Medliorate

Improving medical students

Archive for August, 2009

How to Find Free WiFi with your Mobile Device

Posted by medliorator on August 31, 2009

Windows Mobile: WiFiFoFum

wififofum

This is the latest version of WiFiFoFum – the best WiFi scanner and war driving software for Pocket PC 2003 and Windows Mobile 5 Pocket PC and Smartphone editions.

iPhone/Touch: JiWire’s Wi-Fi Finder
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With more than 200,000 locations in 135 countries, JiWire’s Wi-Fi Finder makes it easy to search for free- and pay-access Wi-Fi hotspots wherever you are or plan to be.

Android: WeFi

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WeFi is software loaded onto your laptop or mobile device. It automatically detects and qualifies all Wi-Fi access points within range and connects you to the spot with the best Internet connection. If the WeFi software detects a new access point, it allows you to be the first to map it. WeFi also provides you with Instant-Messaging tools, allowing you to create a buddy list, and to see where your friends are currently connected.

Posted in How-To, Software | Comments Off on How to Find Free WiFi with your Mobile Device

Envisioning the Hospitalist

Posted by medliorator on August 30, 2009

Edwin Leap underscores the difficulty of establishing your patient’s ‘baseline’ in the years to come:

the hospitalist is a physician whose practice is focused on admitting patients to the hospital, caring for them, and discharging them back to their regular physicians (if they have one) when the acute situation is over.

the idea of the hospitalists makes great sense, and probably bears much fruit… However, a relationship is severed. We have many community physicians who do not do hospital work. And more now that the hospitalist option exists. So let’s say I have patient X in the evening or on the weekend. His physician doesn’t admit. I call the hospitalist. ‘Patient X is having chest pain. His cardiac labs and EKG look alright, but it just seems concerning to me. Can we admit him?’ Hospitalist: ‘well, he doesn’t have risk factors and everything looks OK, what are we going to do? Do a second set of labs and let him see his doc tomorrow.’

Now, that was a technically correct encounter. But if his own doc had been on call, as in the past, he might have said ‘I’ve known him for years. He doesn’t complain. That isn’t like him. Let’s keep him overnight.’ Scientific? Maybe not. Possibly useful? Absolutely.

Medicine and relationship [edwinleap]

Posted in Tips & Advice | Comments Off on Envisioning the Hospitalist

How to Repay Medical School Debt

Posted by medliorator on August 27, 2009

The median debt load for the 87 percent of medical school graduates who have some debt was $155,000 in 2008, according to the Association of American Medical Colleges, up 11 percent from just one year earlier.

Sharply rising tuition explains much of the increase — the American Medical Student Association says public medical school debt has grown by more than 300 percent in the last 20 years

  • If you’re consolidating federal loans, the sooner you lock in the better because rates today are low… For details, go to loanconsolidation.ed.gov. Remember to only consolidate variable-rate loans so you can keep your lowest fixed-rate loans from being wrapped into a consolidated higher rate
  • Loan forgiveness programs offered by the federal government or individual states in exchange for public service can wipe out a lot of debt worries, but only if the terms (such as living in a rural area) are right for you… It makes little sense to spend a fortune on a medical education just to end up in a practice situation you dislike for years, he says.  FinAid offers details on forgiveness programs.
  • If you can’t afford the payments under an income-based repayment plan, you’ll likely need to consider medical residency forbearance, which postpones payment of principal and interest during residency years. But be careful: Unlike traditional deferment, loans in forbearance keep accruing interest while you delay payment

Repaying Medical School Debt [Physicians Practice]

Correlate: How to Defer Federal Student Loans

Correlate: How to Live with Debt

Posted in Debt, Finance | Comments Off on How to Repay Medical School Debt

Approach to Hyponatremia

Posted by medliorator on August 24, 2009

The first question to ask yourself is: Is this a true hyponatremia? …is there truly an imbalance between the ratio of sodium to free water

To calculate what the true sodium level would be in the face of hyperglycemia, take the current level, and add 1.6 times the glucose level minus 100 divided by a hundred.

next consider volume status.  If the patient is dehydrated, then the low sodium is likely due to the compensatory response of ADH, and the treatment is to gently rehydrate the patient using normal saline. However, if the patient is volume overloaded and edematous, think about causes such as cirrhosis, renal failure, or congestive heart failure and treat those as needed. If the patient has normal volume status, they might have syndrome of inappropriate antidiuretic hormone (SIADH) or something more esoteric

How To Work Up Hyponatremia [Scrub Notes]

Posted in Physiology | Comments Off on Approach to Hyponatremia

Speak from the Evidence on Rounds

Posted by medliorator on August 20, 2009

ScreenHunter_02 Aug. 20 22.54

Look sharp on rounds by speaking from the evidence regarding your patient.  EBOC delivers bite-sized factoids that summarize key findings in literature and keep your team up to date.

Example:

Sickle cell crisis

Many patients are regular attenders (b) – contact their regular physician and ask how they are normally treated (d)

  • 30% of patients with sickle cell disease are admitted to hospital each year (c) ,  but a third of all the crises happen in 5% of patients (b)
  • Genotype is important: patients with SS anaemia and S-beta 0 thalassaemia are more likely to have crises than others (c).

