Day 194: Professionalism

Today’s inane image of the day:

We got to know every nook and cranny of the skull during Neuroscience [this has absolutely nothing to do the entry below, but I thought it was a cool image].

“I really appreciated your demeanor and eye contact,” said my Standardized Patient during the feedback period of our encounter. She continued, “but you were too professional.” I reflexively furrowed my eyebrows as I nodded in response. She made a few more comments, but I was distracted by her observation – how could I have been too professional?

The first time I was exposed to this concept was not a memorable one. However, the term pervaded throughout my engineering education [there was not much emphasis on it while I was in the liberal arts], especially during my involvement in the Society of Women Engineers, where our most popular events were designed around this particular subject. During my three years, an image of professionalism formed in my mind as a respectful, well-prepared, conservatively-dressed individual.

But is professionalism only skin-deep?

My preconceived notions of the concept upon entering medical school seemed to imply that it was a superficial thing. In my mind, “professionalism” always translated into a first-encounter-type-situation. Immediately upon meeting an individual, we naturally generate an idea of a person from posture, attire and introduction. Much of the time, slouching, wrinkled dress shirts and a weak handshake translate into an unfit candidate for most professional positions. Unsurprisingly, many recruiters and interviewers take these characteristics into account in their evaluation of candidates for jobs or an acceptance offer to medical school. Although I still believe that a large component of professionalism are superficial features, I have quickly learned that many regard the term to mean much more.

The dictionary installed in my laptop claims that professionalism is “the competence or skill expected of a professional.” It follows that the expected competence and skills of each professional can differ across industries; the expectations of engineers are not exactly the same as those of physicians. The most concrete example of this are the prerequisites for particular professions – engineers are minimally expected to have taken an entire Calculus sequence along with programming and engineering-specific courses, while premedical students are expected to have a broad range of knowledge with some focus on biology and the sciences. These expectations make sense.

But when a college student transitions into the “real world” [I’m going to call medical school the “real world” for this discussion] and attempts to specialize in a career path, the burden of expectations rises significantly. Turning the focus to medicine, there is a presumption that you will be self-motivated, study everything to gain knowledge and understanding of the human body, learn to communicate with a wide variety of individuals, and essentially devote yourself to the practice of healing. There are many, many, many more expectations, but those were the main ones that came to mind when I was writing this.

Considering all of this, what did my Standardized Patient [SP] mean when she claimed that I was too professional? Prior to answering this, it’s important to recognize that every individual has a different image of a professional in their mind. In this case, my SP was referring to my demeanor; her picture of a medical professional included someone warm and receptive, which I hadn’t effectively conveyed during our session. It makes sense retrospectively because I tend to fall back into the engineering professional role during interviewing sessions – I start with a strong handshake and maintain a serious demeanor throughout. Initially, I was somewhat distraught over the comment, but after some time it became clear that she forced me to see my own habits so that I could work on improving them.

In the end, I do not have a definition of professionalism for you but hope that you will at least consider what it means and what expectations your current role holds.

[As always, comments are welcome!]

Day 193: Decompression

Today’s inane image of the day:

My favorite study tools…

The exam came and went. All I can say on the matter is that I’m very glad that Neuroscience is over.

Yesterday we delved right into our Cardiovascular block with some basic lectures and exposure of the heart in Anatomy Lab. Our cadaver has an extremely hypertrophic heart — it was “a rush” [as Dr. Forbes loves to say] to pull out the lungs in order to expose the muscular organ that maintains our blood flow.

My updates might be sporadic this week due to some serious catching up on life that needs to happen.

Day 185: Love is in the air

Today’s slew of inane images:

The Social Committee bought brown bags and decorations so we could celebrate Valentine’s Day with an old grade school tradition [bringing in tiny fold over Valentine’s cards and candy to drop in everyone’s brown bag]. 
John put a lot of effort into decorating his brown bag! [I got permission from him to post this image]
After decorating, we taped our bags to our lockers.

Happy Valentine’s Day! I’m not a huge fan of the holiday [even though I have a significant other], but I’ll take any excuse to decorate things with hearts. Mike was in town over the weekend [hence the lack of updates] and we enjoyed our limited time together [as I tried to explain how a pituitary tumor can compress the optic chiasm and lead to bitemporal hemianopsia]. Anyway, I’ll leave you with one last image before I disappear into study-land [our Neuroscience final exam is on Monday… ahhh!].

I also love excuses to get roses. Thank you, Mike!

Day 181: 6 tips for maintaining [long distance] relationships during medical school

Today’s inane image of the day:

The front-side of a card Mike sent me. Isn’t it the sweetest thing ever?!

[I apologize that this was prematurely published last night… but here’s the full version of the post!]

