Ramblings of a future MD

24 year old 4th year medical student from Canada, avid reader, devoted runner and an ardent foodie ❥

[ozei]

[in-pursuit-of-fitness]

Staying Fit At Your Desk

For those of us who have full time office jobs, staying fit and healthy can be a real challenge. Most of us are faced with hours of commuting each day and relatively uninteresting jobs. By the end …

[asapscience]

Thank you, Drake, for explaining the Na+/K+ pump to us.

[in-pursuit-of-fitness]

Check out this image I found on We Heart It - http://weheartit.com/entry/178313547

[frankiebeanhealthnut-deactivate]

[italian-luxury]

[natureac]

This blog will make you feel at peace

[mexicanmedstudent-life-blog]

10 Rules of Good and Bad Studying

10 Rules of Good Studying

Use recall. After you read a page, look away and recall the main ideas. Highlight very little, and never highlight anything you haven’t put in your mind first by recalling. Try recalling main ideas when you are walking to class or in a different room from where you originally learned it. An ability to recall—to generate the ideas from inside yourself—is one of the key indicators of good learning.

Test yourself. On everything. All the time. Flash cards are your friend.

Chunk your problems. Chunking is understanding and practicing with a problem solution so that it can all come to mind in a flash. After you solve a problem, rehearse it. Make sure you can solve it cold—every step. Pretend it’s a song and learn to play it over and over again in your mind, so the information combines into one smooth chunk you can pull up whenever you want.

Space your repetition. Spread out your learning in any subject a little every day, just like an athlete. Your brain is like a muscle—it can handle only a limited amount of exercise on one subject at a time.

Alternate different problem-solving techniques during your practice. Never practice too long at any one session using only one problem-solving technique—after a while, you are just mimicking what you did on the previous problem. Mix it up and work on different types of problems. This teaches you both how and when to use a technique. (Books generally are not set up this way, so you’ll need to do this on your own.) After every assignment and test, go over your errors, make sure you understand why you made them, and then rework your solutions. To study most effectively, handwrite (don’t type) a problem on one side of a flash card and the solution on the other. (Handwriting builds stronger neural structures in memory than typing.) You might also photograph the card if you want to load it into a study app on your smartphone. Quiz yourself randomly on different types of problems. Another way to do this is to randomly flip through your book, pick out a problem, and see whether you can solve it cold.

Take breaks. It is common to be unable to solve problems or figure out concepts in math or science the first time you encounter them. This is why a little study every day is much better than a lot of studying all at once. When you get frustrated with a math or science problem, take a break so that another part of your mind can take over and work in the background.

Use explanatory questioning and simple analogies. Whenever you are struggling with a concept, think to yourself, How can I explain this so that a ten-year-old could understand it? Using an analogy really helps, like saying that the flow of electricity is like the flow of water. Don’t just think your explanation—say it out loud or put it in writing. The additional effort of speaking and writing allows you to more deeply encode (that is, convert into neural memory structures) what you are learning.

Focus. Turn off all interrupting beeps and alarms on your phone and computer, and then turn on a timer for twenty-five minutes. Focus intently for those twenty-five minutes and try to work as diligently as you can. After the timer goes off, give yourself a small, fun reward. A few of these sessions in a day can really move your studies forward. Try to set up times and places where studying—not glancing at your computer or phone—is just something you naturally do.

Eat your frogs first. Do the hardest thing earliest in the day, when you are fresh.

Make a mental contrast. Imagine where you’ve come from and contrast that with the dream of where your studies will take you. Post a picture or words in your workspace to remind you of your dream. Look at that when you find your motivation lagging. This work will pay off both for you and those you love!

10 Rules of Bad Studying

Avoid these techniques—they can waste your time even while they fool you into thinking you’re learning!

Passive rereading—sitting passively and running your eyes back over a page. Unless you can prove that the material is moving into your brain by recalling the main ideas without looking at the page, rereading is a waste of time.

Letting highlights overwhelm you. Highlighting your text can fool your mind into thinking you are putting something in your brain, when all you’re really doing is moving your hand. A little highlighting here and there is okay—sometimes it can be helpful in flagging important points. But if you are using highlighting as a memory tool, make sure that what you mark is also going into your brain.

Merely glancing at a problem’s solution and thinking you know how to do it. This is one of the worst errors students make while studying. You need to be able to solve a problem step-by-step, without looking at the solution.

Waiting until the last minute to study. Would you cram at the last minute if you were practicing for a track meet? Your brain is like a muscle—it can handle only a limited amount of exercise on one subject at a time.

