Posts tagged centerpiece

Part 4: References

The crux to any good application is the reference letter. You could have a stellar application but if there is no one to vouch for you, it can be an uphill battle to the specialty you want, especially if it is highly competitive.

Part 3: Understanding CaRMS

Since 2002, the residency application process has been managed through the Canadian Residency Matching Service (CaRMS). Everyone who is a Canadian medical student is automatically enrolled into the service. Others can apply to be apart of the process. For medical students in their final year of training, this is where the magic happens.

Part 2: Choosing Electives

One of the first major challenges of applying to residency is making yourself presentable, to tailor your experiences to the career you want to achieve. The last year of school is generally reserved as the time to pursue electives in the various disciplines.

In general, every school has certain requirements that must be achieved, such as having at least one elective in medical, surgical, and primary care specialties. Beyond that however, you have the flexibility to choose whatever you want to do.

Part 1: Knowing Yourself

At some point in the natural order of things, you begin to realize that the journey to medicine is not as straightforward. There was once upon a time when being a doctor meant knowing everything about everything. In this day and age, that has become an impossibility.

With that in mind, you reach the crossroads for a second time: what should I do with my life?

There are many ways to conceptualize the thinking process but it always boils down to three simple questions you should ask yourself:

  1. Do I want to work with your hands?
  2. How comfortable am I not knowing the full picture?
  3. Do I want to know a narrow and deep well of knowledge or a wide and shallower pool of knowledge?

For example, someone who enjoys working with his hands, is comfortable not knowing the full picture and likes a wide but shallower pool might be better suited for emergency medicine.

These three questions are fundamental to understanding where your values and interests lie. As your education progresses, take a moment to reflect. You might be surprised how often and how dramatically things change.

The most crucial time to consider these questions is in the clinical year. Consider how your newfound experiences change or reinforce your choices. 

This becomes important when choosing your fourth year electives.


Making the Match
Part 1: Knowing Yourself

Part 2: Choosing Electives
Part 3: Understanding CaRMS
Part 4: References
Part 5: Research and preparation
Part 6: Creating a schedule
Part 7: Travel planning
Part 8: Interviewing
Part 9: Ranking

Certain universities publish class lectures as a podcast stream that can be revisited at a later date. For the student who likes to review material or have it explained to them, downloading a podcasting app is a great place to start. In addition to class materials, here is a list of free podcasts that I have listened to over the years to get you started:

What do you listen to?

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Making the transition to an all digital workflow can be very challenging when all of your notes and books are in paper form. The easiest time to make this transition is before starting the curriculum. Having said that, making the jump part way is doable but comes with its own growing pains. However, it helps to go into the transition with a plan. Here are some options that are available on how to create a digital workflow in a primarily mobile setting.

As the industry of mobile computer continues to expand, we will have more clinical and academic tools to increase our productivity. The following are all of the apps that have made a mark on the transition to mobile medicine and digital education. (Note: All apps currently listed are in the iOS marketplace).

It was only six months ago that I parsed the marketplace and surveyed my peers for what were considered the best medical apps for mobile devices. Following that three-part feature, I received a lot of positive feedback from the Tumblr community and beyond.
Over the next few weeks, I will be posting a mini-series of features under the heading Digital Medicine whose focus is on how to digitize your medical studies, resources that are available, and my must-have recommendations. 

It was only six months ago that I parsed the marketplace and surveyed my peers for what were considered the best medical apps for mobile devices. Following that three-part feature, I received a lot of positive feedback from the Tumblr community and beyond.

Over the next few weeks, I will be posting a mini-series of features under the heading Digital Medicine whose focus is on how to digitize your medical studies, resources that are available, and my must-have recommendations. 

When I was waiting for test results I tried to make up a description in my mind of the consequences of a bad outcome; for myself and then for my wife and my children. For myself it maybe is not too bad - straight to the grave - which is where we all go; even if we think it is too early whenever it comes to that. It is awful, it is difficult to get used to that thought - if you ever are able to…it would be worst for my wife…she is the one who has to take the blow.

When I heard of going to the cancer clinic, I began shivering all over my body. As soon as I opened the door here I felt the smell of the house of death. I can still feel this smell. The word cancer is loaded with fear, I think, and I know some persons who have died of cancer. A tumor is a tumor; uncontrolled cell division, something growing and attacking inner organs.

I react severely to the cytotoxic drugs. I feel so sick, and although I get other drugs to subdue the vomiting, the sick feeling is there, rocking my body all the way. I feel as if I am being run over by a steamroller - my whole body is reacting.

I remember when I woke up from the operation the surgeon told me they had found “islands of outgrowths” in the peritoneum, which was negative news. Something strange happened to me; all anaesthetics and all drugs disappeared from my body, my brain become crystal- clear and I thought: “How can I tell this to my wife?

An excerpt from Expressive Metaphors in Cancer Narratives by Carola Skott, PhD RN.

Palliative Medicine

One of my clinical preceptors always reminded students: “you are allowed to make all sorts of mistakes; but whatever you do, do not kill the patient.” A patient dying while under our care is something everyone fears. How did it happen? Why did it happen? Was it unexpected? What role did we play in it? What could we do about it? It is a major topic of our healthcare system, and the reason clinical teams run morbidity and mortality rounds. After all, if a therapeutic visit ends in death, it warrants a second look. Did we do everything right? Or did we fail?

Now that I am on a palliative rotation however, the metrics of care have changed. There is an understanding that the patients we see are at the final stages of their illness. Our role in this context is no longer to treat, but to make patients comfortable as we allow the conditions to take their course. Our new metric is suffering.

The transition has not been without its difficulties. It is hard to resist the urge to act, to auscultate, to palpate, and to investigate after so many months on the other side of the fence. No longer is death the undesirable outcome, but rather the inevitable conclusion of everyone I see.

In the short time I have been in this rotation, I have already had the privilege to be involved in the concluding days of a number of patients who have since died of their disease burden. 

It is a strange and humbling realization that within the coming year, the mortality rate of all the patients I have seen in this rotation will be or close to 100%. And for this service and for everyone involved, that is all right.