Becoming a Surgeon and Mastering the Craft

This guest post by Jenna Smith discusses the necessary ingredients for becoming a surgeon.

Individuals pursuing surgery as a career have to have what it takes to handle the job. With a lot of responsibility involved, including having another person’s life in your hands, surgeons have a tremendous amount of pressure to perform well at their jobs. Mastering the craft as much as possible can happen as long as people are willing to put in the work starting from when they’re in school and all the way through to the end of their career.

Learning How to Handle Surgical Equipment
Surgery cannot happen without the proper equipment. It isn’t possible to cut into flesh and fix broken bones without certain utensils and instruments necessary for those types of jobs. Everything from a scalpel to a surgical light needs to be well understood. Watch how others use these items whenever possible, either through video or observation. Another useful tip is to check out resources such as the Surgical Lights Buyers Guide to get acquainted with product details and better understand how to operate the equipment so it works the most efficiently.

Choosing a Specialty
Though general surgery is an option, most people opt for a more specialized field. Plastic surgery, for example, is one of the most sought-after choices in the surgical world. After graduating from college, individuals then must go on to learn at a medical school. A doctor of medicine degree is received after completing four years. During the next three years, hopeful surgeons must complete their residency training. Doctors complete general training first before getting to choose a specialty and focus on only that area. A special certification will need to be obtained to practice surgery in one particular field, such as earning certification through the American Board of Plastic Surgery.

Study, Study, Study
If students think they can go to medical school and never have to study simply because they didn’t study much at their former college, they will be incredibly mistaken. Getting through medical school and preparing to become a surgeon takes a tremendous amount of work. Individuals need to study, study, and study some more if they are going to want to remember all of the information that gets packed into just four years of classes. Medical terminology, proper procedures, hospital rules and regulations, and laws all need to be learned and memorized before school is finished. Having a study system in place will be key to being successful.

Study Some More
Studying for school isn’t the only thing to worry about. Once school is completed, students still need to become certified if they want to practice medicine. The ACLS and PALS tests are two options. If the job specialty you want requires these certifications, then it will take even more studying to prepare for either of them. Finding some good study methods that help retain as much information as possible is important for getting through these exams.

Don’t Forget to Keep Learning
Too many people believe that because they attended medical school and completed all of the required work and hours to become a surgeon, the learning is complete. They have now learned everything they need and can continue to do their job the same way forever. This is not true when it comes to surgery, not to mention medicine in general. Everything is always changing and adapting. New medicines are discovered. New machines are made for efficiency. Doctors must constantly continue learning and adapting to the world of medicine so they can offer the best care.

Becoming a surgeon takes a considerable amount of effort, patience, and desire. People will quickly find out once they start practicing medicine whether they’re truly cut out for the field. With the gruesome tasks, life or death situations, and vast amount of responsibility, only those who can truly master the craft should perform surgery.

Jenna Smith has been blogging since she graduated from the University of Utah.  She finds herself spending less time writing due to a new venture called “MARRIAGE!” She enjoys her new venture very much. Lucky for us, she still finds time to write great articles, including this one.

Do Medical School Rankings Matter?

This is a guest post / repost from Smart Money, MD on the topic of whether going to a highly-ranked medical school matters:

Some of us are overachievers. Some of us are overachieving doctors. What if you’re in-between? Let’s say that you’re an overachiever, and you want to become a doctor.

Should you go all the way up top and get that medical degree from a top private institution? Does it even matter? With tuition costs skyrocketing, you can easily spend $60,000 annually on tuition alone for each year in medical school. Add another $10-$15k in room and board, and you will be about a quarter million in the hole by the time you get out. In contrast, medical school tuition in 2016 for UT Houston for in-state resident is only about $20,000 annually. That’s a big difference.

These are considerations that are rarely taught or even discussed. If you are planning to go to medical school, it does pay to consider the consequences thoroughly before you proceed.

Does a prestigious degree help get you a better job?

It depends. It depends on where you plan to work. In clinical medicine, you can either work at an academic institution or in the private sector. Many job situations in the academic world require teaching, research, or involvement in administration. If I were a departmental chair looking to bring on a clinician-researcher, I’d want someone who not only can practice medicine well, but also has strong writing skills, coherent presentation abilities, and innovative characteristics. If two candidates had similar track records with similar recommendations and charisma, I might lean towards going for the gal with the Ivy-league degree, especially if I am running an Ivy-League department.

If I needed a doctor in the private sector, the institution that granted the degree is unlikely going to matter much at all. Yale? Great. Wayne State? That’s okay with me. You just need to be ethical, hard-working, and reasonable to deal with. For all other qualities, the verification process in each state and governing medical board can do the rest.

DO DOCTORS FROM PRESTIGIOUS INSTITUTIONS MAKE MORE MONEY?

It depends again. To understand this question, you should understand how doctors make money to see whether an Ivy-League degree will translate to higher dollars. This is also contingent upon how you are using your medical degree, whether you are practicing medicine, performing administrative work, or consulting. Remember, you don’t have to be a doctor to get rich. Or you shouldn’t become a doctor if your main goal is to become rich.

If we are considering doctor worth from revenue alone obtained through clinical practice, insurance companies make no distinction between where you obtained your degree. U.S. grad, international grad, it doesn’t matter. As long as you pass your boards (sometimes you don’t even have to do that!), you’re golden. From clinical practice alone, you’re not going to make more money having gone to a top college or medical school. Period.

Now having that special degree CAN get you more business, depending on which part of the country you practice medicine. This is particularly true (and sometimes annoyingly so) in the New England area. Patients in New Caanan Connecticut do (in general) care where you obtained your degree. They may or may not even be highly educated, but the high concentration of Ivies in that region predisposes this behavior. Unless you have significant street cred and have been working in the area for a long time, your patient may doctor shop your degree.

OKAY, I SANK $200,000+ INTO AN IVY-LEAGUE MEDICAL DEGREE, WHAT AM I GOING TO GET IN RETURN? 

Many of us, under the guidance of family, friends, or schooling, end up enrolling in well-known [read: expensive] private universities and medical schools.

DESPITE the equivocal conclusion by Smart Money MD.

Don’t fret. You’re not totally screwed. If you have a good inheritance coming your way or an alternative means to fund the process, you’re actually in great shape.

If the above doesn’t apply to you, don’t fret either!

STEP 1. PAT YOURSELF ON THE BACK.

