How To Publish Papers as a Medical Student or Resident

First and second year medical students often are anxious about the “need” to publish but have trouble finding details about the process and goals of writing. Yes, it’s true. If you are going to be applying in a competitive specialty, you need to have at least one (but maybe a few more) publications. BUT (and this is really important, so please pay attention) there are two important things for you to know:

It’s called academic medicine because we are part of the academy! That means that we are trying to teach and change outcomes for the future. Don’t look on these papers as a “check box”. Find a meaningful question and learn from a mentor how to answer it. You will make a difference!

Secondly, you do NOT have to publish in the field you will ultimately choose. Publications are really a surrogate for being able to think, work in a team, and write. It’s showing that you can take a complex task and actually complete it. No one expects a first or second year student to know they want to be an expert in the pathology of Hodgkin’s disease! The key is to find a mentor who will teach you the process and show you how meaningful and fun it is to study something in depth and then share what you learned with others.

So how do you do this? It starts with a blank form:

So let’s break down the five steps from starting to publishing a clinical research project…. The times in parentheses are my estimates for how long this takes for a student who is on clinical rotations. If you are doing this full time as an month long research elective, it will take less time for each step. (But – note to self – you need to get the IRB request in 2 months before your research elective starts!)

Store your PDFs in Zotero – you can attach it as a file if it doesn’t automatically download. Don’t forget to add the Zotero plugin to Word if it doesn’t automatically install.

This last step is the key step (my opinion, others may have other strategies). My goal is to read each article ONCE.  Therefore, I put EVERYTHING I think might be of interest from each article as I create my outline. It’s a lot easier to edit things out than add things in…

I start with an outline in Word that has headings something like this….

  • Introduction
  • Epidemiology
  • Pathophysiology
  • Natural history of the disease
  • Presentation
  • Treatment
  • Outcomes
  • Complications

So, I might read this paragraph in an article written by Smith et al in 2015 (I’m making this up – don’t quote anything written below!)

Pyloric stenosis was first described in 1886.  Prior to the introduction of surgical treatment, the death rate was 50%.  Surgery, which started in 1923 has now led to an almost 100% success rate with no mortality.  The typical patient is male, and 4-6 weeks of age.  They present with projectile, non-bilious vomiting and do not appear ill between episodes of vomiting.

So – using the outline in Word and Zotero I would do this…..

You then go on to subsequent articles and – even if they mention the same detail – you put it into the outline. For example, if you found 4 articles that said the typical age was 4-6 weeks, it would look like this: Typically 4-6 weeks (Smith, 2015) (Brown, 2011), (Jones, 2000) (Who, 1014)

Next, use your outline to start actually writing about the information you have gathered. As an example, switch to the “text” setting to change your note about age at presentation from “Typically 4-6 weeks (Smith, 2015) (Brown, 2011), (Jones, 2000) (Who, 1014)” to text that says “The average age at presentation is 4-6 weeks (Smith, 2015) (Brown, 2011), (Jones, 2000) (Who, 1014)”

How to save yourself hours by using Outline View properly

The Institutional Review Board is responsible for protecting patients participating in research.  Even if you are “only” reviewing charts, they must be protected with respect to confidentiality, etc.  This is not usually true for case reports, but since many journals require IRB approval, you may have to submit it anyway and have the IRB letter that says it’s exempt.

It takes approximately 6-8 weeks to get the IRB approval after it is submitted.  If they require modifications, it can take longer.  You can’t (and shouldn’t) look at charts until you get this approval.

You must have IRB approval before you can submit the list of patients from the hospital with the disease you are studying. If they are treated by doctors other than the faculty you are working with, the IRB may ask you to send a letter via the hospital medical staff office to the other doctors giving them the option to exclude their patients if they want to.  (They virtually never do, but this is a required step)

The “term paper” is just what is sounds like.  Depending on the topic, it will be ~6-15 pages long with ~20-60 references. Here is where the outline and Zotero are so important.

Change the “view” in your outline to “draft”. The outline levels will be in Blue and will now be section headings. Everything that you wrote as text will be just that – text. You can write in this view or go back and forth between the draft and the outline if you want to rearrange sections.

