#subinternship

[izvmimi]

actually ykw i should do? i should buy and play fields of mistria so i never log into tumblr again or have time to think about blorbo

[allthingsinfectious]

I’ve had the best time growing with these inspiring future doctors. #maroondays #medstuds #subinternship #day24of31 #thenightcomes (at Chicago, Illinois)

[trishmishtree]

So the hospital is closing and we're all screwed

[lazyyogi]

I’ve had such bad insomnia for the past three nights! I just started my internal medicine subinternship and haven’t adjusted to the hours. I’ve been averaging 1-4 hours of sleep per night 😭

Send some good vibes! I’m going to need it today.

[haphazard-randomosity]

Tumblr diary time

This week is technically my “off” week between my Home Program Subinternship and my first Away Rotation Subinternship, and I feel overwhelmed with the sheer amount of stuff I need to do. 

Stuff I got done/good stuff that happened 

-deadline to submit manuscript to conference in T-2 weeks, still editing the final draft within the last 4 hours before deadline.

-Got one rec letter writer, got shot down by another prospective letter writer, am pan

-Impressed a senior physician with my apropos usage of the word Machiavellian

-Turned in my paperwork to get credit for my Away Rotations 

Still to do

-Clean apartment

-Pack my suitcase 

-Finish filling out my ERAS

-Write those program-specific paragraphs...all 90 something of them...

Panicking over:  

-Finishing that manuscript before deadline 

-That last letter writer I scrambled to ask 

-If I’m going to match

-Existential dread 

[anilkhare]

Why Students Choosing Medicine as Their Career nowadays

Why students are more into medicine while choosing their career these days is largely due to family tradition. Some people follow the legacy of several generations of physicians, while others are under the pressure of parents who did not have the same opportunities and may pressurize their offspring to become doctors. Other reasons may be more complex, but they all share some common themes. In this article, we will explore some of the major motivations behind a student’s decision to choose medicine as their career.

Motives for starting a career in medicine

One of the key challenges in assessing motives to enter the medical profession is defining the right mix of factors. Using a survey of medical students to determine why they want to become doctors, we mapped the different factors that students use to determine why they want to become a doctor. The results of our study are somewhat limited, but we can identify a few themes and draw important conclusions from it.

First of all, most people choose medicine for internal reasons, such as caring about the suffering of others and helping to improve their health. These people often find medical courses to be intellectually stimulating. Their intrinsic motivations are often the most important factors in choosing a career in medicine, and they tend to be more satisfied with their choice of career. This is one reason why these individuals tend to like medical school, as they gain valuable knowledge while helping people in need.

Impact of physician/teacher feedback

While personal characteristics are important, they should not be overemphasized. The focus of my PhD study was the role of personal characteristics. However, I did not ask students about their views in any depth. It seemed more comfortable to focus on students’ personal characteristics. Nonetheless, personal characteristics should not be underestimated, especially as it relates to medical education. There are several reasons why a physician or teacher’s feedback may not have an impact on a student’s choice of career.

Participants were recruited from fourth-year medical classes at Memorial University of Newfoundland. Participants were interviewed in 16 focus groups led by a non-faculty facilitator. The transcripts were coded based on recurring themes and topics. Representative quotations were tracked to understand the themes. Overall, there were 20 recurring themes. The most common themes were:

Impact of subinternships

The Impact of Subinternships on Students’ Decision Making Regarding Medicine

The Subinternship is a unique opportunity for medical students to gain clinical experience in an increasingly demanding environment without full responsibility. In addition, many students select subinternships at institutions where they hope to apply to residency. In this way, the Subinternship is essentially an audition for a residency program outside of medical school. But what makes this experience unique? Here are three reasons why it is valuable for aspiring medical professionals:

During the COVID-19 pandemic, a large number of medical school students had new interests in fields other than medicine. Nearly half (48%) of respondents reported that they had developed new interests after the pandemic. Twenty percent of students in third and fourth years reported new interests, while 49 (17.5%) of interns had new interests. The same percentage of students with moderate or weak certainty reported changes in their specialty choices.

