Last Minute Holiday Presents for Medical Students, Residents and Busy Docs

Posted on December 18, 2016 by marylbrandt

It’s the holiday season in a very short time, so I thought I’d put together a list of last minute presents! These are presents that would work for anyone, but are particularly suited for medical students, residents and busy physicians.

A really good water bottle

None of us drink enough water at work …. having a water bottle does help! There are many out there but make sure the one you choose doesn’t have BPA in it. Glass and steel bottles are probably the safest, but BPA free plastic bottles are fine, too. As an added bonus, you can put something in the bottle before you wrap it… chocolates or another favorite candy, gift cards to Starbucks, etc.

Photo credit and link to a site listing “best” water bottles

Pandora One

Listening to music you like without commercials is a great gift for listening while studying, in the clinic or in team rooms. Pandora can be played on any computer but also has apps for mobile devices. There are other sites, too, but this one is my personal favorite.

Here’s where to go for a gift certificate.

iPad

I am a total fan of my new iPad Pro, which has taken over as my computer on a lot of days. Because of it’s amazing power, there are medical apps, like this anatomy app that won’t run on other iPads. But the iPad mini may be a better choice for students and residents …. mostly because it fits in the pocket of a white coat. Make sure you get a cellular network plan with the wireless option, if this is the gift you choose.

Link to information on the iPad mini

Anatomy Coloring Book

This is a great combination of the proven stress relief of adult coloring books and learning anatomy. (or reviewing it, even for docs in practice) Don’t forget to order the pencils, too!

Link to order

Electric Pressure Cooker

Pressure cookers in general are an amazing kitchen tool… but the modern electric pressure cooker is also a rice cooker, slow cooker, steamer which makes it the single best kitchen appliance for students and residents.

Link to order

Prepped meals (ready to cook)

If they like to cook, but don’t have the time to find the healthy recipes and prep the meal, this is a great idea. Check out Green Chef, Blue Apron, and Hello Fresh as examples. You might want to search locally to see if there others close to you.

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A gift card to get them started with Stitch Fix

Stitch Fix is perfect for both men and women that either a) hate to shop for clothes or b) love to shop for clothes but don’t have time. It’s a service many of my friends use and love, so I can personally recommend it. After you sign up, they send 5 items a month (or at whatever cadence you want). You send back the ones you don’t want and get billed for the ones you keep.

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A membership to a local museum

If there are museums in the area that correspond to an interest this could be a great gift. Museums like the Houston Museum of Natural Sciences, the Museum of Modern Art in New York, etc. are a great way to enjoy time off. Include a note that says you are giving this to them as a break from their studying or work!

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Best wishes for a joyous holiday season, peace in your lives and on earth and a New Year filled with health, happiness and joy!

Advice physicians should follow. But don’t.

Posted on November 8, 2016 by marylbrandt

This is a truly wonderful piece from Emily Gibson, re-posted here with her permission from her beautiful blog, Barnstorming. Enjoy!

As we drown in the overwhelm of modern day health care duties, most physicians I know, including myself, fail to follow their own advice. Far too many of us have become overly tired, irritable and resentful about our workload. It is difficult to look forward to the dawn of the next work day.

Medical journals and blogs label this as “physician burnout” but the reality is very few of us are so fried we want to abandon practicing medicine. Instead, we are weary of being distracted by irrelevant busy work from what we spent long years training to do: helping people get well, stay well and be well, and when the time comes, die well.

Instead, we are busy documenting-documenting-documenting for the benefit of insurance companies and to satisfy state and federal government regulations. Very little of this has anything to do with the well-being of the patient and only serves to lengthen our work days — interminably.

Today I decided to take a rare mid-week day off at home to consider the advice we physicians all know but don’t always allow ourselves to follow:

Sleep. Plenty. Weekend and days-off naps are not only permitted but required. It’s one thing you can’t delegate someone else to do for you. It’s restorative, and it’s necessary.

Don’t skip meals because you are too busy to chew. Ever. Especially if there is family involved.

Drink water throughout the work day.

Go to the bathroom when it is time to go and not four or even eight hours later.

Nurture the people (and other breathing beings) who love and care for you because you will need them when things get rough.

Exercise whenever possible. Take the stairs. Park on the far side of the lot. Dance on the way to the next exam room.

Believe in something more infinite than you are as you are absolutely finite and need to remember your limits.

