MINDFUL OF MEDICINE

Happy almost-New Year everyone!

I remember spending so much time trying to figure out what shoes to wear on clerkships before starting. I felt like it should be so simple, but it actually turned out to be a little stressful. The truth is, third year is about many things but one stands out to me in particular: comfort over style. If your feet are in pain it will be hard to do your job. Even so, we all like to feel confident while working so while being comfortable is a priority we can also try to be a little stylish! It can be difficult to invest a lot of money on a pair of shoes especially on a med student budget so I would suggest shopping around and finding the best deals! I've put together some shoe ideas for clerkships and included the links below, I hope this helps!

1. Dansko Clogs: good for both hospital & clinic, and SUPER comfy. They can be hard to walk in at the beginning but you get used to them.

2. Cole Haan Wedges: I love these wedges - they're on my dream list for clinic shoes. I've seen so many people wear them and they look so classy and sleek, plus they're supposed to be really comfy.

3. Clarks flats: these are also on my list (I might have to give in soon since my Vince Camuto flats are on their last leg!). Clarks is known for their comfort and quality. These would be good for clinic, and the wards if you have a short shift.

4. Nike Free 5.0: I included these because I think they're really cute, but any comfortable athletic shoe would be ideal for long hours in the hospital when you're walking several miles in one shift. Surgery and ObGyn (as well as other surgical specialties) are known for allowing athletic shoes and scrubs, but we were allowed to wear them during call days on medicine too! Be warned, though, you might get bodily fluids on your shoes during some rotations and you might end up having to throw them away.

5. Clarks clog: I got these before starting internal medicine and I'm so glad I did. I didn't feel like committing to the Dansko clog at the time and these shoes came in handy. They're light, extremely comfortable, and work for both clinic and the hospital. If you follow me on instagram you've probably seen these a few times.

6. Vince Camuto Flats:  these flats are not only gorgeous, but really comfortable as well. They have a small heel so you're not completely flat when walking. They also feature a padded footbed that resists wear and tear. I bought these in black in June and I think they're the best flats I've ever purchased, plus I always get a ton of comments when I wear them. As a bonus, they're on sale at Dillard's for $58 - I might have to get the light pink and brown ones.

Hi everyone. I'm currently on outpatient medicine (i.e. clinics) and while it's a lot slower than inpatient, I'm enjoying the laid-back hours and much-needed time to study. I've been thinking of doing something fun on the blog for a while now, and I'm happy to announce a book giveaway!

Back in June I got an opportunity to read and review "So You Got into Medical School...Now What? A Guide to Preparing for the Next Four Years," by Dr. Daniel Paull. Being so busy with Step 1 and and the start of clerkships it took me a few weeks to get through, but I found it to be an entertaining and insightful read. As I've gone through these last couple years of med school it's become clear that oftentimes students, including myself, are unaware of what big milestones are coming up and how they all fit into the big picture.

In his book Dr. Paull does a wonderful job of providing this much needed information while including funny, relatable stories of med students in relevant situations. Half the battle of medical school is figuring out what you should be doing next, and this book is a great resource for navigating medical school milestones. Though detailed and insightful, the first and second year-relevant topics were no longer applicable to me. I was lucky to have read the book before starting clerkships since the third and fourth year topics were a great resource for how to tackle the clinical years and applying for residency!

I only wish I had been able to read the book before starting first year - it would have cleared so many things up for me. Med school is a challenging time, but it goes beyond academics. I've often felt like I was just fumbling along trying to keep up with logistical details like planning for board exams, clerkships, letters of recommendations, and most importantly - residency. As a first year some of these things seemed so far away and I assumed they would just fall into place by themselves. That's just not the way things go, and I had to learn the hard way.

I believe that the best tool a new medical student can have is an idea of what to expect. As such, I would like to share what this book has to offer with a few of my followers. Dr. Paull has been gracious enough to provide me with three copies.

- How to Enter:

1) Subscribe to my blog on the left sidebar with an email address to receive future blog posts via email.

2) Follow me on instagram and repost the giveaway picture posted on my instagram page using the hashtag #mindfulofmed. For an extra entry you may mention a friend in the comments section of the original giveaway picture on my page!

- I will choose (1) winner from new blog subscribers and (2) from instagram.

- The contest is open to US residents only - sorry international friends!

- The contest will run for two weeks. You can enter anytime between August 7th, 2015 - August 20th, 2015.

- I will choose the three winners on August 20th and will contact them shortly afterwards.

Good luck!

Disclosure: I received a complimentary copy of the book from the author.

