sanguinemare

June 30, 2017

Week 1 of clerkships, and a little bit about the dissertation submission process

Today marks the end of my 1st week back to medical school, as a 3rd year student on the wards.  (Is it more grammatically correct to say “in the wards” or “on the wards”?  Hmm…) It’s been a pretty crazy ride so far, and I have to say, post-call day was pretty brutal.

So just to walk you through my week, I’ve basically been waking up around 6am this week to make it in on time at 7am (and I’m fortunate that my commute is about a <10 min walk) to be able to look up what happened to my patient overnight, check in with them, and get my thoughts organized before we round at 9am.  Generally I’ve been staying until around 4:30-5pm, sometimes just to go over my notes for the day.  On call day (Wednesday this week – it happens every 5 days), I got in at around the same time, but stayed until ~9pm, and post-call day, I had to wake up at ~4am to get in at 5am to prep for rounding at 7am to go over the patients the night shift team needed to pass over to us.  I still got out around 4:30pm that day.  So as you can imagine, that’s been pretty rough.

After I get back, I’ve been working on revising and sending out our manuscript the first couple nights to a new journal, and then yesterday I got an e-mail about minor edits for my dissertation, so I spent a couple hours fixing that on post-call night (after first taking a nap for a couple of hours), and finally got the final acceptance for that this morning.  Whoo hoo!  That also means I haven’t had any time to study/catch-up yet though, so I’ve been doing pretty poorly in terms of answering questions from the attending/residents.  It’s to the point where our attending didn’t even bother asking me questions when he went over antibiotics with us this afternoon, which is pretty much when you know you’re in bad shape. Sigh.

Anyway, also just wanted to give a brief overview of the dissertation submission process, (at least at our school) since I haven’t had a chance to yet, and did just happen to finish that today.  Basically, ~2 weeks before the PhD defense, you’re supposed to submit your dissertation to all of your committee members.  They review the file, and depending on the department, they’ll either give you feedback before your defense, or after.  My department does that after for some reason, so I didn’t see any edits until after my defense.  Then, you have 10 business days (aka 2 weeks) to make all the edits your committee requires, which can be either minor or extensive, depending.  Mine were pretty minor for the most part, luckily, but since I’m somewhat of a perfectionist, I also went back and fixed wording, added citations, fixed figures, etc.  That last one took an extremely long time to figure out because Microsoft Word for some reason was not converting pictures right, so I tried asking for help, and that person didn’t get back to me until the day before it was due (and actually they made one thing worse and didn’t fix any of the issues at all), so it was quite a bit of a panic there at the end.  Extremely fortunately for me, I was supposed to meet up with a computer engineer friend for lunch that last day, and he finally figured out the rather crude, but effective, method of print-screening the figures really large on a big monitor and copy-pasting into Word.  So there’s a tip for you, if you ever have issues with importing images into Word!

Anyway, after finally submitting it, then we wait until the graduate school looks over it and sends an e-mail with any formatting or other issues that need to be fixed.  I got that e-mail yesterday, made my revisions (and went through everything again with a fine-toothed comb to check for (many) spacing errors and typos), sent it in, and got the e-mail back this morning saying it was officially accepted.  Apparently sometimes that last step can go back and forth for a bit – another MSTP who went back a rotation before me and is now on the same rotation as me said it took him a couple weeks of going back and forth with the graduate school before it got accepted, but I think he also didn’t realize that some of his changes threw off other formatting, so maybe that’s why it took longer.  But anyway, there you have it!  That’s the dissertation submission process in a nutshell.   And it’s past my bedtime nowadays, so goodnight!

June 26, 2017

First Day Back to Clinics

Filed under: Med School and the MSTP,MS-3 — sanguinemare @ 7:07 pm
Tags: , , , ,

Thoughts and impressions about my first day starting back as an MS-3 student on the wards (on Internal Medicine):

Orientation:

Orientation was pretty chill, but unfortunately less informative than I would have liked, in regards to say… what my actual schedule was going to be like (which, if nothing else, I was hoping we’d at least get some sort of understandable schedule.  Someone even had to ask what call/post-call meant, because there was no explanation of the hours or caps or anything in the actual orientation.  FYI, I’m still not actually sure what it entails, but from what my MSTP friend told me yesterday at retreat and somewhat from orientation today, I gather that there’s something called a “short call”, which goes from ~7am-12pm, with a cap of 4 new patients.  “Long call”, means 12pm – 8pm or so (which is when night shift gets there), with a cap of 8 new patients (and takes over if the short call team caps).  Except here’s where I get a little confused, since my interns mentioned that on our call day, we also start rounding at 7am, which also means we need to get there around 5am.  So, not really sure on that… and then “post-call” is apparently the day after long call, where we also have to be in to present by 7am.  So basically post-call days are probably going to be the worst in terms of sleep deprivation and such (but even then, as med students, we don’t have it nearly as bad as the interns).

