My 2nd Career, A Doctor

Vendor fair at the old pre meds conference

2013-06-09T16:03:00.001-04:00

PGY-2 almost done

2013-06-02T22:34:00.002-04:00

I know that it has been some time since I wrote but I have been up to my head in residency. There are so many things that need to get done, that sometimes I even forget that I have a blog and there are people who are waiting for me to write.

I am at the tail end of my second year of my residency. I have learned a great deal and learned what I really do not know and need to work on. But I have also learned about my strengths. PGY2 is a lot different that the intern year. You are considered a senior resident and there are many more expectations from you than before. For starters, you are the leader of your team. When I am on the general medical floors of hospital, I have 2 interns that report to me directly. It is my responsibility to not only make sure that they write all of their notes but that the patient is being properly taken care of. That the attending physicians have been communicated with and the interns come to me for advice on what should be done next. In addition, I am also responsible to teach the interns. It gets even more complicated when there are medical students as well.

If there is a 3rd year medical student, they typically report to the intern. However, this has been changed and now they report to the resident, me. I need to ensure that they see 2-3 patients, review their notes, cosign the notes and write the orders. In addition, they have to do only 4 admissions per call and I have to go over that entire history and physical with them. Not to mention that medicolegally they cannot write the assessment and plan but I have to do it. Finally teach them. If there is a 4th year medical student, they are considered a sub-intern and have always reported to the resident. These students, being senior medical students have a little more knowledge than the 3rd year but they are still students. I need to give them a larger patient load which means that I have more work to do.

Now most of the time this is not a problem. The issue comes in July when the new interns start. Because these are fresh interns right out of medical school or international medical graduates that are not familiar with how US medicine is run. On top of that being the senior resident all of the discharge dictations have to be done by me. But first I have to review the discharge instructions to make sure that the new interns did not miss anything. Luckily this coming July, I do not have that responsibility.

I have been doing a lot of admissions since I have been the admitting doctor at night and during the day. I have been reading all of the consults and the test results on the patients I have admitted to see if I was correct in my assessments. I have been doing a pretty decent job lately. But it is always a learning process. I am very lucky to be where I am as I get to see many pathologies that I may not have seen anywhere else.

For instance, I was able to see a gentleman with early stage Huntington's Chorea (a virtual death sentence if this is diagnosed), late stage multiple myeloma that is non secretory (very rare), and several incidental findings of renal cancer.

Currently I am preparing to apply to fellowship in critical care medicine. There are 4 programs in the area as we are not moving. If I get into one program, I will be thrilled. If I get into no programs, that is alright too as I will be able to practice medicine either as an internist or a hospitalist.

Hopefully I will have more time to write. In the meantime, come to the old premeds conference this weekend in Washington DC. www.oldpremeds.com

Location of the Old Pre Meds 2013 Conference.....

2012-09-25T11:59:00.001-04:00

Drum Roll Please...............................

Washington D.C.!!!! Early June. Stay tuned for more information as it comes about.

2nd year of Residency

2012-09-23T13:14:00.001-04:00

So here I am. It has been quite a long time since I updated this blog, mostly because I have been so busy that I am spent at the end of the day and was too tired to update anything and on the weekends, when I do have off, I am catching up on my sleep or family time. But I can tell you that it is great being a second year medicine resident.

To begin with, I have a lot more confidence in myself and my abilities to treat my patients. This all comes with experience. The more patients that you see, the more that you will understand things. Even more experience came when I was doing all of the admissions. During that rotation, I would be the one who would come up with the assessment and plan and then discuss it with the attending. Most of the time, my plan was right on. Other times, there could have been something better or something was added that should not have been. For example, Vancomycin to a patient who should have had a level first. However these things come with the territory. This is all in keeping with my goal this year.

Last year, my goal was to become a good intern and now this year my goal is to become a good resident. So far, the only thing that has been commented on by my attendings is that I have to read more. But then again, so does everyone. Once I am able to do that, then I will be golden. The issues is trying to come up with a schedule that works. What I am going to be trying is to read for about 1-2 hours per night after 9pm when the kids are in bed. This is not always achievable. Because of course, the kids do not always go to bed at the pre-determined time and of course there is always wife time that needs to be had.

My goal for this year is to really get more into a hobby. I am either going to work or I am at home and sleeping. One reason I am able to update this blog is because I am on vacation and since I have no boards to study for this time, I am able to really relax. So I did what any good doctor does, I played golf and fished. I have to work on both of these things. I am not ready for any PGA tour but I did have a lot of fun. And will not win any tournaments with my little large mouth bass that I caught but as they say, a bad day of fishing is certainly better than a good day at work. Even though I love my job, I love to golf and fish.

On the financial front, the plan is to keep our heads above water just long enough until I am done with residency and I can get an attending salary for a few years. Give us some breathing room. But always remembering to take advantage of discounts and there is nothing wrong with refurbished products, especially if they come from the factory. There is nothing wrong with the products and they are usually cheaper. Besides, there is no reason to get it right away and hold off until all of the hype dies down and then the prices will follow.