For more about the book and the author visit Dr. Paull's website.

 I was reading a profile on a neonatologist that included the quote above and it resonated with me. I’ve often been told that I’m “too nice.” I’m certainly someone who doesn’t like to offend, or impose on anyone and will do my best not to do so. But that can also hold me back in that it keeps me from being what others perceive as assertive. And the more I think about it, the more I realize I have to be proactive. My kindness and easy-going nature is not an “issue” that must be dealt with, but as a woman in medicine it is certainly something I need to acknowledge. There is often a double standard for women in general: risk being labeled bossy (or worse) by being assertive, or passive by being a normal person.

As I approach third year and the rest of my life in clinical medicine, I am committed to being more assertive while remaining kind and compassionate. Physicians are entrusted with patients’ health and lives. It requires a great deal of strength, force, and confidence to act in your patient's’ best interest no matter what. That means fighting for your patients while also listening, and empathizing with them. It’s all about striking a balance.

At my core I am a kind person. I am also a strong person. I can do extraordinary things. There are many interpretations of what being bold with your kindness can mean, but to me it means being bold with who I am and using it to elevate my goals, not hold them back.

So, whatever you are, be that. And do it boldly!



My life has been a series of checklists, each completed in a deliberate and timely manner. Ever since I can remember, my goal was to become a physician. It was a calling and an autonomous way to help those who need care and healing. I also knew that it required hard work, dedication, and planning. In middle school I knew I had to find a high-performing high school to attend. In high school I knew I had to do well to get scholarships to afford university. Starting university was one of the biggest chapters of my life, as I'm sure it is for many. I picked my majors, I performed to the best of my abilities, and I was really proud of my performance overall. My years in university are also where I discovered who I was, and envisioned the person I ultimately want to become. I've never allowed myself to take things slow - I've been on a path where things need to get done so that a bigger, better thing can happen. Thankfully, this approached has worked for me so far. I've completed the checklists needed to get me into medical school, so now as second year comes to a close I think to myself, "now what?"

You don't get to medical school, or other professional / graduate programs without being at least a little competitive. Whether it's an outward competitiveness or competing silently with your self, that competitive nature lies somewhere and its influence is undeniable. It pushes you to do better than before, and be better than you think you're capable of. But to get you to push yourself and grow there must be a drive beyond self-fulfillment, and that drive is uncertainty. The future is always uncertain to some degree, and this is what pushes us, at least me, to work harder to at least attempt to secure the future I want. Up until this point in my academic career, worth has been determined by test scores and grades. It's something I'm comfortable with. In two months, however, I take the most important test of my life - USMLE Step 1. An exam of this caliber is something that I'm not familiar with. The implications of my score go beyond a few numbers on a page - it can determine what specialties of medicine I can comfortably apply to. Though there are students who manage to match into competitive specialties with low Step 1 scores, they are the exception and definitely not the rule. Residency applications are all about numbers, this is something our attendings, student development staff, and mentors remind us of often. It is unfortunate that the individual applicant isn't evaluated holistically, but it's a numbers game and there's only one way to play.

The start of medical school is a clean slate where every student has the potential of pursuing whatever specialty they wish. Some of my classmates came into med school knowing exactly what specialty they wanted to pursue, and for many of them their initial interests still hold true. I, however, have a few interests but I'm not certain about any of them. And it is this uncertainty that pushes me into unfamiliar territory, and isn't comfortable. Nevertheless I know I have to do my absolute best on the boards to give myself the best chance. My biggest worry right now is falling in love with a specialty that my score isn't "worthy" of. And therein lies a whole other realm of what it means to feel "good enough," but that's a whole other topic perhaps for another day.

I know that the best approach to the boards is to do my best and not make any excuses. There's no use in worrying now since my efforts should be focused on these last two months of studying. In the end, there's never regret in knowing that you did your best.

  

This past week I had my final exam for my second-to-last block of second year. It’s pretty crazy how fast MS2 has gone by. We got the whole week off to study, so I figured why not shadow in clinic on Monday and in the OR on Friday. It probably wasn’t the best idea considering how much studying I had to this week, but I did well on my exam! And someone in our class aka The Cookie Fairy baked cookies for all of us rising MS3s, it was very sweet.

