Author: Amanda Xi

Day 207: Riding along

Amanda Xi

Today’s inane image of the day:

In Michigan, you never know what surprises Mother Nature has in store for the weather… I’m not complaining about this one though!

Expect a number of more interesting entries next week while I’m relaxing over Spring Break [only ~3 days left!] — in the meantime, let’s just say I’m trying my best to keep up with the material. Our second block [Cardiovascular] has been running swimmingly [the textbook is clear, concise and actually making for relatively good bedtime reading and lecturers have been prepared and enthusiastic], which has been a breath of fresh air in contrast to Neuroscience.

In other news, we are narrowing down the options for our Capstone projects. Lately, I’ve been picking up my activity over on Twitter through healthcare social media chats and in the midst of Sunday evening’s chat, I uncovered what I hope will be my focus for Capstone. Although I’m bubbling with excitement to get started, I probably need to submit an IRB proposal before collecting any data so the idea has been left to simmer and grow on the back-burner.

Last weekend, I volunteered alongside several of my classmates at the Cranbrook Horizons-Upward Bound (HUB) program to answer the participants’ questions about medical school. It was a wonderful experience that reminded me of how much I loved volunteering my time as a mentor/tutor in the Elementary Mathematics Laboratory program and working with middle schoolers while running the Engineering Club. I’m thinking about volunteering some of my evenings this summer with the HUB program… but we’ll see.

[Who’s excited for the iPad 3? I am!]

Day 203: Cardio experience prior to med school

Amanda Xi

Today’s inane image of the day:

As an undergraduate student in Biomedical Engineering [University of Michigan], we built a basic circuit to view EKGs — last week as a medical student, we hooked up the leads to this magic box [containing the circuit] and saw a beautiful signal. It’s so different on this side of things — instead of building the hardware, we’re just using it to analyze the waveforms.

Being in the midst of the Cardiovascular block has been a constant reminder of how much interaction I had with the field prior to medical school. My Senior design project “client” [the person we were building a medical device for] was an Interventional Cardiologist and through this interaction I had the opportunity to shadow him in the clinic and OR. It was an enriching experience to understand and watch stent placement through a single wire inserted in the thigh area. Already, technology has led medicine to a place where so much can be done through a single, small incision.

Last summer, I worked at Terumo Cardiovascular Systems on their heart-lung machine. This opened the doors to a completely different prospective; we were the diligent people trying to design, test and sell a medical device. In a way, I was on the starting-end of the device while physicians were the end point users [keep in mind that engineering is a cycle — there really is no true “end”]. I learned about the intricate details of how a heart-lung machine operates, how it is built in the factory, how it is tested for safety and how it can fail. Additionally, I learned how difficult it is to be a medical device company in the U.S. — FDA regulation is quite stiff [and for a good reason], which tends to result in many, many, many failed attempts to bring a product to market.

These two experiences really make me look like I’m preparing for a life in Cardiology. And to be honest, I’ve considered it. The heart is a magnificent organ; it’s essentially a glorified pump, but it makes sense. It’s a logical organ with a well-defined purpose. Not to say that other organs don’t make sense, but this particular organ system has always held a special place in my heart.

I’m sure you guys are getting sick of my discussions over specialties, but I think it’s fun to ruminate over every feasible direction I could go in. Anyway, time to get back to work!

Day 201: Summer after M1

Amanda Xi

Today’s inane image of the day:

[From earlier this week] Albeit beautiful on all of the bare branches around campus… the ice was quite scary to maneuver during my commute to school. 

The summer after M1 is well-known as the “last” moments of true freedom. After this summer, we will be busy with boards, clerkships, residency applications, and ultimately preparing to bear the weight of adding MD to the end of our name. As someone who has always loved filling my warmer months with academically-related or volunteer activities, I know that I could not just sit around and do nothing for 2+ months. But at the same time, I do not foresee applying for the most competitive of residencies and thus do not feel the great need to secure a research position in a particular field. Every summer I’ve ever known has been filled with some kind of need, whether it be classes or research or an internship or community service. But this summer, I have a relatively clean slate to work with.

