How to Manage a Negative Clinical Evaluation

Sometimes personalities can clash and an attending may write an overly harsh evaluation that isn’t indicative of your performance. If you feel that this is the case, it’s usually a good idea to speak with the clerkship director and express your concerns. At some institutions, the burden of proof lies with the attending to demonstrate that he or she gave the student constructive feedback and allowed for a chance to improve. If the evaluation is determined to be unjust, it may be removed from your record.

However, if the clerkship director does a thorough investigation and strongly feels that the evaluation is accurate, it’s usually a good idea to stop there

Will a Negative Evaluation Ruin My Residency Options? [Medscape]

How to Find Free WiFi with your Mobile Device

Windows Mobile: WiFiFoFum

This is the latest version of WiFiFoFum – the best WiFi scanner and war driving software for Pocket PC 2003 and Windows Mobile 5 Pocket PC and Smartphone editions.

iPhone/Touch: JiWire’s Wi-Fi Finder

With more than 200,000 locations in 135 countries, JiWire’s Wi-Fi Finder makes it easy to search for free- and pay-access Wi-Fi hotspots wherever you are or plan to be.

Android: WeFi

WeFi is software loaded onto your laptop or mobile device. It automatically detects and qualifies all Wi-Fi access points within range and connects you to the spot with the best Internet connection. If the WeFi software detects a new access point, it allows you to be the first to map it. WeFi also provides you with Instant-Messaging tools, allowing you to create a buddy list, and to see where your friends are currently connected.

How to Start the Day Right

Get Enough Sleep:

• Going to bed earlier (set an alarm to remind you to go to bed, if necessary!)
• Avoiding caffeine and alcohol in the evening
• Switching off the computer and television and reading for an hour or so before bed – bright screens can prevent you from getting sleepy

Drink Water and Eat (a Healthy) Breakfast:

• I’d suggest holding off on the coffee for at least a little while after waking up, and drinking a big glass of water instead: being slightly dehydrated will knock your concentration levels right down.
• healthy breakfast like baked beans on wholewheat toast, or oatmeal, will give you slow-release energy to see you through the morning.

How to Get Your Morning Off to a Great Start [Life Optimizer]

How to Use Medical Literature to Solve Patient Problems

When using medical literature to solve patient problems and provide better care, consult this guide for appropriate use of an article dealing with therapeutic interventions and preventive interventions.

Table 1: Users’ Guides for an Article About Therapy

I. Are the results of the study valid?

• Primary Guides:
  • Was the assignment of patients to treatments randomized?
  • Were all patients who entered the trial properly accounted for and attributed at its conclusion?
  • Was followup complete?
  • Were patients analyzed in the groups to which they were randomized?
• Secondary Guides:
  • Were patients, health workers, and study personnel “blind” to treatment?
  • Were the groups similar at the start of the trial?
  • Aside from the experimental intervention, were the groups treated equally?

II. What were the results?

• How large was the treatment effect?
• How precise was the estimate of the treatment effect?

III. Will the results help me in caring for my patients?

• Can the results be applied to my patient care?
• Were all clinically important outcomes considered?
• Are the likely treatment benefits worth the potential harms and costs?

How to Use an Article About Therapy or Prevention [Centre for Health Evidence]

How to Learn a New Language

If you were a student of English (though the list can be adapted to most languages), [the top 100 most common written words in English] would deliver the greatest ROI per hour invested for the initial 1-3 weeks of study

Content and vocabulary selection beyond the most common 300-500 words should be dictated by subject matter interest. The most pertinent questions will be “What will you spend your time doing with this language?”

Once the framework of grammar has been transferred to long-term memory, acquiring vocabulary is a simple process of proper spaced repetition

How to Learn Any Language in 3 Months [Tim Ferriss]

How to Transfer as a Foreign Medical Student

To find out which schools accept non-LCME students, I went to the AAMC’s website for transfer policies by school. I asked to search by policy then narrowed my search by selecting ALL schools in ALL regions and selecting all the boxes accept for the first four (LCME-accredited applicant, Osteopathic applicant, Dental applicant, Oral and Facial surgeon applicant). This generated a list of 54 institutions accepting transfers into the second year and 73 accepting applicants into the third year. There is some overlap.

