So my question to y'all: what factors are important to you in choosing a med school? Cost? Rankings? Location? Advice from friends? Culture?
see you on the other side,
from ken
read something good? send it my way.
Media Fridays: What Makes a Medical School Great?
http://www.theatlantic.com/health/archive/2013/03/what-makes-a-medical-school-great/274403/
Like I've been saying for the past week, I've been working on evolving sidenote. The last addition I have is to Friday. I'm replacing youtube Fridays (universally unpopular) with a medicine-related article or video + a question. The first is one from The Atlantic called "What Makes a Medical School Great." I came across it in my research for yesterday's post about US News & World Report med school rankings.
So my question to y'all: what factors are important to you in choosing a med school? Cost? Rankings? Location? Advice from friends? Culture?
see you on the other side,
from ken
read something good? send it my way.
So my question to y'all: what factors are important to you in choosing a med school? Cost? Rankings? Location? Advice from friends? Culture?
see you on the other side,
from ken
read something good? send it my way.
ken explains the hidden curriculum: what goes in to US News & World Report rankings?
If you applied to med school, you surely took a look at this website.
The 2014 rankings just came out. The short summary if you're interested: MUSC is #59. There were two public schools in the top 10 (UCSF and Univ. of Michigan). UNC is #1 for primary care. Whether or not you think these rankings are important, everyone else does, so you might as well know how they work. If you've ever wondered why med schools do certain things, it's either to satisfy LCME demands or to move up in US News & World Report rankings. These are the incentives that drive med schools.
Lets start with the biggest chunks:
20% of the ranking is the opinion of other deans.
20% of the ranking is the opinion of residency directors.
So 40% of the rankings are determined by the opinion of extremely busy people. These are individuals who might be keeping up on the latest activity of Stanford med, but they certainly aren't keeping up with the newest moves made by a school like the University of Vermont. At a recent panel of med school Deans, one dean admitted to ranking schools purely based on previous reputation because she did not know how good they were recently. Do you think a top 5 school could get by based on reputation? I'd guess yes. This is a rich-stays-rich scheme.
30% of the ranking is faculty research activity.
First off - how many med students are interested in research? Not many. So, why does this even matter? Second of all - do you really think med students work in these high-powered labs? Unlikely. Maybe the rare gunner MD/PhD student, but otherwise these labs aren't wasting their time training you to hang out for a summer. They're probably busy recruiting Chinese post-doc machines.
So we've already established that 70% of the pie is worthless. Moving on.
13% of the ranking is MCAT scores.
Another 6% is undergrad GPA.
And 10% is faculty:student ratio.
Arguably, these last 29% are the best current measure of the best med schools. It's at least telling you which schools have lots of potential teachers, and which schools are bringing in the best performing undergrads. I'd be interested to see the rankings solely based on this last 29%. The first 70% basically provides the current big ponds with a huge amount of buffer to keep doing what they do, while all the small ponds are left to fight for scraps. It's a system designed to keep lower and mid-tier schools where they're at. Essentially, the only way those mid-tier schools can move up is by improving the undergrad GPA/MCAT scores, or recruiting big grant-getters. Neither of which actually improves the quality of med school education.
Overall - this is terribly disappointing. When motivated and talented 20 year olds get on the internet to decide where they want to do their medical education, these are the rankings they're looking up. I'm sure you've been told these rankings are meaningless, but you sure as hell still looked at these rankings and it meant something to see which schools were high on the list. Really the only thing these rankings tell you is that Harvard will continue to be Harvard until we start coming up with better metrics.
see you on the other side,
from ken
enjoy sidenote in 140 characters or less @kensidenotelife.
The 2014 rankings just came out. The short summary if you're interested: MUSC is #59. There were two public schools in the top 10 (UCSF and Univ. of Michigan). UNC is #1 for primary care. Whether or not you think these rankings are important, everyone else does, so you might as well know how they work. If you've ever wondered why med schools do certain things, it's either to satisfy LCME demands or to move up in US News & World Report rankings. These are the incentives that drive med schools.
Lets start with the biggest chunks:
20% of the ranking is the opinion of other deans.
20% of the ranking is the opinion of residency directors.
So 40% of the rankings are determined by the opinion of extremely busy people. These are individuals who might be keeping up on the latest activity of Stanford med, but they certainly aren't keeping up with the newest moves made by a school like the University of Vermont. At a recent panel of med school Deans, one dean admitted to ranking schools purely based on previous reputation because she did not know how good they were recently. Do you think a top 5 school could get by based on reputation? I'd guess yes. This is a rich-stays-rich scheme.
30% of the ranking is faculty research activity.
First off - how many med students are interested in research? Not many. So, why does this even matter? Second of all - do you really think med students work in these high-powered labs? Unlikely. Maybe the rare gunner MD/PhD student, but otherwise these labs aren't wasting their time training you to hang out for a summer. They're probably busy recruiting Chinese post-doc machines.
