WhiteCoatDO
Medicine, Health Policy, Education

On Board Studying And Clinical Rotations

In late June I took my first set of licensing exams, the USMLE Step 1 and COMLEX Level 1. Scores from these exams play a large role in the residency match process, and as a consequence, most second-year medical students are obsessed (to put it lightly) with exam preparation. A future post will have more details on how I studied for these monster 7+ hour exams, but the short of it is that I used the popular “UFAP” protocol: UWorld, First Aid, Pathoma. I wasn’t alone in finding success with this strategy either, a recent r/medicalschool survey had a respondent average of 243 (~80th percentile) with these three resources being the most widely used.

Following the social isolation that was studying for those exams, my schedule turned to clinical rotations in Family Medicine and Surgery. Jumping from twelve hour study days to twelve hour rotation shifts has been equally exhilarating and terrifying. The exciting part is getting to finally do all the things I’ve been studying for the last two years. Seeing patients, scrubbing into surgeries, hearing heart murmurs, giving shots to crying infants, working on treatment plans, doing procedures, it’s been a blast putting all those hours of studying into use. The terrifying part has been what seems to be a Grand Canyon sized gap between my clinical knowledge and everyone else’s at the hospital. In a way I feel like all the tidbits I learned the first two years formed this giant framework and now all the holes are being exposed and (slowly) filled.

After two years of medical school, I can finally say this is what I signed up for.

From Around The Web

Podcast interview with College Info Geek: “Hardcore Studying Advice”

r/medicalschool Step 1 Survey 

AOA House of Delegates supports single GME accreditation

[Photo via flickr user peterras]

AOA and ACGME Reach Unification Agreement For GME

In a statement released in late February 2014, the AOA and the ACGME announced they have finally agreed to a single accreditation system for graduate medical education. The surprising news comes on the heels of previously failed negotiations in July 2013.

From the official press release:

  • From July 1, 2015 to June 30, 2020, AOA-accredited training programs will transition to ACGME recognition and accreditation.
  • There will continue to be osteopathic-focused training programs under the ACGME accreditation system. Two osteopathic review committees will be developed to evaluate and set standards for the osteopathic aspects of training programs seeking osteopathic recognition.
  • DOs and MDs would have access to all training programs. There will be prerequisite competencies and a recommended program of training for MD graduates who apply for entry into osteopathic-focused programs.
  • AOA and AACOM will become ACGME member organizations, and each will have representation on ACGME’s board of directors.

What does this mean for current medical students, MD and DO alike?

  • The inevitability of a common match: Given all residency programs will fall under a single unification banner by 2020, a single match process is the next logical step. The current system, which forces DO students to choose between the AOA match in February and ACGME match in March, will be streamlined to allow medical students to apply to all US-based residencies at the same time. There is no exact date for the implementation of the common match, but discussions I’ve had with AOA leadership indicate a common match could be implemented in anywhere between two to five years.
  • MD students will be able to apply to DO residency programs: With all residency programs under the ACGME banner, current osteopathic residency programs (which will become residencies with an osteopathic focus) will open their doors to applications from allopathic medical students. Discussions are still underway on how MD students can supplement their current medical education with osteopathic principles to prepare for these residencies.
  • COMLEX and USMLE are to remain separate exams: In talks between the AOA and ACGME, maintenance of the COMLEX as a separate and independent licensing exam remained a non-negotiable item. While a growing number of allopathic-based residency programs are accepting COMLEX (77% according to a 2012 Program Director’s Survey), it’s still in the best interests of most osteopathic medical students to take both COMLEX Level 1 and USMLE Step 1 to keep their options open.

[Featured image via Flickr user uonottingham]

The Best 7 Android Apps For MedStudents

Medical students are a notoriously frugal bunch. Why else do so many lunch-time lectures entice attendees with the allure of free pizza? These Andriod apps are sure to boost your productivity without you having to adjust your student loans.

1. AirDroid

An app that allows you to control your smartphone from a PC web browser, Airdroid blends your phone and computer into one. From a web browser, Airdroid alerts you when you’re receiving a call, lets you send text-messages through your web browser, and turns your phone into drag-and-drop file storage device. The app can even track and lock your phone should you lose it, with the added ability to control the camera and capture photos of the misguided thieves.

