How To Schedule Air Travel / Flights For Residency Interviews

You've taken USMLE Step 1. You've figured out how to choose a medical specialty. You got the recommendation letters, slaved over the personal statement, and submitted ERAS. Finally, it's time to sit back and wait for those interviews to roll in. But wait, there's one big question to be answered.

How are you going to schedule dates, flights, hotels, and rental cars for all those residency interviews?

There are several ways to go about answering this question, but the key is to have a plan. Here is the strategy I used to attack this problem head on. Note, this assumes that you are applying across the country and have roughly 10 to 20 interviews. If you are applying in one region, or are in a situation that requires more interviews, this strategy may not be for you.

No one really discusses the logistics of what happens after you submit ERAS. Sure, everyone understands that programs review your ERAS application, look at your grades, letters, and personal statement, and then decide to send out interview invites. You accept, go interview, then both sides rank, and you wait for Match Day. This model works great for one program, but what happens when you are dealing with 10 to 20 programs simultaneously? And, the programs send out invites at different times on a rolling basis?

To solve this problem, there are a few key principles: submit early, block out time, stay up-to-date, be inquisitive, and be a deal hunter.

Submit Early - There are two seasons to be aware of: the invitation season and the interview season. The invitation season runs from whenever you submit to roughly early December. The interview seasons lags this by about a month and a half, so most interviews run from late October to late January. However, to maximize your timeframe to receive interviews and schedule them, you have to submit your ERAS as soon as possible. Of course, you want to do a good job and have a complete application, but you need to be proactive in getting your application in so you can start receiving invites!

Block Out Time - If you are applying all over the country, it is a good rule of thumb that the further west you go, the later the invitations. That means, you should try to block out months based on regions: November for East Coast, December for Midwest/South, and January for West Coast programs. If you do this, you can save a lot of money by scheduling one flight for multiple interviews in the same region. It also helps you respond when programs offer multiple dates across all three months. Keep in mind that most programs do not interview the week of Thanksgiving as well as the weeks around Christmas and New Year. Remember, interview spots fill up fast so you want to respond to an invitation as soon as possible!

Stay Up-To-Date - Use the message boards either specific for your specialty or on Student Doctor Network to know when programs send out invitations. While this can be nerve-wracking sometimes, it helps you know when you have not heard from a program whether the program has already sent out invites to others, or whether to remain patient. At the same time, you want to keep your resume and information up-to-date as well.

Be Inquisitive - If you have not heard from a program, or know they have already sent out a round of interviews, it can sometimes pay to email the program coordinator to reiterate your interest. A lot of times, programs are trying to decide between many very similar looking applicants, so this extra show of interest can help push your application to the top and win you that invite.

Hunt For Deals - Traveling and interviewing is expensive. Between the flights and hotels, many interviewees end up spending thousands of dollars. Since there's no real way around this, it's important to be on the lookout for deals. Try to stay with friends, fly with the same airline to rack up frequent flyer miles and potentially a free flight, stay close to your hospital, and use public transportation to minimize taxi cab / rental car costs. Those saved dollars will really add up over the interview season.


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A Medical Holiday Gift Guide / Wish List

Ah, the winter season. A time for Christmas, Hanukkah, Kwanzaa, Diwali, and other holidays I am forgetting. A season of giving. But, alas, what to give?

In the past, I've written about practical gifts and must have gifts for medical students and health professionals. This time though, it's just going to be a wish list, plain and simple. Most of it is medically-related, sometimes a stretch, but honestly, some of it just good stuff one might want to have. C'mon, you (or your recipient) is in medical school! A doctor doesn't have to treat only patients all the time - sometimes a doctor should treat themselves too! Now, granted, these are wishes for particular gifts. Maybe you are wishing you were AOA or you could travel the world or perhaps lose weight quickly (quite a challenge in medical school with busy rotations and studying!) Not every wish can be encapsulated by a gift item though. Regardless, hopefully some of these gifts will lift your spirits nonetheless!

The Kindle by Amazon

First up, the Kindle. What's not to love about this device? It's almost as thin as a magazine, can download books wirelessly just about anywhere, holds up to 1500 books, has a super-sharp crisp screen to read, and can even read out loud to you! As a medical student, you can have all your medical reference textbooks in their full-size glory in one easy to carry device. In fact, some medical schools are starting to implement support for Kindle for all their resources (see this blog post about Kindle at Harvard Medical School). Yes, it's a little pricey, but that's a one-time cost - the total cost ends up being cheaper as books cost less on the Kindle. Besides, using a Kindle is environmentally friendly. Heh, and it just looks plain cool. And that's why the Kindle is tops on the wishlist this year.

