Question for Me.. ?

Hello ppl..

Today as  I open my blog/comments I was astonished to see that I have A question  from one of my reader :O , Oh boy !!!

I'll do my best to reply and hope this will help you .

QUESTION : My name is Taj. Let me just start off by saying I am 100% sure that I am going into the medical field. There's no backing down on my part. I am a highschool junior getting ready to start applying to schools next year and my first choice is the Sophie Davis School of Biomedical Education, a 7yr BS/MD program (not sure if you  heard of it). Also any advice you can give on surviving pre-med and medical school I will gladly take :)

I am really interested in anesthesiology and cardiology so my question is really for YOU  I wanted to know how and when did you juggle and decide when to get Marry,have kids and also what do you  love about your career and why and how you  decided to be an  anesthesiologist ? Thanx in Advance !

My Answer:Thanks so much for your questions! I think first of all that it important to keep an open mind going into medical school. You get exposed to so many new things, and there are whole fields of medicine that you never contemplated before that you end up learning about. Anesthesia, in fact, was something I thought nothing about and never did a lick of in medical school. I looked into anesthesia  just before I was about to start my CR  fact is that you have to pick a specialty based on limited information (you can't see everything by fall of your 3rd year) and a significant number of people end up switching.
Within that spectrum, anesthesia definitely falls into my nonworking brain . I thought about ENT and OB,and then decided to go with   anesthesia!! I love that I'll be  the one who gets to push the drugs- I'll think it, I'll give it, I'll see the results- no waiting for a nurse to fill the written order.

I also do not think that the assumption is correct that anesthesiologists are somehow antisocial. I love that I have to establish rapport very quickly with people who are at a very stressful time in their lives- about to head into the OR for a surgery. I'll get to  work with kids, parents, laboring women, awake women having C-sections. Some of the anesthesiologists I know are rather extroverted. But I do like that a portion of my patients do go to sleep, after I have talked to them. I also think that I'll  enjoy lots of small procedures like  intubations, invasive lines, epidurals, nerve blocks, echocardiography. They are not curative but they are hands-on. It would not be enough for a surgeon, but they'll be fun for me. I also love that I'll get to take care of one patient at a time. No worrying about all the other patients on my service and I'll get to  know them literally inside out. I'll know every drop that has gone in and out. I won't have to juggle daily hematorits in my head for 12 patients over 10 days.
Finally, I would be remiss if I didn't mention that  anesthesia will  allow me to separate work and family life a little more easily. When I'll leave the hospital, I'll pretty much leave work at work- no worrying about this or that patient- they are no longer my direct responsibility. That psychological freedom works well for me. All that being said, it's not for everyone. Sitting in a room charting vitals on an easy case gets boring for anyone. I think that there are so many intangibles that cause one to pick a specialty- when you rotate as a medical student and meet attendings and residents whom you enjoy and feel comfortable with, you end up wanting to be like them. 

I think it's so great that you're starting to ask such good questions. Just remember to stay open-minded. You might end up at a place you'd never have imagined when you started.

All The Best.

Sealed with a kiss by Nandini !

What to expect when you’re expecting…to begin clinical rotations !

Finally, the post I have been meaning to write for a very long time. I get questions about clinical rotations very frequently, so below is Nandini’s guide to medical school clinical rotations, in FAQ format..

1) What is a clinical rotation?

It’s a period of time that you spend at a given hospital (or clinic, doctor’s office, etc.), gaining hands-on clinical experience from seeing patients and learning from patients, nurses, residents, attendings, and anyone else who chooses to teach you.

2) How many clinical rotations do I have to complete?

Well, this varies slightly from school to school, but most students must complete required “core” rotations, and “elective” rotations. Core rotations include:

Pediatrics: 6 weeks
Obstetrics/Gynecology: 6 weeks
Internal Medicine: 12 weeks
Surgery: 12 weeks
Family Medicine (considered an elective by some schools): 6 weeks

“Elective” rotations are just that. They are voluntary. You can usually choose which elective rotations to do, but most schools require a certain number of “medicine” or “surgery” sub-specialty electives. My College  requires a total of 30 weeks of electives.

3) How do I schedule rotations?

The answer to this question really depends on your school.  You apply for core rotations through the clinical department. You can request roations at any of the affiliated hospitals, and they will try to schedule you for them. Keep in mind, however, that they can only schedule you for availalbe slots. So, what you get will depend upon your schedule, and availability. For elective rotations, you can can request them through your college  clinical departemnt, or you can contact the hospital directly.

4) How do I know which rotations are best?

My best advice? Ask around. Word of mouth seems to be the best way to find the best rotations. I don’t think ValueMD has much merit. And see question numbers 13 and 14, for more information related to this.

5) What do med students actually DO during clinical rotations?

EVERYTHING!

Okay, let me be more specific. Here are some common things you will do:

- Perform, write-up, and present H&Ps (histories and physicals)
- Write SOAP notes on patients (progress notes)
- Follow up on things related to your patients. This includes (but is not limited to!) following up on lab results, radiological reports, consults, etc. The more you know about your patient, the better you can help them, and the more your residents and attendings will love you.
- Perform “procedures.” Examples include drawing blood, placing lines, placing NG tubes, suturing, putting in foley catheters, and anything else you can imagine. As far as what you are allowed/expected to do, this really varies from hospital to hospital. But at minimum you should be prepared to draw blood, place lines, and hold retractors (for long periods of time!). As far as training for the procedures is concerned, this also varies from hospital to hospital. But remember the golden rule: NEVER perform a procedure if you have no idea how to do it!
- Round on patients.
- Attend all lectures, presentations, etc.
- Present information on various clinical topics.

