Shadowing

Now that school is out for the summer, we have taken to the clinics to see the local professionals in action. Job shadowing with a doctor permits medical students to learn by observation.

Job Shadowing

As I stood in the exam room, listening to the physician taking a history and performing a physical, I was impressed at how much I had learned from my first year of medical school. The terminology was not completely foreign and the medical principles behind diseases were still in my retrievable memory.

TUN students are responsible for shadowing two physicians for a period of 24 hours each. In an effort to cut down on wasted rotations, I chose to observe a gastroenterologist and an anesthesiologist. Despite some interest in their professions, I do not currently expect to choose either specialty, yet I continue to have an open mind towards both.

Thus far the experience has taken me to both clinic and operating room where I observe the doctor's responsibilities and techniques. Occasionally, the physician would surprise me with questions (known in medicine as "pimping") which often catch me off guard. If I can pull the answer out in a split second I feel pretty good, if not, they usually answer the question for me. That said, I find myself studying at home in between visits to prepare for my next pimping session.

Clinical Corner

Shadowing

My clinical preceptors have been fantastic, offering opportunities to educate and learn, they offer more to learn about their fields of practice than a book possibly could. To gain the most out of this experience, I would have appreciated a little more advice from our faculty. For what it is worth, I am listing some job shadowing tips. As usual if you have additional thoughts, please share.

• Set Appointments Early - Contact your preceptor early to set up shadow experiences (especially if it is a class assignment), there is greater flexibility and secretaries have little empathy for those who wait until the last minute
  
• Dress Professionally - This is a "no-brainer" but unfortunately there are some who do not
• Arrive Early - Plan to show up at least 15-30 minutes early, in the event a preceptor starts early or has time to talk it will be to your advantage
• Research the Position - Know a little about what your preceptor does and the educational ladder to get there before shadowing
  
• Questions - Do not overburden the preceptor with questions and carry a card to write on when they are busy performing their responsibilities so you can ask questions at more opportune times...nevertheless, ASK QUESTIONS, you are there to learn
• Shadow - Unless they ask you not to follow or copy them (hand washing etc.) you are there to experience it, do it too
  
• Study - If you have multiple days to follow a preceptor, take the time at home to study relevant terms, cases, diseases or ideas that you observed in preparation for the next visit
• Be respectful - Be nice to the other staff in the office and the patients or clients you work with, you never know when you will see them again
• Show Gratitude - Everyone deserves your appreciation for the opportunity, share it verbally and send a simple note of gratitude once you have completed your experience
  

Things I Wish I knew - First Year

After becoming a second year medical student two days ago, I looked back at the last year and gave each week a point value between 0 and 10 signifying my interpretation of medical school intensity where 10 is the greatest. Low points were often vacations (with the next few weeks prorated) and tallest peaks represent block weeks. Call me a geek if you will, but I think it's pretty cool to see the year in graph format.

Things I Wish I Knew

This last week of exams was not difficult academically, but was more so in anticipation of summer break. With one year behind me I have come up with a list of things I wish I knew before my first year of medical school.

1. Not all the textbooks were necessary - In addition to presentations and notes, the textbooks added a valuable resource, but there was simply not enough time to read every assignment. Occasionally, books were not even used. Contact current students and find out what they recommend. If possible, get used or discounted books. Often times they will already have markings of the material that is important and you save a little money too.
2. Much of the day is spent sitting - Time management is crucial to success. With excessive amounts of lecture and self study, there is little time to exercise. Elbows become sore and dry from hours at the desk, the back sore from pore posture, and the neck aching from constantly looking down. Exercise can be difficult to fit into the rigorous schedule, and it will make a great difference if included on a regular basis.
3. Organizing study habits takes time - It seems like a moot point because most people who get into medical school have some experience in studying. As one who has never used a laptop during class in undergrad, it took some time to learn how to organize my notes. When I realized that wasn't for me, I had to move back to paper. Transitioning between school and home is a challenge that requires attention. Having specific times dedicated to studying and following them will help significantly. Do what you are comfortable with, and most importantly how you learn best.
4. Associations are everywhere - At first it seems like you are struggling to get the fire-hose out of your mouth as far as information goes. Whether it is anatomical structures, terminology, or concepts it can quickly become overwhelming. For example, if you have experience with a condition you are studying (clinical, family or friends), it makes it a lot easier to remember and understand. Making associations to things you are familiar with personalizes the same message in a way you can comprehend.
   