The other 3rd years on this rotation seem pretty chill though, which is nice.  Also got to see an old acquaintance who used to be a year above me, went to Harvard for his PhD, then came back to 3rd year here, so that was nostalgic.  Apparently he’s been back since January.

The team:

We have a pretty full team – 1 PGY-3 (3rd year resident), 2 PGY-1’s (interns), 1 4th year, and 2 3rd years.  It’s good I guess so the work is split more, but it also means so that we are down 1 computer in our team room, which worked out ok today because I still didn’t have computer access yet, but will be kind of a problem later.  I ended up having to grab a “COW” (computer on wheels) after I was finally able to get access to the online system this afternoon, and that was a bit tricky to use because it was kind of cumbersome/blocked a large part of the room, happened to have a broken lever so wasn’t height-adjustable, and just wasn’t great to have to use overall.  Actually now that I think about it, I’m probably going to have to use another one tomorrow, since it sounds like everyone else is planning to get there super early, and I’m only planning to get in around 7am (one of the interns said we just needed to be ready by 8am, but it sounds like the 4th year wants to be in IM so is going to get there really early, and the other 3rd year also seems like he’s going to wake up early), so the computers will likely be all taken up by the time I get there. Ah well.

In terms of the people, our group seems pretty nice and friendly.  It’s apparently almost everyone’s first time though, which makes for an interesting dynamic.  This is the interns’ first rotation, the first AI for the 4th year, obviously the first rotation for me, and the upper level resident’s first time on this service.  The only one whose first time it isn’t is my co-3rd year, and it’s only his 2nd rotation.  So far though, other than the interns and 4th year all looking extremely tired (which is actually rather concerning…) everyone seems pretty friendly.  It’s also kind of interesting because our upper level is actually someone from my class haha.  So that was fun.  (And thankfully he’s super nice and really wants to teach people, so I’m glad it was him).  Our attending seems pretty laid back as well, but we’ll see.  He actually invited us to his place for a party on Saturday this morning haha!

My mental status after today:

Wow.  I am so lost, and know absolutely nothing.  We saw a patient with bullae and the only thing I could think of was “epidermolysis bullosa,” but when the attending asked us the most likely cause, I had no idea.  The other med student didn’t skip a beat, and said “antibodies”, and I had no idea what he even meant.  (And now that I’ve looked up EB, which is apparently usually genetically based, I’m pretty sure that wasn’t even correct…)  And what with all my access being limited and everything else, I was essentially completely useless on the team today.  I have a LOT to learn.  Which is why I need to buy the UWorld Qbank tonight and start doing some questions right away haha.  It’s going to be tough to get back up to speed in such a short time, but I’m going to do my best.  I also need to submit our manuscript which got rejected over the weekend to another journal, and still need to re-draft another manuscript and edit some other files, as well as read up on my patient tonight.  Yikes.  Now I know why everyone says 3rd year is really tough (aside from intern year).  There’s really no time to waste on any unnecessary things.  Well, I guess it just means it’s time for me to finally learn to be efficient with my time!  Wish me luck!

August 31, 2016

Publishing and Reviews

Oh man, I can’t believe it’s been almost an entire YEAR since I last published here!  I’m so sorry… there’s been a lot going on, and also I’m fairly certain I’ve been actually depressed for the last year or so and only very recently started perking up a bit (like literally a couple weeks ago) so that’s probably part of the reason… PhD life and its ups and (mostly, at least in my case) downs, an unexpected and lengthy authorship battle… etc etc… so it was hard to find anything positive to write about, and/or to summon enough energy/brainpower to write about anything at length in general.  But that’s fodder for another post.

Today what I’m going to write about (briefly) is publishing!  Yay, publishing… the currency and lifeblood of the academic.  In case you weren’t aware, basically what, where, and how much you publish is an important factor for your career, mainly because all the people/agencies with money (institutions looking to hire you, government/other organizations looking to award grants) use it as a kind of surrogate measure of your scientific worth when evaluating whether or not to hire you/give you money.  In a way, it’s like judging you based on your contribution to society’s advancement, which I guess is fair, especially if you’re using, say, government funds to help your research. Where it gets a little tricky however, is when you get into the question of where the articles are being published, and whether quantity > quality, and that’s different for everyone.  There’s a whole discussion to be had about the Impact Factor of journals (which itself has some controversy based on how it is determined), but that might have to wait for another time.  In terms of quantity vs quality, from what I gather, I think (a very big emphasis on “think”) the general consensus is that quality is of course important, but publishing regularly (at least every year or so, even if it’s only a review paper) is highly desired because it shows consistency. Which is bad news for someone like me, who hasn’t even had a single (first author) publication yet, and it’s already my 4th/last year in the program (hopefully anyway), heh.

