Wednesday, November 24, 2010
With all the traveling for residency interviews, the ever-increasing invasion of privacy that is the TSA is starting to become more than just an annoyance. They either get to get to look at you naked (via a body scan) or perform a "heavy" pat down (i.e. grope your genitals... or in some cases, cause your urostomy bag to spill urine all over you). A lot of people are afraid of radiation exposure with the body scans, but (based on how little radiation is emitted by X-rays that can actually see your bones) I'm not so worried about that (though I wouldn't go through them if I were pregnant or had any chance of being pregnant). It's more the invasion of privacy. The government has no right looking under everyone's clothes. It's humiliating and unnecessary. The other option (being groped) is no better. But, if someone is going to take away my dignity, I may as well make them do some work. I'm a little disappointed that the planned pre-thanksgiving protest of refusing to be scanned (and thus, backing up the security line) didn't pan out, but I plan on getting to the airport early just so I could make those useless TSA agents get off their asses and work. Also, I plan on getting them to change to new gloves (who knows how many other people's genitals they've groped with the same glove?).
This is even more upsetting because it really doesn't do much to prevent a terrorist. It's all a show that isn't impressing anyone. It's much easier to do all the work behind the scenes from the moment a passenger books a ticket, but I'm sure the government is afraid that people will think that they aren't doing anything to keep them safe. I'm glad that people are finally starting to protest, but, like with all other steps TSA has introduced, (take your shoes off, no water, etc.), I have a feeling people will fall in line, because it's just easier to.
Friday, November 12, 2010
I feel that most residency programs want a token amount of research in your background, but would rather not have your clinical training soiled with research. As such, someone with a background like mine actually has a big disadvantage. With average grades and boards scores my strength is in my productive research (and recommendations). This leads to a strange situation in which some mid-/lower- tier programs decide not to offer me an interview (I assume because they think I will go to a research heavy institution) and many upper-tier programs decide not to offer me an interview (I assume because of less than stellar grades/boards score). I end up with a small number of fairly random interviews with some of the best and some mediocre programs. Of course, maybe I'm just trying to rationalize a (essentially) random process. Anyway, another week or two of potential interview invitations, but I'm feeling a bit more pessimistic now than I did a few months ago.
Tuesday, November 2, 2010
Wednesday, October 27, 2010
Friday, October 8, 2010
One thing I'm really glad I managed to do was to take a large chunk of time off in December and January (prime interview season). With the number of interviews I hope to get (and an equivalent number of intern year interviews since I want to be in the same city for both), I will be traveling all the time. Our school only lets us take off one day per week of class for interviews and (by my calculations) I would have to break that rule to fit in the number of interviews I hope to get. Some classmates who don't have the time off are wondering how to deal with this dilemma. Since the med school administration always strictly adheres to their rules (and no amount of logic will let them change it), the best option is to either call in sick or ask your resident/attending and not bother with the administration. Nonetheless, the administration may find out and you'd have to deal with their fury.
Tips to any future medical student:
1. It's best to plow through 3rd year and free up 4th year for easy rotations/research/time off so that you could focus more on residency applications and interviews.
2. When it comes to needing time off, follow the old adage: It's better to take the time off and apologize afterwords than to ask for permission and not get it (because you won't get it).
Wednesday, September 22, 2010
Wednesday, September 15, 2010
Just for those that don't know (and for me when I look back at all this craziness), the whole residency application process starts with completing an application at a central computerized program, uploading a personal statement about why you want to go into the field you chose, and uploaded grades, national boards scores, letters of recommendation by your medical school. The application goes out to any program you want to click on. This makes it really easy (but pretty expensive) to apply to a lot of programs. Once the you choose the programs, the waiting game involves waiting for them to download your application, go over it, compare it with other applicants and decide to send you a short e-mail that they like you enough to see you in person. This process can take from a few days after submitting for some programs to several months for others (which results in applicants agonizing over whether they got interviews all through the fall and into the winter). Next, you interview at the programs that choose you. Then, by sometime in February, you make a rank list indicating where you want to end up the most from the programs that interviewed you. Finally, on March 17th (this year), the "match," based on your rankings and the rankings of their applicants by the programs you interviewed at, decides where you'll end up for residency. I still don't know how the match exactly works, but (like almost everything in med school), I'm sure I'll figure it out when I get to it).
