Gifts for Medical Students, Residents, Physicians, and Anyone Else with a Stressful Job

The Gift of More Free Time

The everyday needs of a household can become oppressive if you are working 80 hours a week. And, because bathrooms need to be cleaned, and floors need to be vacuumed, this is time that takes away from downtime needed to recover from hard work.

Here’s a list of things that just about every healer or healer in training would appreciate to help free up time:

  • A cleaning service. Hire someone to do a “deep clean” of their home once a month. Look on the internet for bonded cleaning services or call people who might know the best companies.
  • Car washes. Who doesn’t love a clean car…. and who has the time to wash and vacuum their car?
  • Roomba vacuum cleaner. One task taken care of!
  • Someone else to cook meals (see below!)

The Gift of Nourishing Food

  • Instant Pot. The number one time saving kitchen appliance for busy people is the Instant Pot. My Instant Pot has fundamentally changed the way I cook – and has made it easier to eat well.
  • Air Fryer. I’m a new convert to air fryers. 15 minutes to get wonderful roasted or air fried veggies is amazing! There is now an Instant Pot with an air fryer built in – a great option for a gift!
  • Gift certificates for food. Do a little sleuthing and find a healthy grocery store near where they live. Other ideas might be a smoothie or juice shop, their favorite restaurant(s), or coffee shops
  • Prepared meals. Most cities have small, local companies that deliver prepared meals to your door. They usually offer gift certificates which is probably the best plan to give flexibility between a subscription or a la carte ordering.
  • Home cooked meals. If you live near, think about cooking a batch of favorite food(s) and putting them in single serving containers to freeze. You might also want to create a certificate for your personal “cookie/meal/soup of the month club” with a promise to deliver food once a month.
  • A Good Cookbook. Mark Bittman’s cookbooks are all wonderful, but How to Cook Everything Fast is a particularly good choice for busy people.
  • Vitamix. It may seem expensive for a “blender”… but this is much more than a blender. These are the blenders you see in professional smoothie stores. Smoothies become a lifesaver for busy healers. (The Vitamix also makes great soups, sauces, etc…..)

The Gift of Good Beverages

  • Insulated Coffee Mug. Rounds in the morning often starts with “running the list” around a computer, often at “dark thirty” when the rest of the world is just thinking about getting up. Having good coffee or tea from home or a local shop that stays warm for several hours is such a pleasure. The mug of choice for just about everyone I know is a 10 or 16 oz Yeti tumbler.
  • Water Bottle. No one drinks enough water at work in the hospital (and we all agree on this). Again, having a great water bottle that you can fill in the morning with ice water (and a slice of lemon if you like) makes the day better.
  • Nespresso (or other) coffee maker. If you are a coffee drinker, a good coffee maker is key. Nespresso is my personal favorite, but be creative and look at all the options!
  • Good coffee (or tea). There are local roasters in most cities, so rather than support the big chains, look for them and consider a gift of coffee.

The Gift of Music

For those who find solace and joy in good music (and isn’t that just about all of us?):

  • A good Bluetooth speaker for their home or study space. I love the Klipsch The One II speaker I have at home, but I’m sure there are other equivalent speakers, including some that aren’t as expensive.
  • Air pods or noise cancelling headphones
  • A subscription to one of the many streaming music services like Spotify or Apple Music.
  • Tickets to the symphony, ballet, jazz performances, or opera in the city where they live.

The Gift of Good Sleep

  • Good mattress, pillows, sheets. How we sleep determines how well we function the next day, particularly in high stress jobs. Is it time for a new mattress? Is there a better mattress that might help? High quality sheets are usually a welcome gift, too.
  • Light blocking curtains or shades. Post-call sleep is during the day and sunlight can interfere with sleep. Special curtains or shades to block the sun really help.
  • A Weighted Blanket.
  • Nothing Much Happens. This is a free podcast with the subtitle of “Bedtime stories for adults”. Since it’s a present, think about supporting this wonderful series with the very cheap subscription (which means you get the stories without ads.)

The Gift of Healthy (and not aching) Feet

Working in the hospital means a lot of time on your feet. John Wooden, probably the most famous basketball coach of all time, spent the first week of training every year teaching his players how to put on their socks…. because he recognized that if you didn’t pay attention to your feet, it would affect your game. The same is true in medicine.

