Medicine Meets Performing Arts in UAB’s Annual “The Best Medicine Show”

My 90 year-old grandmother told me last week that if this whole physician-scientist thing doesn’t work out, I could still go into the movie business. Before you get disappointed after scouring the student profile pages for a Brad Pitt impersonator, I’m not very good looking. Sorry. My grandfather was a stage actor and comedian and I think Grandma was always hoping I’d follow in his footsteps after my critically acclaimed middle school performance in Fiddler on the Roof.

Lucky for her, she recently learned how to use email and Youtube AND UAB gives a great outlet for us wannabees. The Best Medicine Show is held every year in the Spring. It’s a fundraiser where med students make video skits, dances, and musical performances to raise money for our Student-run free clinic. With the Dean of UASOM matching our efforts each year, students have raised over $100,000 in 3 years.  Not too shabby in my opinion.

My grandmother has seen me dance MJ’s thriller with classmates, sing part of a rap parody, act in a handful of videos, and make both a classic cartoon and a physical exam instructional video completely inappropriate through the magic of video editing software. No regrets except for maybe the rap video parody…

More recently I’ve also helped other students create and edit videos in my role on the Creative Direction Committee for the Show. The CDC, in addition to being the worst abbreviation for a medical school group in the world, is in charge of managing all content that goes into the show. That means helping directors flush out ideas, holding script writing and filming workshops, and helping edit videos that will eventually make it onto the big screen. Consequently, I don’t plan my Thesis Committee meetings in February.

Waste some time on our youtube channel!

-Jeff Singer (GS-3)

The UnABridged Blog is all to pleased to advertise for “The Best Medicine Show”, an annual event featuring contributions from Jeff Singer and other MSTP Students. Those wishing to attend “The Best Medicine Show” tomorrow night (January 30th, 2015) can purchase tickets from its official website.

-The Editors

Traveling for Science: Jason LeGrand writes on attending the Annual Meeting of the American Society of Hematology

Annual meetings for large scientific societies are a bit like 3-ring circuses. There is a lot going on at any given moment, and despite even the best planning, it is almost impossible to take it all in. With its acclaimed 20,000 attendees, the annual meeting of the American Society of Hematology (ASH) is one of the largest meetings focused on the science and medicine of blood disorders and malignancies. Every year in early December, it draws a very diverse international crowd, ranging from clinicians and basic scientists to educators and entrepreneurs, for a four day conference at a US venue that rotates around the country.

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The 2014 meeting in San Francisco was my first time attending the annual ASH meeting and I had such a great experience that I regret not going to past annual meetings earlier in the graduate phase of my training. Of course, there were practical reasons for why I had not gone before such as the cost which for this conference was about $1,500 when totaled. However, the knowledge and cutting edge insight presented at the meetings would certainly have helped that first year in the lab as I was getting oriented to acute myeloid leukemia research. Although the ASH meeting covers a range of hematology topics, leukemia research is a major focus making it possible to get a much better overview of the field than could be achieved at a more general meeting such as the American Association for Cancer Research (AACR) annual meeting that includes the entire spectrum of cancers.

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There is a strong educational training component to the ASH meeting that is manifested by half-day workshops the day before the meeting begins covering topics like myeloid development for those new to the field. ASH also commissions a collection of review and perspective articles on various hematology topics each year and makes them available as an education book to its members at the meeting. The society also engages its members-in-training by hosting special seminars on topics such as how to navigate the transition from trainee to investigator, salary negotiation, and where to find funding for career development. There are also events that allow trainees to meet and converse with society members who are considered leaders in their respective fields. MDs can also find unique training opportunities with sessions focused on how experts in a particular disease treat and manage it in the clinic.

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In fact, I think that one of the most under-appreciated aspects of the annual ASH meeting is that it draws both PhDs and MDs in large numbers to the same event. Although it is true that the clinic and the lab are still treated as somewhat separate worlds at the meeting, with one session focusing on clinical aspects and another on laboratory experimentation, I thought it was very interesting to be able to see PhDs talk about disease models strategies for therapy in one room and then be able to cross the hall and see how those models and strategies were or (more commonly) were not reflected in data from actual patients.