I hope to update more often but I cannot promise anything since I know do 24 hour shifts.

Hasta.

Old Pre Meds National Conference June 7-10; Orlando Florida

2012-04-08T14:57:00.000-04:00

Cecil B. Wilson, MD (keynote address) Immediate Past President
American Medical Association

David W. Kelley, DO Assistant Professor of Anesthesiology
SUNY Upstate Medical University
Founding Member of OldPreMeds

Judy Colwell, MA Former Assistant Director of Admissions
Stanford University School of Medicine
presenting "The Nuts and Bolts of Applying"

Dawn K. Aldrich, MD Founder/CEO of Solutions Health & Wellness Center
author of the audio book series "The Day That
Changed My Life, Cancer: an uncertain journey"

Trena Gologan, MBA Admissions Coordinator/Recruiter
Philadelphia College of Osteopathic Medicine
(Georgia campus) presenting "Professionalism and
Admissions: a viewpoint from the other side"

Conference Registration

And COMLEX is all done!!! I PASSED STEP 3!!!!

2012-04-08T14:44:00.000-04:00

Hello there my friends out in cyberspace. I have just finished my time on nights, which was not that bad. It was a lot of learning that I had actually done even if it was just a few things here and there. For example, one of the biggest things I learned was to steadfastly say no to people who were manipulative in trying to get their narcotics. It is very hard to say to someone who says that they are in pain that they cannot have medication for it. However, I did learn to differentiate between people who are truly in pain and who will benefit from powerful pain medicines and someone who is an addict and is there for you to be their personal drug dealer.

But you can then argue to me "Well, addiction is also a medical condition so you are treating them aren't you? And by withholding the narcotics are you not forcing them to go through withdrawl?" And to these questions I say Yes and No. Yes, addiction is a disease that needs treatment. However, you do not go see a Chiropractor for your heart attack. If the patient truly wants to get off of the junk, they need to be properly treated in a detox unit by a medical staff that is properly trained to handle it. I am not one of them. And yes, I can learn but that is more of a specialty and one that I am not interested in pursuing. And No, you are not treating them by giving them the narcotics that they are addicted to. You treat the withdrawl symptoms and make the personal comfortable. Besides, you can tell when these people are lying because they embelish everything. From the amount of pain they are in (a person who tells me that their pain is 10/10 but when I see them as I walk in the room and they are sleeping or watching TV or talking on the phone without missing a beat). I have seen people in severe pain and they cannot stay still long enough to answer any of my questions let alone talk on the phone.

Another thing I learned was how to handle sleep problems in the hospital. Yes, it is very easy when the nurse calls about the patient not sleeping to give a verbal order for sleeping pills, but are you really doing the patient a service or a disservice by giving them that pill. For starters, it is a hospital and not a hotel. The beds are not the most comfortable thing in the world. Second, there are other people around making noise. Third, you are not in your own environment and maybe warmer or colder than you normally are and finally, you are in the hospital because you are ill for one reason or another. So your sleeping patterns will also be affected. What I started to do was to look at why the patient is here, what other medicines they are on and more importantly talk to the patient. Most of the time, the patient is not on a sleeping pill at home and there is no reason for them to be on one now. They have the TV on or the light on. So I suggest that they create a better sleep environment by turning off the TV, turning off the light and closing the door. There is no reason why the door to the hospital room has to be open. Most of the time, they understand.

Finally, I started to learn how to really put out fires and life endangering problems. While I do need to learn some more, I feel a lot more comfortable doing it or even just starting it.

I was thinking about adding a video every now and again. But only if my readers would like it. Please tell me what your thoughts are about that.

And to close, the NonTrad tip of this posting: One of the greatest assets that us non traditional students have is our maturity and our experience in previous careers. Take your knowledge of office politics and what not to do, and your customer service knowledge about selling your product and apply it to the nurses and the patients. Never say anything that you will regret, and always acknowledge the concerns the families have. And always follow through with what you said you will do. Even if the answer is no or if the news is not positive, the fact that you followed through is enough for the families and the patient.

Night Float

2012-02-26T11:50:00.002-05:00

Well my vacation has been over. During that "staycation" I pretty much tried to catch up on some projects that I have been meaning to do at home. I am now in my 2nd week of nights. Boy is my system off. Right now my main job is to help with admissions. Once I finish at 5 admissions I am done for the night. The earlier this happens, the sooner I go home. But if it happens later, then I tend to go back to the residents quarters and go to sleep so that I can get home safely.

Part of my job is to be the night float intern on Friday nights. Basically for practically anything I get called. This past Friday was especially busy. But not with acute problems, mainly a lot of busy work. Checking up on labs, putting in IVs when the nurses could not, putting in a nasalgastric tube. Every time I went to lay down and get some rest, my beeper went off. I probably got a good 1 hour of decent sleep that night. But that is what I signed up for right. But the cool thing was that I was confident in my abilities. The only time I called my resident was to confirm my plan in a case that I was sure about but need to confirm my suspicions. It is just like they say, time and experience.