All of the links to the references you put into Zotero using “Add/Edit Citation” will be in your draft. At this point, you click on “Add/Edit Bibliography”. It will prompt you to choose which journal you want (Yes! It knows the format of all the major journals!) and then will automatically create the bibliography. If you add new references in at the top of the manuscript, or change the order of the sections, you click this again, and it recreates the bibliography in the correct order.

As you are creating the outline, you are also designing the “data sheet” to retrieve from the charts the details you need to prove your hypothesis.

Writing a term paper is a great way to become an expert in the topic you are researching, but it also helps you later. The hardest part of any final paper to write is the introduction and conclusion – which you mostly do by writing the term paper!

Once you’ve got to this stage, you want to skim through the articles again to see if there are any “big picture” points you might have missed and then write the summary – i.e. the abstract.

It is ALWAYS better to write the abstract after the manuscript if you can.  But – many times the deadline for the abstract will be used as the motivation/pressure to write the manuscript.  Each attending will do this a little differently. 

Use this section as a “journal” for your submission and for notes during meetings.

Good luck with your projects! I hope this helped!

We Are Neighbors

I look around the spaces I work, live, and worship in and I see so many people I love. I believe everyone is my neighbor, but I’m specifically talking about the people I know…the smiling clerk I always choose to check out my groceries, the guy who waves at me every morning when I drive into the garage, my family, the people who share my mission of healing children.

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Only ~50% of the country is vaccinated and in some areas it’s only about ~30%. I know this means that some, maybe many, of the people I know and love aren’t vaccinated and, to be honest, it’s breaking my heart.

Because here’s the deal…

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The Delta variant is dangerous. Every person who is infected with the Delta variant will infect 6-8 people on average (which is more infectious than Ebola or chicken pox)… Unless you are in a group of people like a break room, a church, a gym…. In which case the number will be much higher because of the closed space. Being vaccinated makes it MUCH less likely, but not impossible to infect people around you other because of “breakthrough infections.” These infections after vaccination are rare but expected – it doesn’t mean that the vaccine “didn’t work”.

Masks protect you (some) and everyone around you (a lot) which is why they are so important now – whether or not you are vaccinated.

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But back to my friends and neighbors who aren’t vaccinated. The Delta variant is so infectious and spreading so fast that if you aren’t vaccinated, it’s not about IF you get infected, it’s about WHEN.

That’s why when I think about my beloved friends and neighbors I grieve because…

You will almost surely be infected with the Delta variant if you aren’t vaccinated.

You will go on to infect others around you, including people you love.

You will be sick (and probably really sick)… hopefully at home, but maybe not.

You may end up on a ventilator.

You may die.

And if you don’t die, you may be debilitated.

And it breaks my heart. Because these deaths are preventable.  And even one of you dying or being debilitated is one too many.

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I beg you…Get vaccinated. Wear a mask. #LoveYourNeighbor

(p.s. We are all neighbors)

“Running the List”

Where did this term come from?

For those not in medicine:

  • A busy hospital service needs a way to keep up with the “to dos” of the day.
  • The junior residents and students responsible for these tasks need a way to know what they’ve done and what still needs to be done.
  • The senior residents and attendings need to keep track of the information and what is happening to guide and supervise the junior residents and students.

And all of this means keeping an accurate and up to date patient list. This can happen digitally in Epic, which is often what attendings use, but for most residents and students it means printing out the Epic list to keep in their pocket as they move through their day (and/or night).

p.s. If by chance you are still making your residents use Excel i.e. they have to physically create the patient list, shame on you! (Unless you don’t have Epic or another digital way to keep the list, in which case, I’m really sorry.)

And how do residents and students use the patient list?

  • Almost everyone draws little boxes for every detail they need to check off … and then puts a check in the box when it’s done.
  • Different colors for different tasks? Doodles? Notes during rounds or lectures? All of these and more, I’m sure.
  • Fine tipped pens are key (Every resident has a favorite type of pen which they hide from their attendings).

And then we run the list

“Running the list” means starting at the top of the list and discussing each patient sequentially, one at a time. We make sure to go over the plan for each patient, discuss what has changed, learn what has been “checked off”, and decide what needs to be added to the list.

This happens routinely at the beginning and end of the work day, and during handoffs. But, on a busy day, it may happen even more often.

So back to the original question

Although it sometimes actually feels like the intellectual equivalent of running, I suspect that the origin of “running the list” has to do with the idea of a “running list” i.e. a list that you add to as new things come up. But that’s just an educated guess, since I couldn’t find any actual data. If you have other thoughts, let me know!