At any rate, after you submit your paper for publication, assuming it isn’t rejected outright, it goes to a couple reviewers.  These are usually other scientists, usually in a related field of study, but sometimes not.  They review the paper and help the editors of the journals determine whether the paper is ready to be either 1) accepted as is, 2) accepted with revisions, or 3) rejected.  The first two options are obviously preferred 😛 but if it needs to be revised, the manuscript authors need to address all the reviews (either by doing more experiments or rebutting with explanations why they don’t need to), and resubmit.  This process I hear can take anywhere up to a few weeks to a few months!  I just submitted my first PhD-related paper a couple weeks ago, so will try to update on how that process goes after I hear back.  It is currently in the “under review” status (so at least that means it wasn’t rejected outright, hopefully!)

Anyway, what actually prompted this post was that I got an e-mail from the director of the pre-doctoral training fellowship I’m currently on as a follow-up to a discussion we had about hosting a seminar for all the trainees to learn how to review a paper (something we will all be called to do as scientists in the future).  It was quite an amusing article on how to review papers by Greg Gibson, who apparently was a section editor for PLoS Genetics for 10 years, which exemplifies the type of feedback that was often receive from these things… and really, now that I think about it, it must be pretty difficult to have to constantly make executive decisions as an editor as to whose review gets the most weight if they are this scattered, haha!  But anyway, just wanted to re-post that all here for you guys in case you’re curious how these things work.

Until next time!  (Which will hopefully be less than a year from now! ^.^||)

October 8, 2015

Antibacterial Soap is not Better than Regular Soap… and learning from death

So, fun fact of the day: according to our MSTP seminar speaker tonight, apparently the FDA agrees that “antibacterial” soap is not any more effective at preventing disease transmission than regular soap, assuming both are used to wash hands properly!  Did not know that.  And to back that up, here’s an article straight off the FDA site that speaks about that, from 2013.

He also described a painful experience he had had as a clinician, where he did a procedure on a patient, and that patient ended up dying, even though he had done everything technically right.  This, in itself, was one of his lessons – that you can be technically right, but mess up intellectually.  Because, as it turns out, after that, they did a retrospective study, and apparently that patient was at high risk for bleeding out after that procedure, as they’d had a bone marrow transplant before that.  That wasn’t known at the time, but it cost that patient their life.  There are two lessons I learned from this:

The first, which is rather scary and sobering, is that as a doctor, we’re all going to make mistakes at some point.  Mistakes that may even cost people their lives.  And some of them, like the case here, won’t really be our “fault”, in the sense that it wasn’t anything that could be prevented at the time due to lack of knowledge, but in hindsight, for whatever reason – new research coming out, a new technique our clinic/hospital was not aware of, etc… we’ll realize that our decision at that point in time was what directly or indirectly, caused harm to the patient.  To be quite honest, that scares me quite a lot.  I don’t know if I can handle that. I think that would tear me apart from the inside.  And yet… if no one makes those decisions… even more people may come to harm.  It’s a tough job.  I guess time will tell.  I just pray that over the course of my career, I will be fortunate enough not to do anything so bad that it costs a life or cripples someone the rest of their time on earth.

The 2nd is that even in one’s darkest moments/worst mistakes, something good can come of it.  In this case, research that probably has saved at least a few lives since.  He recognized that maybe there was something about this patient that made them susceptible to the procedure, even though he did nothing wrong, and they went back and looked at records and realized this predisposition, and published a paper on it.  So now, anyone encountering this type of patient before this procedure will know that it is a high risk thing to do in these people, so they may be much more cautious about ordering that test to be done.  So even when making mistakes, analyzing it and building off of it may lead to research that helps others in the future.  And I guess that’s how we have to look at it, in order to keep moving forward, lest we crumble from the guilt and sadness of those we were unable to help.

July 20, 2015

This about sums up how I feel about research right now

Filed under: Med School and the MSTP — sanguinemare @ 11:04 am

Other than the sentient animals panel, since I’ve made it a point not to work with animals, pretty much all of these are spot on.

