Improving medical students

Archive for October, 2007

How To Remain Alert Throughout the Day

Posted by medliorator on October 27, 2007

Excerpts from the Ririan Project’s twelve strategies for all-day vitality:

1. Brighten your morning.


Wake up at the same time, and bathe yourself in sunlight. It enables your circadian rhythms… to stay in sync with the 24-hour day. In the absence of light, your body’s sleep-wake cycle wants to delay by an average of twelve minutes every day and work on a 24.2-hour rhythm. …your body wants to keep pushing your bedtime to later
To keep your circadian rhythms in time with the 24-hour day, head to the light as soon as you get up, even on a Saturday when you’ve decided to sleep in. Your mind will respond to light and bring you out of sleep.


2. Jump-start your body.


You haven’t eaten for at least 8 hours. Your blood-sugar level is at its lowest ebb, so chow down right after you wake up and you’ll trigger an increase in leptin, which will in turn tell your body that the recent fast isn’t a famine.


When leptin goes up, you feel less hungry, and you increase energy expenditure. But be aware, if you want that energy to last until lunch, you need a breakfast that will produce a slow and steady increase in insulin, not a swift spike. Make your morning meal a bowl of instant oatmeal prepared with skim milk. Tufts University researchers recently found that people who

ate one packet of instant oatmeal spiked with 1/2 cup of skim milk received a steady glucose infusion, which increased their alertness all morning and improved their ability to process information.


3. Postpone your pick-me-up.


Caffeine keeps you operating at a high level by blocking the effects of adenosine, a sleep-inducing brain chemical that accumulates as the day wears on. By the time adenosine builds up to the point where you start feeling sleepy generally, late in the afternoon the effects of your morning caffeine will have worn off.


Having 1/2 to 1 cup of coffee or its caffeine equivalent during the late afternoon, when the pressure to sleep is high, will keep you energized. If you’re highly sensitive to caffeine’s effects, you should push your break back to early afternoon so you don’t have difficulty falling asleep at night.


4. Squeeze in an A.M. run.


In a recent Taiwanese study of 29 men, researchers found that the men’s production of thyroid hormones shot up after the men ran on a treadmill. And once thyroid hormones are released, they’ll remain in your bloodstream for hours, keeping your metabolism revved well after your workout.


Aerobic exercise increases your brain’s output of serotonin (a hormone associated with happiness) and dopamine (the hormone most closely linked to motivation).


5. eating


When it comes time to order, choose an entrée that contains both protein and fat. Here’s why: As food enters your intestines, it stimulates the production of two hormones that create a feeling of fullness, known as peptide YY and oxyntomodulin. By adding slow-digesting fat and protein to the intestinal equation, you’ll ensure a steady release of peptide YY and oxyntomodulin and no hunger pangs at 2 p.m.


6. Step outside during late-day slumps.


Step outside into revitalizing sunlight for a short walk. Vary your routine by taking a different path every day, doing a short errand, or catching up with a friend on your cell phone …to counteract the post-lunch dip that many workers experience.


7. Boost your brainpower.


Scientists suggest that when you lose testosterone — your memory worsens, a steady supply of T is critical for the neurons in your brain to properly communicate with each other.


So skip the coffee and take a competition break instead to harness your hormones. Just make sure the contest for instance, trash-can basketball, paper football, or a quick computer game is one that will challenge you. When people are playing a competitive game, the winner will tend to have a higher level of testosterone than the loser. There may be a little bit of a boost for being more dominant. Or you can just compete with yourself. Take 15 minutes to start a crossword or Sudoku puzzle and then return to the task at hand.


8. Enjoy every meal by the clock.


Eat your meals at the same time every day. Your body’s caloric needs are closely tied to its other daily rhythms, including when you get up and go to bed and when you expend the most energy (during your late-day brisk walk, for example). What will make you tired is if your body expects a 7 o’clock breakfast and a 12 o’clock lunch and you skip one of those. Chaotic eating leads to greater hunger and overeating.


Prepare your breakfast the night before so you’re sure to start the day with a boost even if you’re running late. Pack a lunch to take to work in case you can’t get away from your desk midday. Make several meals on the weekend that you can quickly heat up… at the same time every night.


12. Shut it off.


Do you do anything in your bedroom besides sleep? Maybe watch TV, read a book, or play on your laptop? These activities train the brain to associate the bed with excitement. Some people become so sensitive to this that when they go to bed, all of a sudden their brain’s aroused, because normally they’re watching a football game or reading a favorite magazine. Give melatonin an opportunity to kick in by shutting down your computer and turning off your TV about 30 minutes before you go to bed. Sex is fine — it is, after all, nature’s perfect sleep aid.

All-Day Vitality: How to Fight Fatigue Morning, Noon, and Night [Ririan Project]

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Medicine Work Ethic

Posted by medliorator on October 16, 2007

Dear Medicine,


Although I dislike your training practices very much, I would like to thank you for the strong work ethic that you have taught me. Many countless hours studying for your shelf exams and Steps taught me valuable time management skills that I use to be successful today. Seeing many overworked physicians who were unhappy and complaining about their paycheck made me desire something more. Had I not seen the light because of you, I might have been just another pawn in a never- ending game.


It was worth the months on surgery and OB/GYN. Every prostate that I examined made me want something better out of life. I am thankful that you gave me the adequate number of prostates to examine. Each pelvic exam, while oftentimes smelly and always unpleasant, taught me that I must persevere.


Every attending surgeon that ever belittled me during rounds or in the OR gave me a thick skin. I have used that thick skin while failing numerous times on my way to victory. Each case I scrubbed helped to build my foundation of freedom.


The long nights on call taught me that I’m not that efficient while sleep deprived. Now, I always work well-rested. Thank you medicine, I’ve increased my productivity because of you.


I now work smarter instead of harder, and it’s because of you. You have given me so much — the drive and desire to not be unhappy with life. The drive and desire to do something I am passionate about. The drive and desire to finally be free.


Thank you, Medicine, for four years of hell. Had it not been for those four years, I might have spent a lifetime consumed by fire.

The Medicine Work Ethic [Med School Hell]

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Skull Anatomy Tutorial

Posted by medliorator on October 15, 2007

An interactive resource that assesses your knowledge of the skull. Created by J. Crimando Ph. D.

Skull Anatomy Tutorial [GateWay Community College]

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Dissection Videos

Posted by medliorator on October 5, 2007

Refresh your anatomy or prepare for your next laboratory.
Well labeled, Quicktime videos. Just click the thumbnail picture.

Anatomy Dissections [University of Wisconsin – Madison Medical School]

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