What You Pay For

Posted February 7, 2010 by evilangelfish
Categories: healthcare, money, personal finance, randomness

NGM Blog Central – The Cost of Care – National Geographic Magazine – NGM.com

Posted using ShareThis

That skinny orange line with the steep negative slope? That’s us.

Anyone who sat through (and stayed awake during) a cultural competence class during basic sciences could tell you that certain US citizens get an even worse deal for their dollars when it comes to health care. Note Japan’s line, however. You may have to bring your own sheets to the hospital* but at least you don’t have to worry about the bill when you get home.

Read the rest of this post »

How to Survive Semester 5

Posted January 25, 2010 by evilangelfish
Categories: 5th semester, med school, money, personal finance

Tags: ,

I know I said I’d post this ages ago. Here (at long last) is my advice for the current Fifth Semesters (especially those completing AICM in Miami).

1. Save Your Pennies

One thing you don’t learn about fifth semester until nearly the end of it is that it is actually comprised of the 3 months of AICM and the first 3 weeks of your first core (or special) rotation. If you receive any form of student aid, you will not be eligible to apply for aid for sixth semester until you have completed those first three weeks of rotation, which may be months after you begin AICM. Please keep this in mind and try to budget yourself accordingly, as expenses in Miami can be steep, the fees for the Step (and for Step prep courses) are monstrous and there are other incidentals (travel, shipping, health insurance deductibles, etc.) to consider. You may end up having to secure an additional loan (or, find yourself dependent upon the kindness of your parents, if you are fortunate enough to have generous ones) if you don’t keep an eye on your finances. Most personal finance guides recommend having enough emergency money set aside to last you for six months of rent, bills and expenses. If you don’t have that much money just lying around, at least try to live frugally.

2. Practice Early (and Often!) for the Practical

You may have already heard about the 200-point 45 minute physical exam you will have to perform during fifth semester for 20% of your grade. This exam is tough, but certainly not impossible, especially if you practice often with your partner and take advantage of the practice sessions offered by the junior faculty. Even though the grading rubric is made available and an exam demo will be posted on mediasite, it would seem that there is some subjectivity in the grading and how well you perform is not only a function of how much (and how well) you practice but also, who is grading. Since you won’t know who’ll be evaluating you until right before your exam, it’s best to make sure that for your part, you’re as close to flawless as you can be. The standard is quite high – scoring below 90% is usually a failure and if you do fail, you will have to stay a week after the final and retake the practical before you can pass 5th semester (even if you have As in everything else). Also, for the ladies – you must have a bikini top to wear during the practical (as you will serve as the patient for your partner). If you’re shy about that sort of thing (as I was), you’ll have to get over it…

3. Take Medical Spanish

In Miami, there are 2 ways one can earn 5% extra credit in AICM: one can complete an extra DXR case (they’ll tell you more about that) or, one can participate in a weekly hour-and-a-half-long medical Spanish class. I strongly recommend taking the class, even if you are already conversant (or fluent!) in Spanish. If you are a native (or fluent) Spanish speaker, you can get credit as a TA. If you are proficient or conversant, it’s an excellent chance for you to broaden your knowledge, as you will be provided with a medical Spanish “bible” with a full H&P glossary. If you have never studied Spanish before, I implore you to take the class because it is nearly impossible to avoid having to communicate in Spanish in Miami. Everywhere you are sent to rotate, people (patients, nurses, even surgeons in the OR!) will be speaking in Spanish around you. You’ll get so much more out of your experience if you can understand and communicate with even the simplest phrases. You can still do the extra DXR case if you want, you just won’t get credit for it. It’s easier to get credit for the Spanish class than for the case (which is graded) anyway. Plus, the instructor is delightful and for the final class, she makes tres leches, which is delicious.

I hope this advice is helpful. If you have any questions, please feel free to leave them in the comments section.

Setbacks

Posted January 25, 2010 by evilangelfish
Categories: med school

Tags: , , ,

It’s day 22 of Falcon and I spent it having an inordinate amount of fun in the first part of the biochem (of all things!) module, which for a few hours allowed me to forget the miserable weekend I had and the devastating news I received. Remember I mentioned the indignity of having to take the COMP again? Well, I took it and sadly, it did not go well. We received our scores (belatedly) on Saturday morning and I was heartbroken to discover that I’d failed yet again – this time by one condemnable point.

To say I was anguished is really an understatement. Read the rest of this post »

Generosity

Posted January 17, 2010 by evilangelfish
Categories: money, personal finance

If anyone who has been watching the disaster unfold after the catastrophic earthquake in Haiti is compelled to donate to the relief efforts but doesn’t know where to do so, here’s a couple of places:

Doctors Without Borders/Medicines Sans Frontières

American Red Cross

USMLE Boot Camp – Day 7

Posted January 10, 2010 by evilangelfish
Categories: med school

Tags: , ,

“This guy is really good!”

“Yeah, he’s killing it!”

- overheard outside of lecture, 1.8 Read the rest of this post »

USMLE Boot Camp – Day 3

Posted January 6, 2010 by evilangelfish
Categories: med school

Tags: , ,

A belated 明けましておめでとう* to all visitors to this blog!

