the future dr. fame

The title says it all -- this blog follows the musings of the future Doctor Fame. It is my hope that this blog will allow you to understand my life as I navigate the journey towards becoming a doctor.

[thefuturedrfame]

Five Biggest Mistakes Students Make with First Aid for USMLE Step 1

The question for using First Aid for USMLE Step 1 isn’t whether to use First Aid (which everyone does), but how to use it correctly. These five tips will steer your study time and help you crush the exam.

Everyone who has taken boards gets First Aid. With my June/July test date quickly approaching, this is something I’m bookmarking for myself. 

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A slap in the face might be exactly what you need - The DO

The difficulty of med school hit me like a boulder rolling down a hill at top speed, but it also taught me a valuable lesson.

This. This is literally everything I went through but more eloquently-written than I could ever possibly write.

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I have never seen anything so accurate in my life.

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The most important part of your emergency medicine residency application - The DO

Michelino Mancini, DO, shares how students can stand out when applying and matching into emergency medicine residency programs.

Although unsure of what the future holds for DOs with the merger coming up in 2020, this is still an informative read.

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Horrible editorial in the L.A. Times, not researched well at all. No one disagrees that what Larry Nassar did was unbecoming of a physician (of any degree), but to diss the Osteopathic profession in one fell swoop with inaccurate descriptions of what we do was shameful. To educate briefly: there are two degrees in the U.S. that grant physicians unlimited licenses to practice medicine, M.D. and D.O.. Physicians with limited licenses include podiatrists (D.P.M.; relegated to treating conditions below the level of the knee only), chiropractors (D.C.; limited to physical medicine techniques only - they're unable to prescribe medicines or perform surgery), and optometrists (O.D., practice limited only to the eyes without surgical privileges). As I mentioned, D.O.’s, like their allopathic (M.D.) counterparts, are licensed to practice the full scope of medicine including the ability to order diagnostic testing, prescribe medications and perform surgery. In addition to the standard medical school curriculum, however, D.O.’s receive additional training in Osteopathic philosophy (emphasizing a holistic approach to our patients) and in Osteopathic manipulative therapy (OMT). Historically/philosophically, M.D.'s tended to be specialized and focused on particular organ systems in isolation, whereas D.O.'s practiced holistic medicine i.e. they looked at the entire body and the relationships between the parts. Philosophical differences aside, however, many people simply think of Osteopathic physicians as a combination of an M.D. and a chiropractor (D.C.) - allowing for "one-stop shopping" in today’s medical marketplace. Manipulation of restricted joints is very useful in my daily family practice. After the common cold, I see lots of headaches and backaches - we all get these. Osteopathic manipulative therapy (OMT) is particularly effective at hastening resolution of many of these problems when they occur acutely. I’m able to restore my patients (athletes and non-athletes) back to function much faster and cheaper, often without the needless expenses of medications or physical therapy. OMT doesn't work for everything, but it is an important tool in our armamentarium. It is not the only tool, however. I am able to prescribe all medications and I perform surgical procedures. If I never touched another patient's back, I would still be very busy as it's not manipulation that makes us what we are - it's our holistic philosophy and the way that we treat our patients; we listen to them and understand how ailments can affect multiple body systems and parts; we understand that - for many things - the body has the ability to heal itself (it just needs a little assistance in doing so). The statements made by Ms. Heffernan in this opinion piece towards the Osteopathic profession are outright irresponsible. Nasser did what he did because of who he was as a person, not because of his medical degree. The children were correct in saying that he was not a doctor, referring to the fact that he was, instead, a monster preying on them. But he did have a legitimate medical degree and it mattered not one whit of difference if he was a D.O., an M.D., a D.C., etc. That was not germane to the article except to throw out a very obscure historical reference. I'll repeat: Larry Nassar was not a doctor. He was a monster. Ms. Heffernan owes our profession an apology.

Dr. Jeffrey Pearson, DO

in response to the

LA Times OpEd

(which I wrote about in yesterday’s post)

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Recent News

Not news about my life, but about national headlines.

Recently, a former DO, Larry Nassar (whose license has since been revoked), was sentenced to 175 years in prison for being a molesting SOB. As soon as I saw that he was a DO, I knew that there would be someone, somewhere commenting about the fact that he was a DO and it would look bad on the profession.

