Medicine Scutsheet
Behold, the perfect scutsheet for internal medicine rounding. H&P on the front. SOAP format on the back. Get the PDF for free.
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Medicine Scutsheet
Behold, the perfect scutsheet for internal medicine rounding. H&P on the front. SOAP format on the back. Get the PDF for free.
Developing Concentration and Focus for Efficient Studying
When I look back at the studying I did in college, I remember times when I consumed knowledge like it was candy (mostly for science classes). Other times it felt like my brain was stuck in the middle of a battle between procrastination and cognizance of my utter need to hit the books. When I finally would drag myself to the library, turn my phone off, and close all of my browser tabs, my brain still refused to concentrate and this stubborn rebellion cost me hours of valuable time.
During this time, I was unknowingly developing a bad habit. When I faced material that seemed impossibly difficult or too much to get through, I allowed myself to either procrastinate with an exaggerated view of the work or attempt the work and allow my mind to wander and make excuses. What I really needed to do was exercise some mental self regulation.
Concentration is a learned skill, not a natural ability. Just like any other skill, it requires practice (especially if you need to unlearn an old unproductive concentration habit) and improves gradually. In efforts to avoid repeating my past and optimize my future study time, I've researched best practices for increased concentration and read many perspectives that one can adopt to make studying less painful.
BEFORE YOU START STUDYING:
Embrace your learning of difficult or uninteresting material as a necessary evil. Remind yourself why you want to do it and what you will have in the end. This of studying for an hour like a power workout or a feast of learning. Make that time count!
This may take some trail and error, but identify the time of day when you are most alert and productive, and use this time to focus on your biggest, most difficult assignments. Stick to this daily schedule!
Set a goal! Preview what you want to get done in a sitting/time block, maybe even make a list of concepts to learn (but don't spend too much time on this step or you'll lose motivation). With a realistic goal in mind, you can push yourself to focus even when you start to tire, until your goal is attained.
WHILE YOU STUDY:
Prioritize: do the most important tasks on your list first! Start with the critical understanding and deep background concepts before moving on to the easier (less challenging) but necessary grinding out of details.
Get the least pleasant tasks out of the way! If you do the easier tasks first, you will be thinking about and stressing the harder ones the whole time, and feel more tempted to avoid them once you do reach them.
Your brain needs to practice intense focusing, but it also needs breaks! Divide your study block into sessions of 50 minutes of studying followed by a 10 minute break. Plan your breaks out with alarms/timers. The rules are simple: during studying, you should have zero distractions; during breaks you can eat, drink, exercise, check your phone or internet, talk to people, etc; ALWAYS respect the timer!
Turn each section or article into a question to increase your involvement. Then study that material to answer that question. Also, as you study an topic, make a list of questions you can bring to class to actively learn there as well.
Try changing the subject you study every two hours for variety.
Research shows that changing your study location can be beneficial for better information recall. However, be careful that you do not spend too much time looking for a new spot or setting up your study area! If you stick with one place, try to build a mental association between that spot and the act of studying by doing nothing but studying in that spot.
If the computer is a big distraction, leave it in another room and write down any questions you have so that you can look them up later during a "research" session
Do let yourself stray off topic; focus on studying only the material you previewed. If you give attention to other topics, you will not reach your goal in a timely manner. Instead, try making a list of your distracting thoughts or worries to take care of later (or at a specific "thinking" time you set aside during the day).
When you notice your thoughts wandering astray, say to yourself "Be here now" and gently bring your attention back to where you want it. Teach yourself that there are no rewards to diverting your attention to distractions. (However, do not try to keep specific thoughts out of your mind. When you try not to think about something in particular, the thought keeps coming back.)
WHEN YOU THINK YOU ARE FINISHED:
The "5 More" rule: tell yourself to do only five more things or five more minutes before quitting. Once you've finished those, maybe do another five. Just like gradually increasing workout reps will build more muscle, gradually lengthening your focus time can build better concentration.
Review: whats the point of learning material if you forget it because you never review? Use one of the study sessions (either the first or the last of your block) to review information from your last study block. Or if you study in the morning, use a block in the evening to review, as long as it is within 12 hours of the time you first saw it.
Reward yourself. Offer yourself incentives for once you've completed a study task. This will improve your motivation as well as your concentration. Rewards can be anything from going on a jog, doing yoga, taking a power nap, or spending time with friends. Make extra incentives for finishing papers or after an exam! Make a list of things that you want to do but aren't because you are studying and refer back to this list after the paper or exam is finished!
I hope to add more advice after trying out these strategies day in and day out once I start studying in med school. I especially need to learn more about avoiding procrastination and increasing motivation. If anyone has any suggestions or comments, feel free to leave a note or message me!
