Author: Amanda Xi

Day 234: Ready, set, Cardio!

Amanda Xi

Today’s inane image of the day:

This was the view from Starbucks when I was in California… definitely was a fan of the palm trees and mountainous horizon!

Not quite sure if my title makes much sense, but hey, let’s just go along with it. Alas, the last week+ has been filled with EKGs, pharmacology and trying to determine what I don’t know. One of the hardest things to adjust to [at least for me] has been the fact that I can never really know what to expect. With this exam being an NBME one, at least I know these are standardized questions that are unlikely to test minutiae that appeared in one slide and diseases that only affect 1 in 1,000,000,000,000 individuals [just kidding — our exams have never been that bad] [plus, I think the Boards actually like those diseases because they’re more readily identifiable and thus, testable].

We have our Anatomy Practical Examination today and our Final Exam on Friday. Hopefully, all goes well!

On another note, a popular topic around the blogosphere has been about maintaining an online presence as a medical student. I hope to expand on my own views in the near-ish future [don’t expect this website to be taken down anytime soon!], but I’ll leave you with “5 Reasons Mind on Med Won’t Disappear for Interviews,” “My Social Media Manifesto,” and one of my favorites, “Pioneering Unchartered Territory.”

Happy Tuesday!

Day 224: Unseasonal

Amanda Xi

Today’s inane image of the day:

I went to San Diego for an evening during Spring Break to avoid this scene of gloomy, overcast skies. At least there were palm trees and was a gorgeous body of water outside of our window! 

I have so many ideas for future entries, but have been out and about enjoying the beautiful weather [70s all week and sunny!] and mingling with some awesome admitted students [last week was Second Look Experience] that I haven’t really had a moment to sit down at my computer and write.

Our Cardiovascular final exam is creeping up so it’s time for me to ramp up the studying. There are a number of factors that are different for this exam: 1) it’s our first cumulative final exam; 2) the questions are written by the NBME [they also write the USMLE]; 3) it’s on the computer [since they are NBME questions, they can only be accessed through their online system…very much like the boards!]; 4) it’s on a Friday [historically, our class has used the 3 day weekend before an exam to cram… now, that option is no longer available].

Anyway, back to the pharmacology [did you know that one side effect of ACE inhibitors that some patients may not tolerate is a cough?].

Day 216: Breaking the cycle

Amanda Xi

Today’s inane image of the day:

I always tell myself that I’m going to cut back on the Starbucks… and what better time than Spring Break? Well… then the problem of productivity arises and I end up sipping my favorite coffee beverage over my lecture notes. 

By the winter of each academic year, I find myself losing my motivation to be in school. When November rolls around, I just want to make it to break so I can replace academia with [fun] reading, catching up with old friends and quiet time to myself. Yet, midway through winter break, I am antsy to get back into the grind of school; I start to feel the excitement of starting a new semester of material, places and faces. Once classes start up, the feeling quickly wears off along with the treads of my shoes as I trudge through the snow to class. Novelty morphs into mundane and by February, the cycle starts all over again.

Throughout college, I was under the impression that medical school would break this cycle. I thought that by making it to this point, I would love learning about everything and thus the motivation to study would never be an issue. Surely, medical school would be different!

Well, I wasn’t entirely wrong — instead of breaking the cycle, I seem to be settling into a new one. I didn’t lose my motivation last November, despite my difficulty with exams [sort of]. My drive to keep studying even stuck around through most of January. But somewhere between then and now… it dissipated. I suspect that the stress of Neuroscience never had a chance to resolve because we took our final then dived right into our Cardiovascular block. Either way, ruminating over why I feel this way doesn’t really help me with the issue at hand now: I am tired and unmotivated.

My spring break has been filled with a lot of sleep and minimal studying, yet the thought of returning to school on Monday for the home stretch really frightens me. I am well-aware of the fact that the rest of my life will be filled with work — this is medicine! But everything following M1/M2 is a different kind of work. Instead of reading about the cases, I’ll see them. Instead of spending endless hours at Starbucks, I’ll be at the hospital [heh, except there’s a Starbucks in the hospital so I may still spend endless hours at Starbucks]. I am excited for clerkships… but a lot of books, lecture notes, exams and the Boards stand in the way [with good reason, of course].

Regardless, I know I’ll conjure up the motivation to get through this, but I think it’s important to document these moments to look back upon someday.

Do you have a cycle? Have you found a way to break free from it?

[Happy Match Day!]

Day 209: The digital world is a huge distraction

Amanda Xi

Today’s inane image of the day:

If only this photo could show just how worn down my keyboard is… 

The problem: internet/technology is a huge distraction and time warp
More and more, I’m finding that the urge to check my phone or computer for the latest updates on Facebook, Twitter or my favorite blogs is impossible to overcome. I always tell myself that I’m going to close my laptop and switch my phone to silent while I study, but when the inevitable need to look up an unfamiliar term or find a better explanation for a concept comes up, so does my laptop cover. At that point, I decide that it can’t hurt to check up on at least one of my favorite sites for updates… only to find that an hour has been wasted on the latest from my Facebook news feed or refreshing my Google Reader for new updates from Wayfaringmd or Dr. Grumpy.

