Scrub Notes Medical Blog: Tips For Med Students

What Singapore Health Has to Teach the World?

noreply@blogger.com (minava) — Mon, 17 Sep 2012 11:00:00 +0000

Comparative healthcare is a growing area of interest for both medical and political reasons. In this guest post by Lena Paul, learn more about how healthcare operates in Singapore:

The high cost of healthcare in countries such as Australia and America has many politicians twitching. In Australia, government expenditure into health care teeters at around 9%; in America, it's just above a whopping 15%. And yet Singapore only spends about 4% and has a level of healthcare services and health in general equal to Australia and America. What gives? What could the Singapore health system have that could teach others and in doing so, help save a lot of money?

One of the big problems with the healthcare system in America and Australia is that while it's a great way to stay well, it's also growing more expensive and that means a greater burden on those who need it the most-the rapidly growing, aging population. Universal healthcare may simply become unaffordable over time and plenty of people are going to fall through the cracks.

Why are costs high? No competition! Doctors and hospitals are either overloaded with patients or they are discouraged from competing with one another which means that the prices can be higher without fear. However, this system can be tackled: change Medicare to a health saving system and allow for competition over patients without regard to their insurance status. Singapore has this system and it works insofar as spending is concerned; les than 4% of its GDP is spent on healthcare. And though the spending is less, Singapore actually rates higher in World Health Organisation rankings-6th place as opposed to America (37) and Australia (32). So how does Singapore take care of its own?

The system is a two part program. First, Singapore has a compulsory savings program (Medisave). Employees and employers contribute between 6 and 8 percent of the employee's income, split down the middle and dependent on age. These funds are used to pay for medical expenses and unlike the Australian system, people cannot run a 'negative' balance; if the medical costs are higher than what is in Medisave, the difference has to come out of the patient's wallet or through voluntary insurance such as Medishield. But accounts can also be used to pay the expenses of immediate family members. For example, if you have never needed a doctor, but your father needs regular treatments, you can pay for them in part or in full from your Medisave account. Furthermore, those who have few funds can apply for assistance through a government appointed Medifund committee.

It's a far from perfect system; it doesn't provide as much coverage and the poor, unemployed and chronically ill are definitely at a disadvantage. However, the Australian system (and other systems) could take the Singapore method and tweak it to provide healthcare at a lower cost than it is now. How?

Singapore Skyline (Source: Wikipedia)

The big feature to take away from the Singapore system is the ability to have a government-funded savings account system that would offer the safety net features of Medicare without any disadvantage to the poor, chronically ill and/or aged. Within this system, the government would pay a pre-determined annual amount to everyone, based on age of citizens, into a health account for each person held at the Commonwealth Health Bank. Then the account would be supplemented jointly by employer/employee contributions, say 2% of income. Then funds gathered in each account would then only be used to pay for medical services at approved prices.

Private hospitals and individual practitioners could charge more than the approved amount, but the patient would have to pay the difference from his or her own wallet or private insurance. Private insurance would also be used to cover things like sudden and catastrophic events or illnesses that would kill a health savings account such as cancer treatments.

Unlike Singapore, citizens will be allowed to run up a negative health balance to provide a safety net, but if you make above a certain threshold of money a year, a slightly higher tax rate applies until the balance is put back to normal. If you die before the negative balance is dealt with, the estate must be used to pay for it and a positive balance can be willed to someone else. And just like the Singapore system, a positive balance can be used to help another family member out.

Now, the safety net feature does mean that Australia and any other country taking on this system would still pay more, but over the long run, the percentage would drop which is always a good thing.

How does this system also benefit patients? Aside from providing affordable care to everyone, a positive health account becomes an asset which is used to reward people for taking care of their health. There would be an end to over-servicing, over-ordering of tests and general floods to doctors which would reduce pressure in waiting lists. Furthermore, there would be more competition between public and private sectors which mean the system would become more efficient.

These changes may seem radical, but with a rapidly growing and aging population and increasing pressures to pay more and more for necessary services, it's important to overhaul the system now before universal healthcare becomes a footnote in history.

Lena Paul is a medical school graduate who is an enthusiastic blogger and holds an editorial position in Prepgenie, a test prep provider that offers exam preparation courses for GAMSAT, PCAT, UKCAT and UMAT.

Open More Doors by Earning a Master of Science in Nursing Degree Online

noreply@blogger.com (minava) — Tue, 11 Sep 2012 11:00:00 +0000

Thought about a career in healthcare but realized medical school was not for you? Think again, but think different: a career in nursing! Check out this guest post from Susan Smith to find out more:

There are so many excellent and rewarding job opportunities in the medical profession; you don't have to be a doctor to help people. A doctor is only as good as the staff that surrounds him or her. Becoming part of the staff is not only a wise career choice, but it is a rewarding career path that provides plenty of opportunities to help people in need. A career in nursing is stable, it pays very well and it is a job that makes a difference in the lives of millions of people everyday.

Nurses are often the first people to provide care to people who are sick or injured. A nurse can form a relationship with a patient that will last a lifetime, but what is really important is this fact: a nurse is often the first person to put a smile on the face on the patient. Which nursing degree will offer the best opportunities for you, then? Well, there are several to carefully consider:

Licensed Practical Nurse - This is often the first stepping stone towards a career as a nurse; they are commonly referred to as LPNs. A LPN will be able to provide basic care to people who are sick or injured. Schooling is required and usually one year of training at a hospital is also required. A LPN can then choose to further their knowledge and career choices in the nursing field. A LPN is often supervised by a registered nurse.

Registered Nurse - A registered nurse, or RN, will have more job opportunities, but this position will require more training. RNs often have to supervise several other LPNs and certified nursing assistants.

Associate of Science in Nursing - This is the next step an LPN can take to further his or her career. By obtaining an associate’s degree, nurses will not only expand their knowledge, but they will also be able to earn a bachelor's degree with greater ease. This degree is available to both RNs and LPNs. This is a two-year degree that focuses on the more technical aspect of the nursing industry, but once again: this is just a stepping stone towards a better degree.

Bachelor of Science in Nursing - This is not the highest degree a nurse can obtain, but it is often the most sought-after by people who are pursuing a career in nursing, and it will provide the best job opportunities. Numerous current positions in the nursing industry will require a BSN (Bachelor of Science in Nursing). This is a four-year degree, but there are instances where this degree can be earned faster if the nurse already holds an associate’s degree.

Master of Science in Nursing – Also known as an MSN, for many nurses, this is the “Holy Grail” of the industry. Nurses that obtain a Master of Science in Nursing will find a huge amount of career choices. A nurse that has this type of degree can handle as much as 80% of the same work as a primary care physician. This type of degree can also grant a nurse prescription privileges. A nurse with a Master of Science in Nursing does much more than change bedpans. They have the necessary knowledge to provide primary care, examine patients and order and interpret specialized diagnostic tests and studies.

RN to MSN Online - This program allows a RN to pursue a Master of Science in Nursing online. This gives nurses more opportunities and a more flexible schedule to obtain the degree. Online classes can be taken anytime day or night.

MSN Bridge - This program allows a nurse that has a non-nursing Bachelor’s degree get started in the right direction towards earning a MSN degree. The MSN bridge course consists of many of the undergraduate courses that are needed to start graduate level courses required by a MSN.

Nurses are currently in high demand and that is not expected to change in the near future. Choosing to pursue a career in the nursing field is not only smart, but it offers gratifying and challenging experiences every single day on the job.

Susan Smith is currently furthering her education with an RN to MSN online course. She was inspired to enter nursing by her grandmother, a World War II nurse.

Physician Burnout: It's Inevitable, But Not Unavoidable

noreply@blogger.com (minava) — Mon, 10 Sep 2012 11:00:00 +0000

If you have given any consideration to a career in medicine, you have heard about physician burnout. But never fret: Dr. Jewell offers some advice on how to deal with the stresses of a medical career in this guest post:

Doctors are in some way or the other responsible for maintaining the balance of the yin and yang of the universe - well at least that is what they are trained to believe throughout their tenure at medical school. The practice of medicine manages to portray itself as attractive and “fun” during the first couple of years after college, but the fun aspect gradually takes a backseat and eight or 10 years down the line they get engulfed in the burnout pedantic. Experts believe that this is because of the medical training that the physicians receive (or lack of it actually) and also because how people generally define “success”. The problem is there is only one parameter to measure success - busy practice. More often than not the success of a physician is defined by his workplace pressure and his ability (or inability) to continue performing on the trapeze wire that losing balance. Here are the few reasons of physician burnout and how it can be avoided:

The job is “stressful”: Well, how would you define that? Some of the more demanding professions such as that of a physician or a lawyer are characterized as having a heap of responsibility with very little control on the final outcome. Like it or not, the job is one of the most demanding ones and needs one to keep performing under pressure without succumbing to it. It definitely saps all energy every day, day by day.
Physicians are taught to solve problems - not to bask in them! A typical physician encounters hundreds of physically and mentally sick patients throughout the day and he is always expected to be the problem solving machine and hardly a human being (with a whole bunch of emotions affecting performance). Here, the problem does not lie with the profession - the training provided to medical students does not adequately equip them to handle emotional pressure.
The balance is always tipped! Throughout medical school a medical student is taught to shove aside all priorities of life and focus only on medicine and its charismatic capabilities of transforming others' lives. The problem is medical school does not last a lifetime but the training continues to dominate the students and somewhere down the line family responsibilities start qualifying as “other priorities”. Here also, it's the training mythology that is to be blamed when some elemental changes would definitely make things better.
A physician is always expected to have leadership skills but is never taught the same. Military and medicine are two different professions their leaders are only expected to give the orders, but in the latter the so-called leaders are never made to attend even a single lecture on leadership. The dysfunctional top-down leadership system not only leaves a health care delivery team confused but also puts more stress on the “leader” himself.
A doctor is almost always considered as a machine. A physician is supposed to be able to keep performing under pressure and never succumb to it. He is always expected to be the perfect decision maker and service provider in front of his teammates, customers and hospital governing bodies. That definitely saps emotional and mental strength.
So much work and you still have to deal with the money part! More on healthcare system might be a blessing for patients because they can choose to remain blissfully unaware of the twisted proceedings of medical insurance companies, but the physician is never spared. He is expected to have all knowledge about all kinds of insurance companies and also be able to make sure that his cut comes to him without bothering his patient.
There is always an uncertainty about what's going to happen next. No marketing guru can perfectly predict the career course of a physician. So, the subconscious is always worried about what plans the future has for the physician. That is definitely emotionally taxing.
Medical practice is like a ticking bomb. Medical science has evolved tremendously over the last couple of years, but so has the legal noose that almost always is concerned only about patient benefits and rights. A physician is always silently waiting for the bad stuff to happen and that is emotionally taxing.
Too much pressure and you eventually get hurled into a lifelong emotional trauma. That is exactly what happens with physicians. All of a sudden nothing seems to make sense and the volatile love for medicine disappears suddenly. That is the end state of a burnout.

