Speaking of creating a match list, NYT had a great article on a national kidney transplant registry and how they are creating chain kidney transplants. A pay it forward of altruistic organ donations. Check it out if you have time, 60 Lives, 30 Kidneys, All Linked

I found it interesting during the interview tour to see how people transported their suits without getting it wrinkled. There were a variety of methods, so I thought I would share some popular ways of travelling with a suit.

One word of advice, you should always have your suit on hand with you for your interviews. Never check it in as luggage, the last thing you want is to have it gone missing before your interview!

1. Fold it and Pack it in your Carry-on

This method of carrying your suit wasn’t too popular, perhaps because of the wrinkles associated with folding it. I did however, find a neat instructional video of how to go abouts folding one to have no wrinkles.

2. Use a Garment Bag

By far, this was the most popular way people I knew used to carry their suits. Most suits come with a garment bag when you purchase them.

I ended up using the generic garment bag that came with my suit.  Looking back, I should have spent $10 and bought one a few extra features. I used my bag to carry my dress shirts, jacket and pants. I also had a nicer dress coat inside too.

When you get on the plane, if you ask the attendants nicely, they’ll usually let you hang your garment bag up in the closet at the front of the plane.

Some Extra Tips

• Find a bag  that is waterproof and durable
• Get a bag that can be folded onto itself so it’s easier to carry.
• A handle and a way to clip your coat hangers is neat bonus
• It’s convenient if the garment bag has extra pockets to store your ties, tie clips, belts.

3. Skyroll Garment Bag

This was definitely one of coolest ways to carry a suit that I personally saw.

The concept is simple. It’s basically a hollow cylinder which your suit wraps around. Inside the bag, you can store all your shirts, shoes and toiletries. I think one of these things will set you back $100+ … but definitely one of the smartest ways of carrying your suit.

4. Wear Your Suit onto the Plane

If you don’t have any other methods, you could always wear your suit. But I would advise against it.

Your suit could get wrinkled and dirtied. Plus it’s not the most comfortable thing to be flying in.

In the future, I think I might get a nicer garment bag to travel in. Hopefully, I won’t have to do any other interviews until a few years down the road.

So marks the end of the CaRMS interview tour for 2012. Overall, it went a lot smoother than I expected. Flights were on time, accommodations were nice and interviews were not as stressful as I thought they would be. Next up, figuring out my rank order list. For those of you that don’t know, after the interviews, each applicant will rank the programs in their preferred order. Residency programs will also “rank” their applicants. Every rank list in the country is than submitted into a computer which will then churn all the residency matches for next year. I’ve been told the entire process only takes a few minutes. Why they make us wait for weeks for our results boggles me.

I have also been reading certain chapters from a book titled “The Ultimate Guide to Choosing a Medical Specialty.” It’s a good starting point for people who are not sure what specialty they want to pursue. I’ve been using some of the ideas mentioned in it to talk to some friends who are on the fence between specialties.

For those who are still lost on which specialties they want to do, the book (Ch 2-5) really breaks it down into how I think most people choose a specialty.

Unlike the humorous flowchart above, the first step is to decide whether you want to do something either (1) Surgical (2) Medical (3) Supportive. Supportive fields can include anesthesiology, radiology, pathology, physical rehab, etc.

Next would be to decide on the patient population you want to interact with. Kids, women, men, elderly, or minimal patient contact. Afterwards, intellectual content and lifestyle / training duration is considered. Finally personal experiences through clinical rotations and electives usually helps narrow the field down.

One of the ways I figured out what I wanted to do was the wake up test. As I went through my rotations, I made note of how reluctant I was to wake up each morning. Did I find it hard to wake up? Did I kick around in bed in hopes I could avoid rounding? Did I dread going to work or did I look forward to going in? Surprisingly, this test helped me rule out specialties much better than I expected.

Luckily for me, I think I will be pretty happy doing either Internal Medicine or Family Medicine. I am learning towards IM probably 80-20 post-interviews, I’ll leave the final choice for the almighty CaRMS computer to decide. Will keep everyone posted.

I think one of the neatest experiences of residency interviews is visiting the various cities and programs with your classmates. It brings back memories of elementary school field trips. It is so nice to bump into a classmate at the airport or at the interview. It reminds me that we are all in this together.

Furthermore, the hospitality of classmates and friends has made the traveling better than I expected. However, I still get a bit nervous each night before an interview. I find myself struggling to find reasons as to why I would want to attend that specific program, or to come up with good questions to ask during the interview. On the interview day, things usually work out alright.