Final thoughts

Running the list is an important part of caring for patients, but it can also be a practice.

What if, like a competitive runner, you took a moment before you “run” the list to center yourself, take a few deep breaths and get ready to run?

What if you tried to visualize each person on the list as you review the day’s tasks to remember that these aren’t just tasks… they are human beings in your care?

What if we consistently made it a goal to teach just a little bit (or a lot, if the time permits) every time we run the list? (Would this be “walking” the list? 🙂 )

And at the end of the day, when you put your patient list in the shredder (don’t forget this important step! #HIPPA), what if you did it intentionally – to mark the end of the work day and the transition to not being in the hospital?

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Why we don’t ever say [the-word-we-do-not-say] on call…

“I was mad at the ER, so I said, ‘Hope you have a quiet night!” as I walked out.”

There aren’t many people more scientific in their thinking or more evidence-based in their practice than physicians.  And yet, like many of our sports heroes, many physicians are very superstitious.  We know that saying the word “quiet” doesn’t actually change what happens. It’s such a prevalent superstition though, that there is one randomized trial that was designed to prove it! (Make that two randomized trials…)

Why are human beings superstitious? Particularly in the face of uncertainty (…so just how many patients will come into the ER tonight?) superstitions reduce stress by creating a sense of control. It has also been shown that superstitions increase self-efficacy, which in turn results in improved performance in sports and other tasks. Maybe this is why baseball players and other athletes are so superstitious?  

My conclusion? I’m going to keep joining the chorus of groans from my team when the new medical student says [the-word-we-do-not-say] when we are on call. It makes us laugh, creates a sense of being in this together, and who knows… maybe our performance will be improved, too!

Top 10 Holiday Presents for Medical Students, Residents and Physicians: #COVID19 edition

Every year about this time, I create a list of presents I think busy healers (and healers in training) would appreciate. I don’t have to tell you that this has been a year that for all of us, but especially for everyone in medicine, has brought a new level of stress and sadness. The healers need healing… and in that spirit, here are some ideas of what you can send your friends in medicine for Hanukkah, Kwanza, Christmas, the Winter Solstice… or to celebrate the end of 2020 and beginning of a new year of hope.

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#10.  White coat, jacket and/or scrub “bling”.  Everyone who works in a hospital has a badge that must be worn all the time. And we all need pens (except for the attendings… we just “borrow” pens that students and residents keep in their pockets for us … just kidding … mostly). Here are some suggestions: Find a lanyard or badge holder from their favorite sports team or that will otherwise have meaning for them. Buy a box of cheap pens (that can be given away to needy attendings)  + a great pen that will remind them of you every time they write with it. For white coats, find a meaningful or humorous pin that could be worn on other clothes as well.

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#9 Happy Feet.  Think about putting together a “happy feet” box – include things like warm slippers, good socks, a certificate for a pair of shoes to wear in the hospital, compression socks, toenail clippers, and any other foot care products that sounds right. 

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#8 Better sleep. Sleep can be hard if you have had a really hard stretch at work. It’s especially hard if you’ve worked all night and have to sleep during the day. You can put together a combination of gifts like new high-count sheets, eye covers and ear plugs for sleeping after a night shift, a certificate for a new mattress, a white noise machine or a weighted blanket.

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#7 Work food. Busy students and residents frequently miss meals. Think about creating home made “snack packs” for the hospital by combining options like nuts, dried fruits, and high quality candy into small zip lock bags. Or buy healthy meal replacement bars in bulk. Make sure they are high quality, real food bars. My favorites are Kind bars but there are many other bars that are healthy and delicious.

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#6 Gift cards. When you ask students and residents which gift cards would be most appreciated it’s pretty consistently these three:  Amazon, Trader’s Joes, Whole Foods or other grocery stores, and Starbucks.

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#5 Digital upgrades. A high-quality phone is a critically important tool in the hospital. Everyone in medicine spends a good part of the day texting each other, looking up patients on Haiku (the Epic phone app), checking UpToDate for the latest treatments, finding other medical information in many other places and – of course – staying in touch with our teams, friends and families. Up to date computers, iPads, and AirPods (or equivalent) are also great gift options for any student or resident.

