Super Star Blogs!

5 Must Know Dates

As a premed, there are certain key dates that you must know.  These are dates essential to you getting accepted to medical school. Week 32 of the PreMed Mondays book covers 5 must know dates for premedical students.

Premeds, find affordable services designed to help you get accepted into medical school at www.PreHealthMarket.com.

And join the online community of premeds at www.PreMedSTAR.com

A Day In the Life of an M*Modal Scribe: Sarah

My daily routine scribing for Dr. Farooqi consists of the following (and I am a creature of habit):

Wake up with enough time to not feel rushed, meaning that I can wake feeling refreshed, I have my computer turned on and ready to log on for my shift, my pets are fed, breakfast is made, lunch and snacks are ready for the day, and beverages are by my side before I sit down in my comfy chair and prepare to clock in.

Upon clocking in, I document all the patients we are seeing for the day in M*Modal’s Fluency For Scribing. Then I review the patient list to get an idea of how our day will go; will it be a day of physicals and followups or is it going to be a day of acute visits? If the visits are physicals, I’ll go in and review what their histories are and review their labs so I have an idea of what I will be updating in the Assessment and Plan. If the patients are being seen for hospital followup, I will review why they went to the ER and make notes so I do not spend the encounter gathering data. If the patient is here for medication followup and/or refill, I will review what medication they’re coming in for and make a note so I can go through their chart quickly during in the encounter as those last about 5 minutes. For all other appointments, I just have to be prepared with my quick phrases that are saved in Cerner for URI or UTI or muscle pain, which are our most common acute visits.

After each encounter, I ensure that each chart is completed fully for the physician to review and close. If I have any questions regarding what he would like in his Assessment and Plan or the results of a musculoskeletal exam, I ask the physician.

At the end of shift, Dr. Farooqi and I make sure that we have all charts saved for his review if he has not closed them all through the day and answer any questions that may be lingering.

The most important advice I can give is wake refreshed, make sure you have your beverages and food by your side so you are not thinking about how thirsty or hungry you are, and if you need to take a restroom break, let your physician know in between encounters…Most likely, they will wait the few minutes it will take for you to go.

(Sarah lives on the East Coast and scribes remotely for Dr. Farooqi of BayCare Medical Group, which is located in the Tampa Bay area of Florida.) 

Getting The Most Out Of Online Recruitment Fairs

Online recruitment fairs are the new thing to do. These are great events because everyone with internet access can attend. But with so many people logging in to chat with admission directors nationwide, how can you make the best use of your time during one of these events. Here are 3 must do’s!

1) Share your PreMed STAR profile. This should be a no brainer. These recruiters are busy and many are trying to chat with as many students as possible. Many premeds will begin a chat, ask a few questions, then leave. The mistake these students make is thinking that the only purpose of these fairs is to gain information about the school. That’s the secondary purpose. Your job is to make sure the recruiter remembers you, and you do that by sharing your PreMed STAR profile (use the blue share icon in the upper right-hand corner of your profile page). Your profile page will allow the recruiters to put a face to the student and quickly review all your great accomplishments. Rule #1 for these fairs: Make sure to share your profile so they can get a quick and holistic view of who you are!

2) Have deep conversations. The deeper the conversation the better. Many students are simply trying to breeze through the various schools and get as much information as possible. That’s not the right thing to do. You can get that information by visiting their website. Your job is to begin building a relationship. Recruiters will remember the people they have meaningful discussions with. Sometimes it only takes getting that one person to like you for you to receive an invitation to interview.

3) Follow up. This is a biggie! Just because the online event ends doesn’t mean your job is done. You need to build a solid rapport with these recruiters and at minimum send each one a follow up thank you message. Show your gratitude for the time they took to answer your questions and let them know if you are truly interested in their institution. This can open tons of doors for you in the future.

Now you’re equipped to make the most out of online recruitment fairs. I challenge you to do your research and add these events to your calendar, so you don’t miss them. These can be game changers….take advantage!  