6) What are “rounds?”

Some attendings prefer sitting rounds, some prefer walking rounds, and some do a combination of both. Rounding on patients simply means going through the list of patients and presenting information on each one of them. If they are a new patient, you are expected to present the entire case. If they are not, you may just need to provide an update. You then generally go from room to room as the attendings and residents talk to and examine the patients. Expect to be asked many questions during rounds. And this is a great opportunity for you to ask questions as well!

7) What is the “hierarchy” in the hospital?

Med students are the lowest on the totem pole, then residents, then fellows, then attendings. Sometimes you will work only with the residents, and sometimes with the attendings, and sometimes all of the above.

8 ) Will I receive traditional (didactic) lectures during my clinical years?

Again, this really varies highly from hospital to hospital and rotation to rotation. I’ve received lectures in almost every one of my rotations (all the cores), but the amount of time I spent in lectures versus other activities varied widely. You will “learn” clinical medicine via many routes. This includes didactic lectures, “teaching” rounds, and of course, at the patient’s bedside.

9) What is “pimping” and should I be scared?

“Pimping” simply refers to a higher-up (usually an attending, but can also be a resident) asking questions (sometimes in a machine-gun style) about anything and everything. No, you should not be scared. But yes, you probably will be anyway. It’s scary to be put on the spot. And you will never know the answer to all of the questions. But you should remember that you’re not expected to know all of the answers. Keep that in mind, and you will be less stressed out by the situation.

10) What is the schedule like for clinical rotations?

Again, this varies WIDELY based on the hospital and the rotation. Expect to spend longer hours during your core rotations versus electives. Almost all core rotations also involve “on call” hours, which involves staying late or during the night. An average day at the hospital during a core might go something like this:

6:00 – Report to hospital for morning sitting rounds
7:00 – See your patients, write SOAP notes
10:00 – Walking rounds
1:00 – Lunch
3:30 – Follow up on patients
4:30 – Lectures
6:00 – Walking or sitting rounds again
8:00 – Go home

Again, this is just a  my schedule . Night calls vary from a few hours, to 12-hour or 24-hour shifts. Most rotations give you “post-call” days. This means that if you have a call shift, you are allowed to go home afterwards and have the rest of the day off before you come in again the next day.

11) Are there written exams?

Again, this varies, but most of the core rotations will have quizzes and exams. Of course, you will also need to take your board exams (USMLE, etc.) and Shelf exams, if your school requires them.

12) How are you evaluated?

This varies. But for most rotations, your grade is ultimately based on your exam scores and your “clinical performance,” which is based on your clinical skills, clinical knowledge, professionalism, and other areas of performance.

13) What’s the most important piece of advice you can give about clinical rotations?

That you get out what you put in!

Yes, the hospital matters. Yes, the attendings and residents matter. Everything matters. But the most important piece of the puzzle, and the one that YOU have ultimate control over? Yourself. If you show up early, volunteer to stay late, ask questions, and are a very motivated leaner, you will succeed and learn how to be an amazing doctor. It’s as easy as that.

That’s all I can think of for now! I hope this helps some of you out there.I will add them to the list!

Sealed with kiss by Nandini ! 

Things I Love "NOT" to Love the Most !!

Religious Protesters.  Seriously people, if you disagree with my beliefs then so be it... chances are I disagree with yours too but I will never take time out of my  life to picket your place of worship.  As I watch you yelling and screaming all red faced and manic, I can only imagine the examples you are to you children as they watch you berate someone for the way they choose to worship.
 Fat people who blame everything but the Ho Ho's they are eating for the reason they are overweight.  You aren't fooling anyone.  It isn't glandular... it's psychological and it's about self control and what you eat and the fact that you don't exercise.
Peas and broccoli .  Argh, the thought of them makes my stomach turn.  I think I must have regurgitated them way too many times as a child and legend continue. 
Men who constantly grab themselves.  What is with this all about?  Can't you work this problem out in private?  I know this guy who does more ball handling than Kobe Bryant.  I know you may get a pinch or an itch occasionally.. women do to but you don't see us fondling ourselves at the grocery store do you? 

Anyone who acts differently around others to make believe they are a certain type of person than they truly are.  If you like Nascar, then like it.  If you can belch on command, brag about it.  Don't pretend that you are someone else because you think it is more socially acceptable.  Grow a "set" and be who you are and love it. On the other hand, if you are a total social idiot who has no class or tact... don't necessarily flaunt it for the world to see either.  Take a class or read a book or something and learn some social skills.
Hair that grows out of people's noses and ears .  Please manicure your nasty orifices... I know as we age, we get hair in our ears and noses... 1 minute a day can alleviate the need for me to be forced to stare at your 4 inch nose hairs.
One uppers.  I have mentioned this  before.  When I am having a conversation with you... listen.  Don't just sit there pretending to pay attention while you think of a better story to trump mine with.  It's rude and you look like a dumbass.
Liars and Careless.  I don't need to say much more than that.  Out of all these things listed above this is definitely the thing I truly do hate the most.

That was a bit therapeutic I must say....

Sealed with a kiss by Nandini !!

Stuff that won't make sense to you..

Sometimes you feel a million things.

So many, that its mind boggling.

So many, that you do not realise you're feeling it.

Sometimes you feel like laughing and crying at the same time.

Sometimes everything is just there but still is a long, long wait.

Sometimes, all it takes is a hug.

Sometimes, you just sit and stare  for hours.

Sometimes the present itself is a nostalgia.

Sometimes you're insecure of nothing tangible.

Sometimes, everything is like the sea... coming & going.

Sometimes you just don't make sense when you're trying to pen down everything.

Sealed with kiss by Nandini