Word of advice

Burnout is inevitable under the circumstances and in most cases physicians seem to accept it as a way of life. The good news is this can be avoided. Solution on this is quite apparent! Stick to your reason or purpose of becoming a doctor! After spending quite a lengthy span of your life in medical studies, it's obvious to get bewildered when you see the purpose behind your endeavor is lost for some reason. Now, you have to jump in and establish the connection back, for it’s a source of your motivation and endurance.

Source: happymd

Some of the important signs of a burnout include exhaustion, questioning your own ability and cynicism. You need to make something very clear to yourself - you have a talent that can benefit your fellow men, but that does not make you a machine. You have every right to feel sick, feel stuck and feel bored. Just indulge in activities that make you happy, get help from family and stop categorizing everything related to your profession is important and everything else “other priorities”.

Dr. Jewell is a board certified Oregon plastic surgeon who has served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) in 2005-06.

Do Medical School Rankings Matter?

noreply@blogger.com (minava) — Tue, 04 Sep 2012 13:00:00 +0000

Every year medical students agonize over medical school rankings. Specifically, like "AHHHH! MEDICAL SCHOOL RANKINGS ARE COMING OUT SOON!" Pre-Med students are famous for being Type A "gunners" who are at high risk for obsessive compulsive disorder. An exaggeration to be sure and not true of all, but the fact remains that data about rankings in the hands of people who are geared for high achievement tend to produce more angst than relief.

The simple fact is: one cannot boil medical education down to a single ranking! The U.S. News And World Report's Best Medical School Rankings does not even try. It actually breaks the ranks down into research and primary care lists. Oddly enough, most people focus on the research rankings, despite the fact that primary care is what medicine is all about! Taking a look at the two sets of rankings and you quickly realize that the correlation between the two is far from perfect.

As a pre-med student or medical student, which list do you follow? The simple answer is: both! You have to realize which list best applies to you. Are you more interested in research and considering an MD/PhD or similar joint degree? If so, focus on the research rankings. Do you instead prefer caring for the underserved, working internationally, or perhaps rural medicine? Then focus on the primary care rankings. Not sure yet? Try to see which schools rank highly on both. As a guide, the list below shows the top 10 medical schools in primary care with their research rankings (in parentheses); the list below it has the top 10 medical schools in research with their primary care rankings (in parentheses):

Top 10 Medical Schools Research Rankings (Primary Care Rank)

1. Harvard University (17)

2. University of Pennsylvania (7)

3. Johns Hopkins University (25)

4. University of California - San Francisco (5)

4. Washington University - St. Louis (30)

6. Duke University (42)

6. University of Michigan (14)

6. University of Washington (1)

6. Yale (87)

10. Columbia University (62)

Top 10 Medical Schools Primary Care Rankings (Research Rank)

1. University of Washington (6)

2. University of North Carolina - Chapel Hill (20)

3. Oregon Health Sciences University (37)

4. University of Vermont (55)

5. University of California - San Francisco (4)

5. University of Colorado - Denver (27)

7. Michigan State University (-)

7. University of Pennsylvania (2)

9. University of Massachusetts - Worcester (47)

10. University of Iowa - Carver (27)

As you can see, there are some huge disparities. The only schools to make both lists are University of Washington, UCSF, and UPenn. Clearly, if you are unsure of your future career focus, you have better odds of finding out at those three schools. While the USN&WR rankings are not 100% correct, they do serve as a reasonable proxy for the actual underlying quality. Ultimately, you have to make a decision from the heart about what place is right for you.

Want more details about the process or specific medical schools? Check out these titles:

References:
1. U.S. News & World Report Best Medical Schools Research Rankings. http://grad-schools.usnews.rankingsandreviews.com/best-graduate-schools/top-medical-schools/research-rankings. Accessed December 21, 2010

Save 10% Off Kaplan Step 2 CK Prep Now!

noreply@blogger.com (minava) — Fri, 31 Aug 2012 23:14:00 +0000

As some of you third and fourth years gear up to take USMLE Step 2 CK, it is a great idea to both study from a review book like USMLE Step 2 Secrets, 3e or First Aid for the USMLE Step 2 CK, Eighth Edition (First Aid USMLE). However, it is equally important to actively utilize a qbank such as the ones offered by USMLEWorld or Kaplan Step 2 CK Qbank.

This would have worked before the USMLE became computerized!

If you purchase the Kaplan Qbank for Step 2 CK by September 30, 2012, use this link to save 10% on your purchase: USMLE- Step 2 CK Qbank

Good luck! You're almost there!

The Do's And Don'ts For Medical School Admissions

noreply@blogger.com (minava) — Fri, 31 Aug 2012 11:00:00 +0000

While this blog is typically targeted at students already in medical school, many readers have questions about how to get into medical school. This guest post by Carey discusses a few tips for getting past that medical school admissions committee:

When it comes time to decide what you want to do with your life, things are hard enough. Maybe you have already decided you want to be a doctor and you want to try your hand at getting into medical school. If this is the case, there are many things you need to prepare yourself for before getting into medical school. Here are so do's and do nots for getting into medical school.

The Do's

Study Hard
If you want to get to the first step for getting into medical school, which is the interview, you will need to study hard and ensure your grades and GPA are up to par. Your best bet is to have a GPA of 3.5 or higher. You will also need a MCAT score of more than 30 to get many interviews. This is your future so you will want to do whatever it takes to get into the school of your choice.

Gain Some Experience
Do some volunteering at your local hospital to gain some experience. Medical schools like potential students who have tried working in a hospital and still want to go further with getting a medical degree. Volunteering at a hospital or doing something medical related will ensure you stand out from other applicants, and in a good way.

Extracurricular Activites
Choose an extracurricular activity and stick with it for a while. Make sure it is something you enjoy doing. Medical schools like to see that you are committed and will stay with something for a long time. This will not only make you look good but will help you receive a leadership position that you could be happy with.

Get Involved
Get involved with whatever you can. Whether it is sports, research, the arts or helping out with the community. Doing one of these things will surely get you some points with the admissions people.

Harvard Medical School

The Do Nots

Major in Pre-Med Only
Do not just major in one thing when in pre-med. Just because you are a pre-med student doesn't mean you need to only major in medical or science related classes. Try French or journalism as a minor at least. This will show you are interested in many other things as well.

Forget to Breathe
Don't forget to breathe. Don't study too much or you will get burnt out fast. Medical schools like to see well rounded and organized people. You don't have to hit the books too hard, just enough to get the interview.

Stress
Don't stress yourself and make yourself sick. Yes, there are a lot of medical school applicants wanting a chance just as much as you do but there is no need to make yourself sick with worrying about not getting in right away. If you don't get in to be a doctor, why not try for a nursing degree, physician assistant or a nurse practitioner?

You can do it! Take these tips and advice and make yourself stand out from the rest of the crowd applying for medical school.

Carey has been writing professionally for many years now. She started out small on the freelance writing ladder and has climbed her way to the top with bestessay.com.

How To Become A Plastic Surgeon

noreply@blogger.com (minava) — Mon, 27 Aug 2012 13:00:00 +0000

Any interest in Plastic Surgery as a specialty? Check out this guest post by Samantha Ferry about the road ahead:

Medicine is a grueling and incredibly competitive field and, within the field, plastic surgery is among the most competitive routes one can take. Therefore, first and foremost, make sure that you are committed and incredibly passionate before venturing out on the path of pursuing a career in plastic surgery.

Once in college you’ll have to get a bachelor's degree in a premedical major – think biology or chemistry. You must complete all of the required courses for medical school while an undergraduate.

Next, take the Medical College Admission Test (MCAT), and connect with a counselor to narrow down a list of realistic medical schools to apply to. The applications to get into medical school are typically sent out during the senior year of college. Try to look for a school with a plastic surgery residency program as it will make subsequent steps that include specialization considerably easier.

Once in medical school you must graduate with a four-year doctor of medicine (MD) degree (you undergo a third year clinical rotation before choosing a specialty). Once you have your MD degree in tow, you must go through a three-year surgical residency training. Even if you think you’re 100 percent sure that plastic surgery is where your heart lies, it’s a good idea to research the field through the American Board of Plastic Surgery and make sure to do a rotation or externship with a plastic surgeon. These steps will allow you to learn the rules, regulations and the everyday role of a plastic surgeon.

During residency is when you will choose a specialty after completing the general surgery training (think hand surgery, aesthetic surgery). Once your residency is completed, you will need certification with the American Board of Plastic Surgery. However it’s important to note that while the American Board of Plastic Surgery is the oldest certifying body, there are others including the American Board of Cosmetic Surgery.

Some doctors opt to pursue a fellowship after completing their residency before officially beginning their plastic surgery career.

It’s recommended that you seek out job opportunities early on in the last or next to last year of your plastic surgery residency. You’ll also want to remember to network during all of the training as it is key in securing employment opportunities in this very crowded and competitive field. In the same vein you’ll want to attend as many conferences as possible.

Samantha Ferry is a freelancer for AboutPlasticSurgery.com and other medical and health lifestyle websites.

