Here’s the order of importance.
That’d be all.
- Ashish Singh
Reference(s):
1. Evidence based medicine: what it is and what it isn't by Sackett et al, 1996.
Iridodialysis bleeds profusely as the circulus major arteriosus lies near it's root.
Conversely, sphincterotomies or YAG iridotomies hardly bleed. Why? Because the vessels in the iris away from it's root are intertwined within it's musculature. The muscles contract immediately, halting any hemorrhage.
-Sushrut
Burnout is a very common thing among us medicos. That spans from being a medical student upto a resident or even a consultant sometimes!
We feel stupid most of the times and some of our seniors have that bad habit of making the juniors feel bad.
But trust me, you WILL become as good as them, and even better! Medical field needs experience and alot of reading. Med school teaches us maybe 1/10th of what we should know as a doctor. And the remaining we learn on the job.
There is always more to learn more to read and more to understand but medicine is not a lonely game. Always refer, and ask! In Medicine, 2 brains are always better than 1 brain. Don't feel shy or bad to ask for help.
Use your head! If they belittle you, tell yourself you will learn it. Smile and move on.
For me each time I lose motivation, I watch an episode of a Medical TV series. It could be HouseMD, The Resident, New Amsterdam, Good Doctor, Chicago Meds, or any random episode I find in Youtube.
Watching them gives me the feeling of impact I can have in others' lives.
I also go through Youtube videos from famous Medical youtubers, few of my favorites are Jane and Jady, TheStriveToFit, Ali Abdal, DoctAura etc. They have amazing study tips and other medical related things that can give you the motivation to read and learn.
Sometimes I go through #Studygram handle in Instagram. There are many colourful notebooks and workspaces, it really inspires me and gives me a free mind to study.
I also like to read the study tips written by my fellow authors. They have eye opening and motivational tips that really makes me go sit and get that one chapter done.
If all these don't work, just listen to your favorite songs and move your body a little bit when your room mates are not watching! 😂 It definitely gives some positivity to shrug off that sad burnout feels.
Yes! I find most of my inspiration and motivation by online activities rather than going out and resting under the trees. One reason being Im not a very outgoing person and another being I have very little time as a Junior Intern.
And also it helps to clean your room. And cooking a meal for you and/or your family/partner. It would leave you with a clutter free environment and a tasty meal to eat. And if things go well, a lot of praising for your yummy food by others with make your self esteem get better too.
Then get a yummy dessert or make one. Sometimes I just eat a slice of custard cake on my way home, or cook a simple bread pudding and share with my roomies. Although they jump into finish it
and finally leaving me a little piece. ( Those two a-holes!!! 😂😂)
You don't need a trip to beach or hike to mountain, but sometimes sleep on a cozy bed with newly washed sheets, after a warm bath, applying your favorite night lotion, a drop of nice smelling essential oil behind your ears and wearing relaxing clothes will refresh you too.
These are few of my techniques to feel good after a toxic day with disastrous rounds.
Confession : I have had my fair share of bad days. I was punished for silly mistakes. I was sanctioned with extension of duty and forced to work extra hours to compensate for it. But we gotta accept our short comings, learn from our mistakes and move on. We at Medicowesome are not saints or gods to dictate how you should live and everyone of us had made errors, said wrong things in rounds, got shouted at, failed exams, and some of us even went through psychiatric help to get over any of the depressive periods we had
But what is most important is, NONE of us gave up! I take this time to thank my Medicowesome family for helping each other and even helping me rise up in such times when I was so low. Behind the groups and the blog, we are an amazing group of friends although many of us have never met each other. Medicowesome is my support group, and we all need one including you. Find your supportive group, and for the records don't forget we at Medicowesome as also on your back, ready to hold you up.
Stay strong and comment or message us about your methods of tackling a toxic day or a burn out session. So we all can learn from it.
Keep it up! Take care and always....be awesome!
With love,
-Jay
Here's a conversation I had with a friend of mine. She's a resident in a busy government hospital in Mumbai.
I still feel like Jon Snow (I know nothing). I feel like I'm stuck at the basics. And seniors expect a lot. It is somehow unfathomable to me that someday I will be even one tenth as smart as them. Morning rounds as a massacre. It's like beheading my already non existent self confidence. I feel so stupid everyday. I have no energy to study.
I'm trying so hard to not let it get to me but everyday I get to hear criticisms either from professors or immediate seniors. I wasn't born stupid Nakeya but everyday I feel like I've bitten off more than I can chew and chosen a career that's too difficult for me. I feel thoroughly demotivated these days. Like I'm just working because I have to. I feel like I've lost interest only to improve and be better everyday.
Me:
It's OKAY to feel stupid. I think it's everyone of us. It's a part of learning. Indian culture has not developed a way to give constructive feedback... So you got to modify the words they say and take it in a way that motivates and inspires you. It's... I'm pretty sure it's just the culture that makes you feel more stupid than you should feel. The career is not difficult. The training is. You're not stupid. The way they teach is!
We do this thing every week - We share our humanistic experiences with everyone. It could be as simple as holding grocery bags for an old lady. It really helps. We tend to think about the things we did wrong and belittle ourselves. But we need to think about the good things we did. The things we did right. Made a baby smile when they were sick. Made a correct medical decision. Got the IV in the first go. We need to celebrate the little things.
Take time off from medicine and rest whenever you get a chance.
