Fast and Easy Recipes – Protein Bars

The senior class ends their formal education at Baylor with a capstone course called “APEX”. In addition to reviewing critical medical information, communication skills and other important aspects of becoming an intern, there are also wonderful lectures from faculty on “how to be an intern”.

One of the APEX speakers this year was Dr. Sally Raty, who stressed how important it was to take time to care for yourself.. but that you had to look for efficient ways to do it! She promised to share recipes that are easy and take very little time to cook. I’ll share the rest of the recipes on future posts… but here is the first one (which she adapted from this recipe).

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These bars have a ton of ingredients, but they are easy to find, and this bar is way better for you than those processed, chemical blobs you’re spending $2+ on. I keep all of the dry ingredients for these bars in a basket in my pantry. I just pull the basket out and make the bars. The crumbs are amazing on vanilla ice cream….not that I would ever do that, but I’ve heard it is good.

3 cups raw oats
(nothing fancy. Quaker 3 minute (not instant) oats are fine)

1/2 cup whole sesame seeds, or shelled sunflower seeds

1/2 cup shredded coconut (unsweetened is best, but sweetened is easier to find)

1 teaspoon ground cinnamon

1 teaspoon salt

1/4 cup brown sugar

1 cup vanilla Greek yogurt

1/4 cup + 2 tablespoons pure maple syrup or honey

1 cup peanut or almond butter

1 teaspoon vanilla extract

1/4 cup coconut oil, liquefied if solid (or just use canola oil)

1/2 cup chopped chocolate chips (> or = 70% cacao is best)

1/2 cup chopped nuts (almonds, walnuts or pecans)

1/2 cup chopped dates, raisins, figs or other dried fruit–optional (I don’t typically add these)

1 cup vanilla or chocolate whey protein powder– Garden of Life Raw Protein is a good one and is available at Whole Foods Market

2 eggs

½ cup egg whites (or add a 3rd egg)

Heat oven to 350F. Spray an 11 X 7 inch glass baking dish with nonstick stuff. Throw everything in a big bowl. Mix well with your hands. Place in the baking dish, press into the pan to eliminate bubbles and try to get it level. Cook for about 20-25 minutes. Let cool completely to room temp. Refrigerate for a few hours before cutting into bars. Cut into about 48 bars. Refrigerate the cut bars.

 

Fast Food for Call Nights

It’s 2am on call.  All of a sudden you are starving, not to mention craving comfort food.  The only thing available is MacDonald’s or (on rare occasions) the leftover pizza from the noon conference.  It’s a problem.  Eating that kind of food at 2am will almost certainly result in food coma, not to mention that you really know it’s not healithy or what you would recommend for your patients.

Here’s the answer.

These tacos are a great breakfast on the run, afternoon snack or 2am call food.  It takes ~15 minutes to make 10 of them on the weekend – which is enough to last for several weeks.

Start by chopping up the veggies you want to put in the tacos.  My “go to” is one red bell pepper and a poblano pepper.  Corn and rice work well, too.  You can change the taste by using different cheese and different veggies (broccoli, carrots etc with Monterrey Jack, for example).

Buy the cheese you want already shredded.  Lowfat Mexican is my usual choice, but any cheese is fine.  I’ll often cut up a block of 50% Cabot cheddar cheese which is a great tasting low calorie cheese.

Put 10 whole wheat tortillas on the counter and divide one can of refried beans between them.  Use nonfat if you are watching calories.  Black beans, pinto beans, spicy or not – your choice!

Divide up your veggies and cheese onto the 10 tacos.

Roll them up and put them in snack size plastic bags.

Put the little bags in a gallon freezer bag (important to prevent the bad taste of freezer burn) and put them in the freezer.  They last for weeks.

Two minutes in the microwave directly from the freezer gives you a great breakfast, snack, or middle of the night comfort food!