  • Comfortable shoes for the hospital which can be thrown  into a washing machine. High on the list are Atoms, AllBirds, and Merrells. I have shoes from all three companies and so, for some one like me (a surgeon) who walks and stands a lot, I can recommend these specific shoes! Atoms Sneaker, Allbirds Tree Runners, Merrell Encore Breeze, Merrell Antora 2 Rainbow,
  • Good socks. Don’t go for cute, go for high quality, well padded, and functional.
  • Compression socks. There is some debate about whether compression socks can really prevent varicose veins, but there is no debate that your feet feel better at the end of a long day when you wear them!
  • Pedicures. Lots of women (and some men!)  have learned the joy of a professional pedicure for tired feet. Don’t underestimate the power of a gift certificate for  pedicures. But, as an alternative, put together a kit for home pedicures.

The Gift of Fitness

This might not apply to everyone, but most people who work hard know that they feel better if they exercise a little every day. But – a word of caution – tread lightly with fitness gifts since they can be misinterpreted as conveying a “need” to exercise.

  • A bicycle. For many people a good bicycle can make it easy to add some exercise by commuting to work by biking instead of driving. Regardless, it’s a great way to get some exercise outside. If they have a bike they use to commute, you might think of some ways to make it easier such as
  • A gym membership. You may have to do a little detective work to find the right gym that is close to where they live, but it’s worth it.
  • New shoes. Runners are supposed to get new shoes every year or so. Give them a gift certificate from a running store near them, if there is one. Or, be creative and put cash in a tiny toy shoes and wrap them in a shoe box.
  • Fitness equipment for home. Resistance training is important for all of us, regardless of gender or age. Although a bench and weights are part of the classic home gym, they take up a lot of room (and weigh a lot!). I’m a big fan of the TRX system, which makes a great present. Since it has become almost a cult among physicians during the pandemic, I have to at least mention Peleton as another potential fitness gift for healers and healers in training.

The Gift of Calm

Massage and/or Spa Services. This, too, may take a little effort to find the right place, but this is a wonderful gift for stressed people.

Headspace. This might seem a little unusual as a gift idea, but I can’t recommend it enough. Meditation is discussed in most medical schools and hospitals as a tool to gain insight and recover from the depletion that is part of the work we do. The best way I’ve found to learn this practice, and then stick with it is Headspace, which is a great app. The first 10 lessons are free, but for a gift, go ahead and get the annual subscription.

The Gift of Time and Stories

Human beings heal their hearts and souls by telling stories. Although there are many stories your loved one can’t tell you (at least not the specifics) you can totally ask how what they are seeing and doing is making them feel. Set aside some time for a coffee or another beverage and ask – with intention – “How are you doing?” And then just listen. Don’t try to “fix” anything … just listen.

Along the same lines, think about a letter… yes, a handwritten letter or note. Maybe a long one for a specific holiday or birthday, maybe a series of shorter ones through the year. Imagine how you would feel after a particularly hard week if you had a letter to reread that talked about how proud someone was of you, filled with funny stories and words of support.

#MedGradWishList

Revised March 6, 2022

Every year about this time, I try to put together a list for people trying to find the right gift for someone they know who is graduating from medical school.

If you haven’t heard of @medgradwishlist on Twitter, it’s an amazing grassroots effort to create Amazon wish lists for URM medical students with financial needs to help them get ready for their internship. This is a brilliant “pay it forward” initiative. I’ve been a Program Director and a Dean of Student Affairs and I know how many new grads finish medical school with enormous debt and empty bank accounts. The ~17,000 students graduating from medical school this year are about to start on the exciting – but stressful – path of becoming a physician. Not being able to afford the things that make that journey possible just isn’t acceptable. You can buy things on their list anonymously (or not). When you find the right thing for the right person, don’t forget to include some memories of your internship, advice, and words of encouragement!

If you are a student (or even a struggling resident) in need, please join this effort to get what you need. We are sure you will pay it forward to extend this support future classes! If you are a student who can afford to support others, please do. And regardless of whether you participate in #medgradwishlist or not, the following ideas will help with graduation presents.