And sure enough, this weekend, the LA Times published an op-ed that essentially called all DOs molesters, even calling the founder of the profession a “child abuser”. That article ignited in me an extreme anger that rarely ever comes out when reading news, and it brought back my doubt of being taken as seriously or seen as equally competent as an MD peer.

First off, the author herself isn’t even credible, with her “job” as a fact-checker being oxymoronically combined with her creationist views. Not only that, the article plays on the premise that COMMON SENSE DOESN’T OCCUR and that all DOs do osteopathic treatment without consent! It was just so idiotic! As with any doctor, a DO would normally get consent from the patient and explain the full purpose and procedure to the patient. I would also assume that if there was a potential situation that could be portrayed as sexual, like any other doctor, a DO would have someone of the opposite gender in the room whenever possible. But this article threw all of that common sense out the window, essentially going with the assumption that DOs don’t have basic medical etiquette and that they just directly perform treatments on patients without discussing it. 

Luckily, there has been an outpouring of support from many MDs and other medical professionals. The myriad of comments and videos that have been made explaining that, just because Mr. Nassar was an evil man doesn’t mean that all DOs are. 

And for all those people that wonder, here’s a video detailing some of the differences between DO vs MD, as told by a DO: https://www.youtube.com/watch?v=vHn6pers97Q **Note: as of 2020, there will no longer be two separate applications for residency, as stated in this video. This means that when I will be graduating in 2021, I will be applying for residency positions with all the other US MDs.

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So you want to be a female surgeon.  Here are 10 tips to make it.

I am lucky enough, from time to time, to be invited to speak to young women who want to be surgeons when they "grow up."

My school recently had a female physician panel and some of the things of this article reflected most of the sentiments and themes of the panel.

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It begins.

The length of time between this post and my last is indicative of how my life has become. A sad little cesspool of tears. The acceptance of being average. The realization that no amount of studying will help bring me up. Mediocrity...it sucks.

“Work smart, not hard” they say. It’s a bit more complicated than that. Working smart means you understand the system. In a semester where you have 5 different medical classes with 3 other semester-long fluff classes, you need to understand a lot of different “systems.” Each class is a new system and within that class is a bunch of mini-systems that accompany each of the teachers teaching that class. And this also begs the the statement that always clouds my mind: we’re working towards being exceptional doctors, not just beating the test. 

*Sigh* The test only determines our future. No big deal. The test only determines which residency we go to and where; and that “where” determines the most likely place we settle down with our family.

To be honest, the only people who are successful (that I know of), are the ones who can wake up early to get the start on their day at 5 o’clock in the morning. That’s what it takes, and I can’t seem to get my brain to turn on before 9am. 

It’s surprising to think that I’m almost 1/4 the way done with the didactics. 1/4 of the way through before taking one of the more, if not most, important tests of my life. I’m still navigating how to be successful in med school. Other people have adapted so well. Why am I so slow?

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Whirlwind of Emotions

So, it’s been exactly 2 weeks since the last post and it feels like I’ve lived a year. There have been happy times where I feel like it can’t get any better and then there’s days like today where I just cry to myself as I study something I just don’t really have the energy for. Welcome to medical school, right?

Well, we can start with the good because that was the start of the past two weeks. It was my birthday and I felt so loved by the outpouring of well-wishes from family and even the friends who i’ve only just met within the past two months. It was interesting to notice that I felt more love and happiness on this birthday than I did for my past birthdays where I got more presents. I guess it’s really is enough to just feel the love and caring over material things (though those things don’t hurt either, haha). 

Moving on to the week following my birthday, I spent an enormous amount of time studying for anatomy. This is my first time ever taking anatomy. I was genuinely interested in it and actually enjoyed studying. That leads me to the past week-ish. I was productive, everything went smooth, and everything seemed like it was as great as it could be. Studying wasn’t even bad. I felt like I was doing what I was meant to be doing. Everytime I get this feeling, it’s just like the best high ever - the high you feel when you’re being super efficient (though I can’t really speak for the other “highs” you feel since I’ve never experienced them). But everything was great. I was working towards a goal.