Before this week I had never actually shadowed during med school. I had actually never shadowed at all, which is weird considering I should have an idea of what specialties I’m interested in since I have to schedule third year electives this month. Oops. Last semester a new discussion-based elective in orthopedic surgery became available. I decided to enroll since taking the elective for two semesters would count as fourth-year elective credit and could mean a week or two off during four-year. I had never thought about ortho before the elective but ended up really enjoying it. My husband is a structural engineer, so he talks to me about random structural elements all the time, like loading, shear walls, concrete, you name it. Surprisingly, it helped me understand a few things in the elective. And even more surprising: I actually enjoyed it. This semester we had a session dedicated to pediatric ortho and I loved it. No matter what specialty I go into, I know it has to involve children since they are my favorite patient population by far.

Monday was clinic day. I arrived early in the morning and clinic started promptly at 9. The staff warned me that it was goingto be a busy day with 20 patients total, but having worked in a derm clinic where we saw 80-100 patients a day I was more than ready. The morning started with more chronic issues like scoliosis follow-ups, hip dysplasia, ACL reconstruction, follow-ups, toe walking, in-toeing, and a club-foot follow up. There were also a few ankle pain visits. Apparently pre-teen girls with ankle pain for a peds orthopedic surgeon is equivalent in frequency to adult lower back pain in an adult clinic. I learned that sometimes the ankle pain will not have any obvious deformity on an xray or manual palpation, and will raise the possibility that the child is somatizing (experiencing psychological distress in the form of physical symptoms). My favorite patient of the morning was a 6-week-old with bilateral clubfoot. Not only was he adorable, but the treatment for clubfoot has lifelong impact. The idea of maintaining function and mobility in children is amazing and I wouldn’t mind doing that the rest of my life.

The afternoon was a fracture clinic. A Monday fracture clinic meant that all the patients would have likely broken something over the weekend and presented to an urgent care or the ED first. After entering the room the temporary cast is removed, the fracture site is palpated to corroborate what the xrays look like (if they bring some with them), then new xrays are taken to make sure proper casting as well as analysis of the break itself. This last step is important because children have active growth plates. If the fracture crosses or comes near the growth plate it is called a Salter-Harris fracture. They occur in 35% of skeletal injuries in children, and are of concern because they can result in premature closure and limb shortening and abnormal growth. As opposed to adults, children heal quite fast. Most of the casts we put on would only stay for 3-4 weeks with a complete recovery. Children are so resilient.

The surgeon I shadowed was extremely welcoming and made sure that I was learning. He was open to and encouraged questions. He also did a wonderful job at establishing rapport. After entering each room, he would address the child first and make them feel like they were in charge, which I think the kids really liked. Most just found it silly. The kids would then feel comfortable enough to tell their story of what happened. The stories were pretty entertaining - a child’s perspective is just so animated and innocent. I was surprised at the variety of cases that peds ortho deals with. They treat musculoskeletal deformities and pathologies secondary to a variety of causes, across a wide age range (infants, children, adolescents, young adults).

I really enjoyed my day at the clinic. I appreciated that most of the problems were solvable and even if surgery was a last resort, there were other less-invasive interventions most of the time. I also liked that the treatment given by an orthopedic surgeon is tangible and life-changing for patients and their families.

Stay tuned for the second part of my shadowing experience - my day in the OR.

Happy Sunday, everyone!

This was a very busy week for me. On top of block and board studying, I attended a conference where I presented my current research. It was my first conference and it was an oral presentation so it was definitely a bit stressful. It went well, however, and I really enjoyed getting to spend some time with my friends who also got to present. As a med student you know that your peers are smart, but you forget how brilliant they are sometimes. Watching my friends present their incredible research was really exciting. It was also really fun to spend some time at the beach (because we tried to study there but obviously couldn’t get a whole lot done, lol).

In late January we had submitted our preferences for our third year clerkship schedules. Third year clerkships or “rotations” are where you get to use all of the endless information you acquired your first two years of med school and apply it to the clinical setting. It’s also a time where you solidify what your interests are and what specialty you’ll choose to pursue. On top of all of the fun exploratory stuff, you still have to perform at your best in order to be evaluated highly and be worthy of your attendings’ letters of recommendation for residency applications. That sounds like a lot, but I’m really looking forward to it. After all, I’ve been in a lecture-based setting my whole life and this is the next step towards becoming a physician.

My school offered a choice of 16 pre-arranged “tracks” that we could choose from. We were asked to rank all 16 tracks and then submit our list in order for a lottery to be run. It was rather stressful because clerkship order is important, and getting a track that you weren’t totally fond of wouldn’t great, though you could certainly make it work. The only piece of advice that we were given is to make sure what you’re interested in is not first or last. That still leaves a lot of questions. I scoured the internet for other med student blogs that might offer insight on what the “best schedule” was, but it varied. I also asked a few of my friends that are residents or current third/fourth years. I found this resource to be the most helpful.