Healthy, Fast, Easy (and delicious) Recipes: CookingLight.com

It’s not easy to eat well as a medical student, resident or busy physician.  Besides setting a good example, eating well is important to feel well when working hard. .. not to mention it really pays off in the long run.  You don’t have to spend hours in the kitchen to eat well at work but you do have to cook (some) and plan (always).

One of my favorite sites to find healthy, easy, delicious recipes is cookinglight.com.  They have sections like  Superfast Stir-Fries and Sautés and Quick and Healthy Recipes which are fantastic for busy clinicians.  If you aren’t a cook, they also have a section called Cooking 101 where you can learn basic techniques.  Before you say you “can’t cook” remember – If you can learn anatomy, you can learn to cook!

Coconut Curried Pork, Snow Pea, and Mango Stir-Fry

Healthy, homemade steak house pizza

Chickpea Bajane

Setting an Example: Eating Well

At some point all physicians give advice to their patients about dietary changes to improve health.  Let’s be honest.  We don’t do so well ourselves.  The “classic” fare of residency (donuts or muffins for breakfast, pizza for lunch, and some fast food on the way home) doesn’t really give you much credibility when you are talking to patients.

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No medical student or resident is going to be able to eat perfectly, exercise regularly, and do all the other things that lead to a healthier lifestyle.  But every little change you make now will pay off.  You’ll feel better and have more energy.  You’ll be less likely to gain weight.  And – you’ll be able to talk to patients  – with specific examples – about what they can do to improve their own health.

In the crazy busy life of medical school and residency, it’s hard, if not impossible, to spend time and energy to shop, cook and eat really well.  It doesn’t get much better once you start your practice.  What is possible, no matter how busy you are,  is to realize that there are some simple things you can do to improve what you are doing now.

My top 10 tips for better eating in medical school and residency

1.  Eat fruits or vegetables with every meal or snack.  This may mean buying a bag of apples once a week and just eating apples twice a day (boring but effective).  Even better, follow the “USDA plate” recommendation – ½ fruit and vegetable, 1/4 protein 1/4 grain/complex carb on every plate of food you eat.

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2. Eat breakfast.  If you are up too early to really eat, make a smoothie the night before to put on the blender when you wake up and take it with you in the car.  My personal favorite:  ½ cup plain Greek yogurt, ½-1 cup of fruit, ¼ cup egg whites (pasteurized, in a carton), 1-2 Tblsp honey.

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3.  Eat more eggs (especially egg whites).  Eggs have gotten a bad rap, but they are very cheap and very easy to cook.  Cook hard boiled eggs on the weekend to eat for breakfast or snacks during the week.  Make omelets or huevos ranchero for dinner.  Go ahead and spend a little more to get cage-free eggs to do the right thing.

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4. Don’t skip meals.  Even on the worst call day you can keep a meal replacement bar or two in your pocket.

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5.  Pack the food you need for call days the night before so it’s ready to go in the morning.

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6.  Chop up a bunch of veggies on the weekend to throw in salads, soups or in wraps.

7.  Cook or buy one good meal on the weekend that will last for part of the week.   A good stew or soup?  Lasagna?  Look for good recipes on the web.  If you really don’t want to cook, find a healthy caterer or restaurant to buy it instead.

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8.  Take a good sandwich to work for one or more meals.  Peanut butter on whole wheat may be monotonous, but a) it doesn’t have to be refrigerated and b) it beats McDonald’s.

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9.  Free pizza isn’t really free.  It’s incredibly high calorie and the ingredients in the cheap kind aren’t good for you.  (Same for take out Chinese, donuts, muffins, etc)

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10.  Skip the liquid calories.  Cokes may give you an energy boost, but you are better off with real calories from a piece of fruit, a sandwich and some coffee or tea.  (but learn how to use caffeine effectively)

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Starting Medical School: Strategies for Studying

Today is the first day of medical school at Baylor College of Medicine!  Welcome to our students, and to new medical students starting at other schools in the United States (and the world!).  The following is a guide on how to study for new medical students written by senior medical students and faculty for our Transition to Medical School course.  I thought it was exceptional – and worth sharing.