Weep if you need to, even in front of others. Holding it in hurts more.

Time off is sacred. When not on call, don’t take calls except from family and friends. No exceptions.

Learn how to say no gracefully and gratefully — try “not now but maybe sometime in the future and thanks for thinking of me.”

Celebrate being unscheduled and unplanned when not scheduled and planned.

Get away. Far away. Whenever possible. The backyard counts.

Connect regularly with people and activities that have absolutely nothing to do with medicine and health care.

Cherish co-workers, mentors, coaches and teachers that can help you grow and refine your profession and your person.

Start your work day on time. End your work day a little before you think you ought to.

Smile at people who are not expecting it, especially your co-workers. Smile at people who you don’t think warrant it. If you can’t get your lips to smile, smile with your eyes.

Take a day off from caring for others to care for yourself. Even a hug from yourself counts as a hug.

Practice gratitude daily. Doctoring is the best work there is anywhere and be blessed by it even on the days you prefer to forget.

I Forgot To Tell You About My New Favorite Breakfast!

Posted on August 19, 2016 by marylbrandt

This morning I was lecturing to the first year medical, PA and DNP students. At the end of my embryology lecture I included some advice on how to eat well as a busy student. I talked to them about how to set a good example for their future patients, how to increase vegetables in their diet by making Mirepoix every weekend, shopping at the farmer’s market, and how to plan for the week. I also talked about why it’s important to eat breakfast. I told them about one of my favorite fast breakfasts, but forgot the second one!

MLB BREAKFAST TACOS

Here are the ingredients:

This batch had beans, cheese, a red bell pepper, a jalapeño and some cilantro, but you can add anything! Spread out the tortillas and divide up the ingredients between the tortillas.

Roll them up, put them in the freezer. Two minutes in the microwave and they are ready to eat!

OVERNIGHT OATS

This is SO easy and really delicious. Put ~1/3 cup rolled oats in a bowl and add twice as much (~2/3 cup) liquid. (You may need more of both depending on your caloric needs)

My favorite liquid is kefir (liquid yogurt), but it can be milk, almond milk, soy milk, etc. Leave it in the refrigerator overnight. Eat it in the morning. That’s it!

You can add any variety of fruit, nut or nut butter the evening before or in the morning. My current favorite is blueberries and slivered almonds added in the morning.

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How To Study in Medical School

Posted on August 1, 2016 by marylbrandt

Congratulations to all the first year medical students who are starting or getting ready to start medical school. As you will soon seen, from day one there will be an overwhelming amount of information to process and learn … much more than any you have seen during college. It’s going to take a new strategy!

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Unlike college, the information you learn during your preclinical studies will be important when you take the first part of your licensure examination (Step 1) and when you start your clinical rotations in 2 years or so, and when you start your residency.

It’s not just about learning this information for your exams, it’s also about creating a system to organize this information for the future.

What should an ideal system let you do?

Hand write or type your notes
Highlight and annotate notes to make them more easy to remember
Import images, pdfs, powerpoint presentations or other digital information
Review the notes on your phone or iPad as well as your computer
Revise or reclassify notes as you learn more
Make sure your notes can’t ever be lost or destroyed

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What “notes” should you use to study?

Use the notes provided by your professors, usually in the form of a powerpoint presentation or pdf of the presentation. Many students download the presentations into OneNote and annotate the slides during the lecture. If you use this system, it will be very important to make a one page summary of the key points. Going back to review each slide is very time consuming and not a good “juice to squeeze ratio”. (the effort you put into it is not worth what you get out of it).

Take notes in class or to review like you did in college (highlighters and all!). If you choose to do this, use the SQR3 method or the Cornell note taking method to prepare i.e. don’t come in cold to class. Write down the big topics to be covered, and come up with questions you expect to be answered in class. The key is active listening!

Try mindmaps. Your brain doesn’t organize things into bullet points. If you use colors, images and this more “organic” organization, it’s amazing how much you can remember. Like mnemonics, the more outlandish the images and colors, the easier it is to remember. You’ll find an example of a mindmap to learn about pilonidal disease below. Note, for example, that the image for obesity is a stick of butter surrounded by fat globules. It’s creating your own images that makes this so powerful. Even though you can share mindmaps, or use software to create them, it’s more effective to draw your own.

Handwritten may lead to better learning…. Worth thinking about!

pilonidal

How should you organize your notes?