So we've already established that 70% of the pie is worthless. Moving on.
13% of the ranking is MCAT scores.
Another 6% is undergrad GPA.
And 10% is faculty:student ratio.
Arguably, these last 29% are the best current measure of the best med schools. It's at least telling you which schools have lots of potential teachers, and which schools are bringing in the best performing undergrads. I'd be interested to see the rankings solely based on this last 29%. The first 70% basically provides the current big ponds with a huge amount of buffer to keep doing what they do, while all the small ponds are left to fight for scraps. It's a system designed to keep lower and mid-tier schools where they're at. Essentially, the only way those mid-tier schools can move up is by improving the undergrad GPA/MCAT scores, or recruiting big grant-getters. Neither of which actually improves the quality of med school education.
Overall - this is terribly disappointing. When motivated and talented 20 year olds get on the internet to decide where they want to do their medical education, these are the rankings they're looking up. I'm sure you've been told these rankings are meaningless, but you sure as hell still looked at these rankings and it meant something to see which schools were high on the list. Really the only thing these rankings tell you is that Harvard will continue to be Harvard until we start coming up with better metrics.
see you on the other side,
from ken
enjoy sidenote in 140 characters or less @kensidenotelife.
New Wednesday post series: over unders
A couple weeks ago I took an informal poll of everyone's favorite posts, and NBA Wednesdays was unanimously unpopular. I loved writing about basketball - I don't watch nearly enough basketball to write something every week on the NBA, so NBA Wednesdays got the scratch.
My new idea - Over/Under Wednesdays. Every week on Wednesday I'll post a new over/under poll on sidenote. Then, on the subsequent Wednesday I'll post the results plus a reader's thoughts on the over/under. If you want to contribute your thoughts, let me know! Otherwise I'll just ask random people.
Anyways, the inaugural over/under:
Yesterday, which was day two of the block, there was already talk of - "sorry I can't talk I'm already way behind." And there was just a high concentration of people in the library. Typically, the first week or two of a block the library is empty, people trickle in as test week gets closer, and it reaches an absolute high during test week. So anyways, this got me wondering two things. 1) Is the block 6 hype real? 2) the following over/under:
+/- 65 people that are library studiers. Library studiers are defined by people you could see in the library without wondering what they're doing at the library.
See you on the other side,
from ken
let me know if you want to comment on the follow up over/under post next weds. anyone? hello?
My new idea - Over/Under Wednesdays. Every week on Wednesday I'll post a new over/under poll on sidenote. Then, on the subsequent Wednesday I'll post the results plus a reader's thoughts on the over/under. If you want to contribute your thoughts, let me know! Otherwise I'll just ask random people.
Anyways, the inaugural over/under:
+/- 65 people that are library studiers. Library studiers are defined by people you could see in the library without wondering what they're doing at the library.
 |
| vote here |
from ken
let me know if you want to comment on the follow up over/under post next weds. anyone? hello?
half-baked idea: competency-based MD
I was having a conversation the other day with one of my older friends in the MD/PhD program here at MUSC. She was trying to decide whether to get her ass in high gear for a few months and try to graduate a little on the early end, or spend another year in the PhD program and come out with a stronger thesis. That's weird, to some extent, she had control over when she graduated. You can't do that with an MD. But, why not?
We had some classmates decide to drop out because the workload was too intensive, but that student could have been a great doctor had they spent 5 years in medical school, drawing out the work a little bit.
On the other hand, a fast-learning student could put in 3 years and cover the same amount of material. Why keep those students from being doctors for a whole year?
The good news is that this system already exists. It's called competency-based education. The idea is that students focus on mastering a set of skills rather than completing course work over a pre-determined period of time. Basically, it's like the OSCE - there'd be a list of tasks you need to complete, except you could take the OSCE whenever you felt ready. Only takes you two weeks instead of four to get through UG block? Well now you wouldn't have to spend a week rererereading the syllabus, instead you could take the exam early and move on. Want to take 8 weeks instead of 5 to get through neuro? It'd be a more personally tailored style of med school.
I'm sure you can see the potential here.
What if there was a mega lists of 100 clinical procedures we had to learn during M3. We had to spend time in the sim center, watching youtube videos, practice on each other, to master the procedures. Then we'd get tested whenever we felt ready. Less time being wasted randomly walking around the wards figuring out what to do next. SO efficient.
This would be huge for the pre-clinical years. This is the time in med school where students are the most diverse. Some students came in as undergrad English or Psych majors with little background in the basic sciences. Other students were biology majors that took anatomy labs in college. Yet other students have been out of school for ten years. Do you really think all these students need the same time to master the same material? My guess would be no. Why force them to work at the same pace?
You'd pick up the syllabus - then take the test whenever you felt ready. If you pass, you'd move on to the next syllabus. If you don't, you'd try again later.