Congratulations. It is not easy getting in. It is SIGNIFICANTLY more difficult to get in medical
school than law school, business school, or college. Kudos to you.

This is a fact. By numbers alone. There are simply fewer number of available positions in medical school. The Class of 2018 Stanford Graduate School of Business has 417 new students. Last I checked, the Stanford medical school had fewer than 90 students per class. I think the acceptance rate in the medical school was about 2-3%, while the business school acceptance rate was 6%. If you compare these numbers to that of an average public medical school and public business school, you’ll see that the class sizes will be larger and the acceptance rate will also be higher.

STEP 2. YOU’VE GOT A LIFETIME OF PRESTIGE ATTRIBUTED TO YOUR NAME.

Yup, your mother can brag about her daughter at every holiday party. Your distant relatives will direct their children to you for advice. Your alma mater will also hit you up for donations every single year. You can volunteer with your local alumni group and have “exclusive parties”.
You have a lifetime of memories and connections to potentially successful friends and colleagues.
This is not a bad situation to be in.

STEP 3. CLEAR YOUR MIND AND GET TO WORK.

Get yourself back into the real world. Don’t let anything else cloud your judgment. You’re probably not even that smart. Your coworker at the hospital who came from Portugal probably is one the smartest gals in her country. She memorized Harrison’s twice to pass her country’s exams. Oh yea, she also repeated residency in the U.S. and passed all of her U.S. board exams…in English.
That’s right, her native tongue is Portuguese, and she learned Spanish as her secondary language. English was her third language.

Get yourself out of debt if you funded your education through loan sharks. If I dug myself out of debt, so can you. Save up your money. Figure out how much you are worth.

Figure out what makes you happy. Then work to get there. Easy peasy.


Smart Money MD, an ophthalmologist run financial website, focuses on proper management of medical trainee debt, lifestyle, time, and getting the most out of your hard-earned degree.


I can only second what Smart Money said above. In the grand scheme of things, getting into medical school is a much bigger deal than which medical school you get into. For most residency programs, what you get on USMLE Step 1 will carry much greater weight than your medical school. However, all else being equal, more prestigious medical schools will have more famous faculty, who will be better able to plug you into opportunities to advance your career as well as make phone calls on your behalf when it comes time for Match Day or even beyond with jobs. For more competitive training programs, specialties, or jobs, this may make a huge difference. To decide, ask yourself what type of training and career you want, then find a medical school training program that will you make you happy. Good luck!

Medical School Student Loan Consolidation And Refinancing: A Primer

Today's post is a repost from Future Proof, MD covering the basics of medical student loan consolidation and refinancing:


If you are like the majority of medical school graduates out there, you're probably saddled with a good amount of student debt. I know I am. If you are like me, you may have gathered multiple loans from several different lenders over your many years of schooling. Now that you're finally done with school and entered the workforce, you may have been bombarded with emails inviting you to consolidate/refinance your loans. So let's talk loan consolidation/refinancing.

First, let's address what consolidation and refinancing are.

• Consolidation allow you to combine multiple loans into 1 loan, resulting in just 1 monthly payment instead of many. For example, if you have only federal loans and go through federal loan consolidation, you will end up with 1 bill but your interest rate will simply be a weighted average of all the different interest rates of the loans you consolidated.
• Refinancing, on the other hand, allow your to consolidate your loans as above. But the difference is that your new interest rate will be dependent on your credit score and history rather than what the interest rates on your old loans were. In essence, you are applying for a new loan with new terms to pay off your old loans - analogous to a "balance transfer" between credit cards. In reality, "consolidation" and "refinancing" are used interchangeably. If you are getting an offer to "consolidate" your loans through a private lender, they're talking about refinancing. For the purpose of our discussion, I will use the term "refinance".

PROS:

• 1 monthly payment. This is probably the biggest benefit of refinancing your loans. Instead of making multiple monthly payments to multiple lenders, you get 1 bill and 1 payment.
• You may qualify for a lower interest rate. The standard interest rate for federal student loans are fixed at 6.8%. If you have good credit and income, it's likely you will qualify for a lower interest rate. I say "may" because when I went through SoFi (the largest student loan refinancing lender) to check what they would do for me, my refinancing offer was less than generous (see figure).
• You can lower your monthly payment. This can result from you getting a lower interest rate on the new loan, by renegotiating your repayment term (15 or 20 years instead of the standard 10 years for a standard repayment plan), or a combination of both.
• Choice of variable vs. fixed interest rates. Choosing a variable interest rate will benefit those who are planning to pay off their student loans rapidly.

CONS:

• Refinancing your loans with a private lender will make you ineligible for federal loan forgiveness programs such as Public Service Loan Forgiveness (PSLF), and other benefits such as Income Based Repayment (IBR), deferments and forbearance.
• Your interest rate may go up if you choose a variable interest rate plan. Most variable interest rate loans have a cap as to how high the interest rate can reach, but it's usually more than the standard 6.8% fixed you would get through the government.
• It's a permanent decision - if you ever leave the federal system, there is no recourse if you decide later that you've made a mistake.
• Fees - this is a minor consideration for those with a large loan balance, but there may be fees associated with a private loan refinancing application.
• So after considering many of the above factors, I ended up consolidating my loans through the government. I am currently on Income Based Repayment (IBR) with plans to eventually qualify for Public Service Loan Forgiveness.

Head on over to Future Proof, MD to see the table with statistics on medical education debt loads as well as many other great posts on personal finance for medical professionals. 


For those of you currently in medical school, I would also add that I strongly encourage you to seek out grants, stipends, and scholarships to supplement your financing. There are many tied to specific student backgrounds (i.e., if you come from a minority group), or for those willing to perform public or military service for some time after finishing training. Personally, I can attest to this being a very valuable approach as a single scholarship application that I knocked out one weekend evening ended up covering my tuition for an entire semester! Another example is author Ramit Sethi who funded his entire Stanford undergraduate education on scholarship money alone. If you need a primer on personal finance overall, his NY Times bestselling book I Will Teach You To Be Rich is a great place to start:

Financial Advice for the Future Physician

Dr. Jim Dahle runs the popular healthcare-professional blog White Coat Investor. One of his posts detailed 8 Financial Tips for students looking into a medical career:

Choose the cheapest school you can get into

The decision of which school to attend will have a greater impact on your finances for the next 5-20 years than any other decision other than who/if you marry and what specialty you choose to practice. Choose wisely. I’ll give you a hint–Most medical schools in this country provide a pretty comparable education. Most of what you learn in medical school will come from what you teach yourself and the pearls dispensed to you freely by interns, residents, and other doctors you come into contact with. Little of that learning is dependent on the school you choose. Thus, choose the cheap state school if you can get into it. Don’t forget that costs aren’t limited just to tuition and fees, but also to the local cost-of-living. That school in Boston, New York, or San Francisco is going to cost you a lot more than the one in Omaha or Albuquerque.