Here’s where it gets fun. Organizing notes with Evernote is the best way I’ve found (ever) to do this. Evernote is an app for your computer and phone/iPad that allows you to store “notes”. But, the notes can be a lot of different formats:

New notes, typed directly into the software
Imported notes from OneNote or a powerpoint presentation
Scanned notes. Evernote has an amazing free app called Scannable that converts any document into a pdf using your phone. So. if you draw a mindmap, doodle about the anatomy of the rotator cuff or have a typed handout from someone, you can scan it into EverNote.
Photos of whiteboards, paper notes, images.
Videos, like your professor showing you how to examine the knee for instability.
There is an Evernote “web clipper” that can be used on your computer to download any webpage.
Audio notes. You can record a review for yourself and save it as a note.

Other advantages to using Evernote

You can share notes with others
You can find information by searching. Both typed and handwritten words will be recognized.
When you store a link to a video it’s active, so you can click and go directly to the site.

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What should I do before I set up this system?

Start the notes now – even though you don’t have the system in place. Listen actively and take notes actively. Make sure you create one page summaries of every lecture. Keep these to scan in when you start your account.
Download Evernote for your Life | A Practical Guide for the Use of Evernote in Your Everyday Life by Brandon Collins and read it before you create your system. This ebook is concise, easy to read and will explain why you can’t think about EverNote as a “filing” system in the usual sense.

A few other words of advice

Create your Evernote account with an email address that will follow you through your training. (By the way, if your personal email now is sexyguyfromthecity@gmail.com, it’s time to get a new and more professional address!)
I’d create one huge notebook called “Everything I need to know to be a doctor” (just kidding.. but don’t fall into the trap of creating a lot of different notebooks, either.)
When you start, be very deliberate about your tags. You don’t want to end up with “Penicillin”, “penicillin” and “penicillinV” as three tags for penicillin… Decide how to standardize your tags before you start i.e. when to capitalize, generic names of drugs only, etc.
Evernote is not HIPPA compliant. Don’t EVER put any patient information (including photos) that could be identified.
Go ahead and spend the money for Evernote premium. You’ll be using all the storage and the bells and whistles.

Residency Applications: The Curriculum Vitae

Posted on April 4, 2016 by marylbrandt

Other than the personal statement, there is nothing more distressing to medical students applying for a residency than putting together a Curriculum Vitae (CV).

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So, what exactly is a CV?

“The original Latin meaning of curriculum was a course, but of the kind that one runs around (it came from currere, to run). Even more recent — dating from 1902 — is curriculum vitae, literally “the course of one’s life” (from World Wide Words)

Your curriculum vitae is a document that serves as a summary of what you have accomplished as a professional.

What’s the difference between my CV and what I put on my ERAS application?

Your CV and what you put in ERAS differ in two important ways – the content and the format. ERAS will generate a CV from the information you enter, but it’s not in a format that is usually used for a professional CV. In addition, the ERAS generated CV will not have the same information you will want on your CV. For example, ERAS “experiences” don’t translate well into a professional CV.

Why do I need a CV in addition to what I put into ERAS?

You will need to give your CV to any faculty writing a letter of recommendation.
You may be asked to send a CV when applying for away electives.
It’s a good idea to take your CV with you on interviews to provide a copy to the program, especially if you have updated it since your application was submitted.
If and when you send emails to programs after you interview, it’s a good idea to attach your CV if it has changed at all. Bcc yourself when you do – if there is a problem with the email or the attachment, you’ll know it quickly.

What do I need to include in my CV and what should it look like?

There is no absolute “standard” format for a CV, both in content and in style, but there are some guidelines. In general, in addition to the “heading” with your name and contact information, the following sections (if they apply to you) should be included in the order they are listed.

Education (degrees, institutions)
+/- Place of Birth
+/- Citizenship
+/- Languages
Military service
Work experience (this is not summer jobs unless the pertain to your application i.e. don’t list being a waiter, etc!)
Volunteer experience (make sure it’s significant. There is no advantage to listing 20 things that all lasted a week or two …. again, unless it’s specifically related to your application… see “don’t pad your CV” below)
Other training (eg BLS, ACLS, special courses to learn a skill)
Professional memberships (including leadership positions, committees)
Honors and awards
Publications
Presentations
+/- Personal interests (drop after you match if you include it)

It’s a good idea to show your CV to mentors in your specialty to get their feedback since there can be subtle differences in CVs between specialties.