Beaumont is offering 6 week long internships to us and I applied for one of those. But there are more of us applying than spots so there’s always the chance that I won’t be selected. Furthermore, even with the internship, there’s time to do something else — that’s where I feel lost. I want to do more research into the intersection of technology and medicine. I want to learn more about the business of medicine. I want to volunteer somewhere and actually apply my medical knowledge.

What to do? What to do?

Day 194: Professionalism

Amanda Xi

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

Amanda Xi

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

Amanda Xi
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

Amanda Xi

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

Amanda Xi

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:

Community/culture
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].

Curriculum
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

Amanda Xi

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.

Americano
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!].

Latte
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!].

Cappuccino
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!

Macchiato
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!

Day 170: Advice from my first semester of medical school

Amanda Xi

Today’s inane image of the day:

Love, love, love sunsets — beautiful ones really get me through the cloudy, miserable winter days.

Neuroscience midterm? Done.

After all those serious posts, I think it’s an appropriate time for a light-hearted post — so I present to you:

What first semester medical students should and should not do
Let’s start with the should not:

DO NOT wear your white coat in public places.
We all know you’re proud of your little white coat, even if it seems to be sized for a 10-year old. And we know that you want to let the rest of the world know that you’re a medical student. But while the white coat might be respected among the profession, it may evoke negative thoughts/feelings from individuals in public places. Say you’re walking into Starbucks to grab your morning cup of coffee. When the people behind you in line see your coat, these are some of the things that they are probably thinking: 1) Oy, another reminder that I need to go see my doctor; 2) I wonder how many strains of bacteria/fungi/viruses are on that coat…; 3) What is that reddish stain? IS THAT BLOOD? [even though it’s probably highlighter or red pen]; 4) Hmm, maybe I should have that “doctor” check out this hairy, discolored mole on my back…

In my opinion, white coats belong in the hospital or in settings where you are seeing patients. Not at the gas station, supermarket or Starbucks.

DO NOT pull unnecessary all-nighters.
I’ve pulled a couple of all-nighters in my time and while some were definitely justified, most of them were not. Sleep is a really important component of learning [too lazy to pull up a paper on this, anyone want to find one for me to back this claim up?] and general cognitive function, so why cheat yourself of it? THis is especially important as an M1/M2 because our sole purpose is to learn! Furthermore, as medical students in our pre-clinical years, we don’t have the excuse of being on-call or forced to work long shifts [though, I hear that’s changing? already changed?].

I personally would rather forego my favorite television shows and/or limit internet usage than a semi-good night’s rest [at least 4 hours!]. The plan is to get through at least M1/M2 without pulling an all-nighter [not only do they mess with my ability to think clearly, my tummy hurts after being up for 20+ hours].

DO NOT set your heart on a specialty [yet].
As you’ve seen from my discussions on specialties, I’ve considered a number of specialties within my mere few months as a medical student [anesthesiology, radiation oncology, clinical genetics… etc] and I still don’t feel any closer to a specialty. I came into medical school knowing that I wouldn’t fall in love with a specialty until after I rotated through at least a few of them, but I still wish I knew now. And I still don’t think it hurts to ask questions of the residents/physicians I interact with — after all, they can offer yet another layer of knowledge that you likely wouldn’t get from shadowing or rotating as a medical student.

Basically, keep your eyes, ears and options open until it’s actually necessary [i.e. not first semester… or second semester… or even second year].

DO NOT pile on the extracurricular activities [yet].
As an undergraduate, you were a jack-of-all-trades — you started an organization or successfully headed a legacy one. You volunteered at the hospital on a regular basis. You did research, attended conferences and maybe even got a publication. And you got stellar grades while doing all of that.

But in medical school, that all changes. It’s hard to put into words just how much stuff medical students need to cram into their brains within the first two years, but let’s just say it’s a lot. So much so that even just putting your sole focus on school may be just enough to pass.