Studying Techniques in Med School
Now that I've been accepted to medical school, the reality of where I'm going to be next August is beginning to set in. Goodbye days of intermittent English teaching and Spanish learning, goodbye carefree weekends to dance, travel, and relax. How will my life change? Most notably my days will be consumed by studying: learning, memorizing, trying to understand.
The question I've been asking myself is how do you go from undergrad studying and then taking a year off to the proverbial "drinking out of a fire hose" that describes the enormous volume of knowledge that med school expects you to acquire in just 4 years. On my hunt for answers (and not just the obvious study tips), I've read articles on studying, skimmed over med student blogs on the subject, and talked with many current and graduated med students, and I thought I'd share my summary of the advice I gleaned:
Do some studying (or at least a review) right before bed. This tells your sleeping brain what to rehearse and consolidate for long-term recall. Especially when it comes to learning new material just before sleeping, studies show that students have a better chance of recalling and thus a better base to resume learning the following day.
We just said sleep is important so find a good sleep schedule and stick to it! Some studies suggest "early to bed, early to rise" is the better option since those that follow this schedule are less tired during the day and thus more likely to have positive emotions and be more productive.
Have a clear intention as to what you expect to accomplish in the study session (of a given time limit). Without a clear intention, you’re liable to get overwhelmed or distracted, spend too much time organizing yourself, and ultimately demotivate yourself from having an awesome study session. Maybe create an outline of everything that you need to know by test day and break up this material into daily studying goals. Or perhaps make your goal to review X number of lectures per day. Whatever you figure out that works for your situation or course type.
Appeal to your senses: use colors, diagrams, symbols and acronyms to trigger your visual memory. Talking and listening can also be helpful, for example reading the text or notes aloud and listening to yourself as you read.
Review: If you study in the morning, spend some time in the evening to review, as long as it is within 12 hours of the time you first saw it. Or use one of your daily study sessions (either the first or the last of your block) to review information from the previous day's study block. (More to come about the ideology behind study sessions and block in my next post).
Reviewing strategy: Summarizing your notes, using questions from lecture, and writing your own questions are all common strategies that I've never used before but might be helpful. An additional, if you take notes on a word document, you can also make a duplicate document and start condensing the information every time you review.
When you practice with old tests or practice tests or question banks, use these questions to help simulate the actual exam. Time yourself and treat it with the seriousness you will on the real exam.
Especially during clinical years, don't just stick to the textbooks. Learn what medicine is all about. Read journal articles, medical blogs, and books by MDs that are about topics that interest you. Renew your love for the field! Additionally, medicine isn't just about knowing facts. You need to learn how to apply them and understand what the situation requires. What better way to acquire this "common sense" from reading about the experiences of other MDs!
I haven't started school yet so I haven't actually tried any of these suggestions, so in 6 months I may have some new suggestions when I find out what works for me. As an undergrad, one of my biggest struggles wasn't my studying techniques but my inability to concentrate. I've also been reading a lot of literature on this topic so my next post will cover how to train your brain to concentrate and other methods of helping yourself stay focused.
A Collection of Insights about Medicine
In anticipation of starting medical school next fall and needing to distract myself right now as I wait for interview offers, I've been reading lots of posts from several medical student and doctor blogs I recently found. The articles not only have been interesting but also helpful in spurring my own thinking about topics that my arise during interviews. Here are some nuggets of wisdom that impelled me to contemplate:
On Medicine School and Spending Money on Pleasures
"Right now, I happen to have time, but no money. In ten years, I will have money but no time. In a way, I’m borrowing from the future." from Guilty Pleasures that Help Us Survive Medical School
On Medical School and Relationships
“Medical school makes good relationships great and bad relationships worse.” Don't take your school frustrations out on your partner. Ask yourself if what you are doing is fair and how best to get your feelings across. from Medical School Makes Good Relationships Great and Bad Relationships Worse
The Dying Days Perspective
"When a doctor does not speak the truth and does not say the words, 'Yes, you are dying,' then you are robbed of the opportunity to live fully in the present, savoring each song, each touch of a child’s hand, and the heft of your favorite book.
Because of those words, each day, each hour, each second of that month would be seen in a different light than any time that had ever passed before. Each moment cherished, devoured hungrily, and deeply savored. Precious time, never squandered, but focused only on those things which matter most.
Death, the ultimate deadline, allows us to cherish both life and time more fully. from What if I Told You that You Were Going to Die Tomorrow?
Preventing Death
Eventually, science will offer better treatments for the other diseases that living longer makes us all more likely to contract, but for now, we all have to live with the truth that decreasing the risk of dying from heart disease has increased our risk from dying from other, arguably more horrible ones. We have focused on finding ways to living longer, but perhaps now its time to consider improving quality of elderly life.