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#4 A cleaner house. Pre pandemic, I recommended someone to help clean as the number one gift for medical folks. But, even with the limitations imposed by COVID, there are still gifts that can help! Number one on this list would be a Roomba so they don’t have to vacuum.

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#3 Healthy meals at home that don’t take time. The Instant Pot has been my top recommendation as a gift for students, residents and busy healers for several years. Another wonderful gift I’ve recommended before is How to Cook Everything Fast: A Better Way to Cook Great Food by Mark Bittman. This year, I would add a certificate to meal delivery plans. The one I use is Clean Creations (because I like to have vegetarian options), but many of my friends swear by Freshly. Every city has companies that are similar, so do some homework and you’ll find several to compare. If you are a good cook, you might consider creating your own “meal deliveryservice” for your loved one, especially if you live in the same city.

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#2 Caffeine. This comes in different forms for different people, but unless they avoid caffeine for religious reasons, almost every healer and healer in training I know has a go to form of caffeine they love. For most people, it’s coffee. The number one gift on the list (my opinion) for coffee lovers is a Nespresso machine (and some pods to go with it). You can also get them a metal “pod” for their own coffee rather than the Nespresso pods which will save some money. There are other options for pod coffee machines, so you might want to read about them all before deciding. Having tried coffee from a variety of machines, I personal think Nespresso makes the best cup of coffee, but I am partial to espresso. Another great gift option for serious coffee drinkers is programmable coffeemaker so their coffee is ready when they get up at “dark thirty” to get to work. For tea drinkers, there are many options for teas, brewing systems, and pots. For all healers, regardless whether they are coffee or tea drinkers, a gift at the top of the list would have to be a Yeti or Contigo tumbler. These tumblers keep coffee or tea hot for hours… so your drink is still there and still hot when you get pulled away from that first sip.

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#1 Money. Students and residents, with rare exceptions, don’t have money for special things. Some don’t have enough money after rent and loans for things most of us would consider essentials. Giving money may seem a bit impersonal, but you can make it personal with a letter, a card, or creative packaging.

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p.s. If you want to check out my pre-quarantine lists for other ideas here are the links to last year’s list, and the year before.

p.p.s Thanks so much to my Twitter friends for helping me with ideas!

“Do you think it would be ok if I…?”

“We had a graduation celebration, but it was smaller than usual… only 20 people… and the older people just stayed a little while.”

“We meant to stay socially distanced… but you know kids.”

“God will protect me… I don’t need a mask.”

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Oh, how I wish this were over. We all do.

And it will end.

It will end, but what we have to grapple with now is how many of us will die unnecessarily before it ends… because the rest of us “had to get our hair cut” or thought this was some kind of political “hoax”… or just couldn’t be bothered.  

Because I am a physician, I have a lot of friends and family who call to ask some version of “Do you think it would be safe if….” I usually respond by telling them what I’m doing and then answer questions as they try to figure out the changes they need to make to be safe.

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I am in awe of how much we have learned about how the virus spreads in aerosols, how it stays on surfaces and how very infectious it is. We owe a huge debt of gratitude to the scientists who have tackled this pandemic with heart, mind and soul. This knowledge is guiding us, protecting us, and is essential to save lives.  

So, with gratitude for the science that has helped us better understand #COVID19, here’s what I tell my friends and family we are doing when they ask….

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Stay Home. We stay home unless it’s for an essential need. For example – we would go to the dentist for a painful tooth (but not for a routine cleaning). We have supported our local restaurants with pick up or delivery, but we don’t go to restaurants yet. When we do, it will only be outside and only if we are sure CDC guidelines for restaurants are being followed. There is no way we would go inside for a movie, rally, worship or other public gathering. The data are more than clear… large gatherings inside are the highest risk activities right now.

I get our vegetables from Pierre at a Plant It Forward farmer’s market sponsored by Dandelion Cafe. (I’m mentioning them on purpose because having these just picked vegetables has been a true gift!) But I have the rest of my groceries delivered. I ask the delivery person to put them on the step (by text). I wear a mask, and don’t open the door until they are more than 6 feet away to thank them. (BTW, they are doing amazing work to keep our communities safe – please tip often and as much as you can).