Still waiting on the COMLEX results. Less than 2.5 years to go before I make a descent salary. In the meantime, lets take advantage of any and all programs we qualify for.

Step 3 is Done and really on Vacation now

2012-02-10T17:17:00.000-05:00

So dear readers, I am back. It has been sometime since I had written and this is because I have been studying for step 3. This is the last part of the medical licensing exam for me. The only exams left after this is going to be the ones to be board certified. This is for after residency though. So, now I have time to sit and relax and recharge before going back to work next week. I will be on nights for 2 weeks then.

Everything has been great. As I mentioned before, I am no longer working because I love what I do. But things are very difficult because we have to keep all of our spending to a limit because we are still getting back on our feet. Basically we are starting over again as if we were coming back out of college only this time we have 4 other people that are relying on us. But at least I know that I have a short period of time doing this.

One of my fears has been allayed in that I just signed my contract for next year. When I was a medical student there was an intern who was not resigned and this was a fear of mine. I guess some insecurities remain. But over time, my confidence has gone up. And to all of you out there who think that you cannot do it, let me assure you that as long as you out in the work and try you will be able to do it.

I need to put in a shameless plug: OLD PRE MEDS NORTHEAST REGIONAL ADMISSIONS WORKSHOP!!!!! March 18th, 2012 in Stratford NJ. Admissions Workshop If you have had issues in your past where you think that your grades are holding you back, there is going to be an Admissions Officer talking about just that. There will also be a speaker talking about your personal statement as well as how one nontrad went from being a nurse to a cardiologist. Not to mention, a residency program director talking about why nontrads are great for residency programs. and the cost is really, really cheap. If you have gone to other workshops, you are talking a nice chunk of change, but here the cost is only $25.

Anyway. Next time I think I will try a video blog. Let me know if you think that would be a good idea. I want to wish all DO students good luck on the Match for Monday.

Till next time

Welcome to 2012!!!

2012-01-02T15:18:00.000-05:00

Hello there dear readers, I am still here. I hope everyone has had a joyous holiday season and they are recovering from the festivities of new years day.

I have not blogged recently because my schedule has been very busy lately and I have been very, very tired. I was on the general medical floors the past month and therefor was on call every 4th day and trying to recover in between. But this month, I will be on Gyn so I have a little more time.

Well, things are going really well. I submitted a grant for a research project that I am going to do and I am working on a Quality Improvement project as well. Both of these are required for the program but it is still a good thing for the resume. So the plan is kind of changing with recent financial burdens.

One thing that you need to remember, if you are about to start this journey or are thinking about this journey is that once you are done with medical school, things do not necessarily get easier. they get more complicated. You need to contact your lenders to see if you can have a deferrment of a forebearance. The number of loans you have are now very limited and while you do not have to have your school certify your loan, you really need to think about a residency loan early on. What do I mean? Well, since you only have about 6 months after your graduate to apply for these loans, you may not know that you need it until the 6 months are either almost up or are already over. Then, you are in a bit of a lurch. You need to start cutting things. But how do you know where your money is going? I mean there is not enough time to keep a diary or even write things down?

Good point, however there are software out there like MS Money and IBank for Mac that are very helpful. We were able to find the areas where we could and probably should cut. Now it is just a matter to wait and see to determine if these cuts are helping. It is also a good idea to tap into family. These are people that you can create an IOU and discuss terms such as no interest and even a payback policy where you start a plan after you are done with residency and/or fellowship and start making a normal salary.

We have also decided to go see a financial planner and look at what we can do to not only save more but to get through this rough patch.

Well done for now. One of my resolutions is to blog more often, so come back and see if I keep that resolution.

Almost 1/2 way done

2011-11-28T20:19:00.000-05:00

Hello there dear readers. I know, I know. It has been far too long since my last posting. I bet you thought that I forgot about this little blog of mine. Well, I did not. I have just been so tired that I have not had the chance to sit down to write. Of course, right now I am taking a break from writing my grant in order to write my blog. But alas, so it goes.

Since my last update, I have been done with my first time on the medical floors and now I am almost done with Cardiology. Both have been great to do. In addition, I have had clinic time each month. In fact, today I was told the best thing ever. I had a patient come in and say that she wanted me to be her Primary Care Physician!!! How about that. Although I am getting used to it, I still find it hard to believe that this is real. But now there are new challenges.

The biggest one is that of finances. Now that loans are starting to come off of their grace period, I have to get on the ball and call them back to get them onto deferment. No, I did not wait until the last minute but these things are very confusing. I mean I apply for it and first they tell me that I am in deferment until 2014 and then they tell me that I am not. Well that is not a nice thing to do to a guy who is very tired and works about 80 hours a week. Next there is trying to refinance a mortgage in this economy, good luck. And finally there is trying to get back on our feet financially. Well, I decided that we are obviously going to need help and so there is an appointment to be made with a financial planner.

