Tag Archive | "electives"

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10 Tips on Choosing a Specialty

Posted on 14 December 2016 by Pei Jun Zhao

In undergrad, you’ve spent countless hours studying for exams, perfecting your immaculate GPA, and preparing for the MCAT – to become the ideal candidate for medical school. Now that you are medical students – congratulations! – you are studying to become the best doctors. But what type of doctor do you want to be?

Some of you already know the answer before entering medical school. You may have heard your friends say “I’ve always wanted to be a cardiologist”, or “I was born to do neurosurgery”, or “I came to medical school to become a family physician to serve my community”. But no matter if you are set on a career path, or are undecided, keeping an open mind is perhaps the most important. Through personal experience in medical school, I’ve compiled the following 10 tips on choosing a specialty:

1. Keep an open mind, as discussed above. This is a point worth emphasizing. About half of my friends changed their specialty of interest through the course of medical school. A few announced a new interest at the end of each inspirational block.

2. Explore each specialty that interests you. For example, do an observership, take a summer non-credit elective, or participate in research (SRTP, SROP, SWORP)… But if you do not find an opportunity to do so, there is still Year 3 Clerkship where you will rotate through the major areas of medicine.

3. Ask yourself, what do you like about this specialty? You might have seen an exciting procedure such as stent-deployment in the cardiac cath lab, or enjoy talking to people about their struggle with depression and mania, or gain satisfaction by identifying features of nuclear atypia on a pathology slide that lead to the diagnosis.

4. On the other hand, what are the undesirable aspects of the specialty? For example, will you still be happy, at the age of 50, to be paged at 3 am for an emergency appendectomy? Will you be bored of titrating furosemide in the heart failure clinic? On the contrary, some people find these aspects of their job the most rewarding.

5. Will you enjoy the “bread and butter” work of this specialty, and not just the rare and exciting cases? After all, you will be doing this job every day for rest of your medical career. While it’s theoretically possible to “see the light” and change your specialty mid-career; it is generally not advised.

6. If you are unsure, use the process of categorization and elimination. Some common contrasting themes are: Generalist vs. specialist. Primary care vs. consultant. Doctor’s office vs. hospital care. Medicine vs. Surgery. Procedural vs. non-procedural. Adult medicine vs. Pediatrics. etc. Here is an algorithm from the BMJ.

7. If you are still undecided, like many students, then reflect on what fits your personality. Some people prefer working with their hands such as in orthopedic surgery, while others enjoy contemplating complex concepts such as hormonal pathways in endocrinology. Each year, the Learner Equity and Wellness (LEW) Office offers the Myers-Briggs personality test that may help you determine a suitable specialty.

8. Sometimes there are more than 1 path to becoming the doctor you want to be. For example, the family medicine 2 + 1 residency program is an attractive but competitive career path. For example, you can do 2 years of family medicine + 1 year emergency medicine, obstetrics, or anesthesia, to name a few.

9. If you are torn between 2 (or more) specialties and it’s almost 4th year, some students split their elective time in both subjects. Others choose multidisciplinary electives, such as ICU which involves internal medicine, anesthesia, and surgical critical care. But it’s riskier to match into a competitive specialty, that may sense your ambivalence.

10. Although it’s never too late to decide on a specialty, ideally you want to make a decision before applying for 4th year electives, and at the latest before the CaRMS residency match. Never be afraid to seek help. Talk to your peers, upper year students and residents, or make an appointment at the LEW Office, if you would like more guidance.

Choosing a specialty is a career-defining decision. You came to medical school from diverse backgrounds, for a variety of reasons, to become a doctor. I hope that you will soon find the specialty that suits your calling! This blog post covers the main points, but is by no means an exhaustive list. To the upper year students, if you have other considerations that helped you choose a specialty, please feel free to comment below! To the junior students, you will be surprised at how quickly medical school passes, despite the lengthy lectures, mountain of notes, and seemingly endless exams. So may the wind be behind your sails as you set off on a voyage of discovery in the vast ocean of medicine!

