This is ZDoggMD's standup medical comedy from the Mel Herbert’s Essentials of Emergency Medicine 2011. Lame and offensive…well, you really haven’t seen nothin’ yet.
You'll want to notice how ZDoggMD riffs on his students... Now that's just not nice.
Part 1
Part 2
Thoughts from the interview trailFinally the interview season is wrapping up. Here are 5 points to emphasize before embarking on the path to the rank list.
1) Interviews are more exhausting than you might originally think.
It takes a lot of work to put on your "game face" for 36 hours, to make sure you don't say anything inappropriate and to think of insightful questions to ask so you don't look disinterested. Be careful when planning your travel schedule to include time for rest, as a tired interviewee comes across as boring and unenergetic, traits which stellar board scores can never make up for.
2) If you don't enjoy the residents or attendings at an institution, perhaps it just isn't a good fit.
Don't be too hard on yourself. If you're miserable at work, you will not be academically productive and your patients will not get the care they deserve. The best team is a team with excellent work relationships, and though in your head a program might be your top choice, perhaps you will be better off in the long run somewhere else.
3) There's no reason to be nervous.
Most interviewers these days just want to get to know you. Occasionally one will put you on the spot or ask tricky questions. You can prepare for the typical interview questions by pondering them ahead of time (things like "what was your biggest failure?"). The unexpected interview questions like, "what is the therapy for recurrent acute myeloid leukemia?" are likely questions other students would struggle with too, so just be humble and move on rather than letting one question destroy the whole conversation.
4) Some interviewers are quiet and difficult to talk to.
Perhaps this is the way they are typically or perhaps you just don't have much in common with the interviewer. A solid strategy at this point is to take control of the conversation by bringing up topics that augment your applications, either academic or personal. Perhaps if you've done a lot of travel, you might ask "are there opportunities for residents to do international electives?". Or if you're strong in research, perhaps you could ask, "what are the research opportunities like here?".
5) Be confident. You might think you don't deserve the interview or are concerned about matching, but they brought you in for a reason.
If you're at the interview, you're qualified to do the work. At this point they want to see if you will be a good fit for their program, a program which they have worked hard to build and which they have big dreams for the future. If you're a part of that future, they will be interested regardless of your board score.
One excellent and very detailed book to check out is, "The Successful Match: 200 Rules to Succed in the Residency Match" by Dr. Katta and Dr. Desai.
Best of luck to everyone going through the match. Please feel free to comment, as discussion makes us all better.
Leo Babauta Breaks Down The Art Of FocusFor those who have tests looming on the horizon, I thought I would post some tips on achieving zen-like focus. I often find that my focus falls far short of zen-like, so I decided get help from a professional. Leo Babauta is the founder and author of ZenHabits.net, one of the Top 25 blogs in the world.
Here's what he has to say about increasing focus:
I confess to being as prone to the distractions of the Internet as anyone else: I will start reading about something that interests me and disappear down the rabbit hole for hours (even days) at a time.
But my ability to focus on a single task has dramatically improved, and that one habit has changed my life.
While a few years ago I couldn’t sit down to work on something without quickly switching to email or one of my favorite Internet forums or sites, today I can sit down and write. I can clear away distractions, when I set my mind to it, and do one thing. And that changes everything: you lose yourself in that task, become so immersed that you pour everything you have into the work, and it becomes a meditative, transformative experience. Your happiness increases, stress goes down, and work improves.
I know that lots of people have trouble focusing one one task for very long, and so I thought I’d share a few things that have worked for me.
There is no one way to find focus, but what works for me is to clear everything away and create a little space of tranquil focus. Some tips for doing that:
• Close the browser and your email program. If you need to work in the browser then make sure no tabs or windows are open other than the one you absolutely need.
• Turn off all notifications. Trying to focus while something is notifying you of an incoming email or tweet or Facebook update is impossible.
• Turn off the Internet. Shut off your connection, unplug your router, or best yet, go to a place where the is no Internet (yes, those still exist). This is the absolute best way to find focus.
• Close all programs and windows other than what you need for this one task.
• Have a very important task to do. Not just “check email” but “learn today's lecture on lung disease” or “write that kick-ass blog post I’ve been planning” or “write that new Android app”.
• Clear your desk. No need to spend all day on this — shove everything in a drawer or put it in a box to be sorted later. Don’t fiddle with this now. In fact, don’t fiddle with anything — don’t worry about the perfect study setup or perfect notebook for writing or the perfect anything.