2010 is going to be a pretty exciting year for me in terms of medical training. Having completed my fifth semester, I’m now preparing to take Step 1 of the USMLE, which is arguably the most important test I’ll take in my career, in March. I’ll also be starting core rotations, most likely later in the spring. My dad, who, while stoic, is not without a sense of humor, gave me the best Christmas present this year – tuition to attend the Falcon Live USMLE Review in Dallas, TX. There was one catch – this present amounts to my Christmas present from him for the rest of my life. While I am exceedingly grateful, I hope it’s not supposed to cover birthdays as well. Read the rest of this post »

Morbidity

Posted December 21, 2009 by evilangelfish
Categories: med school, randomness

Tags: , ,

I hesitate to devote a post to the recent untimely passing of a lovely young actress who was best known to me from the movies ‘Clueless‘ and ‘Love and Other Disasters‘ because in reading about the unfortunate event in the news, I found the random, almost blase tweets of condolence to be almost distasteful in their casualness. It would seem that the loss of a life (any life) would merit more than 140 characters, and that the actress’ true friends would have more to say than a couple of sentences and I don’t want to be just another one of the masses saying something trite and inane. I suppose for acquaintances and fans, simple RIPs and wishes of comfort and support to her family are more appropriate. And fond memories, so here is one: I screened Clueless with subtitles for the girls in the ESS* when I was teaching at 社高校. It seemed like every 5 minutes I had to qualify with a disclaimer that not all (or really, not many at all) high school experiences were like those depicted in the movie but the girls really liked the characters and the comedy (and really, the plot is not so far removed from some 少女漫画) and I and was struck by how even though the movie was 10 years old and even though I’d seen it a million times, I still loved it as much as I had the first time I saw it. I really enjoyed some of Ms. Murphy’s work and am saddened that she is no longer here to continue it.

The budding clinician in me however, was not so sentimental upon hearing the first scant details about the actress’ death. In fact, the first question that came to mind was ‘what could cause cardiac arrest in a 32 year old apparently healthy woman?’. The initial official reports state that she died from “natural causes”, which makes this case even more puzzling. Usually in young people without congenital heart problems, cardiac arrest is seldom caused by a problem with the heart. In fact, I remember going over a Harvey case with Dr. R (Ross’ resident heart guru) this past semester about cardiac problems in young people (in this case, we were exploring hypertrophic cardiomyopathy vs. aortic stenosis as the underlying pathology) and he mentioned that when you see a case of sudden cardiac death in an apparently healthy young person, you have to put drugs on your list of differentials, as it is the most common acute cause. In addition, given the actress’ history of eating disorders and rumors of recent GI distress, one would also have to consider whether a K+ imbalance caused by vomiting resulted in a fatal arrhythmia… So, cardiac arrest in a 32-year-old female with an unconfirmed prior diagnosis of DM Type II, PMHx of eating disorders, current meds unknown. What would be your list of differential diagnoses? Read the rest of this post »

Step Up

Posted December 16, 2009 by evilangelfish
Categories: med school

I guess when the going gets tough, the tough stop writing…

Apologies to all who’ve been wondering what’s been going on with me since October – I’ve finished up my stint in sunny Miami and have returned to Queens to prepare for Step 1 of the USMLE (dun dun dun!!).

At some point, I’m going to post some advice for those who have chosen (or been assigned) to complete AICM in Miami and other general ‘How to Survive Fifth Semester’ tidbits (as well as the ’secrets’ they don’t tell you until Novemeber, grrr). I’m also going to be posting my Step study plan. Today’s goal is 55 pages of First Aid and at least 48 MCQs. Keep reading for more frequent updates!

And If You Don’t Know, Now You Know

Posted October 29, 2009 by evilangelfish
Categories: healthcare, personal finance, randomness

Tags: ,

Here’s what the White House has to say about health reform. Here’s info targeted to med students and healthcare providers.

Also, for extra-credit reading, check this out.

What do you think about the public option and health care reform in general?

<<a note for visitors – when people visit my actual house, I usually ask them to take off their shoes. It’s a quirk I picked up in Japan; it helps me keep my floors cleaner longer and really, it’s just how I like things done in my personal space. I don’t mind if people don’t take off their shoes in their own house because that’s really their choice, but in my domain,  shoes are left at the door – that’s how things go. If you’ve happened upon this blog, which is kinda like my virtual house, thanks for stopping by! With that said, I’m going to ask that if you’d like to comment on this particular post, please limit your comments to the parameters set by the question I asked.  I’m not the government and I’ve expressed neither support for nor aversion to the bill in its current incarnation. I’m just presenting a piece of information that I found interesting (to further the マイホーム analogy, think of it as a coffee table piece) and posing some questions about it. If you think the public option is ridiculous crap and can back up that opinion with other pieces of information (links, articles, inside info, etc.), feel free to share it. I’d love to know more about both sides of the argument. But no random rants, please. If your comment suggests you just stumbled in to track dirt all over my floor and not actually have an informed conversation about the public option or healthcare reform, I’m not going to approve it. よろしく!>>

<<p.s. grammar is a plus – English teachers (even former ESL ones) always notice.>>

Half Crazy

Posted October 27, 2009 by evilangelfish
Categories: 5th semester, med school

Tags: ,
drjoke

from http://hubpages.com/hub/Crazy-Doctor-Joke

A note to my Ross 後輩*: Miami might occasionally be breezy but don’t let anyone tell you that 5th Semester is a breeze. It’s week 7; we are officially in the latter half of the semester, and things have started to get crazy. After being brutalized by the midterm yesterday, I’ve been at my wit’s end trying to prepare for the slew of assignments due in the next week: a SOAP note (with a to-be-determined presentation date), a literature review (for which I am still scouring JAMA and NEJM to find research articles) and a 15-20 minute presentation on preeclampsia and eclampsia. Ahead lies the 45 minute full physical exam, the final and the Step. It’s enough to drive a person insane, or drive a person to doubt. Can I handle this? Am I smart enough for this? Can I make it through this? Read the rest of this post »