Your goals

  1. Learn material for long term retention
  2. Pass exams
  3. Develop skills for lifelong education & studying (nope, it never stops but it can get faster!)

1. The Basics

  • No magic formula for studying except for diligence and consistency
  • Goal is to learn and apply pertinent material – NOT perfection
  • Efficiency is a skill developed through practice, persistence, and reflection – not the result of drinking more caffeine or a genetic trait that skipped your generation
  • Studying is not a competitive sport – some student take (much) less time to learn than you will, but some take (much) MORE time than you…that’s life! Good news – in the end, we are all doctors.
  • Be gracious.  To yourself and your peers as you pass through the basic science crucible that brings out some less than pleasant coping mechanisms.  It’s normal and will pass.
  • You will succeed!  Don’t believe us some days?  Ask any of the thousands of physicians, professors and mentors around you – we’ll be glad to remind you!

2. The Specifics

  • Choose one way to study and stick with it for at at least 1 week
    • Switching study methods costs more time than it saves and there is a learning curve to all of them
  • Start with the first lecture and go sequentially to be sure you don’t miss topics
  • For all study techniques
    • Study reps: 45-50 min “on”, 10-15 min “off” (see below)
    • Skim before lecture (assigned readings, ppts, syllabus, etc)
      • SKIM to familiarize yourself with how to spell new words and the general outline/concept of the lecture – this is not learning time
    • Attend > stream lecture and actively listen by taking notes, drawing pics, writing qs, etc.
    • Take a lunch break after lectures to get good nutrition, socialization and to recharge
  • Techniques for LEARNING
    • Mind maps
    • Review notes with ppts, syllabi and text book and create a condensed 1 page review
    • Rewatch the lecture while condensing notes and focusing on main points
    • Flash cards of high yield material
    • Single page flow chart of material
  • Techniques for REVIEW
    • Practice questions (online, review BRS books)
    • Small group discussion, lecture by lecture (max 4 ppl)
    • Small group quizzing of lecture material
    • Peer or upperclassman tutoring

Study Reps: 45-50 min “on”, 10-15 min “off”

  • “ON”
    • Close email, g-chat, FB, other distractions, put phone on vibrate/silent
    • Set an alarm and STOP studying when it goes off
    • Write down other tasks that come to mind on a sticky note but do NOT stop studying to do them (ex: reply to email, wash dishes, make a snack, look-up question from another lecture, chat with nearby friends, etc.)
      • These tasks can be done during your “off” period
      • You will be amazed at what distracts you and feels “urgent” while studying, but there is almost NOTHING that can’t be put off for <45 min, including perez hilton
    • Don’t be frustrated if the first 15-20 min (or more) feel “wasted” bc you can’t focus – this is NORMAL and the time from sitting to focused productivity will decrease as you adjust to a daily routine (the same as exercising)
  • “OFF”
    • Set an alarm
    • Reward time! NO STUDY RELATED ACTIVITIES!
    • Grab a snack, read a NYT article, catch up on the FB developments (OMG, so much happened in 45 min!!!), chat with a friend, send off a quick email, check off the list you made during  your “ON” period
    • Get up and stretch, walk around for a couple min – it’ll wake you up, get you out of your “study zone” (wherever  you are working)
    • Congratulate yourself on sticking to your study schedule and breaks
    • Relax and don’t worry about how much time you have/not spent studying, let the alarm clock guide you rather than checking your watch constantly

3. The Refinement

  • What works for others may or may not work for you – don’t be discouraged!
  • Study methods evolve as you discover what sticks best in your own head
  • New topics/blocks may require different approaches
  • At the end of the week or block, reflect on what worked well (timing, setting, method)
    • Adjust study methods to what works best for you – but remember, DILIGENCE and CONSISTENCY are king & queen
  • Exam results not reflective of your efforts?  Ask for help! Professors, upperclassmen, mentors and strong peers can enhance your study skills.
  • STUDYING is STUDYING – it is never wasted.

