Medliorate

Improving medical students

Archive for September, 2008

How are New Members of AΩA Chosen?

Posted by medliorator on September 30, 2008

The Constitution of AΩA gives many degrees of freedom to each chapter for the process of election of student members within certain firm guidelines. These can be summarized as follows:

  1. At approximately 16 months before a given class will graduate from medical school, the Councilor must arrange with the dean’s office, with the students’ permission, to receive in confidence a list of the top quartile as measured by academic performance.
  2. From this top quartile of students, each chapter may elect to AΩA membership up to one-sixth of the projected number of students that will graduate. The Councilor then invites members of AΩA in the faculty who know students and their performance in the classroom and in clerkships to meet in confidence to select students for membership. The chapter may elect up to half of that one-sixth of students in the spring of the third year, and the remainder at any time from the fall of the fourth year until graduation. There is wide variability in the process among chapters. Some elect no junior students, and several elect all student members in the spring of their senior year just prior to graduation.
  3. Those students chosen from the top quartile for election are picked not only for their high academic standing, but as well for leadership among their peers, professionalism and a firm sense of ethics, promise of future success in medicine, and a commitment to service in the school and community. By adherence to these criteria it has happened that one or more of the highest ranked students by grade point average have not been elected to the society.

from Alpha Omega Alpha

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Medical Eponym Database for iPhone (Free)

Posted by medliorator on September 29, 2008

This eponym database from Andrew J. Yee has been made available for iPhone or iPod touch by Pascal Pfiffner. The database currently contains more than 1’600 medical eponyms and is updated from time to time. The app will be able to download updated eponyms without having to update the whole application.  Search for Eponyms (for students) on the iStore.

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How to Suture

Posted by medliorator on September 26, 2008

Stay one step ahead by learning the basics of suturing before your surgery rotation.

  • For step-by-step instructions and streaming video demonstrations of basic techniques, visit Basic Knot Tying and Suturing hosted by Boston University School of Medicine.
  • If your school offers suturing clinics, get a feel for the suturing kit ahead of time with CineMed’s video tutorial.

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Choosing a Mobile Device for Medicine

Posted by medliorator on September 24, 2008

“smartphone” is used to describe a wide range of phone devices, and some are smarter than others! If you plan to use your smartphone to run software applications such as Epocrates, check that it comes with one of the major mobile operating systems (Palm, Windows Mobile, BlackBerry, and soon, iPhone).

Knowing how and where you will use your device will help you determine what features are “must-have” for you, versus only nice to have.

  • As a phone? (you may want to review specific phone features such as loud speaker)
  • For clinical reference information? (check to see that the applications you want are supported)
  • For email? (be sure to select a comfortable keyboard)
  • To access the Web? (look for a large, high resolution screen and easy browser)
  • To take and store pictures or video? (you’ll need plenty of internal memory or a memory card)
  • As a personal organizer?
  • As a voice recorder?
  • To listen to music?
  • To navigate a new town?
  • To play games?

Go Mobile [Epocrates]

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Rational Decisions with Sunk Costs

Posted by medliorator on September 23, 2008

I believe the best way to remember sunk costs is to pretend you were starting with a fresh decision.  Eliminate the past and pretend you were starting over.

a sunk cost is a term from economics to describe money (or time, energy, etc.) that has already been spent in a past decision.  Since the money is gone, it shouldn’t be a factor in making new decisions.

My friends and I had spent $12 to go to a show  …there was another party (and DJ) that we would enjoy more, less than 2 minutes away, for $7.  Some of my friends argued that we should stay here, because we paid $12, so we might as well enjoy the band… A better way to phrase the decision was to pick between staying at this show for free or going to the other party for $7.

A lot of University students need to face a sunk cost problem.  Midway through a degree program, they decide they don’t want a job in their chosen field.  Should they finish the degree anyways or switch?

This is a complicated decision with many factors, so no simple trick can automatically decide the right answer.  However, if you view this problem through the sunk cost lens, you’ll realize that the time already put forwards towards the degree isn’t important.  Whether that time was invested or wasted, it can’t be changed, so you need to focus on the future.

Don’t Forget Sunk Costs, Stupid! [Scott H Young]

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Understanding Sleep Pills

Posted by medliorator on September 22, 2008

“Often people attribute everything bad that happens to them, including being angry and crabby, to lack of sleep,” says Donna Arand, Ph.D., clinical director of the Kettering Sleep Disorders Center in Kettering, Ohio. “It puts such a burden on sleep that not sleeping gets blown out of proportion.”

many [OTC sleep aides] — like Nytol, Simply Sleep, Som­inex, and Unisom — contain antihistamines (similar to the allergy medicine Benadryl) that can have side effects like dry mouth and eyes and next-day grogginess, Arand says. OTC sleep aids are best for people who have occasional sleep problems.