2. AnkiDroid

Flashcards have been a tried-and-true method of studying for ages, but Anki has quickly become a medical student favorite by incorporating the concept of “spaced repetition” into the study staple. To see specific examples of students using Anki in their medical school classes, check out these review from The Hero Complex and Dr. Willbe.

3. Dolphin

The Android browser alternative for techies, Dolphin makes web-browsing a more customizable experience. Dolphin lets users force the desktop version of websites to load (versus the often lower-quality mobile), use swiping gestures or voice recognition to access bookmarks, and sync easily with other services like Dropbox or Evernote. Adding on the Jetpack plugin boosts browsing speeds up to 10x as fast as the default Android browser and 2x as fast as Chrome.

4. Wunderlist

To-do lists have been a saving grace for me in medical school, but keeping track of where I wrote the list is another task itself. Wunderlist is a beautifully simple to-do list app that syncs well between the mobile and browser version.

5. Evernote

One of the most user-friendly apps in terms of organizing notes, attachments, and links. Excellent storage and search functionality puts Evernote among the most popular digital note-organizers for my classmates.

6. Google Drive

The hands-down app of choice for any collaborative projects I’ve had in medical school. Need ten classmates to work together on a case-based learning assignment? Sort out who is going to make a study guide for certain parts of an exam? Throw together a group powerpoint presentation? Create a survey to sort out vegetarian and non-vegetarian attendees for a lunch lecture? Google Drive makes solving all of these dilemmas as easy as that question the professor repeated eight times in lecture.

7. Dropbox

While Google Drive is the main app I use for collaborative projects, Dropbox remains the king of file-sharing and cloud storage for most medical students. Having been in the file-sharing game since 2008, Dropbox boast over 200 million members in its user base. Dropbox starts you out with 2GB of storage, but makes it very easy to get more space for free. New Samsung phone owners may even be surprised to find an additional 48GB of memory added to accounts through a Samsung+Dropbox partnership. If you’re looking for substantial storage (>50GB) outside of the Samsung deal, Google Drive is the better money option, but I’ve seen medical students using Dropbox almost exclusively for sharing study guides or other small files.

Note: this list originally appeared on The Almost Doctors Channel.

[Featured image via Flickr user Saad Irfan.]

Prevent Zombie-Eyes With F.lux

After a year of medical school, I’ve noticed I’m staring at a computer screen for an overwhelming portion of my day. Whether reviewing lecture slides, reading a course primer, or browsing the web, my eyes are fixated on the bright hue of my laptop screen throughout the day. These kind of days seemed numbered with clinical rotations less than a year away, but the most study-intensive period of medical school, board preparation, lies just a few months away.

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In an effort to reduce the eyestrain induced by 10 hour study days,  I’ve installed the F.lux app on my laptop. F.lux takes control of your computers display colors and adjusts them to mirror the lighting of the room around you. In the morning, my laptop displays its natural bright colors, but at night F.lux adjusts the color scheme to a calmer hue in order to take the strain off the eyes. From a medical basis, the theory is that reducing the bright light exposure to your eyes at night-times can help in restoring the natural balance of melatonin secreted by the pineal gland, but there aren’t any studies to back F.lux’s effect on this.  From a personal perspective, I can’t study at night without F.lux on my laptop, and even briefly switching off the app at night produces a noticeable difference in screen brightness. As a completely free app, there’s no downside to giving F.lux a try and seeing if it helps benefit your eyes from those long nights of studying.

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5 Questions With SketchyMicro

SketchyMicro is one of the newest players on the medical-student led quest to shake-up medical education. Led by three UC Irvine medical students, SketchyMicro aims to take the pain out of learning microbiology and improve board scores for COMLEX Level 1 and USMLE Step 1. Somehow finding time in between his surgery rotation and launching SketchyMicro, one of the students leading the project, Andrew Berg, answered some questions for me about the program and how it differs from traditional learning.

What is SketchyMicro? What is the goal of the project?

