Choosing a Specialty

My favorite part of my job is teaching. There, I’ve said it. Yeah, it’s cool picking apart diseases and mix-n-matching treatment regimens for the optimal balance of cure and side effect. I love hand-holding people through concepts that are far beyond their educational level and helping patients and families make impossible decisions with uncertain data.

But give me a new third-year medical student who’s been dropped in the middle of the hospital for her First Real Rotation Ever, and I am just in heaven. I love teaching med students.

One of the things I love the most is helping them figure out what flavor of doctor they want to be. Third year is all about sampling it all, and experiencing what actually happens in the various medical specialties. You rotate through Surgery. You rotate through Internal Medicine. You rotate through Family Practice. You rotate through Anaesthesia. You rotate through Psychiatry. In fourth year, you’re supposed to be narrowing it down to your most likely options for residency.

Tips on Excelling on Rotations

I know that my performance on clinical rotations is important for how I will be assessed. How can I distinguish myself?

Response from Sheila M. Bigelow, DO Resident Physician -- Pediatrics, UH Rainbow Babies and Children's Hospital, Cleveland, Ohio

Clinical rotations can be very challenging. For the first time, you're expected to follow patients, present on rounds, show your medical knowledge, and work well in a team environment with people who are new to you, knowing that you'll be moving on before long. Not only are you expected to meet the basic requirements, you are expected to do well enough to earn an honors grade or a strong letter of recommendation from the attending.

Fortunately, there are some "must know" tricks that can help you distinguish yourself and help get the grade or letter that you want.

Thinking of Quitting

Question:

Medical school and residency can be tough physically, mentally, and socially. What's the best way to get through those tough times when all I want to do is quit?

Response from Sheila M. Bigelow, DO
Resident Physician - Pediatrics, UH Rainbow Babies and Children's Hospital, Cleveland, Ohio




Depression in Medical Students

Medical school and residency are some of the biggest challenges of our careers. Along with the good, exciting times come the hard, rough times. Long hours, little sleep, and a high-stress environment all create the perfect storm. These feelings can fall anywhere in the spectrum from burnout and depression to suicidal thoughts and suicide attempts.

Deep Tendon Reflex

In a normal person, when a muscle tendon is tapped briskly, the muscle immediately contracts due to a two-neuron reflex arc involving the spinal or brainstem segment that innervates the muscle. The afferent neuron whose cell body lies in a dorsal root ganglion innervates the muscle or Golgi tendon organ associated with the muscles; the efferent neuron is an alpha motoneuron in the anterior horn of the cord. The cerebral cortex and a number of brainstem nuclei exert influence over the sensory input of the muscle spindles by means of the gamma motoneurons that are located in the anterior horn; these neurons supply a set of muscle fibers that control the length of the muscle spindle itself.

Hyporeflexia is an absent or diminished response to tapping. It usually indicates a disease that involves one or more of the components of the two-neuron reflex arc itself.

Hyperreflexia refers to hyperactive or repeating (clonic) reflexes. These usually indicate an interruption of corticospinal and other descending pathways that influence the reflex arc due to a suprasegmental lesion, that is, a lesion above the level of the spinal reflex pathways.

Ins and Outs of Being an Intern

Question

How will things change as I transition from medical student to intern?

Response from Graham Walker, MD
Chief Resident, St. Luke's-Roosevelt Hospital Center, New York, New York

As an intern, you are the primary patient data collector. It's probably the most important part of the team. Welcome to the role.

Your first days as an intern may seem like just another medical school rotation; you're still writing notes, but what you write matters much more now. Your team will rely on you to know your patients and their numbers inside out, so if you say the creatinine is trending down, it better be.

Transitioning to INTERNSHIP

In less than 60 days, I will be going into internship and most of my posts will also be transitioning about internship and hospital duty. Thanks for your continued support.

MedicalStudent soon to be MedicalIntern... Hopefully...

Post-Exam Remorse and Realizations

PhotoCredit: Well.Blogs.Nytimes.com

I just made it out of an Exam this day and I just woke up right now. Being in Medical School, the stress of taking an exam and the usual remorse of not studying enough is not an unusual feeling. You can say that it's a cycle that will repeat over and over again and nothing will ever make you become immune of it. It's become of this that I realized a few things that I'd like to share to everyone that you may not or may have realized already:

1. Things don't always work out as you planned in Med School. I've realized this lesson each time I do things and in fact I can fairly conclude that it should be part of a Medical Student's life. It is the norm rather than the exception. There are far too numerous factors that can be in play that will make our lives as uncertain as it's already is ranging from self-deserving consultants, toxic-bringing residents, inconsiderate professors, unsupportive classmates, uncooperative family or your own lazy self. 
2. You cannot give up. After a disappointing exam, you pick yourself up and move on. There is basically nothing you could do about it anyway that you should have done before the exams. It's already too late to undo things that have past and energies are better spent on preparing for things to come. So stop moping, eat your comfort food or have a satisfying sleep, then get over it.