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As you can surmise, there was way more at the ASH meeting than I could possibly see in four days despite the fact that all the general scientific sessions were repeated on alternate days. At times this created the dilemma of whether to stick with attending the AML sessions or to branch out and explore the latest from other areas such as the immunotherapies that I have been enthusiastic about. Of course, even the most exciting meetings will wear you out after a couple days, and by the afternoon of the third day, I was more eager to explore San Francisco than sit in on another talk. San Francisco is an interesting place, and I did get the chance to explore the area around the Moscone center where the meeting was taking place. However, I am sad to say that I did not get to see most of what I originally intended to explore, including the Golden Gate Bridge, but that just gives me a reason to go back.

-Jason LeGrand (GS-4)

Psychiatry: The Field of the Future, Today!

“The idea that depression is the result of a chemical imbalance is nonsense.” This is probably not the message you’d expect to come from National Institute of Mental Health (NIMH) director Dr. Tom Insel, but this is exactly what he told me along with 11 other MD/PhD students gathered for the NIMH MD/PhD Student Conference in San Francisco. The NIMH put together this conference, which also included talks from prominent psychiatrist-scientists Dr. Vikas Sohal (UCSF), Dr. Hanna Stevens (Yale), Dr. Amit Etkin (Stanford), and Dr. Matthew State (UCSF), in order to attract MD/PhD students to the field of psychiatry. According to Dr. Insel, views that the brain is bag of chemicals that can be treated by pouring serotonin or dopamine into it* are outdated and are holding the field of psychiatry back. Advances in basic neuroscience research have opened avenues with tremendous potential for improving mental health treatment, but a new generation of psychiatrist-scientists is needed to translate new findings into clinical treatments. Indeed we are in desperate need for new treatments for psychiatric disorders. Nearly 40,000 people commit suicide each year and this number has remained about level for several decades (http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm). Neuropsychiatric disorders also a leading cause of disability affected life years (http://www.nejm.org/doi/full/10.1056/NEJMra1201534).

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Sushi in San Francisco with the NIMH MD/PhD Student Conference Travel Awardees

I feel very fortunate to have received a travel award to attend the Student Conference as well as the Molecular Psychiatry conference that was also held that weekend. I had never been to a small and intimate conference like this one, my only previous experience with conferences being the neuroscience Hajj that is SfN. It was incredible to not only hear talks from some of the biggest names in neuroscience but also discuss their science and my own research interests with them. Possibly even more exciting for me was that so many of these researchers made me feel like a peer and colleague. As much fun as hanging out in conference rooms and talking about genomics and neurocircuits can be, the best part of the experience was meeting the 11 other travel awardees. For a couple of us, it was actually a reunion of sorts, as we had previously met on the interview trail. My roommate at the conference, Robert Corty (now at UNC), had previously met at the UAB MSTP second look visit. It was great catching up with old acquaintances and forging new friendships, unsurprisingly 11 MD/PhD students who all study neuroscience have quite a bit to talk (and argue) about. The world of science is a small community and I am sure I will see my new friends again at future conferences and symposia, and perhaps some of us may even train together during residency.  Life in graduate school can be painfully difficult, and at times you feel like you’re spinning your wheels but going nowhere, however experiences like this remind you of why you fell in love with science in the first place and reignite your passion for your field.

-Joshua Cohen (GS-2)

Traveling for Science: Travis Hull writes from Australia

Our laboratory spent October 6 – 18, 2014 in New South Whales, Australia, attending the 8th International Conference on Heme Oxygenase, BioIron, and Oxidative Stress. Luckily, and despite about 70 hours of total travel time to and from Sydney, we spent more time exploring the tropical city of Cairnes, Australia than we did in our seats at the Victor Chang Cardiac Research Institute in Sydney. The meeting is a small symposium that usually includes about 80 – 120 researchers from all over the world whose specific focus is on the enzyme, heme oxygenase. Sydney is a beautiful city that honestly gives you the feeling of being in a major U.S. metropolitan area. Luckily Sydney is not in the U.S. because the sheer number and quality of bakeries, gelaterrias (this actually is a word), and coffee shops would raise the U.S. obesity rate by at least another 10%. We visited the Opera House, Darley Harbor, the Bay Bridge and even took a public transport ferry to Manly Bay. Thai food, which we ate for basically every meal, appears to (surprisingly) be a staple in Australian Cuisine, overshadowed only by kangaroo filet and crocodile sausage.