-IkaN
A-a gradient =[PAO2 - PaO2]
where:
A-a gradient = difference between alveolar PO2 and arterial PO2
PAO2 = alveolar PO2 (calculated from the alveolar gas equation)
PaO2 = arterial PO2 (measured in arterial blood)
PAO2 =150 - PaCo2/0.8
Normal range for A-a gradient is
10-15 mm Hg
ALL causes of hypoxemia lead to ↑ A-a gradient, EXCEPT:
Hypoventilation, high altitude, upper airway obstruction (e.g. epiglottitis from Haemophilus influenzae, or croup from parainfluenza virus)
Everything else will cause ↑ A-a gradient (e.g. shunt, V/Q mismatch, etc.).
It's much better to remember the exceptions, then everything else becomes the rule!
Also to adjust for age, the thumb rule to calculate A-a gradient is :
Age /4 plus 4
A-a gradient >30 is considered elevated regardless of age.
Bhopalwala. H
Removal — Following diagnosis of catheter-related infection, catheter removal is warranted in the following circumstances :
●Severe sepsis
●Hemodynamic instability
●Endocarditis or evidence of metastatic infection
●Erythema or exudate due to suppurative thrombophlebitis
●Persistent bacteremia after 72 hours of antimicrobial therapy to which the organism is susceptible
Source :Uptodate
Bhopalwala. H
Lung biopsy in Ventilator-associated Pneumonia may be reserved for patients in whom infiltrates are progressive despite antibiotic therapy or patients in whom a non-infectious etiology is suspected.
The purpose of acquiring tissue under these circumstances is to identify a pathogen that may have been missed with previous sampling or a pathogen that is difficult to culture (eg, fungus, herpes viruses) or to identify a noninfectious process masquerading as infection (eg, cancer, cryptogenic organizing pneumonitis, lymphangitis, interstitial pneumonitis, vasculitis).
Source: Uptodate
Bhopalwala. H
(This is a bit of an off-academic post. So if you are on exam season, avoid reading this.)
Being a doctor!..... we all have dreamt of it. Since we were kids we wanted to wear that stethoscope, walk in long hall ways, go to those people with pain and help them...
You wil watch a TV series and when a surgeon would say "Scalpel please!" you feel goosebumps thinking one day you wanna do it...
But there are somedays you just get home or to hostel from medschool or hospital, and you just don't want to do it anymore. You feel like your passion is lost. You feel like you are no more yourself!
YES! We all have gone through this at least once or even more times in our lives. And when you say this, many other medical students will relate to you too.
Whenever you feel so demotivated, just think WHY YOU STARTED THIS AT THE FIRST PLACE? Did you do it by your will? What made you decide this?
For an example, I always wanted to be a doctor, but my will to become a doctor became so strong when my grandpa passed away in a govt hospital because the doctor in charge didn't diagnose that he was having a heart attack. That day I decided I want to be that doctor who will correctly diagnose and treat people to the best capability I can. I wanted to stop anyone else's family member to pass away because of gross incapacity of a doctor.
You may also have a reason like this if you dig inside your mind. And you will find this reason to fire you up again. To make you push through that one more chapter. Go to that one more ward with a wide smile despite you are sleepless and tired.
Find your reason to stay, not to leave! Because once you are on this voyage, you have decided to work for the betterment of the world and the people, and if you quit midway, it's such a waste, my friend!
Many people dream to be in our shoes. If we give it up, we just are ruining a chance of someone else to be a doctor. So make that medschool seat you owned, be worth it.
Another thing! Going through medschool is not a single man's job. It needs hell load of a support. Find this support system in your family, in your significant other, in your friends, and anyone who would give you strength to carry on, and someone who would motivate you, someone who would be there to say "You can do this! I'm with you!".
Medical books are boring, but books are not the only way you can learn anymore in this digital world. You have millions of videos and interactive websites you can find. You have blogs like our www.medicowesome.com where we breakdown big medical info into small pieces and clarify.
Get your stuff together, clean up your workspace. Cleaner table will motivate you to study too. Use some motivating words in front of your workspace, On your phone's wall paper, On your notebooks! Simply everywhere you would see. If someone would judge you for that, make them your motivation too. Stick up a motivating note on their forehead too! 😂 Just kidding! Ya just keep that smile on always!
Life is great! Medical life is even greater! With all its failures, late night cries, exam phobhias, senior bullies, colleague dramas, its all worth it.
Finish your degree...! This pain lasts only few years! Once you are a fully fledged doctor, you can go ahead and be that wonderful human being you always wanted to be! Don't kill that wonderful person even before you get there!!
We are all voyagers of this same hard journey wherever we are in this world! So let's do this! And in any case you need someone to guide you through your academic related depression or demotivation, always count on us here in Medicowesome!
Have a great day and go own that damn degree!!! 😍
Good luck! See ya later!
Yours,
Jay.
Email Format for a Research Position
Hello Dr. XYZ,
I am ABC, a medical student, currently doing clinical elective rotations.
I'm highly interested in cardiology. Your /Case Western Reserve University's research work ( refer to either the person's or the University's work) , particularly in general cardiology and electrophysiology is exemplary.
I believe you accept volunteer Research Scholars. It would be an honor to work in this institute as a Research Scholar.
I would be willing to work for a year, and would also consider an unpaid position.
I am attaching my CV with this email.
Hoping to hear back from you.
Wish you a happy new year.
Thanks.
Hope this helps :)
Bhopalwala. H