#since my MD classmates graduate in may

[humofnight]

why is it so hard for me to acquire a little creachur in my life

brought to you by my mom finding a GREAT apartment listing that’s in budget since it includes all utilities, actually has like. A bedroom and decent appliances, etc etc but has the dreaded No Pets

[psycholojosh]

hello ! i’m so glad i found your page, first of all. thank you po agad as your posts about psych have helped me get to know more about the /realities/ sa careers na kasama sa field. :))

i am currently taking up an undergrad degree in social science (sociology) in up as well ! i’ve wanted to shift to psych pero mukhang mahihirapan ako if i try as the slots are very limited. however, my envisioned career po eventually ay sa medical side talaga (i dream to either be a psychologist or a psychiatrist).

my question is, does it push me back sa psych path/career na i’m not an undergrad psych graduate? will it affect my goals to either proceed to clinical psych (and then take a psychologist licensure exam) or enroll in med school (become a psychiatrist)? is being a psych major a required step to pursue these careers? further, may advantages po ba na closely related naman ‘yung current program ko sa psych?

thank you very much ! ♡

Hello! I'm glad that my blog is somewhat helpful to you. 😊 Another person actually asked me a similar question, actually. You can check out my other responses to Asks on my page. But, anyway...

I wouldn't say that you're pushed back if the career you want is within psychology and your current program is sociology. However, having a psychology degree in college does afford you an advantage into some opportunities that can propel you into the field in psychology (e.g., jobs, grad school, etc.). But, that's not always the case in the real (adult) world. I have fellow classmates and peers who came from non-psychology college degrees, like fine arts, film, and business administration, just to name a few. I would even argue that other fields can also bring you advantages and creativity into how you will train yourself to become a psychologist. For example, at the top of my mind, I can imagine that sociological thoughts and ideas actually offer a lot of insight into how we look at mental health, psychotherapy, and the like.

When you step into grad school in psychology, many programs and schools will surely teach you the basics you may have missed from a bachelor's in psychology program (i.e., theories, research methods, etc.). Of course, having studied them back in college seems helpful, but ultimately it still depends on how you dedicate your effort and care into learning, no matter what college degree you have. Trust me, it will matter less as you journey further.

One thing though... I do notice that you seem to be considering two distinct paths: a psychologist OR a psychiatrist. These are two different roles/occupations but they do come with some similarities. While both overlap as a mental health professional, each requires a specific kind of training and timetable of formal education. At least in the Philippines, becoming a psychologist is faster on the average since it only requires you to complete a master's or doctorate degree (not MD!) before taking the licensure as a psychologist. On the other hand, becoming a psychiatrist requires you not only a medical degree, but also additional training and certification into specializing in psychiatry. Unfortunately, I cannot speak to how psychiatrists do training. I suggest looking for a psychiatrist you can ask about how they train. There are also some differences in approach to mental health as well but I won't elaborate them here for now (mas mahabang usapan na kasi yun hehe!). But, I do recommend that you learn more about each career path thoroughly.

My advice to you is to keep exploring your possibilities, even if you're in sociology, and decide to what you find is more important now and who you want to be in the future. Also, don't be afraid to take your chances no matter how small they are. I really don't want to tell you exactly what you should do -- and you're always free to disagree with me or take my words with a grain of salt -- but you will always miss all of the chances you never take. 😉

I hope this helps! Good luck!

[the-last-cuddlebender]

Kataang Pilot!AU

(This prompt was really fun. I hope you enjoy reading it as much as I enjoyed writing it, Anon!)

Words: 1,659

*********************************

Katara met him when they were in flight school. Well, ‘met’ might be too strong a word.

She was walking down the hall and contemplating fluid dynamics when she passed him—the boy with tattoos a shade of blue that put the sky to shame and with a smile so bright that she had to squint to behold it. His laugh was a vapor trail that made her giddy like nothing else had done before. He gesticulated so animatedly that he nearly cut off the heads of a dozen passers-by.

Katara tried, once, to talk to him. It was the only test in flight school that she failed. She was too quiet; the world was too loud. It didn’t exactly help that some boy named Haru had pulled the tattooed boy into a headlock that devolved into a wrestling match just as she got his attention.

He tried, twice, to talk to her. He was more than successful both times.

The first time, he spotted her from across the courtyard and damn near teleported to her.

His name was Aang. He wasn’t that tall.

He was the kindest soul she’d ever met.

When he left the school, he took most of her with him, and Katara had been searching for what he stole ever since.

...

Not too long after he left her puzzled, empty, and longing, Katara had to leave, as well. But it wasn’t for an advanced program like he flew off to.

Gran-Gran had a heart attack. It wasn’t pretty. Katara was the glue and the salve cooing her brother and her father to cope and recover. They helped her just as much, and she vowed to visit them more.

(Gran-Gran told her that she saw death, called him a bitch, and reminded him to tell her daughter-in-law that Kya had to wait another ten years for her company.)

...

Katara was only a little behind and only had to retake a few classes when she returned to flight school a year and a half later, but it wasn’t the end of the world.

Graduating was easy, but choosing an employer? That was hard. Katara was an ace—the top of her class. They even put her photo in the hall of notable students.

...She was reminded of Aang and what he stole from her every time she saw his portrait pinned next to hers.

...

It was a requirement to serve as a co-pilot for the first few years after schooling. It was like a continued education after medical school when an MD truly learned what it meant to be a practitioner, but turning from co-captain to captain felt like it was taking twice as long.

Sometimes, it took students twelve years to become a captain. Sometimes, it took them two years.

It took Aang eight months.

Katara was entering her ninth month when she was transferred to his airline.

He spotted her from across the terminal like he had been waiting and looking for her. He vanished and reappeared at her side, and if only he had a puff of smoke, she would have thought him a magician.

He shook her hand and talked at Mach speed. His smile alone nearly blew her away, but his hand holding hers kept her on her feet.

“—it was you! They all said you dropped out, but I knew you wouldn’t! And then I saw your plaque when I visited on a favor-call from Roku, and I couldn’t believe—!”

He paused. Katara’s world stood still. Her world also looked kindof splotchy and dotted with black.

That was weird…

Oh wait.

Breathing.

Breathing was a thing she had to do.

Unfortunately, Katara was too late in her revelation. Her heart broke when his eyes softened like that and his concern boiled over into panic. She was thinking about how nice it sounded when he said her name even as she fell back and fainted.

He caught her, of course.

Luckily, Mai and Lu Ten were willing to exchange their schedules to save either Katara or Aang from being fired.

(He had refused to leave her. It was incredibly foolish. Top in the industry or not, their superiors would only take so much from even him.)

It wasn’t exactly a first date, but he bought her food from the cafeteria and bought her one of those super-fuzzy travel blankets to keep her warm. They talked over pizza that was so greasy that they had to dab it with napkins, and they laughed over coffee that was far too bitter to be called ‘edible’.

They shared secrets over hot cocoa and talked like they knew each other forever.

Aang thought he was being sly when he loaded his straw with a paper wad and blew it at her.

He smiled like a kid on Christmas.

Katara felt like she was one, too.

The g-forces she experienced when he smiled—at her—made her so lightheaded that she whispered a thankful prayer to whoever was pulling her life’s strings that she was seated when she first witnessed the miracle so close and in its entirety.

They fell asleep back-to-back (though it was more like side-to-side) in the terminal—just another ‘couple’ bending under the stress of a connecting flight.

...

“You seem eager to be out of here.” Katara settled into her co-pilot’s chair as her captain fussed over the little details that Katara’s classmates had made fun of her for caring about.

“Ba Sing Se has never been...Well, let’s just say that it’s not like how I was raised.”

“But the South is?”

“Of course! Middle of nowhere, lots of high places, room to run and frolic as I please—”

Katara couldn’t hide her laugh. “Frolic?”

“Have you never frolicked?”

“When I was a girl, maybe.”

“You should try it sometime. It’s not like it gets any less fun with age.”

“Is that an invitation?”

“...Maybe.” Aang scratched his face, didn’t meet her eyes, and flushed a color even brighter than the emergency exit sign. “Or it could...be a date?”

“To go frolicking?”

“Of course.”