Repeatedly solving problems of the same type that you already know how to solve. If you just sit around solving similar problems during your practice, you’re not actually preparing for a test—it’s like preparing for a big basketball game by just practicing your dribbling.

Letting study sessions with friends turn into chat sessions. Checking your problem solving with friends, and quizzing one another on what you know, can make learning more enjoyable, expose flaws in your thinking, and deepen your learning. But if your joint study sessions turn to fun before the work is done, you’re wasting your time and should find another study group.

Neglecting to read the textbook before you start working problems. Would you dive into a pool before you knew how to swim? The textbook is your swimming instructor—it guides you toward the answers. You will flounder and waste your time if you don’t bother to read it. Before you begin to read, however, take a quick glance over the chapter or section to get a sense of what it’s about.

Not checking with your instructors or classmates to clear up points of confusion. Professors are used to lost students coming in for guidance—it’s our job to help you. The students we worry about are the ones who don’t come in. Don’t be one of those students.

Thinking you can learn deeply when you are being constantly distracted. Every tiny pull toward an instant message or conversation means you have less brain power to devote to learning. Every tug of interrupted attention pulls out tiny neural roots before they can grow.

Not getting enough sleep. Your brain pieces together problem-solving techniques when you sleep, and it also practices and repeats whatever you put in mind before you go to sleep. Prolonged fatigue allows toxins to build up in the brain that disrupt the neural connections you need to think quickly and well. If you don’t get a good sleep before a test, NOTHING ELSE YOU HAVE DONE WILL MATTER.

Source: https://www.coursera.org/learn/learning-how-to-learn/home/welcome

[yourcoffeeguru]

[lifeofkhan]

A Few Helpful Videos

Step 1 and Done.

I don’t understand how some people can straight read First Aid and retain. Here are a few videos I found to be very helpful for understanding and memorizing concepts. With the plethora of YouTube videos out there, I feel like there should be a database of worthwhile ones somewhere (please tell me if there is already). Feel free to add any you’ve found particularly helpful. 

Anatomy

Brachial Plexus Speed Drawing

Brachial Plexus Explained

General Anatomy Overview Channel

Anatomy Figure Drawings - Helps visualize muscle actions

Biostats

Watch these a couple of days before your exam for a refresher. Many of his review questions are based directly off of UWorld questions.

Practice Questions

Cardio

General Cardio Overview  

JVP explained with relevant path correlations 

S3/S4 - the simplest of explanations (the accent does’t hurt) 

Antiarrhythmics - follow up with SketchyPharm 

Antiarrhythmics - Refractory Period Explained 

Embryology

This cardio video is amazing. He explains the cardio congenital defects in context of what causes each defect during development. This makes recall much easier as you’re learning the process and can work out each one even if you forget the small details. (make sure to watch both parts)

Heart Embryo Derivatives - mnemonic 

Intestine Development - Overview

GI Development - Foregut, Midgut, Hindgut Orientation

Embryonic Folding 

Pharyngeal Arch Mnemonic (die)  

Microbiology 

Algorithm/mnemonic for viruses. Pure gold.

YouTube Channels of Interest

Armando Hasudungan 

Anatomy Zone

Dr. Najeeb (my hero)

[challenge-brings-change]

For all the students out there! 💪🏻📚

[oh-kevin-gee-deactivated2017082]

[l-echappee-belle]

[positivepaige]

Things You Can Do While Studying, a lil icon chart made by yours truly, @paigehahs

[in-pursuit-of-fitness]

Untitled on We Heart It - http://weheartit.com/entry/174941577

[in-pursuit-of-fitness]

Do it for yourself on We Heart It - http://weheartit.com/entry/181013579

[surrealmeds]

Can we talk about getting the medical blues?

I mean when someone who is normally light and rainbowy starts to see the evil everywhere. When the world that medical peeps are in makes clouds drop over everything good in this world. When the dismal fog makes suicide seem like a legit answer when the question is “why am I getting out of bed for this?” 

(skip to the bottom for lessons learned if you want - I get pretty wordy here)

Before I decided to go to med school I worked in a copy shop. One of our regular clients was a family doc who made me laugh. He was awesome. He went above and beyond for his patients, making great learning tools on his own time. He was also a coroner in the area. When his assistant picked up orders, she confessed that she was worried about how much he was working and how much he put into his practice. I began to notice that he often smelled of whiskey at 08:00. He was in a car accident a year after I met him that took his life. I can’t say for sure that it was suicide, but there weren’t any tire marks from brakes. His EtOH level wasn’t released so I can’t comment on that. It’s possible that he just fell asleep, but something in my gut told me it was a purposeful death. 