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I spent quite a bit of time looking at all the #medgradwishlists on Amazon, and I’m happy to share what I learned. In addition to their great ideas, I have some suggestions to add…

@drmlb‘s Top Ten #medgradwishlist suggestions

Instant Pot. This was on a lot of the Amazon lists, and I agree!!! II had to suggest one item to make life as a resident easier, it would be this. Several people asked for air fryers on their Amazon lists. I love my air fryer and use it all the time so please put it on your list if you think it will help. Just as an FYI, you already (sort of) own an air fryer since your oven set on convection does close to the same thing!

Someone to help clean and do laundry. I know you can’t put this on an Amazon wish list, but if you have a family member who either can do this for you, or pay someone to do this for you, it’s one of the best gifts you will ever receive.

Digital gifts to make communicating and studying easier. The single most important tool for an intern is their phone. If they don’t have a new phone that can reliably work with WIFi and cellular, this should be at the top of the list. A computer that works, has the ability to do streaming well, and is reliable is also key since it’s how they will study, write, and watch educational videos. They’ll want the flexibility of studying in a coffee shop (once we get COVID19 under control) or on their couch so make sure it’s a laptop and not a desktop computer.

There were some great ideas on the Amazon lists for items that aren’t quite as expensive as computers that you might consider as well: ring light for Zoom meetings, LED study light, lap top desk for your lap, iPad Pro, Apple pencil.I should add that buying a large quantity of pens to be “borrowed” by attendings would be a big win, too.

The kitchen (other than the Instant Pot). It’s so important to eat well when you work as hard as interns work (and to stay well caffeinated). There were some great ideas from my new colleagues on their Amazon lists including single serve coffee makers, pot and pan sets, nonstick bakeware set (if they are a baker!), wine opener :-), food storage bags and containers. A box or two of Kind Bars (my favorite) or other meal replacement bars is a great gift, too. And for the times cooking is just one task too many – Door Dash, Uber Eats, and/or Grub Hub gift cards are a great gift. One other must have… a Yeti mug to keep coffee hot during rounds!

Clocks and watches. We all have phones that can serve as alarm clocks, but an alarm clock that gently lights up the room is a much better way to wake up than sudden noise. I wouldn’t say an Apple watch is essential (and if you do a lot of procedures it might be easy to lose) but it is worn by a good percentage of docs.

USMLE3 study book. If you are a family member who is thinking about getting this as a present, you might also want to include a check for $895 as a “bookmark” to cover the cost of registering for this exam.

Make your home a stress-free zone. If you are setting up a new home, this list can be really extensive. You’ll need to go home to a clean, happy space, so whatever you can do to make that happen is important. There were a lot of good ideas in the Amazon wish lists including self-cleaning cat boxes, pet hair removal brushes, furniture, shower curtains, towels, and a video doorbell. I’d add a Roomba vacuum cleaner to this list, too! BTW, a good TV is important, too. We all need to binge watch the Great British Baking Show as therapy sometimes.

Sleep. In this category I would include good quality pillows, a new mattress, light blocking curtains, white noise machines, and electric or weighted blankets.

Music. Most people fill their space at home with sound as well as light, so think about good WiFi speakers like Sonos and/or gift certificates for ad-free music services like Apple Music, Spotify, Pandora.

Health. Last but not least! The most important thing on this list in my opinion is a great water bottle since, particularly with masks on all day, none of us drink enough water. A new Sonicare toothbrush or WaterPik for dental health will be appreciated. Foot care is another important part of being a healthy resident, so consider gifting compression socks, new shoes for the hospital, work insoles and/or a foot massager. Anything that promotes or makes fitness easier is also a good gift – a new bicycle for commuting, workout gloves, free weights, resistance bands. You might also consider a meditation app like Headspace, or subscription to yoga classes on line.

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p.s. What NOT to buy or ask for

  • Scrubs. I noticed a lot of folx asking for scrubs. Nope – don’t do it! You will be required to wear the scrubs from the hospital since there are rules about them being washed in the hospital laundry. Ditto for things to wear under scrubs. You’ll get too hot, they get dirty, and they are against the rules in all operating rooms (and many hospitals)
  • Textbooks. You are pretty much guaranteed to have access to a library where these books will be in digital format and free. These books are heavy! You aren’t going to take them to work and when you get home, you may have other things to read that take priority.
  • Printers. Printers (and printer ink) are expensive and you just won’t use them. You are going to have to stay digital to really learn what you need to learn as a resident. Besides, if you do need to print out the return slip for Amazon, there will always be a printer at the hospital you can use!
  • Black bag. If you are a family member thinking of getting one of these… don’t.