Being in medical school really drives a huge stake into all of your relationships, not only your romantic ones. When you start the journey that we call medical education, suddenly you’re always preoccupied with studying [for that exam in 2 weeks], medically-related facts and just trying to get by. Because of this, all [or most] of your attention, focus and energy shifts away from everyone [and sometimes everything] else in your life. Even when you do find a moment [like the day after an exam] to turn your attention to family, a significant other or friends, it seems that you always end up bringing up how fascinating a patient with visual agnosia is [aside: I read “The Man Who Mistook His Wife for a Hat” quite a number of years ago and didn’t quite get it — now, I understand the true weight of the novel’s narrative and plan on rereading it].

“REALLY?! Is medicine all you can talk about?!” Your family/significant other/friend exclaims. As you turn red with embarrassment at the outburst, you ask about that cruise ship that recently ran into trouble just to change the subject.

[Maybe this last part hasn’t happened to all of us, but it could happen.]

Anyway, as I mentioned in my post featuring advice from my first semester of medical school, it’s really important to keep in touch with your loved ones. I should have expanded on this and said that it’s important to maintain relationships because in the grand scheme of things, your family/significant other/friends make up a huge part of your support network. When times get tough, you will inevitably rely on these individuals to help you pull through. Moreover, if you don’t sustain the strength of this network then you’ll suddenly feel very lonely once you’re finally done with the training part of medical school and can enjoy your glamorous life as a physician [just kidding about the “glamorous” part — it’s still grueling but a different kind].

All of this begs the question, “What can I do to maintain my relationships?” As promised, this is a list of tips for long distance romantic relationships, but most of these tips also apply to maintaining relationships in general.

Effective communication
Everyone always harps on this whole communication thing and with good reason. Any interaction with  people requires effective communication, period. Otherwise, frustration and stress ensues. So what can you do to be effective?

  • Start with effective listening. Focus your attention 100% on the speaker and show that you’re actually interested in the subject. When you’re on the phone, don’t give into the lure of trying to multitask. Also, try not to interrupt the speaker or try to conjure up the next thing to say. Silence doesn’t have to be awkward, so let it slip in here and there.
  • Awareness. I do believe that women tend to be better at picking up and interpreting certain inflections of tone than men, but that men are very capable of learning how to pick these hints up. Sometimes, what is said in between the lines is actually more important than the lines themselves. Try to pick up on these little indications [but don’t look too deep! sometimes there really isn’t anything there…]
  • Consider what you’re saying before you say it. I’m very guilty of letting the words spill before processing what they may be processed to mean. Sometimes you get excited about something and the words tumble out before you had a moment to phrase it more tactfully and you find that it is received in a completely different manner than you had intended. While this can be overlooked if you are interacting often with your family/significant other/friend, it can be a lot harder to overlook once you’ve entered the busy realm of medical school.

Establishing a routine
This is especially important for sustaining long distance relationships with significant others — if you establish a time of the day that is set aside especially for video chatting or a phone conversation, then you will have something to look forward to each day and you will maintain the regular contact/communication necessary for keeping the relationship strong. Mike and I usually chat during my commute and right before bed [and because of the 3 hour time change, sometimes he’ll be up late and serve as my alarm clock — this is especially helpful for the mornings that I opt to wake up at 4AM].

Plans & realistic goals for the future
Prior to embarking on my long distance relationship, Mike and I sat down and discussed how often we will realistically be able to see each other and identified an end point for the long distance. We discussed how we could ensure that we are together at that specified point [will he follow me? will I follow him?]. Although I realize that the “best laid plans of mice and men often go awry,” it’s settling to see the light at the end of the tunnel. Furthermore, our open lines of communication allow for adjustments to these plans as we see fit.

Little surprises
The image for this post is of the front of a card Mike sent me as a surprise. It was such a sweet gesture and it still makes me smile to see it each day. Just little handwritten notes or sweet emails with photos can really go a long way in keeping a relationship strong. This also applies to relationships in general — if you haven’t heard from someone in a while, why not give them a call and catch up or send them an email?

Reminiscing on good memories
I love when my best friend comes back into town and we catch up on what’s going on in our lives [usually my end of the conversation is “we have another exam coming up” or “ugh, I didn’t do well on that last exam”… heh]. But it’s especially fun to reminisce about how we used to spend all of our time in Robotics after school [yes, we were quite nerdy… and probably still are] or the adventures we had in college. This also works really well for diffusing an argument with your significant other — I’ve found that if I’m annoyed about something Mike said or did [or didn’t do], I can’t stay angry for very long when I think about how we met or how supportive he was through my medical school application process.

Knowing when to let go
Long distance relationships and relationships [in general] during medical school requires recognition of when it may no longer be healthy to maintain. Sometimes a great relationship in one setting is just not sustainable outside of it. I don’t think that this applies to most relationships, but it’s always important to realize that it might be a valid possibility.

Did I miss anything? Do you have any additional tips?