Sure, there are definitely some geniuses in the mix that can somehow always do well AND get a full night’s rest AND do research AND know what happened on the latest episode of Grey’s… but they aren’t the norm. This being said, be careful about what you commit to within the first couple of weeks of classes — definitely get out there and go to a couple meetings for various clubs/organizations, but set realistic goals for extracurricular activities. Also, make sure to remember that you are first and foremost a medical student [you don’t pay 5-figures/year in tuition money just to participate in extracurriculars!].

Once you’ve gotten a feel for things, then start adding things [slowly].

DO NOT attempt to bring all or many of your textbooks with you to Starbucks/library.
If you’re like me and regularly reference textbooks for information, then chances are you purchased some or all of the textbooks on your “required” [many people get by without ever purchasing a textbook…] list. And if you’re like me, you really like to have everything you could possibly need within an arm’s length [i.e. your backpack is 3X your size AND you need an extra bag or two to carry other “necessary” things]. If these characteristics apply to you at all, then heed this advice: do not even try to bring even a fraction of your textbooks with you to where you plan to study. I’ve tried, and failed, many times [and I’ve probably ruined my back because of it!].

Instead, plan ahead and be realistic about what you’ll be able to get through in one sitting. Only plan on sitting at Starbucks for a couple hours? Then you probably won’t get through even a couple chapters of Robbins [1464 pages, hardcover… not fun to bring with you everywhere], let alone all of your Pharmacology/Anatomy/Microbiology lectures from last week that you haven’t had a chance to review yet. Choose a couple things you want to accomplish, try to triage things so that you bring the least number of books [and binders of notes] as possible. Plus, it’ll make you feel better at the end of the day to know actually got through a specific task instead of spreading yourself thin and setting unrealistic goals [that should be an entry of its own!].

DO NOT convince yourself that you’re alone in this process.
One of the most important factors that I considered when selecting a medical school to attend was the community. Did it feel supportive? Did it feel conducive to success? Did I feel like I could connect with my future peers? These were questions I asked myself and the answers ultimately led me to select OUWB. By choosing a school I felt comfortable in, I knew that when I started to despair about how impossible it seems to cram all of a 2 inch binder into my head, that I would have a great support network built from my peers.

But even if you don’t feel like you have that support within your class, when you’re feeling overwhelmed or tired or frustrated at your limited brain capacity, know that somewhere out there, there is another medical student that feels exactly the same way you do. Guaranteed, there is another human being just as stressed, anxious and scared as you feel. And I promise you that your thoughts had flitted through another medical student’s mind at some point in time. Basically, never forget that you are not alone. We all have our ups and downs, but we make it through. And even if things don’t work out for medical school, then chances are you have something else great coming your way — just be patient.

Hmmm… now that was a lot of what not to do… what can I do, anyway?

DO study. A lot.
The most important piece of advice I can give to any incoming medical student is not to fall behind. In order to do this, you really need to train yourself to study on a regular basis without the distraction of Facebook, the television, email, etc. Even if you can only unplug and focus for an hour, it’s a start. In the end, quality always trumps quantity — so 3 hours of “studying” with Facebook and 3 Google Chat windows open probably won’t be as effective as just 1 hour of focused studying. Make sure to maintain at least this baseline, and build upon it slowly. Soon enough, you’ll be a champ at this studying thing!

Keep in mind that things do come up — I found that various AMWA events could only be held in the evenings so I made sure to prepare ahead of time allowing me to be 100% at the event [and not floating off to the decussation of the spinothalamic or corticospinal tracts]. When Mike comes into town, I make it clear that we need to go to the library to study for at least a couple of hours in order to relax for the evening [after all, he’s in school too so it works for both of us], but sometimes I just take the whole day off and realize that it’l be tough to play catch-up later on.

In the end, just try to stay on-track and if you veer off for a couple of days, know that it happens to the best of us and try to get back to your regular study schedule ASAP.