Consider the merits of “scholarship” programs carefully

There are several organizations that would like to pay for your medical school in exchange for a commitment. The military Health Professions Scholarship Program is the best known, but the US Public Health Service, Indian Health Services, and other private deals also exist. None of these programs is a “scholarship” in the traditional sense of the word, and many a “scholarship winner” has later realized he would have been much better off, personally and financially, if he hadn’t been awarded the “scholarship.” As a general rule, use these programs only if your career goal is to be a military doctor or a rural primary care doctor. Choosing them for the money is almost surely a mistake you will regret.

Personally, I can attest strongly to his first piece of advice. Choosing a cost-effective medical school has meant the difference between graduating essentially debt-free versus graduating with loan repayments stretching out as far as the eye can see. As life progresses, your costs will increase, so that "manageable" monthly repayment will become increasingly burdensome, especially if you are interested in purchasing a house or having a children as you near the end of the long road of medical training (or already have those obligations!)

For the rest of his tips, check out Dr. Dahle's post 8 Financial Tips for Pre-meds and Medical Students.

Why Not Watching Enough College Basketball Is My Greatest Regret: Guest Post

Leah Kroll is a medical student at NYU. She writes about her life as an MS4 in this post from MotivateMD:

I made it through the rigors of pre-med. I made it through (almost all of) med school, with a few scars to show for it. And now that I’m a big, bad MS4, I finally have the time and the distance to reflect on all the literal blood, sweat, and tears it took to get here... I am a loud and proud Duke Blue Devil. It was my dream school despite my born-and-raised New Yorker parents saying, “South of the Mason-Dixon line? Absolutely no way!” My 4 years there surpassed my wildest expectations. But I failed to live all of my Duke dreams out. 

I’m proud of the person that I have become as a result of persevering through the MCAT, Steps 1 and 2, clerkships… you get the picture. But throughout all of this, since the moment I decided to go into medicine, the pressure to succeed has been a heavy weight dragging me down. I had to have a 4.0 every semester in college or I wouldn’t get into medical school. I had to run myself to the bone trying to excel as a medical student or I wouldn’t be a good residency applicant. I had to get at least XXX on Step 1 or I would be worthless. 

At Duke, basketball is king and I went to as many games as I could in the beginning. But as my medical school aspirations grew stronger, the number of games I attended dwindled to a pathetic 1 during my senior year season. Looking back on the night we won the NCAA tournament during my freshman year, I remember 2 things: 1. The electric rush of taking part in the ultimate Duke experience 2. Taking myself out of the party when the clock struck midnight so that I could retreat to my all too familiar spot in the library. My organic chemistry midterm was in 2 days and I had to get an A.
Every year at Duke, a good chunk of the undergraduate student body (The Cameron Crazies) sets up a tent village outside Cameron Stadium. For months, students live in these tents hoping to score tickets to the main event of the year: Duke Vs. UNC. My non pre-med friends tented every year. We pre-meds never did. After all, would we get enough sleep in the tents to study as much as we needed to? We had to keep our grades up. 

I got that A in organic chemistry. But, at what cost? 

We take the best care of our patients when we take the best care of ourselves. My relationships and interests outside of medicine keep me happy, healthy, and well-rounded. They help me be a better doctor. Regularly watching Duke basketball with my college friends, for example, has kept me sane as I grapple with the rigors of medical school. 

If my memory serves me correctly, organic chemistry came up in medical school just once: a 3-day metabolism and biochemistry unit in my first year. Other than that, my knowledge of electron pushing has not made any contribution to my medical training. Duke Basketball, however, has come up many times with my patients. It’s something that really excites me, and the people I meet in the hospital can relate to that. It makes me stand out from the assembly line of faces and scrubs poking and prodding hospital patients all day. 

Rooting for a basketball team brings all sorts of people together, and it’s that one common goal that serves as the glue. Cheering for a team is not unlike rallying around our patients to help them beat their illnesses. That’s how Duke basketball makes me a better doctor- it reminds me how to connect with almost anyone. 

I only wish I had participated more in my college years. I would have been happier then and it would make me a better doctor now. As hard as it may be to remember when pursuing a profession that requires us to compete and claw our way to the next step, there is such a thing as holding on to academic excellence too tightly. Albus Dumbledore said it best: “It does not do to dwell on dreams and forget to live, remember that.” Wise guy, that Dumbledore.

Looking for more inspiration as you journey through your health professions career? Check out MotivateMD.

A Primer On The Different Types Of Medical Education/Courses

This guest post by Danielle Ward details the various options available to those interested in a career in the healthcare professions but not sure about what type of degree or what type of specialty to pursue.

The field of medical science is not just confined to physicians and doctors; there are so many degree courses and areas you can specialize in. A Bachelor’s, Master’s, or Doctorate Degree in Medicine is among the most common and popular academic course that almost every aspiring doctor wants to achieve, but there’s much more than that. You also have to crack tough entrance exams and fight through intense competition to win a seat in a prestigious medical college or institution. Most medical colleges cover major subjects, such as medicinal drugs, anatomy, and physiology

Let us delve deeper into the many different types of courses and degree option. Listed below are some practical and interesting career choices for medical students:

General physician

The most primary of medical courses, this involves studying all the different and diverse subjects in medical science. General Physicians are almost never out of work and have ample earning opportunities. It prepares you to deal with the most common ailments, such as common cold, to deadly diseases and disorders, such as cholera and jaundice. One can pursue a career as a general physician after getting an undergraduate degree in Medicine (MBBS) or a post graduate degree (MD) in general medicine.   

