MCW Class of 2010, Part 3

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Back to the grind today.

Two months off was not enough.
 
I'm so glad to be on vacation.

What are you on this month, Don?
 
His rank list is due on Friday... he'd be in trouble if he still had interviews. 🙂 Yay for early match.
 
His rank list is due on Friday... he'd be in trouble if he still had interviews. 🙂 Yay for early match.

the poor guy is about to come apart at the seams. He was practically sobbing on my shoulder this morning. Then he punched another M3 in the face when they asked him about his rank list and then he disappeared for the rest of the day.
 
creepy?
[YOUTUBE]http://www.youtube.com/watch?v=eD8qiiNJq2E[/YOUTUBE]
 

As if modern American women don't have enough to worry about. Now we can have guys slipping Zicam into our drinks when we're not looking and ameliorating our cold symptoms. What is the world coming to?
 
What do modern women worry about that olden-times women didn't? Roofies have been around forever.
 
What do modern women worry about that olden-times women didn't? Roofies have been around forever.

Yes, but now they'll make our colds better. The horror. The horror.
 
Yes, but now they'll make our colds better. The horror. The horror.

How is osmotic diarrhea better? Well, I guess if you are trying to lose that holiday water weight...
 
How is osmotic diarrhea better? Well, I guess if you are trying to lose that holiday water weight...

it beats complete bowel obstruction to the point of fecal emesis!!! wooooo fecal emesis!!!!
 
pics from the ski trip with my sister and a girl from my high school

stayed here with a friend of the girl I went with. it was quite nice, and quite free.
6wolbfo.jpg


top of the continental divide at Loveland
8amegk0.jpg


my sister skiing down a double black on the top of a mountain
6kp2a0l.jpg


did a lot of skiing in the trees
80kwexl.jpg


top of Keystone
6nrptdx.jpg


yours truly, on a mogul run at Beaver Creek
6q22p1u.jpg


the people I went with, when we went snowshoeing on our day off
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School starts tomorrow. I would like to say that I'm ready, just because I've often wondered what it's like to be struck by lightning for lying.
 
School starts tomorrow. I would like to say that I'm ready, just because I've often wondered what it's like to be struck by lightning for lying.

Pharm is fun.

That sounds like the game I wasn't allowed to play as a kid "fruit is fun." In pharm is fun, everyone can stick horse sized pills in their mouths one at a time and say "pharm is fun."

I totally didn't go into work today expecting to get stuck in an 8 hour surgery. I went in expecting to round and be done by 10am.
 
I totally didn't go into work today expecting to get stuck in an 8 hour surgery. I went in expecting to round and be done by 10am.

Nobody expects the Surgeon Inquisition.

Oh, and pharm is decidedly not fun. Quite the contrary.
 
Pharm is fun.

That sounds like the game I wasn't allowed to play as a kid "fruit is fun." In pharm is fun, everyone can stick horse sized pills in their mouths one at a time and say "pharm is fun."

I totally didn't go into work today expecting to get stuck in an 8 hour surgery. I went in expecting to round and be done by 10am.
that blows
 
So, if any other M2s care, I'm compiling a list of what I'll be using for Step 1 studying. HY=high yield, RR=rapid review.

Thus far, I'm planning on using First Aid 2008, Goljan RR path, HY Neuroanatomy, HY Embryology or the devo textbook, RR histo, BRS phys, Micro made ridiculously simple, Lippincott's biochem review, and our immuno textbook.

I'm deciding between some/all of the following - Wheaters, HY Cell/Molecular Bio, and RR Pharm. I'm also thinking of getting a number of question books, because with 8-12 hours of studying a day, I need something fairly interactive, like the Robbins review questions, Goljan's question book, and probably Qbank. And WebPath is free.
 
My 0.02, and you should get Don's advice on books if you haven't already, since he is a rock star, is to spend significantly more time doing practice questions than just studying. I went through 100% of Q-bank, making sure to read the explanations of any question that I got wrong or "happened" to get right, as well as making sure that I understood why each wrong answer was wrong on the questions I had gotten correct, especially if I felt not especially strong on the material. Just sitting down and going through things like BRS/HY/etc was beneficial at the very beginning, especially to review the distant stuff (i.e. not path or pharm, since we'd just had comprehensive finals), but really, I learned so much more from doing questions.