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After a clean sweep at the meeting, with our lab winning 3 of the 5 awards for best abstract and best oral presentation by a post-doc, the meeting ended and we extended our “business” trip by a week to vacation in Cairnes, Australia, which we picked because of its proximity to the Great Barrier Reef and the Australian rain forest. Snorkeling and scuba diving the GBR was definitely one of the coolest things that I have ever done. Riding a glass-bottom gondola through the rain forest canopy and cruising around looking for crocodiles on a dingy that looked like it came straight out of the movie Jaws were both a close second. Our meeting down unda’ was the perfect mix of business and pleasure, wholly exemplifying the awesomeness that is graduate school. I would definitely add opportunities to attend meetings in new and adventurous locations to the list of things to consider when picking a PhD lab.

-Travis D. Hull (GS-4)

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First Year Perspective: Daily Life in the MSTP

As someone from out of state, I wanted to enlighten those as to what life is like as a UAB MSTP student.   A simple way to do this is to give you a day in my life. First, I live about 1 mile away from campus in a house owned by a second year MSTP student.  I am now renting a room from him but plan to purchase my own in about 9 months.  The housing market in Birmingham is very favorable for MSTP students, aka those on a tight budget.  The weather has just transitioned from nice and warm in the summer, to a soothing 75 degrees with a slight wind chill.  After eating a nice breakfast, I drove to school.   Although, I haven’t been in school for too long, I have enjoyed the material.  I am currently finishing up Fundamentals 1 which is a mixture of biochemistry, cell biology, anatomy, histology and physiology.  All of the lectures are recorded, so I usually spend my time in class, trying to start memorizing the material and finding areas I will need to spend more time going over.  Lectures aren’t’ mandatory, but I like going.

After 4 hours of lecture, I was ready for a break. So, a friend and I went over to Highland Park golf course for a quick 9 holes.  It’s a nice short course, and with how beautiful of a day it was, I felt it would have been a crime to not spend some time outside. After finishing up, I headed back to campus to do some studying in the MSTP office.  It has pens, folders, coffee or anything else I need to study with.   The last time I went golfing was right before one of my favorite MSTP classes, 794, a monthly translational research seminar also known as CAMs. I am served a great dinner followed by a presentation by one of the plethora of fantastic scientists on campus.  Afterwards, I study for a few more hours on campus and then head home.  As someone who definitely had some preconceived notions about Birmingham, I have to say it’s a lot more cultured and fun then I could have ever imagined.  I look forward to speaking more about this in my next blog post.

-Garrett Brinkley (MS-1)

A big thank you to Garrett for ending our blog post drought. We hope our readers will forgive us for the past few months. Due to a combination of board exams, research rotations, trips to Africa, grant applications, and marriages, we fell short of our goal to keep this blog continuously updated. However, we are now proud and excited to declare that we have established a group of regular contributors who should keep this from happening again in the future. We hope each and every one of you will enjoy the stories posted here and we look forward to sharing our experiences with all of you on a much more frequent basis.