• Plug in the headphones. If you have people around who might distract you, wearing headphones and playing some good, peaceful music is perfect.
Once you have this environment (and you shouldn’t spend more than a few minutes setting it up), get going on your task. Do nothing but that one task. Don’t switch to another task.Having trouble doing that?
Read on.
How to Increase Your Focus Abilities
If you can’t focus on one task for very long, don’t worry. That’s normal. Our brains have been trained by technology and society to switch tasks often. One way we’ve been trained is that switching to check email or Facebook/Twitter is rewarding — we are rewarded with a little nugget of satisfaction in that someone has sent us a message (social validation!) or we have something new and interesting to read (shiny and bright!). Switching tasks becomes a positive feedback cycle that is hard to beat by single-tasking.
The way to beat that is to set up a positive feedback cycle for focusing. Here’s how:
1. Start small. You only need to focus for one minute at first. Clear everything away, pick your one important task, and just do it for one minute without switching. This is hard to do in the beginning but if you consciously focus on focusing, you can do it. It’s just a minute.
2. Reward yourself. The reward for focusing for one minute can be one minute (or 30 seconds) of checking whatever you want. Email, Facebook, whatever. Or get up and take a one-minute walk. Stretch, drink some water, massage your neck, enjoy your small victory. Empires are created with small victories.
3. Repeat. Keep doing one minute focus, one minute reward (or 1 minute to 30 seconds if you like) for about half an hour (15 of each). You’re done. Repeat that later in the day. Rejoice in how much work you got done! And notice how you’ve set up a positive feedback cycle for focusing.
4. Increase in small steps. Tomorrow, make it two minutes on, one minute off. Repeat that for 30 minutes, do it later in the day too. Feel free to go wild and do three focus sessions in a day if you like, but it’s not necessary.
5. Keep taking baby steps. I think you can see the pattern by now. Make it three minutes on, one minute off on the third day, then 4:1, then 5:1. When you get to 10 minutes, be crazy and take a 2 minute break. When you get to 20 minutes, take a 3 minute break. At 30 minutes of focus, you’ve earned a 5 minute break. And once you’re at 30 minutes, you can stay there. No need to become a monk.
Set up a positive feedback cycle for single-tasking focus and you’ll reverse the years of training your mind has gotten to switch tasks. You’ll get more important work done, and it won’t seem hard. You’ll find that focus becomes a form of meditation. It’s a beautiful, beautiful thing!
Share This Post tagged Exams, Focus, Inspirational, Interview, Motivation 
A personal yet rational case for the pursuit of the moon, and stars... and throw the asteroids in while we're at it. Heck, wrap it all up for a "to go" order. I can’t push these questions out of my mind.
They seem to invade my skull with a fervor that can only be explained by the fact that the answers will determine what my future life will hold.
Will it be a life defined by passionless work, constantly feeling out of kilter in an environment that just wasn’t quite made for me? Will it be the romantic visions I indulge in of a man on a mission in the heart of a wild land, with an invaluable skill and zeal to match, righting the wrongs in a forgotten corner of the world? Will it be relegation to a large grey building filled with sick and dying people who in many cases won’t lift a finger to help themselves, but frustratingly expect to be cured by modern wizardry and a pill? Will it be the life of a nomad, drifting from here to there; in and out of towns and countless lives, cursed with an incurable nomadic soul? Perhaps the life of a key-clicking storyteller will be mine. Writing the stories that deserve to be told of the unsung hero, the underground hero that deserves recognition and a face.
These are the questions that have been floating through my cerebral cortex of late. They will not go away, they will not improve, I cannot banish them from my thoughts.
Some people seem at ease living a life unexamined. I cannot indulge thusly. I need my existence to mean something. I need my action to be meaningful and deliberate. I need the possibilities to be endless. I need to believe that I can be passionate about how I am living NOW and not just scraping for a grade, which will POSSIBLY eventually lead to a small measure of meaning. I need to be on top of my game and in the moment and full of the rapturous joy of living. Pain? I can handle it if an end is in sight. Disappointment, I can weather it if I am convicted of my cause. Grief, I can bear it if I see the purpose in it. What I cannot abide is an endless number of days filled with a transient existence… mere platitudes in exchange for a real life of weight and substance.
Money is fun, yes, but past what is needed to maintain some semblance of comfort it matters little me. I hold this view principally because I have little of it, if I possessed a fortune my tune would doubtless change. That very fact is a good reason to steer clear of fortunes. Money. That pitiless taskmaster under whose whip so many voluntarily bows their heads. That alter upon which so many sacrifice their souls and lives.