It was quiet until it wasn’t. A giggle slipped past Katara’s defenses. She hugged her middle and laughed so hard that she cried, and she nearly laughed herself into a coma when Aang bent over, too. His laugh sounded like how good memories felt, and Katara never wanted to hear more of something in her entire life.

She couldn’t feel her seat beneath her—just the feeling of her hand on his arm and the soft bumping of his head against hers.

Katara was falling, and she was falling hard.

But, for some reason, she wasn’t scared of hitting the ground.

If she didn’t know any better, she might have thought that she was flying.

...

Sokka, having heard the hint of interest in Katara’s voice when she recounted her tale with her dreamy tattooed captain, made immediate plans and cashed-in on more than a few favors to get himself onto her new schedule. He didn't trust Aang, not at first. No one could be that happy.

“—and gentlemen, in the event that you have not been in an automobile since 1942, we’re gonna show you how to fasten a seatbelt, so watch closely—”

Sokka, while a phenomenal flight attendant, was walking a razor’s edge onto Katara’s last nerve.

But Aang and her brother got along famously.

Katara should have expected nothing less.

This was Aang she was talking about.

Her boyfriend could befriend the devil himself.

The thought made Katara’s world get fuzzy and black-splotchy again. Luckily, Aang was laughing too hard with Sokka to notice her holding tight to the wall.

Breathing.

Breathing was a thing she had to do.

Aang’s vapor-trail-laugh gave her the cardinal directions and guided her towards which way was up. His arm curled around her waist like the seatbelts that had kept them anchored when they hit turbulence two months ago and dropped 400 feet.

Katara didn’t notice when next she blushed so hard that her vision went black-splotchy again.

But Aang, without pausing his conversation, was already tugging her closer so she all but pressed right against his heart.

His laugh died out. His chest slowly expanded.

Breathing.

Katara smiled.

Breathing was a thing she still had to do.

...

When Katara finally got her wings, Aang couldn’t have been more proud.

Sokka puffed his chest. “This is Katara, my flying sister.”

“Sokka, please…”

“Yeah, Sokka.” Aang was a grinning shadow touching her shoulder and a reminder to smile brushing her side. “Katara isn’t your ‘flying sister’.”

“Thank you, Aang—”

Aang hugged her from behind and held her so tightly that he curled over and started to eclipse her. “Katara is my flying girlfriend~”

Aang rubbed his cheek to hers. Katara grumbled and fought fate to keep angry as long as she could. “You both are insufferable.” She kissed Aang’s cheek like she was swatting a mosquito, but it only made him giggle and hold her tighter.

Sokka pretended to gag and uttered ‘Oogies’ like a mantra.

Katara blushed, lost her slippery grip on the smile fighting to make itself seen, and looked at her father just as the shutter on Hakoda’s camera went off.

...Aang carried the photo on his person like it was a medical device so vital that he would die if he was ever without it.

“Do you have to keep it there?” Katara pulled one switch and then two, and she side-eyed her smirking First Officer.

Aang ignored her and adjusted the photo pinned to the gauges in front of him. His smile got a little bigger, his eyes a little softer. He looked down at the clouds below them and then up at the heavens beyond. “...The stars sure are beautiful, tonight.”

His hand found hers—they were at an altitude that required little more than autopilot, but it was still breaking regulation.

Katara gently squeezed his fingers. “Yeah. They are.”

...

All of their nights melted into a routine that felt like the same night played over and over.

Katara wouldn’t have had it any other way.

She didn’t mind when Aang put up a fuss just because he could and because he liked to get her flustered. She didn’t even mind when he cocooned himself in the blankets and pouted in a silent demand for five more minutes.

He was only playing. He could be plenty serious if he wanted.

Like the time he crabbed the plane onto an icy runway in an emergency landing. Or like the time he dove into the belly of the plane to give CPR to an elderly passenger.

His seriousness could only go so far, though. He truly was a child at heart. There was nothing wrong with that, of course. Something forever young could never grow brittle and die.

Like the way he blushed every time she reached for his hand. Or like the little hitch to his voice that took over his words whenever she hugged him.

He could hardly speak when he asked her to marry him.

Katara wasn’t that much better off, but neither of them had needed words for the longest time. They sat side-by-side in the nose of the plane and ‘spoke’ in the silence for hours on end.

Kisses were quiet, anyways.

Well, not entirely.

Aang laughed, absolutely giddy, every time, no matter how much or how often they did.

Katara’s laugh drifted in his vapor trail as a gentle hum that made his smile impossibly bigger.

Then, and only then, did it feel like she had finally gotten back what he had stolen—all those years ago—from her.

...

His voice was a song, and his love bled into every worded lyric. They were the warm purrs of an engine that would never fail, and they made Katara’s stomach fall and bounce heaven-ward like her wheels had just left the ground.

When she danced with him, every step felt like lift-off. Every turn gave her g-forces that had her sinking into him to keep from being blown away.

The wedding was over, their guests were gone, but every star and galaxy crowded the sky to witness their love for each other.

This was her captain and co-pilot—her husband and best friend for life.

His name was Aang. He was very tall and quite proud of it, though he made himself eye-level with every person he met.

He was a simple monk and a dirty thief.

But Katara finally had back what was hers.

What was hers was named Aang.

He was the kindest soul she’d ever met.

He kept her grounded even though her feet never touched the earth when she was with him.

He was the part of her that she loved most.

His kisses were g-forces.

His ‘I love you’s were free-falling.

His hugs were the wings that handed her the sky.

His smiles were the spirit that held her aloft.

His name was Aang.

He was hers.

He was the kindest soul she’d ever met.

And Katara would remind him of how much she loved him even long after they were both tied to the earth.

*********************************

.

.

If you spotted that reference to Tao philosophy, I give you a cookie🍪☺️

[paging-dr-bowen]

Tips for Fourth Year of Medical School

So at this point you’re so over Medical School am I right or am I right? But you have one tiny year left…well it’s actually the biggest year sort of kind of…Okay so Fourth year is when you apply for the residency of your dreams, enter the Match, go on the adventure that is interview season, Match day, then graduate with your MD and live happily ever after in residency and beyond.  With the current pandemic that is Covid-19 I’m not sure what fourth year will look like but my advice should still apply. Here are some tips below for scheduling your fourth-year electives, letters of recommendations and what is expected of you as a medical student at this level.

1. When scheduling your fourth-year electives it is advised that you front load rotations in the field you are applying to.  It shows interest in the field and you get more exposure in the field to add to the conversation on interviews because let’s be honest a 6-week core rotation is Psychiatry isn’t enough if you love it and are applying to that field. It also gives opportunity for an extra letter of recommendation if you did not receive enough (suggest 2 in your field of interest and 1 in another field in which you made a great impression). Aim to schedule a rotation 3 months before the rotation start date or as early as the hospital graduate medical education allows you. 2. For the months of September-December you should schedule rotations that are less demanding.  These months are high activity months for interviews (especially November).  If your schedule allows you to graduate on time and skip a month, you might even want to leave a month unscheduled (November or December) to do multiple interviews back to back.  I had rotations scheduled the entire interview season and was fine, but it was annoying having to tell my preceptor that I had an interview multiple times a week.  I was lucky enough to not receive much push-back, but I do know of classmates who weren’t as lucky and had to cancel or reschedule interviews due to this. 3. Unsure of what rotations to schedule in addition to ones in your field of interest? Pick anything you might want to learn that you weren’t exposed to yet- Dermatology, Radiology, PMN&R etc.  Don’t try to recreate a residency schedule by difficult picking rotations you think will prepare you for residency (i.e. 2 months of ICU) – nothing will prepare you but don’t worry…that’s what residency is for. 4. What is expected of a fourth-year medical student? You are expected to act like an intern…But you know nothing John Snow…Hysterical I know.  At this point in time you do not have any shelf exam lurking at the end of the rotation nor a near approaching USMLE Step exam (you should have taken Step 2CK and CS prior to fourth-year if applying for this year’s Match).  So, when you arrive at the hospital or the clinical site you are expected to work as if you’re receiving a paycheck (only you’re not).  There won’t be much to study daily, you’ll be focusing on putting your clinical skills to practice. 5. Timeline – The summer’s focus is on gathering all your letters of recommendations you requested from your preceptors during third year eons ago and writing your USMLE Step 2CK and CS. Take your business headshot for ERAS.  Buy your interview attire. September’s focus is on submitting your ERAS and all supporting documents as soon as the application is open. September-January is interview season. February your Rank Order List of all the programs you interviewed with and desire to go to is due. March is when you find out if and where you match. May or June is graduation depending on your school. I suggest you create a timeline you can easily access with all important dates of your interviews and when things pertaining to the match are due.  A nice app to store interview information such as date of interview and any notes you make is the NRMP Match prism app (it also has a list of important due dates). 6. Additional – Go to a conference or multiple conferences during third year through fourth year once you decide what specialty you’re interested in. You learn a lot about what the specialty offers in terms of career paths as well as get the opportunity to network at conferences.  Conferences are great conversation pieces during interviews.  Most conferences have discounted or free tickets for student attendees and often have scholarship opportunities as well. 7. Make a monthly budget with wiggle room for unexpected expenses that may come up. 8. Eat healthy, exercise and find time for your hobbies.  You get a lot of your free time back for fourth year since you don’t have to study – take advantage, you deserve this! 9. Don’t try to fit in – you are unique, and your dream program will want you for YOU. 10. Be kind to yourself and everyone around you.