The other challenge is trying to spend enough time with everyone. Yes, I did lapse a little in my Daddy/Daughter time and I am trying to get that back on the role. However, I also need time for the wife and myself. At least the time for myself should not be at the library writing a grant. But rather maybe reading a non medical magazine or going out with a friend (which I am planning). I did find out that our babysitter can come back from college with enough notice. Phew, now the wife and I can plan some outings. As long as I am not on call or post call. That is something I would advise those parents who want to go to medical school. Not only should you find a babysitter, but have several back up ones as well. They do come in handy. Sure you can find one or two or three amongst your classmates, but also have a local teen or two who are available as well.

Not much else to report. Other than the upcoming local NonTraditional Conference in March. I am going to try to get back into Paintball, I had so much fun with it and I have a cousin who is really into it. Always nice to have a hobby other than driver of kiddoes to birthday parties. Till next time.

NonTraditional Conference has been announced

2011-11-20T15:18:00.000-05:00

This is a quick one dear readers. The Annual Old Pre Meds Conference has been set for Orlando Florida in June. But, there is more good news..........

The Old Pre Meds NorthEast Regional Conference is set for March 18, 2012 at UMDNJ-School of Osteopathic Medicine in Stratford, NJ.

The school is in Southern NJ just outside of Philadelphia. So far there are 3 confirmed speakers and once I get everything fully confirmed I will post.

TTFN

on the floors

2011-10-15T11:05:00.001-04:00

I know it has been some time since I last posted, but then again I have been very busy at work. well maybe not at work because I love what I am doing and therefor do not feel as if I am working.

Last month I was in the SICU, Surgical Intensive Care Unit, medically managing some of the post operative patients. The good thing about that rotation was that I was the only intern and resident so it was just the Intensivist and I which was great for 1:1 teaching time. But at the same time, if something was not done, the onus was 100% on me with no backup from a senior resident. And boy did I learn a lot.

There was one patient were I really learned how to manage shock and maintain blood pressure. I was in constant communication with the attending and it took about 5 hours to get the patient stable. By the end of the night, I really knew what to look for and how to manage things. Although I can use more practice my confidence went up. In addition, I really learned how to prioritize things in the ICU patient. And since my census was not very high I had to do several presentations to the other interns in the ICU so I learned a lot about topics including compartment syndrome, acute coronary events, delirium, etc.

Now I am on the general medical floors and I am doing well. These patients are much more stable and I am happy to be able to generate some form of relationship with them while they are in the hospital. And with my experience in the ICU, I do have confidence because before calling the resident, I think about the problem and come up with potential solutions. However, this is having a hard time at home because of my schedule.

I am on call every 4th night so I am at work from 7am until 9:30 pm and do not get home until about 10/10;30 so I can go a day or so without seeing the girls. This is why I do my best to spend quality time with them. Not always successful because I am so tired. I am learning to be much more patient with my girls, which is hard when you are sleep deprived. The other day I became angry and I took a drive to calm down, of course I went to get my clogs for work which are more comfortable for my feet but I was able to cool it and chit chat with my 10 year old the next day and smooth things over. Now I am going to close my eyes and count to 10 when I am starting to get frustrated because I forget that they are kids and are going to do kids things. Forgive me, I am human and therefor flawed.

With the wife, the issue is spending couple time. And the solution apparently has to be to schedule our time. While it may seem unromantic to say, "9pm thursdays is our night" it almost guarantees that it will happen because we wont schedule things at that time. However, while the schedule may not be romantic the time itself can be romantic. From putting a fire place on the computer from youtube, to going to the backyard and having some wine. It is a chance to be creative. Hopefully this will resolve one issue.

The other issue of course is finances, but that is for another discussion.

in the ICU!!!!!!!!!! Love it.

2011-09-10T14:02:00.001-04:00

So I am in what we call a "Golden Weekend". The first weekend in almost 2 months that I don't have to work either day. I was actually able to not only sleep in today, but I can look forward to doing it tomorrow.

Last month I was in the ICU and loved every minute of it. I was able to put in central lines, write orders, evaluate patients, but I also had the unfortunate responsibility to pronounce 3 patients, with family in the room.

I have been learning a TON in my program so far. I was also involved in several family meetings regarding the potential outcomes of the patients and having to tell the families that there is almost no chance of any meaningful recovery and that we would recommend comfort care and letting the patient die comfortably with no more invasive tests or procedures. While some families have agreed, others hold out hope beyond hope that things will change. I learned that with families who want everything done, the only way for them to come to the decision that they should let their loved one die peacefully is with time. But we never give them any false hopes.

Right now I am in the Surgical ICU, which in my program is my surgery rotation. Makes more sense than my doing surgical consults or being in the OR since I do not want to do that. Rather I take care of the patients Post operatively with the intensivist. So not only am I still doing ICU but I get 1:1 time with the attending and therefor get teaching.