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What should I do to avoid common mistakes in creating my CV?

Pick one font and stick with it. (11 or 12 font and something really standard).
List items in each section in reverse chronology (most recent first)
Number your publications and presentations.
Leave plenty of “white space”
Don’t “pad” your CV with trivial events or accomplishments – it’s more important it’s accurate and appropriate than long.
Go ahead and list “hobbies and interests” as your last topic for the residency application, but remove it as soon as you match.
Double (no, triple) check spelling and formatting. Your CV is often the first impression a program will have.
NEVER put any designs, photos or logos on your CV.
If you put your personal email address, make sure it’s a professional email address. If it’s not, it’s time to get a new one.
Don’t EVER lie or exaggerate.

Where can I find examples or templates for my CV?

Many medical schools have examples on line and all schools have help in the Office of Student Affairs or through other faculty mentoring programs. You can also sign into Careers in Medicine to see examples of CVs, which are also here.

What should I do with my CV after I match?

Remember, your curriculum vitae is a record your professional life… so it’s a “living” document that will need to be updated as new things happen. There is no one else who will every know exactly what you do and what’s really important more than you will. Keep a list somewhere of everything new that should go on your CV and sit down at least every month or so to review and update your CV. After residency when you “graduate” to having an assistant of your own, it’s still probably better to update your CV yourself. The AAMC provides a good example of a typical Faculty CV here which gives you an idea of what your future CV will look like!

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Overwhelmed by Email

Posted on February 15, 2016 by marylbrandt

“Email is both a miracle and a curse. At no other time in human history have we been able to exchange messages instantly globally; but at the same time, our ancestors didn’t spend hours each day sifting through memos, missives and newsletters we probably should just unsubscribe from.” Kadhim Shubber

In the last few weeks, I have spent time counseling colleagues who had real issues after missing one or more critical emails. I totally understand why… the volume of emails, and particularly of spam we all get is totally out of control. But the volume doesn’t really matter when you miss a critical deadline or, in the case of some medical students this year, an offer for a residency interview.

Young man receiving tons of messages on laptop

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The key is to have a system – and to change the way you look at email.

When you open an email message you only have three options and one of them is not to keep it in your inbox! Don’t use your inbox as a “to do” list – the emails will stack up and it becomes unmanageable. The simple way to avoid this is to open each email message and immediately do one of three things:

Delete it
Answer it
Create a task

Other important things to know about deleting (or not deleting)

Microsoft has recently introduced a new function for Outlook called Clutter. It’s a good thing – as long as you know it is there and how it works! In a nutshell, this function uses your behavior to decide if you want to see the email or if the email should automatically be sent to the “clutter” folder. Beware – you need to either check the folder or disable this function, particularly at first.

The two other critical tools to help “debride” your email are to unsubscribe to emails you really don’t want to see, or block the sender (for true spam). For other great tips, check out How to control your inbox from lifehacker.com and these tips from The Observer

Create a task? I am a big fan of Remember the Milk, but there are many other “to do” programs out there that would work, too. When I get an email that I need to turn into a task I send it to the “inbox” of my Remember The Milk account. Once it’s there, you then

Put it in a list (the four lists in my account are “Today”, “This week”, “Projects” and “Ideas”, but you can create any lists you want)
Give it a priority
Give it a due date
Set a reminder (if you need to)

Check your list! However you choose to make your task list, check it every evening to organize the next day’s tasks. This is critical to making this work. Don’t list 20 things either. Be realistic and put the top 3-5 things on this list!

Check your email! Check your email at least once a day, but not all the time… and NOT at your most mentally active time! For most people that means checking email in the afternoon or evening.

Change your mindset. Email is how professionals communicate, so we all have to learn how to handle our inbox without becoming frustrated or angry.

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I learned a very valuable approach from a friend one day when we were talking about email. I said there were times I just dreaded sitting down … and even got angry because of the volume of emails I have to answer. Her solution? Turn answering email into an exercise of gratitude. Be grateful that you have hands to type, eyes to see the screen, and the privilege of work.. As simple and potentially silly as this seems, it is a powerful tool to change how you look at answering emails. (p.s. it also works for the EMR!)

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Don’t Lose your Wedding Ring!

Posted on October 24, 2015 by marylbrandt

“I can’t go home.”

