Medliorate

Improving medical students

Archive for September, 2007

Free Wake-up Calls

Posted by medliorator on September 28, 2007

Schedule free wake-up calls to your phone online.

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How to Examine Better

Posted by medliorator on September 28, 2007

The attitude overall, however, probably makes the exam less awkward. Projecting confidence and normalcy to the exam – that you’ve done it many times, and that it’s pretty much standard operating procedures – helps alleviate some of the potential anxiety a patient may feel. Communication is key. I find using medical terminology to be helpful – asking patients to move their “buttocks” toward the end of the bed, instead of their “butt” just makes it at least sound much more objective – that I am simply the doctor asking a female patient to do something, nothing more. Telling the patient beforehand what will happen, and explaining what he or she may feel helps, too. Body language I think is also key. I often close my eyes and lower my head when listening to heart sounds to help me concentrate on them, but I believe it has the added benefit of ensuring patients that I am touching them for medical purposes only. You never know what prior experiences a patient has had that may make them uncomfortable.

You’ve Come Along Way, Boobie [Over My Med Body]

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Embryology Tool

Posted by medliorator on September 17, 2007

From Indiana University
a useful embryology learning tool
boasting detailed animations and quizzes of the following:

-Cardiovascular embryo
-Head and Neck development
-Gastrointestinal embryo

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How to Survive the Wards

Posted by medliorator on September 17, 2007

Nearly every medical student will have a negative encounter with someone higher up on the ladder… these situations can lead to the most dreaded of outcomes – a negative comment in your dean’s letter or file. Oftentimes, a perceived offense to the ancillary personnel can be particularly damning, because physicians often have close relationships with these staff members.

This can also work in your favor: getting in the good graces of the rest of the staff can help secure a favorable impression on your supervisors. Attendings may be quite removed from your daily activities as a medical student. If this is the case, they may count on secondhand reports from other staff members as part of your evaluation.

The third year clerkships [are] a difficult situation to be in, but the key is to keep smiling. Being cheerful and enthusiastic is usually more important than getting “pimping” questions correct.

if you are like many medical students and have been misconstrued in something you said or did despite good intentions, you may have alternatives.

First, apologize regardless of the situation and whether you feel the complaints are justified. Attempts to defend yourself may add fuel to the fire, because you will appear to be questioning authority. Titrate your apology to the offense: if it is minor, a simple apology will suffice… the best response to a low-level negative comment is usually just a cheery “all right, I see what you are saying, I will try not to let it happen again!” Although this type of response may not only feel false but may be tough to fake, mastering it will help you deal with a multitude of situations that have the potential to go on a downwards spiral. It is also often said that the best doctors are great actors.

Second, if another authority is available who you feel will be sympathetic, go to them for help. For example, if your problem is with your preceptor, but you have a kind clerkship director, make your case to that person. If you go down this road, never appear to be accusing the person who criticized you. Explain it in terms of being a misunderstanding, or propose extra credit work you could do to remedy your grade. If you come off well in this encounter, this person may leave out the offending comments or alter your grade accordingly. If this option is not feasible, or if the person you appeal to is unwilling to change their colleague’s ruling, consider giving up. Further pushing may get you into more trouble.

Finally, as a last resort, find out if your institution has an “ombudsman” or “ombudsperson”. These individuals act as student advocates in situations where students have been intimidated, harassed or otherwise wronged by faculty members. Ombudspeople are meant to serve as equalizers in the large power differential between students and attendings.

If none of the above is helpful or appropriate, consider writing a letter that you will not send stating your grievances. You will likely feel better after making your case on paper/in e-mail, but you will not risk getting yourself in deeper by appearing to accuse, blame, or inflame those who are above you.

Above all, the rule in clerkships is to try to avoid the negative encounter in the first place. Remember that you are being watched. The way you talk, the way you dress, and the way you treat patients are being minutely scrutinized. Remember that one of the most common accusations leveled against medical students is that they have acted “unprofessionally”. Avoid any language that even borders upon ‘colorful’, even if you are only in the company of colleagues. Do not make jokes with colleagues or patients on any political, religious, or personal topics, particularly about the patient’s appearance. Do not complain about a co-worker’s behavior to another staff member unless it is of crucial importance to do so.

It is also prudent to avoid giving negative feedback (about persons or activities on the rotation) in general, unless you can do so anonymously. You are not protected from repercussions otherwise. You have the rest of your career to be opinionated and blunt. As a student, stay conservative and positive. And, because expectations of students can be unrealistic, if you cannot avoid a reprimand, use the tips above to counter it.

Clinical Rotations: Dealing with Conflict [Student Doctor Network]

Posted in Clinical Rotations | 1 Comment »

CPR Innovation

Posted by medliorator on September 10, 2007

A CPR alternative, called “only rhythmic abdominal compression” or OAC-CPR, works by pushing on the abdomen instead of the chest. Unlike conventional CPR, it elliminates the risks of breaking the ribs and transferring infection with mouth-to-mouth breathing.

A biomedical engineer at Purdue University has developed a new method to perform cardiopulmonary resuscitation that promises to be more effective than standard CPR because it increases nourishing blood flow through the heart by 25 percent over the current method.

OAC-CPR eliminates the need to perform mouth-to-mouth resuscitation.

OAC-CPR requires only one rescuer.

conventional CPR has a success rate of 5 percent to 10 percent, depending on how fast rescuers are able to respond and how well the procedure is performed. In standard chest-compression CPR… the rescuer pushes on the chest and blows into the subject’s mouth twice for every 30 chest compressions… Many doctors and nurses often refuse to administer mouth-to-mouth resuscitation. In one 1993 study of 433 doctors and 152 nurses, 45 percent of doctors and 80 percent of nurses said they would refuse to administer mouth-to-mouth resuscitation on a stranger.

Findings will be detailed in a research paper appearing this month in the American Journal of Emergency Medicine

New CPR promises better results by compressing abdomen, not chest [Purdue University News]

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How To Manage Debt

Posted by medliorator on September 4, 2007

Average educational debt

  • $130,571 – According to the Association of American Medical Colleges, the average educational debt of indebted graduates of the class of 2006 (including pre-med borrowing).
  • 72 percent of graduates have debt of at least $100,000
  • 86.6 percent of graduating medical students carry outstanding loans
  • 40.2 percent of 2006 graduates have non-educational debt, averaging $16,689

7 Tips For Managing Your Student Loan Debt

  1. Just because you can borrow more doesn’t mean you should.
  2. I still say buy versus rent.
  3. Max out your subsidized loan borrowing power first.
  4. Pay interest on your unsubsidized loans if you can.
  5. Avoid private loans if possible.
  6. Get those credit cards paid off. If you have additional borrowing power on a federal student loan, borrow the extra amount to pay off your credit card in full. Do this only once.
  7. Consolidate your loans while you’re still in school.

7 Tips For Managing Your Student Loan Debt [Med School Hell]

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