This was great because it solidified my decision to go into critical care medicine. One day I am up to my neck in new admissions, 2 code blues, 3 lines, the next day I discharge 4 patients and pronounce 2. The next day, the unit is sparse and the hospital is quiet. Only to be broken by a rapid response.

But the hours are a killer. I have put in, on average, 75 hours a week. The one week I was actually over the limit with 85 hours. But I am so happy that it does not bother me. It really is true, I am not working. I am enjoying my new career.

But it really is weird, when someone calls me who does not know and I hear, "Dr., would you like some saline for this patient?". and all I can think is, holy crap, they are talking to me.

wwwwwwoooooowwwwww

2011-08-12T22:55:00.000-04:00

I know that it has been quite some time since I posted but a lot has been going on. First of all, I am done with the ER, and thank god for that as I can now really work and not just feel like a student. I have been in the ICU for 2 weeks now and I am not only loving every minute of it but I am exhausted.

I have to be in the hospital by 6am which means I have to get up at 4:30 and leave by 5. Then we sign out to the overnight crew at around 6pm and it takes about 30 minutes to go through each patient and give the night team an idea of who the patient is, if the patient is new to the unit, what happened during the day, and what needs to be followed up or what needs to be done. Sometimes it even takes an hour if we get paged. I have a 6 day work week. Last week I worked 89 hours and this week I will be pushing 75.

We get an incredible number of sick people. From heart attacks to strokes, to terminal conditions. I have had to speak to patients about their illnesses, talking to families about their loved ones and communicating with other doctors. Everything I have been experiencing has substantiated my decision to go into medical school late in life. And because I am older and have been in the workforce, I know the politics of work and I have the emotional intelligence to react or not react to things that are said.

In about a month, I start clinic hours and I get my own census of patients that I will be following for the next 3 years. This is just getting better and better.

Till next time.

Month almost over

2011-07-22T16:26:00.000-04:00

So my first month as an intern is almost over and I finally have access to patient charts in the ER. But I cannot write anything or order anything. Fine. But I did get to spend some time in the ICU, which is where I will be tomorrow night, next saturday night and then for the entire month of August.

While I was there, it was great. But nothing was really going on at night so it was still no different from being a medical student. Until the nurse paged me. She told me that the patient's blood pressure was still high even after getting medication and wanted to know what I wanted to give him. Well, my heart DROPPED!!!!! Now I really have to make a decision. If I do not give the right medication then the patient can be in bigger problems. But if I give too much they could be in problems also. The nurse hinted that it may be a good idea to give the patient hydralazine. So I looked up the labs and called my resident, which he told me the same thing. And I wrote the order.

The nurses know that we are all brand new doctors and so they are there to have our backs. As long as you are not nasty or rude to them. Which I am not (something that gives non trads an advantage over our traditional counterparts due to our emotional intelligence). Since then, I have decided that I am going to be reviewing the treatment of each emergency for each organ system. So far, so good. The only issue is that I have not been able to put the information to good use, yet.

Since starting, I have seen common medical problems enter the ER. Things that I eventually will take care of either on the floors or in the ICU. I have been able to perform several pelvic exams (with a chaperone of course), put in a couple of nasalgastric tubes, and IVs. But I am looking forward to putting in central lines, intubation, and other stuff life that.

I am looking forward to my time in the ICU. I plan on reviewing my notes on the information I have been reading about. And wondering how I am going to feel when I put in 72 hours a week.

It has been 1 week

2011-07-08T17:21:00.000-04:00

So I have been an Intern for a whole week, as stated in the title of today's episode. The cool thing is that when I walk into see patients, I say I am Dr. Lerman, no longer saying Student Doctor Lerman and it is awesome. This whole month I am in the emergency room, which is kind of like an extension of medical school because I cannot chart anything, order anything, and I have to report everything to attending and have to try to follow my patients.

But, I am learning some. And that is the main point of course. I have taken the time that I am not seeing people and using it to read articles and get myself ready to take on the role of a good intern and eventually a good resident and practitioner. Not to mention, I have to get ready to take step 3 of the boards. I plan on taking them in 6 months. So to get ready, I am reading Kaplan's Mastering the Boards and will be signing up for the Q-banks. The more questions I do, the better I will be. I plan on getting a fellowship so I would like to score very well. While I did about 2500 questions to prepare for Step 2, I plan to do at least this many for Step 3. The big difference is that this test is 2 days long. That's right dear readers, you heard me; 2 DAYS!!!! Lord Help Me.

Our last loan check came in, so we no longer have to eat Ramen Noodles and I am going to start getting paid, which is a nice return to the way things ought to be.

Uptodate: Clinical Reference

Next time, I will talk about my first on call in the ICU!!

Last Day of Vacation

2011-06-30T11:38:00.000-04:00

So today is it. The last day of my vacation and the last day that I am among the ranks of the unemployed (hopefully for good). I am putting finishing touches on my vacation, am going to try to get some fishing in later today when the sun goes down a little and get some me time. The last time I had me time was in Las Vegas.