June 18, 2015

Learning Communities, Lead Mentors Interviews, and Moving Forward

I am actually pretty excited about the changes happening in our medical school regarding Learning Communities and just the overall culture here.  Learning Communities (LC) are in some ways the med school equivalent of Harry Potter Houses, in a sense – every class upon entering the school gets divided into one of these communities, and then stay with that community for the rest of their time here.

Having been here for starting on 5 years now, with LC’s having started 2 years prior to my entrance to the school, I’ve been able to see it evolve from something that people didn’t care much for and that was seen as just a small social thing, to one that finally, seem to be something people enjoy and that reps are proud to be reps for.  The first years this year in particular seem to really like the system and feel more connected to faculty and each other.  We are also finally going to have funded positions for lead mentors this year!  It’s actually a really big step for us, because not having the resources was one major reason we believe it was hard for mentors to come to events (since they didn’t have protected time) and for students to be regularly engaged with their mentors.  So as part of the LC executive board members at our school, I’ve been helping to sit in on some of the Lead Mentor interviews.  And I have to say, I’m pretty freaking excited about a lot of the ones I’ve seen so far.  They seem very motivated and eager to help students in learning to deal with the realities of a physician lifestyle, including all the hard conversations, life events, and other things that students might have to go through during medical school and beyond.  They’re also often good listeners and very open in sharing their own experiences, which I think will be invaluable for students to hear as they’re going through med school.

One example was a professor who talked about how difficult it was for him to transition into the clinical years after so many years of schooling through college and the first two years of doing very well on tests.  Another today shared about the experience of seeing a fellow medical student pass away right in front of him during a party after a med school test – that student was apparently sitting at the bar when his eyes rolled up and he fell over backwards, never to wake again.  And then they all had to start the next module the very next day.  How do you cope?  Or another experience of a friend whose father had pancreatic cancer and was dying, but that friend saying things like “I hope he doesn’t pass away this week, because we have a final at the end of the week”… which reminded me of one of my own anatomy lab groupmates, whose father passed away during medical school, and he was gone for a while.  We never really got a chance to talk or mourn with him about it, besides checking if he was doing ok a few weeks later when he reappeared in lab.  Or the father of a family friend of one of my growth group members, who she would always ask us to pray for along with her friend, the daughter, who was stressed out because she had a test on top of her dad’s health situation.  It was always a weird dynamic to me, that she would ask us to pray for her friend’s stress because of the test rather than the health of her dad being a main concern, but I guess part of that was this underlying message some people take from med school that grades are everything.  And they’re not, or at least, they shouldn’t be.  Learning the material and understanding how to better take care of a patient should be the main thing, not getting a certain score on a test.

Anyway, I digress.

My main point is I’m really glad that it sounds like we have so many attendings and faculty at our school willing, and really desiring, to get to know the students better, and to guide them through medical school with wisdom gleaned from experience, and to foster a healthier viewpoint of medical school as a whole.  I’m also glad we have a fairly diverse population in such a small group of people in terms of age, sex, race, experience, and specialty (the Emergency Department in particular has been outstanding in presenting applicants, and major props to their Department Chair for signing off on so many of their staff to encourage participation in this!)  Really looking forward to seeing how LC’s grow in the next few years with such dedicated mentors, and how the school’s culture as a whole… or dare I hope, the culture of medicine in general… will change.  I know it’s already starting with all the emphasis on holistic admissions and patient-centered care, but with this new rise in awareness of health and wellness in the physicians and those training-to-be, I am hopeful that we will train up a generation of doctors who are more compassionate, in addition to knowledgeable, than some of their current counterparts, and that they can become proper role models to the patients that they work with in terms of both health and happiness.

March 17, 2015

Match Week

Filed under: Med School and the MSTP — sanguinemare @ 3:44 pm
Tags: , , , ,

My classmates with whom I entered medical school with are graduating this year.  Match Day is coming up at the end of the week, and it’s a highly charged atmosphere.  Yesterday was apparently when people found out whether they matched or not period, and my Facebook newsfeed was blown up with a ton of posts, both from med school friends here and around the country, about how happy and excited people were to have matched (though they won’t find out where they will end up until the Match Day Ceremony on Friday).  Lots of congratulatory statements and likes were passed around on Facebook – so much that a couple people posted in our private class page with memes to the effect haha.  It’s kind of a surreal feeling – that we’ve all been here for four years already, and that people who I still think of as classmates have gone through so much training already and are going to be official doctors soon.  To them, as well as to those who are unfortunate enough to be in SOAP (where one ends up in the week-long, stressful process of desperately trying to find a place to do residency at on of the remaining spots after finding out they did not match on Monday), I wish the best of luck.