Nurse Practitioner Vs. Physician Assistant: What Should You Choose?

noreply@blogger.com (minava) — Fri, 24 Aug 2012 11:00:00 +0000

The allied health professions have rapidly proliferated in the last two decades. Making sense of all the variations on a mid-level provider takes some effort. This guest post from Atlanta Home Care helps shed some light on the matter:

Differentiating between the two professions poses to be a confusion among people but both the professions- Nurse Practitioner or Physician Assistant require a formal degree of education and are about taking care of the ill and delivering healthcare facilities to the ones in need. These two sorts of professions are somewhat different but there are many similarities. This article will help you understand the two professions in detail and consequently will clear out the confusion.

It is important to understand the real differences between a Nurse Practitioner and a Physician Assistant. At first glance, they may appear to be the same but doctors and those in the field of medicine can tell you exactly what the difference between the two professions is.

There is a difference between a registered nurse and a nurse practitioner. A nurse practitioner has to be a registered nurse. A nurse practitioner is more experienced and academically advanced than a registered nurse is. A registered nurse becomes a nurse practitioner when they advance from a bachelor’s level education to a Master’s degree qualification.

The work and duties of a Physician assistant will encompass taking care of the patients, diagnosing their problems and providing them with health care under the supervision of a registered physician. Physician assistants can also make prescriptions but only under the guidance and help of the qualified physicians. The final authority lies with the qualified physician. Where as a Nurse practitioner has greater independence and carries out his tasks in providing healthcare and assistance independently.

Now considering the issue of salaries and pays, a nurse practitioner is more qualified than a Physician assistant and consequently earns more money than a Physician assistant, as it is the case in almost every line of work. But in many states it is only a matter of experience. Many states will fix salaries according to the number of years that they have practiced and served.

The Physician assistant has to work in sync with the qualified physician therefore their number of working hours is very closely related to the number of working hours of a physician. However the nurse practitioners are more autonomous in that case. Since they work solo, they decide when and for how long they work. As they work independently they rule their own professional lives and routine.

One major difference in the practice of Nurse practitioners and physician assistants is that Physician assistant offers almost the same services as a qualified physician, which includes treatment and diagnosis where as a nurse practitioner’s job is only limited to basic health care and prescription.

One other difference is that physician assistants are responsible for the qualified physician’s duties as well as their own whereas the nurse practitioner is responsible only for himself.

Keeping the above points in mind, it all depends on what you can manage and who you want to be. Both of these options are excellent considering the help you will be to the sick people. But at the end of the day it boils down to what you want.

Atlanta Home Care can provide you with expert and licensed care takers and nurses who would be extremely gentle, kind and amiable. Our nurses are certified by the Georgian state and provide services for all including senior citizens.

Education Path for Doctors Without Borders

noreply@blogger.com (minava) — Mon, 20 Aug 2012 11:00:00 +0000

You may have heard of Doctors Without Borders, but do you know how it started or how you can participate? Find out all about it and more in this guest post by Melissa Miller:

History

The international medical humanitarian organization was created by French doctors and journalists in 1971 in response to a blockade in the Nigerian Civil War. France was the only major country that supported the newly independent county whose residents were suffering from the blockade. The humanitarian crisis and lack of support from the outside world highlighted a need for a medical organization that would operate without political or religious restraint.

“Every year, Doctors Without Borders/ Médecins Sans Frontières (MSF) provides emergency medical care to millions of people caught in crises in more than 60 countries around the world. MSF provides assistance when catastrophic events — such as armed conflict, epidemics, malnutrition, or natural disasters — overwhelm local health systems. MSF also assists people who face discrimination or neglect from their local health systems or when populations are otherwise excluded from health care.” –Doctors Without Borders Website.

There are a variety of positions that are described as urgently needed – OBGYN’s and surgeons being the most in-demand. For general physicians, however, there are a few specialties that the organization considers highly valuable.

French

Because Doctors Without Borders is a French organization (Médecins Sans Frontières) speaking French is a major asset to applicants who hope to work with the program.

Tropical Medicine
The field of Tropical Medicine focuses on the health problems of tropical and subtropical regions. Many of these health problems were once endemic in areas of colder climates, but have been controlled or eliminated as those areas have become more developed.

Poor housing, diet, sanitation and personal hygiene cause these infections to remain endemic in tropical areas, making culture, not climate, the factor that perpetuates these diseases. Thus, the field of medicine is also known as “Geographic Medicine” or “Third World Medicine.” Tulane University in New Orleans, LA, is currently the only American school of Tropical Medicine. The school offers undergraduate degree in Public Health, and there are also various specialty fields in the Master’s and Doctoral degrees, one of which is Tropical Medicine.

Many medical schools, like West Virginia University and Johns Hopkins, also offer courses in Tropical Medicine.

HIV/AIDS Specialists
The University of California at San Francisco currently has the highest rank AIDs research institute in the country. To become an HIV specialist as certified by the American Academy of HIV medicine, you must have completed your residency and must have clinically managed at least 20 HIV patients within 2 years. You must also “demonstrate continuous professional development” through education and re-certification. The paths to satisfying the developmental component will depend on your medical degree.

This guest post is provided by Melissa Miller. She aims to help you understand the challenges and benefits involved in earning an online associates degree, and show you a way through the often confusing process. She welcomes questions and suggestions at melissamiller831@gmail.com

What Is Remote Patient Monitoring?

noreply@blogger.com (minava) — Fri, 17 Aug 2012 11:00:00 +0000

Perhaps you have heard the phrase 'remote patient monitoring.' Most likely though, you - like me - was not sure exactly what it meant. Laira Davidson joins us today to explain what remote patient monitoring entails:

Remote Patient Monitoring and Its Impending Effects on the US Healthcare Systems

The business of home monitoring is expected to change the face of American healthcare. From sleep patterns to cardiac events, physicians can monitor patient vitals remotely. By the end of 2011, physicians were remotely monitoring the health of 2.2 million patients around the world according to Berg Insight. From 2010 to 2016, the number is expected to grow to 4.9 million patients. The market for telemonitoring is colossal.

Telemonitoring equipment is reducing the cost of caring for patients with diabetes, chronic pulmonary disease or congestive heart failure. Remote patient monitoring equipment is projected to reach an 18 percent “compound annual growth rate” during this same time period. Experts also expect the market to grow from $7.1 billion in 2010 to $22.2 billion by 2015.

This near exponential increase should have a positive effect on the U.S. healthcare system. As the healthcare system becomes more efficient, physicians will provide better and more personalized care to home-bound patients. Comprehensive data cannot be captured without a lengthy hospital stay that many patients cannot afford. Remote patient monitoring makes it easier to capture data and identify environmental-specific triggers that may not occur in the hospital. This is great advancement for healthcare.

What is Remote Patient Monitoring and How Does It Work?

Remote patient monitoring allows physicians to monitor patient vitals while they are in their homes. Patients must obtain the equipment in their homes for home monitoring. The data captured will be updated in real-time with a physician. A landline connection, cellular network or the Internet is required to complete the data transfer. Many physicians are currently monitoring sleep patterns and administering sleep therapy through remote patient monitoring. Cardiac rhythm management can also be achieved with remote patient monitoring equipment.

Benefits of Remote Patient Monitoring

Reduced Costs. Patient costs are reduced because they are not paying for expensive hospital rooms for this type of monitoring. Instead, patients are in the comfort of their own home with their monitoring equipment. While saving money, physicians can avoid admitting patients for long periods of time for monitoring who simply cannot afford the expense. Physicians reduce losses associated with non-paying patients. The concept helps both physicians and patients save.

More Patient Involvement. With at-home monitoring, patients play an active role in their healthcare. Physicians can deliver more accurate diagnosis and treatment with extensive at-home monitoring. Remote patient monitoring will yield better care.

Potential Challenges with Remote Patient Monitoring
Lack of Coverage. Remote patient monitoring services and equipment are not fully covered by insurance providers. The coverage is very limited. As the idea becomes more widely accepted, health insurance coverage may increase.

Medical-Loss Ratio. While the medical-loss ratio does not directly affect remote patient monitoring, it could have an indirect effect. Physicians, under this regulation, are required to spend at least 85 percent of the savings on activities that improve the quality of health care and on medical benefits. Given this requirement, physicians may have an extra incentive to re-invest the money collected on premiums into adopting remote patient monitoring and also advanced equipment related to the migration.

Physicians who are resistant to change may not view this as an added benefit and may not view this as a “value-add” in their practices. In the past, physicians have used the savings on implementing new International Classification of Diseases codes (ICD-10) or on health information technology such as electronic health records (EHRs) and electronic medical records (EMRs). If physicians will also invest in remote patient monitoring, patients will benefit from the savings also.

While there are many implications for improvement, there are likely to be some other challenges as the integration and adoption occurs. Remote patient monitoring is expected to have a significant impact on the United States healthcare system.

This article was written by Laira J. Davidson for PETAP, your guide to finding accredited online nursing schools.

Books For Fourth Year Medical Students

noreply@blogger.com (neoram) — Mon, 13 Aug 2012 11:00:00 +0000

You see the title and think "Books for fourth years? Do MS4s even show up to class?" Haha, well depending on where you are for med school, there may still be significant rotations to take during the fourth year. Books for those rotations are addressed in the books for MS3s post. However, there are two types of books fourth years should consider: board exam prep books and residency planning books.

Confused again about why board exam prep is listed here? Step 1 is in the rearview mirror, and maybe Step 2 CS/CK as well. However, all US medical graduates will have to take Step 3 at some point and trust me: sooner is much, much better than later. USMLE Step 3 is a comprehensive exam that covers all the same topics as Step 1 and 2, but with more clinical applications. Additionally, the exam is longer, requiring two separate days to complete.

To be honest, any Step 3 prep book should be fine. If you liked the style of First Aid for USMLE Step 1, then stick with First Aid for Step 3. The real key to success here is to do questions from a qbank, like Kaplan's USMLE Qbank. As they say, practice makes perfect. However, do not fall into the trap of "Two months, two weeks, two pencils (or two days)" as a schedule for Step 3 prep: the exam is as tough as Step 1 and Step 2. If you do not take it seriously and do not study, you will fail. I repeat: you will fail. While the test is not as critical as Step 1, it is *not* a blow-off exam.