This is my story of fighting against the dark and twisties and almost failing. 

Flash forward to me getting into med school. Oh happy day! I cried happy tears all day. I’m an emotional person who feels all her feelings on the outside. This is me. That’s not going to change. When I went to see my family doc to get immunizations all up to date, I told her I was worried about my emotions. She told me to never disclose that I have a mental illness and suggested that I read Iron Doc by Mamta Gautum. She also told me I was going to be a great doc. 

I entered med school with eyes wide open. There are dark and twisty places in medicine and I needed to make sure that I was safe from. I read about how to stay sane in medicine from Mamta’s book, but then quickly stopped that practice because who the hell has time for exercise, hanging with family, etc. when you have a firehose of information coming at you? The one thing I did do consistently was blog about my thoughts about medical culture and my place in it. That blog was both a harsh reality for me and a way to express my gratitude for being allowed to be a medical learner, and then a physician. 

Residency was hard on me. I was an older than average, fat learner who did not fit the approved ideals of how a learner should look. I was either treated as a moron or as someone who was capable of doing everything without any guidance. There was rarely any in between. I became afraid to ask for help because when I did, well, badness. As a people pleaser, I worked harder and harder trying to get to the point where I would be seen as a good doctor. This was a futile mission, and I would likely see that now, but then, entrenched in those emotions of inadequacy it was impossible to recognize that I was surrounded by idiots. It must be my fault. 

I started taking SSRIs to deal with the sometimes crippling anxiety and depression. I had a hard time getting out of bed. My new family doctor suggested a leave of absence to give myself time to recover, but the thought of my previous doc saying to never admit I have mental illness rang in my head. As tempting as a medical leave was I refused to do it. Looking back, I’m not sure it would have helped. I was lying to everyone about how hard things were. I didn’t tell anyone that I was fantasizing about suicide. I was increasing my SSRI dose then telling my doc about it later. I was in hard core denial. I would likely have just spent the time beating myself up for not being strong enough to follow the program, and for letting down my husband who had been footing all my education bills for the past 10 years. 

Between residency and practice I took a few months off. I blamed it on my papers not being ready, but the truth was, I wasn’t ready. All I did was watch TV and sleep. I was not recovering my strength at all. 

I knew I needed to get a therapist if I was going to be a doc that my patients could rely on. Knowing that 1300 people needed me to be strong is what finally got me to the point of going for help.

How stupid is that?

I could have been a stronger learner the whole way through, but I had too much to prove as an outsider to medical culture. My discussion about being an outsider to a culture of privilege as well will come another day. 

The stress that I was under during my first years of practice was intense. I was diagnosing cancers almost daily. I was working 85 hours a week. Locums that took care of my patients refused to come back because they were too complicated. When I went to my colleagues and supposed mentor for help, I was told this is just how it is. That once I learned to stop being so nice, and stop caring about my patients everything would be better. 

I never want to stop caring about my patients. When I am no longer passionate about medicine and about keeping my patients well, it’s time for me to find another job. 

I lost a patient my age to malnutrition. Fuck. How the fuck does that even happen in the 2010s??? She had an opioid issue that I frankly hadn’t had time to address. She also had so many social determinant concerns that I was often at a loss at where to begin, but she also wouldn’t let me help. So there’s that. I will work as hard as my patients will to keep them healthy. If they’re not ready to work at it though, I will wait until they are. 

Other patients lost their family to suicide or homicide. Children died. I kept diagnosing cancers, many terminal. Patients went back to jail. They cheated on each other. They hit their partners and their children. So many kids were raped. OMG so many…

Stress piled up, so did paper work, and I missed a new cancer in a patient. He’s fine, all’s well, he kicked me in the ass to take a vacation. (btw, when patients are telling you to take a break, take a break.) On this vacation, the thought of having to go back to this practice with those colleagues was too much. I had a plan to kill myself while I was away. 

A plan. WTF???

Medical professionals know too much. We can make a plan that will make it seem like an accident, and we know that our colleagues in the coroners office are often implicit in this plan. No one is allowed to know how hard it is to be a doctor sometimes. It was a good plan. Murder mystery of the week quality. 

It scared me. 

When I got back, I called the physician health program in my province and went to see a psychiatrist. I quit my practice and am somewhere that respects physicians (and nurses, and social workers, and rec therapists - is this heaven???) I am significantly more balanced, but am not even close to being the person I used to be. 

Lessons learned

1. I am allowed to feel my emotions - they make me into a better doctor who will learn more from her patients.

2. EVERYONE in medical practice needs a therapist. None of us think we do. We have ZERO perspective on this. 

3. When your family and docs are telling you to take a break, asking if things are wrong, take a step back. Something is screwy. 