What, then, is the best disease from which to die? Unfortunately, the one we’re the best at preventing. from The Best Disease From Which to Die
Preserving Compassion
Hopefully every doctor begins the path of medicine with some capacity for compassion. Ironically, the career which demands such a high level of the virtue can also stamp it out as well. This is why it's important to fight every day to withstand the erosion of compassion: to make room in the business of daily life, fight disensitization to others' pain, resist labeling patients, and always listen to your patients' stories. from Preventing Compassion Fatigue
Holiday Movies to get in the Chirstmas Season Spirit
There's nothing like getting in the holiday spirit by watching Christmas movies, and this year I'm going to start early to fit in all of my favorites before December 25 has come and gone. Especially because I'm spending Christmas in Spain this year where the emphasis is more on January's Three Kings Day holiday, I'm planning to get my Christmas fill watching a variety of movies on this list!
Animated Christmas Movies
Charlie Brown Christmas (1965)
Rudolph the Red Nose Reindeer (1998)
How the Grinch Stole Christmas (1966)
The Nightmare Before Christmas (1993)
The Polar Express (2004)
The Snowman (1982)
Frosty the Snowman (1969)
Mickey’s Christmas Carol (1983)
Old-Time Classics
Miracle on 34th Street (1947 / 1994)
It’s a Wonderful Life (1964)
White Christmas (1954)
The Bishop’s Wife (1947)
Holiday Inn (1942)
The Shop Around the Corner (1940)
A Christmas Carol (1951)
Meet Me in St. Louis (1944)
Comedies
A Christmas Story (1983)
Home Alone 1, 2, 3 (1990, 1992, 1997)
Elf (2003)
Scrooged (1988)
National Lampoon's Christmas Vacation (1989)
The Santa Clause (2004)
Christmas with the Kranks (2004)
Bad Santa (2003)
The Ref (1994)
Trading Places (1983)
How the Grinch Stole Christmas (2000)
Love Actually (2003)
Jingle all the Way (1996)
March of the Wooden Soldiers (1934)
Christmas in Connecticut (1954)
The Holiday (2006)
Action/Foreign/Other
Gremlins (1984)
Joyeux Noel (2005)
Go (1999)
Die Hard (1988)
Edward Scissorhands (1990)
La Buche (1999)
Lethal Weapon (1987)
The Dead (1987)
Brazil (1985)
Rare Exports: A Christmas Tale (2010)
Batman Returns (1992)
Flipping Cats!
Smarter Every Day investigates cat physics, or the mechanics of why cats always land on their feet. Complete with footage of weightless felines "defying" the laws of momentum!
No cats were harmed in the making of this video. Stuck the landing.
You Know You've Lived in Spain When...
I recently found this list on a website for expats living in Spain. This humorously look shows how one's view of life and life itself can change after living in Spain. In addition to this list, there are a ton of articles on advice and general information expats might find useful while living in Spain. I definitely plan to reference it in a couple months when we are there.
You know You've Lived in Spain When...
You think adding lemonade, fanta or even coke to red wine is perfectly acceptable. Especially at lunch time.
You can’t get over how early bars & clubs shut back home - surely they’re shutting just as you should be going out?
You aren’t just surprised that the Spanish plumber / decorator / electrician has turned up on time, you’re surprised he turned up at all.
You think it’s fine to comment on everyone’s appearance. And to openly stare at strangers.
Not giving every new acquaintance dos besos seems so rude.
You’re shocked by people getting their legs out at the first hint of sun - surely they should wait until at least late June?
On msn you sometimes type ‘jajaja’ instead of ‘hahaha’
You’re amazed when Spanish TV ad breaks last less than half an hour, especially right before the end of films.
You’re not surprised that the Spanish TV programme info doesn’t match with what is actually being shown, unless it is “Prensa Rosa”.
You forget to say please when asking for things - you implied it in your tone of voice, right?
You know what a pijo / pija is and how to spot one.
Every sentence you speak contains at least one of these words: ‘bueno,’ ‘coño,’ ‘vale,’ ‘venga,’ ‘pues nada’...
You know how to eat boquerones.
You know the difference between gambas, gambones, cigalas, langostinos, etc.
You know the difference between jamón pata negra and jamón de York, and you prefer the first.
The scientist does not study nature because it is useful; he studies it because he delights in it, and he delights in it because it is beautiful. If nature were not beautiful, it would not be worth knowing, and if nature were not worth knowing, life would not be worth living.
Henri Poincaré
Why Zombies, Robots, and Clowns Freak Us Out
A post by my new favorite science blogger:
Pennywise the clown is downright terrifying. But take away the fangs and penchant for haunting the dreams of New England youth, and a large portion of adults would still find the circus performer-turned-gore-freak purely terrifying. Zombies and humanoid robots fall into the same category: They just give some people the willies.
Why is that? Clowns are supposed to be funny. Zombies aren’t real. Data was the best character on Star Trek: TNG. We’ve known for a while that as a creation gets more and more humanlike, our comfort level goes up for a while, and then suddenly drops into what we call the “uncanny valley” (illustrated above).