Areas to focus on will be your second year courses and physio. I know people sometimes get biochem-heavy or embryo-heavy exams, but really, I would guess that over 75% of my exam was pathophys, micro or pharm, or some combination thereof.
 
My 0.02, and you should get Don's advice on books if you haven't already, since he is a rock star, is to spend significantly more time doing practice questions than just studying. I went through 100% of Q-bank, making sure to read the explanations of any question that I got wrong or "happened" to get right, as well as making sure that I understood why each wrong answer was wrong on the questions I had gotten correct, especially if I felt not especially strong on the material. Just sitting down and going through things like BRS/HY/etc was beneficial at the very beginning, especially to review the distant stuff (i.e. not path or pharm, since we'd just had comprehensive finals), but really, I learned so much more from doing questions.

Areas to focus on will be your second year courses and physio. I know people sometimes get biochem-heavy or embryo-heavy exams, but really, I would guess that over 75% of my exam was pathophys, micro or pharm, or some combination thereof.


I was the opposite. I did about a third of qbank before I decided it sucked balls. Definitely do questions though...just not qbank.
 
My 0.02, and you should get Don's advice on books if you haven't already, since he is a rock star, is to spend significantly more time doing practice questions than just studying. I went through 100% of Q-bank, making sure to read the explanations of any question that I got wrong or "happened" to get right, as well as making sure that I understood why each wrong answer was wrong on the questions I had gotten correct, especially if I felt not especially strong on the material. Just sitting down and going through things like BRS/HY/etc was beneficial at the very beginning, especially to review the distant stuff (i.e. not path or pharm, since we'd just had comprehensive finals), but really, I learned so much more from doing questions.

Areas to focus on will be your second year courses and physio. I know people sometimes get biochem-heavy or embryo-heavy exams, but really, I would guess that over 75% of my exam was pathophys, micro or pharm, or some combination thereof.

I agree w Xandie. I did all of Qbank and really only read BRS path and First Aid and half of "USMLE Secrets" I think. But then I usually remember things much better after missing a question about it. I do think the Qbank questions are little harder than the real ones, which is good because I missed more and hence remembered more.

Also, bullseye for Xandie on biochem and devo. I wouldn't spend more than a day reviewing either.

I was also pretty surprised that the pharm questions on the real thing were way easier than I expected. They tend to overprepare you in pharm here, if you manage to do well in the course, step 1 should be a breeze. Anyone disagree?
 
I agree with most of the above.

QBank for me was by far the highest yield. Read every explanation whether you get the question correct or not.

I used HY Neuroanatomy, HY Embryology (a bit overkill), HY Behavioral Science (has a great stats section), and HY Anatomy (also overkill, but it saved me on at least a few questions).

For path and phys I read BRS.

Micro Made Ridiculously Simple, Lippincott Biochem (which was time well spent for me, as I had a ton of biochem), and our little immunology text (because I liked it).

Also, I went through First Aid along with reading the above, making annotations.

The last few days, I spend entirely with First Aid (one last full read through). By this time, I was really getting sick of studying, but I think this last "power review" was really worth it.

Also, make a study schedule, and stick to it. Include catch up days, and definitely include a day or two completely off for your own sanity.

I think that's about it.

I'm always available if you guys have any other questions. You can probably figure out my email, or just PM me.
 
I highly recommend USMLE World. Qbank sucked.

I used RR path, HY neuro, HY embryo, HY cell/molecular (quite helpful for me), HY immuno, BRS phys, BRS behavorial, micro made ridiculously simple. I used first aid, but didn't really like it. I think that's it.
 
Hmmm, I have some old Qbank questions at my disposal, so I'll look through some of it before I shell out the cash. I tend to get distracted near computers though, so I'm leaning towards using more question books (Robbins, Goljan, Kaplan, and others). Anyone use any of those? What about the exams you can buy from the NBME?