SketchyMicro is a learning modality that utilizes visual learning as its primary form of teaching. Instead of having to memorize long lists of facts, we try to incorporate all the details of a microbe into it’s own unique, memorable scene.  We then draw these scenes out piece by piece on video starting from a blank canvas, explaining each symbol as we go. By providing intuitive associations of facts with pictures, we hope to present information in a clear and easy way in order to ultimately increase recall and efficiency.

What I mean by all of that, is that we draw cool pictures to teach microbiology.

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What separates SketchyMicro from conventional learning methods?

We believe that students who use visual learning techniques will learn the material more quickly and retain it for longer. There are loads of journal articles that support the power of visual learning.  Unfortunately I don’t remember any of them… they didn’t have any pictures.

So rather than making too many unsubstantiated claims, I really encourage people that are interested to just check out the six videos we have available for free on our website.  We’ve made every effort to create a course that eliminates the stress of rote memorization and finally makes microbiology fun!   After all, studies show that having fun increases board scores… but don’t quote me on that.

What has the development process been like? Has there been anything you’ve discovered about the “learning process” along the way?

Honestly, it has been a great learning experience! Going from sketching the mnemonics in our notebooks to a digitally-formatted story that is sketched in real-time along with the narrator was a huge transition. But, we were able to adapt and continue to do so. We have gotten a lot better since our first couple of videos, not just in content and story-telling, but visually as well. The whole process has taught us just how far teamwork can take you.

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Can you share any details on the final product (launch date, pricing, differing levels of access, etc.)?

Since our first two videos, we have actually been very hard at work and are finishing up all of the bacteria category! In the meantime, we’ve also already started working on viruses, fungi and parasites.

As far as launch date, we’ve already done a “soft-launch” to allow viewers to see the already-made videos.  Mostly we did this so that people who had tests coming up in the near future could have access to the videos we finished right away. Our program will be divided into two parts. The first part is solely bacteria. The second part will be viruses, fungi and parasites. Right now, people can pre-order the first portion and watch the bacteria videos as they are uploaded. We expect to finish the first part by the end of 2013 and hope to finish the second part by February or March, just in time for Step 1 studying!

What is your vision for SketchyMicro in the future?

We hope to have all of Microbiology done in the very near future (hang in there!) and are also hoping to create a more robust platform for self-testing and review features.  However, we’re also always trying to rethink ways to best get all of the information across.  We’re also getting some great feedback and ideas from our beta testers.  I’m really excited to see where we take things.  Our primary goal is to become the best resource for medical students wanting to learn microbiology.  However, there has definitely been talk of expanding into other subjects! SketchyPharm anyone?

SketchyMicro is now open to product pre-orders that include instant access to 21 bacteria videos and extended 6-month access when the program officially launches by late 2013.

A Beautiful Mind, Crowdsourcing, and Animated Microbes

Some of the best medical links from early November 2013:

[Featured image via Flickr user joiseyshowaa]

Is IBM’s Watson the Future of Medical Decision Making?

Ever since soundly winning Jeopardy! in 2011, IBM’s Watson has been quite busy.

Besides soundly beating out members of Congress in an untelevised Jeopardy! match, Watson also became possibly the smartest second-year medical student of all time. But like any bright medical student, Watson didn’t just stop there.

IBM recently announced the development of two paradigm-shifting projects, WatsonPath, a diagnosis and education program, and Watson EMR Assistant, a tool for analyzing information stored in medical records. Building upon Watson’s question-answering abilities, WatsonPath draws from clinical guidelines, evidence-based studies, and reference materials to either support or refute a set of hypothesis. WatsonPath is essentially the algorithm machine every medical student wishes they had in their head during board exams. And with a “learning regimen” that includes breaking down board-style questions, why wouldn’t WatsonPath score the highest USMLE score ever?

How can WatsonPath be used as an educational tool?

The video above explains how the project not only offers answer suggestions, but also displays a schematic flow diagram showing the reasoning behind answers and confidence levels. WatsonPath breaks down clinical scenarios the same way any medical student would, looking at signs and symptoms, interpreting lab values, and searching for key associations. The project is currently being assimilated into the Problem-Based Learning (PBL) curriculum at the Cleveland Clinic Lerner College of Medicine.

