Medical Resident

Days off during residency

Sun, 09 Oct 2005 10:52:18 -0500

Residents have very few days off during training. Usually it is one day in 7 during inpatient rotations. At least during my training, inpatient rotations comprised most of the first and second years. So, I often had difficulty figuring out what to do during my days off. For example, I had some research and reading to do, but there was always this feeling that these valuable days should be really used to unwind. Usually I would read or write very little, and use the rest of the day to do something completely non-Medicine related. The temptation to spend most of the day sleeping was also significant, but it is important to get out and do something.

What do you do on your days off ?

Discount Travel for Residency Interviews

Wed, 05 Oct 2005 17:57:16 -0500

The AAMC has renewed an agreement with American Airlines to offer discounts for senior medical students traveling to interviews for residency programs.

Valid travel dates are October 1, 2005 - May 31, 2006.

Discount is 5%% off the lowest applicable coach fare.

Discount is not currently applicable to internet fares.

Tickets should be purchased at least seven days prior to departure in order to receive the discount.

Discounts/fares are valid for round-trip travel on American Airlines and American Eagle to your meeting destination for travel from anywhere in the contiguous 48 states, Hawaii and Canada. Seats are limited.Certain restrictions may apply. Applicable taxes and service charges may apply. Please call for details.

For reservations and ticketing information, call American Airline's Meeting Services Desk, or have your travel professional call (800) 433-1790 and reference the AAMC Index #17603

Maximizing your Conference $

Mon, 03 Oct 2005 00:26:21 -0500

When planning to attend a conference here are a couple things to keep in mind:

1) Contact the conference organizer, you'd be amazed, but many will wave registration fees for those in training

2) Book flights early and use multiple search engines when doing so

3) Most hotels have their own "conference" rate which may be lower than the rate you were offered by the organizer, so contact the hotel directly, or use a service such as Expedia/Hotwire/Orbitz

4) If you're in a major city, it may be the same money or cheaper to rent a car for the duration of your stay than the additive cost of taxis to and from the conference center and to and from the airport

The heavy labcoat

Sun, 02 Oct 2005 16:54:18 -0500

I have several colleagues that have a 10lb labcoat. They have all sorts of pocketbooks, acessories, lists, rulers etc. I asked one of them how often he used that equipment. His response was simple: "almost never". I challenge you to empty your labcoat pockets and examine each item, thinking how often you have needed it. Really.

I do not carry any pocketbook with me. I use my PDA for my medication databases, and the only real pieces of equipment I need are my stethoscope and a tiny penlight. I used to carry a bunch of things in my pockets, but then I realized that carrying that much stuff really did not accomplish anything except making my feet hurt more by the end of the day.

On being a team member

Sat, 01 Oct 2005 18:54:10 -0500

One of the things that matter the most during residency is the notion that you are working as part of a team. Frequently there are several levels of learners, and you are only one of them. Being a good team member will make the days flow better and you will be recognized as someone who brought something good to the team.

Some topics that deserve mention:
- Organization: organize your tasks, time and patient information. Try to have good knowledge of what needs to be done for each patient.
- Patient care: no matter how much you know about a specific disease, at least in the hospital every patient needs a good plan for the day. If there is no formulated plan, there is something wrong.
- Teaching and learning: like I mentioned above, sometimes you will act as a learner, sometimes as a teacher. Respect each learner's timing and level of experience. Don't create unrealistic expectations.

I will expand on each of these topics in future posts.

Welcome !

Sun, 25 Sep 2005 17:46:17 -0500

Thanks for visiting our newly designed website. Medicalresident.net has been around, however I decided to reformulate the entire site so that it gets more interactive.

I also asked Brian to post with me here. Brian is currently a medical student, so he is very aware of how hard it is to go through Medical School. Brian and I will be posting here regularly, and we will cover aspects related to medical residency in general, including preparation for it and post-residency issues.

Please let us know how to improve this website !

Efficient rounding

Sun, 25 Sep 2005 17:05:30 -0500

By far the most important things to make your day a good day is to stay ahead of the game. And you do that by planning ahead and allocating time to see your patients.