Make sure to share your PreMed STAR profile with recruiters at the OSTEOPATHIC MEDICAL SCHOOL ONLINE RECRUITMENT FAIR ON JANUARY 17, 2019.

Congratulations to Armelle! Premed of the Week!

1. Tell us a little bit about yourself. 
My name is Armelle, and I’m from Cap-Haitien, Haiti although I came to New Jersey when I was eight as an international student. I am a junior at Georgetown University double majoring in Biology of Global Health and French. My hometown is the biggest influence on my career as I plan to return to Haiti as a general surgeon, and I also have hopes of informing health and hospital policies there. I enjoy sleep, food, languages, and the outdoors; fun fact, I binge watched bushcraft videos all winter break, and I totally feel like I can survive a deserted island now.

2. Who was your favorite teacher in school and how did he or she impact you?
I’ve had many favourite instructors, but, after reading this question, my fourth-grade teacher came to mind immediately…so we’ll go with her. My time with Ms. Pijack was the first time I remember actually LEARNING as opposed to simply following along with assignments. Each day, she would have someone in the class pull from the “word jar” so that we could learn big words each day. I learned words like poltergeist and -to tie it back to pre-med- deoxyribonucleic acid (later in college, I would learn the chemical structure that led to this name). Ms. Pijack challenged our class immensely, giving out prizes to students who did things like memorizing all 206 bones of the body (guess who won that challenge). While I had decided to be a doctor well before meeting her, my love for science deepened in Ms. Pijack’s class. I am constantly finding that the new knowledge I acquire in college ties back to her class, and each time I am thankful I had the opportunity to be taught by her.

3. When did you first decide you wanted to become a doctor and why? 
In my head, the memory is of a Sunday on our way to church, but I know that the day I remember is, in fact, a compilation of many such Sundays. Actually, every Sunday until I was eight. 

Our church was only three blocks away so my family and I would walk to mass. On the way, we passed a raised sidewalk where a number of homeless individuals slept, and each time I scrunched up my nose at the foul smell that surrounded them (and that I still remember vividly). We’d cross the street and I’d forget about them and their cracked feet that peeked from makeshift blankets that were too short. On the way out of mass, many more, often the same ones from the sidewalk, would gather on the steps of the sanctuary, hoping that the Good Word had inspired churchgoers to be generous. I began saving the change my parents gave me for offering to pass out to them after church. Of course, it was never enough, and I carried their begging eyes and low murmurs home with me until the next Sunday. 

There were many people in my life who were in the medical field including many aunts who were nurses, an aunt who was the director of a nursing school, a cousin studying to be a doctor, and family friends who were doctors. Perhaps this acted on my conscience when I looked for a solution to the heartbreaking conditions I was witnessing. I thought that if anyone, physicians would be able to improve the living conditions of the poor, and I had resolved to be that doctor. Although, I have since learned that the lack of health care was not the cause of their homelessness and poverty -but that relationship between the two is more so reversed- my resolution to become a doctor remained.

4. What area of medicine are you interested in?
As with my decision to become a doctor, my area of interest is highly influenced by my desire to work in Haiti. Right now, I would like to be a general surgeon although I have strong interests in health policy as well. 

5. What’s the coolest experience you’ve had so far on your premedical journey?
I was able to practice sutures a couple months ago, and, while I found it frustrating to open the needle holder, I was elated about the experience. I was even able to keep the sample I sutured! 

6. What is your favorite book? 
Can’t say I read much for leisure anymore, but this past Winter break I did manage to sneak a book in. I believe there might be an English version to the book, but it’s titled “Les Identités Meutrières” by Amin Maalouf. The book speaks of the clashing of identities, particularly for expats, and I was able to resonate with much of the text. It has given me a lot to think of concerning my identity as well as the language to express how I feel about it. Highly recommend!! 

7. Tell us one thing interesting about you that most people don’t know.
Most people would actually know that I am very picky about my food. A little less known fact is that I like bananas but not anything made of bananas. Same thing with peanut butter. But the relationship is reversed for watermelon – I like watermelon flavoured things, but not watermelon. 