*Tomorrow I’ll post everything I did in preparation for and during interview season.

[psychokangaroo]

Hi! I don't post like at all but I'm not a troll I swear! I'm a sophomore in undergrad and I'm super interested in getting an MD/PhD after I graduate-- probably neuropsych stuff? Although I like math so maybe not? Basically I'm wondering what propelled you to choose that path over an MD. Also, because I can't be too different from every other person on this website, what kind of qualifications do you need for an MD/PhD? Is it true I'll need to take Gap years?

Hi! Thanks for writing! Looks like you have lots of questions about MD/PhD, so I’ll try to answer them all. 

First of all, you don’t *need* to take gap years to be a strong applicant for an MD/PhD program. I didn’t, nor did nearly half of my class. MD/PhD application, like MD applications, in the end comes down to just making sure you have checked most/all of the boxes: competitive GPA, competitive MCAT score, longitudinal research experience, some sort of contribution to scientific knowledge (ie, publications/posters/oral presentations), some sort of meaningful clinical experience, and the usual gamut of leadership and altruism. A good way to think about an MD/PhD application is a strong MD application, but with a strong focus on research and lower focus on clinical experience. I was about a sophomore when I seriously considered switching over to an MD/PhD path rather than an MD, and here I am ^_^. (so if you do not have the ability to take a gap year, now is a really good time to start focusing your application towards and MD/PhD, aka, get into a long-term lab, apply for fellowships/grants, lots of summer research).

As for why I chose an MD/PhD path, the simple answer is that I love science. I’ve been doing science fairs and science competitions since I was in middle school. Aside from the first 2 years of med school, I’ve been a lab tech/assistant since high school. As much as I loved the idea of practicing medicine and patient care back in college, I realized that I can’t imagine doing a career that doesn’t involve some sort of research focus, whether it was clinical or basic research. Even if I didn’t apply to an MD/PhD program, I would have ended up in a research focused MD program. 

Moreover, MD/PhDs are in a really unique place to do translational research, taking ideas from the bench and doing preclinical studies that help create new methods for treatment that are clinically applicable. (My interest is in cancer treatment and imaging). I like the idea of being able to directly develop new methods/treatments that can be easily translated to clinic. I also spent a few years in a basic chemistry lab, and I was not happy with how completely removed my research was. (Research for the sake of discovery is important, of course, but I felt like I was not making the difference i want to make by synthesizing this molecule to sense this biologic molecule that may or may not play an important role in treatment a few decades down the line. I am not a patient person :P )

Of course, it also helps that 1. MD/PhDs generally have a better chance of matching than MDs alone controlling for other factors; 2. MD/PhDs have a much easier chance successfully applying from major funding, such as K grants and R grants; and 3. MD/PhDs can get through med and grad school debt free. 

One last thing, regarding finding an area of interest to go into for research, I would advice against choosing an area of interest just because you enjoy the techniques used to answer those questions. I personally thought i was going to be doing synthesis forever because I really enjoyed it, but it took me 3 rotations to realize that the questions that synthesis labs are trying to answer are not the questions I want to spend 4 years answering. Furthermore, a bunch of MD/PhDs further in their careers have all discused about how common it is for MD/PhDs to completely change their research path from what they did in undergrad, or even what they did in graduate school and post-doctorate fellowships. Of course, it sounds like you have a lot of different research interests. A good way to explore what you want to do is to spend some time in different labs to get a feel for whether the questions they answer are the questions that interest you. That may take a little while longer and may require a gap year, but I think finding the fields that you love is worth it 

(and just for reference, computational neuroscience is definitely a thing! At least one of my classmates in the program is doing this. Also psych genomics uses a lot of programming, math, and statistics to answer probably one of the biggest questions in psych - the genetics behind the inheritance of mental health illnesses)

Anyways, sorry for the long post. I hope I have answered all your questions. Good luck in college and in your application! If you have any other questions, just let me know. 

[samuelfields]

The Best Life Hack For Americans: Taking Advantage Of Canada

I’m always looking for arbitrage opportunities to help readers make more money and live better lives.

My favorite arbitrage opportunity for the next couple of decades is investing in non-coastal city real estate due to lower valuations and higher net rental yields. Technology is accelerating the flow of capital towards attractive real estate opportunities, and I want to get in front of that wave.

Recently, I found another multi-decade opportunity by looking north towards our friends in Canada. Despite the frigid weather for four months a year, Canadians have a lot going for them.

Their GDP per capita is a respectable $45,000. Few people go through medical bankruptcies because healthcare is heavily subsidized. Meanwhile, the average annual tuition for Canadian universities was only $6,571 for the 2018/2019 academic year.

Let me share how one Canadian friend is taking advantage of America and how we, in turn, can take advantage of Canada.

How Canadians Take Advantage Of America

A 25-year-old friend in my SF softball league is from Vancouver, Canada. He went to the University of British Columbia, a top five university where annual tuition is only $5,399 in the computer science department.

When he graduated, he decided not to find a job in Canada, but come down to San Francisco where the computer engineering jobs pay much more. He works for online real estate company.

“Sam, I make twice as much in San Francisco as I would if I got a similar job in Vancouver,” my softball friend told me.

“But don’t you want to give back to your country? I thought brain drain is a big thing in Canada?” I responded.

“Yes, but let me make my money first. After five years in San Francisco making double the money, I’ll then move to Seattle with my girlfriend where my firm is headquartered. Seattle pay is similar to San Francisco pay, despite the cost of living being 30% cheaper. Further, Vancouver is only a 3.1- hour drive away.“

“Sounds like a good plan!” I responded.

“Once I’m in my 30s and ready to start a family, then I’ll move back to Canada and live a less hectic lifestyle. With a stronger government safety net, I feel more comfortable raising a family back home,” he explained.

Although I feel a little bad for Canada for not getting the benefit of his productivity after providing him with 22 years of education, I can’t fault his logic.

If Canadians wish to participate legally in our labor market and also buy and sell U.S. stocks and property, why not take advantage of the opportunity? After all, America is the greatest country in the world.

How Americans Can Take Advantage Of Canada

Following my softball friend’s logic, Americans should take advantage of Canada’s government safety net and immigrate to Canada after we’ve amassed our fortunes as well.

One of the biggest problems we face in America is the runaway cost of healthcare. Medial-related expenses is our nation’s #1 cause for bankruptcy. It would, therefore, seem logical that those who decide to retire early and are ineligible for Medicare should migrate to Canada and get their healthcare paid for.

For example, my family pays about $21,000 a year for healthcare premiums plus co-pays and co-insurance. Does this sound reasonable to you for a healthy family who never sees the physician? To generate $21,000 in retirement income at a 4% rate of return requires me to first amass $525,000 in capital.

If we moved to Canada, we’d be eliminating most of our present healthcare costs and could use the savings towards living a better lifestyle. We wouldn’t have to purposefully reduce our income to get healthcare subsidies either. What a shame to stop writing on Financial Samurai, something I love to do, just for the sake of affordable healthcare.