And finally…

For my new colleagues matching this month and starting your internship in June …

May your journey through this liminal time be as stress free and as joyful as possible. May every day as an intern bring you hearts to heal and hands to hold, new learning, and a sense of wonder and awe.

We are so happy you are joining us in this noble and sacred work!

Lessons from the Pandemic: Richard Rohr, Walking, and Lawn Chairs

It’s almost impossible during times of stress to be motivated to do hard things. For all but the most hardcore exercisers, ice cream just seems more soothing than running when you are emotionally exhausted (Right?). I’m no different. But, as much as I would like to think “later” will be ok to regain what I have lost in these months of being more sedentary than usual, I have begun to realize that I needed to get moving again.

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Enter Richard Rohr

I’ve been a fan of Richard Rohr for years. He’s a gifted writer with the laugh and smiling eyes of someone who has tapped into something I want to know more about. I subscribe to his weekly email, which this week introduced Jonathan Stall’s practice of moving “as a way to invite brave creativity.”

There is a lot to unpack in that idea.

What exactly would “brave creativity” look like? I’m not sure, but it sounded like something I, and I suspect all of us, need more of right now.

“We invite you, as able, to take some time this weekend to move mindfully through your local area.”

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I set off on a different kind of walk.

I grabbed my mask and headed out for a walk in my neighborhood, trying to think about this not just as exercise, but as something more. I read Jonathan Stall’s advice again:

  1. Bring something to jot ideas down while you are out, but more importantly, invite your “goals/pains/dreams”  to join you on this walk.
  2. Walk for at least 30-40 minutes
  3. Wear a mask if you get within 6-10 feet of anyone (respect for your neighbor)
  4. Start the walk with a sense of being open. “As you begin to move, seek the realms of wonder, of space, and of reaching high into what’s possible…”

Where did all these lawn chairs come from?

I’ve walked many times before in my neighborhood, and I’m an observant person.  But today, as I walked, I began to notice all the chairs on people’s lawns and all the swings, and “tires” hanging from trees. 

Were they always here and I didn’t notice them?

Are more people sitting outside now than before – even though it’s outrageously hot here in August?

Is this because of how much we all need (safe) connection to each other during the time of pandemic?

Are there actually more chairs, swings and tires because of how much we all need to hear birds, see trees and listen to the cicadas in the summer evening right now?

Next steps?

Yes, there will be next steps. This experiment led me to more questions than answers, but I had a real a sense of being taught, too.  

Try it?

Let me know what you see.

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Self care in the time of #COVID19

It’s so important, and so very hard, to care for yourself when times are tough. When routines are disrupted and fear and anxiety are present, our usual ways of caring for ourselves seem to (appropriately) fly out the window.  So, here are some ways to think about caring for yourself in the time of COVID19, whether you are working (at home or in the hospital) or isolated at home.

Connect with nature. Long after this pandemic is over, the earth will still be here and spring will continue to happen every year. Make sure you get a good dose of the smell of grass, the sight of a blue sky, the feeling of a cool breeze on your face at least once a day (but hopefully more).

Move. It’s normal that workout schedules are disrupted right now, but it’s not a good time to completely give up on your physical wellbeing. There is nothing good about being sedentary – not only does it make you feel physically bad, it also contributes to sadness and anxiety. A good, brisk walk outside may be the best “workout” right now since it combines movement and getting a dose of nature… but please make sure you practice social distancing and stay six feet away from everyone.

Eat well and enjoy good chocolate. You may be limited in your choices and your ability to get real food, but do your best. This is not a good time to succumb to the junk food as comfort food diet. Nor is it a good time to be overly restrictive. Splurge on small doses of the foods that make you feel comforted, but make sure it’s the best version of that food possible! Now is not the time for cheap chocolate… just sayin’.