Okay, that got intense - on a lighter note, the second topic is of more interest to your future career. As you prepare for interviews, you should have a good idea of what your field is about and what you need to do to prepare. The following two books are quick easy reads that will help orient you to the fields of your interest. If you are still figuring out what to apply for, they will help narrow that down as well.

While the Iserson book is somewhat dated, it is still an excellent resource to refer to as you go through the process, as Iserson provides a good system for comparing programs to each other on the interview trail. Additionally, this site had a series of posts in the past dealing with residency interviews: Residency Interviews Tips, Parts 1 - 5. The posts are quick easy reads with the intent of providing high-yield information for interviewees.

Enjoy fourth year! Good luck with residency applications!

The Highest Demand Health Professions

noreply@blogger.com (minava) — Fri, 10 Aug 2012 11:00:00 +0000

With all of the recent debate about the growth of health care as a share of the U.S. GDP, one surely wonders what is driving all this growth. Guest poster Justin Davis sheds light on sub-sectors of healthcare that are growing fastest:

When you’re choosing a program of study, it only makes sense to focus on an area that is experiencing growth. You don’t want to spend several years and thousands of dollars studying something that will only land you in the unemployment line.

One area that’s almost guaranteed to get you a job is healthcare. Healthcare, encompassing everything from doctors all the way down to office support, is one of the largest employers in the U.S., and shows no signs of slowing down. Consider going into one of these areas of healthcare to virtually guarantee that you’ll always have a job.

Registered Nurse

While certain professionals will always be in demand, there is one career that eclipses them all: Registered Nurses. In the coming years, there will be a greater need for registered nurses more than any other type of professional, thanks to our aging population – Baby Boomers, the largest generation in American history, are nearing retirement age and increasing their usage of healthcare services. The following generations are also having children now, further taxing the healthcare system. As a result, the Bureau of Labor Statistics projects that there will be more than half a million new nursing positions opening up over the next four or five years – and that’s not even counting the thousands of positions that will open up when current nurses retire.

Landing one of these coveted positions may require relocating, though, as certain areas of the country have nurse shortages, while others are well-staffed. The rewards, though, are great. In addition to the satisfaction of caring for people, on average, RN’s earn $31 per hour; specialized nurses working in critical care areas can more than $40 per hour. Most RN jobs are in hospitals, but you can also find work in physician offices, outpatient clinics, nursing homes home healthcare agencies, and in healthcare related businesses, like insurance companies. In some cases, RNs can also climb the career ladder, landing administrative positions after serving in a patient care for a number of years.

Home Health Aide

Home health aides provide care to those who are house bound, or living with a chronic illness and need regular care. Aides visit these patients at home each day to check vital signs, administer medication, help with personal care and household tasks, and basically monitor patients for changes or conditions that might require further evaluation or treatment. The vast majority of patients are either elderly or disabled, and the job requires a great deal of patience, sensitivity and the ability to work independently.
Home health aides are often employed by hospitals or health systems, or private agencies – and the number of job opportunities is expected to grow significantly over the next few years. The Bureau of Labor Statistics projects that nearly 400,000 new jobs in this field will be created in over the next four years – meaning that there is plenty of room for trained professionals. However, the pay is relatively low for this work, meaning that there is a great deal of turnover.

Healthcare Administration

Not all jobs in healthcare require direct patient care. In hospitals, health systems, insurance companies and government agencies, there is a need for healthcare administrators. Administrators are the backbone of the healthcare industry, developing the policies and procedures that govern the day-to-day operation of the facility, and managing the often complex infrastructure of finances and personnel involved with running a healthcare entity. Administrators develop strategies for growth, answering the ever increasing demands placed on the system, and advocate for quality healthcare for everyone.

While many healthcare administrators have a background in patient care, the majority come from a business background. Healthcare finance in particular is complex, requiring in-depth knowledge of financial and accounting concepts. And because of ongoing changes in the healthcare industry, there is a growing need for experienced administrators – the Bureau of Labor Statistics projects growth of 9-17 percent over the next five years.

Of course, there are plenty of other areas of healthcare that are showing growth as well. Demand for medical assistants, medical records technicians, pharmacy technicians and medical secretaries and billing professionals is also growing – all fields that offer well-paying jobs and decent wages. So consider these jobs when you’re planning your education and career track – even in challenging economic times, a degree like MSN nursing or an MPH degree will enable you be to count on having work.

This article was written by Justin Davis who is currently working towards a master’s degree. Justin loves to write and believes strongly in the importance of higher education.

The Medical School Olympics

noreply@blogger.com (minava) — Mon, 06 Aug 2012 11:00:00 +0000

As we all enjoy watching the 2012 Summer Olympics in London, I am struck by the parallels between various sports and aspects of medical school. Just as the athletes take four years of their life going for gold, we spend four years of our lives, striving for that MD (or DO or DDS). Many of the characteristics that make for a champion also help forge a successful future physician. How do the sports and the rotations stack up? Let's count the ways:

The 400 Meter Hurdles
In medical school, these are the first two years, the basic sciences. Why? Well, you sprint for a few weeks, learning a wide swath of material, only to face a hurdle at the end: the test or shelf exam. Like the sport, it is important to pace yourself and most importantly clear those hurdles. Especially as a first year medical student, learning how to learn medical knowledge may be the key thing to take away from these courses rather than any particular fact or figure.

The 10,000 Meter Run
Middle distance running does not have the glamour of the 100 meter dash or the sheer respect one must have for a marathon. Similarly, USMLE Step 1 feels like an interminable slog yet it is something every MD goes through. Like the 10k, studying for Step 1 is all about pacing. You want to start strong but steady through the first 9k, saving up for that last 1k when it turns into a sprint. Step 1 works the same way: that last week and test day are an all-out burst of knowledge, unloading everything you learned in the two years before.

The Decathlon
The clinical years really stretch a medical student in all kinds of directions, much like the decathlon. You're delivering babies, treating patients with cancer and heart attacks, and participating in code situations. You have to be versatile and quick to adapt. Much like the decathlon, it's not important that you "win" every race - you do not have to be the best medical student in surgery and pediatrics and neurology. What matters is performing at a high level in each specialty. A decathlete can often win the decathlon without winning any one of the 10 events. Similarly, focus on performing at a high level and maintaining that momentum moreso than being the best at any one area.

The Long Jump
Making the move from medical school to internship and residency is a big deal. You go from being the student in the corner, barely acknowledged at times, to "Doctor, the patient's potassium is 4.5 - what do you want to do? Doctor, the ultrasound tech thinks there may be an ectopic, what do we do? Doctor, the x-ray shows a possible tension pneumo?" So many decisions! Many of which you will be ill-equipped for on Day 1. But never fear - like the long jump, you push off from the end of the runway of medical school and have faith that your preparation will carry you to where you need to be.

Bob Beamon, one of the greatest long jumpers ever, setting the world record in Mexico City 1968

The Marathon
The epitome of the Olympic Games is the marathon. The 26.2 miles are a true test of human endurance and the human spirit. The road past medical school is much the same way - it is important to maintain the momentum you built in medical school. As cliche as it sounds, being a good physician really is about lifelong learning.

What do you think? Do these sports match up with these phases of medical school? No matter where you are in your education, hopefully you can take some time away from medicine and enjoy London 2012!

How the Australian Healthcare System Can Help American Health Care

noreply@blogger.com (minava) — Fri, 03 Aug 2012 11:00:00 +0000

Given all the attention given to the healthcare in the U.S., ever wonder how other countries manage to keep their citizens happy and healthy? This guest post from Lena Paul offers a glimpse at how Australia tackles the situation:

Universal healthcare is often viewed as a hallmark of western civilization, save in the United States where it is only just now getting a very rocky beginning that is under threat by the oncoming election, despite the fact that comparisons between America and other countries definitely puts America off the worst. In America, it's assumed that people use employer-subsidized healthcare, private insurance and Medicare, with no universal medical record, lots of lawsuits and a disparity of lawsuits. Somehow, with all these lacks, Americans still manage to spend more on health care than anyone else does while still being ranked very low by WHO (World Health Organization). Sheesh! But other western nations are different and a good comparison is Australia. This is because certain aspects of the Australian system are very similar to the traditional American setting while being different in fundamental ways.
The core of Australian healthcare isn't too terribly different from the American system. It relies on a combination of employer and public funding; with 8.8% of the GDP spend on healthcare (compared to 15.3% in 2007 in America, before the advent of 'ObamaCare'). About two-thirds of this spending is public and the rest is private. So what accounts for the lower level of spending?

Largely, a better level of health but also a better funded healthcare system which takes advantage of slightly higher taxes and better organization. There is a lower rate of mortality from diseases, it's easier to get to a doctor, wait times for elective surgeries are the same and, one of the most important points, in Australia, people are more likely to go to the doctor or get prescription drugs because it costs less. The big difference is hospital wait times, which can be extremely long, particularly for elective surgeries or a sudden need.

Another major aspect is how the universal healthcare is slanted. Medicare in Australia provides basic coverage to citizens, free treatment in public hospitals and free or covered treatments. Dental, optho and mental health are covered as are services for the disabled and seniors. If you go to a private hospital, you'll have to pay more of your bill, but that's the price you pay for privacy (and speed of getting in). Subsidized prescription drugs and a safety net for the poor round out the list, plus you can choose your doctor or hospital. Neat! People get a choice of whether to go for public care and risk waiting longer or pay for private care and get faster service, at a cost. Many people opt for both over the course of their lives, depending on circumstances.

How is this funded? As always, your tax dollars at work; income tax is about 1.5% higher in Australia, plus there are some out of pocket/cost sharing expenses, private company funding and higher taxes on those with cash to spend who don't purchase private insurance.