5. Get involved - At first it was hard to imagine that there would be time to do anything but read. Initially, I was going to avoid the groups and activities until I could handle more which was not wrong thinking, and permitted proper time to habituate. Study groups are vital to bounce ideas and thoughts around. Student organizations are a great way to participate in community events and gain more experience. There is no better time to become a team player than in your first year class.

I am but one medical student in the sea of many. If you have something you wish you knew before your first year of medical school, please share.

Healthy Aging

As the semester and first year of medical school draw to a close, appropriately, we discuss the subject of aging.

Getting Older

Like a phenomenal French cheese or a well conditioned antique, aging carries a subtle tone of refinement. Unfortunately, with that comes the breakdown of tissues and a host of systemic problems. Despite being relatively young in years, it's nice to be growing older in relation to my education. I can certainly feel the tissue breakdown as my waistline and muscles tend to have a little more "give" than before. As for the systemic problems, neurologically I may have more stored away, but my brain has never been more ready for a break.

As depressing as the subject can be at times with all the diseases and disabilities that come about, there is still something to be learned. One fascinating discussion we had related to memory loss. When we learn something for the first time neural connections are made or activated allowing a short term memory to become long term. The circuitry is very susceptible to damage from a lack of oxygen or corticosteroids, which accompany increased levels of stress. That's when the light turned on above my head, "no wonder why I can't remember anything, too much stress and not enough fresh air." Well I am happy to announce, we only have one more week of educational stress and then a summer break to get the much needed fresh air.

Clinical Corner

Healthy Aging

"Use it or lose it." Eating right, regular exercise, and intellectual stimulation are exceptional ways to keep your body, mind, and spirit fit as it grows older. There are many problems that could be avoided if we simply worked hard to keep fit. Along the way we will incur our bout of troubles, but if we play an active role in our health today, tomorrow will be that much better. For more information on this topic visit WebMD's Healthy Aging Guide.

Kidney Health

What do acids, bases, filtration, resorption, and secretion all have in common? If the title and image have not already given it away, they are crucial components of the kidney's functioning.

Renal Physiology

From that glass of lemonade to micturition, we have most recently explored the kidneys down to the smallest functional unit, the nephron. Understanding how it all works can be complicated and at times convoluted (pun intended...for those who are kidney junkies). Fortunately, the internet is full of wonderful teaching aides and notes on the subject.

• Kidney Function - Flash tutorial that shows the absorption and secretion of various substances
• Mechanical Nephron - A digital video approach from the University of Hawaii
• Drawn Physiology - A collection of visual mnemonics

Although they are somewhat daunting, kidneys make sense, if studied enough. "Where sodium goes, water follows," and with that little phrase you have a lot of the kidney solved. Just make sure there is enough water in the system to begin with.

Clinical Corner

Hydration

Our bodies are composed of a majority of water, yet we don't replenish it often enough. Drinking 2-3 liters of water each day is a difficult task, but when we lose so much throughout the day it is important to replace it in order for our bodies to function properly. "Pee pale" is a suggested line that implies getting enough clear fluids so that the urine is less concentrated. This ensures a well hydrated body that can filter waste products, run vital molecular reactions, and maintain optimal health. So the next time you are about to order a fountain drink, get a water instead, your body will thank you.

Student Organizations

With the latest public health scare, swine flu, people are taking drastic measures to avoid exposure and in some cases society. There is no need to show up at work or school in your bio-suit yet.

Medical Student Organizations

I am certainly not avoiding the masses, at least not those that get together at school or in the community. As the first year of medical school comes to a close and the second year students are graduating from the classroom setting, each organization has to pass the torch to next year's student officers.

Organizations range from student government and class officers to a smattering of specialty interest groups. Recently, I was voted into office as secretary/treasurer of both the TUNCOM a cappella singing group "in TUN" and the "Emergency Medicine Interest Group." With the course load I anticipate next year, preparing for board examinations, and my involvement in another handful of groups these positions suit me just fine.

In preparation for residency programs, many students incorporate a variety of skills to better their curriculum vitae. Participation in student organizations provides opportunities for leadership, community service, and an unique way to learn a new skill or interest. Officers and members of these organizations build skills that are valuable in residency and future careers. Holding leadership positions, however, build a student's CV for the upcoming residency interviews. The bottom line is, get involved. Just like going from college to medical school, they will be looking for diversity and experience.

If your school doesn't have an organization that you think would be helpful, start one. Not only would you be a member, but you could be the founder too. If you are looking for organizations outside of school you may consider the Red Cross or Medical Reserve Corps for opportunities to get involved in your community.