Specialized courses

Outside the US, once you’ve achieved a bachelor’s degree in medicine i.e. MBBS, you can either start off with medical practice right away or major in a specialized field. Discussed below are some of the specialised courses that medical students are qualified to apply for:  

Surgeons

Surgery medicine is one field you can specialise in. It involves learning more about the anatomy and the various intricacies of the internal organs of the body in detail. You can further narrow down your course by choosing one particular organ such as the eye or the brain and specialise in it. Your job involves examining the patient, diagnosing his condition and operating on the body to surgically remove the source of the problem. Getting a degree, MD in surgery medicine boosts your credibility and influence in the medical community.  

Dentistry

Dentistry is a brand of medical science that deals with oral care and surgical treatment of teeth. From fixing the alignment to dealing with cavities you have to do it all. The MD in dentistry course involves learning all about the various dental disorders and infections that can possibly happen inside the mouth. It also covers a section about treating disorders relating to gums, and soft tissues inside the mouth.  You’ll also have to study about the many surgical operations and high powered medicine.

Neurology

Neurology as the name suggests deals with nerves. The syllabus is a detailed account of the different nerves and their functions in the human body. Most neurologists are also physiotherapists who plan out proper exercises that help bring sensation back to dead nerves. Neurology also involves a bit of psychiatrist study. As a neurologist you’ll have to diagnose and treat nervous disorders relating to the brain and the nervous system.   

Other areas:

Other than these major courses mentioned above, there are other equally lucrative medical fields that you can choose from. For instance, an MD in paediatrician qualifies you to treat babies and young kids. Studying cardiology trains you to identify and treat heart problems. A dermatologist deals with skin abnormalities and infections. A course in gynaecology includes diagnosing and treating the disorders in the female reproductive system. All these areas of study require a basic MBBS degree and offer high pay packages.   

Medical research

There are many medical students who take up internships at established hospitals and ten join the topmost medical institutions as doctors and surgeons. But not everyone who takes up a medical course ends up being a doctor, there are students who continue their academic studies and venture out in the field of research. A relatively unknown yet interesting course, medical research involves a lot of effort and patience.

The bottom line:

Medical science is a sector full of opportunities. And there are loads of other major and auxiliary degree courses that you can opt for. Consider your field of interest and the practicality of the course before you apply for it.      

Acing Your Medical School Interview

The following sponsored post discusses important considerations for an outstanding medical school interview. 

Going to medical school is no laughing matter. Not only do you have to be smart and hard working but you also have to be determined, patient, strong etc. On top of that you need to have resources or the money to pay for the tuition fee, expensive books, and all the other requirements you'll need. Furthermore, you have to think a hundred times if you really want to be a doctor so that no matter how hard it gets you won't easily give up. You should also be the type who doesn’t complain when they're swamped with homework and would do every single one of them with enthusiasm. Otherwise, you'll end up like those medical students who purchase assignment just to be able to survive med school.

Having said that, you definitely won't be able to enter medical school with only good grades in hand. You must ace the interview or else your chances of getting accepted will be greatly reduced. Interviewing applicants is very important because this is where you'll get essential information that won't appear in any test and academic records. It provides interviewers with an insight on how these students carry themselves in the patient room. Their answers let interviewers know how good and comfortable you sound when interacting with other people which is very important. Since you don't want to fail, there're steps that you can take to ace the interview.

To prepare for an interview, the student should know and understand the different types of interviews. A panel interview is where you'll meet several interviewers in a single meeting and is usually a cross section of the medical school faculty and may include a medical student. A stress interview determines how an interviewee would behave under pressure and often involve personal and sensitive topics. In an open interview, the interviewer may choose the specific information to which he is acquainted with. In a blind interview, the interviewer doesn't know anything about the student and would ask him to say something about himself. Behavioral interviews operate under the theory that past performance is often the best indicator of how you’ll perform in the future.

Being well prepared is a must in any type of medical school interview. Learn and study the usual interview questions, give good answers, and practice the way you'll answer them. In preparing, you must know your strengths and weaknesses and prepare to address them. Get ready to be asked with ethical and moral questions. You should also try your best to make a good first impression. Furthermore, get ready to answer questions as to why you want a career in the medical field.

It's also essential to know the mistakes they’re usually committed so as not to make these mistakes such as answering questions too fast and not staying on topic. You should also stay positive and professional at all times. Always remember to relax and don't give out robotic answers. It's likewise important to listen very carefully to the interviewer so as to get a hint of what they're interested in. Learn about the specific programs and medical specialties the university offers and while you're on campus, talk to medical students and ask them about the program.

Radu Anthony is a blogger who writes about education, travel, health, finance and technology.

Advantages of Electronic Health Records

With the requirements and incentives built into the Affordable Care Act, many healthcare facilities will be transitioning to electronic medical records. Read the guest post below from Jenny Richards to find out more about the pros of using electronic or digital medical records:

Medical records are vital as they can often make the difference between a patient receiving care that is appropriate or treatment that is based on just the experience of the attending medical staff and diagnostics performed in a hurry. Often paper records may not be legible, complete or even systematic requiring doctors to make educated guesses about the line of treatment to be followed. It can also be extremely optimistic to expect patients who are travelling to carry all their medical records with them just in case they fall ill or need medical attention for any reason whatsoever. Digitization of medical records that are already in paper form or generating records in the electronic form and uploading them to cloud storage has quite a few benefits resulting in a simpler and better treatment environment.

Reduction of Paperwork

Getting treated for any ailment can generate quite a large amount of paper not only for the patient but also for the care provider or hospital. These records ideally should be preserved for reference. When you take into account the number of patients this can easily amount to a humongous task in terms of sheer physical work, let along the responsibility of ensuring their safety and confidentiality. An electronic health record system eliminates most of the paperwork and can be extremely useful in giving easy and fast access to information with a proper classification and search procedure. The result of this exercise will be that both patients and doctors will have almost instantaneous access to medical records from anywhere in the world without having to locating the required documents and then transporting them to wherever they are required. The vital time that is saved in accessing the medical records can put to better use by the medical staff in treating the patient and having patient interaction that is more meaningful. Electronic records also ensure that the content is legible and not open to any misinterpretation by doctors trying to read often very difficult-to-read handwritten documents.

Reduction of Erroneous Drug Prescriptions

A sophisticated electronic health record system also enables doctors to prescribe drugs electronically. The process automatically compares the medical history of the patient and generates an alert if the drug being prescribed is not suitable for the patient. This electronic system acts as a surveillance system over the doctor’s actions and prevents erroneous drugs from being prescribed. This system acts to substantially prevent a lot of patient distress and hospitalization stress and expenses that would have easily occurred. The electronic health record system also enables doctors to compare between the various drug compositions offered by various manufacturers to select the most appropriate or even suggest a generic alternative that saves money. If you wish to know more, you could browse through recent HFA.co.in guide on DMR's.