One of the questions I get asked about staying home is “but I’m young… isn’t it ok for me to go out?”. The answer is yes and no. Younger people are less likely to die or develop chronic lung disease from COVID19, but it’s not impossible. Here’s the real issue – If you end up infected with COVID19 you’ll infect people around you that are at high risk… and they could die or have horrible outcomes from the disease. Do you really want to risk hurting your grandparents or that nice guy at the store who always says “Hi” to you? Think about creating a “quarantine pod” as an alternative to going out to restaurants, bars and concerts… it’s not going to be the same, but it’s a good compromise to keep socially connected while being as safe as possible.

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Do it virtually if you can. If we are asked to run or be in a meeting, we do everything possible to make it virtual. If you are in charge of gatherings, this is an important responsibility. There is no reason to expose any of your colleagues or employees unnecessarily.

I’m an academic surgeon. I can’t do surgery virtually, but I can do a lot of clinic visits by video. I can do all my group teaching and committee meetings by Zoom. There is no moral justification to have meetings in person if they can be done online and I’m happy, as someone who can decide, to make sure my students and colleagues aren’t exposed to more risk than necessary.

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Socialize outside. If I am meeting a friend (or friends) I’ll only do it outside and only if we have discussed in advance how to manage the event. I’m excited that this weekend I’m going to an outside workshop that FAMHouston is facilitating to teach refugees how to grow vegetables in container gardens. These are my friends, so I really want to see them! We have established in advanced that we will meet CDC guidelines with everyone in masks and more than 6 feet apart.

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#WearYourMask. If I’m around anyone, I wear a mask, and I ask them to wear one – AND we stay at least 6 feet apart. The masks only come off if we are outside and more than 6 feet apart. It’s also really important to wear it properly! In particular, if your nose is hanging out, you might as well not have it on. Two other important things: 1) A face shield alone is better than nothing, but isn’t as protective as a mask and 2) the masks with the “breathing valve” aren’t worth wearing. Remember, my mask protects you. Your mask protects me. That’s why if we all wear masks we can stop the spread of COVID19!

Exercise with a mask available. When I’m outside exercising, I have a cooling mask (it is Houston, after all!) around my neck. As soon as I see someone coming towards me, I pull up my mask. I get a good 20-30 feet beyond them before it comes back down.

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Bring your own glass. I had a friend over for a glass of wine on the back porch not too long ago. They didn’t come through my house (and I would do the same for them). I opened the gate to the backyard, and they walked through my back yard to the back porch where I met them. They brought their own wine glass. We sat on opposite sides of the porch, 10 feet away from each other and had a wonderful, soul healing visit.

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Assume if someone else has touched it there is COVID19 on it. It’s a long shot, but what if… the UPS driver has COVID19 but is asymptomatic, coughs on their hands, picks up the package they are delivering … and now you pick it up. One inadvertent rub of the eyes at that point could easily mean an infection.

We put an old towel on a table and designated that table as “contaminated.” We put new packages on the table and immediately wash our hands. (If you work in an OR, you will understand this well… if you touch something contaminated you “rescrub” i.e. wash your hands before touching something else.) This sounds complicated but it’s not… if it’s just been handled by someone else, we assume it’s contaminated.

We have found that it’s easy to leave things on the table for 3 days before we open them (surprised us, too!). Obviously, groceries that need to be in the refrigerator are a little different (they get put in new plastic bags which go into the fridge). And, because three days may be long for some items…bottles of beverages get washed with soap and water before they go in the fridge.

Now, I have to be honest. A lot of new data are coming out that says we may be on the far end of safe with this. Some surfaces clearly are more at risk (like door handles), but things that get delivered are probably not really a problem. This is one to figure out your comfort level, stay up to date on the new info, and come up with a reasonable plan.

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I hope this helps.

Whenever I am tempted to say “just this once” … or fall into the trap of feeling like it can’t really be “that bad” to meet without masks, I think about how all my colleagues are putting their lives on the line to care for infected people… and how I would feel if I were the one responsible for their death, or the death of someone I know and love.

Be safe and take care of each other.

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#EyesOpen

Like you, I’m surrounded and sometimes overwhelmed with the fears and anxieties of the COVID19 pandemic. The world seems so very fragile and vulnerable right now. This morning was tougher than usual for some reason. So…. I got out of my chair, put on my shoes and went for a walk trying to look, with eyes open, for things to sustain me, connect me and provide solace.