Some would call me a gambler. Willing to risk the safety and certainty of a “stable” and “responsible” choice in lieu of the moon. “The paradigm you seek is unattainable,” they say. “The reality you pursue is not measurable or concrete in a way that we agree with, and it makes us uncomfortable,” more accurately reflects the sentiment.
I am not lauding the senseless disposal of resources into that most heinous of bandits in need of a prosthesis, but at the gamblers heart is not evil. That misguided soul has hope, albeit of a gnarled and mangled fashion. They would turn nothing into something, if they had their wishes. All the gambler’s underpinnings are not sordid and ominous. They possess the ability to lay things of importance down, to detach themselves from the sure thing in pursuit of the dangling possibility. A gambler is really an entrepreneur, gone wrong.
To harness that talent means to be a successful investor, to over-indulge and misalign that same gift means to fall into that certain and stealthy abyss. Addiction or passion? The wafer thin wall that separates the two is often nearly translucent. That may be why so many won’t allow themselves near it, for fear of breaking through.
Passion is a strangely amorphous, yet universally desired, commodity. It as been directed at nearly every conceivable endeavor from the seemingly mundane act of button collecting to such adrenaline-drenched pursuits as hurling one’s body from a ledge wearing naught but a glorified sheet stuffed haphazardly into a backpack. The domicile of this enigmatic feeling is often hard to predict. It can spring up and take root in nearly any soil; no matter how seemingly desolate or blank the slate appears. Passion is also desired by nearly all humans, but in spite of all these favorable characteristics, this most sacred of grails is a painfully scarce commodity.
I am going to hazard a wager. My wager is this: that nearly every singular activity at which a passion has been directed throughout the whole of history could/ has/ or will be molded into a monetarily feasible proposition. Creativity and ingenuity will be required, more in some cases than others, but the POSSIBILITY is there to turn nearly every activity or passion into a business model.
Now I will take that last paragraph, blind fold it, and turn it loose in a different direction. Can a person find something they are passionate about doing, an activity that drives them to pursue perfection unharried, in virtually any existent professional circle? It is an interesting question to be sure.
Sadly, medicine has one of the greatest potentials of any professional to be a soul sucking passion-sink. I have been a first hand observer of this throughout my life. My family is somewhat of a medical mafia family. The strange customs and rituals, the secretive and enigmatic lingo, the bleeding together of home and work, the all consuming nature of the "family business," and even the fact that a lot of blood flows in the course of doing business... all similarities between my medical family and the mob.
I HAVE seen many family members use the profession as a means to do great good, while preserving and USING their external passions to do so and I laud them for this ability. I have also seen people in my family loose themselves, their spark, their drive and passion, because they pursued medicine instead rolling the dice on a dream.
If one is going to "do medicine," without losing their soul... it is going to be a no-holds-barred royal rumble. It is not a profession that generally rewards the balanced individual. The individual that seeks a medical career, but also desires a sane lifestyle. People that work a normal amount of hours or try to work more efficiently are often viewed as being a slacker (I am experiencing this first hand as I try to keep balanced during first year).
In the established medical system, the gambler is wholly vilinized. Keep your head down and follow the protocal. Don't make waves. Don't suggest a good idea to an attending or you'll be singled out for a good old fashioned pimping. Work harder. Whether you are working smarter or not is of lesser importance. Give up your hobbies. Be consumed by the profession. Cover your ass in lieu of making the objectively correct decision.
These are generalizations sure, but too often accurate ones. The really sad thing is that many times the aforementioned traits are touted as preferable or morally superior in some skewed sense. It isn't explicilty verbalized this way, but the predominent currents flow from these icy tenents. Going down this rabbit hole is supposed to somehow makes you a better doctor.
This is NOT the case.
The new generation of doctors are beginning to realize this. As compensation decreases and information load increases, young would-be doctors are forced to take a hard look at medicine for it's face value. The days when benjamins could universally override doubt are slowly coming to a close. This article has some salient points and perspective on why this is the case. Suffice it to say that the ROI is often not good enough anymore to make people part with their less secure dreams and a "balanced life."
The status quo is being challenged. The "medical establishment" is realizing that it is having a harder time recruiting the top tier of innovators and free thinkers that will push medicine forward.
Passion and innovation must be rewarded or this will continue to happen. The gambler must be embraced and utilized. Balance must be encouraged. A more human person will also be a more humane person.