Better Care Coordination

In complicated cases, the patient is often attended by a number of specialists, who will need to maintain independent records in the absence of an electronic health record system. Since it may be very difficult for doctors to keep on comparing notes on the diagnostics they may have ordered, it may so happen that the patient undertakes the same test a number of times resulting  in a complete waste of time and money. An electronic system of maintaining health records that can be shared online by multiple doctors can be extremely effective in implementing a treatment plan that is collaborative and effective.

An Effective Tool in Preventive Care

It is a common and unfortunate human foible not to undertake medical checkup tests and screenings unless there are some symptoms that have already manifested themselves. When there is an electronic medical record system that is online and accessible by people with portable connected devices, they can be easily reminded of tests that are recommended keeping in mind the profile of the person, his age, sex, family history, his own medical history, etc. Reminders may be sent to the patient in a variety of ways such as email and SMS to enable him schedule an appropriate appointment. The incremental cost of implementing these warnings is miniscule whereas the potential benefits are unimaginable. Learn more about the importance of digitized medical records by instructables.com.

5 Effective Ways To Study Human Anatomy

Every medical student has to pass through the gauntlet of anatomy lab. Whether or not this is relevant to a modern medical student is debatable, but the rite of passage persists. This guest post by Krystle discusses several ways to enhance your anatomy study techniques.

Human Anatomy has to do with the study of the structure of the body which includes cells, tissues, organs and systems.  It is usually coupled with the study of physiology which is the study of how biological processes function within a living body. The reason being is that in order to understand the various parts of the body properly, it would make sense to have a knowledge of the functionality that they each carry out.

Anatomy can be one of the most daunting subjects for early-year medical and nursing students because of the magnitude of parts that are covered in the human body. A recollection of the technical terms used can prove overwhelming unless proper systems are implemented to assist the mind in recalling each part and function. It is better to strategically approach this study for successful retention of content. The human body consists of 206 bones held together by over 600 muscles, and knowing all this in detail does require above ordinary skill. It is with this that we have put this piece together to assist the Anatomist in absorbing the knowledge of the beauty and intricacies of the human body.

Understand Body Language

In this context body language has less to do with human attraction than it does the syntax and tone – the pronunciation of the words that make up each body parts labeling – so that information is always easily accessible. Having a standard for anatomical terms also makes it easier when communicating those terms. Look at prefixes and suffixes for example; those used in anatomy generally follow a pattern that once understood is like unraveling a scientific code that leads to better retention. Examining the brachiocephalic artery for instance, can tell you what it is, where it’s located and its function if one understood the language of anatomy. That language would tell us by prefix that brachio is a reference to the upper arm, and cephal has to do with the head, and with a general understanding of arteries – a blood vessel that carries blood away from the heart – it’s then simpler to make connections that may infer that the brachiocephalic artery is a blood vessel that carries blood to the such regions of the body as the arms and head.

Look at the thing

One of the best ways to study human anatomy and physiology is via the use of either physical or digital study aids. These come in the form of flash cards, handy interactive 3D apps, charts and beautifully illustrated e-learning platforms designed with medical students in mind.

Flash cards are by no means a replacement for detailed book-content but they quickly assist your mental capacity to draw for information. Specific to anatomy are e-learning gateways such as Kenhub’s Library of Anatomy which covers information such as the upper and lower extremities of the body, the trunk wall, head and neck, thorax, abdomen & pelvis and neuroanatomy. Utilizing resources such as the afore-mentioned, can dramatically improve your ability to obtain better grades in human anatomy courses. Platforms such as this one provide quality illustrations of anatomical structures in a detailed yet easy to remember manner.

Looking Deeper

Now if ever you’re in the position to be able to look at models of the human body don’t hesitate to. Perhaps it’s a model in class, or you may be privy to viewing certain operations in a medical facility. Any chance you get to peer at the human dissections gives you an opportunity to see and recall all the things you’ve been studying. You may not be fortunate to be able to see man-made models, or worse, the real thing, and so you can practice drawing parts of these models and labeling them on a board or on sheets of paper wherever possible. You will find that being able to constantly re-imagine the systems and body parts and to call them out on your own, as if teaching yourself, goes a long way in retaining the material. Having someone close by to talk to while doing your demonstrations helps meditative retention immensely as well.

Pick your brain

Any system that offers quizzes are good for keeping your mind focused on anatomy and physiology. Most popular 3D apps come with these and others are easily found online. By constantly training your mind to remember even short questions on a particular body system or function, helps to boost your memory of it. And remember, when you find that you don’t have your usual quiz materials handy, from just your memory, draw diagrams, label them, and then quiz yourself orally.

Always Review

The importance of reviewing cannot be understated. Not only should you review all that you have studied, but if there’s an anatomy review session by your tutors, make yourself available.

Simply put, anatomy students need to re-read, review illustrations, re-draw, re-contemplate, and review short quizzes, and take breaks from studying. It’s never best to cram this information but to moderately and consistently go back to the content. In the end you will acquire knowledge far greater than any amount of information-hogging could accomplish; your ultimate aim being knowledge and mastery of the art of the human body and functionality.

Krystal Crumbie is an Anatomy Geek at Kenhub.

The DSM-5 on the USMLE: What Should You Know?

Wondering how the new DSM will affect the Step exams/ Check out this guest post from Vincent Stevenson to find out more details: 

The American Psychiatric Association officially released its latest version of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, in May 2013. The APA made several significant changes in to the diagnostic criteria in the DSM-5 even changed several diagnostic categories themselves. While these changes will have broad effects on the practice of psychiatry, the more immediate concern to medical students and recent medical school graduates is the effect that these changes will have on the USMLE boards.


The USMLE’s Stance on the DSM-5
On November 4, 2013, the United States Medical Licensing Examination directors announced that they would be moving from the DSM-IV to the DSM-5 immediately. However, since Step 1, Step 2 CK, and Step 3 of the USMLE are each derived from a large pool of questions developed over a long period. In actuality, the transition between DSM versions will actually be far from “immediate.” In fact, the USMLE publishers acknowledge that the complete change will likely take several years.

