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This too shall pass:

Posted on 05 April 2015 by Jimmy Yan (Meds 2015)

So here we are, the last couple hours before the CaRMS match results are released. While there’s still the issue of the licensing exam and graduating at hand, this feels like the moment we’ve all been waiting for (or at least for me).

Now considering how this decision is kiiiiinnd of important, it has been a bit of a nervous period.   But since I don’t have a stache of Ativan hidden away at home, I needed to figure out how to deal with this in some other way. And of course, because this is the UWO blog, I have to put it in a list form.

So I guess this following list is more for future classes’ references than for this current group, but here are some strategies that I came up with to pass the time waiting for the result.

1) Netflix.

Go read another post, because we’re done now. But seriously, this one is pretty much all you need. I mean the 3rd season of House of Cards just came out, and Better Call Saul is on there (if you have access to the UK version). Okay nuff said.

2) Read a book.

Because when was the last time we had time to do some leisure reading (reading for the sake of having an answer to your CaRMS interview doesn’t count). Rummage a library or download an e-book. Who knows there might be a book out there on how to deal with CaRMS results stress.

3) Work out

Speaking about stress, a good way to get a handle of it is to let off some steam. A run, yoga, bike ride (maybe tough to do with the snow), or a trip to the gym can definitely help you feel more refreshed and revitalized. If you don’t mind the cold and the weather is amenable, checking out a local pond and playing some hockey is just a must for a good Canadian kid.

4) Travel

Because you want to beat the cold. Because Family Day weekend is happening. Because Mardi Gras and American spring break is happening. Because you aren’t sick of flights yet from interviews. Because you really want to make the most of your line of credit.

5) Go out and party.

My logic is that if you are going to be up all night sleepless anyway, you might as well be up all night having some fun.

6) Relax to some music.

Some suggestions I have are “Everything is Awesome”, or the classic “Final Countdown”.

Of course, there are also some really fun parody songs out there too. My current favorite is this one that spoofs T. Swift.

7) Study for exams

Because nothing is better at diverting panic and anxiety for one major life event than focusing it all on another major life event.

8) Write something for the UWOMJ blog

This is a great tip and I’m recommending it based off personal experience. The mere act of writing this little piece has killed the last couple hours before the results are released. Now time for me to go meet up with my roommates, drink some mimosas, and figure out the rest of my life.

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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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Better than you think

Posted on 09 June 2014 by Jimmy Yan (Meds 2015)

Exhaustion from call; PTSD from getting barked at; loss of a social life. For many medical students, the surgical rotation during clerkship is supposedly the “doom and gloom” block. While it is a challenging block with a lot to learn, that is not a phenomenom unique from the other specialty rotations either. In fact, there are a lot of misconceptions on how “brutal” the rotation will be. As someone who is just finishing their 12 weeks in it, my personal testimony* (note: am interested in doing a surgical residency) is that it is not as frightful as many make it. There are in fact quite a few hidden gems about the surgical block that I am really going to miss.

1) Wearing Greens to work. – Sure you might miss out on being able to choose your outfit for the day, but think of all the time that saves as well! Over the past 3 months, I’ve greatly cut down the cost of my laundry (both time and money for supplies) and also get to the enjoy what is essentially pajamas to work. There aren’t many fields of work that let you do that, aside from maybe mattress testers and these guys.

2) Premium Parking – Okay, okay, okay. I can’t really personally attest to this because I’m still cycling my commute to the hospitals, but word on the street from other clerks and my roommate who just finished a few months on general surgery as part of his residency electives is that when you come in at 6am or earlier, you get the best parking in the house. Guaranteed. This makes getting out when you do get to leave all the easier. Also in the winter days this shortens the walk from your car to being inside with the warmth. That definitely makes a big difference.

3) Less road rage, aka less traffic – I don’t think I’ve been in a city with more infuriating traffic lights and less efficient roads than London. Even in some cities in China which have populations the size of Ontario on the road at least there is movement and is programmed to accommodate the flow of traffic. London’s traffic doesn’t make any sense, which is baffling considering how short distances one has to cover to span the city. Particularly in the normal peak “rush hours” the pace crawls by – I am definitely able to move quicker on my bike during these jams. Yet if you arrive early and leave late, you never have to deal with the extra strength Advil requiring headache that is London traffic. Picture it: leisurely arriving to work, air is still clean because you aren’t breathing in idling exhaust fumes, able to actually hear the birds sing in the morning as you go about your way, and smoothly getting to the hospital from home. No fuss, no muss. It’s almost kind of nice, right?

4) Getting to enjoy the sunrise each morning – Lost in the frenzy of the hospital and the pace of clerkship are those moments to just step back and be in the moment. Yes, we’re up at an hour the night owls are just going to bed at. Yes, we have to round on patients so quickly sometimes I get my cardio for the day just through that. But even if it’s just for a few seconds through a window in a patient’s room each morning, getting to see those first rays of a new day break over the horizon is just so moving. Getting to see the sunrise helps charge up my batteries in preparation for the long day ahead.