Further, given the average college tuition is only $6,571 a year, we would no longer have to contribute $30,000 a year in our son’s 529 college savings plan. We could easily afford to pay the $26,284 for four years in Canadian university tuition from the money sitting in our online savings account.

It is truly mind boggling that four years of Canadian university tuition costs $9,000 less than one year of private kindergarten in San Francisco!

Saving $51,000 a year in healthcare and college expenses just by moving to Canada sounds like a home run. That’s $1,275,000 less in capital I need to amass at a 4% rate of return.

Even though the average home price in Vancouver is an absurdly high $1.4 million, it’s still about $200,000 less than the median home price in San Francisco.

Moving to Vancouver, Canada might just be the best geoarbitrage move for us. For Americans living in lower cost of living areas, there are plenty of lower cost of living areas in Canada as well.

Our Children Can Take Advantage Of Canada Too

In addition to recommending all FIRE Americans not yet eligible for Medicare consider immigrating to Canada to take advantage of subsidized healthcare and other government benefits, there’s also a way for our children to take advantage of Canada too.

One of the reasons why I’m a high school tennis coach is because I want to learn how to interact with teenage boys before my own boy becomes a teenager in 2031. It may sound crazy to prepare so far in advance to be a better father, but I figure why not try?

During practice one day, I had a nice conversation with one of my favorite players, a senior who will be attending Occidental University in Southern California.

He mentioned a classmate was attending McGill University in Canada and I was immediately impressed because I remember having a financial analyst classmate at Goldman Sachs who had also attended McGill University.

She was extremely kind and smart and was the only one in my 1999 financial analyst class who survived the post dotbomb layoffs and made Managing Director 10 years later.

“McGill is the Harvard of Canada!” I exalted in a somewhat joking way. “I wonder what their acceptance rate is?” I asked.

My student responded, “Really? The Harvard of Canada? How can that be if their acceptance rate is 50%?“

“There’s no way Mcgill has a 50% acceptance rate! I’ll happily bet you 20 pushups that it’s 45% or less! You’ve got to accept the bet since I’m giving you a 5% buffer.” I retorted.

Secretly, I was thinking McGill’s acceptance rate was closer to 20% given the best universities in America have single digit acceptance rates.

“You’re on!” My student immediately looked up McGill’s acceptance rate on Google and started to dance.

He showed me his phone and Google had the acceptance rate at 46.3%. “Time to do some push-ups coach!“

Never one to surrender so easily, I looked at the data closely and the 46.3% acceptance rate was from 2016. As someone who is proficient with SEO, I knew Google often had old data in its featured snippets.

Once I clicked on McGill’s website, it showed they made 15,986 offers to 38,320 applications for a 41.7% acceptance rate for the 2018 school year.

“Bahaha, never challenge the coach! 20 pushups right now!” I boomed.

A 41.7% acceptance rate for arguably the best university in Canada is comical by US standards for the top school. Does everybody get a participation trophy in Canada too? The high acceptance rate shows that Canadians really are much more accepting of everybody than we in America.

Let’s say you disagree that McGill is the best university in Canada. Here are the acceptance rates for the other top universities in Canada.

University of British Columbia: 52.4% acceptance rate

Queen’s University: 42% acceptance rate

McMaster University: 58.7% acceptance rate

University of Waterloo: 52% acceptance rate

University of Montreal: 57% acceptance rate

University of Toronto: 40% acceptance rate

In other words, the best universities in Canada have an acceptance rate of 40% – 58.7%!

Now let’s take a look at the acceptance rates of some of the top US colleges.

Good luck getting into a top 10 school in America unless you’re a really rich legacy student or cured malaria while fighting against gun violence.

Remember, even some rich celebrity kids couldn’t get in on their own merit. If you don’t have $500,000 in bribe money lying around, then forget about it.

What is the point of trying to grind so hard in middle school and high school to try and get into a top American university with a 10% or lower acceptance rate when you can be an average student and still get into a top five Canadian university?

The reputations of the top Canadian universities are higher than their respective acceptance rates indicate.

Over the past three years, I’ve seen and overheard my students talk incessantly about their studies and how they needed to go to expensive SAT tutoring after practice, take more practice AP exams, and so forth.

Several even showed up late to important matches because they required extra time on their exams and then wanted to talk to their teachers after. I could feel the pressure they were under to try and do it all.

Maybe the pressure cooker environment has always been there in high school. But is it really a necessary rite of passage given college is becoming less necessary thanks to the free internet?

Instead of spending $48,000 in annual tuition going to Harvard only to end up with the same type of job as everyone else, why not spend $5,399 in annual tuition at University of British Columbia and work at a US-based firm for more money instead? You might have to live in Canada for a year or two to be able to pay Canadian tuition, but it’ll be worth it!

Not only might you land a $120,000 computer engineering job at Zillow, but you might also even make more than $1,000,000 a year as an MD at Goldman Sachs by your early 30s!

Time To Move To Canada

I encourage all our high school students to apply to Canadian universities to get a great education and save on cost. Then once you’ve accumulated enough capital in America to leave work for good, you can then return to Canada to live off the government’s good graces.

Having a Canadian university education should make it easier to be accepted by the Canadians. You don’t even need a job thanks to Canada’s Express Entry program. All that’s required is at least one year of work experience, proficiency in English or French, and $1,500 – $2,000.

If you intend to be self-employed when you move to Canada, you’ll need to show you have at least two years’ relevant experience in the field in which you intend to self-employ.

But once you get to Canada, there’s no law that states you need to start a successful business. You can just be a hobbyist to keep yourself engaged.

Taking advantage of Canada truly is the best life hack for Americans. Who’s with me? Go Canada!

Related: In Search Of FIRE: The Never Ending Retirement Grind

Any Canadian readers who want to recommend some of the best neighborhoods in the best cities to migrate to? Given PM Trudeau is very welcoming of immigrants, surely he’s very accepting of us Americans too? Any American readers who went to Canada for university? I’d love to hear from anybody who has executed this plan and share some of the downsides. 

The post The Best Life Hack For Americans: Taking Advantage Of Canada appeared first on Financial Samurai.

from Finance https://www.financialsamurai.com/the-best-life-hack-for-americans-taking-advantage-of-canada/ via http://www.rssmix.com/

[ddinardo6018]

Band Camp

May 30, 2017

After spending a lifetime around Rock and Roll, I finally decided to do something about it.  

First some background.   I am in my late 50’s (OK almost 60), married for over 30 years, and the Father of two daughters.  I have lived in Northern Virginia outside Washington, DC since 1980 and am immersed in a variety of activities; I play golf at a local Country Club, have been involved in Competitive Swimming as an Official for nearly 20 years, still play pick-up ice hockey, and I’ve had my Pilot’s License since 1985.  I have no shortage of things to do.

As a kid, I played the piano and clarinet in grade school before graduating to the acoustic Guitar.  I played in Church through High School, but not much else.  In College at Colgate University, I gravitated to the Campus Radio Station, WRCU-FM.  I was a DJ and play-by-play man for both Hockey and Football.  After graduation, I came to the DC area to work as a DJ for a variety of AM and FM stations, including WFMD in Frederick, MD, WXTR-FM (”Extra 104″) and WMZQ-FM.  After getting the radio bug out of my system, I entered the Commercial Real Estate field where I’ve worked for over 30 years.

I’m the oldest of 5 kids, 4 boys and my “8 year-old Sister” who will turn 50 this year.  My Mom was a pretty good piano player and the likely source of any musical talent in the Family.  As kids, my Brothers were the musicians.  All three played in bands in High School and/or College and continue to play.  I made many road trips to Boston when I was in school to see their bands play at a variety of Clubs.  My youngest brothers, Chris and Jim, were drummers in Rods & Cones, which had a modicum of success in Boston and the Northeast during the early 80’s.  My other brother, Steve, played with a few groups while he was in College (part of the time with Chris), and even traveled up to Colgate in Upstate New York to play a couple of gigs at my fraternity.  These guys can play.  They spent the time during High School practicing and working on their craft.  I was too busy playing hockey and doing other extra-curricular stuff.  My sister was a pretty good singer and played the piano for a while as well.