DO shower regularly… especially right before the exam.
This is pretty self-explanatory. Be cognizant of your peers in the examination room…

DO incorporate regular physical activity into your schedule.
As I’ve mentioned before, maintaining your own health is very important. This and the one below it go hand-in-hand, but let’s focus on the physical activity part first.

I know it’s difficult just to get started on a regular exercise regime without the stress of medical school over your head, but try to set yourself up for success by enlisting a partner in crime, switching up your routine or participating in IM sports teams. I personally like to exercise on my own, but until I got into the habit of forcing myself out the door, I made a lot of great excuses just to put it off. I have to study. I have homework to do. The weather is bad outside. The list goes on…

In the end, it’s up to you to take care of yourself. You’ll reap the benefits from 30 minutes of physical activity each day [even if it’s 10 minutes, 3X during the day] — I can say that after I finally got over the initial hump of regularly exercising, I noticed that my energy levels increased and I felt a lot more emotionally stable [even during stressful times!]. It really makes a huge difference.

DO try to maintain a healthy diet.
Anyone close to me can tell you that I absolutely love fried carbs — chips, donuts, elephant ears… I love it all. And when it comes to exam time, you will find me munching away at these empty calories. I admit, it’s a bad habit and I’ve been working on kicking it.

On the other hand, I’ve been packing healthy lunches for myself each day and found it’s a lot harder to ruin healthy eating when all you have to eat are “healthier” things. This means packing veggies, fruits or whole grain snacks like low-fat Triscuits [and only a single serving!]. It can be difficult to keep this up, but if you’re able to keep this up for even a week or two each month [leaving a week or two for exam-stress-eating… yes, we all do it!], it could make a huge difference in the long run.

DO talk about concepts/ideas with peers.
Not only will you benefit from reinforcing your own knowledge, you will also be forging a relationship with your peers. Especially in larger medical schools when it’s sometimes hard just to get to know your own class, by using the excuse of talking about school-related things, you are getting to know more people and expanding your network.

Since our class has only 50 people, we all know each other… but I do find myself learning more about my peers as time passes.

DO make a serious effort to keep in touch with your family and non-medical school friends.
It really pays off to keep up with the world outside of the medical community. As it is, our community can be — and usually is — overwhelming. There’s a lot going on, at all times of the day. But by cutting yourself off from the rest of your non-medical world, you’re depriving yourself of the opportunity to step outside of it all for a breath of fresh air. I personally find that the rare opportunity to talk about topics completely unrelated to medicine [and school] is crucial to my well-being. Conversation on my part usually steers me right back into medicine, but listening to what’s going on in the life of a full-time engineer or graduate student or teacher is a nice way to peek outside for a moment [that is, before running back into my study room to bury my head into lecture notes!].

DO take things one day at a time.
As a compulsive planner, this was hard advice for me to swallow [not sure I’ve swallowed it completely yet, either]. I still find myself trying to plan for things many years down the road, only to feel frustrated that there’s really nothing I can plan much further out than the next week or so. Sure, I still have a forecast of where I’d like to be in X years, but you don’t know what you’re going to get with the boards or residency match [or life in general] or whatever comes afterwards. This is what medicine is. This is what life is. I’ll try as much as I can to forge a path in the direction I aspire to, but in the end, I need to focus my energy on making today the best that it can be.

DO celebrate your accomplishments.
Whether it be through a quiet night cozying up with a book or your favorite television show, a night in with your significant other, or a night out on the town with your friends, make sure to take some time to celebrate what you’ve done. Every tiny accomplishment brings you closer to your larger ones.

Sometimes if I feel discouraged by an unproductive day, I sit down and make a list of all the little things I completed during the day [laundry, dishes, listening to X number of lectures, gym, etc] and it reminds me that usually the day hasn’t been a complete wash. If I find that I’m unsatisfied with my list, then it usually motivates me to get other stuff done, or realize that I needed that time off [like today… I am exhausted, so I don’t feel particularly guilty about my lack of productivity].

What do you think of my list? Do you have any additional things to add?