Never drink and then immediately take a sleep aid. Why? Alcohol acts like a sedative at first, so you’d essentially be getting a double dose of sedatives. This can dangerously slow your heart rate and lead to dizziness, fainting, and shallow breathing, which can deprive your body of oxygen and damage brain cells. Worst case: You may even stop breathing altogether

Q: Can I safely take sleeping pills for several months?
A: There are no known long-term health risks with most sleep aids, but some are more addictive than others.
“The newer medications like Ambien C.R., Sonata, Rozerem, and Lunesta have been approved by the Food and Drug Administration without a limit on how long they can be prescribed,” Arand says. “They have a small addiction potential, and some have been shown to be effective up to one year.” The older sleeping pills with secobarbital (Seconal) and pentobarbital (Nembutal) pose a much higher risk of addiction.

When to take a sleeping pill [CNN Health]

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Countering Low-Productivity

Posted by medliorator on September 21, 2008

  • Walk around. Anywhere will do …It’s all about looking for something positive you have never seen. Taking time to smell the roses may be just a cliché, but those roses could be anything. A restaurant you’ve never seen. A friend’s cubicle. Some kids playing ball.
  • Set an alarm and work on just one thing for that period of time. Maybe it’s just 5, 10 or 20 minutes. Maybe it’s two minutes. But at the end of the time, you will notice what’s it’s like to experience real focus. And if you complete the task, you have something to anchor your day around. You’ve gotten at least one thing really done.

How to Kickstart a Low-Productivity Day [Lifehacker]

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How to Excel on Surgical Rotation

Posted by medliorator on September 19, 2008

Another gem from Half MD:

become very familiar with the reasoning behind the procedures. Attendings don’t care if you know how to remove a gallbladder. They will, however, expect you to know what are the indications for taking one out… How urgent is this procedure? Are there any alternatives to this procedure, including medical ones? What are the risks to a cholecystectomy? If the resident in the case prematurely cuts the bile ducts, what do you do then? What’s some of the relevant anatomy in that area? That is, what do you have to watch out for during surgery? Once the gallbladder is removed, is there any chance for recurrence of disease?

[You’ll be expected to] manage hospitalized patients.  [Understand] fluids and electrolytes because those issues become very important once a patient comes out of surgery and cannot eat for several days. You should also be aware of your patients’ conditions at all times… Some attendings are also very big on wound care—so you should always carry gauze, tape, suture removal kits, staple removal kits, and a pair of scissors.

Do not speak unless spoken to. If you have a question, you should keep it to yourself and look up the answer later. …Do not ask your attendings any questions regarding any disease is that you may encounter. You’re attending will very likely turn the question around and either pimp you or force the resident to answer.

The Life Raft for surgery [Half MD]

Posted in Clinical Rotations, How-To, Surgery | 1 Comment »

For-Profit Medical School

Posted by medliorator on September 13, 2008

Yife Tien bought the 24-acre Colorado property and built Rocky Vista, a 145,000-square-foot building tricked out with bright anatomy labs, patient simulators and fully wired classrooms, with $30 million from his father, Paul Tien, a wealthy 80-year-old Taiwanese immigrant who started the American University of the Caribbean medical school in 1978. Tien’s grand plan, revealed in an application with state accreditors, is to have tuition revenue explode from $2.7 million this year to $25 million in 2012 as four classes of students arrive on campus. In 2012 net income is supposed to be $3 million. Still, at a $152,000 list price for a degree in osteopathic medicine (D.O.), which is what Rocky Vista is offering, this could be a tough sell, even though a Yale M.D. costs $169,000 before discounts

An Uncommon Practice [Forbes]

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Cervical Cancer Biomarker

Posted by medliorator on September 12, 2008

A simple test for a protein called P16INK4A provided a biomarker showing cell changes that indicated a woman likely has pre-cancerous lesions

“The marker shows there was some sort of disruption by the HPV virus,” Ronco said. “Only a small minority of women who have an HPV infection actually develop cancer. The challenge is to find out who are at higher risk of developing cancer.”

The Italian team collected cervical cell samples from women who had already tested positive for the HPV virus… Then they tested for P16INK4A protein in more than 1,100 of these women and found that it helped identified 88 percent of those who had the cancer-causing lesions with far fewer false positives. The protein is more active in cervical-cancer cells.

The refined test also identified 50 percent more of the dangerous lesions than pap smears and required fewer women to be referred for colposcopy

New cervical cancer test beats pap smear [Reuters]

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