This week is also tough because we are still waiting for our last residency loan check to come in but expenses do not wait for that. The cash reserves are starting to really scratch the bottom of the barrel and I may have to suck it up and take a few late fees just to wait. But at least in 2 weeks I get paid and then a steady stream of income will come our way.

The wife and I were talking yesterday about all of the great FREE things that are going around that, if we can, we should take advantage of. For example, free concerts sponsored by the recreation department, going to parks with a picnic, etc. This is certainly the lowest point in our financial life. It is ironic that I am going to be 37 years old and I still cannot hold my head above water financially. It will be great that I can start feeling that my family can hold its own. Yet, I know in my mind that this will be the case once I am done with training either in 3 or 6 years if I get into my fellowship (which I intend to).

So many things that we would like to do. And yet we still have to wait. But if we waiting this long, what is another few years right? We are young and fairly healthy.

OK. till next time.

Orientation almost over

2011-06-26T17:43:00.000-04:00

Hello there dear readers. I hope that everything is going well. I am speaking to you from the other side of orientation. Well, not quite. I have 2 more days to go. Tomorrow I take the ACLS exam and then on tuesday I learn the electronic medical record. Then I have 2 days off and the I officially start with my first day as an intern.

So, according to my schedule I am spending my first month in the Emergency Department. Kind of ironic in that this is what I was originally trying for. However, I get to be on call in the ICU and THAT is what I AM going for. Then I do 1 month in the Intensive Care Unit. I will be happier than a pig in shit.....Then I get a month of elective, which I may either stay in the ICU, or do pulmonary. Although I am leaning towards ICU. My hours are probably 7a-5p unless I am on call, then my hours increase until 10:30pm. But I am psyched.

This whole week in orientation, I was anxious and excited and scared at the same time. I am anxious and excited to start, but I am also scared that I do not know much....this is normal for all new interns. But I started reading. I read the NEJM every day and I am going to be adding 1-2 hours per day of a pertinent subject. I will take 1 or 2 cases and read all about them.

In the meantime, have been reading "The Jungle" by Upton Sinclair. It is about the meatpacking industry at the turn of the century. Since the Kindle is a free app for android, the book is available for free as well. So when there is a break, or lunch, or I am in line I break out the phone and read the book. It is a nice diversion from everything else.

Until Next time.

Calm before the storm

2011-06-16T10:14:00.000-04:00

So I am relaxing right now. I have until next week, exactly, to be able to sit at the dining room table with a cup of coffee and be able to drink it properly and not have to wait for a red light to prevent spillage. In the meantime, I have house-husband stuff to do. For instance, put away the laundry, clean the house, pick up the girls from the babysitter, pick them up from the bus stop. But that is all in the afternoon.

I plan on going fishing at least once this next week and even hitting the driving range before I start. The good news is that I was able to secure a residency loan to keep the family afloat until I start earning a regular paycheck. This, in addition to more cost cutting items will certainly help. Some of the cutting is to shift money from a low interest rate CC to a higher one in order to pay that off more quickly. I found out that the local supermarket offers free family movies once a month. Free tv shows and movies on the internet such as hulu and comcast. But also I discovered Groupon, where you can get things at a cheaper price. Let's see how that works out.

Also this week, rather than going to the movies at night, the wife and I will take in a matinee. Since the girls are in school or at the babysitter, no need to pay extra. And matinees are usually 1/2 the price.

During this time, I am also starting to work on a new concept for Old Pre Meds, and that is a Northeast Regional Conference. One that is only for day and will provide a good amount of information but will also introduce people to the larger, annual conference. I do not know where or when it will be held but stay tuned. And if you are in the area, please check it out.

I really should start ramping up the reading, considering I have been decompressing. See you later.

10 days to go

2011-06-13T08:27:00.001-04:00

So in 10 days, I will have orientation for residency. During these next few days I will have the time to fix things around the house, probably hit a Matinee with my wife (date day) and just enjoy and relax.

A recent issue had come up that I wanted to share with you all. I miscalculated how much we would need between medical school ending and getting a paycheck. So I applied to get a residency loan and I was turned down because of an issue with my credit report. It turns out that said issue was an error by the creditor which needed to be taken care of right away. Had I looked at my credit report before I applied for the loan, I would have seen the error, fixed it, and then applied. Since I fixed the problem, I am debating whether or not to apply for the loan again. The question is, should we grin and bear it or should we give ourselves some breathing room.

Last week, I had the utmost pleasure to go and speak at the Old Pre Meds conference in Las Vegas (www.oldpremeds.com). For those of you have not gone to a conference of this kind yet, I urge you, nay, I STRONGLY urge you to go next year. Word on the street is that it will return to the east coast but nothing formal has been announced. The conference is 100% non traditional. There is nothing in the conference that does not aim at the non trads. Not to mention there was a good showing of schools and programs to speak to.