This system would eliminate grades as an arena for competition among students and produce happier doctors. As well as provide flexibility for students with non-syllabus interests. Tuition is still paid per time so it would incentivize graduating earlier, and working harder, which would prevent students from getting too lazy.
See you on the other side,
from ken
enjoy sidenote in 140 characters or less @kensidenotelife.
On the other hand, a fast-learning student could put in 3 years and cover the same amount of material. Why keep those students from being doctors for a whole year?
The good news is that this system already exists. It's called competency-based education. The idea is that students focus on mastering a set of skills rather than completing course work over a pre-determined period of time. Basically, it's like the OSCE - there'd be a list of tasks you need to complete, except you could take the OSCE whenever you felt ready. Only takes you two weeks instead of four to get through UG block? Well now you wouldn't have to spend a week rererereading the syllabus, instead you could take the exam early and move on. Want to take 8 weeks instead of 5 to get through neuro? It'd be a more personally tailored style of med school.
I'm sure you can see the potential here.
What if there was a mega lists of 100 clinical procedures we had to learn during M3. We had to spend time in the sim center, watching youtube videos, practice on each other, to master the procedures. Then we'd get tested whenever we felt ready. Less time being wasted randomly walking around the wards figuring out what to do next. SO efficient.
 |
| What if M1/2 were like the OSCE? |
You'd pick up the syllabus - then take the test whenever you felt ready. If you pass, you'd move on to the next syllabus. If you don't, you'd try again later.
This system would eliminate grades as an arena for competition among students and produce happier doctors. As well as provide flexibility for students with non-syllabus interests. Tuition is still paid per time so it would incentivize graduating earlier, and working harder, which would prevent students from getting too lazy.
See you on the other side,
from ken
enjoy sidenote in 140 characters or less @kensidenotelife.
Relationships in med school pt 13: So you think you know Marshall Oelsen
 |
| with the gf |
Ken: Tell me 3 things about you.
Marshall: I'm from Texas.
Being diagnosed with Diabetes completely changed my life - it made me a control freak on so many levels.
I can say the thing I'm best at in our class is having the most energy. I think a lot of other people would agree, so I'll brag about that.
Ken: Yeah I'd agree to that. So tell me a little about how you got here. What'd you do in college?
Marshall: Well I graduated from Davidson in 2010. I just wasn't focused academically. My college was super tough, and I just didn't take it seriously enough. I knew I wanted to go to med school, but I never understood what sort of grades it took. I was on the honor council there, and my senior year I was an investigator. I hated when people called me a prosecutor because I didn't see myself like that. My job was to present the facts and have the most fair trial. I mean, someone's future is at stake. It's hard to find the truth, it was a tough job. Thankless. It's not like there's any trophies for it, you know?
K: Yeah, it's too easy to go after the trophies to stack up on the AMCAS. So I saw you were elected to the honor council at MUSC, congrats on that. If the job was so tough at Davidson, why keep doing it?M: Good question. It's the best way I can serve our class. Since I have that experience - I just feel like it's my duty.
K: Makes sense. And what'd you do after you graduated?
M: I started working for [one of our unnamed professors]. Actually, and I might have told you this story, but the first thing he ever said to me was hilarious. He walks in, sees me, looks at his #2, and says, "Who the fuck is this kid?" It was something else.
K: [laughs] nice, nice. And how did it grow from there?
M: It was a really good conduit for me to work hard and be challenged. I felt like I had to prove myself. I know I'm not the smartest mind here, but those two years off really helped me harness my inner control freak into a great work ethic.
K: And what else did you do?
M: I learned to surf. I started running a lot, and worked on my nutrition. I got my A1C down to 5.7. Now it's back up a point. It's hard to eat right in school.
K: So tell me more about the Diabetes.
M: It really is a sad story of how I got diagnosed. I had been sick for a long time, and when I actually got diagnosed it was with a pediatrician I had never seen before. My regular doctor was out of town. And we had this awkward conversation where I was explaining to him that I had lost 25 lb and I'd been drinking water all the time.
So he brought in a tech and they tested my blood sugar, just to check. All I remember is that when the result came up it didn't even have a number, it just said HI. They said we'll be right back and fled the room. And it sucked. I was sitting by myself with nothing. I was a confused kid. And I lost my temper. I found the guy's office and I yelled at him to tell me what was going on. He let me into his office, and just gave me this stack of papers. He said, "You have type 1 Diabetes." And that's been a lot of my driving force. I suddenly had to care about my health. I was way more laid back before the diagnosis. Now I'm always conscious of what i'm eating, and it makes me a control freak on so many levels. I had to figure it out on my own, how to live with Diabetes. So I've tried my best to make myself available to other kids that get diagnosed. Whether it's just over the phone or email. I still have probably 4 or 5 kids I try to stay in contact with. Just try to check in on them.
K: And how does this whole experience change your perspective as a student?