4. Things in our personal life are the first to go. I stopped crocheting and making Sunday dinners for friends. It might be running, clubbing, walking the dog. 

5. The last thing to go is our capability at the office. This is when alarms had better be flashing in your brain. When you can’t hold your shit together at the office, you need a vacation, you need help. Ask for it. If your colleagues are useless tools, ask outside your group. 

6. Lots of med peeps turn to substances for help. Alcohol, morphine, fentanyl. If you NEED a drink when you get home from work, or are considering diverting to enjoy a fix, please get help. 

7. There are some fantastic resources available to med peeps if you ask for them.

8. There is a MONSTEROUS stigma around needing mental help in our profession. I am still not allowed to say I suffer from anxiety on my college app in case I get denied. Colleagues act like illness is a weakness (even cancer, that’s another story, not mine, but really eye opening). Find better colleagues. They don’t all suck. 

9. I am the hugest proponent for mental health for health professionals, but I am still only confessing this in an anonymous blog. Our culture needs a huge change. My side blog fckya professionalism focuses more on self care since I think that self care should be honoured as professionalism more than not being drunk in public. 

10. Even the strongest, most go - to person you know may be suffering. When I told my colleagues I was fantasizing about suicide, they thought I was joking because I was such a strong person. 

This was hard to write, but I need to let others who were in similar situations know it gets better. I don’t want to lose more colleagues to suicide. 

[shanny-do]

Wow. Fantastic perspective. A must read ❤️ #physiciandepression

[effectivestudies]

How To Stop Scrolling Through Tumblr For 3 hours When You Have Work aka Time Management

Without motivation, you will get nothing done!

-consider your pros and cons, remember education is a privilege, think about the things you want to achieve in your life/what you’re working for.

-“Fake it ‘till you make it” is scientifically proven. Meaning if you are in the positive mindset, positive things will happen! Print out some quotes or pictures that inspire you and speak to you. Put it on your desk, on your wall, wherever you can see it. 

-Nice environment/background noise helps you feel motivated surround yourself with people who are positive/don’t bring you down about not hanging out to do something like study. Here’s my playlist tag!

-know how to say no. If you don’t, learn. Learn what habits you have and what speaks to you and will get you off your butt and working. Use those. Set reminders on your phone to make sure to get off it. Know what makes you say no.

-If you need a lil help to feel motivated you can check out my motivation tag

Depending on what kind of learner you are, they are different things you can try.

-For example  30/30 could help for visually learners as the whole design is very appealing to the eye. 8tracks is great for auditory learners who want to listen to things while studying. And voice recorders are also really great for auditory learners. You can check out riseandstudy’s masterpost about this! You can use it during lectures/classes and you can record yourself saying your notes out loud and listen before bed. It’s scientifically proven that you have a better memory of something if you think of it before you fall asleep. 

-Remind and the calendar app that comes on IOS is really helpful. If you are constantly on your phone and you set a reminder to study or exercise or whatever else and it pops up on your screen you feel guilty if you don’t actually do it. And it helps you keep track of the time and things that are coming up. Have a calendar in your desk to remind yourself of the things that are coming up. Or keep track of the calendar app on your phone. 

-my study apps tag+reccommendations for blocking;

strict workflow stops you from going on your computer during a pomodoro 

forest is an app you have to pay for but it essentially stops you from going on your phone by blocking it

Lots of these. There are so many different kinds. You can use whatever benefits you and suits your needs. You can use printables, bullet journals, calendar journals. Here is a more in depth explanation of each:

BULLET JOURNALS  📔                                                               

this is the most popular method of keeping in track of yourself and your schedule. It’s where you have a notebook and you setup to do lists in a way you want (it’s commonly done in weekly form) and you check it off at the end of the day. That’s the general idea and you don’t have to use this method if you don’t want to. Just because a lot of studyblrs use bullet journals, it’s not an obligation. Do what works for you. If it’s a bullet journal then great! If it’s not then that’s okay too!

Pros: you can use whatever layout fits you. you can change the layout if you want. you can access other lists and trackers to help schedule in your notebook. Cons: it’s hard to schedule ahead of time.

CALENDAR JOURNALS 📒 (i don’t think this is actually the name but i don’t know the name whoops)

this is also a common method. It’s essentially the same as a bullet journal except everything is already set up for you. There are different kinds you can get so you might wanna research these a bit. Hobonichi for one, is very well received with consumers. You can find these in my supplies tag. Pros: you have the layout in front of you. Cons: not free. you can’t get out of a certain layout. PRINTABLES 🗒 

It’s easy to use and access especially in this community. Countless studyblrs make great free printables  for your use. Printables are schedulers of sorts you can print out designed by studyblrs to help manage your time. There is also an option of putting printables in your bullet journal if you prefer. Pros: you can put it anywhere. cool designs. free. Cons: you need a printer. lots of loose sheets.