According to sources at the USMLE, the first goal was to purge questions from the existing content pool that are based on the DSM-IV. In fact, they have insisted that any psychiatric diagnosis content not based on new, DSM-5 criteria has already been eliminated from all three steps of the USMLE. On the other hand, they admit that the transition clinical psychiatric terminology from fourth to fifth edition standards will merely begin in 2014. So it is quite possible that someone taking a USMLE exam within the next three years may be tested on questions from both the DSM-IV and DSM-5.


What is new in the DSM-5?
One of the main changes (mostly important for clinicians and those who are interested in billing for psychiatric services) is that the axis system of the DSM-IV has been largely revised. The DSM-5 now follows a multiaxial system in which diagnoses from Axis I, II, and III are all included on a single “axis” for purposes of diagnostic coding. Axis IV and Axis V, as they were known previously, have been eliminated. Clinicians now use a rubric called “dimensional assessments” to assess the severity of the particular patient's symptoms or disorder and response to treatment. For medical students studying for the USMLE, changes in terminology will be the greatest “high yield” topics.

Intellectual Disability
An example of a change in terminology is that the DSM-5 no longer uses the term mental retardation. The term mental retardation is potentially pejorative and offensive to some people. For this and other reasons, the term mental retardation has been replaced by “intellectual disability.” Intellectual disability is a condition in which deficits in cognitive ability first occur during development and are consistent with a mental disorder as defined by criteria listed in the DSM-5.

Attention-Deficit/Hyperactivity Disorder
The diagnostic criteria for ADHD are largely similar in the fifth DSM version. The 18 symptoms listed in the DSM-IV are still used in the newest edition and are split into the domains of inattention and hyperactivity/impulsivity. It is now possible for patients to be diagnosed with ADHD and autism spectrum disorder at the same time. There have also been some changes with the age cutoffs—in essence, younger children need to exhibit fewer symptoms in early life in order to meet new diagnostic criteria.

Schizophrenia
The diagnostic criteria and guidelines for schizophrenia have changed rather significantly with the recent update. Because they are not useful from the diagnostic or treatment perspectives, schizophrenia subtypes (e.g., paranoid, catatonic ) have been eliminated from the new edition. Patients must exhibit at least one of the so-called positive symptoms (delusions, hallucinations, or disorganized speech) in order to qualify for a diagnosis. Also, some of the more structured requirements for hallucinations or delusions have been eliminated (e.g., bizarre delusions).

Bipolar Disorder
The biggest change to bipolar and related disorders is in Criterion A. Specifically, patients do not need to exhibit "classic" symptoms of major depressive episode and mania. Instead, the criteria has been “softened” a bit to include the concept of "mixed features." Mixed features are intended to account for cases in which mania exists with only depressive features (rather than frank unipolar depression). On the other hand, it may also apply if the patient has clear depression with some manic or hypomanic behaviors.

Depressive Disorders
The diagnostic criteria for major depressive episode have remained more or less identical between the two versions. Of note, the bereavement exclusion of DSM-IV has been eliminated from DSM-5. This means that prolonged bereavement now qualifies as major depression, essentially. Also added to the DSM-5 were a number of specifiers, especially for suicidal thoughts and tendencies.

Anxiety Disorders
Obsessive-compulsive disorder, post-traumatic stress disorder, and acute stress disorder are no longer included under the categorical umbrella of anxiety disorders. Instead, anxiety disorders are mainly limited to generalized anxiety disorder, panic disorder, phobias, and social anxiety disorder. Changes within anxiety disorders, while great in number, are not likely to be tested on the USMLE because they are somewhat subtle. That said, it is important to note that panic disorder and agoraphobia represent two separate diagnoses in the DSM-5. Moreover, patients are no longer required to recognize that their anxiety is excessive or unreasonable. The newest edition requires only that the anxiety is out of proportion to the realities of the provocative situation.

Trauma- and Stressor-Related Disorders
This category is the new home to posttraumatic stress disorder and acute stress disorder, among others. It has undergone broad changes – perhaps as dramatic as any section of the DSM. The diagnosis of acute stress disorder, for example, no longer contains some of the more restrictive stipulations of earlier versions. Patients may qualify for a diagnosis of acute stress disorder if they exhibit 9 of 14 symptoms in certain diagnostic categories.

PTSD has changed dramatically in the DSM-5. Clinicians must specifically identify if the trauma was experienced by the patient, witnessed by the patient, or in some other way in directly experienced. There are four symptom clusters rather than three, including re-experiencing, avoidance, persistent negative alterations in cognitions and mood, and arousal. Certain features of PTSD, such as irritable/aggressive behavior or reckless/self-destructive behavior, are now more prominent among the diagnostic criteria for PTSD.

Conclusions
Students who are planning on taking the USMLE will need to consider how to study for the psychiatric portion of the test. The makers of the USM LE have attempted to adapt to the newest edition of the DSM, but these changes will take time. Therefore, examinees should focus on the high-yield changes listed in this article. The highest yield material are changes in terminology that appear in the DSM-5. Because the questions may still come up in an actual examination, students should also recall what these terms meant in the DSM-IV. While diagnostic criteria are different in the DSM-5, especially for disorders such as PTSD, most of the questions included on the USMLE will not drill down to this level of detail. On the other hand, top students will be aware of the key changes that were made to the DSM in the most recent update and be able to answer questions based on the DSM-5.

Vincent Stevenson is the creator of Scrub Wars (www.scrubwars.com and @scrubwarsapp), an innovative medical gaming app targeting the USMLE Step I and COMLEX Level I exams.

The Ultrasound—More Than Just a Diagnostic Device

Today's guest post discusses some of the cutting edge work being done using ultrasound. 

Imagine a world where a woman can give herself an ultrasound without leaving the comfort of her own home. To anyone who has ever gotten an ultrasound, this sounds like science fiction. After all, it currently takes anywhere between 2-4 years of sonography school become a fully qualified ultrasound technician. The level of training and technical expertise required to use an ultrasound machine make it difficult to imagine a world where getting a sonogram is as easy as taking your own temperature.

According to Paul Carson, a professor of radiological sciences at the University of Michigan, sonography machines will someday be among the many medical appliances that have made their way from our hospitals into our homes. If the current rate of technological development continues, we could have hospital quality, at-home sonogram technology within the next twenty years.