I had the pleasure of speaking to several people who are just starting out and they have families. Specific questions included how to assuage your spouse from fearing that once you are done with medical school that you will not leave them. This is one of the most feared situations a support person has. The best advice that I can give is to constantly remind them how much you appreciate them, how much you love them, and how much you cannot do this without their support. Recognize them whenever you can. Whenever I am asked how I was able to accomplish medical school with a family, the first words out of my mouth are that "I could not have done it without my wife. She deserves the praise". In addition, during graduation, I had the family gather around and I presented her with my own gift to her. Which is seen below. The wording took me about 3 weeks to figure out.

"Three weeks!!!! Why did it take you so long to figure out what to say. Why not say 'I Love You' and be done with it?" And the answer is, because she KNOWS I love her. She does not need a plaque for it. What she wants to know is how much I appreciated her SACRIFICE she sacrificed everything for me. And I needed to not only let her know how much I appreciated it, but that I publicly acknowledged it. The wording, I felt, needed to reflect not only how much I appreciated her love, but how much I appreciated her doing a lot more of her fair share so that I can study, go to conferences, build my resume, and participate in school functions. But the sacrifice was not isolated to medical school but also to the preparation for it. For the time I took to go to graduate school and prepare for it. Write and defend my thesis, study and take the MCAT (not once; but twice). But most importantly, for keeping the family together during this stressful time. And while a gift or a plaque will not fully assuage the fear that I would leave her after I am done, telling her that I will not and showing her that I will not (by being open and honest) will do that. But the most important thing you can do, is to acknowledge the fear and keep telling them that all will be ok.

And so with that, fellow non trads I leave you for now. Stay tuned for more as I enter Residency.

Transition Period is hard

2011-06-01T14:29:00.000-04:00

Well here I am, a fresh Doctor of 1 week, and we are in a bind. Because I am not in school anymore, I am unable to get anymore student loans and since I have so many loans because of school, my credit report is affected. As a result, time to scrounge up some cash!!!!

There are things that we have been doing to reduce payments but still. It is very anxiety ridden to not be able to tap into funds. I feel like I have to go out and find a part time job, but then I remember that I already have a job and I just have to wait for it to start. Once I start the residency then I know that I will be earning a paycheck again and things will start to get better. But still, it can make some one go nuts.

So now the question is, what can I do? Rather, what can my family and I do? Well, we still have our reserves (which will only last for so much longer). I will learn to love Spaghetti but not meatballs, and will look for free things to do with the kids. The park is a great place. One thing that I did do, was get a bike rack from Craigslist for a much lower price than I would have if it were new. And because of that, I can take the kids to the park and they can bring their bike while I bring the cooler with food from home, as well as water from home. That way, there is nothing to buy.

And while I know that this period is only so long, it reminds me that I was able to weather the economic downturn at school only for so long. And with the reports coming in that the economy is still not doing well, it is time to think about the long term again. Keep reducing the balance on the credit cards, think about refinancing the mortgage, etc. This brings me a very important point: No matter how much you want to, no matter how much you think it is the right thing to do: DO NOT USE YOUR CREDIT CARDS WHILE YOU ARE IN SCHOOL UNLESS ABSOLUTELY NECESSARY!!!

Remember, you will have to pay that back plus interest. And unless you feel that you have no other choice, the best thing is that Cash is King and a debit card it preferred. Even though you fell the pinch right away, you will not have to worry about paying it off later. I mean it is not like the cash was yours anyway because you already gave it to the credit card company once you signed the agreement and you have the interest to pay as well. So even though it is hard, do not use the cards.

1 week until the Old Pre Med Conference: The line up

2011-05-31T08:44:00.000-04:00

Rebecca J. Patchin, MD, (keynote address) Immediate Past Chair, Board of Trustees, AMA
Past Chair, Council on Medical Education, AMA
Past Co-Chair, Council on Graduate Medical Education, AMA Faculty, Loma Linda University School of Medicine

Kenneth Geller, MD, MEd, FACS (featured speaker) Director, Academic and Advising Program for
USC College-Keck School of Medicine
Vice Chair, Department of Surgery and
Head of the Division of Otolaryngology
Childrens Hospital Los Angeles

Miriam Bar-on, MD (featured speaker) Professor of Pediatrics and Associate Dean for Graduate Medical Education, University of Nevada School of Medicine

Terri Richardson, MD, MS Consultant Special Projects University Corporation & California State University Chancellor's Office, Health Professions Advisor, California State University, Northridge

Judy Colwell, MA Former Assistant Director of Admissions
Stanford University School of Medicine
presenting "The Nuts and Bolts of Applying"

Jacqueline DuBose, MD
Department of Family Practice
Medical College of Georgia
presenting "I’m Not Old, I Have Short Telomeres"

Tara Cook, MD
Department of Neurology, Malcolm Grow Medical Center, USAF, presenting "Choosing a Residency (and other things I wish I had known"

Gina Moses, M Ed Associate Director of Application Services, American Association of Colleges of Osteopathic Medicine

Trena Gologan, MBA Admissions Coordinator/Recruiter
Philadelphia College of Osteopathic Medicine
(Georgia campus) presenting "Professionalism and
Admissions: a viewpoint from the other side"

Gabriel Lerman, DO, MS
Internal Medicine Resident, Mercy Fitzgerald Medical Center presenting "You've Been Accepted! Congratulations. Now What?"