Sincerely,

The Editors

Dr. Stranger or: how I learned to stop worrying and love my MS-3 year

It is widely accepted that the transition from graduate school (GS) to medical school third year (MS-3) clerkships is the most challenging transition in the Medical Scientist Training Program (MSTP). In attempt to lighten the blow, I arranged a hospital experience for myself a few weeks before starting clerkships. It had been over 4 years since I last stepped foot in a hospital ward, and I planned to shadow Dr. James Willig (Asst. Prof., UAB Division of Infectious Diseases [ID]) on his consult rounds on Spain Tower 9th floor (S9).  Dr. Willig was 15 minutes late, likely because I was supposed to meet him in Wallace Tower 9 (W9). While waiting in vain at the nursing station and observing medical students and house staff perform their daily duties, my throat dried, hands moistened, heart rate hastened, and I felt so lost. In spite of four years of lab work, publishing multiple manuscripts, traveling to various conferences, giving numerous talks, and obtaining expertise in a major biomedical topic, the regular workings of UAB hospital were extremely foreign to me.

I recently re-experienced a comparable mini-panic moment within hours of flying to Seoul, Korea. It was the first night of my 4-week international elective, and as I struggled to read the roadway signs while my Korean colleague drove me from the airport, a thought dawned on me: “I am stuck here!” This was my first trans-oceanic trip, and for the first time my grasp of English and Romantic languages were pretty useless for communication. My reactions at the S9 nursing station and Seoul highway heralded remarkably similar times of transition. And though experienced thousands of miles apart, I approached both transitions using the same strategies. Here I describe these approaches and give advice in an attempt to help readers achieve the smoothest MS-3 transition as possible.

Before heading to battle, have friends on the inside. This is probably the one best thing you can do. The drive from the Inchon Airport to Yonsei University was a lot more complicated than I thought when I originally planned to make the trip alone. I hugely benefitted from having friends and collaborators anticipate my trip, meet me at the airport, and get me settled in the dormitory where the doormen only speak Korean. Also, I owe multiple outstanding Korean meals and experiences to these friends.

Eating lunch with various faculty and house staff of the Infectious Disease division at Severance hospital at Wonju, Korea

Eating lunch with various faculty and house staff of the Infectious Disease division at Severance hospital at Wonju, Korea

A “ddong ppang” (loosely translated “poo bread”) stall in Insa-dong in Seoul

A “ddong ppang” (loosely translated “poo bread”) stall in Insa-dong in Seoul

Back at UAB, I had the privilege to befriend Dr. Willig years prior to shadowing him on rounds. Since meeting him, he was appointed the Internal Medicine Clerkship co-director and became my faculty career mentor. His advice and guidance helped me achieve my MS-3 milestones and develop my ID-focused training path. Beyond faculty, I was fortunate to have valuable friendships with non-MSTP students who started clerkships during my GS years. For example, my friends through Infusion (the UABSOM Acapella group) consistently shared resources and knowledge related to important topics limitedly addressed in MS- 3 orientation. MSTP upperclassmen and program leadership are important sources for MS-3 guidance, but you should not rely solely on our inherently biased knowledge. Foster multiple and diverse “insider” relationships during your GS years by regularly attending divisional seminars (e.g., ID seminar in the Bevill Building every Thursday at noon) and joining social or service medical student organizations (e.g., EAB), not just specialty interest groups (e.g., Surgery Interest Group) populated by like-minded students and potentially toxic relationships come Match Day. Moreover, forging friendships should not end on the day you defend your thesis.

Make new friends fast. In Seoul I have found great friends in the attending, residents and fellow to whom I was appointed. People who organize a Pizza Party solely due to an off-hand comment that you “craved pizza the other day,” have the ability to soften the hardships of any transition. Similarly, it is important to form new support networks with others sharing the MS-3 struggle. Start early. Invite yourself to lunch with other medical students during MS-3 orientation or organize dinner outings and coffee breaks after morning rounds. Identify students with whom to form mutually beneficial friendships. In addition to my friends from MS-1,2 and GS years, it was valuable for me to socialize with new people who I met during clerkships. We helped keep each other abreast of clerkship requirement and, more importantly, how to avoid bad situations. I continue to meet monthly with the same group of non-MSTP medical students (one with whom I shared almost every clerkship rotation) to gossip, discuss residency progress, complain and share success stories. Unfortunately, some students regard at MSTP students as different or unapproachable. The only way to change this perspective is to show people how awesome, yet equally vulnerable to MS-3 stress, we are.