Then it came to this week, and it all came crashing down. I took my test and got my first failure in medical school. As I was going through the material, I kinda had a feeling I wouldn’t do very well. It just got to be too much material and I just didn’t seem to have the time to study for everything. This has legitimately made me scared for my future. Anatomy is one of the more important classes and I’m not standing afloat yet. It’s debilitating. I keep having to tell myself that I just have to keep on pushing. I just need to work hard and ace the final (which is worth more than this midterm) and I could still make it up. But really, I can’t shake this sadness I feel when I think about it every once in a while. 

And to make matters worse, I interviewed for an ambassador position at my school and didn’t get it. I’ve always known I wasn’t the best interviewer but I figured I was ok enough to get through a few medical school interviews coming out on top. But this just made me freak out even more. What about when I need to do residency interviews?! How am I gonna get that great job that I want if another candidate can out-interview me? I know that it’s just practice, practice, practice but it’s just so nerve-wracking and my true personality never comes out in interviews. I just don’t know how to put my best self forward and that has costed me. My other half is so great at them and it’s just even more frustrating that things like this can come so easily to other people. What is it? Is it the lack of socialization from my younger years that makes me unable to communicate well in interviews? How do you just force yourself to change how you are to become better for those 15-30 mins? I just don’t know...

All of this happened within the last day and it’s all just hitting me really hard today. I guess the realization has just really sunk in my head. Or maybe it’s the mix of ingesting an excess amount of caffeine today. Either way, I’m not sure how I’m doing. People are asking and I say I’m fine, but I’m not. I’m having my first bad day of medical school and as of now, I’m not quite sure how and when I’ll get over it.

P.S. I’m really sorry if this was such a depressing post. I’ll try to get happier soon.

[thefuturedrfame]

Congratulations! If you’re reading this you’ve probably matriculated into medical school and are trying to figure out which specialty might appeal to you.

As someone who has considered Emergency Medicine as a possible future specialty (though really, I’m not sure what I want to do yet), I found this article to be a great timeline of what is expected of a medical student wanting an EM residency.

Honestly, after reading it, I was surprised at how not rigorous it was. I was expecting to have to do so much more! Ergo, this article really made me feel more confident in my ability to be able to go towards the EM specialty, and not as a “reach” residency, but as a viable one.

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What week is it?

It has come to the point where I’m not even sure what day of the week it is, let alone how many weeks I’ve been in medical school.

Time has flown by. I’m not even sure when my last post was; but, so far in school, I’ve gone through 3 weeks of biochemistry, 3 weeks of immunology, and 1 week of anatomy which included a lab where I dissected some fascia. The fast pace of medical school is no joke. PEOPLE ARE TELLING THE TRUTH! 

This week especially has just worn me out. My immunology final got postponed to the next day, so the one-day break my cohort was expecting didn’t happen. We went straight from a 2 hour final into 2 hours of anatomy lecture...only to have 2 more hours of class that teach  how to diagnose dysfunction of the hip and knee. And that’s just Tuesday. Wednesday was 4 back-to-back hours of lecture, followed by 2 hours of anatomy lab that made me leave smelling of formaldehyde. A shower was needed ASAP. Thursday and Friday weren’t too bad, but by that point, I just wanted the week to be over so I could fall into my bed. And all of that was not adding the amount of side study time I had to do on my own. Sooooo, when people tell you that medical school is fast-paced and like drinking water from a fire hose, BELIEVE THEM!

Luckily, the week died down so my body ended up catching up with my schedule. Life is starting to be back to homeostasis. Until next week...

[thefuturedrfame]

A paper from the Yale Journal of Biology and Medicine

This was an interesting read from an evidence-based scholarly article. Normally articles are about medical concepts rather than the learning of them.

This would have been great to know before I started school but hopefully might help someone else out there who’s about to start!

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First Class...Done!

Biochemistry was brutal.

I learned a lot. [That’s the understatement of the year...three weeks to learn what I learned in 10 weeks in undergrad.] But I’m not just talking in terms of actual biochem concepts, but also on how to study effectively for that class, which methods worked for me, and what resources to use. 