Tuesday, September 7, 2010
Edit: Make that, if you wanna look stupid, give attention to a nut that wants to burn books. Seriously, that guy not only just increased his influence about 1 million times, but there will be hundreds of copycat nuts out their trying to get their 15 min. I don't care that it's the Koran, it more that the media and the government has elevated this guy's voice to an international level. A simple "who the hell are you" and "who cares" would have shut him up easily.
Saturday, August 28, 2010
(best quote: [James Dupree - the lead singer] once had been asked, "How the hell can you play a chainsaw?" to which he responded, "How the hell can you not play a chainsaw?")
Thursday, August 26, 2010
This just points out the fact that most science/health reporters suck. They are trained as journalists, not scientists, but they have no problems making conclusions about science/medicine without actually knowing what they are talking about.
Wednesday, August 18, 2010
|The Daily Show With Jon Stewart||Mon - Thurs 11p / 10c|
John Oliver: You can build a catholic church next to a playground. Should you?
This whole ground zero mosque nonstory, noncontroversy is basically right-wingers being racist and trying find a way to get attention from their failures in time for November, the media gladly complying with whatever they say, and the democrats hemorrhaging votes by feebly attempting to make the fake outrage die down.
Tuesday, August 10, 2010
It's worth watching all 14 minutes of it, if only to make sure you never live in the Southwest (of course, the US kicks ass at this game).
Wednesday, August 4, 2010
There are a lot of science journals that have been publishing pure crap (I suppose in order to get more readers) and it really diminishes their value. Not quite this bad, but even bigger named journals like the New England Journal of Medicine have been trending towards legitimizing pseudoscience, such as this recent review of acupuncture (discussed by Orac). A few years ago, I actually got in an argument with an editor from the American Journal of Health-System Pharmacy because they published a letter to the editor that used a posting from prolifeblogs.com to support their argument against the availability of over-the-counter emergency contraception. The response I received from the editor was that they can't be selective against the literature their contributors cite (yes you can! And, a blog post can't count as scientific literature).
So, similar to my post on companies that underhandedly promote religion, I want this post to include a (probably) growing list of scientific journals that aren't exactly scientific:
Journal of Cosmology
The Open Information Science Journal - accepted a fake paper without review from a couple of people from MIT claiming to be researchers at the "Center for Research in Applied Phrenology" (CRAP) - as long as they sent an $800 check to an address in a tax-free zone in the UAE.
Has Ulterior Motive:
Australasian Journal of Bone and Joint Medicine (sham journal for Merck provided by the supervillain of scientific journals: Elsevier).
The Journal of Global Drug Policy and Practice - funded by the Department of Justice and only publishes "research" that shows that punishing people is the only way to reduce drug use.
Ignores scientific process for publicity/money/religion:
An exhaustive list of preditory open-source journals can be found at Scholarly Open Access
American Journal of Health-Systems Pharmacy
American Journal of Surgery
British Journal of Psychiatry
Journal of Medical Hypotheses
Social Science Research
Southern Medical Journal
... and more coming when I get the chance to get to them.
Sunday, July 25, 2010
We've been going to the library and randomly grabbing children's books to read to mxh jr (he has no idea what they're about, so any book will do), and we happened to grab a book called "King and King," about a prince who needs to get married and can't seem to find the right person. All the princesses don't cut it out for him. Finally, he sees the person of his dreams (and from the title you could guess that it wasn't a princess). Pretty cool. It's about time that children get exposed to all types of relationships and learn that love isn't about gender.
Of course, some people aren't happy to see this book in libraries. The Amazon reviews bring out some less-than-enlightened reviews. And someone tried to sue a school for having the book, claiming that "the book in school constituted sexual education without parental notification." Pretty lame... with that logic, you'd better get rid of every other book that ends with "and they lived happily ever after." Luckily, the judge threw the lawsuit out saying, "Diversity is a hallmark of our nation."
Thursday, July 15, 2010
Tuesday, June 29, 2010
Oh well, at least I'll never have to deal with fake patients anymore.
Tuesday, June 15, 2010
This article is a pretty funny (but in my experience true) description of how some doctors justify their treatment plans. My favorite:
Eloquence based medicine---The year round suntan, carnation in the button hole, silk tie, Armani suit, and tongue should all be equally smooth. Sartorial elegance and verbal eloquence are powerful substitutes for evidence.