In case you’d like to know a bit more about The Match, which is arguably the most important day of a medical student (even more-so than graduation day), here is one article that explains the gist of the process and how it’s become so much more competitive over the years, and if you’re interested, here’s another rather angry article about how The Match is not the best way to get into residency, from a graduating medical student last year, presumably after her own match.  It is true that the cost burden of the current system is quite high for seniors – at a recent talk, people mentioned how the average one spends on applications and the residency trail may be somewhere around $11,000, if I remember the number correctly, which is kind of on the ridiculous side.

In a way, it’s interesting that the concept of the Match is made such a big deal of over here, because that is standard practice in Asian countries (or at least for sure in Taiwan and I think China as well) all throughout every major school transition (elementary to middle school, middle school to high school, high school to college, etc), but in America, where one’s individual choices leads to the promised land, I guess this is one of the few times one feels so very out of control of one’s life and future. I understand that feeling, especially when studying for Step 1 (and in the aftermath), when it finally hit me that one test score could determine my entire future career in a way that is not really readily alterable.  It’s a scary thought.

So in light of all of that, my sincere congratulations to all of my classmates and the graduating class of 2015 that have matched!  I’m glad you will be able to become the kind of doctor that you aspire to be. 🙂

April 7, 2014

Life/MSTP journey update

Hellloooooo!  I am alive!

So sorry it’s been so long since I last posted… a lot has been going on this year, so it has been difficult to find time to actually sit down and write something cohesive/coherent.

Part of the reason it’s taken a while is because I started up a blog for our MSTP earlier this year, as an additional part of our Communications Committee (which previously only consisted of making a bi-annual newsletter).  As you can imagine, that took a decent amount of time getting off the ground and trying to find people to write for it, and/or writing for it myself, which made me less inclined to write here, due to brain fatigue and the desire not to duplicate posts.  I have recently passed on the responsibilities of the blog to another member of my team though, so I am finally able to take some time and come back here to post.  Yay!

So since I’m on the topic, I’ve done a decent amount as the head of the Communications Committee this year – put together 2 newsletters so far, which I decided to have come out in time for the first applicant interview day, and another one for 2nd look day which was early last month.  Our next one will come out in time for our summer retreat.  By the way, newsletters take a surprisingly long time to put together… or at least ours does, which may be more a reflection about how our “newsletter” is more like a “newspaper” in glossy pages and in color, at this point.  I’ve realized why it’s important to set a word limit now – trying to put together a newsletter when some stories run 3-4 pages and others run 3/4 of a page is rather difficult.  Plus, I had to completely revamp the newsletter the first go around, since my team was unanimous in saying the layout, design, fonts, and everything pretty much were pretty displeasing to the eye at the time.  So I took about 2 full weeks’ worth of time learning how to use InDesign (and really also how to use a Mac… ugh, I hate Macs).  There was a lot of time spent fighting both the machine and program… many many hours.  And a couple of my team also tried tackling one page for at least 5-8 hours each, and also barely got anywhere.  Frustration abounded, but we eventually got something decent-looking, I thought.   I thought it would go easier the next time, but this was where I ran into the page limit problem, and had layout issues, so it again took at least 15-20 hours to put together. *Sigh*.  Here’s to hoping the next one will go smoother.  I’m definitely thinking about stepping down from that next year, as I’ll presumably have more research going on than I did this year.

So now research/grad school.  Both have been rather trying, in different ways.  Hm. Looking through my blog, it looks like I started an update draft back in October (10/8/13 says the date on WordPress) before my last post on conferences but didn’t end up getting time to write anything.  So!  To recap the whole school year then – last semester was ridiculous, school-wise.  Due to obligations in both my PhD program and the MSTP, I ended up with 16 units (normal load is 9-10 units), so it was effectively almost a double load, and unsurprisingly, not a lot of research got done that semester, though I did do enough to write an abstract over winter break for the American Diabetes Association (ADA), which got accepted as a “guided audio tour” poster (which I gather is better than a poster, but less than an oral presentation).  Whoo.  Also, I am going to insert what I wrote back in October here – since I wrote it at some point, might as well not let that go to waste right?

I finally picked a lab!!!  