Though I don’t know exactly specialty I’m set on, I have a few that I’m interested in: surgery, peds, ob/gyn - in that order. With that I was able to look for tracks that would keep these three somewhere in the middle and definitely not first/last. I had also been told that in order to do well on on the surgery shelf exam, a strong background in internal med is a great starting point. I know for sure that I’m not interested in internal med as a career, and since it is so fundamental for success in other rotations I decided to place internal med first.

A few of my friends and I submitted the same rank orders since we know we would work well together and also have similar interests. And lucky for us we ended up with our first choice!



As far as subsurgical specialty choices I’m leaning heavily towrads Ortho. I’ve had exposure to the fireld through an ortho elective and find it surprisingly interesting. We also have the option to choose a hospital setting or a private practice setting for a few clerkships. I’m considering doing ob/gyn in private practice because my friend (who is now an ob/gyn intern) had such a great experience doing that. Also, ob/gyn tends to be more of a malignant experience for medical students at my institution’s hospital so private practice seems like a better choice for me, especially if I’m looking to learn a lot and be an active member of the care team.

I’m so excited to start clerkships this June. I’m also looking forward to sharing my experiences regularly through this blog since insight into the clerkship experience online is pretty bleak.

Have a great week!

Happy Sunday! This week was the first week of second semester of MS2. I arrived from travelling a few days into the week with a raging cold! It’s pretty funny because prior to winter break I thought to myself - wow, I haven’t gotten sick in, like, a year. Ooops. And so I basically did nothing all week and this weekend was spent doing some intense catching up. The current block is called “Life Cycles” and it is basically what it sounds like. It’s centered on reproductive anatomy, physiology, embryology and all the fun path that goes with it. I’ve been looking forward to this block since first year since I heard everyone wants be an ob/gyn after finishing it, but we’ll see about that!

My biggest struggle right now is figuring out how to incorporate focused board studying during this last semester of med school. Step 1 is in June, and I plan on taking it really early that month to give myself two weeks of vacation before starting clerkships. My institution allots 6-weeks of dedicated board study time starting in mid April, but of course that’s not enough time. Studying for step 1 really does start the very first day of med school and I’ve studied for blocks with that in mind. But now that I have six months until step 1, it’s time to get focused and effective. I have a general idea of my study strategy but I will have a definite plan by the end of the week and will share it in my next post. For now, here are the resources I’m going to use: Pathoma, Firecracker, First Aid + UWorld qbank.



On Friday night, my fellow coordinators and I held a student/resident/attending mixer for our chapter of the Association of Women Surgeons. One of the breast surgeons on faculty was generous enough to host the event at her home. I had been looking forward to the mixer for months and was so excited to meet and talk with female surgeons and residents about their perspectives on balancing a surgical career, family and life in general.  We had an incredible turnout that included three orthopaedic surgeons, two breast surgeons, and the chief of surgery herself. One resident joined us as well as about 15 other med students. I’ve been drawn to surgery for a while now and it was so refreshing to get a female’s perspective on how the surgical climate has changed over the years in terms of welcoming more women. I mainly chatted with an orthopod who specializes in foot and ankle surgery. She was so cool and easy to talk to; and I really loved how real and genuine she was. Though she did stress that surgery, specifically ortho, is extremely competitive, she also made it clear that a supportive mentor is extremely important at any level of a surgical career. All of the surgeons at the mixer were incredibly supportive of other women choosing to pursue a surgical career and were extremely receptive to all of our questions. It was really great to be among such inspiring women. When I think of my future specialty I struggle with what I want my life to be outside of work and talking to the surgeons reminded me that I can have it all, but it will be hard work. And that’s okay, I’m a med student after all - delayed gratification and hard work are my specialty :).

I’m really looking forward to this week, since I will finally get to work with some pediatric patients in our teaching clinic. At my school we are separated into groups of six students + a faculty mento, called our “Societies” group. We start from the first day of med school seeing patients every week in the hospitals, teaching clinics or simulation labs. Up until now we have only worked with adults, and I am SO excited to finally work with kids. The children in this week’s clinic will range from a few weeks old to adolescence.  We will see real children and their parent or parent-equivalent with the goal of learning the unique aspects of the pediatric clinical encounter including the importance of development, prevention, and age relevant approaches to the pediatric physical exam. Did I mention how excited I am?

Have a wonderful week, everyone!