Wednesday, May 26, 2010
The one thing I learned from the paper: In the UK, GERD is called GORD (gastro-oesophageal reflux disease).
Friday, May 21, 2010
Ms. X is a 80-something year-old woman with congestive heart failure, high blood pressure, diabetes, rheumatoid arthritis and asthma (among other things). She on about 15 medications that adds up to nearly $4000 a year. Unfortunately, this falls right in the middle of the famous donut hole of Medicare Part D (the prescription coverage part of medicare). I never really thought much about it until I saw how this affects Ms. X. Here’s Medicare Part D’s payment schedule from 2010:
If your drugs cost between $2830 and $6440 per year, you get no coverage, but if your drugs cost more than $6440, you get 95% of it covered by medicare. This makes absolutely no sense to me. I was wondering how the hell this came about and it turns out that it’s the consequence of two separate coverage plans (one clearly made completely independently of the other). There’s Medicare initial drug coverage that covers 75% of all drugs on the formulary from $310 to $2830 (there’s a $310 deductible). Above $2830 there is no additional coverage by Medicare’s initial drug coverage. However, if you have to spend (out of pocket) more than $4550 (that’s your prescription drug costs go over $6440) Medicare’s catastrophe coverage kicks in. At this point, Medicare pays 95% of anything that goes over. Medicare does have an “Extra Help” program that includes coverage of the donut hole, but you have to make less than $16245 a year to qualify (not really much). Ms. X is a widower who rents an apartment in town. She has an income of about $18000 a year. She makes too much to qualify for the extra help. She can’t really afford to pay an extra $60-$80 a month that the extra “gap coverage” insurances cost. Now, I don’t spend much money, but I know that you really can’t do much on $18000 a year, especially if you have numerous chronic medical problems. Ms. X has gotten to the point that she is not eating well, she’s not filling some of her prescriptions and has even resorted to taking her son’s albuterol (he has private insurance) for her asthma.
Luckily, the healthcare reform package that recently passed will start closing this donut hole, but it looks like it won’t be until 2020 before the gap is completely closed. I’m not sure why it should take 10 years to fix it. I’d bet that none of the people who set this system up or who decided that it's ok to wait 10 years before closing the gap have an 80 year-old grandmother who steals their albuterol.
Thursday, May 20, 2010
Thursday, May 13, 2010
Anthem coffee shop in Tacoma, WA
Chik-Fil-A (aah! Making employees pray and Christian-themed toys in their children's meals... that's pure evil!)
Chymorvah bed and breakfast in Marazion, Cornwall, England
Domino's Farms in Ann Arbor, MI
Florists in Cranston, RI
Forever 21 (owner likes to demonstrate his faith by putting a bible verse on bags)
Oklahoma Joe's Bar-b-cue in Broken Arrow, OK (breaking its agreement to donate to Camp Quest after taking profits from supports).
Prometric (testing center was playing Christian radio in the waiting room... not what I want to hear just before I start taking Step 2).
Korte & Luitjohan Contractors in Highland, IL
Sting Ray Cafe in New Bern, NC
Trijicon (Hidden Bible verses written on military weapons).
Tyson Foods (thousands of chaplains "serving" their employees)
United States Postal Service (somehow packages that say atheist on them tend to get lost)
US Plastics sends religious messages to their customers
Voss Lighting Company of Lincoln, NE
Weingartz Supply Co. in Ann Arbor, MI
Wyndgate Country Club in Rochester Hills, MI
This is a slowly growing list. If you have any additions, please let me know.
Wednesday, May 12, 2010
Sunday, May 2, 2010
Tuesday, April 27, 2010
Friday, April 23, 2010
Just for fun, here's something amusing that happened during the rotation:
Attending (while talking to a crack addict that didn't want to stop): You need to stop smoking rock and get addicted to something else. Like this (shows a picture of his cat). You can start getting high off of this.
Me (later): Dr. X do you watch South Park?
Me: Do you remember the episode where they get high off of cat urine?
Attending: It's called cheesing.
Attending (later, to patient): You should probably ignore what I said earlier about getting high off your cat. It's called cheesing and it's bad.