This is probably the biggest hurdle that I had to get over this summer, and a pretty decent source of chronic, underlying stress because picking a lab is one of the bigger decisions I think we as MSTP’s have to make (prior to residency decisions), since that’s where we’re basically going to be living for the next 4 years or so.  Given that I had chosen a field that is not normally part of the MSTP-affiliated PhD programs here, and rather late at that, I had not had any rotations with professors in the program yet, so had to cram 2 6-week rotations in this summer.   One was a pathology lab, and my project focused on inflammatory markers and monocyte rolling, while the 2nd was an obesity/diabetes lab where I worked on glucose transport in cells.   In total, over the last 3 summers starting the summer before med school, I had rotated in 4 labs: a LC-MS lab that was more chemistry-based, a stem cell lab, and these last two.  Ultimately, I decided to make this last lab rotation my thesis lab for a few reasons: the funding is relatively stable (or so I think/hope), the projects were decently interesting, the PI knows a lot and is willing to introduce me to a lot of people involved in the field (actually I was lucky enough that all 4 PI’s seemed like they would be great mentors), and there is potential to do translational research – that is, some bench-work, but also some clinical work.  The last reason was probably one of the more important deciding factors for me, and it seemed like that was something the PI really wanted to push for in my training with him.”

Well, looks like I was rather excited at the beginning of the school year in relation to lab, which subsequently has waned some due to the complications listed above and below.  This semester, I had somewhat of a lighter load, but still above the normal (13 units), which has been fine for the most part… although I recently had a review paper that I literally spent the entire spring break working on, as well as pulling my first all-nighter ever for school, working straight from 9am the previous morning until 5pm on the due date… which eventually came out with a poor grade last week, and I now have to re-write it.  That was quite a bit of a disappointment, as I’ve never spent so much time on something for school before.  Plus, due to some miscommunication, the professor who graded it (who happens also to be the director of the program) now probably thinks I’m one of the worst students ever… blah.  I really hope that doesn’t prejudice them against MSTP’s because I am not reflective of the typical MSTP, and also I think there was just bad miscommunication. :\  Research was also basically stalled for 3 months, due to my mentor not being that available and thus me not being able to do much since no one else in the lab is doing anything related to my project.  At least now I have a direction and can actually start gathering data again this month, whoo hoo!

Anyway, with all that going on, as well as helping out with being an SP (standardized patient) and various other things, I think I may have over-stressed myself because I have been having strange joint pains for the last 3 weeks or so, and a couple days ago, after being outside for a few hours, I noticed I had redness on my face and in patches around my legs.  Given the distribution of the rash, the arthralgias (joint pains), photo-sensitivity, and various other problems I’ve had in the past, I’m fairly certain I have either exacerbated or just triggered a systemic autoimmune disease, which is rather unfortunate.  (I’m sure if you look up those symptoms, you’ll be able to figure out what it is).  So that has been something that’s been weighing on my mind a bit the last couple of days.  I am hopeful this won’t impact me too much, but I think it’s also a sign that I need to stop piling up so much on my plate and to start taking better care of my health.  I just sent an e-mail last night to the people in charge of SP’s to let them know I might need to quit, especially if I can’t become a trainer anytime soon (which is the whole reason I became one in the first place, since it was a prerequisite to the position).  I may slowly need to start phasing other things out of my life as well.

In other news, I have also become much more involved in the church that  I decided to officially join/become a member of here.  I see that in October I was probably going to write a decent amount about it because I started out with “This is generally not something I would normally share on here, but I feel it has been such a significant part of my life in the past couple of months especially that I felt I should”… and it ends there.  Not going to go into too much detail right now as this is already getting long, but becoming involved in the church (which I’d been attending fairly regularly for a year prior) this summer and subsequently has played a huge role in helping me get over a depressive spell over the summer due to a bad break-up situation, as well as helping me feel a lot more grounded here.  I feel like I actually have community and friends now.  Not to mention being able to play violin on worship team has been a HUGE blessing… I knew I missed it, but did not quite realize how much until I was able to play again.  It helps center me a lot, and is good for stress relief sometimes, or just as an expression of joy.

Along that route, I have also started teaching violin this semester – one student has now been with me for 2 months and has made pretty good progress (to even my surprise haha, since it’s my first time teaching violin really).  I may also be getting a second student soon, which I am pretty excited about.

Ok! I think that about sums up things going on in my life right now.  I had a bunch of links I was going to put at the end here, but as this is so long, I think I’m going to save it for the next post.  Stay tuned!

October 27, 2013

Oral Presentations, Conferences, and Publications – What’s the Big Deal?

Well, that was… interesting.

Today, I gave my first ever oral presentation at a conference.  For those who are unacquainted with how this all works, basically, after you’ve done research, you are in a sense under (ethical/moral, scientific, etc) obligation to share what you’ve learned somehow with the world.  Or at least put it out there someway, somehow, so that should someone develop an interest in whatever minute sector of the vast forest of science you have decided to devote x number of years to, they will be able to access it.