Richard Levy, MA
Executive Director, National Society for Nontraditional Premedical & Medical Students presenting "Lexicon for the New OldPreMed"

This year's raffle grand prize is an Amazon Kindle New E Ink Pearl Technology Free 3G + Wi-Fi, 3G Works Globally and Marware Eco-Vue Leather Folio Black. Also on the raffle are a pair of consulting hours with our own Judy Colwell, former Ass't Director of Admissions at Standford University School of Medicine, a Kaplan MCAT course scholarship, and some OldPreMeds goodie bags

This year's exhibitors feature our major sponsors
Physician Assisted Student Success (PASS) Program
Georgia Campus of the Philadelphia College of Osteopathic Medicine (GA-PCOM)

Additional Sponsors
University of Guadalajara School of Medicine (UAG-SOM)
Lincoln Memorial University - DeBusk College of Osteopathic Medicine (LMU-DCOM).

Other Exhibitors scheduled include:

American Assoc of the Colleges of Osteopathic Medicine (AACOM)
American Medical Student Association (AMSA)
American University of the Caribbean School of Medicine (AUC)
Apprentice Doctor
A.T. Still University (ATSU)
...Kirksville School of Osteopathic Medicine (ATSU-KCOM)
...School of Osteopathic Medicine in Arizona (ATSU-SOMA)
Des Moines University including:
...College of Osteopathic Medicine
...College of Podiatric Medicine and Surgery
Kaplan Test Prep and Admissions (KAPTEST)
Lake Erie College of Osteopathic Medicine (
Mid-Western University (MWU) including:
...Arizona College of Osteopathic Medicine (AZCOM)
...Chicago College of Osteopathic Medicine (CCOM)
...Arizona Podiatric Medicine Program (AZPOD)
Oceania University School of Medicine (OMU-Samoa)
The Princeton Review (TPR)
Touro University Nevada College of Osteopathic Medicine (TUNCOM-NV)
University of Chicago, Pritzker School of Medicine
Western University Of Health Sciences including:
...Osteopathic College of Medicine of the Pacific (COMP)
...Lebanon Oregon/Northwest Campus (COMP-NW)
...College of Podiatric Medicine (CPM)
MedEdPath - Univ. Queensland Australia & Ochsner Health Systems
University of Medicine and Dentistry of New Jersey – School of Osteopathic Medicine (UMDNJ-SOM)

Me with Degree in Hand!!!!!!!

2011-05-26T20:44:00.000-04:00

Can't Forget the Award I gave my wife.

It is Done!!!!!!!!

2011-05-24T07:16:00.000-04:00

Yesterday, I ended my very long career as a student and started my dream of being a Doctor. I graduated yesterday and would like to thank many people for their support.

1) My wife. Who without her love, her dedication, and her support I would never have been able to do this.
2) My daughters. Who without their love and their support I would have forgotten to live
3) To my Brother, who without his support and love things would have been very difficult
4) To my parents for their guidance, love, support, and unwaivering faith in me.
5) My in-laws, who not only helped me, but more importantly supported my wife and emotional support during these very hard time.
6) To my friends who always supported my dreams.

Thank you all and now, a rest followed by residency.

1 week to go

2011-05-15T09:59:00.000-04:00

So here I am, one week before convocation where I officially become a doctor. It has been something. These last 2 weeks, unlike many of my fellow students, I have had to make up my radiology rotation. And since they are very laid back about it, I have been going in the mornings and getting my fill of CT images, MRIs, and flat plates. Once I have seen a bunch I usually go. The radiologists prefer that since they have a lot of work to do, and I ask questions and go over the chest images with them. But I am learning. Also, I am taking it easy since there are no exams or other requirements for this rotation. It gives me something to do in the morning.

This past weekend, I went with my father to get a new car. It was great, not only spending some quality time with my father but also it is a sign that I am finally getting on with my life where it should go. Up until recently, I had a 2000 Chevy tracker that I needed to get a couple of years ago because my car at the time was always going back to the mechanic for breaks. Well, this car just kept leaking like a sieve and it was not very reliable. I was throwing good money after bad in order to get it to stay on the road. Finally I decided to drive it into the ground until I can get a more reliable car. And this happened late last week.

I was able to get a 2009 PT Cruiser with very, very low mileage on it. And with the help of my parents, I was able to finance it. And when I finish fellowship, it will be all mine!!!! It is a sleek black color, which is what I was looking for. It kind of feels like a graduation present, but one that I bought myself and that I have to pay the bank to eventually own outright. Heck, when you are $250,000 in debt when is another few thousand right?

Now that the car headache has been taken care of, I can focus on the loan repayment headache. But, that is nothing that I have not dealt with before.

Well dear readers, till next time.