Impact of work-life balance

The study revealed that most medical students prioritize family responsibilities and time off. Female students generally view part-time employment as essential to their future well-being, while some male students find it difficult to work full-time. Students with a high value on work-life balance typically choose careers that have flexible working hours, and they negotiate their hours with their parents and partners. The study findings suggest that the need for work-life balance is becoming more prevalent than ever.

The study also found that Australian medical students have a range of attitudes towards work-life balance. For example, they were more interested in pursuing a career in rural areas or developing countries than in metropolitan areas. A few students chose medicine because they wanted to help those in need, but most did not regard it as a career; they saw it as a calling. Students’ responses also indicated a strong commitment to a career in medicine and rejected the stigma of being a “workaholic” and spending long hours in hospitals.

[medschooltutors]

Sub-internships are short and sweet, but can be so much more if you really get in there. #SubInternship #Residency #MedEd #InternYear

[dfergrthetrg]

(EPub/PDF) Download BRS Pediatrics - Lloyd Brown

  Read/Download Visit :

http://en.ebookcorner.xyz/?book=0781721296

Book Details :

Author : Lloyd Brown

Pages : 528 pages

Publisher : LWW

Language :

ISBN-10 : 0781721296

ISBN-13 : 9780781721295

Book Synopsis :

Read Online and Download BRS Pediatrics .Like other titles in the Board Review Series , BRS Pediatrics is designed to offer students a strong foundation for subsequent learning in both primary care and subspecialty pediatrics.BRS Pediatrics features:A comprehensive overview of the basic principles of pediatricsDetailed information for the pediatric subinternships and pediatric subspecialty rotationsCase-based review tests (simulating USMLE Step 2 questions) at the end of each chapterExplanations for the correct answers and the incorrect responses with cross-references to the appropriate text for student follow-upEnd-of-book comprehensive 100-question examinationYou'll find that BRS Pediatrics will be an indispensable resource for the pediatric rotation, the end of rotation exam, and the USMLE Step 2. .

Lloyd Brown book BRS Pediatrics.

 s

[jkhkmkjkmjkmm]

(PDF/Books) Download BRS Pediatrics - Lloyd Brown

  Read/Download Visit :

https://greatbooksonline12.blogspot.com/?book=0781721296

Book Details :

Author : Lloyd Brown

Pages : 528 pages

Publisher : LWW

Language :

ISBN-10 : 0781721296

ISBN-13 : 9780781721295

Book Synopsis :

Read Online and Download BRS Pediatrics .Like other titles in the Board Review Series , BRS Pediatrics is designed to offer students a strong foundation for subsequent learning in both primary care and subspecialty pediatrics.BRS Pediatrics features:A comprehensive overview of the basic principles of pediatricsDetailed information for the pediatric subinternships and pediatric subspecialty rotationsCase-based review tests (simulating USMLE Step 2 questions) at the end of each chapterExplanations for the correct answers and the incorrect responses with cross-references to the appropriate text for student follow-upEnd-of-book comprehensive 100-question examinationYou'll find that BRS Pediatrics will be an indispensable resource for the pediatric rotation, the end of rotation exam, and the USMLE Step 2. .

Lloyd Brown book BRS Pediatrics.

 sreading

[thegloober]

Judges versus coaches in medical education

I flash a smile as I look up from my notes. “Do it again,” I say, encouraged by his progress, “but this time start with the physical exam.” I am the internal medicine resident leading our “twilight” admitting team, and Vikram, a student on the first day of his medicine clerkship, sits across from me. It is his third time practicing the presentation of Ms. R, a 56-year-old woman with pancreatitis who was recently admitted to our hospital.