Pizza party organized by the Dr. Han medical team, with who I worked at Severance Hospital at Sinchon

Pizza party organized by the Dr. Han medical team, with who I worked at Severance Hospital at Sinchon

Also make friends with Medical Student Services staff. For example, introduce yourself to Marla Ferguson, the impressively understanding woman in charge of scheduling our MS-3 and MS-4 courses. Introduce yourself to one of the staff who will likely write your Dean’s letter (for me it was Dr. Kezar). And do not let Dr. Hoesley’s fervent passion for student education intimidate you from approaching him for designing a course, say a course titled “Infectious Diseases in Korea.” There is a lot on our academic plates secondary to the unique nature of the MSTP curriculum. Trust me on this one: making sure that the key people know about your individual situation early makes the ride smoother.

The last group worth mentioning is MS-4 students. Chances are if you meet them on your clerkship it is because they want to be there. And unless they are there only for themselves and a recommendation later (you can easily spot them), most MS-4’s are excited about the field and will want to teach. I owe my passing the Surgery Clerkship to the three MS-4 Acting Interns (AIs) on my Trauma ICU rotation. They showed me the ropes, and gladly accepted all my unwanted OR trips. In my experience, most MS-4’s are supportive, so don’t be bashful about bugging them and sharing a few drinks.

Do not let “Day 1” be your first day back. I am very glad about the efforts by the Griffin Society and Dr. William Geisler, our new MSTP Associate Director, to introduce clinical exposure during our GS years. I was fortunate to stay clinically active through Equal Access Birmingham, Cahaba Valley Healthcare and Objective Standardized Clinical Examination (OSCE) employment. They kept my physical examination and patient- physician relationship skills sharp outside the hospital. The statement “Juan, I would not have guessed you were an MSTP student after observing your interaction with that patient,” from my supervisors was a repeated confidence boost, albeit containing a somewhat back-handed compliment.

Wearing contact precaution gear in the Vancomycin Resistant Enterococcus Isolation Ward

Wearing contact precaution gear in the Vancomycin Resistant Enterococcus Isolation Ward

But as I explained above, what I did was not enough to prepare me for how to fulfill hospital duties. Research has repeatedly identified that a large amount of stress in medical students in general stems from the first two years ill-preparing us for how to perform MS-3 jobs. I beseech readers to seriously approach learning how to write a history and physical, and shadow residents or MS-3/4 students as much as possible during your GS years. Familiarizing yourself early with the clinical environment and basic skill set for everyday functioning will save you a lot of anxiety, and get you on your way to learning about real patient care a lot sooner. Unfortunately there was no opportunity for Korean exposure prior to my Seoul trip. However, Seoul “Day 1” was made a lot better by following by the following means.

Learn basic communication as soon as possible. During the 12-hour plane ride to Korea I was fortunate to be seated next to a very friendly Korean. She had recently studied biological engineering in Illinois, and her ability to teach me Korean was superb. By the end of my plane ride, I was able to read and write using the Korean alphabet, Hangul (a surprisingly easy feat). My Korean vocabulary is brutally lacking, and by no means can I have a conversation in Korean. However, knowledge about reading and writing gave me insight into communicating with Koreans. For instance, there is no “f” sound in Korean, so every time my attending tells me “we are giving this patient plucanazole” [sic], I easily understand. I also identify signs pointing to Severance (세브렌스) Hospital or Yonsei (욘세) University. Learning basic reading and writing drastically eased my adjustment.

Seal of Yonsei College of Medicine, where I performed my away rotation in Infectious Diseases

Seal of Yonsei College of Medicine, where I performed my away rotation in Infectious Diseases

Similarly, you do not have to be a master of clinical medicine when starting your MS-3, so do not stress about rereading Bates and Robbins. Instead, familiarizing myself with just common abbreviations, procedures and medications early freed me to earlier to learn the more intricate details of ventilator settings or diagnosing Kikuchi disease. Which brings me to this controversial advice: as MSTP schedules become more flexible thanks to the strong effort of program’s leadership, consider doing Family Medicine as your first clerkship back. I had literally forgotten about the existence of statins during GS years. The 4 weeks of low stress medical exposure (MSTP student do not take the Family Medicine shelf exam) was a great time to identify and teach myself the bread and butter of patient care, e.g., hypertension and cholesterol control, common antibiotics and anticoagulants, general medical lab testing, reading X-rays, etc. I believe actively approaching your Family Medicine clerkship as protected time for clinical learning can enable one to hit the ground running early in hospital clerkships. (That, and at all costs avoid doing the Surgery clerkship before Internal Medicine).