Anyways, I will have to write some posts on this whole interview process when the tour is finally over. There are so many things I wish I had known before starting residency interviews. Hopefully, I’ll get around to it…

• What should you bring in your luggage and how to pack like a pro
• How to minimize your costs and save money during your CaRMS tour
• Why preparing for your interviews is essential
• Key questions you must be able to answer and how to ace your interview
• Making a good first impression
• Enjoying your CaRMS tour – sightseeing, eating, rest
• Reflecting on the programs and how to come up with a rank order list

The show goes on!

Starting this weekend, I begin my cross Canada CaRMS tour. It is an understatement to say I am feeling more stressed than usual.

• 7810 km
• 10 Residency Programs
• 6 Cities
• 2 Specialties (IM, FM)
• 1 Match (hopefully)

I’m pretty happy about the number of programs I have received interviews for. It’s a 60-40 split between Internal and Family. I will be only interviewing at cities I think I will be happy living in. I have been preparing responses to typical interview questions the last few days. Sometimes, I feel overwhelmed. I haven’t felt this anxious since my medical school interviews.

Hopefully, I will try my best to enjoy the process. I’ll be sure to let you guys know how it goes, once these next few weeks are finally over with…

What makes the biggest difference to your health? According to Dr. Mike Evans, a  family medicine professor at St. Mike’s Hospital, exercising for just 30 minutes a day can have a big impact on your health!

Staying active during medical school is one of the hardest things to do, especially during clerkship. When you’re working 40, 50, 60 hours a week and have lots of material to study for, the last thing you might have energy for is exercise. I myself gained ten pounds – and not the good kind of weight – during my third year of clinical rotations. I am only now starting to return to my normal weight.

What I have found is that you have to make your health a priority, even amidst your busy schedules! I have put together some tricks I have gained over the last two years. According to this video, all you need is half an hour a day. I hope you find these simple tips helpful.

1) Take the Stairs, All the Time

According to this humorous CMAJ article titled “Elevators or Stairs?” taking the stairs at work saves an average of fifteen minutes each day! And that doesn’t even include the calories burned or health benefits gained from it. Time saving and healthy!

2) Exercise at Home

Finding the motivation to head to the gym can be difficult at times. Do whatever you can to overcome exercise barriers. Simple push-ups and sit ups are easy exercises to start. There are so many home exercise programs on the Internet that not having the right equipment or space should never be an excuse.

3) Make Exercising a Priority

If you don’t think staying fit is important, you won’t be able to stay fit. During my first few clinical rotations, I prioritized studying and sleeping over my health. That however only made me more fatigued and tired. I later discovered, a quick fifteen minute run would boost my energy levels and help me focus more clearly.

Similarly, I discovered that setting aside time for exercise made me spend my other time more effectively. Since I had a tighter schedule, I procrastinated less and did what needed to be done sooner.

4) Drink Lots of Water

Carry a water bottle around. Know where the water fountains are. Dehydration makes you sluggish. Your voice can become raspy and your expressions dull. Avoid caffeine and alcohol if it’s not necessary.

5) Pack Your Own Lunch / Dinner / Late-night Call Snacks

Your appetite becomes blunted if you eat the same food from the cafeteria each day. Packing your lunch is such a simple way to control your calories and save money too. When I cook dinner, I usually aim to make more food so I can pack the leftovers for lunch.

If I have the time, I try to prepare several batches of meals on the weekend and freeze them for the week.

Snack on vegetables and fruits throughout the day. Putting some carrots, cucumbers, or celery sticks in a ziplock bag and then pocketing it in your white coat or bag is a good idea. Small meals throughout the day prevents major food binges after work.

6) Exercise with Others

Be accountable to your friends and partners. Make exercising a social outing! Choose sports you like to play, sign up for intramurals, establish common goals. One of the best things I ever did was sign up to do a half-marathon with other people in my class. I had never run such a distance before, but having other people motivate you for race day made training for it fun!

Let me know if you have any easy to implement healthy / exercise tips too!

I don’t profess to having the healthiest lifestyle as a medical student. In fact, my clerkship year was downright bad for my body. Luckily, you learn from your experiences and you try to avoid making the same mistakes. I know residency (which will be in a half a year’s time) will be much more stressful and busy than clerkship was. Hopefully, I will be able to gain a better work-health balance moving forward. 

Do you spent too much time on pre-med/medical forums?