4. The Balance

  • All work and no play makes a miserable and burned out student, resident and physician
  • Set aside at least 1 hour as sacred for meeting your personal needs (NOT chores)
    • Examples: exercise, cooking a nice meal, calling friends and family, reading a great book, prayer or meditation
  • Sleep on a schedule: go to bed and get 7-9 hrs of sleep every night, your brain needs that time to literally build memory
  • Eat well: again, your brain and body need good protein to build synapses for memory, carbohydrates for fuel to burn while studying, and plenty of water to keep you going in the Houston heat
  • Break up your week: take Sat. afternoon/evening off for fun activities with friends/family (movies, restaurants, dancing, bars, parties…), sleep in Sunday morning and have time for yourself and your personal development (reading, writing/journaling, church, chats with significant other)
  • Schedule it: if we write it, we do it.  Use your gmail calendar, phone app, planner, etc. and plot out your week including your studying, exercise, family/friends and other activities.  It will give you a sense of control over your life as you plan your days, rather than your days ruling you.

5. The Non-Science Major

  • You’re not alone – great physicians come from a variety of backgrounds!
  • You may play catch-up at first, but you undoubtedly can succeed
  • Writing and theoretical dissection of literature/theory/philosophy/art will be applicable in medicine – but basic sciences throws you back to the forgotten days of multiple choice exams and memorization.  Dusting off those skills and learning to study for regurgitation/application rather than creation may take some time, so don’t despair if you are spending longer in the library than the Bio-E major.
  • Link up with a science-major classmate who is good at identifying high-yield material AND explaining it.
  • Contact the upperclassmen study tutors – many of us had limited science exposure starting med school (“Wait, is it 2 livers or 2 kidneys – I’m not really sure?” – General Surgery Bound MS 4) and more than succeeded — but we’d love to make that transition easier for you!

Cold Summer Treats

It’s summer and it’s hot.  I’m on call this weekend.  That combination made me think about cold comfort food I could take to work.

Chocolate (in any form) is always the answer… but I decided maybe I could find something a little more healthy (and a little less caloric) that could serve as the “treat” we all crave when we are working hard on call.  I’m thinking the team will like a little Salpicon mid afternoon tomorrow…

Salpicon – a sparkling fruit drink from Columbia

This soup looks delicious, but with the heavy cream probably isn’t in the “low calorie” list.  You can substitute milk or yogurt to cut calories (without too much sacrifice of taste).  But, then again, as an on-call treat this still beats McDonald’s!  This is just one example of cold soups – which are great for summer on-call days.

Cold avocado soup

Smoothies are great comfort food – but logistically not easy when you are on call.  If you love smoothies, you might want to invest in an inexpensive single-serve blender.  Take the fruit in a baggie, put some yogurt and ice cubes in… instant smoothie.  Alternatively, you can blend your smoothie at home and put it in a container in the refrigerator that you can shake up before drinking.

Banana mango smoothie

What To Do This Summer

This week approximately 16,000 US medical students are going to receive their diplomas and become physicians. There are also about 16,000 college graduates who will start medical school later this summer or early in the fall.  Congratulations to you all!

Nearly all of you have a well-deserved month (or two)  to rest and get ready for the next step in your training.  So, I thought it might be helpful to pass on a few words of advice on how to spend your time this summer.

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Do NOT study!

  • If you are starting your residency and you think it might help relieve your (normal) anxiety, here is what to do:  Buy one of the major textbooks and use it to get excited about what you are going to learn.   If you want to, plan how you are going to study for the year.   Skim the book if you really have to do something to feel less anxious, but don’t spend hours studying.
  • If you are getting ready to start medical school – step away from the books!  Seriously, there is nothing you can do that will make it any easier, so just enjoy your time off!