So why is the Australian health care system a beneficial case study for Americans to consider? This two tier system in Australia would be relatively easy to implement. America already has a strong infrastructure in place for private healthcare and so adding a greater emphasis on public healthcare could blend in well. Universal coverage could let people get the basics they need when they need it while the ability to purchase more comprehensive private coverage would be offered.

Australia, like America, has a mixed public-private funding system for its universal healthcare coverage. Unlike America, it has a top of the line care record and the costs are less. There are some ways in which Americans can tweak this to fit their needs, but overall, the Australian system bears some closer observation, particularly as ObamaCare falls into threat and heavy criticism. Healthcare should be incredibly important to everyone and for that reason, it's important to take a hard look at it and see what other people in the world are doing and how their ways can be implemented best.

Lena Paul is a medical school graduate who is an enthusiastic blogger and holds an editorial position in Prepgenie, a test prep provider that offers exam preparation courses for UKCAT, GAMSAT, PCAT and UMAT.

Books For Third Year Medical Students

noreply@blogger.com (neoram) — Mon, 30 Jul 2012 11:00:00 +0000

We previously covered books for first year medical students and second year medical students. The section on books for USMLE was important enough to merit its own post. But, as third years, you are through with Step 1, you are through with basic sciences, and you're geared up for the clinics. Alas, day 1 comes and goes and you realize: there is still a ton to learn! Where do you go to find all that information?

The books described here are meant to give you a high yield, high impact approach to each core clerkship you take. Ideally, for each clerkship, try to read one book throughly and use one book for case reviews / questions. Here is a break down of the books you should get, rotation by rotation:

Family Medicine

Family Medicine is generally a nice rotation, with students primarily rotating in outpatient clinics. If you have already done pediatrics and internal medicine, family medicine covers many of the same topics, but in the outpatient setting. Preventative care is also much more emphasized. Blueprints Family Medicine does an excellent job of covering the major topics and preparing you for the shelf exam.

Internal Medicine

As discussed in the post on Books for the Internal Medicine Rotation, the three books above are all you need. Pocket Medicine will get you through the wards on a day-to-day basis while the other two are what you need to power through on your nights and weekends to ace the internal medicine shelf exam.

Neurology

Neurology should be on the relatively lighter side of the clerkships, especially if you have taken internal medicine already. Since there are relatively few therapeutics, focus on learning how to differentiate major disease patterns.

Ob/Gyn

My recollection of OB/Gyn is somewhat fuzzy as I took it during fourth year just as interviews were starting up. The major challenge in OB/Gyn as I recall was learning the skills as well as knowing how to work up various conditions (such as an abnormal pap smear). For OB, just remember: almost always the treatment is - deliver the baby!

Pediatrics

Pediatrics is generally a fun rotation (babies!). The books you should get for pediatrics are much like the other rotations. Conceptually, again there is some overlap with internal medicine, but there is much more of an emphasis on congenital and infectious disorders.

Psychiatry

All you need is the book above - First Aid for the Psychiatry Clerkship, Third Edition. 'Nuff said.

Surgery

Surgery can be a challenging rotation for many students. Not only is there the typical fund of knowledge of disease that needs to be learned, but also anatomy needs to be refreshed as well as technical skills acquired. Many students ask - what books could possibly prepare me for the surgery shelf exam? Studying for the surgery shelf exam will be a constant challenge. If you can wait, pre-order the latest edition of Essentials of General Surgery, so that you can get it right when it is published in October 2012. For the NMS< make sure you get the casebook, not the full surgery review.

Wards

Some topics come up routinely on wards, no matter what service you are on. First Aid for the Wards: Fourth Edition is a great book to cover all those topics that might otherwise fall through the cracks.

Hopefully the books listed above will prove as valuable to you as they have to me - best of luck out there in the wilds of the wards!

What Do Medical Administrative Assistants Do?

noreply@blogger.com (minava) — Fri, 27 Jul 2012 11:00:00 +0000

Ever wonder what all those people in the back-office of a doctor's office do? In this guest post by Nancy, find out all about who medical administrative assistants are.

Essentials for a Career as Medical Administrative Assistant
If you are on the lookout for a career that promises job security and satisfaction, attractive compensation, and positive growth prospects, then your search is about to end!

Medical assistance or medical administrative assistance, ranked as one of the top healthcare jobs of 2012 by the U.S. News and World Report [1] offers all this and more. Belonging to the burgeoning allied healthcare industry, medical administrative assistants perform important supporting roles in hospitals, private practices and other healthcare facilities.

Here are some noteworthy facts about this profession:

Medical assistants held 527,600 jobs in the year 2010 [2]
The median annual income of medical assistants in the same year was $28,860 per annum [3]
The employment of medical assistants is projected to grow by 31% over the 2010-20 decade [4]

If all this has made you even a little bit more curious about the profession than you were before, it may be worth your while to dig a little deeper into what medical assistance is all about. And to help you out, we present the absolute essentials for a career in medical assistance.

Medical Administrative Assistance Training
If you have done some research about breaking into this field, you probably know that it does not have any educational prerequisites save a high school diploma or its equivalent. But that’s not something we’d advise aspirants to this profession.

As things stand in the current job market, postsecondary training has become essential for getting your foot in the door for most white collar jobs. So, look for medical administrative assistant training programs at career schools, community colleges or online vocational institutions.

Career training programs in medical assistance may take from a few months to a year’s time for completion. Typically, these programs include coursework in medical terminology, anatomy, healthcare reimbursement system, medical office procedures, typing skills and Microsoft Office training.

Medical Administrative Assistant Certification
Again, it’s not mandatory for medical assistants to be certified, but it’s a highly desirable credential to showcase your competency for the job to prospective employers. Four voluntary certifications are available to medical assistants who meet the eligibility criteria of the awarding organizations:

Certified Medical Assistant (CMA)
Registered Medical Assistant (RMA)
National Certified Medical Assistant (NCMA)
Certified Clinical Medical Assistant (CCMA)

Medical Administrative Assistant Skills
It’s all very well to complete amedical administrative assistant training program and get certified, but there are some basic qualities that one must develop to build a successful career in the field.

Since one of their primary responsibilities is to interact with patients who visit healthcare facilities, medical administrative assistants must be customer service oriented in their approach. It also helps to have a pleasing persona as they are the first point of contact for patients.

Medical administrative assistants are also expected to have analytical ability, attention to detail, as well as excellent time management and organizational skills.

You can consider taking some additional courses to develop the required skill set. For example, taking a course in Microsoft Office suite may make you more proficient and productive in your day-to-day work. Increasing your typing speed is another way to improve your efficiency in fulfilling your responsibilities as a medical administrative assistant.
Sources:

http://money.usnews.com/careers/best-jobs/rankings/best-healthcare-jobs
http://www.bls.gov/ooh/Healthcare/Medical-assistants.htm
Ibid.
Ibid.

Nancy is a 36-year old stay at home mom of two. She worked as a medical assistant for five years before taking a break to be with her children. Being an SAHM, Nancy is a huge exponent of vocational training programs that provide women like her the power to be their own boss.

Can A Social Media Profile Be A Resume?

noreply@blogger.com (minava) — Mon, 23 Jul 2012 11:00:00 +0000

Thinking about applying for medical school? Residency? A scholarship, perhaps? Your online reputation may precede you. This guest post by Dr. Gregory Mackay explains some of the do's and don'ts of maintaining an online social media profile as a healthcare student and professional.

Social networking has become an inevitable part of our daily lives and although social media and healthcare privacy are not exactly two sides of the same coin, you need to be very careful about how you socialize because social behavior on social networking websites could have a significant contribution to make towards shaping your future career.

Source: FredCavazza.net

These social networking websites have grown by leaps and bounds (the code of conduct has also changed tremendously) over the last couple of years but so have the medical schools and universities who have already embraced social networking and made it a part of the learning curve. Most medical schools and universities have already got a defined set of guidelines that they expect their students to follow while socializing online.

Now, why is it important for medical students to “behave” themselves while socializing online? Social networking, as it used to be some 5to 7 years back, isn't only about having an online presence - it is now seriously considered as an identity replica by the corporate world which does not have enough time to go through background check reports and small details in a curriculum vitae - the only option they are left with is to take people on face value and that is what calls for “socially responsible behavior” on social networking websites. So, that actually translates to medical schools and universities creating a set of social media policies that can help inexperienced students have better profiles and the behavioral patterns on social media websites. Just warning them is not going to do the job because everyone would interpret the instructions differently - only a written set of guidelines is going to help them.

As a matter of fact the popularity of social media policies has also grown by leaps and bounds. More and more people have realized the benefits. But the million dollar question is “what needs to go into those policies”? Some of the key things that need to be integrated in social media policies include:

The student should be selective about where he establishes a profile. His online presence should mirror his professional responsibilities and interests - he should never go overboard.
A student should remember that having profiles on online social networking websites does not make him a different person - he is the same professional and his behavior should match his professional profile.
He should be very selective about what he makes public and what information he keeps under wraps.
Students should understand that every online behavior can be recorded and monitored. It's best to think twice before displaying certain characters online. His behavior should in no way be able to tarnish his professional reputation.
A medical student also needs to understand that deceit and pretence are not supposed to be considered positive traits in health professionals and he should steer clear of such things while socializing online.

This actually needs to be taken very seriously because a study that was conducted in 2010 has clearly pointed to the fact that not less than 20% of residency pharmacy directors (employers) completely trust social media behavior while recruiting candidates. As a matter of fact, 89% of them also strongly agreed to the fact that the behavioral patterns of social media websites clearly define the identity and character of a candidate and that speaks volumes about the kind of professionalism that they have and also the kind of attitudes that they would display towards others.

There is another huge benefit offered by social media policies. A set of written guidelines is also going to make sure that the privacy of the patients remains intact and that does not jeopardize the careers of young medical professionals. It was found out in a study in 2010 that medical students not having a “respectable” social media behavioral pattern are more prone to diagnosing patient information on social media websites. That could be a dangerous thing and could seriously jeopardize the careers of young medical professionals.