I know how addictive premedical forums can be. I used to lurk them all the time. I discovered premed101 and SDN in high school while searching for medical school information. There were other sites like College Confidential and Student Awards that I frequently visisted too. When I found these forums, it was like I had stumbled upon a trove of knowledge. Quickly, I read through hundreds of threads on what I needed to do to best improve my chances for medical school. I began visiting the forums daily, I registered and began posting too. In fact, I created one of the most viewed threads that has been stickied and still in use today, “ FAQ: What are my chances?” I was addicted.

And then I got into medical school. I was thrilled, I had achieved what I set out to do and I thought that these forums had given me that extra advantage. But looking back now, I’m not sure if it was all that beneficial. Here’s why I think why reading premed forums are not as helpful as I thought they were and why I have stopped reading them regularly since.

1) It’s a Big Time Sink

It’s easy for you to waste hours reading all the posts and replies that people write. Although you may feel like you are getting good information, it isn’t  helpful if you put those ideas into action. All that time spent reading forums could be spent doing things that actually improve your chances of getting into medical school. Studying for your classes, volunteering, becoming a more well-rounded person.

After a while, threads became repetitive. People asks the same few questions over and over. What are my chances, what do I do if I get a bad mark, how do I study for the MCAT. Once you have your answers to these questions, I found that were wasn’y much additional value to be gained. So I stopped reading and began using my time better.

2) There is a lot of Wrong Information

Remember, the majority of posts made on these forums are by anonymous people. You don’t know their credentials, reliability, or even motives. You can’t be sure if they are even telling the truth or not. Furthermore, a lot of information out there is outdated and outright wrong. Not all posts are made equal.

Stick around forums long enough and you often notice a herd mentality on certain stances. It almost seems like there are certain do’s and don’ts of being a premedical student. I want to tell you there is no right way of being a premed/medical student. I know because I did things that were unconventional. Phrases such as “Take your MCAT after your second year when you complete your pre-requisites” or “Don’t do a summer research project and study for the MCAT at the same time.” If I had listened to the advice I had found on these forums, I would have probably disadvantaged myself.

Take home point – learn to critically think about what other people tell you, because not everything will be right for your own situation.

3) It’s just like a Pre-med Club, but perhaps worse

One thing I avoided like the plague in undergrad was the pre-med club. This was something I knew I didn’t want any part of. I’m sure pre-med club can be of benefit to certain people, just not for me. The last thing I wanted to have was neurotic classmates asking about my grades and MCAT scores.

Then I realized that premed forums were in a way an online version of the premed clubs. Cut-throat, secretive, competitive, neurotic, anxious, except with the added disadvantage of anonymity. The majority of users were friendly, but the bad ones could be real downers. You are a product of who you surround yourself with, and the last place I wanted to hang out was with gunner premed students.

What am I currently doing instead?

1) Cut back and set limits

I no longer read premed forums on a regular basis and I have yet to miss out on anything big. I have more free time to spend on activities that matter to me – studying, exercising, spending time with friends and family.

Instead, when I do get an inkling to see what people on the forums are talking about, I limit myself to 15 minutes once a week to peruse the forums. I pick only a few threads to look at and perhaps write two to three replies. That’s it. In a way you get to see the best of that week, you spend less time sifting through garbage and you spend more time on threads that interest you.

2) Read Medical Blogs

If you like keeping up with the internet buzz but feel forums are a bit too monotonous, I highly recommend picking a few good medical blogs to read. I only read a small handful myself, with less than a dozen subscriptions in my RSS feeds. I have found that blog posts are often more well thought out than discussions found in forums.

Be warned though that they can be quite addictive to read too, and it’s important to set some boundaries of how many and how often you want to read them.

3) Pursue Interests outside of Medicine

My motivations are still to be the best doctor I can be, but I know that there is more than just medicine in my life. Perhaps after surviving medical school, I understand it more clearly now. Premed forums are a niche market, they focus in on an already narrow subject. When you spend too much time on these forums, you begin to lose sight of the big picture and see that there’s more life than getting into medical school.

Take it from someone who is almost on his way out of medical school, being a well-rounded individual is important for your health and happiness. It is ironic that medical school has an ability to turn so many well-rounded applicants into highly trained but narrow individuals at the end of four years. Similarly, don’t let your undergrad experience be all about getting into medical school. Finding some other interests will make you a more rounded applicant to medical school anyways.

So I hope you make it one of your new year’s resolutions to cut back on reading premedical forums and more time doing things that are productive!