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Take a vacation (or two or three…)

  • Visit family and friends – take a road trip and connect with people you haven’t seen in a while
  • Hang out on a beach, go for some great hikes, read some great novels
  • Sleep late, eat well, and just rest

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Develop (or strengthen) an exercise habit

  • Use this summer to develop a daily exercise routine that you can take into your new (and crazy) schedule.  Overall, your goal for the summer should be to develop a balanced exercise program (cardio, strength training and flexibility).  If you’ve never done any strength training, hire a trainer and learn about it.  Your goal should be at least 30 minutes of cardio 4-5 times/week, 2-3 strength training sessions/week and stretching every day. If you develop a balanced exercise routine this summer, it will be much, much easier to continue this once you start medical school or your internship. Commit to doing at least 30 minutes of exercise a day this summer.
  • Running is one of the best (and most convenient) cardio exercises for medical students and residents (because it’s cheap, efficient and effective)  Use this summer to become a runner. If you hate running, find another good cardio exercise habit to develop instead – but pick one!
  • If you don’t own a bicycle, think about getting one that you can use to commute to school or the hospital.

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If you don’t know how to cook, learn.

  • Unless you want to gain a lot of weight, have poor energy and feel bad, you are really going to have to cook for yourself (or at least plan for good food cooked by someone else).  You won’t be able to eat what you need, particularly as an intern, unless you bring the food with you.
  • Learn some basic skills to cook simple things.  If you have good cooks in your family, have them teach you.
  • If you don’t have family members who can teach you, find cooking classes near you and sign up.  Many high end grocery stores and gourmet stores offer classes for beginners – look on line for classes near you.

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Healthy Habit: Eat Breakfast Every Day

One of my New Year’s resolutions was to come up with monthly “resolutions” for myself and for anyone who follows this blog.  Cooking Light magazine (which is one of my favorite sources of recipes and ideas for healthy living) had the same idea, so I am shamelessly borrowing their healthy habits!

Cooking Light’s 12 Healthy Habits

It’s a lot easier to commit to 30 days of a new habit than a full year.  So this month’s goal is to eat breakfast everyday.

Granola with Yogurt & Berries from zestycook.com

Most residents and medical students start their day early.  At 5 am, no one wants to eat a big breakfast.  But, you really should eat something as you are heading out the door.  By 9 or 10 am, you’ll be hungry – and the muffins in the surgeon’s lounge (or breakfast at MacDonald’s) will be calling out your name.  You have to have a strategy to manage this rise and fall in insulin (and accompanying “starvation”).  If you don’t, you’ll end up eating nothing but fast food (and the box it comes in).

Physicians in practice and training should probably make a commitment to eat two breakfasts, not just one – an early breakfast to literally “break the fast” from the night before and a second breakfast in the mid morning.  (aka “Elevenses”)

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A good breakfast should give you a balance of protein and carbohydrate, with a little fat.   Here’s a list of suggestions for breakfast that provide the right mix of nutrients and are easy (fast) to prepare:

  • Cold cereal with milk
  • Yogurt with cereal and fruit
  • Oatmeal or other whole grains with milk +/- toppings
  • Leftovers from last night’s dinner
  • Frozen waffles or toast (whole grain is better) with peanut butter
  • Bagel or toast with cream cheese and salmon
  • Rice (or other grains) with eggs
  • Energy bars
  • Sandwiches
  • Egg mugs
  • Smoothies
  • Breakfast tacos (see below)
  • Scrambled eggs (plus whatever you want) in a tortilla
  • Healthy fast food
  • Homemade muffins or breakfast bars (make a batch on the weekend)
  • Hardboiled eggs and fruit

Healthy breakfast sandwich from foodnetwork.com

MLBs Breakfast Tacos

These breakfast tacos are my “go to” breakfast for hectic mornings.  I make them on the weekend in a big batch to freeze for the week

Buy 10-12 whole wheat tortillas, 1 can of fat free refried beans, 1 bag of reduced fat shredded Mexican cheese.   (if calories aren’t an issue for you, use regular refried beans and shredded cheese)

Spread all the tortillas out on the counter and divide everything up between them.