Day 177: Reasons I love OUWB

Today’s inane image of the day:

Manter and Gatz [our Neuroscience textbook] broke my highlighter! 

With so many students starting to compare their medical school acceptance offers, I thought it would be an appropriate time to make a case for OUWB. Keep in mind that deciding on a school is all about fit — I selected a school based on what I thought would be best for me, and I think it’s pretty clear from my entries that I’m happy with my selection. Moreover, I believe that if you find yourself at a school that you genuinely love, you’re more likely to be successful. With that being said, here are the reasons I love OUWB:

It’s no secret that Dean Folberg boasts about building an OUWB culture — so far, I have to agree that there is definitely a distinct feeling tied to being a part of the “OUWB fam.” Within the class, everyone knows everyone and we have all interacted with one another at some point. Faculty and staff know each and every one of us by name [they all have a cheat sheet with our photos…], which is really quite a nice change from my experience at the University of Michigan [it’s almost comparable to my experience at Simon’s Rock].

I’m sure that most of you have already read my review of our curriculum thus far, and recognize that I am pretty happy about how things have been going so far. A couple of highlights:

  • Integrated/Systems-Based Curriculum
    The integrated part really helped me make the necessary connections to commit the material to memory and I am really enjoying our first system course [Neuroscience] despite the organizational issues we encountered. It makes a lot more sense in my mind to learn about everything from one system rather than bits and pieces of each one — for example, I love that in our Neuroscience block we started off with CNS/PNS Embryology, Histology, Pharmacology and Anatomy then delved into the Neuroscience portion of it. Sometimes it feels like there’s all too much information coming at us at once, but eventually the moment comes when things start clicking into place and it’s wonderful.
  • Team-Based Learning
    Keep in mind that we do not only do TBLs… they are scattered here and there [maybe one every couple of weeks, on average]. I really enjoy them since they break up the lecture time and also offer a great way to really drill a clinical pathology into our memory. I still remember details from most of the clinically-based TBLs we’ve done!
  • Capstone
    Although I am torn on how much lecture we should be getting from this course, I still see it as a great way to give us an advantage when applying for residencies. Furthermore, I am really excited about my own Capstone project [I’ll just say that it’s Social Media based!] and can’t wait to see what it becomes over the next 3ish years.
  • Medical Humanities
    I was a bit annoyed by how this course was graded last semester, but it has changed to an H/P/F system and the topics we have been discussing [Experience of Illness, Physician-Patient Relationship: Basic Skills, etc] are more applicable and interesting… so now I really do enjoy this course a lot more.
  • Art and Practice of Medicine
    This course is still a constant reminder of why I decided to put myself through all the grueling hours in front of a textbook or in the classroom. Last week we did a Neurological Examination [see! everything is integrated!] and we had a very informative Standardized Patient. It was a great experience. Also through this course we had real patient contact in our first semester!

Beaumont Hospital
Having been born at Beaumont, I am a bit biased on the subject, but that doesn’t change the fact that it is still the only level 1 trauma center in Oakland County and is consistently highly ranked nationally. It also has a great reputation as a teaching hospital [anyone I’ve talked to who did a rotation at Beaumont raved about how positive their experience was]. And all of the Beaumont physicians I have interacted with are extremely willing to take the time to help in any way they can [the residents, especially!].

Aside from how great the hospital itself is, we have our very own Clinical Skills Center at Troy Beaumont, which is modeled exactly like a clinic would be, but with extra gadgets such as video cameras to record our patient interactions for review.

Finally, another perk of being in a medical school with a designated hospital is that there is absolutely no question about where I’ll end up for my rotations. While students at most other schools have to enter into a lottery to determine where they’ll end up [and keep in mind that some of these clinical locations could be many miles away!], we know that we’ll be at Beaumont. No anxiety over a lottery for placement. Whew.

Faculty and Staff
I still find it incredible that the majority of OUWB faculty and staff are friendly, compassionate and 100% invested in our education. Where else will you find professors who are primarily concerned with teaching you? Not sure… but there aren’t too many places that can boast about this!

Student Organizations
I haven’t had many opportunities to highlight the student organizations already off the ground, but there are a bunch already. Not only do we have the best AMWA branch [Like us on Facebook!], ever [ha, I had to!], we also have Radiology, Surgical, Emergency Medicine and Anesthesia interest groups that are offering awesome opportunities for us to get hands-on experience. Plus, even though they don’t fall under the designation of a “student organization,” our medical student government [MSG] has represented our student body effectively.

Opportunity to make a difference
By joining OUWB at an early stage, you will have the opportunity to influence its history. You will mold the school’s future. Plus I’m always pleasantly surprised by just how quick the turnover for change is — sometimes we see a difference the next day.