When I first met Vikram earlier that day, I explained that I viewed my role as both his evaluator and coach as a conflict of interest and admitted that I could only choose one — I had chosen to be his coach.

Atul Gawande discussed the concept of a medical coach in his New Yorker article “Personal Best,” where he describes the experience of enlisting a former surgical mentor to observe him in the operating room. In the article, he raises the question of why elite performers often have coaches but physicians rarely do and makes the compelling case that dedicated coaching can lead to significant improvement in clinical skills. But what about young physicians, like Vikram or myself, who are still in training? Some would argue that we are surrounded by coaches — our program directors, clinic preceptors and hospital attendings amongst others. However, I would contest that these individuals play the dual role of coach and judge — a task that on the surface seems plausible but contains within it a set of opposing responsibilities.

Although coaches and judges are similar in some ways — they assess performance, provide feedback and possess domain expertise — their differences are more notable. Coaches carry us forward while judges assess us how far we’ve come. Coaches feel like they’re on our team, while judges feel impartial. Coaches see mistakes as opportunities for improvement, while judges see them as opportunities for evaluation. In clinical training, is it fair to ask one person to play both roles? And what is it about coaches that make them more effective in helping us improve?

My hypothesis to Vikram is that coaching allows clinical skills to flourish because trainees feel safe in discussing their weaknesses, and the trainer feels longitudinally invested in the trainee’s success. I suggest that medical education needs fewer judges and more coaches — and most importantly, that the two roles be separate.

Especially early in my training, I often concealed my clinical weaknesses to attendings because I feared their evaluations of me could have an adverse effect on my career aspirations. During my fourth-year subinternship, I rounded one morning with one of our school’s prominent teaching faculty. He leaned in to listen to the heart of a young man with meningitis and upon removing his stethoscope whispered to me, “A classic systolic flow murmur, you should have a listen.” I hurried to take his spot and leaned in myself. But I heard nothing besides the normal sounds of the heart. I stepped back, unsure of what to say, but eventually nodded in agreement, “I hear it as well.” At the time, it was an innocent lie about an innocent murmur, but the repercussions now seem much larger. Maybe I was listening with the wrong side of the stethoscope or in the wrong part of his chest? Maybe I needed to push harder with the stethoscope or palpate the pulse at the same time? What was a flow murmur and why couldn’t I hear it? I tabled these questions at the time, electing to search for the answers myself rather than learning from the expert before me, for what if my questions caused him to doubt my abilities — “A fourth-year medical student who cannot appreciate a simple murmur…” I imagined him telling our clerkship coordinator. On many occasions such as this, my desire to impress a judge overwhelmed my desire to improve.

Coaching is built upon a mutually beneficial relationship in which an individual’s success motivates both the trainer and the trainee. The opposite is true for judges; by common ethical standards, they must not be invested in the success of those they judge for doing so would be a conflict of interest. By asking our medical teachers to serve as both coach and judge, we place upon them an unsolvable contradiction — want what is best for the trainee but be prepared to evaluate them in a way that may hinder their success, whether by rating them poorly at the end of a rotation or recommending them less strongly to a future employer. In contrast to judges, effective coaches are allowed to be deeply invested in the learner’s success.

There are many barriers to implementing a coaching model in medical training. Coaching thrives when a coach can focus on a small cohort of learners, which is challenging in the resource-constrained environment of medical education. Coaching also requires longitudinal investment, but in medical training, we are frequently introduced to teachers who work with us for only a few days or weeks. These individuals parachute into our training without an understanding of where we started or how far we have come, and their impending departure makes them poorly suited to invest in our long-term success. These barriers may be difficult to overcome, but an acknowledgment of their existence is the first step toward change.

By the end of our week together, I am impressed by Vikram’s growth. His first few presentations were riddled with filler words and lack of structure, but within a few days, his presentations are almost indistinguishable from those of an intern.