At-home sonogram technology won’t render ultrasound technicians obsolete any more than at-home thermometers rendered nurses obsolete. That said, the rapid rate at which sonogram technology is advancing could redefine the role that ultrasound technicians are expected to play.  

There are many medical professionals, for example, who believe that ultrasound technology could one day become the foundation for entirely new types of surgery. A team of scientists at the University of Michigan, for example, has recently pioneered a technique they’ve labeled “histotripsy”. 

For those who haven’t heard of it, histortripsy involves using high-intensity ultrasounds to create and break apart microbubbles, which fragments cell-tissues with a high degree of accuracy. Doctors could theoretically use histortripsy to target and destroy damaged cells while leaving healthy cells intact.

Other doctors are experimenting with ultrasound technology to develop more effective methods of drug delivery. One of the experiments that Professor Carson’s team is conducting involves injecting inert liquid droplets into the body, then vaporizing those droplets with targeted ultrasound blasts. 

There are two benefits to this new process. First, an active drug contained within an inert liquid droplet is exposed, but only in the part of the body targeted by the ultrasound. Second, doctors can deliver much higher doses of drugs without having to worry about side-effects that would otherwise be present.

If these experiments are successful, it could expand the medicinal role that ultrasound technicians are expected to play. People would begin to rely on ultrasound technicians for both diagnosis and treatment. The implications of these technological trends are all too obvious—if you’re considering become a ultrasound technician, there’s no better time than now.

Arthur Posey is a retired guidance counselor who now spends his days as a freelance blogger. Given his wealth of experience in the field, Arthur frequently writes about the importance of pairing students with the right trade school. When he's not doing that, Arthur is likely to be found rafting on his favorite rivers or working on his motorcycle.

Ultrasound Technician Online Classes

Our guest post today talks about the exciting field of ultrasound and online ultrasound technician classes: 

The field of ultrasound technology is focused on utilizing advanced equipment to direct sound waves into a human body and analyzing the outcome images to diagnose medical ailments. Ultrasound technicians, also known as sonographers, must be well acquainted with sonographic instruments as well as human anatomy and the physics. Online ultrasound technician course offers students insight into different sectors of sonography including echocardiography, abdominal sonography, ob/gyn sonography, and vascular sonography. These courses allow students to improve their critical data analysis, manual dexterity, administrative, communication, and computer skills.


Knowledge Gained

Online ultrasound technician classes offer students with knowledge in various sectors, including:

• Abdominal Sonography: Students may learn to use noninvasive imaging to detect and analyze medical ailments within the organs and structures of the abdominal area. This area of study includes the spleen, kidneys, urinary bladder, pancreas, gallbladder, and liver. 
• OB/GYN Sonography: Classes concentrated on ob/gyn discuss the fields of gynecologic sonography and obstetric sonography. The gynecologic sonographic deals with the organs of the pelvic region, while the obstetric sonography examines the progress and condition of an expecting woman and her fetus. 
• Vascular Sonography: The vascular sonography classes teach students about the pathology of the veins and arteries of the human body. Students learn to diagnose the diseases of the blood vessels that can cause conditions such as aneurysms, strokes, peripheral arterial diseases, and pulmonary embolisms. 
• Anatomy and Physiology: Anatomy and physiology classes teach students about the structure of body. Through these courses students become familiar with respiratory system, circulatory system, skeletal system, functions, placement and appearance of organs, and many more. 
• Sonographic Instrumentation: Students learn about the physics and different advanced sonography equipment. Typically the coursework of sonographic instrumentation include digital imaging station, EKG machine, and ultrasound transducer/probe. 

Skills Developed

The online sonography classes help students to develop their skills in various areas including:

• Communication: It is a must for potential ultrasound technicians to master the medical dialect. They must be able to communicate properly in a hospital setting, deal directly with patients, and convey the condition of patients to superiors properly. 
• Administrative: Students learn to do the administrative tasks which go along with the technical activities. They learn how to prepare various reports, record results, participate in the maintenance of laboratory accreditation, and organize tight schedules for the specific machines. 
• Computer Skills: The computer classes teach students about the current medical technologies. Students are taught about the software which is required to create ultrasound waves and turn them to proper digital images. 
• Data Analysis: Students learn how to analyze and interpret the data returned by the ultrasound frequencies and differentiate between pathologic and normal findings, as well as the different sorts of phenomena that can take place during imaging such as propagation artifacts and attenuation artifacts. 
• Dexterity: Students learn to manipulate the transducer around different areas of human body, maintain advanced sonography equipment, and take care of other related health care materials. They are also taught to place the patients in proper position for imaging procedures. 

Kenneth Miller is a career counselor and a blogger. He has written lots of articles about online education and training. Find out more on his blog.

How to Get into Med School The Second Time Around

This guest post sheds some light on those of you who are reapplying to medical school: 


The first time you attempted to go to medical school, things didn't really work out so well. For whatever reason, you either did not make it there, or you left before you could finish. Now, you are ready to try again. If this sounds like you, check out these tips, because the process may not be as straightforward as you think.

Brush Up
If it's been some time since you last attended a college course, you need to brush up on those hard sciences. This will facilitate success on both your application and your eventual coursework. While you may not need to take every single class over again, you should pay particular attention to those courses in which you didn't do well. Perhaps you didn't get into medical school because your grades were low, and now you have an opportunity to fix these problems. To save money, find out if the school will accept community college credits. It's key to remember that med schools are looking for big improvements. If you earned a B in Organic Chem, shoot for nothing less than an A. Simply upgrading to a B+ won't do much for you.

Study, Study, Study
The MCATs are a huge part of getting into medical school, so you must be prepared. Remember, in order to score well on the MCATs, you also need to sharpen your writing skills. Enrolling in a class specifically designed for medical school students is the smartest thing that you can do. If you took the MCATs the first time you tried to get into medical school, think about what might have gone wrong on that particular exam. Even if you did well, your score should improve, at least marginally. The last thing you want to do is get better grades and more life experience, but do worse on your MCAT.