M: Other students say this all the time, and of course I do too. But everyone says, "Oh we don't need to know that for boards." And I'm not saying I'm a saint because I do it too. But at the end of all this, we're going to be dealing with people, not tests. These exams aren't the end all be all. We'll be doctors soon. Well, we'll be. Not you.
K: [laughs] So true. Don't remind me.
M: When I'm your resident I'll show you some mercy. But yeah, I just remember sitting back in that exam room all by myself. It's a tough thing to reach a patient. I hope I'm good at it. That's why I'm here. To be there for your patients that are alone and confused.
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| my future boss |
Plus all those Diabetes questions on the test like, do you snack? I got all those.
K: Any last things you want the class to know about you?
M: I'm really impressed with how brilliant everyone is, and how interesting everyone is. It just feels like everyone has a cool story, I meet new cool people everyday. We all have the same focus, but at the same time, everyone has had such a different path of how they got there. Just a lot of cool people here.
K: preach.
See you on the other side,
from ken
who do you want to see interviewed next?
The Next Episode
 |
| spring break doing work |
Anyways, the main idea that came from my meditations: the world needs more interesting conversation. I've had a chance to interview some classmates, and I keep hearing 2 comments.
1) Our classmates are interesting.
2) I love talking about life things.
I believe sidenote has been popular for a reason far greater than my overrated writing skills. sidenote reaches an unmet need - the need for talking about life things. Our lives are littered with surface level interactions, and it's boring. Deep conversations are how we get to know our interesting classmates. My goal is to enhance deep conversations by increasing sidenote's interaction with readers.
So to increase reader interaction I came up with a new post schedule:
Monday: So you think you know. Interview with one of our classmates. If you want someone to be interviewed - let me know.
Tuesday: Half-baked idea. Any random idea I have/overhear regarding med school. Please send your ideas my way.
Wednesday: Over/under. I'll put up a new over/under poll every Wednesday for readers to vote on, and I'll ask a reader to submit commentary on the over/under which will get posted on the next Wednesday. If you'd like to provide some commentary, let me know!
Thursday: Grab bag. Random day - will vary from 'everyday I'm shufflin' to 'ken explains the hidden curriculum' to me complaining about neuro block.
Friday: An article about medicine. I consume lots of medicine-related media. TED talks, NYT articles, Atul Gawande commencement speeches. I'll post my favorite one every week and try to get some conversation going. It's like when people post articles on facebook, except it will only happen once a week so I won't spam your newsfeed. Please send any interesting articles my way.
As always, 9 AM. Tell your friends.
see you on the other side,
from ken
enjoy sidenote in 140 characters or less @kensidenotelife.
sidenote week off
To my favorite fans,
Sorry to say there will be no posts this week. I need to go off to the beach and meditate on where sidenote should go next. Any suggestions?
See you on the other side,
from ken
enjoy sidenote in 140 characters or less @kensidenotelife.
Sorry to say there will be no posts this week. I need to go off to the beach and meditate on where sidenote should go next. Any suggestions?
See you on the other side,
from ken
enjoy sidenote in 140 characters or less @kensidenotelife.
Love is a Thread - Justice Conference promo
Also, no posts next week. I need to take Spring break to re-think sidenote. Back on Monday March 25th: So you think you know Marshall Oelsen.
see you on the other side,
from ken
taking requests for future blog posts. please comment or email.
Everyday I'm Shufflin #6 - anatomy practical day running diary
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| #6 |
3/12/13 Tuesday
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| 5383, wow |
6:00 AM: Alarm goes off.
6:02 AM: 5 push ups.
6:35 AM: Depart for MUSC.
6:52 AM: Arrive at gym. Elliptical while listening to "This American Life." They are playing Dr. Dre's "Still D.R.E." in the background while talking about prohibiting lap dancing in Tampa. The topic was Rosa Parks. I bet Ira Glass has a good life. Fun facts about Ira - is a staunch atheist and his college major was semiotics.
7:51 AM: Arrive at library. Check fantasy basketball team - "Linsane in the Membrane." Realize I forgot to set my lineups. Test week. [shakes head]
8:05 AM: Start Anki flash cards.
8:27 AM: This flash card comes up: When is the villous stage?
What the f..? I hate placenta.
9:02 AM: Finish flash cards. Post on blog.
9:30 AM: Reread placenta lectures. Still doesn't make sense. 8 months into med school and I still don't understand amnion and yolk sac folding.
10:40 AM: Where is BPH? The middle or the transition zone? Oh, it's the same. Different lectures just call it different things. Thanks.10:47 AM: Need break.. First lunch. Overhear conversations about anatomy practical. I keep hearing things I don't know. Could be a bad sign. Not sure yet.
12:30 PM: Pre-practical coffee break.
Keith: What's your TPP? (tough pin predictions)
My pick was puboprostatic ligament.