Early on, I decided I would not let my schooling be the determinate of my education. Instead, I set out to learn from the best minds in the worlds, and made it a goal to read good books. I decided to read 52 books over the course of a year, one for each week. Although I fell short of that goal, I ended up reading a total of 42 books that year, many of which introduced me to new ideas and changed my world views. I still try to average a dozen or so books a year.

For instance, reading Richard Dawkin’s The Selfish Gene inspired and taught me more about evolution than any of my biology classes. My classes in physics became way more interesting after reading Richard Feynman’s adventures on learning and being inquisitive. For psychology, I “enrolled” myself in a Harvard course on Happiness. Due to my premed scheduling, I was unable to take any economics courses, but through extracurricular reading, I’ve gained at least a basic understanding of how market forces work.

Reading good books changed the way I thought about the world more than my university courses did. Well written books are often the results of years of research and experiences. They are much richer in content and thought out than blog posts or news articles. If you haven’t gotten into the habit of reading outside of the classroom, I would recommend you start right away!

I have created a books section on this website with a list of  books that I have personally read and recommend. I’ll be sure to add to the list and write reviews whenever possible. Although medical school can be quite busy and there is a lot of medical reading that needs to be done, I still try to find time for leisure reading.

With the holidays coming up, try to find time during your break to read something outside of academics. It might just be the best thing you could do for your education.

It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.

Many times in the last year I have seen patients suffer from inappropriate medical decisions. Metastatic cancer patients who receieve aggressive treatment despite of the physical, emotional and financial costs associated with it. A 94 year old post stroke brain dead patient being kept alive in the ICU by a ventilator and triple-pressor support because the family did not want to withdraw care. Dieing can be a messy thing.

In undergrad, I read a book titled “How We Die“ by Sherwin Nuland, a physician practising at Yale, that challenged many of my pre-med notions of death. Particularly, it helped me understand how little mastery we have over our mortality and that death is a natural process of life.  People are always eager to tell you how we should live but few broach the topic of how we should die.

One of the tasks we do as a medical student whenever we admit a patient is to determine their code status. We ask questions that people are unfamiliar with. What should our medical team do if anything was to happen to you. If your heart stopped beating, do you want us to perform CPR? If your lungs stopped breathing, would you want a tube passed through your throat to help you breathe? Discussing code status is an often misunderstood topic. Many patients and families find it difficult to approach the subject.  Does this mean the medical team is giving up? Does it mean the patient won’t receive any help if anything was to happen? What the patient and their families often fail to understand is the difference between quantity and quality of life. Many times in the course of a disease, our medical interventions cross over from benefiting the patient to harming them.

During my Internal Medicine rotation, an attending taught me to be specific with my do not resuscitate orders. Explain what each aspect of their code status meant and clarify each point. No CPR, No ICU, No Intubation, No Heroic Measures.

Death is a terrifying event for patients and their families. I know my views on it have changed this last year after repeatedly seeing death firsthand. What I’ve learned is that we shouldn’t be afraid to talk about death. As health care workers, we spend most of our time talking about possible treatment options, even when there is none left. We don’t spend enough time explaining realistic outcomes to patients and discussing what their final wishes will be. Are we continuing treatment for the benefit of the patient or are we causing suffering to spare the emotions of those that are living. Becoming a doctor is more than just learning about how to save lives. In the process, you learn to respect human life and the complexities associated with it, and you begin to understand the possibilities and limitations of our art.

- focus: a simplicity manifesto in the age of distraction – by Leo Babauta of zenhabits

- Best New Year’s Resolution? A ‘Stop Doing’ List – by Jim Collins

- Better - by Merlin Mann (author of InboxZero)

I am now in my fourth and final year of medical school. Perhaps with some hindsight, I now see how distracting medical school really was at times. The clubs we were involved in, the group study sessions, the meaningless emails, the trivial tasks. You regret some of the priorities you sacrificed, your health, your hobbies, your friends and family.

From here on out, I am choosing to make my daily life simpler. I want to take on less tasks in hopes that I can do my important tasks better. I have unsubscribed from medical blogs that I don’t really enjoy reading, and spent a bit more time reading around the patients I see. I spend less time in my inbox and more time with friends. On this blog, I am focusing less on advertising and revenues and more on writing and reflection. I am slowly minimizing my distractions so I can focus on things that do matter.

Are there things in your life you can simplify? What’s distracting you from doing your best work?