“Why?”

“I’ve spent the last 3 hours with the folks in the laundry room trying to find my wedding ring, but I think it’s really gone.”

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One of the lesser-known hazards of working in a hospital is that you have to take your wedding ring off to scrub for procedures.

I started with tying my rings into the drawstring of my scrubs … then moved to the “watch band” method. I use my badge lanyard now – which I think may be the most secure solution yet.

Even though I’m happy with my solution, I thought it might help to poll my colleagues to see what they do. After looking at their responses (below) , I realized that the most important thing is to develop a routine – i.e. do it the it the same way every time. And, while you are at it, make it a ritual to remember and be thankful for the support you have at home!

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1. Tie it to your scrub pants.

“Tie it to my scrub tie”

“I tie it on my scrubs with about 5-6 surgical knots.”

“I tie it in my scrubs. I tried the necklace thing but found it too cumbersome.”

“Take it off. Tie in drawstring of scrub pants. When changing, never set it down. Finger-drawstring-finger. 46 years without a hitch.”

“I tie it to one of the ties on my scrub pants, that way it doesn’t fall off when I untie… and I check it on my finger like I check my pager on my hip.”

“Tie watch, wedding and college rings in drawstring of scrub pants.”

“Tie it to my scrub ties with a square knot (after losing my ring 3 months after my wedding). Does require some planning if you need to hit the head quickly between cases!”

“Tie it onto your scrubs. Can’t get your pants off without getting your ring.”

“When tying your pants, do the bow. Then double knot it through your ring. As of today, has worked for me for 33 years.”

2. Put it in a pocket

“ I used to tie mine in my scrub ties, but that got cumbersome and I was afraid I’d toss it by mistake. I toss it in my back pocket, which seems not terribly secure, but it works for me. ”

“Back pocket – also lost a ring a few years after my wedding. Now going on 28 years with the same ring.”

3. Put it on your watch band (which then goes on your scrubs, on the desk, in your locker or in your loupe box)

“The best may be to put it on your watch band and tie your watch to your scrubs. That way you would know it was there.”

“Put it with my watch in my loupe box. I wear loupes for every case so that works. If you don’t… it may not be as effective.”

“I tie it to my watch and leave it in the locker!”

“Put it on my watch band.”

“Put it around watch band which I tie to scrub pants drawstring while scrubbing.”

4. Put it on a chain or lanyard

“I used to tie it on my scrubs but lost it one night in L&D. I got home and noticed it was not on my hand, went back to L&D, and found it under the couch but since then I got a silver neck chain with an easily accessible latch that I thread it through right before tying my mask.”

“After losing several watches tied to my scrubs I wear wedding band, engagement ring and bootie for each child on chain around my neck.”

“Necklace. I always wear the same one.”

“I wear mine on a necklace when I scrub. Got a nice one that I trust will not break. 7 ½ years so far….”

“Necklace that my wife bought me for this very purpose. Tried putting it in the scrub pocket, but inevitably it would end up on the floor in a dirty OR”

“Necklace!”

“Colleague put hers on necklace, but technically doesn’t meet OR dress code (although it was a long chain, hung inside her scrubs).

“I clip it on my ID lanyard.”

“Use a necklace made for this.”

5. Put it in your wallet

“I have a key case with a zip compartment for coins and ring – though I must admit I am on wedding ring number 2 (I suddenly had to jump into a case to help with bleeding – the ring went into my scrubs pocket and that was it.) Fortunately my wife made my second ring herself – am taking extra care.”

“Place it inside my wallet, which then goes into my back pocket.”

6. Put it in your loupe box

“I put it in my loupes box with my watch and regular glasses – but I wear loupes for every case. Over the years, I’ve had to go searching through dirty scrubs too many times when I forgot to every attach it any way to my scrubs again!”

7. Pin it to your scrubs

“Hang it from the over-sized, decorative pin that your wife gave you.”

“I use a safety pin on my bra strap. You may have to change scrubs, but I’ve never had to change the former!”

“I always pinned it to the front of my scrubs, but the real motivation to not lose it was to envision the slow and painful death I would face if I did!”

“Diaper pin on the outside of scrubs where the back part of pin passes behind your bra strap so pin must be removed to get scrub top off.”

8. Wear something other than the “real” ring

“I wear a comfort band to work instead of my fancy ring.”