Why is this important?  Well, science would never advance without building upon what others have done, for one thing.  That’s what the whole “we’re standing on the shoulders of giants” thing is all about, after all.  Another very important reason that is related to this is the real-world application of this science, whether using principles of physics to build MRI’s and computers, or how to create poison darts from frogs, or invention of new treatments.  (Although medicine is traditionally actually quite poor on having good, solid, “scientific” evidence for the things they use to treat people… but that’s a different story.  Plus I think that is slowly starting to improve as information gets more widespread and people realize that more rigorous trials need to be done.)

Anyway, back to dissemination of research findings.  Ever hear the term “publish or perish”?  If you weren’t aware, the phrase is a semi-mocking commentary on how anyone who wants to survive in academia has to publish (papers) on a regular basis in order to stay competitive.  Everyone talks about how if there’s a say 3-4 year “gap” where one does not publish at all (for example, during residency), future employers for an academic position will look skeptically at that and wonder if perhaps this applicant was not that interested in science after all, and therefore not fit for the position.  This principle is clearly still very true today, as this conference reiterated whenever we talked about grants or career advancement.  So we publish.

Now, fortunately there are many different forms of publishing – the best of course being a first/primary-authored manuscript with primary data, especially in a high-impact journal like Science or Nature.  (I won’t go into all the vocab/nuances of the different types of journal articles today, but that last sentence was basically a fancy way of saying publishing work that you did yourself, that you wrote yourself, and in a famous and well-established/trusted scientific journal).  But another way you can be “published” or otherwise share what you learned with others (and learn from them in turn) is going to conferences.

The way this works is generally, at various conferences, you have the opportunity to submit an abstract (which is basically a short summary of your work including introduction/background, methods, results, and conclusions).  The people in charge of the conference will read through all the abstracts and decide which ones merit an oral presentation and the rest will end up as just poster presentations.  Sometimes, conferences will also throw in a travel award, which means if your abstract (and/or other assorted materials like a CV/statement of interest/letters of rec, etc) is good enough, they will subsidize either all or part of your travel/stay for the conference.

Now that I’ve given you some background on all this, so far, all of my submitted abstracts have only resulted in poster presentations.  This is not really surprising, given that all of my posters so far are from either 6 or 8 week rotations (which is generally understood to be not nearly enough time to accomplish much of anything if one is doing basic science benchwork – aka lab work – as versus analyzing data or making models on a computer, for example). In fact, I am usually quite impressed by anyone who does get an oral presentation (or a paper!) from a rotation project, which some students actually get, believe it or not, because it means they either worked really hard, were extremely lucky (both data-gathering-wise and timing wise coming into the project towards the end point), or both.

In my case, I think it was probably the latter, and the fact that 1) this conference is student run, meaning students were the ones reading the abstracts, and 2) my abstract fell in the “other” category because it didn’t fit any of the usual departments like neuroscience, cancer, or pathology, and they probably wanted to make sure the topics of the talks were diverse.   (Huh, side note: now that I think of it, I’ve only really submitted an abstract to one other conference, and that was only because I had to in order for our program to fund me to go to the national MD/PhD conference in Keystone after my first rotation… long story.  But yeah, all my other abstracts were just submitted because we have to every year for our school’s Medical Student Research Day, which is not really a conference). ANYWAY, the point is that this was my first oral presentation at a conference.

So… if you’ve never done an oral presentation before… it takes a LOT of time.  Even presentations for graduate courses take me quite a while, but for this one, I spent at least a couple full days trying to put together the presentation the first time, then presented it at our lab meeting on Monday.  I was critiqued on literally every slide, and spent all of the last week when not in class or doing homework working on the slides, and then a few additional hours on rehearsing.  I have discovered that rehearsing in one’s head is good for putting together the “story” and figuring out the order to talk about things in.  However, it is not enough, because once I started trying to speak out loud, I would realize I didn’t know how to phrase things, or there would be gaps in my understanding of something, or, as one of our collaborators said, I said “um” as a placeholder way too much.   So I wrote notes on the side to remind myself of phraseology, I looked up things I didn’t fully understand, and practiced – while drying my hair, walking to school, walking to the conference, mentally rehearsing when I didn’t have it in front of it, etc.