This is what our generation grew up with
When my family got our first computer, I remember spending every evening tinkering around the settings, instant messaging my friends that I had seen only an hour prior, or discovering the infinite depths of the internet. The world was literally at our finger tips… all we had to do was apply pressure to a specific pattern of keystrokes and we could get the latest news, relearn how to knit, or even figure out how others were getting into medical school. Anyway, the point is that as I matured, so did the internet and the technology that can be used to access it… making it something that our generation grew up with.

A semi-recent study shows that the current generation would rather text rather than talk — admittedly, I fall into this category because many times it’s more convenient to do so [imagine sitting in the silent reference room of a library and you have to ask someone you’re studying with a question — definitely more appropriate to use instant messaging/text] or the question is so small that it wouldn’t warrant a full-blown conversation [are you wearing business casual for tomorrow’s event?]. But in the end, yes, I am more comfortable sending a text rather than chatting over the phone.

An interesting NYT piece, “Growing up digital, wired for distraction” really delves into the issue I’m facing now: “…computers and cell phones, and the constant stream of stimuli they offer, pose a profound new challenge to focusing and learning.” This. Exactly. The scariest part of all of this is that medical school doesn’t really forgive these kind of distractions — in order to keep up, we need to find fail-safes to avoid being sucked into the time warp. If we do not overcome this challenge, then we may find ourselves facing more bumps in the road.

What has been done
I’ve considered trying to unplug from everything as one of my favorite physician bloggers, Wendy Sue Swanson [Seattle Mama Doc] did during her online sabbatical, but it isn’t the most realistic thing for me to do at this point [Facebook has been an important medium for our class to exchange important information, alert each other of upcoming deadlines, etc]. Furthermore, I am just starting to discover and gain traction in healthcare social media communities, so leaving would feel a lot like taking two steps backward.

Another way to address the issue is by blocking specific websites for a period of time. One tool I found just by Googling “block sites for studying” is an add-on called “LeechBlock” for the Firefox browser. I don’t use Firefox, so this wouldn’t really help me. On the other hand, the site “Hack my study” contains a browser-specific tutorial for blocking sites. This seems like something I will probably have to use in the future.

Where to go from here?
One of my favorite non-medical blogs, A Cup of Jo [she’s a Michigan native, too!], recently posted this article asking readers if we really are as busy as we think. The idea is that we actually exaggerate how busy we truly are [claiming to work 80 hours, but in reality it’s actually less than 60; claiming to sleep only 6-7 hours/night but really sleeping more than 8, etc] and don’t realize what we are really doing with the 168 hours we have each week. The way to resolve this issue is by keeping a time log — similar to a food log for those of us on diets. From there, it becomes glaringly obvious that a lot of our time isn’t spent on high priority tasks.

Right now, I am not in such a terrible position that I cannot buckle down and study when I need to [yes, I can study for hours without checking my laptop], so I don’t plan on doing a complete online hiatus. On the other hand, I will probably turn to these drastic measures come this time next year when the Boards will be looming. But I do think it might be telling to start a time log [I’m start by trying this program] and assessing where I could optimize my activity. Even if it doesn’t lead to a drastic improvement in time-management, at least it’ll be one way to see how I’m spending my weekly 168 hours. I’ll keep you updated on the numbers.

Do you feel like the digital world is a distraction? What do you do to alleviate the problem?

Day 208: International Women’s Day

Amanda Xi

Today’s inane image of the day:

This year’s theme: Connecting Girls, Inspiring Futures

I don’t remember exactly how I stumbled across this, but I saw it and thought it would be interesting to try something new. Gender Across Borders and CARE are hosting this online event — I encourage you to check out their websites.

Anyway, the question I’ll be musing over is: How can we, as a culture and as members of the global community, involve, educate, and inspire girls in a positive way?

Here are a couple of my [rather jumbled] thoughts:

I attribute much of my success to always having strong role models and mentors to look up to — my parents, teachers and professors have all contributed tremendously. Thus, I believe that by connecting young women at an early age to an invested mentor, we can make a positive impact on young women. Furthermore, I think it’s imperative that we expose girls at an early age to women who are successful in STEM [Science, Technology, Engineering and Mathematics] fields — I have written before about how few women pursue science-based careers and I will say it again: it’s maddening that there are so few women in science. Anyway, I digress.

A huge issue that young women face is that of body image. We all went through it at some point in our lives and many women still struggle with it today. I personally remember how tough it was to be a pre-teen or teenager at the mall — left and right there are images of women who have been airbrushed and cropped to a size that is either underweight or right on the bottom border of a healthy BMI. Or even just watching television — everyone always looks glamorous with perfect make-up and exotic hair styles! How can we try to address this? Well, how about by reinforcing what healthy really means (eating right, staying physically fit) and discussing how beauty is in the eye of the beholder? Maybe by having these dialogues early on, we can veer young women away from eating disorders and other damaging behaviors.

I also believe that acceptance is key — exposing young women to non-judgmental individuals allows them to grow and discover things they are passionate about. When I’m expressing my thoughts to someone, I am always searching for a reaction, and if my words are met with a disgusted or disappointed expression, I tend to take it personally. When I was younger, many of my actions were directed by these responses, which leads me to believe that it’s vital for girls to be surrounded by other open-minded individuals that can guide them.

Ultimately, girls need supportive, devoted mentors that are invested in their success and that’s where we fit in as members of the global community. All it takes is a couple hours a week to connect with  a young woman — in the end this small investment will probably make a huge positive impact on her future.

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!]