[I] called every single institution to ask about their transfer policy for non-LCME students. This is important to do if you are serious about transferring and this level of effort will separate you from your peers.

There are several schools that often have spaces available

1. Drexel University
2. George Washington
3. New York Medical College
4. Northeastern Ohio University College of Medicine
5. SUNY Upstate
6. Tulane University
7. University of Medicine and Dentistry, New Jersey (UMDNJ)

In addition to this list, I was able to confirm that eight [additional] schools would accept non-LCME applicants.

Transferring from the Caribbean: Which Schools Accept FMGs? [the rumors were true]

Creating & Editing PDFs

the days where you needed Adobe Professional to manipulate files are quickly receding.

Mac users have the advantage when creating PDFs, with the ability to print any document to PDF from within the print menu… [For] Windows, I use CutePDF , which is free and small.

Preview, the PDF viewer that is bundled with Mac OSX allows basic PDF editing.  [For Windows,] you can try online services such as PDFHammer, which allows similar basic editing.

PDF Undo Online converts PDF files to Word documents. There is no registration required, but copy protected or scanned PDFs can not be converted.

How to manipulate your PDFs [AppleQuack]

Correlate: How to Fax Smarter

How to Write a Note

The basic format for a note is the SOAP note

S – Subjective: any information you receive from the patient (history of present illness, past medical history, etc)
O – Objective: any data, whether in the form of a physical finding during your exam, or lab results
A – Assessment: diagnoses derived from the history and objective data
P – Plan: what you intend to do about the diagnoses from your assessment

The H&P should include the history of present illness, past medical history, past surgical history, allergies to meds, current meds, relevant family history… and social history… For HPI, a helpful mnemonic is OLD CHARTS:

O - Onset: when the problem began

L - Location: what area of the body is affected

D - Duration: how long has it been hurting, is the pain continuous or intermittent

CH - Character: words to describe the problem (dull, sharp, burning, stabbing, throbbing, itching, etc)

A - Aggravating / Alleviating Factors

R - Radiation

T - Temporal: is there any pattern to the pain, such as always after meals

S - Associated Symptoms

How To Write A History/Physical Or SOAP Note On The Wards [Scrub Notes]

How to Correct Medical Errors

Megan Fix, MD:

When medical errors occur, it is our duty to disclose them. Truthful disclosure is good for patients. Recent evidence shows us that most patients actually prefer to know about medical errors that have happened to them. Furthermore, surveyed patients said they would be less likely to sue if they were informed of the error by the attending physician.

The easiest way is to be direct and honest in a respectful manner. You are never wrong if you put the patient first. Remember that you are a part of a team.

Get the facts
It never hurts to say something like, “this may be a ridiculous question but…” or “I may be mistaken, but…” This is a respectful way to ask what is right for the patient and oftentimes, once the error is identified, both you and the attending physician can then respond and inform the patient together.

You may feel compelled to “tell” on the attending physician or resident who committed the error, but this will not only undermine your relationship with the patient, it will also create distrust and lack of confidence within the whole medical team… One way is to respect the authority of the attending physician by asking for their assistance. This can help deflect possible defensiveness that may arise. For example, you might say, “I spoke with Mrs. Jones and she is very concerned about X. I would like your help discussing it with her.” If that does not work, then approach your resident. Again, put the patient first as in, “I was concerned about our patient when I saw Y. I’d like to talk to the attending physician, will you join me?”

What Should I Do If I Witness a Medical Error? [Medscape]

How to Take Strategic Breaks

On a short time span, there are really only two kinds of breaks you can take:

• Short breaks to rest during the day
• Breaks that finish a day and begin the next morning

Here’s my rule for taking short breaks:
Whenever I hit a roadblock in my energy and can’t accomplish anything, I set myself a timer for 15-30 minutes.  My goal is to keep working throughout this time.  Once the timer is done, I see if I’ve made any progress.  If I haven’t, I know it’s time to take a break.  This rule helps because it prevents you from quitting whenever you hit a small obstacle.

Don’t Waste Day-Ending Breaks
If you’re going to quit for the day, rest fully.  Set a big to-do list for the next day and plan to start early again.  You’ve postponed work to rest strategically.  That will only be successful if you actually regain your energy.

How to Know When to Take a Break [Scott H Young]