A few days after our experiment, I receive an email request to evaluate Vikram’s performance. As promised, I kindly refuse to complete the evaluation; I will reserve this role for someone else. Meanwhile, I return to my place on his sideline, eager to offer my support when he needs me next.

Muthu Alagappan is an internal medicine resident who blogs at his self-titled site, Muthu Alagappan.

Image credit: Shutterstock.com

Source: https://bloghyped.com/judges-versus-coaches-in-medical-education/

[allthingsinfectious]

And so she went to her reward. #subinternship #day31of31 #labordayweekend2018 #sighofrelief #lakehouselife (at Fond du Lac, Wisconsin) https://www.instagram.com/p/BnKbarjAtROHqc3hvXTEo0t7lR5eAsjAU66MRw0/?utm_source=ig_tumblr_share&igshid=mjna7lfbe6b6

[mferna]

JME-Enterprise Microblogging to Augment the Subinternship Clinical Learning Experience: A Proof-of-Concept Quality Improvement Study | Anderson

See on Scoop.it - Salud Publica

A New Peer-Reviewed Journal with Focus on Technology, Innovation and Openess in Medical Education

[sidenotelife]

You have to be sane to be a psychiatrist, an MS3 progress note.

Loosely based on a true story,

I have been meaning to write an MS3 progress note to my previous writings on dealing with anxiety and depression during med school (Here’s one general post I wrote about it, and here’s another about my running thoughts in the days leading up to Step 1). Most recently having been on a psychiatry rotation I’ve found myself introspecting about my own anxiety and depression. Sidenote - there may be some observer bias here, everytime I did SIGECAPS on a patient I found myself reflexively SIGECAPSing myself:

*Disclaimer* Medical Student Note - Educational Purposes Only

KN is a 29 YO M patient presents with concerns of worsening depression and anxiety in the setting of social stressors. 

Sleep - Poor, having bad dreams causing nighttime awakenings. 

Interest - Less interest in watching NBA due to fatigue at end of night. 

Guilt - Patient endorses major feelings of guilt towards lack of energy to care for kids and be nice to wife. 

Energy - Main complaint of patient is per patient “just feeling tired of this shit”. Patient mumbles incoherently to self when asked to elaborate.  

Concentration - Objective scores on UWorld are low but patient says they are always low. 

Appetite - Due to nausea has missed breakfast some mornings but no weight loss reported. 

Psychomotor - Denies. 

Suicidal ideation - Denies. 

Patient endorses symptoms of anxiety, denies symptoms of mania or audio/visual hallucinations. Patient endorses alcohol use <14 drinks per week and denies tobacco/cocaine/opioid/benzo. 

Patient has been seen by several psychiatrists and psychologists at CAPS for past 6 years. Current rx: 60 mg fluoxetine for 2+ yrs and has been on some psych meds for 6+ yrs.  Past hx of suicidal ideation but no suicidal attempts. No past psychiatric hospitalizations. 

No relevant medical history or surgical history. Social history is pertinent for wife and two young children of age 1 and 3 which serve as both a source of motivation for living and also a source of stress. 

I think I found a lot of aspects of my psychiatry rotation challenging, but for me the hardest part was the self-imposed pressure of feeling like I need to look engaged. sidenote - This has been the most common MS3 struggle for me, the constant need to look engaged towards residents and attendings, but also with patients. It’s not that I’m not engaged. I mean sometimes I’m not engaged, but most of the day I’m pretty interested and I really really want to learn clinical medicine. My greatest priority is to learn how to talk to patients and I obsessively study the way different attendings talk to patients. It’s just my natural body language tends toward slouching or my eyes being half-closed. Sidenote within a sidenote - This is one thing that my introverted self likes about science. When I’m reading a paper or thinking about science nobody gives a shit how much or how little engaged I look, all that matters is how engaged I am. This sometimes makes it hard for me to be with patients because I not only have to be engaged which takes energy but I have to spend another subconscious amount of energy focused on thinking about my posture - Am I sitting up straight? Am I sitting up too straight? Am I thinking too much? Can they tell I’m thinking too much? FFFFFFFFFFFFF *head explodes* Anyways, on psychiatry more than other rotations I’ve felt pressure to be engaged with patients. It kind of makes sense, on psych there’s this patient sitting across from me telling me the exact progression of thoughts going through their head as they decided to down 30x tylenol with a handle of vodka. And this pressure to be engaged slowly built itself on top of me and weighed me down. Slowly robbing me of my energy to engage with patients, but more importantly with myself and those around me. 