Wear silicone rings or other cool alternatives

“Bought a back up (I lost mine 16 years ago, but mine had never been in outer space like yours.)”

9. Leave it at home

“I leave my ring at home on OR days.”

“No ring on OR days.”

“Leave it at home.”

“Lost two; leave at home on OR days. If I lose another, I’ll replace on the sly… 🙂 17^th anniversary Saturday.”

“Always left it at home.”

10. Find a different but creative alternative.

“Duh. Loop it thru your belly ring.”

“Get a ring tattoo”

“I had parts of my ring used to reconstruct earrings, so I guess you could say I wear mine on my ear.”

Use A carabiner – can clip to lanyard, necklace or leave in locker.

Use unique solutions like the RingCling

Tie it to your shoe.

11. Don’t worry about it.

“If you’re my husband, you lose it and don’t look back. At least he still loves me. :-)”

“I lost two and gave up.”

“No longer wear one after losing my third. Gave up.”

“I’m not very successful with keeping my wedding bands. But I don’t care cause I’ve got the same loving guy for the past 43 years!”

“After two diamonds and three bands – and a first name basis with Alan, owner of the antique jewelry store near me – I just don’t fret too much. It’s the love, not the gold, that counts.”

And as I final note…

“If so many people have lost rings, where do they all go?”

“They go join the lost orphan socks of the world.”

It’s the First Day of Medical School – What Should I Do?

Posted on August 1, 2015 by marylbrandt

I’ve written before about what to do before medical school starts, how to study in medical school and strategies for succeeding in the basic sciences. But how do you put this information about organizing your studying and your day into a system that works? Everyone will have variations on how they do this, but there are some fundamental principles that apply to all.

Don’t get behind

From day one, the material matters and, from day one, it is voluminous. If you get behind, it’s really hard to catch up.

Study, don’t just read and reread.

You have to actively engage this material and review it (multiple times) to really learn it. You are no longer studying for a test, you are studying to take care of other people. The SQ3R method is used by many students, but there are other systems as well. What is important is to develop a system that works for you. One tool used by many students is Anki, software that allows you to create electronic flashcards to review key points.

Tips on active studying from UCSD

Tips on active studying from the University of Utah

Use going to class as time to “study”

One of the important components to active learning is to review the lecture material before it is presented. This is the opposite of what most of you experienced in college, but it’s key. Survey the handouts or slides and make a list of the important points to be covered. Stay actively engaged.

p.s. You can’t learn medicine if you are on Facebook in class.

Create a summary page for each lecture

Include the big concepts, and key points. Include specifics that are stressed by the professor, but avoid listing all the details. You may choose to hand write this, but most of you will come up with an electronic format and will organize the class notes, and your summaries using One Note, Growly or an equivalent software. Although your personal notes are fine on the cloud, don’t put copyrighted material or your professor’s slides where other people can see them (it’s illegal).

Begin with the end in mind

In the long term, what you are learning (yes, all of it) will be applied to taking care of patients. In the slightly less long term, you will be tested on this information on the USMLE Step 1, a high stake exam and the first part of your medical license. Although some dedicated time to study for Step 1 is important, having a system to really learn the material in your basic science courses is by far the best way to do well on this exam.

Don’t sacrifice sleep.

If you don’t sleep you don’t learn as well. Organize your schedule so you get at least 7, but preferably 8 hours of sleep every night.

Eat well, play hard and stay connected.

Clay Goodman,MD the Associate Dean of UME at Baylor, tells our first year class that the first year of medical school is a 60 hr/week job. They need to get up in the morning and “go to work”, using the afternoon and evening to study. He then points out that if they work 60 hours and sleep 56 hours (8 hours a night) they still have 52 hours to work out, spend time with family and friends and do whatever else they want.

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So, what should you do the first day of medical school?

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Here’s what your schedule might look like…

The night before – pack your breakfast for the morning break and lunch for the next day. Review any posted slides – survey them to understand the “big picture” and use them to start your summary of the lecture. Write down what you don’t understand from the slides (yes, at this stage it may be every line… but that will get better!).

7am – wake up (If you prefer morning workouts, you can get up earlier and workout before class)

7:30 Grab a piece of fruit or a smoothie if you don’t like to eat an early breakfast. (If you are ok with it, eat the full breakfast now, but whatever you do, don’t skip breakfast)

8-12 Attend class – Stay engaged. Take notes, make sure the questions you asked yourself in the review are answered, raise your hand and ask questions if they weren’t. Eat your breakfast or a snack at the 10 am break.