I'm thinking that I'll go through some of my review books at a fairly casual pace throughout this semester, and use First Aid as often as possible when it's relevant to my current course material. I'm definitely not going to put much time into anything other than path, pharm, phys, and then next up things like anatomy, brainstem lesions, and some histo.

I did read from a number of posters on the Step 1 forum that HY Cell/Molecular Bio was surprisingly helpful, because they had a fair number of those questions on the real exam.
 
Quick advice, and maybe I'm smoking something here, and I also *hate* working on computers. That being said, however, the boards are on computer, and the more used to the interface you are, the smoother test day goes. Really. It sounds insignificant (yeah, I know how to take a test on a computer, blah blah), but there really is something to be said for having built up the endurance to do eight hours in front of the screen.
 
Quick advice, and maybe I'm smoking something here, and I also *hate* working on computers. That being said, however, the boards are on computer, and the more used to the interface you are, the smoother test day goes. Really. It sounds insignificant (yeah, I know how to take a test on a computer, blah blah), but there really is something to be said for having built up the endurance to do eight hours in front of the screen.

agreed. I didn't do much computer time so I was definitely getting pretty fried by the end. luckily I still got the 289.
 
Quick advice, and maybe I'm smoking something here, and I also *hate* working on computers. That being said, however, the boards are on computer, and the more used to the interface you are, the smoother test day goes. Really. It sounds insignificant (yeah, I know how to take a test on a computer, blah blah), but there really is something to be said for having built up the endurance to do eight hours in front of the screen.

Especially without checking random sites. I hate computerized tests, for the record. I was able to have my laptop in front of me while studying and do questions without checking email unless it was an allotted break.
 
Especially without checking random sites. I hate computerized tests, for the record. I was able to have my laptop in front of me while studying and do questions without checking email unless it was an allotted break.
Your self control is probably better than mine.


That said, the advice about a computerized test is something I'll definitely keep in mind.
 
randomness - my brother's fiancee had her very successful weight loss program through Weight Watchers, and now here's her face on a Times Square billboard - http://206.188.22.22/default.aspx?detail_id=13


Awesome for her! I remember how amazing her story was. My wife just started Weight Watchers this week. Her aunt and cousin have each lost like 40-50 lbs on it in the last year. I don't know how I feel about the whole points thing. It seems like she can still eat quite a bit, and we already ate pretty healthy, so I don't feel like her diet has changed a whole lot. I guess the portion control will help a little bit, though. Did your bro's fiance do the in-person meetings or just the online stuff? If she has any words of advice for my wife, let me know.
 
Awesome for her! I remember how amazing her story was. My wife just started Weight Watchers this week. Her aunt and cousin have each lost like 40-50 lbs on it in the last year. I don't know how I feel about the whole points thing. It seems like she can still eat quite a bit, and we already ate pretty healthy, so I don't feel like her diet has changed a whole lot. I guess the portion control will help a little bit, though. Did your bro's fiance do the in-person meetings or just the online stuff? If she has any words of advice for my wife, let me know.

I have some, if you'd like, though I only took off about twenty pounds: Front load your day with HEALTHY very low-point food, like egg-white omelettes full of zero-point veggies. I used to make a big giant fritata along those lines at the beginning of the week and freeze portions so I wouldn't have to think about breakfast. The veggies fill you up and are good for you, and the feeling of having points left at the end of the day is very relaxing. It's nice to know you can have a two-point microwave-baked apple or a three-point scoop of sorbet in the evening if you want one.

The other thing is, some days you won't eat within your points, and you'll know you've blown it. Office parties, for example, can sometimes do that. EVEN THOUGH you'll never stay within your points that day, keep tracking them, not in shame and horror, but just to observe yourself. It keeps a binge from becoming an attempt to eat the whole world and makes it easier to get over yourself and get back on track tomorrow. It helps to keep you from giving up.
 
I have some, if you'd like, though I only took off about twenty pounds: Front load your day with HEALTHY very low-point food, like egg-white omelettes full of zero-point veggies. I used to make a big giant fritata along those lines at the beginning of the week and freeze portions so I wouldn't have to think about breakfast. The veggies fill you up and are good for you, and the feeling of having points left at the end of the day is very relaxing. It's nice to know you can have a two-point microwave-baked apple or a three-point scoop of sorbet in the evening if you want one.