And this was seeping into my home life too. On the weekdays I could force myself to wake up and hustle over to make it to rounds on time, but on the weekends I just felt drained. Lazy. Not an emotion I’m used to, if you can imagine. I struggled just to get out of bed to take care of my kids, leaving my wife to bear the brunt of the additional to childcare responsibilities. Let’s just say I am not the only one in our house glad my psych rotation is done. Sidenote - I would at this point like to thank psychiatrists. Not only for the care they have provided me, but also for the thankless work they do. Sidenote within a sidenote - My favorite attending thus far in med school is a psychiatry attending. I loved him because he was so passionate about the wellbeing of his patients that he managed to inspire a cynic like myself to believe slightly more that it was possible to deliver patient-centered care despite the challenges provided by the system. 

Anyways, the further I progress through MS3/4 clinical years the more I see what people become frustrated with regarding these years of training. For me what frustrates me most about the clinical years is the same thing that pissed me off about the pre-clinical years, that progression is time-based and not competency-based, thus making it a huge time-sink for fast-learners and a perfect setup for failure for slow-BUT ABLE-learners. 

Sidenote - here is a quick MUSC-specific change I would make to streamline the training process. I would eliminate family medicine as a mandatory rotation. I would shorten the following rotations from 6 weeks to 4 weeks because in my opinion the primary objective for a medical student that is not interested in these specialties is to gain a broad exposure to these specialties: surgery, OB-GYN, pediatrics, and psychiatry. I would expand internal medicine into 2x 4 week rotations, one inpatient and one outpatient, and also neurology from a 3 week to a 4 week rotation. I would make all the 3 week selectives into 2 week selectives with the primary goal to be career exploration. This would take the third year curriculum from 48 weeks down to 34 weeks. I cannot speak much to MS4 yet, but I imagine my take would be put those extra 14 weeks + half a year of MS4 (27 weeks) towards interviews/away rotations/subinternship/research. Combine this with my plan to shorten the first two years of pre-clinical med school into 1.5 yrs and boom 3 yr med school. I really think more med schools should test this approach, a lot of time spent during med school gives me the impression of being low-yield to actually being a doctor. 

..How did I even get here, sorry to everyone who signed up to read about psychiatry. Shoutout psychiatrists. 

see you on the other side,

from ken

[lazyyogi]

Today I finished my first month-long subinternship in ENT! I was at Rutgers University Hospital in Newark, NJ. My next two months will be at hospitals in Manhattan.

There is something very cathartic about packing everything in my temporary apartment into my car and leaving my temporary life here behind 😇

[allthingsinfectious]

I owe you my life. #nightshift #mycaffeinequeen #subinternship #day30of31 @starbucks (at Starbucks) https://www.instagram.com/p/BnIAj3PAaxIzEwdmYxlFOGuQiBSoBuGMEO8sUU0/?utm_source=ig_tumblr_share&igshid=1m1j1nj9l1gsg

[allthingsinfectious]

Puddle pictures. #walktowork #rainwentaway #subinternship #day29of31 #almostthere (at Chicago, Illinois) https://www.instagram.com/p/BnFbHQ2ABAcCWZuv4mZ1xdbHvkRJrD1PNU9d0U0/?utm_source=ig_tumblr_share&igshid=1t9qszgr41ugz