Fast-forward twenty years or so, and I found myself thinking, “If only I had stuck with those piano/clarinet/guitar lessons, maybe I could play like my Brothers.”  Not too long after that my wife Kim surprised me with a Christmas gift of a new acoustic guitar and surprisingly it came back to me pretty quickly.  It just also happened that we ‘inherited’ an old spinet piano from my in-laws.  We wanted our daughters to take lessons; a side benefit was that I was able to fool around on the piano as well.  I didn’t take any lessons so the progress was slow, but I started to be able to play a few tunes.

At my 25th Colgate Reunion in 2005, some Classmates reconstituted their Band, 151, as our entertainment for the weekend.  As I mentioned to several people, the highlight of the weekend was Campus Security literally pulling the plug on them at 2:15 Sunday morning during the crescendo of ‘Freebird’.  As we lingered in the tents until nearly sunrise,  I told myself that I really wanted to be able to share that experience.  Five years later, I got the chance to fill in when 151’s regular keyboard player, Mark DiOrio, was unable to attend.  While a bit shaky, I managed to pull off playing bit bit less than half of the tunes.  I earned some kudos for handling the organ intro to ‘Freebird’ and was invited to join the Band as we accepted applause and a small gift at the Class Dinner on Saturday night.  Even though Mark returned for our 35th Reunion in 2015, I was able to participate, playing on over half of the songs as second keyboard/organ and adding background vocals.  I even sang lead on ‘Sweet Home Alabama’.  It was a blast.

Bolstered by my relative success at our 35th, I finally got up the nerve to revisit my woodwind background and took saxophone lessons for nearly a year.  I have acquired both an alto and a tenor horn, and continue to work on my sax skills.   Its been fun to explore another instrument.

About a year ago, I started discussing forming a Band with two guys from  my Country Club.  I know, not the place where you’d expect to make a rock ‘n roll connection, but Rob Francis, Chris Brown and I decided to give it a try.  After kicking it around for a while, in October of 2016 we committed to renting a rehearsal space every Sunday from 4 to 7 pm.  We recruited another guy from the Club, Jay Hawkins, as an additional guitar player.  Mark Leheney, a long-time friend/neighbor of mine joined as our drummer.  The final piece of the puzzle was the addition of Chris’s former band mate, Steve Harmon, as our lead singer.

Not long after we started rehearsing, a mutual friend from the Club approached Rob and Chris to see if we could play at his wife’s 50th birthday, an outdoor ‘gig’ at his home in late April.  After lots of discussion regarding potential police visits and knowing that the audience would be lots of friends, we elected to move forward.  One problem, we still didn’t have a name for our Band.  After a spirited debate, we settled on the name of ‘No One You Know’.

Next we had to come up with a set list, which wasn’t as hard as I thought it would be.  Within a week or so we had 25 songs that we were comfortable performing.  7 weeks of intense practice paid off, and our first public appearance was a success.  Of course there were mistakes and things we wanted to correct, but overall we were happy with the result.

Going forward, we are hoping to play every 6 to 8 weeks at some of the local establishments here in Arlington.  We’ve decided that our focus for events will be on charity, with all net proceeds going to an organization that could use our support.  In the interim, we are doing a Block Party for another friend this Saturday (weather permitting).  I’ll have more to add after the weekend.  

All in all, its been a great experience that I look forward to sharing with you via Tumblr.

[junctionstreet]

I have a confession to make. To start I would like to start by saying this past week has been quite a journey. The first two maybe three weeks of this time off I was living very shamefully. I was eating all the food. Candy, chips, junk food everyday, not taking care of my body, not exercising. I was staying up late and waking up at sometimes 1 or 2 pm. I was not praying. I was not cleaning my room. I was not working. I was not studying. I was masturbating to pornography once, sometimes twice a day, could’ve been three on an extreme rare day (that may not be true but I don’t want to leave any room to withhold the truth here), Nothing. I was not even talking to you, I just looked at the phone and I couldn’t even engage. My body, my heart, and my mind completely shut down on me and I had no energy for anything. And I remember, one morning, I woke up kind of late of coarse, I rolled out of bed. Got on my knees, closed my eyes and started to pray. Just out of the blue. Hadn’t prayed in all those weeks being off that I can remember, I do kinda remember speaking to God the night but if I did it was brief. But going back to it, I got out of bed feeling like complete crap and got on my knees looked up at the ceiling and prayed. I told God what was up, how I was feeling, and I don’t know if you’ll listen because of my behavior lately, but I need you I want to be closer to you. Save me, rescue me, it feels like I’m spiritually dehydrayed and I was defintely physcially dehydrated as well becasue I was not drinking any water. So How did I get here right? How did I get to such a consuming mind and eating, fornicating, not drinking water, not texting you, letting myself sleep and wake up whenever, not work, not exercising, and not praying. Well, when you work in an environment like mine and I had just spent the past week or two stressing about my evaluation because I felt I was on thin ice, our attendance audit, keeping up with my tasks and responsibilities at work, keeping up with both good and bad energy from the kids and parents. It all just led me to a point of consumption and take all I can, eat all I can, snack all I can, lay down as often as I can, sleep for as long as I can, rest as much as I can like take advantage of this time while I have it, just because my mind body and soul were in that place of need and just weak, really really weak. 

Well, after that I got up and started reading the book you bought me Mental Toughness (which I truly love you for because you engage in my interests and support my interests and you feed my interests). I started reading it outside in the sun. I started reading it in the bathtub, and I learned that laughter, fun, and play should be taken very seriously. I don’t remember the exact science behind it, but the concept was that play releases hormones or neurochemicals or just overall body chemicals that keep the body health and promote growth and optimization and it’s like recovery for your body and reinforecment for your body. You have to review for their examples and explanations but that’s the point that you must work hard, but also have fun and that’s a big part of sustaining you working so hard and also just maximizing that process of learning and nueral plasticity and the building of the brain. This was coupled with a few walks with my mom here and there. I was actually applying it. I was like okay. If fun is a part of success then I am going to do it. So i’m laughing joking, being really positive, and everything was great and then I started to feel better. Like I really started to feel good. 

Then, you know I also started to have memories appear in my mind while I’d sleep at night and just have these memories (good, bad, and neither good or bad, some were just plain nuanced memories)  of my experiences at UC Davis. Just started pondering on some decisions like, why did I do that or do this? Then I went of Facebook and I saw that some people that I was either housemates with or acquaintances with or classmates with met their goal. Like Sarosh became a dentist (housemate). Nick is in medical school (housemate). Titus became a civil engineer (acquaintance from class). Ryan became an engineer (classmate). Brenda became a nurse (ex-girlfriend) And some other guy, (philipino guy is in Stanford medical school, the crim de la crim). Then there were other friends and acquaintances classmates, whoever, that maybe did not accomplish their goal. Like Ajee she wanted to be an engineer and she’s doing make up now. Like. Brandon or Segun, who both had goals of being engineers at some point. And you know I am not judging them. I honestly didn’t even examine them to much. I looked the people who achieved their goal more than the people who did not, so I was not being spiteful at all, like oh look this guy or girl didn’t do this, not at all. In fact, I would smile in nostalgia for how we’ve all grown so much and moved on with our lives since the last time we had an interaction. The people who did accomplish their goal like Stanford and Titus - I was like ecstatic for them I was truly happy for them because I felt like I knew them in a sense. I knew the hustle, I knew the grind, I knew the focus, I knew the discipline it must have taken. I was just thrilled for them and just had good feeling you know. Like Titus posted a grad photo of him, and it said “By the Grace of God” I graduated in engineering it was some of the worst and best times of my life. But through it all I learned from my mentors to trust the process, etc. etc. etc. And I was just like, wow, that is like, a victory statement. It is a victory statement. Then Ryan (old old classmate) started to post these videos and with so much humbleness, unique personality that is truly authentic (reason for that per Ryan is because he understands that in society we are all expected to behave or act in a certain way, but he acknowledges that he’s different and he’s okay with that, because it’s somehow connected to his soul), and with an outstanding genuine positivity. He said the hardest thing he ever did was gradaute with a degree in engineering. He said he got like a 2.8 and he felt really bad about that, but like people were telling him it was good, and how like he got C’s in his classes, but he graduated. And like if he wasn’t sleeping, he was studying, and if he was studying he was sleeping, and if none of those he was asleep dreaming about studying. Like, this man struggle how I struggled but was victorious. 