Can a medical student (as I find myself) find passion in medical school by starting a medical school blog, even if they currently find their situation passionless? Can a previously stolid accountant breathe passion into his professional world by changing a venue, entering a niche, or altering a mental paradigm? Can a barista gain a passion for their work by starting their own mobile coffee cart instead of working at a major coffee chain that shall remain nameless (it rhymes with car-ducks). I posit that in many or most cases this is possible.
Not ALWAYS possible though... If medicine is not your passion GET OUT MAN! Make a responsible exit strategy and EXIT. If you can be passionate in a different part of medicine, CHANGE your course. Get into something that you think is FULLY great.
When a person sees that it is not a feasible proposition to turn their current pursuit into a passion... why then do they persist? There is no excuse for this! There are more niche market opportunities now than there has ever been in the history of the earth! That statement should be self evident in describing the possibilities. Allow me to provide examples.
There is a guy who’s living, his calling, his passion is to read the mail of complete strangers and expose their secrets to the world… His name is Frank Warren and he is the founder of Postsecret.com
There is a man named Jerry Greenfield who thought he wanted to be a doctor. He, in fact, applied on three separate occasions to medical school and was denied each time. He thought he wanted to be a doctor, but it didn’t seem to be working for him. He decided to take stock of his passions. He loved ice cream. He wanted to start a small business. He took a $5 correspondence course on ice cream making and promptly opened a small ice cream shop in Burlington Vermont with his long time friend Ben Cohen. You may have heard of his shop. It’s grown a little since then. It’s called Ben and Jerry’s.
There is an individual who was in medical school at Harvard University. During his time there, he found that he was spending much of his time writing instead of studying as religiously as many of his classmates. Realizing that art of the pen was his passion, he decided not to discard it and continued writing feverishly throughout his four years of medical school. When he graduated, instead of stuffing his aspirations on the back shelf and entering a full time clinical career, he began the risky proposition of writing full time. It turned out to be a good move for him, because in 1994 he became the only creative artist ever to have works charting at #1 in film, TV, and book sales simultaneously. If you have ever seen the film Jurassic Park, watched the television series ER, or read one of his numerous best-selling books, you have appreciated Michael Crichton’s decision to follow his passion.
Engaging in passionless work is one of the greatest crimes that can be committed against oneself and society as a collective entity. Creating a passionate place where one can use their natural gifts for betterment of humanity and fulfillment of self, conversely, is one of the greatest goods.
These thoughts continue to consume my mind. They will leave me no peace until I have donned the unitard of action and wrestled with my doubts. Will it require a roll of the dice or a calculated reshuffling of the cards I have been dealt? Likely Both. The platitudes must stop. My life can have passionate direction. It will. It must. This is my manifesto.
Through the slightly course language, this guy makes a great point.
But, says physician Brian Goldman, medicine's culture of denial (and shame) keeps doctors from ever talking about those mistakes, or using them to learn and improve. Telling stories from his own long practice, he calls on doctors to start talking about being wrong.
Okay, here's the honest truth: I am not a career counselor, HR expert, or business savant.However, recently a friend emailed me and asked for some advice. She had a number of interviews set up and was wondering if I could give her some tips on interviewing.
I sent her the following email, and she later told me that she felt like the tips helped her and that the interviews went well.
So, for those who are curious, I've reproduced my tips below. Her intervierws aere non-medical, but I believe these principles still apply regardless of your type of interview.
Remember, consider these tips at your own risk. If you quote me, I'll deny I ever wrote them...
Having A Good Mentor Can Make A Big DifferenceIt has been said that you are the average of the five people you spend the most time around. If that is true, the formula is simple; find people that are doing what you want to do and tag along. Unfortunatly, it's not always this simple; however, StudentMentor.org is changing that. This company is dedicated to helping college students find mentors to help them along their journey. They are working with students from over 700 colleges in the the United States. They are currently partnering with the White House on several national education initiatives. It's an impressive operation!
So how did this whole thing get started? I caught up with Stephanie Bravo who is Co-founder of studentmentor.org. At the time, she was a medical student at University of California Irvine School Of Medicine. She is currently President of the company and works full time with the organization and has alot of good advice for medical students.
How did you decide to start StudentMentor.org?