Someone had the half-baked idea to ask every person their TPP so we could have a comprehensive list of every possible hard pin. It made perfect sense at the time, except the time might be better spent scanning through the anatomy class notes. Everything that could be pinned is in there.. right?
1:00 PM: Practical begins. I hope ganglion impars is pinned.
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| tunica albuginea |
1:45 PM: Leaving the practical. Took the stairs for the first time. 6 floors is long. Following the guy in front of me in a daze. What just happened? All I remember is a lot of obturating.
1:48 PM: Back in the locker room. Everyone complaining about this and that pin. ..I really don't want to hear about the ten questions I just missed. Can't we just forget about it and move on? Is this what happens in the girls locker room?
2:15 PM: I hate studying after the practical. Instead, with Sudeep - en route to Bojangles.
2:21 PM: mmm. Fried chicken biscuit.
2:58 PM: Now at Walmart. Looking at Easter Candy selection. mmm. Jolly Rancher jelly beans.
3:28 PM: Heading back to campus, but it's not 4:30 yet so we can't park in the close lot. Still need to kill time. Guess we should go for a romantic walk at Colonial Lake.
3:30 - 4:30 PM: Did about 5 or 6 laps around Colonial Lake, breaking down life with Sudeep. If I was a girl I would definitely date Sudeep.
5:07 PM: Finally back at the library. I feel guilty, like I need to do some studying. It is test week.
5:09 PM: Sitting around with four pissed off students complaining about the practical. I should really study.. Fighting urge to study for honors. Although.. if we're going to sit around and do nothing, we might as well drink beer.
5:23 PM: Sitting around with four pissed off students complaining about the practical. While drinking beers at Fuel. Great post-practical tradition. I mean, you aren't getting anything done after the practical anyways. 6:45 PM: Back at home. Hanging out with wife friend. Loving UG block - taking procrastinating to the max.
See you on the other side,
from ken
enjoy sidenote in 140 characters or less @kensidenotelife.
ken explains the hidden curriculum - we don't believe you. you need more people.
I had a friend that once asked me, "What's the biggest problem facing humanity?" His answer was overpopulation. My answer was that we are becoming less and less awesome. Think about it. How many truly awesome people do you know? We're drifting farther and farther away from awesome as we lose what makes us human - believing, loving, caring. Our society acknowledges this, yet it continues to pump out boring adults that don't believe, love, or care.
If I had to label our generation I'd go with overly-sensitive. Being sensitive to other humans is certainly a sign of maturity, but did we go too far? Now we're so hyper-sensitive that we won't ever talk about what we believe because god forbid we come across as self-righteous. Which, in a counterintuitive way makes us look better, so we're actually being selfish by not talking about ourselves. Confusing, but here's my take-away: the less we talk about what makes us awesome, the less awesome we become.
What does this have to do with medicine? More and more doctors enter their practicing years burned out with little energy left to care for patients, and we're left with hospitals staffed by robots. As Dr. Kern would say, this is not the fault of individual doctors. It's the fault of the medical system at large, breaking down the humanity of doctors.
Our transformation into robots starts in med school, where the hidden curriculum is at work. Per wikipedia - the hidden curriculum is a side effect of the education system that teaches lessons that were not intended. Example - med students are encouraged to ask for help, yet anatomy lab professors chastise us every week by pimping us on the origin of obscure nerves. If they make us look like fools for not knowing every small detail, why would we dare to ask any stupid questions? And if we can't ask questions, we're left on an island to fend for ourselves. Coupled with having zero free time, the hidden curriculum leaves us too burned out to believe, love, care. Here's a diagram for you visual learners.
If you don't believe me, hit up pubmed. There are studies that document a decrease in empathy during med school. sidenote - before I go on, I'd like to make one thing clear. This is not me vs MUSC administration. I love MUSC. I really do. I sincerely respect the work the higher ups have done to keep MUSC on the upward trajectory. MUSC is the #5 most popular medical school, 75% of students offered an invitation to attend decide to accept. That is really great. Working in academia is thankless, and I am in deep admiration. What I hate is the hidden curriculum. This is a curriculum that reaches every med school from Harvard to the Caribbean.
You might be thinking, "So what? That's the system. It's too big to change."
Please don't believe that.
I wish I could tell you to look up to the role models in the older generation, but Ben Carsons and Paul Farmers are few and far between. And frankly, I've heard enough about Farmer and Carson. I get it - they're great - but they're past their prime. I want to hear about how we are changing medicine.
Throughout history, old people have dominated what young people think. They hold leadership positions, their faces run on television, they write newspaper columns. But not today. The media that modern med students consume are twitter, the blogosphere, and youtube. Conveniently, anyone can publish on those platforms. This is a time when young people can broadcast their beliefs loud and clear to anyone who will listen. This is a revolution. For the first time in history - naive, idealistic, young people have control over the propaganda.