Dr. Gregory J. Mackay is a board certified atlanta cosmetic surgeon by the 'American Board of Surgery' who practices for “The beauty of knowledge”

Books For Second Year Medical Students

noreply@blogger.com (neoram) — Mon, 02 Jul 2012 13:00:00 +0000

After writing previously about books for first year medical students, gotta follow up with a post about books for second year medical students, right? Since the second year focuses more on pathophysiology, the books are geared towards those topics. Eventually though, the two years of training will culminate in the USMLE Step 1 examination, so it is important when purchasing books to keep taking notes with that in the back of your mind. MS2s, as you start your second full year of medical education, consider adding the following titles to your collection:

1. Robbins & Cotran Pathologic Basis of Disease
Although mentioned in the MS1 book list, Robbins remains the definitive book on general pathology. I thought the book did an excellent job not only describing the underlying pathology of almost any major disease you can imagine, but it often clearly explained the physiology as well. Definitely the best reference book I bought and the one I used most often, especially when very detailed questions came up during pathology and immunology courses. The book also serves as the go-to reference when a detailed issues comes up during Step 1 and Step 2 CK studying. For a brief overview of topics, perhaps prior to Step 1, consider Robbins and Cotran Review of Pathology, 3rd Edition as well.

2. Renal Pathophysiology: The Essentials

Regardless of whether your medical school teaches via an organ-based system or not, the second year will typically focus more on pathology and pathophysiology. There are many different books out there with regards to each system, but understanding renal pathophysiology will cover the majority of clinically relevant areas of physiology, including the relevant areas of cardiology. Renal Pathophys by Rennke, a Harvard Medical School professor is an excellent, succinct primer on the physiology of the kidney. The book's numerous diagrams and examples help clarify concepts that can at times be fairly subtle to grasp. The thing I appreciated the best was that nearly every questions I had was addressed somewhere within the book - pretty impressive for such a small volume!

3. Rapid Interpretation of EKG's, Sixth Edition

While the author of this text Dale Dubin is covered many times on this site due to his hard-to-believe story, the book itself remains a good introduction to what an EKG is and how to interpret the various patterns seen. The numerous diagrams help clarify concepts that other books attempt to describe in text. While his writing is... unorthodox, to be charitable, his medical knowledge is correct and he does get his points across. The book is also a relatively quick read and has lots of white space for easy annotation. I'd suggest reading this later in the year as you start to ponder wards, and then updating it with copies of interesting EKGs as you enter the wards.

4. Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine (Pocket Medicine Series)

Like the book above, this is traditionally considered to be a "book for clinical rotations." However, I would argue that it is smart to purchase it early, during second year. Anytime you come across a common clinical complaint, such as chest pain, look at this book's section on it. The book efficiently lists fairly comprehensive differentials diagnoses as well as the next management steps that help you determine the etiology of the symptom or problem. Oftentimes, students in the basic sciences will have heard about various diseases and diagnostic modalities but do not have any idea how to sequence the different diagnostic tests. Pocket Medicine concisely and precisely defines each test and lets one know when and how each test should be used to diagnose a disease.

5. First Aid for the USMLE Step 1 2012 (First Aid USMLE)

While technically this book does not relate to second year courses, USMLE Step 1 comes to dominate the second year, especially the latter half. As I have stated many times before, the trick with First Aid and Step 1 is to buy the book early and annotate it as you go through the year with additional facts or clarifying notes and diagrams. if you annotate the book as you go along, you will create this wonderful resource for yourself that you are intimately familiar with when it comes time to crack open the books to study for the boards.

While there are many other books to buy and refer to during second year, the five books described above should be essential for any medical student in their second year. The beauty of these books in particular is that you will continue to utilize them as you go forward in your medical career, both for directly learning about your patient's conditions as well as to study for board exams. Essentially, these are the books that keep on giving... giving the gift of concise, easy-to-access and understand medical knowledge.

If you have read Books For First Year Medical Students, and now this post, you are probably wondering about what books to buy for third and fourth year. Don't worry - keep your eyes posted here for those posts coming soon.

Close Your Books and Take a Test

noreply@blogger.com (minava) — Mon, 11 Jun 2012 11:00:00 +0000

The following guest post from Joshua Courtney, DO compares learning methods for test preparation and discusses the research behind the various techniques.
For many students, springtime equates with hundreds of hours preparing for standardized examinations spanning over a decade of medical education at many levels. While exams such as the SAT, MCAT, USMLE, COMLEX, NCLEX and NAPLEX all possess their own unique attributes, they are all defined as high-stakes standardized tests. Although most standardized exams within health care are primarily given to ensure a certain minimal level of competency amongst practitioners, it is common knowledge that these examinations are also used as selection criteria by institutions and residency programs to distinguish between applicant pools. A score alone, in some cases, may function as the sole factor in limiting a physician’s future specialty or even the ability to gain licensure - warranting the “high-stakes” descriptor. Surveys published by the National Resident Matching Program (NRMP) have identified USMLE/ COMLEX Step 1/Level 1 scores as the number one selection criteria used by residency program directors to identify candidates for which to offer interviews.

Preparing for any standardized test is daunting, to say the least. In the recently published How To Study For Standardized Tests, Sefcik, Bice & Prerost point out that students who have received low (or failing) scores on standardized exams in the past often describe themselves as “poor standardized test-takers.” The authors further note, “the phrase itself creates the impression of a mysterious innate quality (or lack thereof) that renders someone constitutionally incapable of taking a standardized test.” While it is true that some individuals inherently do better than others on these tests, the more accurate phrase should describe certain students as being “poor preparers for standardized tests.” Now we are saying the individual is inherently capable, just lacks effective methods to achieve their high scoring potential. This speaks highly of the importance of simply believing in one’s self.

Standardized tests are very different from teacher/professor written exams on many levels. Teachers write tests that rewards the student who pays attention in class, studies adequately, and can easily pick out important lecture points – all behaviors a “good student” should possess. Recall of highlighted facts and memorization of the material, alone, are usually enough to sufficiently perform on professor-written tests. Because they are limited in focus, cramming knowledge over a short timespan may be adequate. When it comes to standardized test-taking, traditional methods that have been effective in the classroom may not work.

Preparing for a standardized exam is an entirely different experience, requiring an entirely different strategy. Unlike teacher-written exams, a well-designed standardized test should have global focus with emphasis on integration, associations, and application measures. Standardized exams are written by individuals you have never met. Their purpose is to test a your global knowledge base. There may even be intention to evaluate specific cognitive skills, such as verbal reasoning or analytical thinking. The high-level thinking items tested on standardized exams require a deeper understanding of principles and concepts, leading to a greater degree of difficulty.

The weeks leading up to any high-stakes examination are stressful, to say the least. Most students use a multimodal approach to exam preparation, consisting of review books, practice questions, flashcards, review courses and other methods recommended by upperclassman that best fit their learning style. Students often default to the same study behaviors that have work well for them in the past – an approach that makes sense on the surface. Although individualization of any study plan is a must, there are certain preparation behaviors that are common amongst “high-scorers.”

Rodin's The Thinker

In a recent study performed at Purdue University, and published in Science, researchers looked at the effectiveness of three distinctly different study methods they termed (concept mapping, retrieval practice, and repeated study) to assess their impact on knowledge retention. Below are clear descriptions of each of these learning methods:

Concept mapping: recreating subject matter through diagrams to organize and encode meaningful relationships among concepts.

Retrieval practice: process of using cues to actively recall and reconstruct knowledge (ex: group discussion, reciprocal teaching, taking practice tests)

Repeated study: act of rereading notes, books, or other study materials

When comparing each of these methods head-to-head, it became clear that time spent rereading notes and review materials would be better spent practicing retrieval to ensure better learning. Of the three groups tested, students who took practice tests were found to have retained nearly 50 percent more of the information a week later than students who used the other two methods of studying. These results have been supported by further studies, and are shown to contradict the perception of many students preparing for standardized exams.

In repeated scenarios, when students were asked to make predictions of the long-term learning benefits of different methods of study, they have indicated that both rereading of information and concept mapping (diagrammatic reconstruction of knowledge) would produce more learning than active retrieval. While students believed they would do far better after elaborative studying as compared to taking practice exams, the later group (retrieval practice) was found to have a greater impact on both learning and examination performance. This phenomenon has come to be known as the “testing effect” and shows that acts of retrieval have a potent effect on learning while enhancing long-term retention of the information being tested. These findings parallel research from Washington University in St. Louis suggesting that the common practice of rereading material is no more effective in improving learning than performing a single, initial reading of the text. The practice of spending large amounts of time rereading materials despite limited benefit to memory and retention is a phenomenon coined “labor-in-vain” learning. This method of preparation is pervasive among test-takers, despite being ineffective.

Students and residents preparing for licensure and specialty boards alike often incorporate practice questions into their exam preparation as a means to assess areas of strength and weakness, as well as to assess exam preparedness. Although using practice tests for this purpose can be an effective means to both self assess and drive one’s focus, this differs from the concept of using testing as a learning device of its own. The process of practice retrieval has been shown to be of far greater value to impactful learning than previously thought.

Although medical schools and other institutions provide some level of guidance for students undergoing high-stakes exam preparation, self-study and self-guidance are implicit in great extent to the process of preparing for any standardized test. The incorporation of taking practice items is important for diagnostic purposes, but the true impact comes from the actual learning that takes place during the process of testing itself. This may seem obvious, however, in repeated studies, students have been shown to lack awareness of the testing effect, and its potent impact on learning itself. In multiple cases, when asked to select only one learning modality by which to prepare, the majority of students resort to traditional study of material through rereading of books. Using active practice retrieval is typically thought of as an adjunct means of preparation, rather than a primary study tool.

Thinking back to my initial days as a first year medical student, I remember a discussion with an upperclassman that offered a candid portrayal of what my next two years of medical school would look like. He told me I would feel as though I was standing openmouthed in front of a fire hydrant spraying full blast. This unappealing analogy is surprisingly accurate in correlating the amount of information presented in medical school to the amount of material retained over time. Information learned in a manner that allows individuals to make inferences and apply knowledge in a robust and enduring way is known as “meaningful learning.” This is often described in contrast to “rote learning,” which is considered brittle and transient. Rote learning is short-term and is reflected in failures to make inferences and incorporate knowledge for problem-solving and inference-related tasks.