Evidence-Based On-Call [EBOC]

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Coping with Difficult Teammates

Posted by medliorator on August 13, 2009

1. Be calm – Someone who is calm is seen as being in control, centered and more respectable. Would you prefer to work with someone who is predominantly calm or someone who is always on edge?

3. Get some perspective from others – In all likelihood, your colleagues, managers and friends must have experienced similar situations in some way or another. They will be able to see things from a different angle and offer a different take on the situation. Seek them out, share your story and listen to what they have to say.

4. Let the person know where you are coming from – Letting them in on the reason behind your actions and the full background of what is happening will enable them to empathize with your situation. This lets them get them on-board much easier.

5. Build a rapport – Re-instill the human touch by connecting with your colleagues on a personal level. Go out with them for lunches or dinners. Get to know them as people, and not colleagues.

7. Focus on what can be actioned upon – Sometimes, you may be put into hot soup by your difficult colleagues, such as not receiving a piece of work they promised to give or being wrongly held responsible for something you didn’t do. Whatever it is, acknowledge that the situation has already occurred… focus on the actionable steps you can take to forward yourself in the situation.

9 Useful Strategies to Dealing with Difficult People at Work [Dumb Little Man]

Posted in Clinical Rotations, Professionalism | Comments Off on Coping with Difficult Teammates

2008 Physician Compensation Survey – Assessing Average Physician Income

Posted by medliorator on August 11, 2009

Sample size unknown.  Salary ranges reported in $K

Specialty Low Hi
Cardiology(Invasive) 389 561
Radiology 386 600
Orthopedics 372 512
Radiation Oncology 357 453
Urology 352 426
Cardiology(Non-Inv) 332 439
Anesthesiology 331 446
Gastroenterology 330 490
Plastic Surgery 300 792
Oncology / Hematology 296 410
Dermatology 287 385
General Surgery 271 356
Pathology 239 331
Ob-Gyn 231 304
Emergency Medicine 216 300
Neurology 203 298
Internal Medicine 175 209
Hospitalist 174 217
Psychiatry 171 248
Family Medicine 150 204
Pediatrics 140 202


Specialty Low Hi
Cardiology(Invasive) 389 561
Radiology 386 600
Orthopedics 372 512
Radiation Oncology 357 453
Urology 352 426
Cardiology(Non-Inv) 332 439
Anesthesiology 331 446
Gastroenterology 330 490
Plastic Surgery 300 792
Oncology / Hematology 296 410
Dermatology 287 385
General Surgery 271 356
Pathology 239 331
Ob-Gyn 231 304
Emergency Medicine 216 300
Neurology 203 298
Internal Medicine 175 209
Hospitalist 174 217
Psychiatry 171 248
Family Medicine 150 204
Pediatrics

Physician Compensation Survey [Modern Physiccian]

Posted in Finance | Comments Off on 2008 Physician Compensation Survey – Assessing Average Physician Income

Common Phrases Medical Students Must Avoid

Posted by medliorator on August 10, 2009

1. This won’t hurt at all – many procedures do hurt, at least a little, even when performed with skill, and patients would rather know that going in. Pediatricians, in particular, must be careful that patients don’t eventually take such assurances as a prelude to pain. Try, “This could be a little uncomfortable,” or “This will hurt some, but it’ll be over before you know it.”

2. We’re just really busy – uttering these words can disparage the patient, who is probably also quite busy and perhaps missing work for this appointment… apologize and give your patient an estimate for when he will be seen.

3. I understand how you feel – you don’t want to insult your patient or belittle her experiences. Instead, try expressing empathy by saying, “I can only imagine how you feel.”

5. I’m sure it’s nothing serious – false promises are a death blow to patient trust. Instead, provide assurance through thorough exams and attentive listening to patient concerns.

6 Things You Should NEVER Say to a Patient [Physicians Practice]

Posted in Clinical Rotations, Communication | Comments Off on Common Phrases Medical Students Must Avoid

Lipid Lowering Agent: Crash Course Podcost

Posted by medliorator on August 8, 2009

The Science of Pharmacy offers a 7 minute review of lipid lowering agents. hosted by a registered pharmacist.  This is a worthwhile and efficient review of very common drugs.


Lipid-Lowering AgentsThe top video clips of the week are here

Posted in Pharmacology | Comments Off on Lipid Lowering Agent: Crash Course Podcost

Survey Study: Surgical Lifestyle & Job Satisfaction

Posted by medliorator on August 7, 2009

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researchers conducted a national survey of American Board of Surgery-certified surgeons who completed their training in the years 1988, 1992, 1996, 2000, or 2004.

Of the 3,507 surgeons who were certified in these years, 25.5% completed the questionnaire on their professional and personal lives.

Both sexes reported that they worked too much.

Notably, most surgeons of both sexes would recommend their profession to others, indirectly suggesting a high rate of professional satisfaction and fulfillment…

women were somewhat more likely than men to say they would choose the surgical profession again (82.5% versus 77.5%, P=0.15).

Female surgeons were also less likely than their male counterparts to have children (63.8% versus 91.3%, P<0.001). Female surgeons with children most often gave birth to their first children while they were in actual practice, while male surgeons typically reported that their first child was born during their residency.

Female Surgeons Report High Job Satisfaction [medpagetoday]

Posted in Surgery | Comments Off on Survey Study: Surgical Lifestyle & Job Satisfaction