12-1 – Lunch with your classmates. Play foosball, talk, or just eat, but take a real break.

1-5 Study. One hour of studying for each hour of class is about right for most people. This may need to go until 6 or 7 if you have afternoon labs.

7 – Workout and then make and eat dinner. Working out is an important part of self-care. Exercise is essential to decrease stress and also will help you avoid the “freshmen 10”. Your dinner should be healthy, not processed, and definitively not Ramen noodles. Make sure you have fruits and/or vegetables at every meal.

9-10 Look over tomorrow’s lectures and start your summary pages for those lectures. Once you are a week or two into this, you’ll be adding in reviews of material from previous weeks on a schedule.

10-11 Read a novel, watch TV, decompress.

11 Go to sleep!

You are starting on one of the most amazing journeys any human being can have… enjoy it! Don’t forget to keep a journal and take photos (but not of patients). The first time you actually interview a patient, put on your white coat, hear a heart murmur or take a test in medical school are just that … the first time. Write about the experience.

Let me know in the comments what other advice you have for the students starting medical school this summer!

Letters of Recommendation: Advice for Faculty

Posted on July 23, 2015 by marylbrandt

It’s the time of year when fourth year medical students have decided on their specialty and are working on their applications to enter the NRMP match. It’s also the season that faculty are asked to write letters of recommendations. With approximately 17,000 medical school seniors applying, there will be around 100,000 letters of recommendation written this year!

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If you have had the benefit of sitting on a residency committee to evaluate and rank applicants, you’ve read these letters – and you know that they matter. If you haven’t had that experience, it will be important to seek advice on how to write these important letters. Seek help from other faculty with more experience or review the great advice posted by the University of California- San Francisco and the University of Illinois Urbana-Champaign.

A few other points that may help:

This year, for the first time, faculty will have to upload these letters themselves. You can have a “designee” (your assistant, for example) do this for you – but it cannot be someone in the Office of Student Affairs. Make sure you get started early so it doesn’t become an issue as deadlines approach! The help desk at the AAMC is wonderful, but it’s going to be a problem if you wait until the last minute!

Proofread. Twice. This is the first year that the Deans in your school won’t be able to look at your letters. No one means to make mistakes…. but in years past, I’ve found letters with the wrong names, the wrong gender and grammar that only sort of made sense. Needless to say, for the Program Directors it raises a question about whether your letter is legitimate.

Instead of having the students worry (think back…. you worried, too), let them know when you plan to upload their letter. Regardless – make sure they are uploaded by September 1^st.

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On behalf of all the students you are helping, and all the departments who rely on your letters to help match students to their programs – thank you!!

Resilience, Grief, and Remarkable Wisdom

Posted on June 4, 2015 by marylbrandt

My heart breaks for Sheryl Sandberg’s loss of her husband … and I am so grateful for her honesty, her wisdom and for the effort it took to share her journey. As I read her post on Facebook today, I realized that all of us in medicine could benefit from her thoughts as she ends sheloshim, the Jewish 30 days of mourning for the loss of a spouse.

One of the things that is so hard to teach in medical school (and all other health professions) is to honor the resilience of those we accompany on their journey through times of struggle and loss. It is so hard to let go and realize there is nothing to “fix” in these situations. Far more important than trying to convince our patients, their families or our friends that it will be “better” or that there is “hope”… we need to commit to just being there with them, and walking with them on this very human… but incredibly hard journey.

“I have learned that I never really knew what to say to others in need. I think I got this all wrong before; I tried to assure people that it would be okay, thinking that hope was the most comforting thing I could offer. A friend of mine with late-stage cancer told me that the worst thing people could say to him was “It is going to be okay.” That voice in his head would scream, How do you know it is going to be okay? Do you not understand that I might die? I learned this past month what he was trying to teach me. Real empathy is sometimes not insisting that it will be okay but acknowledging that it is not. When people say to me, “You and your children will find happiness again,” my heart tells me, Yes, I believe that, but I know I will never feel pure joy again. Those who have said, “You will find a new normal, but it will never be as good” comfort me more because they know and speak the truth.”

Thank you for your wisdom, Sheryl. We will hold you in the light.

Rabbi David Wolpe: What Sheryl Sandberg’s Post Teaches Us