Pei Jun Zhao

Meds 2017

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Insights off the run:

Posted on 22 November 2014 by Jimmy Yan (Meds 2015)

Ah yes, 4th year. The time when suddenly it becomes real: I’m going to be a doctor. That MD is so close I can pretty much touch the serifs. But before we can bust out singing to Vitamin C (yes, you know the song), there’s still a long trial before us. The long 16 weeks of electives.

Now electives are the shot for us to show off what we have to the various programs and locations across Canada (or even the world if you are so ambitious) that we have the stuff that it takes to be chosen for their program.

Through all the bedlam and rush of these electives, we get the added bonus party time fun of having to write personal statements, update the CV, scrounge together letters of reference, and fill out all the extra redundant paperwork that is required for a CaRMS application. 

Yes Natasha, I agree.

However, if we let ourselves take a step back from the daily double grind of working while being on show, move past the exhaustion from the long days, and separate ourselves from the stress of the applications, these elective times are great opportunities. They’re a time to really show off to yourself how far you’ve come. They’re an amazing opportunity to adventure through and live in (albiet VERY temporarily) different places. And you’re likely going to meet a bunch of new people who may become future co-residents, colleagues, or friends.

As the three quarter mark is approaching for the current elective tour, I thought it would be a great time to sit back and reflect on some of the subtler lessons I learned from the long haul.

1) Pack light, travel quickly (alternate title, scrubs are the best)

In one of my favorite movies, Up in the Air, George Clooney poses this question at the beginning of his seminars “What’s in your backpack?“. While his speech is focused on the metaphorical baggage that bogs a person down in everyday life, it’s a good prompt to examine the actual physical baggage that can encumber your peripatetic lifestyle during this year.

From one standpoint, it’s more economical: the airlines have recently implemented more fees for check-in luggage and driving around with heavier loads will also hike up your vehicle’s fuel costs. From another, it’s also easier to move around, you need less time to pack, and it frees up some of the clutter.

Which is why scrubs are awesome because I’ve pretty much cut down two-thirds of my clothing needs as a result. Plus you can look like a ninja at work, which is awesome.

For those without the luxury of having the scrubs option at work, there are still other ways to lighten the load. Simplifying outfits, or finding multifunctional pieces are one way. Eliminating excessive electronics, books, or other accessories are all options as well. Personally I thought that I was traveling pretty efficiently already but after my first couple electives I realized I still did not use a good chunk of what I packed. With my next stopover at home, I hope to be able to make like a bro in summer and cut down the excess bulk.

2) When in a new city, make friends with a local and do what they do

So you’re in a new city and like any good medical student you’ve done your research. You’ve never been to Toronto, Calgary, Halifax, or Vancouver (etc etc) before and want to see all the attractions (and more importantly eat all the food) before you fly out 2 weeks later (come to think about it, visiting medical students are kind of like a pack of cicada – we swarm in, drum up a bunch of cacophony, eat a whole bunch, and in a couple weeks of annoyance to the locals we’re gone).

Yeah, that’s a lot of fun and be sure to take part in it, there’s a reason why those places become the hotspot.

But at the risk of sounding a bit too hipster, it’s better to make friends with some locals or inquire a classmate who is a local and get tips from them.

Why? Well, A) they may have better knowledge on which places are worth the hype and which aren’t. This leads to much better use of your limited time. Secondly, they probably know some other up and coming trendy places that may not be listed on Fodor’s. Finally, locals can probably offer tips that make your day-to-day life on elective easier. You know, stuff like helping figure out transit routes, good places for groceries, and what you might need to bring before heading to the city.

In essence, utilize those interviewing skills you picked up in clinical sessions and strike up a conversation with a local.

 3) There are a million “absolute right way” to do a simple procedure

From suturing, approaches to presenting a case, to even taping people’s eyes, you’re never doing it right. On day one you might get a nice lesson on how to approach intubating a patient. Great, you think, I’ll just do it like this with the next few docs here and I’m set. Day two, your doc looks thoroughly unimpressed with your “technique”, even though you did the exact same thing as the other attending.

Great, don’t tell me this is your first time intubating. You’re doing it all wrong! and you get another lesson, which will only be corrected by the next guy.