Some new research out of UC San Diego may have put a little neuroscience behind this phenomenon. People viewed androids and people while being imaged by fMRI:
They hypothesized that, at least in part, the effect might result from a violation of the brain’s predictions. When we anticipate one thing but see another, we get an error, and that error makes us shy away from the thing we’re viewing.
… ”Your brain’s gonna be like, ‘Hey, wait a minute, you told me this was a human, and now this area told me that this is not moving like a human. So, I have to really compute that,’ ” [Ayse Sagin] said. “That’s what we think the uncanny valley might be partially caused by, and we have seen some brain activity that looks like that.”
The dissonance between what your brain expects to see and what it does see may be at fault. The tiny movements that don’t match, the slightly different facial ratios, Tom Hanks’ weird porcelain skin in The Polar Express … they all make your brain uncomfortable. Other researchers think that our keen perception of “healthy humans” might be an evolutionary adaptation to take care of our fellow living humans, and perhaps it even plays into our fear of death. Quickly recognizing human faces and features may be so core to our brain’s function that we can track it to the single cell (sort of).
All I know is that my wife punches me if I make her get within 50 feet of a clown. Remember, in the uncanny valley … they all float.
(via CNN.com)
Learning Spanish: The Best Online Practice Sites
I've been on a search for online tools to help me practice my Spanish before heading over to Spain. I realized there are a ton of sites out there, but it's hard to find ones designed to hone language skills rather than begin a new language. These are some of my favorite sites. This list is very short so I hope to add more and better practice materials soon and would greatly appreciate any suggestions!
Duolingo - I am new to this website, which is easy to set up and use. I can already tell it focuses just as much on grammar and writing as it does in memorizing vocab. It incorporates talking, listening, and typing which makes the practice seem comprehensive.
StudySpanish - This site is a great reference if you need to clarify grammar rules. You can also do verb drills by tense in the context of a sentence, but the downside is you can only do one tense per drill set.
Conjugemous - This is a great site for practice conjugating verbs. You do need to create an account, but it's a pretty simple process.
Only those that risk going too far can possibly know how far they can go.
"Walternate" Bishop, from Fringe (originally said by T.S. Elliot)
Bank of America: International Partners and Foreign Fees
Bank of America has many partner banks around the world in various countries (see list below) but their fee system is not clearly presented. I wasn't sure where I could use the ATM without incurring fees, that is, until I read this blogger's post about his personal experience in Europe with his BoA card:
He was aware of the list below, but noticed that we was still being charged $5 international charge + 3% fee. He emailed Bank of America asking them to explain, and they simply replied: The funds were not withdrawn in the country of the partnership. For example, Barclays must be withdrawn in the UK and Deutsche Bank must be withdrawn in Germany. However, an International Transaction fee for converting currency (<1%) may still apply.
This list has been updated to include new BoA partners since this blogger's post. Fee-free cash withdrawal cash with a Bank of America ATM card: Australia (Westpac) Canada (Scotiabank) Caribbean (Scotiabank) -most countries China (China Construction Bank) -excluding CCBs in Hong Kong France (BNP Paribas) Germany (Deutsche Bank) Italy (BNL Banca Nazionale Del Lavoro) Mexico (Banco Santander) New Zealand (Westpac) Spain (Barclays, Deutsche Bank) UK (Barclays)
See Bank of America's Global ATM Alliance list for more information.
It is motive alone which gives character to the actions of men.
Jean De La Bruyere
Frozen History
What may be the oldest fragments of the modern human genome found yet have now been revealed — DNA from the 7,000-year-old bones of two cavemen unearthed in Spain, researchers say.
These findings suggest the cavemen there were not the ancestors of the people found in the region today, investigators added.
Scientists have recently sequenced the genomes of our closest extinct relatives, the Neanderthals and the Denisovans. When it came to our lineage, the oldest modern human genomes recovered yet came from Ötzi the Iceman, a 5,300-year-old mummy found in the Alps in 1991. Researchers have salvaged DNA from even older human cells, but this comes from the mitochondria that generate energy for our bodies, and not from the nucleus where our chromosomes are housed. (Mitochondrial DNA is passed down only by mothers.)
Now researchers have rescued fragments of genomes from the remains of two cavemen unearthed in northern Spain.
The skeletons of two young adult males were discovered by chance in 2006 by cave explorers in a cavern high in the Cantabrian mountain range, whose main entrance is found at 4,920 feet (1,500 meters) altitude. Winters there are notably cold, which helped preserve the DNA in the bones.
These bones date back to the Mesolithic period, before agriculture spread to the Iberian Peninsula with Neolithic settlers from the Middle East. These cavemen were hunter-gatherers, judging by the ornament that one was found with of red-deer canines embroidered onto a cloth.