Keep your spaces clean. Our homes need to be a safe sanctuary now more than ever, and that means we need to know they are clean. In addition to creating a ritual to enter your home, come up with a plan to keep your home neat and cleaner than usual. If it helps, what we’ve done is set a mindfulness timer to ring 3 random bells an hour when we are home. Every time it rings, we do one small bit of cleaning (or one set of an exercise) e.g. vacuum one room, clean the countertops, wipe off all door handles or do some pushups. What you lose in efficiency is made up for by breaking up an otherwise boring task and by the “surprise” of the random “request”.

Dose your news. We need to know what’s happening, but we don’t need to know it all the time. The human brain doesn’t like being continually bombarded with potentially dangerous information. It promotes the physiologic stress response and pushes us towards fight, flight or freeze… none of which are helpful in this time. I love Twitter, but I have to be careful right now… it can be an echo chamber of sadness and stress. The news I’ve found that is the most informative, most accurate and least stressful is the PBS News Hour.

Guard your spirit. Find a place and a way to keep your heart full, your #EyesOpen and your compassion alive. This is not a sprint… it’s clear we are in this new world of COVID for a while. #WeNeedYou so please protect yourself in body, mind and soul.

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Last minute holiday gifts for busy people in your life

There’s still time!

If you have a medical student, resident, physician or anyone who is super busy in your family, here are few last minute gift ideas for you….

A Letter

I’m starting with this one because even though it’s obvious, we forget the power of stories in our lives to heal and support each other. Consider writing a long letter with stories about how they inspire you, when they decided on their career, funny events, etc.  Stress joy, humor… and gratitude.

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Spotify and/or Pandora without commercials

Many of us study with music, and most of us work (at least sometimes) with music in the background. These two platforms are currently the most used in the hospital. Being able to listen to the music of your choice without commercials is a great gift!

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InstantPot

Of all the cooking appliances and gifts, this one is the best for people who want to eat well but don’t have a lot of time. Even if you have to wrap the “IOU” (i.e. a picture of the InstantPot), it will be a very appreciated gift!

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A clean home

No one likes to clean their home, but all of us need this!  Even if it’s a deep clean every 3 months for a year, this is a great gift for anyone. Although there are professional services you can find, consider contacting local places of worship or non-profit organizations who may know responsible individuals who need the work.

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A subscription to Headspace

This one might seem a little strange, but you’ll have to trust me. For anyone who is “too busy” this is an easy way to really stop – even for 10 minutes a day – and “refuel”. BTW, get yourself a subscription (or at least try the first 10 lessons which are free). You’re welcome 🙂

Link to Andy Puddicombe’s TED talk (the founder of Headspace)

Other ideas for gift certificates

  • A healthy grocery store
  • A smoothie or juice shop
  • Their favorite restaurant(s)
  • Car wash
  • Starbucks (or even better, a local coffee shop near them)
  • Prepared healthy meals from one of the many companies that do this now
  • Membership to the YMCA or a gym near them
  • A new bicycle? (we never get too old to love this!)
  • “Date night” certificates for movies, plays or music and a meal
  • A favorite museum

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Happy New Year’s Resolutions!

Like most of you, my New Years resolutions in past years have been something like “Exercise every day” or “Eat fruits and vegetables with every meal.” And, I bet that you had the same experience I did… a few weeks of “success” and then they seemed to fade away. The problem with these kinds of goals are how they are structured. They end up being “either-or” goals … you are either able to do them or, more often, you miss a day (or two… or three) and feel like a failure.

I recently read a blog post by Ryder Carroll, the originator of the Bullet Journal which profoundly changed the way I think about goal setting and New Year’s Resolutions

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It’s a simple, but very powerful concept. Set your goal as a destination… as a “lighthouse” in the distance, and then head in that direction every day. As Ryder Carroll explains, “When goals are lighthouses, success is defined by simply showing up, by daily progress no matter how big or small…”

So instead of the usual New Year’s Resolutions, pick a few “lighthouse goals”. Write them down and keep track of how you are doing (every journey needs a map). This can be as simple as one piece of paper for each goal, but I am such a fan of the Bullet Journal, I hope you consider using it.

When you get up every morning think about how to move towards your goal(s). If you veer off course, that’s part of the journey…. look up, find your lighthouse, and correct your course.  Every once in a while (maybe monthly?), look at the progress you’ve made and celebrate it! If, on the other hand, the goals you originally chose don’t make sense for you any more, pick some new goals, draw a new map and start over.