We are the young generation. We leave high paying jobs to pursue a life with meaning because Christopher Wallace taught us that mo money mo problems. We spend our free mornings building relationships with poor kids at local high schools. We care about 'us' instead of obsess over how to get 'mine' because we know getting 'mine' is empty. If we band together, no one can beat us.
And that's exactly how the hidden curriculum is taking us down - the hardest part about med school is being so isolated. They want us to believe that it's 'normal' to bottle up our emotions and power through every struggle. They teach that 'humble' is doing good deeds without talking about it. They want us to prioritize our own grades over relationships. And the more we stay quiet, the more they win. Well, fuck they.
We need med students coming together and talking about life. I'm not saying don't study. I'm just saying, don't let them take over. We need to get together and talk, respectfully disagree, and figure out how we're going to fix this mess that they left us. If we stop talking about it, we'll forget it ever mattered. And then, shit. We'll just be they.
Fellow med students. If you are still resisting the robot transformation, get at me. Keep talking. I know you are out there. Maybe we could broadcast what you believe to the world. We need you on our side.
You know where to find me.
see you on the other side,
from ken
enjoy sidenote in less than 140 characters @kensidenotelife
 |
| closer than you think |
What does this have to do with medicine? More and more doctors enter their practicing years burned out with little energy left to care for patients, and we're left with hospitals staffed by robots. As Dr. Kern would say, this is not the fault of individual doctors. It's the fault of the medical system at large, breaking down the humanity of doctors.
Our transformation into robots starts in med school, where the hidden curriculum is at work. Per wikipedia - the hidden curriculum is a side effect of the education system that teaches lessons that were not intended. Example - med students are encouraged to ask for help, yet anatomy lab professors chastise us every week by pimping us on the origin of obscure nerves. If they make us look like fools for not knowing every small detail, why would we dare to ask any stupid questions? And if we can't ask questions, we're left on an island to fend for ourselves. Coupled with having zero free time, the hidden curriculum leaves us too burned out to believe, love, care. Here's a diagram for you visual learners.
If you don't believe me, hit up pubmed. There are studies that document a decrease in empathy during med school. sidenote - before I go on, I'd like to make one thing clear. This is not me vs MUSC administration. I love MUSC. I really do. I sincerely respect the work the higher ups have done to keep MUSC on the upward trajectory. MUSC is the #5 most popular medical school, 75% of students offered an invitation to attend decide to accept. That is really great. Working in academia is thankless, and I am in deep admiration. What I hate is the hidden curriculum. This is a curriculum that reaches every med school from Harvard to the Caribbean.
 |
Please don't believe that.
I wish I could tell you to look up to the role models in the older generation, but Ben Carsons and Paul Farmers are few and far between. And frankly, I've heard enough about Farmer and Carson. I get it - they're great - but they're past their prime. I want to hear about how we are changing medicine.
Throughout history, old people have dominated what young people think. They hold leadership positions, their faces run on television, they write newspaper columns. But not today. The media that modern med students consume are twitter, the blogosphere, and youtube. Conveniently, anyone can publish on those platforms. This is a time when young people can broadcast their beliefs loud and clear to anyone who will listen. This is a revolution. For the first time in history - naive, idealistic, young people have control over the propaganda.
We are the young generation. We leave high paying jobs to pursue a life with meaning because Christopher Wallace taught us that mo money mo problems. We spend our free mornings building relationships with poor kids at local high schools. We care about 'us' instead of obsess over how to get 'mine' because we know getting 'mine' is empty. If we band together, no one can beat us.
 |
| we don't believe you you need more people |
We need med students coming together and talking about life. I'm not saying don't study. I'm just saying, don't let them take over. We need to get together and talk, respectfully disagree, and figure out how we're going to fix this mess that they left us. If we stop talking about it, we'll forget it ever mattered. And then, shit. We'll just be they.
Fellow med students. If you are still resisting the robot transformation, get at me. Keep talking. I know you are out there. Maybe we could broadcast what you believe to the world. We need you on our side.
You know where to find me.
see you on the other side,
from ken
enjoy sidenote in less than 140 characters @kensidenotelife
Relationships in med school pt 12: So you think you know Ashley Smith
An interview with the one and only, Ashley Smith. Ken: So tell me 3 things about you.
Ashley: The first thing I want people to know is that I'm a Christian. I think it's important for future physicians to know what we believe about things like death. Medicine is a serious field. Also that I'm open to talking about it.
The second is that I'm MUSC's biggest fan. I'm so grateful to be here, and I love the people.
The third thing is that I love music. I was really excited to see the brass quintet play the other week. My favorite is Canon in D, and Xylophonia.
K: So you're a Christian, how do you feel like med school has affected your spiritual life?
A: Well I'm pretty grounded. I know what I believe, so not too much. Although, praying for exams has definitely strengthened my prayer life. [laughs]
K: Right, right. And what's been your favorite part of med school?