Then it was kinda like woah, like I just saw all this, like, let me go take a shower it’s 6 am in the morning, I stood up the whole night. Then when I got out of the shower, I think I made breakfast or went to my bed. But either way, at some point I ended up on my bed, pulled out my tablet, and started this ebook called “Making Smart Decisions” and in the chapter I read it said like, for some reason, people make the same decions over and over again. And there’s like a term for it. It’s like some kind of bias. Then I learned that there’s this one term and concept where, someone will take small little decions or mistakes or actions that will usually go unnoticed but after awhile it’s just a disaster waiting to happen in business. And then I made the connection and realization like, woah, that’s true. I did make little mistakes that went unnoticed. Like like decions that truly, served as death blows when they all add up, I mean look, it’s obvious, I failed to meet my dream of being an MD. Then I just started to write them down, on the tablet. Then I was like, you know yes, I failed to meet my dream and goal. But now I know why, or at least have a better understanding of at least two things forsure as to why I failed, 1. I kept walking away, like when I did not understand a concept, had to read a science book, had to answer problems, workout a solution to those problems - then be asked to keep that up with the remaining classes, and then be mindful of the midterm that Thursday, then like I never really studied or never really rested because I was overwhelmed by the fact that I had the midterm Friday, yet couldn’t even understand last weeks material, so I somehow ended up awake the night before having felt and believing and actually not knowing any of the material the night before. But I knew I could’nt fail or else my dreams of MD would be over. So I pulled the all nighter, someone how managed to pass, or not. Then, I would feel relieved that I passed with at least a C, and be like almost relieved that I passed, kinda disappointed but hey, going from stressing that you’re going to fail becasue you’re learning all the material the night before and are likely to get a big fat F on your transcript - to staying up all night, sleep deprived, motivating yourself, to actually like getting a C and passing grade. You’re like almost releived, sure a little disappointed, like I would mostly leave tests disappointed. But when the grade comes in you’re like Thank you God I got a C. I remember I got a C+ in Calculus 21B -truly by the grace of God, because that summer I was taking Calculus 21B and I remember going to office hours, talking to the instructor during office hours, he understood that I was trying, there’s a few memories I have of that time, I remember sitting in his office and he showed passion in calculus when the concept of infinity came up when discussion how him in his friends debate on infinity or have conversations on infinity. Also, when I was in office hours and we had the big white board and he was trying really hard to explain it to me, and just like trying to break it down, and seeing where my reasoning was missing, and he had a point where he just put his finger on his chin, like “man, what can I do, how can I teach this kid, with a look of responsibility that he had for me” then I also at some point he was like you can’t memorize, you actually have to understand how it works, and we both ended on a feeling of we just tried really hard to learn this and for me to teach this, and just walked away being cool as always. I dropped by office hours, one more time after that expressing my concern for passing his class. He gave me advice, like don’t stress it’s going to be what it’s going to be at this point, just try your best, and he seemed a little forward a little annoyed, but I felt that was because he probably failed me or like there was litteraly no point of stressing and so he expressed his forwardness for something that had no point. And you know what, I am pretty sure I must have prayed that night. Because, the day of the test he was about an hour late to the final exam. He came rushing in with his bike or helmet or one of the two, and like a big box full of exams, and stuff, and he’s like he he had some printer trouble etc. etc. etc. I will compensate for giving everyone 30 more points, or something like that, he made it clear he was going to make up for it point wise, and he even gave us extra time i think. Then, I remember going to his office after the test, just to communicate and earn more points, something you know, like I was doing everything I could to ensure the guy remembered me and liked me before he graded my test lol and also to genuinely say thank you as well like he was cool, he did try to help me and he was cool, like I felt like I got to know him a little bit that summer, and it was the end of my calculus summer, so I wanted to just conclude and say bye. Then I walked to the room through the math building and I hear him like shouting (not crazy because he was a very very chill guy, but just enough to where it sounded like he was talking to a loved one, telling them what happened, and getting it off his chest), and it even sounded like he was moving things around in a rush. I heard him say something like, “the printer crashed and I was late! I said I was late like 50 minutes to 1 hour late” Then I heard this, realized I probably don’t want to see this guy right now if I don’t want to get on his bad side. So I walked away, took a deep breathe and realized calculus was over. Time for a new journey...

I am studying hard that new semester, feeling good everything is positive, girls living in the house, I am one of only two straight guys in the house. I am good. Then you know, I get my study grind on, and I’m prepping before the quarter has even begun, studying stuff that probably wan’t even going to help me prepare for the class anyways. I would study at a starbucks all that. Then I remember, Jocelyn and Stephanie coming in the starbucks, and watching me study. Then like, towards the more beginning, I actually did follow up with the psychiatrist in Vacacille, then I was like, you know, I’m here I drove all this way, like let me kinda fight for this, let me kinda actually do this, like it’s scary, like this doesn’t feel comfortable, but then I was like you know this is all part of taking control over my study habits and results, and this is what’s going to truly to get me the results i’m looking for. Then I recall meeting with a therapist, and the therapist was like are you sure you want this? I can provide you therapy, do you have good habits, etc. etc. like she did do her part, I remember she looked at me with like, you really want the medication huh, and like you know we can try this and that instead, and like I don’t remember how much she tried to present a better case for therapy instead of medication, But I do remember her offering therapy, and asking me at least twice, if I was sure. Then, also have to consider that I also knew what kind of questions these people were going to try to ask me to deny the adderral, like I was prepared to address these questions and points with exaggerated claims or even false claims, in other words, I lied. I used slickness and manipulation and lies to get what I thought and felt I needed at the time to be successful, when all I needed was myself. All I needed was work hard, all I needed was small SMART goals, little ones that can be accomplished each day as part of accomplishing an even bigger goal, the only work hard involved is not reading/review notes, recalling what I knew, acknoweldge what I didn’t know, fill in the gaps and make note of them, and work on practice questions, the urge to walk away from those previous are the work hard that’s all. I didn’t work hard by accomplishing my little goals for each day no matter what, that’s all I needed, and a positive belief in myself that I could do it, and a positive belief in God. I felt like I had to take it because of the environment I was in, the extra boost was necessary, probably pressure from my classes starting to creep in, and also just self-doubt, and doubt in God or like not even thinking about God. 

But also there’s this other idea too like not taking time to rest over the summer led to an increasing pressure to rely on something else to sustain, when in fact all you needed was a break, was some fun, was some engagement, was some home, some family, you know something. Just that time to rest. Had I done that I think I would’ve made better decisions, or more confidence in myself, or something. Just something to point out, thankfully we made a principle out of it.

SIDE NOTE: During this summer of calculus 21B, I had went to Kaiser and said look, I am doing everything I can do in these classes, I am still not getting it, etc. etc. Just a side thing because I had the time it was the only class I was taking - I thought I was addressing the problem, my goal was to keep it low key. Take care of this. Get A’s and study better. Go to Medical School. I knew a guy named Michael who took it and he got into Cornell Medical School, and I remember he spoke on it, then I told him I was thinking of it and he said he didn’t recommend it because of the crashes, which I disregard like crashes no big deal whatever, if I get A’s I’m doing it how bad could it be. Anyways, I need this to be fixed because I am studying and still not getting it, and I have dreams of being a doctor. So I need to fix this now, and be prescribed some medication to help me focus. The doctor referred me to a psychiatrist. (I don’t remember what he told me, if he recommended or what, or if I asked for it, which was probably the case because I didn’t go the doctor’s office for nothing, you know.) so i got the psychiatrist referral during that summer. 

also, I gave up on myself when I dropped Chemistry 2A, that summer will be written about as well. 