Potential New Year “Lighthouse” goals

  • Learn more about compassion and practice it
  • Be a better friend
  • Write genuine thank you notes to people who have helped me
  • Become more fit
  • Eat real food for as many meals a week as I can
  • Find out more about who I really am through meditation
  • Keep a “stop doing” list
  • Be better at my work through deliberate practice (practicing and learning the things I don’t like and aren’t good at until I’m better)
  • Stay organized so I don’t waste time (and end up focusing on trivial things instead of what’s really important)
  • Read things that bring me joy
  • Learn about and use a Bullet Journal
  • Find a community to support me
  • Learn the names of as many people at work as I can
  • Take the stairs as often as I can
  • Make my living spaces enjoyable spaces
  • Keep a journal to remember milestones and work out struggles
  • Get good sleep as often as possible
  • Learn Spanish (or any new language)
  • Be on time
  • Remember people’s birthdays and send a card
  • Start the day with intention
  • Appropriately limit email and social media time

Holiday Gifts for Medical Students, Residents, Physicians and Other Busy People


Every year I try to post gift suggestions for the family and friends of people in medicine (and all other busy professions).  Here are this year’s suggestions!

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Photo credit (and article on the Art of Empathetic Listening)

Listen.  A great friend of mine told me once that human beings heal by telling stories. There are lots of stories in medicine that go untold, but I promise you there are stories. Listen mindfully, without judgment and without trying to “fix” anything. Start with “Tell me a story about something that amazed you”… and then take it from there. 

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Write a letter.  Write a “letter of recommendation”. Yes, I’m serious! Not a letter to “get” or be elected to anything, but a letter that shows you know who they really are and how amazing it is that they have dedicated themselves to something so important. Make it a love letter, a letter of support, a letter with family history to encourage them… but a real letter. Write it on a computer and then print it, or use some beautiful stationary and a pen, but create a physical letter that will sit on their desk. Put the letter in a special box (something you might add to from time to time with other short letters?). 

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Instant Pot. There are kitchen conveniences, there are fads, and then there is the Instant Pot. This has taken on almost cult like status among users for a reason. It’s a 6 in one device (pressure cooker, slow cooker, rice cooker, saute, steamer and warmer) that makes it easy to cook healthy food. For students and residents, the 6 quart basic Instant Pot does everything you need it to do, but feel free to choose one with more bells and whistles if you want. 

A cleaning service. No one likes to clean toilets. And, if you are working 80 hours a week, housework takes away precious personal time to socialize, exercise or restore your batteries in other ways. If you are in a position to do so, see if you can make this a win-win by working with a church, refugee placement group or another social justice group to find someone specific who really needs this kind of work. Whether it’s a one time “deep clean”, a monthly clean, or weekly cleaning and laundry, any help will be a deeply appreciated gift. Another approach is to do a little “sneaky” homework – your loved one may have a friend who has already found someone wonderful who might need more work.

 

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The Gift of Organization.  I have become a huge fan of the Bullet Journal. It is incredibly easy, very versatile and, I believe, a perfect system for medical students, residents and docs. (especially when paired with a list on your smart phone when you are separate from your Bullet Journal). Choose a good Moleskin journal and the new book by Ryder Carroll, who developed this technique, and wrap them together as a perfect gift. If you want to really make their day, include a package of good (but not too expensive) pens

A gym membership (and other related gifts).  It’s really hard to find time to exercise if you are busy, but it’s critical for mental and physical health. There are a lot of options here, but they need to be specific to the likes and dislikes of your loved one. If they are a runner, maybe a gift certificate for new shoes? Do they like spin classes? If so, check out where the good classes are near them. Same for yoga, dance, ice skating, tennis, swimming, etc. A membership at a YMCA ( if there is one near them) will give them access to weights, classes and often a pool. Would they commute to school/work if they had a good bicycle? Can you get them a new watch or fitness monitor that will help count steps and flights of stairs? Would an “on the go” exercise kithelp them? 

A Meditation App.  I tell my students that if they can only pick one thing on the self-care list to choose, that this would be it. There are plenty of data that show the stress-reducing benefits of meditation. What is amazing is that if you have a meditation practice the other self-care is easier, too. This is a great tool to help meet the goal to be better and happier physicians. 