Beyond the classroom walls, the possibilities of Watson for actual clinical settings are also already being explored. Through a partnership between IBM and the University of Texas MD Anderson Cancer Center, Watson is being used as “MD Anderson’s Oncology Expert Advisor.” This was after Watson was trained to “understand” over 600,000 pieces of medical evidence, more than two million pages of medical journals, and 1.5 million patient records. With a depth of medical information that no single human could ever match, Watson has already been touted as being “better at diagnosing cancer than human doctors.”

This post originally appeared on the Almost Doctors Channel.

3 Unusual Classes You Should Take Before Medical School

One of the most frequent questions premeds ask  is “what classes should I take before going to medical school?”. The AAMC and AACOM require (at a minimum) a year of biology, English, and chemistry, but there are a few non-traditional classes I wish I took in college. With medical school experimenting with more holistic approaches to admissions, perhaps these 3 classes will be more favorably looked upon by admissions committees in the future.

Acting

Every few weeks, 1st and 2nd year medical students from around the country knock on doors, ask to come in, wash their hands, and pretend to be doctors for 15 minutes. They take medical histories and perform physicals on real people, but the catch is that these “patients” are actually actors. Standardized patient encounters are increasingly being used as a part of pre-clinical medical education and offer medical students the chance to “practice” being a doctor before heading out to hospital rotations.

If the “patients” are trained as actors then, wouldn’t it make sense for the “doctors” to have some training in acting as well? While it won’t help memorize the different cranial nerve exams, a background in acting could help students get into the “character” of a physician and develop “on the feet” thinking.

Public Speaking

Nearly 75% of people experience some anxiety about public speaking, but it is a critical skill to develop for a successful medical career. Whether presenting cases to an attending on the wards, giving a lecture at a research conference, or teaching the pathophysiology behind a disease to a crowded classrooom, public speaking opportunities are at every level of medical education. Furthermore, so many medical student are so bad at public speaking that even being marginally good can pay off huge dividends.

Writing

Well of course the guy with the blog is going to suggest taking a writing class. Besides the obvious bias though, consider that in the past two years I’ve had to write essays for medical school applications, secondaries, ethics class assignments, scholarship applications, summer project proposals, and leadership position openings. Simply put, the essays don’t stop in college and nearly every competitive opportunity is going to require persuasive writing skills.

[Featured image via Flickr user starmanseries]

The Second Year

And just like that, school is back in session. Summer nights spent catching up with old friends or playing foosball with family are now filled with pathology slides and bizarre mnemonics. Despite the 8am pharmacology lectures, I’m enjoying second-year so far. My school’s systems-based classes (currently in endocrine) are heavily focused on the clinical aspect and the idea of applying these principles to real patients in the not-so-distant third and fourth year is certainly motivating.

In someways, I feel like I never left school in the first-place. Back in my life are the marathon study sessions and the erratic trips to the grocery store. In other ways, however, the differences between first and second-year are stark. Board studying was a running joke during first-year, but now is invariably on everyone’s mind in one way or another. Constantly hearing that the USMLE and COMLEX will make-or-break certain residency choices has induced a certain obsession with finding the “best” way to prepare for these exams. My current strategy-in-the-making (based partly off great advice from Survivor DO)  will employ the use of Kaplan (provided by my school), First Aid, Pathoma, and UWorld. As my study habits changed quite a bit during the first-year, I’m expecting this strategy to fluctuate a few more times before I settle into a groove with serious studying.

Another big change is the presence of first-years around campus now. Seeing them around reminds me of a few things, namely 1) I smelled terrible after anatomy lab 2) how terrified I was the first few weeks of school and 3) just how absolutely terrible I smelled after anatomy lab. Talking to them reminds me of that initial mix of fear, amazement, and constant stress that was Gross Anatomy. Hopefully, they’ll be used to eating pancakes and drinking from a fire-house in just a few weeks. And if you’re a first-year reading this right now, contact me for some high-yield study guides.

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[Featured image via Flickr user topfife]