Repeat ad nauseum to every elective and every physician you encounter along the way. It’s like facing Tyson for the first time on Punch-Out: you cannot win. I feel like you simply got to go with it, and take solace in the fact that you’ll likely do it yourself once you got medical students of your own to “teach”.

4) Find a good coffee shop

Quick quiz, what’s some of the signs that you’re a #BasicMedStudent?

a) You need caffeine to operate.

b) You need wifi to either work on applications or go on social media (or blogs) to procrastinate from working on applications.

c) You consume a large amount of sugar/carb dense snacks to compensate for the lack of sleep you get.

d) All of the above.

The coffee shop provides all of these amenities, making it the natural stronghold of the traveling medical student. The trick is finding a good one to bunker down in when you’re in a new city. A good coffee shop will cover the basic necessities of survival: protection from the elements whether it’s rain, snow, or the cold; a means of communicating with others via a strong wifi connection, hydration in terms of coffee/tea/beverages; and food in terms of an assortment of baked goods.These are the basics, and everyone has their own personal preference on what they value more. For me, it’s the wifi. Sometimes I can’t count on the connection at the accommodations I’m staying at and I need to get online to work on CaRMS. But that’s just me. 

And, when in doubt, find a Starbucks: they’re everywhere (especially in Vancouver)

5) Wade, don’t jump, in.

Every hospital will run slightly differently. There’s a lot of desire, especially at first to try to jump right in and look like a star off the bat. I would recommend against that. Seriously.

There’s no rush and it’s better to be a fly on the wall and watch what happens, ask the right question, and ease into it. People like to welcome the rookie and it’s pretty favorable to appear as the person who fits in well seemlessly and remembers all the veterans’ advice.

Don’t worry if you don’t try to jump in. It’s just too confusing and stressful trying to figure out a hospital’s way of doing things before you really even have been there. Each are it’s own beast. And it doesn’t matter if you might look bad in front of someone stumbling around lost the first few days. Sorry to burst that bubble but you’re pretty forgettable.

6) When it comes to accommodations – location, location, location!

Electives can be pretty expensive, from application fees, gas fees, air fare, and costs of living. And even though you’re expected to be in the hospital and clinic for most of the day, you actually won’t be allowed to live in one while you’re visiting.

Bottom line: you need to find a place to live.

Now generally the options are: rent/sublet from someone (usually another medical student or resident), find a friend, or stay with family. A lot of people go with the options of staying with friends and family to save cost or to have a good time. But I feel the most important aspect of choosing your lodging is location.

The key number is 15 – that is minutes or less from your main hospital/clinic/centre. The main reason for that is it’s close enough you can escape the clutches of the hospital quickly, but that also means you can get to the hospital quickly when you need to. This is beneficial when you want to come in early in the morning, if you want to get a few more minutes of rest or have a long morning routine, or (if you’re close enough) even having a place to retreat to on a night of call that isn’t a stuffy room with a molded plast mattress.

Having paid for a place right next to the hospital and having saved money by staying at home and commuting, I still say the location is worth missing out on the free meals and cheaper save. Over time, the earlier mornings due to the commute and having to still spend up to an hour getting home after work is done just adds up and cuts into your productivity.

7) Never turn down offers from physicians

While they may be strangers to you, you shouldn’t turn down offers from any of the physicians you meet while on electives, especially if it’s candy.  Often these offers come up innocuously, and have a very short time period to respond.  So are you in? And while that answer yes might not always be crazy, memorable, the hospital turning into a bumping club, adventures, there is often some benefit awaiting, even if there might seem to be some work involved in it.

Help out with a report? Sure that’s a bit of work, but you can get published and it makes a good impression with the residents.

Why not stay later for a case, who knows what you might learn.

Volunteer a weekend to go on an organ retrieval? Always answer yes. It’s a magical, humbling experience.

In the end the electives are not only a chance for you to demonstrate that you’re a great potential resident to each program, but it’s an amazing opportunity for you do tailor your education independently. While it can be a lot of fun to play tourist, go out and eat fun meals, and travel, it ultimately comes back to have the freedom of 16 weeks for you to pick up additional skills for your future as a ______this spot left intentionally blank________ physician.

Happy trails.

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