Now, the thing about medical school is this: it’s hard. I know it is! It’s not supposed to be easy. There’s supposed to be too much material to learn (everyone says that studying in medical school is like “trying to drink out of a firehose”). And biochemistry definitely didn’t let me down in that aspect. With a range of two to four lectures per day, five days a week, my brain was overloaded with information that I started to feel like I couldn’t keep it all in. 

It was detailed yet at the same time, not as detailed as some concepts in undergrad -- more like, selectively detailed. I tried to read my textbook. People and the internet told me it wasn’t realistic but I thought that I would be the exception. I was proven wrong after the first day. I saw that I couldn’t possibly handle reading 100+ pages in addition to going through the 100+ lecture slides for that day, only to consolidate it down to what was important to rewrite in a notebook. The process itself was theoretically awesome but not realistic in terms of time. I wouldn’t end till 5pm and that process would take 6+ hours. That would be nonstop studying for more than 12 hours a day, which would make any person insane. 

I learned to regroup and retry a new method that I later on found was working. I relied on the teacher’s thankfully-instructive lecture slides and only used the textbook for clarification of concepts. Then, I sprinkled in the high-yield concepts (meaning, the concepts that would most likely show up on the board exams I would take at the end of second year). This made me refer to the Holy Bible of med school - First Aid for the USMLE. This book was a lifesaver and I would definitely recommend it to any medical student EVER! It is a staple...ask anyone who’s ever taken the USMLE. It includes mnemonics and pictures and, though it’s not exactly a page-turner, it fulfills its purpose.

I wish I had known this earlier, as I didn’t really use my First Aid book until Week 2 of 3. At that point, I was already slightly behind schedule, but I made it work. In the end, the happiness and relief I felt after finishing the 135-min, 90-question final told me that my hard work and countless times making myself a hermit and sacrificing myself to the studying gods totally paid off. A giant weight lifted off my chest, knowing that I PASSED!!

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Week 1... Done!

So.....week one sucked. 

It was so filled with class and I couldn’t get any time for a non-study-related break until Friday afternoon. BUT, I still loved every minute of it. I loved being in the classroom again. I loved sitting next to people I consider my friends while we discussed class. I loved being back on the grind of learning. And I especially loved knowing that everything was all going towards the goal of being a doctor.

 Day 1 - Monday

Monday was honestly the worst day of the entire week. I was at school from 8AM until 7PM, and it was allllll classes. It was like they wanted us to be super scared on whether we could handle medical school before coming out, like “JUST KIDDING! It’s not that bad...” 

Though the first few hours was science lecture, the rest of the time was just orientation-type stuff where each class went over what was expected and the important information to know -- so kinda like the syllabus. But it was all basically required. I came outta school with my brain as mush and I legitimately couldn’t think about anything clearly for 2-3 hours. 

Thankfully, I just had dinner with my family still in town and that took the edge off. I wouldn’t have been able to study (like I had planned) anyways.

Day 2 through 4 - Tuesday to Thursday

Each of the middle weekdays was essentially the same: science class in the morning and filler classes in the afternoon. Some of the filler classes were fun, teaching us all “how to be doctors” and how to approach talking to a patient, the ethics behind certain actions, and how to use doctor toys.

After I got home, I’d end up studying till I slept. It sounds bad but studying went slowly but surely. By the end of the night, I felt tired but luckily didn’t feel tired of studying. I think getting enough sleep really helps with that. And, of course, I sprinkled in a bit of breaks here and there.

Ultimately, each day ended with me feeling more and more excited for my life path. 

Day 5 - Friday

First week of school and there’s already and quiz and midterm. Today was just a quiz though Monday has a midterm. Throughout the week, it just felt like there wasn’t enough time in the day to go over all the material, but I did it anyways. I passed the quiz (which, during the test, I honestly thought I wouldn’t be able to do after getting a picture of what the questions were like). Don’t get me wrong though, the test was fair. However, after going over the test, I felt disappointed that I got such easy questions wrong and wished I had studied just a little bit harder.

The rest of the day was light and the school even had a social event at a local baseball game. I had my first break and utilized it to run errands. It made me feel ultra productive coming back to the apartment and getting all the things I had wanted to get for the past week. The baseball game was fun and a great time to socialize with classmates. I am quite satisfied with my decision to hang out with my friends rather than staying at home like the hermit that I am.