5) A lot of complimentary coffee – And this has nothing to do with the fact that I was on surgery during Tim Horton’s Roll Up the Rim contest. But the residents/attendings seemed always willing to buy the clerks a coffee when there was a moment’s of downtime between cases. As a person who enjoys a good cup of the black stuff, this was a very nice touch. Stick taps to that. Yes, some would say that if we had longer hours to sleep we wouldn’t need the coffee during the day, but I just like to drink coffee.  Even if it’s Timmies. 

6) No trouble sleeping at night – My brain is a troll at night. Previously, if I’d try to sleep my mind would keep me up overthinking about things that happened during the previous day, trying to figure out stuff I should be prepared for the next, or just generally screwing around with random streams of consciousness. While on surgery, when I want to sleep I just do the flop. I might have gone to bed earlier before, but I’m actually getting more sleep now.

Detractors might argue that this is simply Stockholme Syndrome reasoning but I feel that there are many overlooked moments to enjoy in the surgery rotation. There’s great teaching, a lot to do, and the feeling of being included in the team while on the rotation, but those are the obvious ones. The above list tries to address some of the hidden, little things that generally go by everyday without appreciation. But really, it’s often these little things that add up and make a difference in the end.

 

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Those Post Call Days

Posted on 14 October 2013 by Jimmy Yan (Meds 2015)

So for those keeping track at home, right about now marks just past the 1 month point since the actual beginning of clinical rotations. By now we’ve probably have had a decent exposure to a range of clerk responsibilities, including…(dramatic drum roll)…call.

Yes, call, that one word that make your average preclerk pull off a near perfect Macualay Culkin impersonation.

But no, we’re clerks now, and just like Freddie serenades, we must go on.

And besides, inevitably, we all got to do call. It’s just a fact of life (of a clerk).

But it turns out, the whole process of being up in the night, isn’t that bad. Note: this is the personal opinion of a self inflicted insomniac. Like Hooch, I’m craaaaaazyAs long as you’re up and about and doing something, the body’s seems to shunt enough fresh blood to the brain to keep it perfused enough to maintain lucidity and sanity. And if something active or acute is happening, then at least the adrenaline is better than coffee!

What does suck though, is when that buzz comes crashing down. Dawn breaks, morning rounds or handover occurs and you finally exit to sweet, sweet, fresh air.

And then what? You got a post-call day, which is some much coveted free time; yet you’re not exactly at the peak condition to enjoy it. So what to do?

Fortunately our handy research crew (ie: me) has searched high and low, even with the government shutdown. From that, we present to you the list of the top 5 to do, and also, top 5 things not to do, during that post call daze (oh hey wordplay!) if you DON’T want to simply sleep.

Don’t:

5) Go on a shopping spree.  – Seriously, you’re judgement is impaired, you’re blood sugar is a little off, and you’re vision is a bit blurry. You’re going to be after any little sparkly doodad or supposed “good deal” out there. Even worse, the Masonville Apple store is just a short bus ride away.

4) Fall asleep in a frat house. – While sleep is key. Make sure you’re vigilante of your surroundings when you do snooze. Make sure you don’t nap in any area where people could assume you’ve simply passed out from intoxication (because, let’s admit it, by this point you could pass off as a drunk), and you end up on this site (NSFW).

3) Try to pick up. – You simply aren’t as sauve as you think right now. Period.

2) Go for a long, extended drive. – Yes, you need that car to get back home to that ever alluring bed, but you don’t need it to just hit the open road (even if Bryan Adams compells you). Seriously, there are a number of articles telling you this is a bad, bad, idea.

1) Do another call shift. No. Just. No. 

Do. 

5) Attempt to do some course reading : Yes, nerd alert , but just hear me out. This is a win-win. Either the act of reading puts you out to a peaceful sleep completely…OR you learn something and get to impress and WOW your residents and attending on your next shift (only you won’t but it’s nice to think that).

4) Eat, and lots of it: Typically you finish call at around noon the next day. This calls for five words: All. You. Can. Eat. Sushi. ‘Nuff said.

3) Have a light work out: Emphasis on the light, as you probably aren’t at your peak self. Despite this, take the opportunity to stretch the muscles a bit, get that cardio going, and burn off some of the crappy calories you consumed during the middle of the call shift.

2) Sit/Lay down on the grass: When was the last time you got to see the sun afterall? If you have the opportunity, take it, you never know when you’ll hit that dreaded streak of “go in when dark, leave when dark” phase known as the Canadian winter, so make like Superman and recharge off the rays of our yellow sun.

1) Catch up on some shows: From Netflix to YouTube, the web is brimming with series to start, catch up on, or rewatch. I’m recommending some Archer, or if you can’t get enough of medicine: Scrubs.

So there you go, what do you think of this list? Have more ideas or suggestions? Why don’t you put them in the comments below.

Didn’t like the post? Well don’t blame me, I’m writing this post-call!

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