Rote learners may do well on course exams and get by on their ability to memorize short bursts of material for transient periods of time. This method may work on teacher-generated tests, which limit focus and emphasize specific details of course material, resulting in adequate or even high course grades. By contrast, however, rote learning is detrimental to generating a high performance on a standardized exam that has a more global focus and requires application of learned concepts. Rote learning often becomes apparent with students who’s standardized test scores appear to be considerably sub-par to their classroom performance. Meaningful learning, by contrast, is both impactful and preparatory for the depth and complexity of questions tested on standardized examinations. Students who engage in meaningful learning methodologies are likely to achieve standardized test scores more on-par with course grades, and may even outperform their score expectations. Recent evidence has shown that practicing active retrieval enhances the performance standards used to measure meaningful learning.

Most students I have worked with during my career seek a give-it-my-all approach when preparing for a high-stakes standardized test. The last thing any student wants to do is settle for a different specialty or career path because of a lackluster study effort that resulted in a lackluster score. Students sometimes spend upwards of 10-15 hours per day studying for their board exams in the days and weeks prior to their test. Much of this time is spent rereading popular board review texts 3,4 or even 5 times. Although this approach may be perceived as tried-and-true methodology to some, recent evidence suggests this may be a “labor-in-vain” method of learning. Time spent participating in learning activities that promote active retrieval are shown to have a more potent effect on meaningful learning. This leads to both higher board scores and better long-term retention. Participating in group discussions, reciprocal teaching, and taking practice exam items are all likely to engage active learning processes. We may believe we have mastery of a particular topic, but the most effective way to examine knowledge through self-assessment is by engaging in the process of retrieval.

Although much work is needed to further assess the most effective means by which to utilize retrieval as a tool to enhance meaningful learning, our preliminary data suggest that taking a larger quantity of questions over a sustained period of time is correlative with improved standardized test performance. Further work is needed to assess the extent to which this correlation exists. Taking practice items that are constructed to reflect the types of questions specific to the actual test, and similar in the level of inference required for completion, appear to offer an effective approach to practice retrieval.

So the next time you are tempted to reread your notes or the biochemistry chapter of your favorite review book, stop and consider a different approach - take a test.

Joshua Courtney, DO is an anesthesiologist and the founder/CEO of COMBANK, a leading online q-bank for the COMLEX exams.

In Stitches: A Book Review

noreply@blogger.com (minava) — Mon, 04 Jun 2012 11:00:00 +0000

The pun in the title of In Stitches by Anthony Youn, MD is the first big clue to the tone and content of this light-hearted book about the medical and life education of Dr. Youn. The book describes how Dr. Youn grew up in the U.S. as a bit of an outcast but fashioned a career as a plastic surgeon out of his experiences. The book has two main threads essentially running parallel: Tony's development from boy to man, and Dr. Youn's emergence from student to physician. In many ways, the dichotomy is something all medical students struggle with to some degree, given the degree of commitment this profession requires.

The first act of the book focuses on Dr. Youn's upbringing. Born to two hard-working Korean parents growing up in small town Michigan with his brother. His father early on instills in him the importance of dedication and sets a career goal of becoming a physician. His father had grown up in difficult conditions, but through perseverance, had thrived, running a successful OB/GYN practice in the town the family settled in. In many ways, Dr. Youn's recounting of his youth is a realistic retelling of the "American Dream", warts and all. While the net result is success, it does not come without sacrifice and struggle. There is a bit of a lull as Dr. Youn describes his high school and college (mis?)adventures. There was a bit too much of teenage awkwardness for my tastes, without tying back to the other thread of the development of Dr. Youn.

The pace picks up as Dr. Youn enters medical school and begins to form the relationships that will in turn make him the physician he is destined to be. There is still a bit of the hijinks of his high school year, but the evolution is apparent in the writing. The book's high point comes when Dr. Youn enters the wards as a third year medical student. The story regarding how he handles his first 'difficult' patient is particularly poignant. The vignette embodies what is meant by empathy in medicine. While cliche, such moments show just how 'actions speak louder than words.' While at times, I wished to have more insight on why Dr. Youn chose medicine initially (other than his father's insistence) and how he developed his passion, it is clear from the writing that Dr. Youn cares deeply about his profession.

Ultimately, In Stitches is a wonderful, light-hearted narrative of one person's transformation from outsider to professional. Even for readers not pursuing medicine, the book offers lots of laughs for anyone who has ever felt different.

How Healthcare Professionals Can Improve Patient Relationships

noreply@blogger.com (minava) — Mon, 28 May 2012 13:00:00 +0000

Erin Palmer writes today about how we as future physicians can strengthen the relationship that is at the center of what we do: the patient-physician relationship.

How Healthcare Professionals Can Improve Patient Relationships

Trust is an integral component in any successful doctor-patient relationship. Even as a medical student, it is important to learn and practice relationship building. If patients trust, respect and like their physicians, they will communicate more effectively and be more open to the information the doctor presents, proactively working to improve their own health. That is why building strong patient relationships is important for anyone in the healthcare field.

It isn’t just the right thing to do professionally; it’s the smart business decision, too. With the prevalence of social media, bad patient reviews can spread like wildfire, having a negative impact on your career. New patients often research their physicians, so satisfied patients can help bring in business.

Below are a few tips to help you hone the communication skills necessary to keep patients coming back year after year.

Plan to Build Relationships
Gaining your patients’ trust is not a happy accident. It is something physicians must plan for. Make sure relationship building is part of your personal/professional mission statement and then work it into your daily clinical practice. Determine concrete techniques for making your patients feel valued as individuals and employ them during every visit. Simply shaking hands, making eye contact and initiating small talk during routine examination procedures can help make the patient feel at ease. Choose tactics that feel comfortable and natural to you so you can be consistent in your efforts.

Create a Conversation
In our digital age, conversation often gives way to emails, texts and instant messages. Technology can help, but face-to-face communication is a vital skill for doctors. At Georgetown University’s School of Medicine, students are learning how to converse with patients while reading and inputting EHR data. They even practice incorporating the laptop into patient interaction, sharing the screen and discussing the information presented with the patient.

Whether or not you choose to make your computer a participant in your conversation, striking a balance between talking and listening is the key to a successful conversation. Physicians are doing more listening these days so the doctor-patient relationship can be more teamwork and less lecturing. Patients can feel overwhelmed if they feel that their doctor is talking at them rather than to them. Think of your time spent listening as detective work. Your patients are more likely to be honest when they are a part of the conversation.

Determine Your Patient’s True Needs
Often patients come into a doctor’s office with a specific problem and perceptions of their symptoms. It’s the physician’s job to listen to these descriptions and ferret out a diagnosis and its underlying causes. In some cases, you will be presenting new information and answering the patient’s questions. In other cases, the challenge is to motivate the patient to make healthy choices they know they need to make but can’t quite seem to pull the trigger on. Motivation is a very individual thing; what inspires one person to finally lose weight or quit smoking is completely different than what works for another. The better you get to know your patients, the more able you will be to figure out what they really need and how best to give it.

It’s All in the Delivery
This old axiom isn’t just for comedians and obstetricians. Every physician needs to be aware of what they say and how they say it, especially when offering up a diagnosis or prognosis. Be sure your body language is consistent with your words. People don’t trust authority figures with cagey or closed-off mannerisms, especially if their demeanor doesn’t match the message they are delivering. If, as is often the case in healthcare, the news you are giving is neither all good nor all bad, strive for a tone of cautious optimism. Remember, your job is to present the patient with all options and help them make an educated decision as to which course of action to pursue.

Empathy is Key
On a related note, it is of course important to be sensitive to both your patient’s physical and emotional needs. People seeking medical attention are often in very vulnerable positions. They may be hurt, in pain and scared. It will probably fall to you to tell them things they do not want to hear.

Many physicians have come to the conclusion that empathy is the key emotion to project. Patients don’t want you to feel sorry for them. They want you to understand and identifywith what they are going through and how they feel. Empathy can be especially powerful in urging patients to find the strength to take responsibility for their medical condition and improving it. People want to know they are not alone; others have been through this and come out the other side.

Call for a Consult
Nobody trusts a know-it-all, especially a young one right out of medical school. You have the right to expect your patients to respect your knowledge and experience, but they have a right to know when you are out of your element. There is no shame in asking for help, calling in a specialist when you are facing a case that is outside your sphere of expertise. Sometimes the best way to build trust is to show your humanity. Simply saying, “I don’t know, but I will find you someone who does” can instill confidence that you are your patient’s advocate and will stop at nothing to get him or her the care needed.

Always Follow-Up
Relationship building doesn’t end when the patient walks out of your office or exam room. With the understanding that every clinical practice has different protocols, determine ways you can follow-up with your patients within the boundaries of how your practice operates. These might include the personal touch of a call or email or putting a note in the system to have a nurse check in or a receptionist verify that the follow-up appointment was made. In a typical office visit, patients are barraged with information on topics that are foreign and far out of their comfort zone. You will definitely set yourself apart from other healthcare providers by reaching out to make sure all your patients’ questions have been answered and they are following treatment orders appropriately.

People are complex, which is why building relationships is a tricky business, but it is absolutely essential to providing quality healthcare. If you value your patients, they will value you. Try to meet them where they are – probably nervous and scared – and extend empathy, respect, honesty and caring.

Erin Palmer writes about online healthcare degree programs and allied health careers for US News University Directory. For more information please visit http:// www.usnewsuniversitydirectory.com

3 Ways To Improve Your Personal Statement

noreply@blogger.com (minava) — Sat, 26 May 2012 14:32:00 +0000

This guest post by Lauren Bailey describes some key ways you can spruce up your personal statement as you apply for medical school, residency, fellowship, and beyond. As your stare at that blank Word document, or even as you are about to hit 'Submit' on ERAS, keep these points in mind.