Flip Video Camera

Those commercials got to me - using a Flip Video Camera to record the goofy moments in life seems fun. From a med student point of view, it's also useful for recording bits of a lecture or perhaps for composing a skit for your school's version of fall follies or senior skits. Not sure what I'm talking about? Clearly you haven't seen Jizz In My Scrubs.

5 in 1 - Neurology Combo Tool

This thing is frickin' awesome. First, the 5 in 1 combo tool just looks way more professional than the standard issue orange reflex hammer. Frankly, I lost mine a while back and have felt none the lesser for it. Second, you can really examine people thoroughly with this device. Instead of making ad hoc solutions to assess pin-prick sensation, you can use an appropriate tool for it. I guess I'm a sucker for gadgets, but the 5 in 1 - Neurology Combo Tool actually seems useful.

Apple iPod Touch

What can I say? The Apple iPod Touch is simply amazing. It plays music, it surfs the webs, it does apps. In some ways, it's even better than an iPhone - no lousy contract, but still get all the perks. From a med student standpoint, it's great because many apps have been developed for the OS that are relevant for medical professionals, and many are free. For example, you can get Epocrates on your iPod Touch now. Many hospitals provide Wifi service, so you can also use your iPod Touch to do research in between rounds. The device basically does it all.

Gift Cards

Still not sure what to get? Heh, can't beat a gift card. Get them something you know they'll love - something they picked out themselves!

First Year Medical Student Resource Guide

One of the most difficult parts of the first year medical school is distilling a large volume of information into easily digestible parts. Here are some links to online resources you might find helpful.

• A Beginner's Guide To Medical School
• Books For First Year Medical Students
• Eponym Finder
• Firefox Tips For Studying Medicine
• How To Buy A Stethoscope
• How To Study Anatomy
• Medical Images Online
• Mnemonic Finder
• Tips On Studying And Surviving The First Year of Medical School
• Virtual Human Anatomy Guide
• Wikipedia In Medical School

This concludes my series on first year of medical school. I may add posts to the series in the future. My next set of posts will deal with planning for and traveling for residency interviews.

The Basic Science Medical Education Dilemma

This is a guest post by John Wetzel from Wiki PreMed

For medical education, the question is not only what to teach and what to leave out but also how to teach it. Alfred North Whitehead in his famous essay 'Science in the Modern World' described a situation in which the explosion of knowledge in modernity made the 'Renaissance Man' no longer possible, and that to be effective, a modern person had to content themselves with being a specialist, and this was in the 1920's! I think this predicament of modernity creates a real tension for medical education, especially, because the human body is a microcosm of the universe, of the whole of science, not only in the sense of complexity but in the sense that a person's health is bound to it, so it is very difficult for any person studying medicine to leave off something potentially important just because the mind has limited capabilities. Furthermore, there is a tradition which makes it hard for any teaching generation to make things easier for today's students than they had it themselves in their own education. However, the rate of increase of the knowledge base means that even if the discipline doesn't change, the disposition towards the knowledge among educators has to change. Medical students can't learn everything. In biochemistry alone, medical students are asked to retain an incredible amount of information regarding mechanism after mechanism, but this was true even fifty years ago. However, in the intervening years, students have been given a new encyclopedia to learn in the field of molecular biology. With gene expression alone, there are now elaborate signaling pathways and mechanisms like alternative splicing and RNA interference which have been elucidated only in the past ten years. So there needs to be a lot of debate about what to teach and what not to teach.

Of course one important standard is whether a piece of information is relevant to clinical judgment. Something as fundamental as the Krebs cycle is likely only important in clinical practice for a subset of metabolic disorders. Within every clinical specialty there are fundamental principles from basic science which are important for understanding of symptoms and treatment on a daily basis, but not for other specialists. Bernoulli's Principle and Poisseuille's Law for the cardiologist. Solution and acid-base equilibria for the nephrologist. Hooke's Law for the orthopedist. An infectious disease specialist is not going to think about these things very often I suppose. In fact, the specialists themselves probably don't think about them too much on a daily basis, except in difficult cases, but the knowledge must be there in the first place for the specialist's education to have been coherent when they received it. This is where I have an issue with the complaints of many medical students that much of the science they learn is irrelevant information. Students complain about learning every structure in the Krebs cycle, but this is the wheel at the center of the living system. To understand energy flow in metabolism makes a great deal else coherent, although I have big problems with how the Krebs cycle and a lot of biochemistry is taught. In my opinion, if instructors felt they could use the field of reference of physics and general chemistry in a sophisticated way to animate the presentation of the Krebs cycle, it would mean a lot more to students.