For me, I calculate about 15 minutes per patient. So if I have 6 patients, I know that 90 minutes will be about what I need to pre-round. I also add 5 minutes for that quick run to the cafeteria.

Everyday routine will also include ordering labs for the next morning. I try to do that before attending rounds if I can. If you are requesting a procedure or something that has to be scheduled, I usually call so that the test is scheduled right away and is done as soon as possible. That leads to a more efficient hospital course for your patients and less patients on your service.

A good way to keep track of your patients is either a Microsoft Word or Excel document where you keep most of their information. I do not really like the PDA solutions for following patients, so I developed my own simple non-electronic solution. Go to your office supply store and buy blank 4x6 cards. I use a ring to keep them organized. I made my own template which I print on each card.

Internal Medicine fellowships: an introduction

Sun, 25 Sep 2005 16:59:29 -0500

Choosing a residency is not easy, and shortly after starting residency you already have another choice to make. First, you have to decide whether subspecialization is for you. If you think you want have subspecialty training, there are several factors to consider.

I will briefly outline the main fellowships in Internal Medicine.

Some specialties are using the NRMP "Match", but most are not. Check the NRMP website.

Cardiology - probably the most competitive subspecialty fellowship. Very fast-paced, intense. Lots of specific areas and different practice options. For example, you may want to do a mostly echocardiography- and office-based practice, or you may want to be an interventionist, doings caths, stents all day. Very evidence-based. Length of training 3-4 years. Uses the Match.

Gastroenterology - also extremely competitive. There are few spots per program. Some programs emphasize procedures more than others. Length of traning 3 years. Does not use the Match.

Hematology-Oncology - getting more competitive over the last few years. Currently would rank about 3 in terms of competitiveness. Most programs are research-intensive. Length of training 3 years for the combined program, some programs allow training in Hematology or Oncology separately, with training time being 1 less year. Does not use the Match.

Critical Care / Pulmonary - moderately competitive. Obviously inpatient-oriented. Length of training 3 years. Uses the Match.

Rheumatology - not competitive. Lots of office-based practice and chronic diseases. Some procedures. Length of training 2-3 years.

Endocrinology - mostly not competitive. Length of training 3 years. Does not use the Match.

Nephrology - mostly not competitive. Length of training 3 years. Does not use the Match.

Infectious Diseases - not competitive. Length of training 3 years. Uses the Match.

Allergic Diseases - becoming more competitive. Excellent lifestyle attracting lots of applicants. Length of training 3 years. Does not use the Match.

Equipment for wards

Sun, 25 Sep 2005 16:42:57 -0500

Fortunately there are not that many pieces of equipment you will need. As a general rule, this is what intern-level residents in most fields will need to carry with them most of the time.

Before you get anything, make sure you place ID bands or stickers on all your things. Odds are you will leave something behind eventually, but if they are identified you have a chance of a good soul finding it and returning it to you.

A good stethoscope - there is a growing trend towards the digital stethoscopes. I have a regular one, but the quality of sound with the new digital stethoscopes make a big difference. Expect to pay a hefty price, though, and carry replacement batteries with you. Treat this as an investment. If you do not have a stethoscope, this may pay off but hearing subtle murmurs that will be unnoticed to other people, and make you a star.

A Personal Digital Assistant - even if you are not a computer-savvy person, PDAs are very easy to use. And they keep a lot of weight off your pockets. Learn how to use the calendar, tasks, and there are many free applications with calculator, drug information, guidelines, algorythms and such. More on PDAs for medical staff on medPDA.

A small flashlight - I like the mini Mag Lite ones a lot. They are very durable and their light beam is decent. Those drug-rep flashlights have a very limited lifetime and they fail when you need it the most.

Reflex hammer - unless you are a Neurology resident, you can use the cheap hammers.

Cheap pens - no need for that nice fancy pen for your residency. If you are like me, you will lose at least 2 pens per week, so just buy a 100-pack of cheap pens so you can feel ok about losing them.

Things you will not need to carry unless you are a resident in specific areas:

Ophtalmoscope
Otoscope
Peak flow meter