Improving medical students

Archive for December, 2008

Holiday Brownout

Posted by medliorator on December 20, 2008

We will resume regular content aggregation on 1/7/09. We wish our readers a relaxing holiday and a happy new year.

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Making Time for Sleep

Posted by medliorator on December 8, 2008

1. Put work early in the day. If you’re working until 2 a.m. on a regular basis, it’s probably because you don’t manage your time well. Move work into earlier hours in the morning. This will put less pressure on you to stay up all night to finish.
2. Set a bed time. Sounds childish, but it works. If you currently go to bed whenever you feel like it, there’s a good chance you’ll keep pushing your day later and later into the night. Humans didn’t evolve with electric lighting, so you can’t just trust your body for when the best time to sleep is.
3. Get rid of the caffeine. Caffeine is a band-aid.

How to Get More Time to Sleep [Scott H Young]

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Family or Internal Medicine?

Posted by medliorator on December 6, 2008

Does family medicine training close doors?
Some argue pro and some con.  When examined objectively, family medicine opens many doors but does close some doors.  Choosing family medicine clearly leads to primary care or a closely related field.  Internal medicine still often leads to subspecialty training.  Many more internists become hospitalists than do family physicians.  I suspect that occurs due to a combination of ones preferences in selecting a specialty and the impact of the training.

Of course as an internist I am biased about the value of inpatient adult medicine education.

Once again, both choices are legitimate and desirable.  You should choose the one which fits your personality and your career goals.

Family medicine vs internal medicine II [DB’s Medical Rants]

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Diagnosing ADHD with EEG

Posted by medliorator on December 5, 2008

he use of QEEG [Quantitative EEG] is based on findings that individuals with ADHD have a distinctive pattern of brain electrical activity that is often referred to as “cortical slowing”; this is characterized by an elevation of low frequency theta waves and a reduction of higher frequency beta waves in the prefrontal cortex. Theta wave activity is associated with an unfocused and inattentive state while beta activity is associated with more focused attention. Thus, an elevated theta/beta ratio reflects a less alert and more unfocused state.

In past studies, roughly 90% of individuals diagnosed with ADHD based on a comprehensive evaluation tested positive for this EEG marker. In contrast, about 95% of normal controls tested negative. Thus, while not a perfectly reliable indicator, the sensitivity and specificity of QEEG in identifying ADHD was extremely strong.

Neurofeedback/ Quantitative EEG for ADHD diagnosis [SharpBrains]

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USMLE I Daily Trivia via Twitter

Posted by medliorator on December 5, 2008

The First Aid Team post a few short questions daily.


Your on your own for the answers.

Posted in USMLE | 1 Comment »

Embryo Cell Footage

Posted by medliorator on December 4, 2008

The footage of fruit fly embryos helps explain how a key genetic mutation disrupts development, and could also improve understanding of how human embryos form.

Complex dance of embryo cells filmed in new detail [NewScientist]

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How to Correct Medical Errors

Posted by medliorator on December 2, 2008

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]

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Managing Exam Stress & Optimizing Performance

Posted by medliorator on December 1, 2008

Philip Zack:

Many people have an automatic train of “self talk” in their heads, which has the effect of giving up control to external factors with unhelpful statements such as, “The exam is making me stressed” or “I’m bound to fail again.”

Take control of these self talk messages by challenging them—for example, “The exam is making me stressed” becomes “I let myself get stressed in the exam;” or “I’m bound to fail again” becomes “I might fail, but if I prepare well I might pass.”

You can also control your emotional state by practising simple meditation or visualisation exercises, both before the exam and during short breaks in the exam itself. Box 3 shows a simple example, using a technique called anchoring. You can use a range of techniques, which can either be self learnt or taught by a professional, such as a yoga teacher or hypnotherapist.

the Yerkes-Dodson curve:


Exam technique 2: performing [BMJ Careers]

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