Do not wait to get the help you need. On my first day at Severance Hospital, I needed to meet my attending at the medical school but had no idea where it was located. So I walked into the first hospital-looking building I saw and asked for an English speaker at reception. The next series of events is a testament of how incredibly helpful Korean people are. The receptionist ran and pulled a nurse who knew functional English from the back. Not knowing the location of the school herself, she instructed a nursing assistant to escort me to the International Health clinic in the adjacent main hospital building. One of the clinic translators then snatched my phone (because it contained the e-mail with location and time of my meeting), paged my attending, and organized a dispatch of no less than three women (including a Russian fluent in English) to walk me to my meeting place. We obtained further directions from various receptionists and doormen on this last leg of my trek. I got to my appointment (embarrassingly) 30 minutes early, forcing my attending to run from his morning rounds to meet me. People will surprise you when you ask for help.

Outside Severance Hospital

Outside Severance Hospital

Unfortunately, I did not follow this piece of advice until late in my MS-3 transition.  I share this personal story to emphasize the importance of this lesson. Since college I had always experienced a basal level of anxiety and would repeatedly have 20-minute conversations Marla (my wife) without registering a word because “my mind was elsewhere.” Furthermore, on car drives I would hit the steering wheel in bursts of frustration for no apparent reason. They happened so regularly we playfully named them “Tourrete’s” moments. “Stress and zoning out is a normal part of this career” I would tell myself. The problem was that, during my first three clerkship rotations, all this worsened and started to affect life outside of research and school. At Marla’s insistence, I sought advice from Dr. Robin Lorenz, who strongly suggested I visit the counseling services available for all medical staff and students at UAB. After hearing my symptoms and significant family history, the counseling staff advised me that, while experiencing stress is completely normal, the way I was experiencing it was abnormal and perhaps reflected an underlying Anxiety Disorder. I was referred to a neuropsychologist and subsequently a psychiatrist, and was instead diagnosed with ADHD. After marking all the yes boxes on the screening panels and reading more about the disorder, she once chuckled to me, “this makes too much sense to be wrong.” I started medications in the middle of my Medicine Clerkship, and the haze of uncontrollable intrusive thoughts lifted. As expected, I did not get markedly better grades than before, and people with who I interacted daily (including MSTP co-graduate and friends with who I worked at the time) did not appear to notice any changes. However, my overall well-being and home relationship considerably improved, and now Marla, who can easily tell when I forget to take my meds, makes sure I stay medically compliant.

Not everyone requires medical intervention. However, please remember that stress and anxiety is a normal part of our careers, and many seemingly normal medical house staff and medical students at UAB seek professional advice and support in order to continue functioning at healthy levels. Ask the nursing staff for the bathroom usually used by medical students. Talk to your mentor if you are experiencing trouble staying afloat with the new daily requirements. Please remind yourself, do not hesitate to ask for help.

Though the first days back to clinics can make MSTP students feel like a six foot two inch balding Latino in the middle of Korea, there are ways to ease the stress. The thoughts discussed above focus on making active efforts to plug oneself into the mainstream of MS-3. I observed that MSTP students too often choose an isolationist approach and tend to limit meaningful non-MSTP interactions to only people directly encountered through work. This attitude may contribute to the mixed reception we come to expect from house staff and other medical students. Because of this reception many of us choose to not introduce ourselves as MSTP to avoid “being different.” Do you see a vicious cycle forming? I firmly believe that a key to an easy-as-possible transition back to clinic is active and timely integration.