A: That's hard, there's so many things. .. Probably the friends I've made. I mean, it's people we didn't even know 7 months ago and it feels like we've known each other for years. I have awesome lab partners. We're forced to hang out for five hours a week. We almost always sing reading rainbow songs.
K: With Sudeep in your group, that doesn't surprise me. Did you always know you wanted to come to med school?
A: Not exactly. There's a neuromuscular disease called Charcot-Marie-Tooth that runs in my family. It's a demyelinating peripheral neuropathy. It can be associated with hip dysplasia, which is what I have. I randomly started limping around age 11, and eventually I had to have hip surgery. And that didn't really last because with the Charcot your muscles change so fast. After that I went to a hospital up in Boston, and it was awesome. It was such a stark contrast. Not that I didn't love my doctor back in Columbia, but it was just such a different experience. I ended up having both my hips reconstructed there.
Being up there, I just loved learning about the disease. It became my life because I had to stay in bed for 2 months, then get on crutches, then finally start walking, and it was all such a long process. That was really the time I started seeing medicine as my future.
K: [insert token empathetic statement here] And you liked your doctors up there?
A: Definitely, it amazed me to see how skilled the doctors could be. At the time there were only two surgeons that could do my specific hip surgery. One was in San Diego, and the other was up in Boston where I ended up going. Looking back on it, it's incredible the difference one doctor can make in a person's quality of life. Before the surgery there were times when I'd walk into a store and I couldn't even walk out, my dad would have to carry me out. It was bad.
K: Yeah, stories like that really make surgery sound cool.. Do you have any ideas for the kind of medicine you want to practice?
A: I don't really know. I like so many things! I know i can't be a surgeon because my hands are weak from the disease. My lab partners know my hands are useless when it gets too cold in the lab. And I can't do loads of walking. So maybe something more like radiology, but at the same time I want to talk to patients. I'll see. I'm just looking forward to rotations.
K: Makes sense. And have you been back up to Boston since that surgery?
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| CC |
K: Nice, Cape Cod is great. And what do you do at these checkups?
A: Well, things change so fast with the Charcot so I need to get constant checkups. My labrum is torn, and I just need to keep checking on small things like that. And, oh, I have no psoas function. Which, now I know what that is!
A: Having been a patient is different. Knowing what patients deal with at home. And of course, every disease is different but everyone needs to adapt your home life. After my surgery I wasn't allowed to sit up at 90 degrees, which sounds weird, but it was really inconvenient. My mom had to help me put my socks and shoes on. Even once I could start sitting, I could go places, but I couldn't even pick up my pencil if I dropped it, and it was hard. I know how it is for patients to comply, and hopefully I'll be understanding when they don't.
K: Any last things you'd like to say to the class?
A: I don't know.. I'd just like to give a shoutout to my lab partners. They're awesome and we have a lot of fun!
See you on the other side,
from ken
taking requests for future blog posts. please comment or email.
Barack Obama raps 99 problems
That, is high art.
see you on the other side,
from ken
taking requests for future blog posts. please comment or email.
ken explains the hidden curriculum: lone wolf studying in an age of specialists
I asked a nurse his greatest complaint about doctors:
--
Nothing we learn in med school is that complicated. Take this anatomy slide we have to learn:
There's nothing to understand about the seven nerves that go through the greater sciatic foramen, it's a list. The best way to gain this sort of low level knowledge is to solo studying. Make up a mnemonic, repeat it to yourself fifty times, write on a white board, whatever.
Whenever people ask me questions about the material I usually want to tell them: "Dude you're over-thinking this, just memorize the words, and you'll be fine." I'd love to understand the concepts underlying cell signaling, that's why I signed up for a PhD. But during M1.. ain't nobody got time for that. The list of things we need to memorize is endless, and we aren't even at second year yet. Do you really think you're going to be spending the time to understand the mechanism of every single antibiotic? I sure as hell won't be.
Group learning is useful for solving complex problems like say, understanding basic science research papers. That's the kind of problem it'd be nice to tackle as a group. Science is supposed to be about the discovery of new ideas, and this sort of higher level knowledge demands collaboration between peers. Yet, everyone has to tackle the ME paper assignment by themselves.
In med school - there's really zero incentive to work together. The lone wolf studying strategy is the most efficient way to do med school. And a lot of times, it's the only way to do med school. It's not like they let you take exams together. And frankly, that's what they want you to do.
Who is they? It's abstract, but they is everyone that is cynical. Everyone that says, "Yeah, healthcare is messed up, but it's so big you can't do anything to fix it. You'll learn eventually." Everyone that wants you to leave med school dead to the world.