The other thing is, some days you won't eat within your points, and you'll know you've blown it. Office parties, for example, can sometimes do that. EVEN THOUGH you'll never stay within your points that day, keep tracking them, not in shame and horror, but just to observe yourself. It keeps a binge from becoming an attempt to eat the whole world and makes it easier to get over yourself and get back on track tomorrow. It helps to keep you from giving up.

Thanks! Great stuff...so far she's had enough points at the end of the day to have an ice cream bar or whatnot for dessert and still be at/under her points, so I think she's doing good. You stated exactly what her problem will be, though - they go out to eat at her work a LOT for meetings, and it'll take a lot of willpower to get something healthy and/or only eat a reasonable portion of it. This Friday they're getting barbecued pork and chicken from Speed Queen for the whole jobsite, which is definitely not going to help.

With the "extra" weekly points (she gets 26 per day and 35 bonus points weekly, but hasn't used any of the bonus points yet), did you find yourself spending almost all of those each week? One thing Jen does not like to give up is having a beer or two on weekend, so I think those points will probably be at least partially spent on that.
 
Thanks! Great stuff...so far she's had enough points at the end of the day to have an ice cream bar or whatnot for dessert and still be at/under her points, so I think she's doing good. You stated exactly what her problem will be, though - they go out to eat at her work a LOT for meetings, and it'll take a lot of willpower to get something healthy and/or only eat a reasonable portion of it. This Friday they're getting barbecued pork and chicken from Speed Queen for the whole jobsite, which is definitely not going to help.

With the "extra" weekly points (she gets 26 per day and 35 bonus points weekly, but hasn't used any of the bonus points yet), did you find yourself spending almost all of those each week? One thing Jen does not like to give up is having a beer or two on weekend, so I think those points will probably be at least partially spent on that.

I spent every single one of my extra points almost all the time. I think one of the ways to succeed on Weight Watchers is NOT to give up the things you love, but instead to plan your eating so you can still have them without going overboard. So she should absolutely have a couple of beers. Just don't have them before dinner. Weight Watchers warns you, and it is very true, that alcohol makes that extra portion or six of dinner seem like a really great idea at the time.

On the fabulous junky stuff from Speed Queen, I got nuthin'. Unless it's to bring a fabulous fruit salad or something from home to share with people to eat along with her one or two pieces of chicken. It has to be something low in points and high in volume that she really likes and that other people will also praise and appreciate and want some of so she can eat for just as LONG as the other people are, and so that nobody looks upon her with pity, but instead they want some of what she's got. And it must come with a run-on sentence.
 
Awesome for her! I remember how amazing her story was. My wife just started Weight Watchers this week. Her aunt and cousin have each lost like 40-50 lbs on it in the last year. I don't know how I feel about the whole points thing. It seems like she can still eat quite a bit, and we already ate pretty healthy, so I don't feel like her diet has changed a whole lot. I guess the portion control will help a little bit, though. Did your bro's fiance do the in-person meetings or just the online stuff? If she has any words of advice for my wife, let me know.
From what I know, the points also factor in things like the glycemic index of food, so it also helps control cravings and such. Food like oatmeal is filling over a much longer period of time than simple carbs. If it's actually adhered to, Weight Watchers is pretty effective. My (almost) sister-in-law went to the actual meetings, and she said that it really helped her change her viewpoint on the purpose of food, from emotional need to nutritional value. She made a video on it right before Thanksgiving that you could probably show your wife - http://www.youtube.com/watch?v=A4daMtppwMs
 
So if I understood Dr. Lund correctly, the right way to being a pelvic is to say "Okay, here I come. You're going to feel me now." It seems counterintuitive, but I'll go with it.
 
Ah, the pelvic exam lecture.