Here’s what I heard on my walk …

A virtuoso mockingbird singing to the world (and, I assume, a few cute nearby mockingbirds), six different languages from people walking near me (I love Houston!)… friendly “hellos” from almost everyone I passed (all more than 6 feet away)…

Here’s what I saw on my walk…

A magnificent tree that I had never really noticed before… a family rescuing a caterpillar from the street with a stick… small purple flowers in the grass… kids on bikes… a butterfly garden in a “pocket” prairie…

Here’s what I learned …

Fear is gone when gratitude is present. They can’t be present at the same time.

It’s therapeutic to spend a little time with your #EyesOpen, preferably outside.

If you are a healer, thank you for what you are doing and stay safe. I’ll hold you in the light.

On the Twelfth Day of Christmas….

Did you ever wonder why Christmas is on December 25th? … or why we decorate pine trees if Jesus was born in the Middle East? To make the long story short (while begging forgiveness from my theology professors for the oversimplification), it has to do with the Roman Empire adopting Christianity as the state religion in the 4th century. When the Romans moved to conquer what is now England and Germany, the people they were conquering were more than a little reluctant to give up their celebration of the solstice and their understanding of the wonder of trees…. so the two religions “merged”, allowing these symbols to become part of the Christian tradition.

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And what about the 12 days of Christmas? Christmas (the religious holiday, not the shopping season) starts on December 25th and ends twelve days later on January 6th (Epiphany)… hence 12 days.

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As I thought about the holiday season, and the 12 days of Christmas, I came up with a different idea to celebrate this season… What if we all started a new tradition of donating a small amount to worthy groups for twelve days?  

I’ve listed twelve of my favorite charities below, but feel free to come up with your own. Even if you donate a few dollars to each one, you are celebrating the season of Christmas, Hanukkah, Kwanza and the Solstice in a powerful way.

  1. Doctors Without Borders (Médecins Sans Frontiers). This amazing group takes medical care into parts of the world where no one else will go. Their entire charter is worth reading, but they live by “observing neutrality and impartiality in the name of universal medical ethics and the right to humanitarian assistance.”
  2. Your local food bank. Whatever preconceived notion you might have about hunger in America is almost surely wrong. So many families, Seniors and disabled folx rely on food banks. Make this year a time to learn more about hunger in America and donate to feed your neighbors.
  3. A local animal shelter. Kindness to animals is the mark of a compassionate heart.
  4. Neighborhood initiatives. Regardless of your own religious background, or lack thereof, mosques, churches, temples, and synagogues seek to help those in need. Find the places of worship in your neighborhood,  look online to see what good works they are doing, and donate to help them. Better yet, take your donation in person to meet your neighbor and thank them for their work.
  5. Donate to help fight discrimination and oppression. There are so many important groups working for justice, a particularly important mission during this time of conflict and division. Consider donating to the Southern Poverty Law Center, the Human Rights Campaign, RAICES, Human Rights Watch, the ACLU or other groups focusing on justice for all.
  6. Action Against Hunger.  This group spends 94% of the money they raise in 47 countries to “take decisive action against the causes and effects of hunger.”
  7. The National Alliance to End Homelessness. You can also donate to local shelters for the homeless, or programs like Healthcare for the Homeless in your town or city.
  8. Prevent Child Abuse America. As someone who works with abused children, I would also encourage you to donate to the chaplain program at your local children’s hospital. The chaplains see the specific needs of these children – but more often than not don’t have resources to provide meal vouchers, toys or clothes to help a family during these moments of tragedy and pain.
  9. Consider donating to a group that is working to stop climate change, or other groups that advocate for and protect our natural resources such as the American Bird Conservancy or the Nature Conservancy.
  10. Make sure an isolated senior has a visitor and food by donating to Meals on Wheels.
  11. Time. If you don’t have money to donate, make a commitment to volunteer with a local group to help others. “You make a living by what you get. You make a life by what you give.” ~Winston Churchill
  12. I am personally involved with FAM Houston (consider this my COI declaration!), a group that inspires me through their mission of “working for justice by building empowered community among refugees, immigrants, and local Houstonians.” Through building friendships and creating community they show that any light, no matter how small, is a miracle of love. If you are in need of a worthy group for your twelfth day of Christmas donation, please consider them!

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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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