-And it also helps to have a schedule of your studying so you can keep track. Keep a calendar solely for your studying, it really helps prevent a burnout. And it’s easier to arrange breaks for yourself. I’ll explain each in detail. 

-But remember not to over plan! Great masterpost on over planning by universtudy. 

-And set realistic goals. It’s going to help. You won’t feel as bad about not getting a lot down and it will help you avoid a burnout. 

wake up early! it makes you so much more productive! 

-Clinomania! Clinomania is the obsessive need to stay in bed. You are not alone there a billions of people who have a hard time getting up in the morning. There is even a word for it. 

-Waking up early and being productive makes you feel good and get so much more done! You can try this method by Steve Pavlina where you set several alarms before you go to bed and go to bed normally then an alarm will wake you up and you do your normal morning routine except at night this repeats for about 5-10 times at random intervals. And when you finally go to bed you’ll be exhausted enough to actually go to sleep the next morning when your alarm wakes you up your body will be so used to the routine you’ll just get up and do it. It’s extensive but it works! 

-Also on IOS and Android, the label on your alarm can be changed. So normally when your alarm sets off you see it as “Alarm” on your lockscreen but you can change that to say something else. Whatever that will wake you up or at least motivate you to get out of bed. You can also change your wallpaper to something that will motivate you to get up. If you tend to stay up because of technology, use the blocking apps I mentioned before.

-my tag for relaxing and health

the important/urgent things should be done first.

-use your planners to write everything you need to get done and when you need to get it done. you can try the one minute touch!!!

-if you have a lot to get done than you can try the one minute touch where you set a timer and do one minute of each thing. The idea is that you get concentrated and keep doing the thing for longer than the original minute but I think it’s also great to finish a lot of things at once. Instead of one minute you can use the pomodoro timer where it goes off every 25 minutes. You can also use both where you do the things for a minute each and until your 25 minute timer goes off and you can take a break. Whatever works for you.

It’s important to keep a consistent schedule

If you work on it more everyday you’ll develop a habit and it’ll be better. It doesn’t matter how small it is as long as you do it everyday. A person who does 4 push-ups a day will have better biceps than a person who does 10 once in a while. Leave daily to do lists in your eyes view in order to stay motivated. It helps to write it in order of what needs to get done more quickly or is more important in terms of circumstances. You can take a picture of it and use it as your lock screen wallpaper on your device.

Set your environment

-You can do this by turning on some music/sound, changing to comfortable clothes, cleaning your desk a bit, and getting some snacks and obviously everything you need for whatever you need to get done. 

-Then it would be great if you have a planner or to do list or both in your hand that you can look at but if you don’t you can write a quick to do list. Make sure to write it in order of priority. 

-Make a starter for yourself. It can be anything a starter is something you say or do that kind of triggers you to start doing things. Like say your to do list out loud and then do it. Grab a bite of that strawberry and then get started. Etc. And you can finally get started. 

-It will definitely help to use some kind of timing method like a one minute touch I mentioned before or the pomodoro technique. Also if you find yourself procrastinating a lot, try productive procrastination. Productive procrastination is when you don’t feel like doing whatever you’re working on and instead procrastinate by doing something else in your to do.

-Pressure yourself into doing work, time lapse it! I don’t know if it’s just me but when I time lapse myself I feel like I actually have to work. And it will help you not go on your phone because you have to use it to record. And time lapses are extremely rewarding. When you finish and watch it over, you’ll feel really good. 

-If you feel like you are getting distracted, it’s a good idea to take a little (5-10 min) break before getting started again. During that break, look up some motivational quotes or pictures. 

-Don’t stay up late it’s not good for you. If you are feeling sleepy and you haven’t gotten through something, outline it to do it in the morning and then go to sleep. Wake up and do it. You’ll thank yourself for that outline. 

-When you are done your session of productivity, reward yourself. Watch a little bit of tv or eat that snack you’ve been saving up. Or go on tumblr for a meaningless hour. Even if it isn’t productive, you won’t feel guilty about doing it because you’ve already been so productive today! Make sure if it’s late, you don’t reward yourself with anything too time consuming because sleep is important!

-here’s my time management tag 

-also apologies for my weird capitalization I kinda did this in different stages and I was too lazy to fix it so.