8. If you couldn’t be a doctor, what would you want to do?
Nothing! But, practically, probably something related to medicine and public health. I could also potentially see myself following in my mom’s footsteps in real estate, but I can’t imagine being happy being so far from medicine.

9. What has been your biggest obstacle as a premed and how did you (or are you) overcome it?
The older I’ve gotten, the more uncertain I feel about my future and my ability (both innate and circumstantially) to follow through with my goals. I’m not one that likes to ask for help much, but my goal is to be frank enough with myself to do that. 

10. What do you like most about PreMed STAR?
I love the communal feel of PreMed STAR! The premed coursework and path can often feel lonely, and even when there are other premeds around you, the underlying competitive sentiments keep us from being honest about our failures (and successes) sometimes. Love having other students and professionals in the field with who to interact.

5 Tips to Create an Amazing Curriculum Vitae

You’ve probably done a LOT of great things as a premedical student and your Curriculum Vitae is your opportunity to document them and share them.  Week 31 of the PreMed Mondays book covers 5 tips to create an amazing curriculum vitae.  This is your opportunity to shine and you want to do it right!Premeds, find affordable services designed to help you get accepted into medical school at www.PreHealthMarket.com.And join the online community of premeds at www.PreMedSTAR.com

THREE TIPS FOR AVOIDING MEDICAL ERRORS IN THE EHR

A friend once told me that when her PCP retired she went to establish care with a new physician, and as he looked over her records, he asked if she had ever been worked up for her infertility. Startled, she asked what made him think she was infertile. It turned out that the PCP who had treated her since childhood had recorded that she and her HUSBAND had been married for 5 years, did not use contraception, and were childless. In fact, my friend and her WIFE were discussing conceiving and raising a child together.

Johns Hopkins published a study in 2016 (URL shown below) estimating that more than 250,000 deaths per year in the U.S. are due to medical error. This would make medical error the third leading cause of death, following only heart disease and cancer. How can careful charting help minimize errors?

One of the easiest ways to reduce the introduction of inaccurate information into a patient’s medical record is to verify that you’re entering information in the correct chart! When working in a fast-paced, real-time environment, it’s not uncommon to have multiple charts open at once and possibly several notes you’ve jotted down to go back and enter when you get a chance. PRO TIP: Develop a strategy in your workflow that allows you to keep track of which chart you’re working on, especially when you go back later to enter or revise information.

Information bloat and overdocumentation can often be barriers to providing the best possible care. Busy physicians aren’t inclined to wade through huge paragraphs of prose, no matter how lyrical or beautifully written they are. A January 2017 publication (URL shown below) by the National Institute of Standards and Technology pinpoints “copying and pasting” as contributing significantly to overdocumentation and even illogical content. As useful as this function is for allowing the easy and efficient reuse of information without having to retype it, how much of the information is relevant? PRO TIP: When copying and pasting, ALWAYS review and update the text and remove any extraneous and irrelevant portions.

Faulty assumptions can lead to mistakes when documenting a patient’s complaints and/or history. A common error can be to rely on what the receptionist has entered as the reason for the encounter or on what the medical assistant lists as the chief complaint. Sometimes the patient has misrepresented their reason for presentation, or the medical assistant has entered the patient’s (incorrect) self-diagnosis as the chief complaint. PRO TIP: Always rely on interaction with the patient to establish the facts of the encounter.

What are some tips you have for avoiding medical errors in the EHR?

https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us

https://nvlpubs.nist.gov/nistpubs/ir/2017/NIST.IR.8166.pdf  (This site is temporarily unavailable due to current government shutdown) 

5 Ways to Spend Your Summer

Summers are critical to your success as a premed!   Week 30 of the PreMed Mondays book covers 5 ways that premeds can spend their summers.  My summer experiences provided excellent experiences for me and played an essential role in my matriculation to medical school.  The same is true for a LOT of now doctors.

Premeds, find affordable services designed to help you get accepted into medical school at www.PreHealthMarket.com.