Not that you were really asking, but since this is sort of my area of expertness (yep, chose that word on purpose), here's my approach.
I always start with my hand on the inside of the thigh, saying "you're going to feel my hand on your leg."
"Now you're going to feel my fingers on the outside."
"Now I'm going to insert the speculum. Relax and let me know if this hurts."
Then I do a speed pelvic exam (really, I'm a champ), and say "alright, I'm going to remove the speculum now".
I make eye contact with the patient whenever possible, and keep the sheet draped over the legs but depressed a little in the middle, since I'm short and I can't see over the sheet otherwise.
Anyway, there's my pelvic exam advice. Rah rah!
 
I did the points for a while. It takes into account calories, fiber, and fat per serving to come up with the points value. I had some trouble with it because I wasn't very good at planning out my day. So once I knew the points value of some combo of food, I tended to eat that everyday. Which becomes quite boring. So it's good to be able to sit down and kinda plan out what you're gonna eat. And I highly echo the advice about veggie-loading. Soups are usually a good choice too. I only got 22 points/day with 35 bonus, and often used them up a little too quickly.

So since I was kinda bad at the planning part, I switched to eDiets. I did lose weight with WW, but eDiets was easier for me. I'm trying to get back on the bandwagon, cuz I only got halfway to goal. Lost 7 lbs til I went home for xmas. Who knew you could gain 7 pounds in one week. I'm better at planning now, so could probably do WW again successfully.

Never went to meetings, so can't comment on that. I just bought the points slider thingy and book online.

No matter what though, don't let her buy Nutrisystem. GROSS! No wonder people lose weight on that - they don't eat.


Oh, and us ob-gyn peeps had our pelvic refresher today. Good stuff. One of the guys said something like i'm going in now or something like that.
 
Ah, the pelvic exam lecture.

Not that you were really asking, but since this is sort of my area of expertness (yep, chose that word on purpose), here's my approach.
I always start with my hand on the inside of the thigh, saying "you're going to feel my hand on your leg."
"Now you're going to feel my fingers on the outside."
"Now I'm going to insert the speculum. Relax and let me know if this hurts."
Then I do a speed pelvic exam (really, I'm a champ), and say "alright, I'm going to remove the speculum now".
I make eye contact with the patient whenever possible, and keep the sheet draped over the legs but depressed a little in the middle, since I'm short and I can't see over the sheet otherwise.
Anyway, there's my pelvic exam advice. Rah rah!

According to my family med eval, I'm a pro, and wonderful at doing Paps. I just can't feel anything on the pelvic, but after the patient complimented me on my pap technique in front of my attending, they wrote that I'm excellent at such skills as paps on my eval. I just hope I never have to do another one.
 
Ah, the pelvic exam lecture.

Not that you were really asking, but since this is sort of my area of expertness (yep, chose that word on purpose), here's my approach.
I always start with my hand on the inside of the thigh, saying "you're going to feel my hand on your leg."
"Now you're going to feel my fingers on the outside."
"Now I'm going to insert the speculum. Relax and let me know if this hurts."
Then I do a speed pelvic exam (really, I'm a champ), and say "alright, I'm going to remove the speculum now".
I make eye contact with the patient whenever possible, and keep the sheet draped over the legs but depressed a little in the middle, since I'm short and I can't see over the sheet otherwise.
Anyway, there's my pelvic exam advice. Rah rah!

I just push the "play" button on the nearby remote control so "kung fu fighting" blares when I start.
 
man, some people really half-ass the co-ops they write. I usually try to make them pretty good, so I can actually put my name on that. I had the pulmonary hypertension one last semester, and it was the first time he gave the lecture, the lecture was terrible to follow, the handout was awful, but I figured I'd actually make something that people could study from. I just did the path lecture from today, and the one last year was "Slide 1. blah blah blah. stupid unrelated comment I thought I'd make. blah blah blah. Slide 2."

How about a format that's easy to follow and highlights the relevant information? I hope that the person who does the co-op next year can just use mine with a simple comment or two.


/rant
 
i'm interviewing applicants tomorrow. i'm thinking about just bringing in my computer and forcing them to watch my favorite youtube videos with me, then rating them based on how well i think they liked the videos.
 
i'm interviewing applicants tomorrow. i'm thinking about just bringing in my computer and forcing them to watch my favorite youtube videos with me, then rating them based on how well i think they liked the videos.
conduct the entire interview in Klingon
 
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