And despite my efforts, perfectionism on the visuals, and practice, and despite the fact that I had to present my poster the hour beforehand, which theoretically should have helped me practice even more through interacting with people, the actual presentation still turned out less than stellar.  In fact, I would say I messed up quite a bit.  I was nervous, and it showed.  It felt like my tongue kept getting in the way of my words, so I would be simultaneously blurting things out while stumbling and stuttering on pronunciation.  Word vomit, really.  And I remember saying “Sorry, I can’t talk today” at least 3 times throughout the talk after trying repeatedly (and failing) to pronounce a word correctly, as well as literally stopping after a particularly miserable failure, taking a deep breath, apologizing again for my inability to (ironically) say “ability”, and attempting to move on.

In addition, I’m not sure if this influenced me or not, (it probably did subconsciously – I was probably just too nervous about presenting to consciously realize this until later, fortunately) but I think there was literally only 1 person in my room who was from my school listening to my talk, and that person was the guy who is probably my closest friend from the MSTP.  It’s a little discouraging when it looks like everyone in your entire program is not interested in your talk or in supporting you.  But I was grateful that my friend was nice enough to be there, even though it meant he would witness the train-wreck that was my performance today.

So practice doesn’t make perfect. At least not yet.  And practice definitely doesn’t mean people will be interested in what one has to say.  But hopefully that will change as I get more experienced (and when I actually know better what I’m talking about/have my own project that I am leading with more work under my belt).  And while there was a lot in today’s presentation that went wrong, there were a few small victories: I was able to finish in the allotted time (usually I go over), I think I was able to answer the two questions that were asked to me in a reasonable way, and my friend actually said he thought my presentation was good, that I had a good story, and that it was interesting!  That last one made my day, as he is generally pretty analytical/critical (in a good way), is often bored by talks unrelated to his research/things he finds interesting, and he’s pretty straightforward about his thoughts.  (In hindsight, I realized that I didn’t remember seeing him engrossed in his phone, which is often the case during talks, reinforcing the claim that he thought it was interesting. Yay! Of course, it could simply be that my talk was just much shorter haha.  But hey, I’ll take what I can get.)

I’m told I’m lucky my first presentation was at this kind of conference with peers rather than a research-area-specific conference with lots of faculty etc who would probably grill me much harder on the science behind what I did.  Thinking about it that way, I am pretty grateful that I had this chance to “practice” before having to get up in front of renowned experts in my field and deal with hard questions about my work.

Sooo yup!  That is a summary of my first experience of giving an oral presentation at a conference, as well as a bit of background on why publishing and sharing information is so important for us as scientists and researchers (and medical/health care professionals as well).  Conferences are also great because sometimes when you’re listening to a poster or oral presentation, it can give you ideas for your own work and help remind you that what you’re doing actually is pretty cool.  I experienced that for the first time myself at this conference, talking with someone from my school about his work at his poster.  It was actually pretty invigorating – I think I’ll be checking in with him on how his research is going more in the future, and/or maybe consider a collaboration… hmm we’ll see!

Anyway, I hope this post was informative in some way, shape or fashion, and that you have a better understanding of why publishing is so important in academia, how people publish, what it’s like preparing for an oral presentation (n=1 hah), and why conferences are cool.  Thanks for reading!  It’s sleep time for me… goodnight!

September 22, 2013

Crossfitters, beware

Filed under: Med School and the MSTP — sanguinemare @ 10:03 am
Tags: , , , , ,

Here is a great post about the dangers of overexercising, and of Crossfit in particular.  There is too much of a good thing.  This got on my radar from another medical student in my school’s facebook post, and while it’s not surprising that this happens from a physiological standpoint, I was surprised that this otherwise rare condition was so common in the Crossfit culture that the first thing a trainer would ask when hearing about someone being hospitalized was “is it rhabdo”?

A statement could be made about the fact that if trainers know about it, I certainly hope they would inform their trainees about the importance of proper rest and how to recognize when they’ve reached their limit, and if the issue is that not  all trainers know about it, then I think there is definitely a problem.  However, the only thing I can do is repost the blog post and hopefully inform both trainers and trainees alike not to let the culture of Crossfit (and other similar programs) drive one to the point of rhabdomyolysis – basically where your muscle breaks down from too much abuse and the resultant spill of proteins and contents (especially myoglobin) overwhelms your kidneys and it is potentially fatal.  Yes, fatal.

So if you notice that suddenly your muscles are suddenly weak and useless, or have suddenly swollen a day or so after a workout and are no longer the ripped, lean muscle that it was, please go to a doctor and tell them you’ve been training hard.  Better yet, don’t even get to that stage – make sure you protect yourself and rest when you need to, despite what you or anyone else might think of you.  Take care.

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