Medliorate

Improving medical students

Archive for January, 2009

Eating Out on the Cheap

Posted by medliorator on January 31, 2009

Ueatcheap.com

Find places to eat for $10 or less

Posted in Finance, Tools | Comments Off on Eating Out on the Cheap

How to Schedule Clinical Rotations

Posted by medliorator on January 29, 2009

Daniel Egan, MD:

If you are certain about the specialty you plan to pursue, you should avoid scheduling a rotation in that clinical area first. During your earliest rotations, you will be learning basic medical practices, how to pre-round and round, how to write a note, and how to use the computer system. The best place for you to experience that learning curve is not in the specialty you intend to enter. However, it may make sense to do a so-called “difficult” rotation first, such as surgery, if you are not going to pursue a residency in that clinical area. More difficult rotations can accelerate the process of learning the ways of the hospital as well as decreasing your anxiety level (and requirement for sleep) as the year moves forward.

How Should I Schedule My Clinical Rotations? [Medscape]

Correlate: Electives vs Rotations

Correlate: General Etiquette for 3rd Year

Posted in Clinical Rotations | Comments Off on How to Schedule Clinical Rotations

Managing the Stress of a Medical Career – Talking to Eachother

Posted by medliorator on January 28, 2009

George Hossfeld, MD, assistant professor of emergency medicine at the University of Illinois-Chicago, on is medical malpractice experience:

It felt very personal when they asked for an award far more than my policy limits, and I, as the sole defendant, had to imagine the possibility of losing my house, retirement savings, and kids’ college fund. Through a stroke of luck, the jury returned a decision for the defense. No one will convince me that on another day, a different group of 12 people could not have found me guilty, and awarded my future to the plaintiff.

There is no way the term winner can be applied to me. With luck, survivor is all I hope to realize.

Physicians do not advertise the fact that they are being or have been sued because they know that it is a slur on one’s reputation. The secrecy with which we treat the issue serves to underscore that point.

Silence contradicts all we know about stress management. Stress causes anxiety, isolation, and helplessness, and has led some to suicide. Enlightenment through exposure would go a long way in removing the stigma associated with its very name.

The public has been told that malpractice occurs to those few bad doctors, and that the rest of us have no experience with it. It’s hard for them to have much sympathy when that’s the case. What an epiphany it will be to find that their doctor, in fact, all of their doctors have experience with being sued! Now that’s a horse of a different color! Exposure will lighten the shame, disgrace, and dishonor that we have falsely granted it. Exposure may create a groundswell of disgusted colleagues who are going to demand change.

Speak the Unspeakable: ‘I Was Sued for Malpractice’ [Emergency Medicine News:Volume 31(1)January 2009p 3, 16]

Posted in Medical Errors, Tips & Advice, Wellness & Health | Comments Off on Managing the Stress of a Medical Career – Talking to Eachother

Perform Statistical Calculations Online: StatPages.org

Posted by medliorator on January 27, 2009

StatPages

The web pages listed here comprise a powerful, conveniently-accessible, multi-platform statistical software package. There are also links to online statistics books, tutorials, downloadable software, and related resources

Posted in Research, Tools | 1 Comment »

Forum Filter: Should I Attend Lecture?

Posted by medliorator on January 26, 2009

Jeff Wonoprabowo – I attended over 80% of lectures.  It wasn’t because I had figured out that I learn better through lecture. It was because of fear.  I had this paranoia that I would miss something important… Do you attend lectures?

ELP – overall I’ve found that, when I have the self-control to actually study when skipping a class, I get a lot more done and retain the info much better than if I’d been in class

min – Lectures are actually a guide for me to study and I felt myself can study better with these guides. The lecturers might share some of their special experiences and there is no harm to listen also.

Ali – I started to deviate away from going to lecture because, just as you, I saw a lot of people who didn’t go to lecture and still were at the top of the class when it came to tests. By not going to class, I realized I became less dependent on the prof and more dependent on myself to learn the information. Remember, you’re not learning medicine for the grade, you’re learning it for the sake of treating people in the future. So just because the prof doesnt say “this is important” for a certain topic doesn’t mean it’s not important.

laura – I have not attended class more than 2x/mo for the past year. My scores went up when I stopped going to class.

To Be, Or Not To Be (In Class) [The Differential]

Posted in Tips & Advice | Comments Off on Forum Filter: Should I Attend Lecture?

New Data Compare Aliskiren & HCTZ

Posted by medliorator on January 25, 2009

The new direct renin inhibitor aliskiren (Tekturna, Novartis)—when given as first-line monotherapy—reduced blood pressure to a greater degree than one of the usually recommended first-line agents, hydrochlorothiazide, in a new year-long study of patients with essential hypertension. The results were published online January 12, 2009 in Circulation

Schmieder and colleagues randomized 1124 patients with essential hypertension (mean diastolic BP, 95 to 109 mm Hg) to aliskiren 150 mg (n=459), hydrochlorothiazide 12.5 mg (n=444), or placebo (n=221) once daily. Forced titration (to 300 mg for aliskiren or 25 mg for hydrochlorothiazide) occurred at week three; at week six, patients receiving placebo were reassigned (1:1 ratio) to aliskiren 300 mg or to hydrochlorothiazide 25 mg. From week 12, the calcium channel blocker amlodipine 5 mg was added and titrated to 10 mg from week 18 for patients whose BP remained uncontrolled.