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Your time.Can you cook some meals once a month and put them in their freezer?  Do laundry? Bake cookies and mail them? Get their car washed every once in a while? Make an elaborate certificate with something you could do for them and wrap it as a present?

 Need other ideas?  Here are links to some previous lists: 201720162014,

Take the Stairs

When I was an intern, I had an attending who always took the stairs.

Twelve flights.

Fast.

Multiple times a day.

We’d be on the second floor and he’d announce “Let’s go see Mr. Smith.” He would take off to the 12th floor with a trail of panting residents and students spread out behind him. Here’s the punch line: Every summer he would take a vacation to climb a mountain. To get ready for the climb he did…nothing. Climbing the stairs was enough.

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Why you should take the stairs

It is a great way to keep from gaining weight during med school and residency since it burns three times the calories of a brisk walk (even at a slow pace)

As little as two flights of stairs climbed per day can lead to losing 5-6 lbs of weight in a year.

You burn 8-11 kcals per minute climbing stairs.

Climbing stairs is essentially a series of vertical lunges.  You’ll tone your leg muscles – good for both strength and appearance.

55 flights of stairs/week = overall decreased risk of mortality.

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Tips on taking the stairs instead of the elevator

Even if you are fit, you’ll be out of breath climbing stairs. It’s normal.

Make sure you don’t overuse your calf muscles to power up the stairs – use your quads, hamstrings and gluts to protect your knees.

It’s ok to take the elevator down if you want to. Walking down stairs is actually much harder on your joints than taking the stairs up.  If you choose to walk down, use the rails (it’s stupid to fall).

It’s ok to use the rails going up the stairs. It provides a little upper body workout and doesn’t really diminish the advantages of climbing stairs.

Want to add more?  Find a more isolated stairwell and do additional exercises on the landings (e.g. crunches, burpees, pushups). Do “ladders” – up and down one flight, then two, then three, etc.

Want to go to the next level? There are actually “races” to climb the stairs of tall buildings.

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How to Succeed in Clinical Rotations (and residency, too)

Today I have the incredible joy of talking to the medical students on our rotation.  No agenda, just a conversation that they requested for some “advice”. They just started their surgery rotation last week and it’s their first rotation.  First rotation, beginner’s mind, unbridled enthusiasm… it is so wonderful!. I decided I would come up with what I wish someone had told me at the beginning of my rotations…

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Be mindful, deliberate and excited about learning.

This is probably the most important piece of advice I can give.  Clinical rotations are often a whirlwind of work and you can be swept away without realizing it. Residents can ignore you, people can be cranky, patients can be difficult… and in the midst of all this, you are expected to learn to be a doctor.  You have to stay in charge of that mission, no matter what is happening around you.

Take a little time to reflect on why you are doing this and what kind of person/doctor you want to become.  When times get tough (and they will) hold on to it.  If it helps you, come up with a slogan to repeat, keep on a piece of paper in your wallet or on your wrist

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Learn about the practice of mindfulness.  Mindfulness has been shown to be effective in decreasing stress and may help to prevent burnout.  It’s not hard to learn, but it’s hard to master … which is the point of a “practice”. (e.g. the practice of medicine)

Learn to keep a “beginner’s mind”.  When I was a student on core medicine I had a senior resident that showed me what beginner’s mind looks like.  It was 2am and I was tired.  We were seeing a gentleman at the VA hospital for his diabetes, hypertension and some electrolyte abnormalities.  I presented the patient to the resident and then we went to see him together.  He had a rash, which I thought was so insignificant that I didn’t even include it in my presentation.  But, instead of scolding me, this resident got excited.  Yes, you read that correctly, 2am and excited about a rash – because he didn’t know what it was. (This next part will date me, but it’s a great example to make us grateful for the access we have to information now).  He called security and had them open the library.  We spent a wonderful hour looking through books – like a treasure hunt when we were little kids – until we found the rash in one of the books.  We were laughing, excited and couldn’t wait to get back to start the appropriate therapy.