Monday, April 19, 2010
Of course, the administrators don't really remember being students, so they've implemented things like quizzes that ask questions about topics that were in the readings, but not exactly important to clinical practice or (rumor has it) actually make sure that you've clicked on and watched the entire 26 minutes and 13 seconds of the video that is posted on line. This is what happens when you lose sight of priorities... so, if you'll excuse me, I've got to play another video at 2X speed with the sound muted in the background.
Wednesday, April 7, 2010
A bacon cheeseburger with a Krispy Kreme donut as buns. Looks like I have a good reason to apply for residency in St. Louis.
Friday, April 2, 2010
This sickens me. I would hope that other doctors in the area realize that he's an asshole who won't treat his patients equally and refer their patients with urological problems elsewhere.
(part of me thinks, I'm glad that he's advertising his idiocy and losing patients)
Wednesday, March 31, 2010
Thursday, March 25, 2010
Later in the week I talked to a medical ethicist at our institution about this. He didn't say anything clear cut. But, he reminded me that confidentiality can be broken if the information we reveal has a high probability of saving the patient's life or the lives of others. So, assuming she's telling the truth (not sure if she is) and there is a high probability that the taxi driver would rape again (and statistically speaking, it is), ethically we should have reported the incident. Is that right? I'm still on the fence about this. I just hope I don't hear anything about a cab driver raping someone else on the news.
Friday, March 12, 2010
Thursday, March 11, 2010
Monday, March 8, 2010
2. Productivity: You got the logistics down. You've gotten to know how the system works. You're actually being useful to the team. You're actually learning from your patients. You know when to go home without asking.
3. Burn out: You're getting tired of the routine. You're getting tired of the busy work. You're less excited about the day. There are less learning opportunities during the day. You look forward to going home.
4. Numbness: Your mind is elsewhere and your goal is to just get through the day. Unless something really exciting happens, you're not gaining much from the rotation. You find ways to get out early.
This is kind of a tongue-in-cheek thing, but for some rotations it's definitely true.
Friday, February 26, 2010
Resident: You guys can do whatever. But stay in the hospital. We're getting an interesting patient soon. I'll page you guys when she gets here
Students: OK, thanks.
5 hours later, no page... students page the resident... no response, students go home
The next day:
Student: Did the patient get here yesterday?
Resident: Oh yeah, she cam at one (2 hours after he said he'll page us).
Student: Did you get my page?
Resident: Yeah, I already took care of the patient by then.
I know the resident has more important things to think about, but med students really, really appreciate it when someone keeps them in the loop (especially when they say they're going to).
Wednesday, February 17, 2010
Monday, February 15, 2010
WTF? Just because you have an MD doesn't make you any more worthy of the hallways than us. (I replied with "Kiddos? I'm probably older than you!")
Later that week we were all sitting in a room with other residents and attendings, when the same resident walked into the room and said, "Med students, get out of your chairs. I need to work." Granted she may have been doing some important work, but she could treat the students like human beings and ask nicely, rather than ordering us to give up our seats as if we're second class citizens.
There are lots of simple things that residents and attendings could do to make med students enjoy their time in the hospital better. The easiest one is to treat them like normal human beings. I hope I'll treat my students better.
Sunday, February 7, 2010
Friday, February 5, 2010
Wednesday, February 3, 2010
Ten of the original 12 authors of the study retracted their support for the study and its interpretation. In 2004 the Lancet published a retraction. However, it was only a partial retraction, and the study remained as part of the published literature.
10 out of 12 authors wasn't enough to fully retract it?
Monday, February 1, 2010
Will I go into it? Not sure yet. Radiology is still winning, but peds neuro is a quick second. The training in peds neuro is a little strange (for most people, 2 years of peds, 1 year of adult neuro and 2 years of peds neuro - you have to go through two different matches). Also, I'm not completely sure if I really like the pediatric population... we'll see, my peds rotation is next. Stay tuned.
Friday, January 22, 2010
Tuesday, January 19, 2010
Dan, a chiropractor father of a fussy baby, came up with this fuss fixer. Hold baby at his hips and swing him upside down at sixty beats per minute, like the pendulum of a grandfather clock. According to chiropractic research, upside-down swinging has a calming effect.
Yikes... how did that research get IRB approval?
Sunday, January 10, 2010
Sunday, January 3, 2010
Saturday, January 2, 2010
See National Geographic's In The Womb specials for more cute animal fetus pictures.