And now, here I am, on a Saturday, studying all day for the impending midterm. The material is not too hard to grasp because I have already gone through the material as preparation for the quiz so I conceptually understand everything. So hopefully I spend the time doing some quality memorization and I’ll be alright.

Till then, wish me luck!

[thefuturedrfame]

Orientation Week

Last week was orientation week and it concluded with the fanfare of my white coating ceremony. We got a lot thrown at us with a back-to-back-to-back schedules of nonstop informational sessions, TB testing, pictures, volunteering time, and academic seminars. However, the week’s activities only made me more excited about becoming a doctor with my fellow classmates, as well as made me more cautiously nervous about handling the rigors of school. So many emotions rolled into four days.

Wednesday (Orientation Day 1):

I was nervous. I couldn’t sleep the night before. Tossing and turning, waking up at 4AM for no reason and being super tired waking up. I think it was the fear of not making any friends (a fear I’ve had all my life because I’ve just never been one to socialize) mixed with the fear of the unexpected.

That fear was instantly quelled when I met my first friend walking to school. I live across the street, as does about 90% of my apartment building. As I was walking to orientation, not knowing anybody (whereas other people organized social events and knew each other already), I zoned in on the first “alone” person I saw and found the courage to introduce myself. It all went well from there. 

Once the nervousness subsided, my usual chatty self took over and I felt more confident in myself. Though, not gonna lie, I stuttered a bit when introducing myself to my peers over the microphone. The rest of the day was long but the information really made it hit home that I WAS IN MEDICAL SCHOOL.

Thursday (Orientation Day 2):

Orientation day 2 was really more a community service day at my school. The class split up into multiple groups going out to different organizations that allowed us to volunteer with them. This included a senior center, the Ronald McDonald foundation, lots of gardening opportunities, and a lot of activities with kids and schools. I was lucky and got an arts and crafts-type activity and LOVED IT. It made me remember how much I loved to volunteer. Don’t get me wrong, volunteering at the hospital was great, but doing something completely non-medically-related was such a breath of fresh air. 

Friday (Orientation Day 3):

Orientation day 3 was when the advice really started rolling in. Though the “advice” sometimes seemed like a scare tactic, it really ingrained in me a sense of hustle and mentally prepared me for the difficulty of med school. I don’t know if they were exaggerating to make us expect the worst so we start off over-prepared from the get-go. But this day definitely left me with the impression that medical school was no joke (which I already knew, but now i REALLY know).

Saturday (White Coating Ceremony):

The white coat started out innocently enough, similar to an anti-graduation. The dean and the president and the VPs and the blah-blah-blahs gave short speeches. Then I presented myself in front of everyone and walked over to my coater to get assistance in putting on my coats (because otherwise, I am a totally incapable person :P ). I didn’t start to get emotional until a girl broke a little during her introduction because she was thanking her dad. Then, for some reason, I teared up a bit when reciting the Hippocratic Oath. I think that was the moment it really hit home for me that, if I did it right, I would be a doctor in 4 years. Then I cried when I left the area and met up with my family and they all expressed how proud they were of me. Sometimes, you just don’t hear it enough, or simply, the word “proud” doesn’t affect you until you’re proud of yourself. Either way, that really just broke the dam and the floodgates opened and all of my pictures came out with me being a red, blobby mess.

By the end of the week, after all was said and done, I came out feeling a mix of emotions. I was satisfied that I found people I got along with and could see myself being friends with. I was nervous to see if medical school was really as barely-manageable as it seemed. But most importantly, I was ready to take on medical school.

[thefuturedrfame]

For those of you who have been accepted and are preparing at this point for matriculation and orientation, congrats! You did it! You WILL be...

Another great article for pre-meds. Goro, the author of this post, is a well-known advisor on these forums. I think (s)he is also in an adcom committee.

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Hey all, I wrote a guide to NSU-COM a few months back for one of our school publications. Some friends told me it would be pretty generally applicable...

Great article to read for any pre-meds (in my opinion). It contains a lot of advice that I ignorantly would have done.