At the end of the monotherapy period, aliskiren 300 mg was superior to hydrochlorothiazide 25 mg in reducing BP (-17.4/-12.2 vs -14.7/-10.3 mm Hg; p<0.001).

Criticisms include the fact that the study looked only at a surrogate end points (i.e., mm Hg), and that hydrochlorothiazide is not the ideal comparator. Despite the fact that it is the most commonly prescribed antihypertensive drug, there is little evidence that it favorably affects clinical outcomes, said Dr Franz Messerli (St Luke-Roosevelt’s Hospital, New York). Also, most hypertension patients are controlled on at least two agents, which makes the comparison of monotherapies somewhat futile, said Cockcroft.

New Data on Aliskiren Provoke Debate [HeartWire]

Posted in Pharmacology | Comments Off on New Data Compare Aliskiren & HCTZ

Cancer Patient Becomes Doc

Posted by medliorator on January 24, 2009

“I wanted to work next to Dr. Mott and I wanted to train with him,” said Banka, a 28-year-old second-year oncology resident at Detroit’s Henry Ford Hospital. “We have a very special relationship.”

That relationship started in 1993 when a 12-year-old Banka was diagnosed with bone cancer in his right knee.

Mott and his former partner performed the surgery, removing the cancerous bone and replacing Banka’s knee with a prosthetic.

Mott continued to treat his patient throughout high school, college, and even periodically while Banka attended medical school at Michigan State University.

Shortly after Banka joined Henry Ford, Mott transferred to the hospital. They now work together occasionally.

“Going through this, I saw the ability the physicians had with, not only saving my life, but to give my life back,”

Doctor, former patient now colleagues in Detroit [Yahoo News]

Posted in News | Comments Off on Cancer Patient Becomes Doc

Smoking Cessation Meta-Analysis

Posted by medliorator on January 23, 2009

CMAJ.  2008; 179(2):135-44

We performed a meta-analysis to compare the treatment effects of 7 approved pharmacologic interventions for smoking cessation.

RESULTS: Six of the 7 pharmacotherapies studied were found to be more efficacious than placebo: varenicline (odds ratio [OR] 2.41, 95% credible interval [CrI] 1.91-3.12), nicotine nasal spray (OR 2.37, 95% CrI 1.12-5.13), bupropion (OR 2.07, 95% CrI 1.73-2.55), transdermal nicotine (OR 2.07, 95% CrI 1.69-2.62), nicotine tablet (OR 2.06, 95% CrI 1.12-5.13) and nicotine gum (OR 1.71, 95% CrI 1.35-2.21)… In our analysis of data from the varenicline trials that included bupropion control arms, we found that varenicline was superior to bupropion (OR 2.18, 95% CrI 1.09-4.08).

INTERPRETATION: Varenicline, bupropion and the 5 nicotine replacement therapies were all more efficacious than placebo at promoting smoking abstinence at 6 and 12 months.

Pharmacotherapies for smoking cessation: a meta-analysis of randomized controlled trials [Medscape]

Posted in News, Pharmacology | Comments Off on Smoking Cessation Meta-Analysis

How to Avoid Procrastination

Posted by medliorator on January 22, 2009

  • What will happen if you don’t progress? It won’t hurt to scare yourself a little

Develop your plan, list..

  • Major, realistic steps – A project is easier when it is built in stages;
  • How much time each will take – A schedule helps you keep a progress chart and reinforce that there are way-stations on your path
  • What time of day, week, etc. you dedicate yourself to work – This helps you develop a new habit of working, build a good work environment, and distance distractions
  • Rewards you will have at each station – also what you will deny yourself until you arrive at each station

Avoiding procrastination [Study Guides & Strategies]

Correlate: Conquer Procrastination

Posted in Productivity, Study Tips | Comments Off on How to Avoid Procrastination

How To Register For USMLE Step 1

Posted by medliorator on January 21, 2009

Check out medliorator’s guest post at Scrub Notes entitled, How To Register For USMLE Step 1.

While you’re there, don’t forget to visit Scrub’s newest post, My USMLE Step 1 Study Strategy

I repeated this pattern of studying for particular subjects for about 6 weeks, but I made sure to reserve the last week before the exam to go through First Aid again. Doing so really helped solidify all the material in my mind. Also, as I had been taking notes in First Aid as I did review questions, I had a much richer resource to study from during that last week, and did not have to waste time hunting for notes in other resources

Posted in USMLE | Comments Off on How To Register For USMLE Step 1