I don’t hold anything against white people. Because my calclus 21B professor gave me a C+ because he saw the work I was putting in, because I’m pretty sure I din’t know anything on that test, maybe I did, becasue you know like I said, I tried. But I remember when I was at office hours, he litterally heard me telling my grandma to wait becasue I was in office hours trying to earn some extra points, I was like waitining in line to speak with him, he walked over to me, broke it down, as fast as he could on a paper, that I saved actually and I wish I still had or could find (it was blue and like of a long trianguar graph this <> but side ways. It might be in the basement, gosh. Secondly, my biopsychology professor TA if it weren’t for him I don’t know if I would’ve graduated - he litterally siad “we are going to get you into grad school” he truly supported me because I don’t think I was going to pass that class without his help, he would ask me questions that he pulled from his laptop, that truly served to help me on the test. I am telling you, those questions were pretty specfic trick A B C or D questions and I knew about half of them because of that. Thirdly, Ms. Martin gave me a holy bible that I still use today - and there’s something about books I received while at Jefferson that just have some kind of special meaning to me. I don’t know but she was tied to it, and the bible she gave me has truly truly led me well. Fourthly, Mr. Stolz is white, c’mon man. Fifth, Matt and Jaiyme is white, I fricking love those guys! So nothing against white people. There’s some good and there’s some bad in every race, the media can choose what they want to focus on and present to the public. 

[thegloober]

Sometimes the most entitled people aren’t those you expect

Cory Michael, MD | Physician | September 30, 2018

As I sat in a frozen yogurt store a couple of years back, I watched as two young men pulled up in an expensive vehicle. They were wearing athletic attire from a private faith-affiliated university in the neighborhood. Both grabbed sample cups and cup-by-cup consumed about ten dollars-worth of yogurt each before jestfully yelling “Gracias” to the Latin store employee and walking out the door without paying for anything. Then I saw the same thing happen with another group a few minutes later. While this may have been the most “entitled” I think I have ever seen anyone act, it occurred to me how commonplace this term has become in recent public discourse.

At some point in the past ten years, we began speaking publicly about government-sponsored health insurance and retirement plans as “entitlement” programs. The term is accurate. Veterans are entitled to VA benefits. They sacrificed their lives for the security of our nation. Senior citizens are entitled to Social Security when they retire. Their payments are commensurate with what they paid in over their careers. Since health insurance in the United States is employer-driven, Medicare is needed to provide a safety net for those beyond retirement age. Our values hold that children are entitled to healthcare even if their parents can’t provide it. That is where Medicaid comes in.

I can’t help to think that we started using the label “entitlement programs” in somewhat of a pejorative sense meaning that maybe the entitled people shouldn’t really be entitled to the government programs voted into place by the leaders we elected. Just like the affluent college students above, I have to say that the most “entitled” people I have met since becoming a physician have not been the poor or infirmed.

At a graduation party for my medical school at a nightclub, one of my classmates (the son of a physician) felt as though the bartender wasn’t serving him fast enough, so he reached behind the bar and helped himself to a bottle of liquor. During residency, one of my fellow residents (the daughter of a physician) parked in a handicap slot because she was late for work.

One of the attending physicians at my residency program who was compensated entirely by a private practice radiology group once complained about “entitled” patients over-utilizing the emergency room. In the meanwhile, this attending enjoyed never having to work overnight as well as the financial reward of having residents generate hundreds of thousands of dollars in revenue for her practice. You may think that the radiology practice that was sending the medical bills to the patients was paying the radiology residents who were doing much of their work for them. Nope. Just like most other medical residents in the United States, the residents were paid by the federal government through the hospital. Private radiology practices are entitled to having the government buy them call coverage overnight in exchange for offering an educational program that meets minimal standards, regardless of whether more radiologists are needed or not.

Maybe government health insurance isn’t the first “entitlement” program that needs to be modified.

Cory Michael is a radiologist.

Image credit: Shutterstock.com

Tagged as: Radiology

Source: https://bloghyped.com/sometimes-the-most-entitled-people-arent-those-you-expect/

[dorcasrempel]

Exploring cancer metabolism

Nearly 100 years ago, the German chemist Otto Warburg discovered that cancer cells metabolize nutrients differently than most normal cells. His discovery launched the field of cancer metabolism research, but interest in this area waned; by the 1970s most cancer scientists had shifted their focus to the genetic mutations that drive cancer development.

In the past decade or so, interest in cancer metabolism has resurged, and the first drugs that target cancer cells’ abnormal metabolism were approved to treat leukemia in 2017.

“Cancer metabolism is a very sophisticated field at this point,” says Matthew Vander Heiden, an associate professor of biology at MIT. “We have a lot better understanding of what nutrients cancer cells use and what determines how those nutrients are used. This has led to different ways to think about drugs.”

Vander Heiden, who is also a member of MIT’s Koch Institute for Integrative Cancer Research, is one of the people responsible for the recent surge in cancer metabolism research. As a graduate student and postdoc, he published some of the first studies of how cancer cells alter their metabolism, and now his lab at MIT is devoted to the topic.

“All of the time that I was in grad school and working as a postdoc, I was never working in a lab that was dedicated to studying metabolism. So my vision, if someone gave me a job, was to set up a lab that could really be built in a way that would allow us to ask questions about metabolism,” he says.

Metabolism and cancer

Vander Heiden grew up in a small town in Wisconsin, and unlike most of his high school classmates, he headed out of state for college, to the University of Chicago. He was interested in science, so decided on a pre-med track. A work-study job in a plant biology lab led him to discover that he also enjoyed doing research.

“At that point I already had this idea I was going to go to medical school, but then the idea of MD/PhD came up, and I ended up going down that path,” Vander Heiden says.

While in the MD/PhD program at the University of Chicago Medical School, he worked in the lab of Craig Thompson, now president of Memorial Sloan Kettering Cancer Center. At that time, Thompson was studying the biochemical regulation of apoptosis, the programmed cell death pathway. For his PhD thesis, Vander Heiden investigated the function of a protein called Bcl-x, which is a regulator of apoptosis found in the membranes of mitochondria — cell organelles responsible for generating energy.

“That project really got me thinking about how the mitochondria work and how metabolism works,” Vander Heiden recalls. “At the time, I came to the realization that we don’t understand cell metabolism anywhere near as well as we thought we did, and someone should really study this.”

After finishing his degrees, he spent five years doing clinical training, then decided to pursue research in cancer metabolism.

“Altered metabolism has been known about in cancer for 100 years, but few people were studying it,” Vander Heiden says. “The challenge was finding a lab that would allow me to study metabolism and cancer, which in 2004-2005 was not such an obvious thing to do.”

He ended up going to Harvard Medical School to work with Lewis Cantley, who studies signaling pathways in cells and was receptive to the idea of exploring cancer metabolism. There, Vander Heiden began studying an enzyme called pyruvate kinase M2 (PKM2), which is involved in regulation of glycolysis, a biochemical process that cells use to break down sugar for energy.

In 2008, Vander Heiden, Cantley, and others at Harvard Medical School reported that when cells shift between normal and Warburg (cancer-associated) metabolism, they start using PKM2 instead of PKM1, the enzyme that adult cells normally use for glycolysis. Cantley and Craig Thompson have since founded a company, Agios Pharmaceuticals, that is developing potential drugs that target PKM2, as well as other molecules involved in cancer metabolism.

While at Harvard, Vander Heiden also worked on a paper that contributed to the eventual development of drugs that target cancer cells with a mutation in the IDH gene. These drugs, the first modern FDA-approved cancer drugs that target metabolism, shut off an alternative pathway used by cancer cells with the IDH mutation.

New drug targets

In 2010, Vander Heiden became one of the first new faculty members hired after the creation of MIT’s Koch Institute, where he set up a lab focused on metabolism, particularly cancer metabolism.

His research has yielded many insights into the abnormal metabolism of cancer cells. In one study, together with other MIT researchers, he found that tumor cells turn on an alternative pathway that allows them to build lipids from the amino acid glutamine instead of the glucose that healthy cells normally use. He also found that altering the behavior of PKM2 to make it act more like PKM1 could stop tumor cell growth.

Studies such as these can offer insights that may help researchers to develop drugs that starve tumor cells of the nutrients they need, offering a new way to fight cancer, Vander Heiden says.

“If one wants to develop drugs that target metabolism, one really needs to focus on the context in which it’s happening, which is the environment of the cell plus the genetics of the cell,” he says. “That is what defines the sensitivity to drugs.”

Exploring cancer metabolism syndicated from https://osmowaterfilters.blogspot.com/

[carasueachterberg]

Frankie’s going to school!