They want you to study by yourself and become obsessed with how well you understanding the material. ergo - stop caring about whether anyone else understands it. It sounds like a great system to develop overconfident get-mine solo practice doctors, but everyone knows there's too much paperwork to run a solo practice these days. We're also coming upon the age of specialists when collaboration will be at a premium. Think about a disease like diabetes - it's complex. You might need primary care physicians being the point guard for vascular surgeons, endocrinologists, physiatrists, opthalmologists, I could literally list every speciality. Not to mention nutritionists, personal trainers, policy makers...
Doctors are notorious for not playing well with others. Well, the root of the problem starts here in med school. Instead of talking with my classmates about complex medical problems like environmental exposure and diabetes, I'm spending every waking hour with my headphones on, noise-canceling the world, and sorting out meiosis. So I can get mine.
That's your education at work.
See you on the other side,
from ken
taking requests for future blog posts. please comment or email.
"I wish doctors would communicate better with each other."
--
Nothing we learn in med school is that complicated. Take this anatomy slide we have to learn:
There's nothing to understand about the seven nerves that go through the greater sciatic foramen, it's a list. The best way to gain this sort of low level knowledge is to solo studying. Make up a mnemonic, repeat it to yourself fifty times, write on a white board, whatever.
Whenever people ask me questions about the material I usually want to tell them: "Dude you're over-thinking this, just memorize the words, and you'll be fine." I'd love to understand the concepts underlying cell signaling, that's why I signed up for a PhD. But during M1.. ain't nobody got time for that. The list of things we need to memorize is endless, and we aren't even at second year yet. Do you really think you're going to be spending the time to understand the mechanism of every single antibiotic? I sure as hell won't be. Group learning is useful for solving complex problems like say, understanding basic science research papers. That's the kind of problem it'd be nice to tackle as a group. Science is supposed to be about the discovery of new ideas, and this sort of higher level knowledge demands collaboration between peers. Yet, everyone has to tackle the ME paper assignment by themselves.
In med school - there's really zero incentive to work together. The lone wolf studying strategy is the most efficient way to do med school. And a lot of times, it's the only way to do med school. It's not like they let you take exams together. And frankly, that's what they want you to do.
They want you to study by yourself and become obsessed with how well you understanding the material. ergo - stop caring about whether anyone else understands it. It sounds like a great system to develop overconfident get-mine solo practice doctors, but everyone knows there's too much paperwork to run a solo practice these days. We're also coming upon the age of specialists when collaboration will be at a premium. Think about a disease like diabetes - it's complex. You might need primary care physicians being the point guard for vascular surgeons, endocrinologists, physiatrists, opthalmologists, I could literally list every speciality. Not to mention nutritionists, personal trainers, policy makers...
Doctors are notorious for not playing well with others. Well, the root of the problem starts here in med school. Instead of talking with my classmates about complex medical problems like environmental exposure and diabetes, I'm spending every waking hour with my headphones on, noise-canceling the world, and sorting out meiosis. So I can get mine. That's your education at work.
See you on the other side,
from ken
taking requests for future blog posts. please comment or email.
NBA wednesdays - Best of NBA Tattoos
This post was inspired by two previous posts. 1- Getting my own tattoo made me ten times more interested in other people's tattoos. 2- an NBA post I did with Amulya a while back where we discussed Jason Terry's ridiculous tattoo. (below) sidenote - only 53% of NBA players have tattoos. I expected more. I guess the guys with tattoos just stand out so much. Anyways, enjoy.
Worst omen tattoo - Jason Terry. He called the 2013 Celtics championship via tattoo. If there was ever a bad decision..
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| premature |
Best tattoo evolution - Chris "Birdman" Andersen. I watched him in the Knicks-Heat game on Sunday, man he looks out of shape. Still.. I wish the Celtics had signed him.
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| birdman needed wings |
Player with the best rationale not to get a tattoo - Luis Scola. "Tattoos are not cute."
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| should've stayed in Houston |
Tattoo that just fits - (Tie) Jason Kidd and DeMarcus Cousins. Kidd has always wanted to own a panther. It's hard to get a panther in the states, so he got a tattoo of a panther instead. Makes sense.
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| rar |
No explanation necessary. DeMarcus Cousins:
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| misunderstood |
Most surprising player without tattoos - Andrew Bynum. With hair like this.. it seems crazy he doesn't have some off-the-wall tattoos. I would not give this guy the max in a million years. The ratio of Dwight Howard bad press: Andrew Bynum bad press blows my mind.
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| after a wild night of bowling |
Most obsessed with tattoos - Monta Ellis. Once got 14 tattoos in an offseason, because he was bored. He shoots 23% from beyond the arc. For some reason, these things feel related.
Most intense - Wilson Chandler. Has a juggernaut tattoo. In China he put up 26 ppg/12 rpg so he was certainly unstoppable then. Back in America, only 11 ppg. eh.
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| dude I think your underwear are showing |
My favorite NBA tattoo - Unfortunately, not an actual NBA player. Would be even more hilarious if it was. I hope Shaq knows about this.
from ken
taking requests for future blog posts. please comment or email.
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