I decided to start StudentMentor.org after having a life-changing experience with a mentor during my years as an undergraduate. I was a first-generation college student who felt completely lost at a large public university and was unsure about my future. But then I found my mentor through the Stanford University Minority Medical Alliance Medical Mentorship Program, and this experience changed my life. My mentor, Dr. Matthew Goldstein (http://www.studentmentor.org/about-us/advisory-board/#goldstein), was a medical student at Stanford University School of Medicine, and he provided so much guidance throughout my studies, especially during those challenging times when completing college and attaining a career as a physician seemed out of reach. Even more than that, we got to talking about life, family, and a variety of other things where he provided tremendous support for me at times when I had no one else to help me. Because of my life-changing experience, I wanted to help other students connect with mentors who could help them at crucial stages in their academic and career pursuits. Thus, StudentMentor.org was born to help students complete college and enhance their career readiness by connecting them with seasoned professionals from a wide variety of backgrounds and industries.
What where some of the challenges/perks of starting a company while in medical school?
There were not enough hours in the day for me to be a well-balanced person, succeed in medical school, and lead an organization. It was very difficult to maintain my course load and go through the process of creating something from scratch. I had to rely on my StudentMentor.org co-founder and friends in medical school to help me juggle. Shifting between these roles was tough, but both required a great deal of tenacity and a strong work ethic. With those in tow, I pursued both medicine and my startup nonprofit for a while. I managed to survive by being very diligent, disciplined, and organized. But, because I was incredibly passionate about StudentMentor.org and the broader issue of higher education, I decided to fully commit to leading my organization and put becoming a physician on the backburner. I know I made the right decision when we received a call from the White House inviting us to meet the President and speak with officials about StudentMentor.org in December 2011. Additionally, after one year, 5000+ mentors and students from all around the nation are connecting and beginning meaningful mentorships. It’s very exciting to be at the helm of an organization that is soaring to great heights at a record pace.
How can medical students and residents get involved as a mentor and what is the time commitment that a mentor makes?
The time commitment for mentors varies depending on their availability. You can communicate with mentees at any time convenient for you. We recommend that mentors set aside about 30 minutes a week to mentor one student. Since professionals come from a variety of industries and backgrounds, it’s very flexible to their schedules. Medical students all the way up to attending physicians can serve as mentors. We even have resident physicians in the program who somehow find time to help their mentees. I hope that those UncommonStudentMDs will consider joining StudentMentor.org too.
You have become an expert at helping people find mentors. Can you give some advice on how to find and approach a mentor?
The best way to reach out to potential mentors is to ask them if they have time to grab coffee. If you speak candidly about looking forward to hearing their experiences and learning from them, then a potential mentor will be receptive. It’s not a good idea to lead with what you want to get out of the relationship, e.g. a letter of reference, the contact information for their colleague, etc. Like with any relationship, you have to put in the time to build trust, and that starts with putting yourself out there by telling your story, sharing your goals, and realizing that a mentor’s insight is extremely important in helping you achieve your goals.
Do you have any advice for medical students who would like to start a business?
Taking time off from school might be the best move since building a business is a huge time commitment—kind of like medical school, but without a 4-year plan or any other roadmap. That being said, I’ve had amazing classmates at UC Irvine School of Medicine who have written and published novels, created student organizations, and ran underserved clinics while still maintaining a full course load—so it is possible!
Another, big tip is to reach out for help and persuade people to your cause. If you can build a movement that your classmates are passionate about as well, then you’ll have 100+ medical students in your corner to help get your business off the ground. It’s very important to build and utilize your networks in any business, including medicine.
Why did you want studentmentor.org to be a non-profit instead of a for profit company?
There are pros and cons to both entities. In a for-profit entity, the bottom line would always rule and not necessarily doing the most good for the cause. We decided to become a nonprofit to keep the monies accrued by the organization focused toward achieving its goals. Additionally, it was a lot easier to recruit mentors who are all volunteers.
If you could pick one book for every medical student to read what would it be?
I would recommend “The Empowered Patient” by Elizabeth Cohen, CNN Senior Medical Correspondent. It’s great to read books on the “white coat” reading list, but a holistic understanding of the medical profession comes from reading books written for patients as well. This book by Cohen offers patients insight into how patients should go about getting the best medical care possible. She argues for being a “bad patient” by asking questions and not blindingly doing what you are told until you understand what and why you need to do it. As future physicians, it’s absolutely critical to be able to communicate with patients. So, learning more about the patient's perspective and trying to meet them where they stand is a good start to becoming a great physician.
The cure for the common medical student or resident.
Uncommon Student MD is the student companion site of Freelance MD which provides information and resources doctors who want more freedom and control of their career, medical practice, income and lifestyle.
Justin Weaver DDS
Jeremy Weaver
Matt Ward
Greg Bledsoe MD
Richard Gunnerson IV
"I wouldn't do it twice, but I would not 'not' do it once."
- ZDoggMD