If you read discussions among medical educators, you see a lot of advocacy for more emphasis on clinical experience and communication at the expense of basic science. Medical educators may be giving up on making medical school an experiment in finding the maximum possible amount of information a human mind can hold, which is probably a good thing. It may be that there is cost benefit to teaching doctors to be better communicators because it leads to better outcomes for patients without too much trouble. Convincing people to quit smoking has done more against cancer than understanding the mechanism of histone acetyl transferase, at least so far.

The proposition that animates my own work is that a more effective curriculum at the earlier stage would prepare entering students significantly better for the challenges of understanding and retention they face in medical school, by which I mean the education they receive at the fundamental level of physics, chemistry, organic chemistry and biology. Medical school would be more vivid if students learned the fundamental physical and biological sciences within a combined curriculum that builds on itself, not within disconnected modular courses. How can a person understand free energy change in chemistry without mechanics, electrodynamics, and thermodynamics from physics? How can you understand oxidative metabolism without oxidation reduction? Being a person who has worked very closely with many small groups of premedical students, taking them through the basic sciences in review more times than I want to admit, I'm burdened with knowing how little conceptual fluency entering medical students actually possess after their undergraduate years that would help them unify the enormous encyclopedia already in their heads, let alone what is coming in medical school.

So I made the WikiPremed MCAT Course because I hoped it would benefit people. It’s just a small part of the whole movement to make education more accessible online. I also hoped it would be a way to share some ideas about designing the basic science curriculum to be more appropriate for future doctors at the undergraduate level. The sequence of topics and goals in the course represents my best effort at what a unified, interdisciplinary, spiraling curriculum for basic science would look like (without lab component). I think medical school would be more interesting and enjoyable if students were prepared by a science program that followed a sequence like this one, where chemistry comes out of physics and the biological sciences out of the physical sciences. If anyone is interested, they can go visit, at least to see what a person is capable of who gets so deep into a project they can only double down. I'm probably too close to the work to see it's problems clearly, so I am very interested in substantive criticism, although any encouragement is also welcome.

To learn more about John's project, visit WikiPreMed at http://www.wikipremed.com

Have your own views to share? Submit a guest post at scrubnotes at gmail dot com today

How To Study First Year Medical School Anatomy

Anatomy is a fundamental part of any medical student's education, and usually it starts early on in the first year. The education is usually a mix of didactic lectures as well as time spent in an anatomy lab, dissecting cadavers. Some have suggested switching to a method of instruction utilizing technology for prosections, avoiding the need for cadavers, but most medical schools still have a formal anatomy lab.

How does one make the most of their time studying in anatomy lab? Studying the material is just like studying for any subject in medical school. However, the lab is a little different. It's hand-on, it's visual, and heh, it smells. Some may also be concerned about finding it macabre and morbid, but usually you get over your natural aversion rather quickly as you focus on learning the material instead of your surroundings. Here are some tips for making the most of your time in anatomy lab:

• Repetition - Whatever you learn, repeat. A lot. On different cadavers, different angles, different lighting even. You need to have a fundamental understanding of the visuospatial relationships between structures as well as the range of normal variation in them. Otherwise, on exams, you will simply see a mass of flesh and get confused.
  
  
• Know the ideal - Use Netter's Atlas of Human Anatomy to learn the ideal relationships beforehand. Otherwise, you can repeat all you want, but each time you'll just see 'mass of flesh.'
  
  
• Learn tissue features - Know the characteristics that differentiate nerves, arteries, veins, and muscles, both by look and feel. Sometimes, these structures run together as in the brachial plexus, and can be difficult to differentiate.
  
  
• Study in a group - Having someone quiz you and prod the lacunae in your knowledge can help you realize your weak spots and strengthen them. Perhaps gastric anatomy always confuses you; maybe its neuroanatomy structures. Either way, a study buddy can help you see things in a new light and learn the material in a way that sticks.
  
  
• Study prosections - if your anatomy lab has idealized dissections, also known as prosections, study those well. It wouldn't be too surprising to see some of these show up on your anatomy practical exam.

Study hard, and anatomy will become the foundation for the rest of your medical learning.


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