And join the online community of premeds at www.PreMedSTAR.com

2018 PreMed STAR Review

Here is my review of PreMed STAR in 2018!  Here’s to an even better 2019!

An Intern’s First Encounter with Death

This was the longest walk of my life. 3am in the morning and I was about to pronounce my newly admitted patient dead. You could hear a pin drop as I walked down the never ending 4th floor hall towards the elevators.

It was only the second week of my internal medicine intern year. Still wet behind the ears, I certainly wasn’t ready for what that night had in store for me. My upper level resident was paged from the ER to admit a very pleasant, middle aged, African American lady for abdominal pain. It turned out this patient had been diagnosed with an aggressive (triple-negative) breast cancer months ago but refused therapy. She now presented to the ER with diffuse abdominal pain. Walking into the ER, I wasn’t prepared to have my senses tested that way. The patient had a fungating left breast cancer wound showcasing a full range of neon colors and purulent drainage. The two fans and air freshener in the room could not mask the putrid smell emanating from the lesion. Despite her pain, the patient had a very sweet personality. She shared her distrust for the medical system and after the diagnosis of breast cancer nearly a year ago, she decided she would quietly live out her remaining days at home. I recall the patient sharing with me how proud she was to see a young African American male practicing medicine. This was not something she was accustomed to seeing.

After examining the patient, I hurriedly left the ER and took the elevator back up to the internal medicine call room. I shared the case with my resident who then evaluated the patient herself. We diagnosed the patient with an acute abdomen likely from metastases to the abdomen and paged the trauma surgeon hoping for STAT surgery. Unfortunately, a different path was taken as the surgeons were slammed with multiple trauma cases and the ER staff transferred the patient up to the medical floor without our knowledge. Two hours later, my resident was paged that the patient had expired. I was then the chosen intern to call the death.

The precise look I gave my Resident after she asked me to call my first death..

So there I was, walking to pronounce my first death. This was something I had never been trained to do. I had no clue how to officially call someone’s death. I had witnessed a few deaths as a medical student, however I never dwelled on the protocols surrounding such tragedy. This was a patient full of life, smiling and having a pleasant conversation with me a few hours ago. She declined resuscitation (DNR) but I couldn’t help to feel bad that emergency surgery was not performed. What if the nurse was incorrect and the patient was still alive? Maybe she was just sleeping and all it would take would be a little bit of nudging. Sweat beads began to form on my forehead. I nervously began flipping through my memories of old TV medical drama episodes hoping to stumble upon clear instructions. My trusty pocket reference book also provided no immediate answers.

And then… I walked into the patient’s room. Pure silence.

I shuffled around the bed staring at the patient. I then began to think of how privileged I was to be one of the last people to speak with this lady. I had the honor of officially placing the period at the end of her life. I don’t know if I impacted her life in the slightest bit those few minutes we spent together but she would forever impact mine. This is one of the many privileges of being a physician and I think every young trainee has encountered this special moment. In the middle of the night while others are asleep, there is a doctor out there providing aid to the sick. There is a doctor spending the last few minutes of life with a dying person and their loved ones. I checked the patient’s bracelet for her name, listened for a heartbeat, checked for a pulse and observed for spontaneous respirations. I stepped out of the room, looked down at my watch, and called her time of death.

In loving memory of my patient. Thank you for allowing me the honor to spend your last few minutes of earth together.

The Premed G.R.I.N.D.

***Listen to this episode, we’re giving out a FREE Kaplan MCAT Prep Course (worth $2400).  Listen to hear how you can win****

This is how to become a successful premed!  G.R.I.N.D.!!!   Week 29 of the PreMed Mondays book covers the Premed G.R.I.N.D. success strategy.  I use G.R.I.N.D.  to take on many of my goals!  The idea here is to be systematic and have a real plan that works!  G.R.I.N.D. is just that!  Goals, Reason, Information, Network, Discipline!  

Premeds, find affordable services designed to help you get accepted into medical school at www.PreHealthMarket.com.

And join the online community of premeds at www.PreMedSTAR.com 

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