3 Story Telling Elements that Can Instantly Improve Your Personal Statement

Every year medical school admission officers get hundreds of the same type of "formulaic" personal statements from their applicants—the statements typically lead with a mere, "I want to become a doctor because of x,y,z" and are usually dry throughout the entire piece. While yes it's true that admission officers favor clean and simple writing and usually pass on applicants that sound too pompous (or those that already write in "doctor-speak"), that doesn’t mean that they want personal statements that are boring. If your statement sounds like the rest, it will get thrown in the rejection pile. But by simply incorporating some traditional story telling elements to create a narrative, you can help your statement stand out. To learn how to do this effectively, continue reading below.

Start with a Personal Anecdote
Your introduction is the make it or break it point. From the very beginning you need to draw-in your reader. Otherwise, he or she may toss out your application almost instantly. One of the easiest ways to captivate your audience is to lead with an anecdote—a personal story that describes why you want to be a doctor or what brought forth your passion for medicine. There has to be some "aha!" moment or epiphany you experienced that made you think, "This is the profession for me, this is my true calling." Paint a narrative that helps re-enact that epiphany moment and then carefully tie it into a strong thesis. For example, maybe you wanted to become a doctor after someone in your family got severely ill. You could start it off like this: I was 8-years-old and cancer was a term I'd never heard of before. As my grandmother rested in the hospital bed, frail and hairless, I wanted nothing more than to have the power to heal her. How desperately I wanted the power to be able to heal everyone around world. At that moment, I realized that I wanted nothing more than to become a doctor. I feel attending [blank] medical school will not only help me accomplish my childhood dreams, but will also help me become the best possible healthcare provider possible.

Focus on Character Development
Your main objective when writing your statement is to come off as likable—admission officers must like you, otherwise you will get denied. Like in any story, there is always a main character. In this case, it's you. You want to make sure that when describing your strengths and weaknesses for example, you don't come off as arrogant, a know-it-all, or have any traits that some people might be turned-off by. For example, a popular "weakness" that applicants like to state is the fact that they're a perfectionist which can be both a blessing and a curse. While it's extremely generic, it's still a valid point. However, if you try to demonstrate that this by saying, "One semester I got a B and I was really hard on myself for a whole week" you might rub admission officers the wrong way. They already get plenty of applicants with pristine grade point averages. And who's to say that someone who makes 100's on written exams can translate those skills to real world scenarios? Instead, if perfectionism is truly a weakness then at least explain a scenario where it affected something that directly relates to healthcare—perhaps when volunteering at the local hospital or health care facility for example.

Be Careful with Language Choice
Last but not least, you need to use your power of language. That's not to say that you need to take out a thesaurus and use "fancy" words to help you sound intelligent. The admission officers already have your transcripts and records, they know you're intelligent. Instead, use this opportunity to sound like a "real" person—someone they'd like to meet in real life and interview. Your best way to accomplish this is to write using your natural voice; steer away from sounding too formal.

Personal statements don't have to be so cut and dry. But figuring out a way to incorporate the story telling elements mentioned above, you should give your statement that added spice that will persuade admission officers you deserve an interview.

This guest post is contributed by Lauren Bailey, who regularly writes for online colleges. She welcomes your comments at her email Id: blauren99 @gmail.com.

Can Pit Crews Heal Medicine?

noreply@blogger.com (minava) — Tue, 08 May 2012 11:00:00 +0000

Atul Gawande recently gave a TED talk entitled "How Do We Heal Medicine?" (check it out below).

In the talk, he harkens back to the central thesis of his recent book The Checklist Manifesto: How to Get Things Right that medicine has become too complex for physicians to act as cowboys and instead should adopt the paradigm of a pit crew, utilizing teamwork and the humble checklist to solve problems and avert emergencies.

Is this really true though? Can "pit crews" heal medicine? To extend the analogy a bit, can a pit crew win the Indy 500? Try as they might, they would be completely unable to do so without three critical people: the team owner, the driver, and the pit crew boss. Honestly, all analogies fall apart at some point, and this one is already near the breaking point, but bear with me another moment. The patient in some ways is like the owner: he has the most at stake, yet relies on others to achieve his goal (a win). Similarly, the patient has her health on the line, and relies on medical professionals to get them to the finish line. To do so, they need a driver - someone who is pushing for that result. Ideally, the healthcare "driver" would be the patient's primary care physician - the doctor who is harnessing the resources of the "pit crew" of professionals to deliver the desired result. Unfortunately, all too often, this does not come to pass.

I suppose Gawande's true argument is that physicians and healthcare professionals should adopt some of the tactics of a pit crew, not literally become one. While necessary, this does not solve the dilemma from a patient's perspective. The patient has the most at stake, yet enters the healthcare arena under-informed and under-empowered. In complex cases, even their PCP may become overwhelmed by the complexity of their care. To remedy this, the incentives need to be reassessed. Currently, PCPs like all other providers get paid based on what they do. If it cannot be coded, it cannot be reimbursed. The sad reality is that there is no financial incentive for a PCP to have a thoughtful conversation with a patient, to visit them at home when they are very ill, or to even visit them in the hospital. With that link between patient and primary doctor under siege, the 'pit crew' of professionals in the hospital lack a driver, the PCP, the physician who knows the patient best. As our current system shows, our healthcare pit crews can still do amazing things - they just may not be in line with the patient's wishes.

Ultimately, the changes Atul Gawande advocates are certainly necessary. The concern I have is that they oversimplify the problem. Without working on strengthening the doctor-patient relationship at its core, any improvement to the efficiency of the hospital will not necessarily yield the benefits in patient satisfaction or healthcare outcomes we as a society desire.

Tips for the 2012 USMLE Step 1 Exam

noreply@blogger.com (minava) — Thu, 03 May 2012 11:00:00 +0000

This guest post from MedStudentBooks gives a few tips for Step 1 preparation as well as mentions a few resources they have put together for students preparing for USMLE Step 1.

The USMLE Step 1 exam and the studying for it is often times seen as the most stressful period during medical school. Luckily, the team at Med Student Books (http://medstudentbooks.com) is dedicated to providing insightful and money-saving information using the direct experience of upper classmen within this unique educational setting.

While there are a lot of opinions out there, the best come from groups of medical students who have already taken step 1. With that in mind, the USMLE Step 1 Series is kicking into high gear to bring the best study tips from evidence and direct experience.
While individual study habits and learning strengths should tailor each student's specific Step 1 study schedules, a few basic concepts apply to all.

Creating a comprehensive but flexible schedule is the most important first step that should be completed before studying.
First Aid for the USMLE Step 1 should be at the foundation of all study plans, but should not be used as the only book. It is a starting point, to be annotated to create a complete Step 1 resource. In-depth specialized books should be used to complement First Aid deficiencies. Specific recommendations can be found at this post.
USMLE World is the recommended question bank.
Relaxation and avoiding burnout is vitally important and often times overlooked.

Along with great tips on getting a competitive edge for Step 1, MedStudentBooks.com is also currently hosting a Step 1 Exam Survival Sweepstakes in collaboration with one of the largest medical book publishers, Lippincott, Williams, & Wilkins. The prize includes several books recommended by MedStudentBooks.com, along with gift certificates and some other items that are helpful during board study time. The contest ends May 7, 2011, and further details can be found at the above link.
Lastly, we recently released a Step 1 Percentile Calculator designed to help students keep track of progress with question banks and books over the course of their studies. Other new and exciting applications are currently in development, and several more posts in the Step 1 Series will be coming out shortly. Check back to MedStudentBooks.com over the course of the Step 1 study season for more ways to increase your score.

Learn more at MedStudentBooks.com. Good luck on Step 1!

Residency Application Personal Statements

noreply@blogger.com (minava) — Mon, 30 Apr 2012 11:00:00 +0000

The following is a guest post by Jedd H. regarding how to approach the dreaded 'personal statement' when you start ERAS and apply for residency programs.

The medical profession is one of the most sought careers by many people. In fact, there are universities that specialize in providing medical education. In the United Kingdom, leading medical schools include the universities of Cambridge and Oxford. But medical training does not end after a person has graduated from a medical school. The tertiary-level education offered at a medical college is not enough for those intending to pursue this career to a greater extent.

Since medical training in schools is not enough to make a person expert in handling medical situations, education at this level is only considered an entry-level. Additional training could be obtained by a medical school graduate from a hospital or any medical institution that offers residency program. But before one could become an intern on one of these medical institutions, the medical student must convince the hospital’s residency directors to offer him as slot to become a resident.

Residency directors most likely have already read an applicant’s credentials from his transcript or from his curriculum vitae. They may already have a grasp of what the applicant is intellectual-wise and skill-wise. However, there might be information about the applicant that cannot be read or inferred by just reading the transcript or the CV, like the candidate’s motivations, interest, skills, relevant experiences and other interesting details. Thus, residency directors often require applicants or candidates to submit their personal statements.

The residency applicant’s personal statement is his best opportunity to convince the residency directors that he is qualified to become a medical intern. It allows an applicant to stand out from other candidates, especially if has submitted a well-written and very persuasive statement. A good application should be coupled with a first class statement to ensure that a candidate would be able to stand out from others.

Basically, a well-written personal statement should be able to answer two key questions. The first question refers to the applicant’s choice of expertise or specialization: Why is the candidate applying for the specialization? The applicant should be able to show his motivation for applying for the residency. The candidate must be able to present the reason why the medical specialization has drawn his interest. The candidate should be able to show that he knows what he is applying for and he fully understands the sacrifices required to master the certain specialization.

The second question refers to the applicant’s suitability to the medical specialty he has chosen: Why is the candidate suitable to become a medical resident? The candidate must be able to show that he is well-qualified to undergo residency. The applicant must showcase certain skills, experiences and personal qualifies that he believes would help during his residency years. The applicant could highlight his clinical skills as well research skills. The applicant could also highlight his patient or teaching experiences.

If the applicant’s personal statement contains the answers to these questions, then he has a high chance of being accepted a resident in a medical institution.

Jedd H. is a freelance writer with years of experience consulting with students on writing and personal statement drafting.