Gain Practical Experience
Speaking of which, how can you help yourself if your grades are low and you don't think they're going to improve? In all honesty, it will be tough to get into medical school with sub-par grades. Furthermore, it may be a sign that you won't do so well once you're there. However, if they are hovering somewhere that you still think you have a shot,, adding on more practical experience could certainly be of help. Try to attain an internship in your desired field. Since you probably have a bachelor's degree in an associated field, look for job openings that require the use of your skills. When medical schools see that you have practical experience in the field, it's a sign that you're serious and can see yourself there everyday. However, this can definitely reach a point of diminishing returns. If you've already got great internships, part-time jobs and more on resume, consider something big. How about a year volunteering in a medical clinic in Africa? You want to stand out - don't let yourself fall between the cracks of generic candidates with a 3.56 GPA, a few years as a CNA and 29 on the MCATs.

Set Realistic Expectations
Knowing what schools you can reasonably get into is a major part of succeeding in your application endeavor. For example, when your grades and MCAT scores are just average, you are probably not going to get into the top medical school in the country. Of course, you can still submit your application, but you should have some more practical choices lined up in there as well. Talk to your college adviser or find out if the campus career center has any information to offer you. You want to be sure that you are applying to a wide enough range of schools that you actually get into one of the programs you want. You may need to apply to international schools in the Caribbean if you really want to be a doctor.

Stepping Stones
Sometimes, you need to take a step back to really set yourself apart. Consider applying to a PA, Nursing or MPH program. If you know you have the skills to succeed there, you could do well in the degree program, get a few years of experience, find solid recommendations and then come back to earn your MD within a few years. It may not sound practical, but it may exactly what you need to be successful.

You might feel a little bit discouraged since you did not get into your intended program the first time you applied to medical school. However, you shouldn't give up hope. Instead, think a little bit harder this time around and figure out exactly what you need to do to succeed. Always, always, always meet with professional advisors to be sure you're putting your best self forward!


Jackie Taylor writes about education. Her recent work is on online health informatics degrees.

Overcoming The Biggest Hurdles in Med School

Briani Delgado writes today about some tips to getting through medical school:

As you probably know, medical school can be overwhelming. You're going to face some pretty difficult obstacles, and you might not know how to get through them. However, by employing the following tips, you should be able to accomplish your goals. Here's what to keep in mind:

Support System
Trying to get through medical school without a support system isn't something anyone should try. For example, if you're preparing for an exam, working with a study group is always a smart idea. When you all have questions about a particular topic, you can overcome them together. Of course, you'll be busy with your schoolwork, but you don't want to cut off all of your family members and friends either! They can be a huge source of support on your journey.

Refresher Courses
Sometimes, you might find that the subject matter is just too much for you to understand, and you wind up withdrawing from that course for a particular semester. Before doing so, find out what your school's policies are on withdrawals and if they can negatively affect you later. Before you attempt to take the class again, taking a refresher course would be wise. Your school might offer them, or you may be able to find them at a local community college.

Talk to Professors
Yes, it can be intimidating to tell your professor that you don't understand what is going on. This fear is especially pronounced when you're competing against so many other intelligent individuals. However, your professors can be a valuable source of information, and they can help you to be successful. If you;re having difficulty with a particular subject, ask your professor how you can learn more about it. Professors might be able to recommend tutoring services or other programs, and they generally have office hours during which you can speak to them about your concerns. They want you to come in - who knows, these could lead to great connections someday.

Tutoring
Some students assume that since they are in medical school, they would never need tutoring. However, tutoring can be an extremely valuable tool. Normally, an official tutor employed by your school will already have completed the class, and perhaps the biggest aspect of help they will provide you is what you actually need to learn from all the information you've been presented. They can tell you to not worry about this, focus on that, and exactly what something seemingly vast and complicated boils down to in a few points.


Briani Delgado writes about health sciences and careers. Her most well-known work is about earning an online associates in health informatics

How Is Canadian Healthcare Doing?

This guest post by William Sheffield discusses the history and current state of healthcare of our neighbors to the north:

The Canadian government takes a different approach to healthcare than its neighbor. In the U.S., the healthcare system is private - each citizen pays for his or her own medical services through insurance or out of pocket. In Canada, the physicians and hospitals are also private, however, the country employs a single payer system. Put simply, all medical services are paid for by the government.

The Birth of Canada's Health Care System

It was the shortage of doctors in the Saskatchewan province around 1946 that inspired the single payer system used by the country today. By 1972, all provinces had complementary programs.

Around 1977, the federal government found it necessary to create a single plan. Having each province design its own health care system was cumbersome. In 1984, the Canada Health Act streamlined the process further.

About the Canada Health Care System

The Canada Health Act set criteria for the system in each province but has left management in the hands of the local governments. The Act states that medical insurance must operate on a non-profit basis. Doctors and hospitals remain for-profit businesses.

Canada supplies a physician-to-population ratio much like other countries, but employs more practicing nurses than the U.S. There are significant drawbacks to this approach in both countries. The most common complaint is wait times. The Canadian government addressed this issue in 2010 by establishing Patient Wait Times Guarantees to limit the amount of time a patient could be asked to wait before being treated.

Does the Canadian Health Care System Work?

In the sense that all residents have access to medical care, the system works. In the U.S., people without insurance can be denied help in non-emergency cases. The quality is also comparable to other countries. Statistics from the journal Health Affairs scores Canada healthcare at the same level as other countries including England, Australia, and the U.S. when looking at in survival rates for cancer and wellness care.

One of the most effective benefits of the Canadian approach is the distribution of funds. The bulk of a payment goes for medical services, not to the administration. The U.S. has allowed politics to clog their healthcare facilities. Over-administration takes funding away from service providers, driving up the cost of medical care to patients.

The Drawbacks

Canada has one of the most expensive healthcare systems in the world. Other healthcare systems, especially those in under-developed regions, provide quality care for less money. That is the principle behind medical tourism--people travel to these areas for surgeries that are prohibitively expensive at home.

Even with the changes made to reduce wait times, Canadian residents still have problems getting timely access to services. Part of the reason for this is the inflexibility of the system. It is difficult for the government to stay on top of all the issues because the program is so massive.

Above all things, the health care system in Canada must remain financially viable and that makes the decision-making process primarily political. The government is deciding what it can and cannot do based on budgeting restrictions. This limits the care offered to the Canadian public and forces them to look elsewhere for service.

It is safe to say that there are good and bad aspects to the universal health care system offered in Canada. The government is attempting to improve it, but the vastness of the program makes management difficult.

William Sheffield is a freelance writer who focuses on health insurance, medical science, medical education, the medical profession and other related matters. Those looking into health insurance in Canada should consider the coverage options at Kanetix in order to obtain a desirable deal.