After searching high and low, I finally settled on a dog-training school that seemed to offer the most options, a solid reputation, and a reasonable price.

Before we could sign up for classes, we first had to attend a free orientation. This seemed like a great idea because of 1) Free! And 2) a chance to see how Frankie would react to the other students and 3) an opportunity to meet the trainers before shelling out any bucks.

Everything was looking stellar until I attempted to sign up for orientation and discovered that the next available slot for orientation was a month away. To make matters worse, orientation is on Tuesday evenings– the same night I teach creative writing for our local school district (and the next session starts in two weeks). The training classes themselves (should we decide to take them) were held on different days so there wouldn’t be further conflict, but first, we had to figure out how we could attend the required orientation.

I emailed the school and explained my dilemma and the next day I received an email that we could come to the very next orientation only five days away!

On the day of orientation (much like when I prepared my oldest child for preschool), I fed Frankie a good breakfast, made sure he wasn’t smelly, and carefully packed his school bag. I filled his bag with treats and a towel and toys and, just in case, I packed his head collar.

We’ve been using the head collar on Frankie for hikes away from the house. When the leash was connected to his regular collar, he tended to pull and strain and eventually barf. The head collar worked like magic and made for much more pleasant walks. I tucked it in the bag just in case.

In my investigation into local trainers, I found that there are a plethora of opinions (strong opinions) about head collars or front harnesses or e-collars or any of the modern tricks available to control your dog. When I was packing up Frankie’s bag, I couldn’t remember exactly what My K9 Buddy’s position was on head collars. I was prepared to try whatever tools they recommended, but I decided to bring my life jacket, just in case.

I left the house an hour early for what google maps said was a 35-minute drive. I’d planned to stop at a park close to our destination to take Frankie for a quick walk so he’d be calm and focused for class.

This would have been a great plan—if I’d gone to the correct address.

Turns out that MyK9Buddy.com and MyK9Buddy.net are two entirely different places. I wandered up and down a rural road for a few minutes before pulling over to look up the address again and discovering my error. I was 37 minutes away and class started in 15 minutes.

I briefly considered bailing but decided to turn the car around and high-tail it to the correct address. I couldn’t expect the powers-that-be to make an exception again to allow me to jump the orientation line twice. Best to get there as quickly as possible and throw ourselves on their mercy.

I’m pretty sure the roads between Hanover, PA, and Westminster, MD have not been improved upon since we switched from horse and buggy to cars. The GPS took me down some crazy rural pathways – paved and unpaved. It was a very good thing that Frankie seems to have outgrown his carsickness habit.

We flew into the parking lot, exactly 16 minutes late and raced into the building. Our entrance was not at all subtle as the door opened upon the class in progress. The instructor paused in her presentation to ask, “Orientation?”

I nodded and she pointed to a spot next to the door. I hate being late for anything, so I appreciated her graciousness, but I’m sure she thought, “Oh great, first she needs a special exception to be here and then she arrives when the class is half over.” I’m confident Frankie can win her over for me, though, so we take a seat.

There were about eight other dogs separated by empty crates, many with solid dividers to hide the dog beside them from view. Each of the other dogs was accompanied by two parents, and some had brought entire families. I told Nick about that later and he said, “So you were the single dog mom.” Much like I was the single parent at so many back to school nights in the past thanks to his travel schedule.

Frankie was very excited to be there. So excited, in fact, that he strained at his collar, leaning with all his might in an effort to reach the other dogs, I tried to focus on the lesson, but Frankie’s whining and panting made that nearly impossible. He just could not understand why I was preventing him from greeting his classmates.

Another trainer came over and slipped a cardboard barrier against the crate that separated Frankie from the next dog, effectively blocking his view. But my pup is no dummy. He knew the other dogs were still there and continued his campaign, now making choking sounds and coughing. I knew what was coming next, but didn’t get my towel out soon enough and Frankie barfed at my feet.

Not wanting to disrupt class any more than we already had, I pulled out his head collar and put it on him. Then I used my towel to scoop up the barf, seeing no trashcan in the vicinity, I balled it up and put it back in my bag. I remember doing the same thing with dirty diapers and spit-up back in the day.

One of the other trainers noticed Frankie’s pulling and when the instructor was waylaid with a question, she walked over and handed me a paper. She was surprised to see that Frankie was now wearing a head collar.

“You’ve already desensitized him?” she asked.

I had no idea what she was talking about, but I just nodded and took the paper. When she stepped away, I glanced at what was on the paper. It explained the steps for desensitizing your dog to a head collar. Turns out we did it all wrong when we simply slapped it on Frankie a month ago with no introduction. It also turns out that My K9 Buddy recommends the use of head collars for dogs that pull!

A few moments later, Frankie began pacing and whining. I knew what this meant.

It was bad enough that we’d arrived late, Frankie had barfed, and we’d disrupted class, I didn’t want to add pooping in class to our list of crimes, so I stood and led him outside. The instructor glanced my way, paused in her presentation and said, “Looks like someone has to go.”

She was right, only when we got outside there were a dozen dogs lining up for the next class and Frankie’s need to poop was superseded by his need to meet ALL THESE DOGS.

I dragged him away up to a grassy knoll and then realized I’d forgotten to bring a poop bag. I was willing to bet that every person standing in that parking lot had a poop bag in his or her pocket. Did I dare ask? There was no need because, after several tours of the hillside, Frankie offered nothing but his great desire to get back where the other dogs were.

I hurried him back into the building and took my seat. The class was breaking up. The nice young trainer who had brought me the sheet on desensitizing head collars came over and began to tell me what we’d missed (pretty much everything). She demonstrated the different homework assignments and then said, “The other thing she went over is how to get something out of your dog’s mouth he shouldn’t have—it’s really easy, you just offer him something else.”

“Oh, I know that trick, I’ve done a lot of puppies,” I said.

She gave me a confused look, and I realized that if you’re not in the foster world ‘doing a lot of puppies’ might sound like ‘doing a lot of heroin.” I quickly explained that I foster for a rescue and a big smile lit up her face. I told her which rescue I was with and explained that Frankie was my 95th foster dog.

“I can see why you would fail on this one,” she said as she knelt down to properly greet Frankie.

Before I left, I signed us up for six weeks of classes. There are four sessions each week and you can attend up to two of them. I told the trainer I planned to be a twice-a-week student. I’m sure she was thrilled to hear that.

At home, later that night, I took out the homework assignment and tried out the exercises. Frankie’s favorite was called, ‘Doggie Zen.”

For Doggie Zen, you hold two fistfuls of treats or kibble. You spread your arms apart at waist height. Naturally, your dog is going to look at your hands full of treats, but you want him to look you in the eyes instead. You wait until the dog glances your direction and immediately use your ‘bridge word’ (mine was “Good!”) and give him a treat.

The trainer had said, “Even if you just get an accidental drive-by, reward that so he can figure it out.”

Frankie’s eye rolled past me on his way from one hand to the other and I quickly yelped, “Good!” and shoved a treat at him.

Two sessions later, as soon as I assumed the position for Doggie Zen, Frankie would sit directly in front of me and stare into my eyes, knowing that this led to a steady feeding of treats.

Smart pup. The other homework exercises were even easier for Frankie.

I may be biased, but I predict we’ll graduate from Level one before our six weeks are up.

First Day of School Pictures (we weren’t late!):

Modeling his new color-coordinated head collar

Waiting for the door to open for class (and watching the other dog who got there before us)

Thanks for reading! If you’d like to know more about my blogs and books, visit CaraWrites.com or subscribe to my monthly e-newsletter.

If you’d like to know how you can volunteer, foster, adopt or donate with OPH, click here. And if you’d like more regular updates of foster dogs past and present and news of our 100th dog’s arrival, be sure to join the Another Good Dog facebook group.

I love hearing from readers, so please feel free to comment here on the blog, email carasueachterberg@gmail.com or connect with me on Facebook, twitter, or Instagram.

Best,

Cara

COMING AUGUST 2018 from Pegasus Books:

Preorder available NOW on Amazon!

It was a rough start, but Frankie is now enrolled in doggie school. #myamazingpitbull #myk9buddy Frankie’s going to school! After searching high and low, I finally settled on a dog-training school that seemed to offer the most options, a solid reputation, and a reasonable price.