 

Understand what you are going to learn (the big picture)

On every rotation, you will be given a list of learning objectives.  By all means, know them, study the things listed and make sure you know them (they will be on the test).  BUT… please realize that diseases don’t stay conveniently siloed in a single specialty so this is not learning “surgery”, it’s learning about how surgeons approach a specific disease you will see elsewhere, too.   You also need to know that what is listed as learning objectives today may well be obsolete tomorrow  (if they aren’t already).

You have chosen a career that ethically demands life-long learning.  That means that one of the most important skills to learn is how to develop a system of learning that you can use in medical school, residency and later in practice.

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Develop a system for lifelong learning now

Learning is iterative.  You will learn broad concepts on each rotation along with a “fly over” of the entire terrain of the specialty  You will need the information you learn on your surgery rotation on your medicine rotation when you are consulted on a patient with an ischemic leg who needs surgical treatment, or on your pediatrics rotation when your patient with a pneumonia develops an empyema.  If you choose surgery at your career, you will read and learn the same topics throughout your residency (and after) but with increasing depth.

The practical points on how to develop a system to learn during your rotation are here: How to Ace the NBME Shelf Exams: How to Ace the NBME Shelf Exams, In-Training Exams and Your Boards, but the key points are summarized below:

  • Remember it’s school.
  • Make a list of all the topics in the textbook.
  • Breathe deeply. You are not going to read every page in the textbook in addition to your assigned reading.
  • Create a schedule to SKIM every chapter
  • TAKE NOTES. All the time.
  • Figure out how to store your notes so you can find them in the future
  • Go through your daily notes in the evening and then store them in your system
  • Review, review, review

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Take care of yourself.

Pay attention to ergonomics, diet, exercise and sleep.  Most importantly, take care of yourself emotionally and spiritually.  You can’t learn or serve others if your tank is empty.  Come up with what is important for you and make a list.  Seriously.  Make a list of what you find helps you stay on track and then check it off every day.  Look at it before you go to bed.  Celebrate the things you did and don’t be hard on yourself for the ones you didn’t get to.

Don’t forget to take a “Sabbath” every week.  True time off is critical for recovery from this stressful work.

If it gets too hard, seek help.  It’s a sign of strength, not weakness, and most (if not all) of the people around you have been there.

We have the most amazing job on earth.  When the administrative issues or political conflicts get to you (and they will), just remember – you get to take care of another human life with the goal of relieving their suffering.  What could be more important than that?

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Top 10 Holiday Gifts for Busy People (including medical students and residents)

What’s the best gift for a medical student or resident (or any really busy person)?

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Seriously, anything that frees up time for them is the best present you can give them.  If it supports their health or decreases stress, it’s even better!

Here are my top ten choices for best presents for medical students and residents – or any really busy person:

  1. A service or person to help clean their home.  Once a month?  Once a week? Any time they don’t have to vacuum or clean the bathrooms is a true gift.

Portrait of man with cleaning equipment

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  1. An Instapot. I’ve long been a fan of pressure cookers, but the Instapot takes it to the next level.  This is my new favorite kitchen tool and it’s high on my list because it both saves time and increases healthy food consumption!

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  1. A subscription to Headspace. This might seem counter-intuitive since it adds a 10 minute task to their day… but there are data (and lots of testimony) that a daily mediation practice “expands time” by decreasing stress.

Link to Andy Puddicombe’s TED talk (the founder of Headspace)

 

  1. If they live close enough to walk or bike to school/work, think about something that might help them combine that commute with getting some exercise. How old is their bicycle?  How about panniers to store gear on a bike? Would a great backpack help if they are likely to walk?  How about a gift certificate to a bicycle shop?

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  1. A gift certificate for Whole Foods or any place near them that has good, healthy prepared food.

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  1. Cookbooks with quick but healthy recipes like Thug Kitchen or Mark Bittman’s How to Cook Everything Fast.

 

  1. A Roomba vacuum cleaner. Plus, they may go viral with a cat on a Roomba video if they have a feline roommate.

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  1. A gift certificate to have their car washed and vacuumed every few months.

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  1. If they are a coffee drinker who spends time stopping at Starbucks, think about a really good coffee maker. I prefer Nespresso because the pods are recyclable (and the coffee is delicious).

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  1. Your time. Can you cook some meals once a month and put them in their freezer?. Do laundry? Bake cookies and mail them? Get their car washed? Make an elaborate certificate with something you could do for them and wrap it as a present.

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