As you can see, there are a lot of great things going for this school. Are there times when I am frustrated by how the newness sometimes translates into disorganization? Yes. But ultimately we are the guinea pigs — subsequent classes will definitely find things running much smoother. Furthermore, it’s almost impossible to find the “perfect” school — students will find something wrong regardless of where you go [this goes for more than just medical school!]. The most important thing is that the little bumps along the way have not changed my opinion of the school.

So, to all of you trying to decide where to call home for the next 4 years, the most important thing is to ask yourself is this: is OUWB the right fit for me? If not, look elsewhere. Otherwise, welcome to the family!

Day 175: Demystifying coffee beverages

Today’s inane image of the day:

My tower of empty Starbucks cups… [and yes, I decided to hop onto the Instagram bandwagon to spruce up my photos a bit].

Soon after I transferred to the University of Michigan I decided to get a job at a coffeeshop. I won’t say which one because I didn’t have the most positive experience there and things could have gotten better since I last visited. Anyway, I learned a lot about the different kinds of coffee beverages [it was a lot of fun making up new ones too] and thought that I’d share some of my knowledge. Here’s a run down:

Brewed coffee
The classic coffee beverage that pretty much everyone knows how to make. There’s not much to say on this…

Iced coffee
We used to use double the coffee grounds when we made the base for our brewed coffee, then just poured it over ice. So keep that in mind if you ever get iced coffee without the ice… it’ll really pack a kick!

Red eye
It’s called a “red eye” for a reason — there’s an added kick of espresso included with your brewed coffee. I personally cannot handle how strong this beverage is, but I had a regular customer come in every morning and order a large quad red eye [4 shots of espresso + 20 oz of coffee]… that adds up to a lot of caffeine.

These are are like an “upgrade” on brewed coffee — it is just hot water with espresso shots. I haven’t tried an Americano before, but now that I think of it, I might have to… by using espresso the coffee is fresher [plus I like the taste of espresso better]. I’ll let you guys know how this goes…

Café au lait (or Caffè Misto)
For individuals who have sensitive stomachs and cannot handle black coffee first thing in the morning, this is the solution — coffee with steamed milk. I used to love the vanilla soy milk at the coffeeshop I worked at and often made myself a soy café au lait [most coffeeshops use vanilla soy milk so keep that in mind if you’re trying to cut back on sugar or calories!].

This used to be my beverage of choice — espresso with steamed milk. When I first started frequenting Starbucks, I always got a tall nonfat vanilla latte. Well, that was a number of years ago when I could afford extra calories and sugar in my diet… so I gradually cut back on the number of pumps of vanilla then finally one day just cut the vanilla altogether. Now I enjoy the way lattes taste without the extra add-ins.

A Mocha is essentially a latte with chocolate sauce. Most coffeeshops get creative here since you can add a variety of different flavors [mmm peppermint mocha…] and mask the coffee flavor completely, allowing for quite a marketable product.

Iced latte
Still my beverage of choice in the summer — you start with ice, add milk then put the espresso over it. For anyone in warmer climates… this is the best way to cut milk calories out of your diet because you end up using less milk to make this [woohoo for ice!].

This is my current beverage of choice — espresso with half steamed milk and half foamed milk. I started getting cappuccinos when I wanted to find places to cut back on calories — although it doesn’t make a huge difference, baristas usually don’t use much milk to make a cappuccino which translates into a stronger coffee taste and less calories. I think this is the lowest calorie option my stomach can handle first thing in the morning!

I’ve never had one of these, but it’s espresso with foamed milk. Not sure why people enjoy macchiatos [it definitely is a European thing]… but I guess if you get a barista that really takes the time to foam the milk well then this could be a fun beverage [when you foam the milk you’re supposed to minimize the number of bubbles and get it to almost a whipped cream consistency… I was quite proud of my milk-foaming skills].

[FYI — the Starbucks Caramel Macchiato is essentially a caramel latte…]

Tea latte
This doesn’t actually have any coffee in it, but I loved making these — it’s just hot tea topped off with steamed milk. The most popular kind is a chai tea latte, but I’ve found that most places use too sweet of a base so I generally try to avoid them [unless it’s for dessert… then I ask for less chai mix]. My favorite thing to make was a soy earl gray tea latte with a little bit of almond flavor — it’s amazing!

Caffeine content
I think it’s important to know that the caffeine content in a 12 oz brewed coffee  [~250 mg] is significantly more than a 12 oz latte with 1 shot of espresso [~75 mg]. While it is true that espresso has more caffeine when you compare the same volume of liquid [say 1 oz of brewed coffee vs 1 oz of espresso], but usually you don’t drink 12 oz of pure espresso. So, the next time someone notes that you’re ingesting a lot of caffeine in your venti latte, tell them that it has much less caffeine than a tall coffee [~150 mg — keep in mind that a venti latte only has 2 shots of espresso in it!].

I think I covered all the major ones… let me know if i missed anything you were curious about!