Add whatever else you want:

  • cooked chicken or turkey (grilled in the deli is best)
  • Sausage (regular or veggie)
  • Corn
  • Rice
  • Bell peppers or Roasted red peppers (from a jar)
  • Fresh or canned green chiles

Put the tacos in the freezer in individual freezer bag .  Put the individual bags in a big freezer bag if you want to further limit freezer burn.

2 minutes out of the freezer and into the microwave = breakfast.

Breakfast taco from cleananddelicious.com

Other links to ideas for fast, healthy breakfasts

Why You Should Eat Breakfast from wellnessrounds.org

Healthy breakfast: Quick, flexible options to grab at home from mayoclinic.com

10 Quick, Healthy Breakfast Options from thedailygreen.com

10 Tasty, Easy and Healthy Breakfast Ideas from zenhabits.com

Healthy Habit: Get Moving!

One of my New Year’s resolutions was to come up with monthly “resolutions” for myself and for anyone who follows this blog.  Cooking Light magazine (which is one of my favorite sources of recipes and ideas for healthy living) had the same idea, so I am shamelessly borrowing their healthy habits!

Cooking Light’s 12 Healthy Habits

It’s a lot easier to commit to 30 days of a new habit than a full year.  So this month’s goal is to maintain or improve fitness by increasing activity.

It may seem daunting to stay in shape or even improve your fitness level when you are swamped with studying or work in the hospital.  It’s not easy, but it is absolutely doable.  The best way to start is to pick one or two of the following ideas and make them a resolution for this month.  Pick goals that are “SMART” (Specific, Measurable, Attainable, Realistic and Timely) and then just do it! Consistency is the most important part of setting this goal – so pick something that you know you can do on a regular basis.

Some ideas to consider:

  • Take the stairs at work instead of the elevator
  • Commute to school or the hospital on your feet or on a bicycle
  • Park as far away from school or work as is reasonable and walk the rest of the way
  • Plan ahead for 10 minutes of exercise while you are on call and take what you need
  • Wear a pedometer and get 10,000 steps/day
  • Do push-ups every morning before you go to work
  • Find a cardio exercise that isn’t boring for you and do it 30 minutes 3x/week
  • Run.  It’s easy, it’s cheap and it’s the most effective exercise for busy people!
  • Hire a trainer for one workout a week (or ask for this as a present)
  • Play golf, tennis, racquetball – any game that gets you moving!
  • Find a spin class or other organized exercise class to attend once a week
  • Organize a basketball or ultimate Frisbee game with your friends once a week
  • Shoot for a total minute goal/week of exercise (start with 100?) and keep track
  • Whatever you decide to do, PLAN – make it an appointment on your calendar, put it on your daily scut list, get your clothes out the night before – do whatever it takes to make it happen!

Why You Should Eat Breakfast

Most of us start very early in the morning and have a variety of excuses why we don’t/won’t eat breakfast, most often “I’m never hungry this early” or  “I’m in too big a rush”.  You don’t have to go to medical school to realize that your blood glucose levels will be low after 8-10 hours of no food.  It’s why things like donuts and sweet cereals are so popular for breakfast  But a quick infusion of sugar to spike your serum glucose leads to a spike of insulin which leads to hypoglycemia.  Not a good idea if you want to stay awake in class or be sharp when seeing patients.

It’s much better to eat a breakfast with carbohydrates, protein and little fat if you want to sustain your glucose levels.  There are a lot of other advantages to eating a good breakfast.

No one with a busy schedule is going to spend time preparing a “fancy” breakfast in the morning.  But there are many, many good options that don’t take any time at all.  I’ve listed some great websites and recipes below – but don’t limit yourself to these.  Look into typical breakfast choices in other countries, eat the leftovers from last night’s dinner…. Just don’t skip breakfast!

15 ways to eat a beautiful breakfast

18 Quick Breakfast Recipes for Busy Mornings

12 Smart Ideas for Breakfast On the Go