning facts and concepts) is average, which is why she did not stand out in school. Still, if she exists, there are likely people with nearly flawless semantic memory, right? The whole thing makes one wonder where the true limits of human ability lie.
Monday, December 01, 2008
When Donna Campiglia learned recently that a genetic test might be able to determine which sports suit the talents of her 2 ½-year-old son, Noah, she instantly said, Where can I get it and how much does it cost?
“I could see how some people might think the test would pigeonhole your child into doing fewer sports or being exposed to fewer things, but I still think it’s good to match them with the right activity,” Ms. Campiglia, 36, said as she watched a toddler class at Boulder Indoor Soccer in which Noah struggled to take direction from the coach between juice and potty breaks.
“I think it would prevent a lot of parental frustration,” she said.
In health-conscious, sports-oriented Boulder, Atlas Sports Genetics is playing into the obsessions of parents by offering a $149 test that aims to predict a child’s natural athletic strengths. The process is simple. Swab inside the child’s cheek and along the gums to collect DNA and return it to a lab for analysis of ACTN3, one gene among more than 20,000 in the human genome.The test’s goal is to determine whether a person would be best at speed and power sports like sprinting or football, or endurance sports like distance running, or a combination of the two. A 2003 study discovered the link between ACTN3 and those athletic abilities.
The whole thing seems like a money-making scam to me. I say scam because the entire concept discounts the notions of practice, a work ethic, and intelligence in athletics. Except for certain endeavors, like weightlifting perhaps, raw athletic ability will only get an athlete so far. Beyond that, other factors come into play to determine success. I worry that children with "good" results will face even more pressure from their sports-crazed parents to perform up to expectations.