I do not claim that these suggestions are silver bullets, or that these steps are appropriate for everyone in every situation. Furthermore, it has been my experience that the transition is only the first step, and that in order to excel during clerkships (e.g., get strong letters, get “honors” designations, and more importantly, become good physicians) MSTP students must appropriately stand out in ways permitted by our unique training. MSTP student experiences vary, and comparing viewpoints through collegiate conversation about these issues should help others navigate these very important MS-3 and MS-4 challenges. To this end, I will start regularly sharing more of my experiences as part of the MSTP blog and invite everyone to read and contribute to these topics. Also, readers should consider attending upcoming “Topics in Transition” meetings sponsored by APSA, where students from all years in the program meet to discuss the topics in person. Lastly, I also plan to blog about my experiences in Korea and on how others can participate in this valuable exchange opportunity.

Taken from Severance Hospital overlooking Muak Hill and the rest of the Yonsei University Campus – the dorm where I stayed is 2/3 the way up the hill

Taken from Severance Hospital overlooking Muak Hill and the rest of the Yonsei University Campus – the dorm where I stayed is 2/3 the way up the hill

I end with one more personal story. Six weeks into my surgery clerkship I was dumb enough to read the section of “Surgery Recall” describing the “ideal medical student.” As I perused this inane list of requisites, I started to freak out because I am so different from the “bladder of steel, never saying no to procedures, 40 minutes early and staying until your residents leave” person that the section describes! After having an arguably successful clerkship tenure (i.e., receiving clinical honors in all but Surgery and Psychiatry) while not adhering to the those guidelines, I now firmly believe this principle: being a “model medical student” and getting the best grades does not make you a good physician; however, be a professional student physician, take interest in your patients, learn from them, and be a good team worker, and I promise you the reputation as a model medical student and good grades will come to you. If I had really believed this from the beginning, I would have been spared a lot of stress.

Juan Calix, (PhD) MSTP-8

Juan Calix obtained Ph.D. in Microbiology in August, 2012. For his residency and fellowship, he plans to join a physician scientist track program and sub-specializing in Infectious Diseases. At the time this article was written, he was participating in an international medial rotation in adult infectious disease at Yonsei University Medical College in Seoul, Republic of Korea. He always welcomes direct contact and hate mail concerning his views.

Fundamentals 1 and 2: Fall of (many) MS-1

I thought I might write a short description of my experiences during the first two classes during the fall of medical school. As you may already know, the fall term of your first year consists of two “Fundamentals” courses, which will sarcastically be referred to hereafter as “Fun-1” and “Fun-2.” After a slow-paced summer of adjusting to Birmingham, Fun-1 is an altogether shock to the system. One of my fellow classmates and MSTP likened it to letting several bears into an auditorium full of people; an unfortunate number of med students fail the course faster than they realized they were in medical school. Although realistically, the fateful few (1) needed to fail, and (2) get to try again next year. Regardless, Fun-1 is about learning how to handle more information than can possibly be mastered within the allotted time. Therefore, my biggest lesson learned was how to study “outside-in,” i.e. learn the big picture concepts, then work my way into the details. If you’re anything like me, knowing you don’t know something is worse than not knowing that you don’t. I had to learn how to maintain my perfectionist nature to study hard, without letting the random obscure exam questions get to my head.

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Fun-2: Everyone says “it gets better after Fun-1,” and I hate to be cynical, but it doesn’t. Fun-2, which consists of pharmacology, immunology, and microbiology, was the most memorization I have done, ever. There came a point in my studies where every fact I memorized simply replaced another fact. The huge advantage to this was that, despite the bulk of information, nearly everything we learned seemed to have a purpose. For really the first time, we began to solve clinical cases, from diagnosis to treatment plan. My advice: make charts; they are compact, organized, and the best way to learn information in that “outside-in” strategy. In summary, Fun-2 was a lot of work, but was well organized and useful.

So, there are my two cents on what is allegedly “the most difficult term of the basic science years,” although I will test that designation in the coming months.

-Mark