typical Anki screenshot

I finally managed to register for the USMLE Step 3 after going through all the hoops that the NY State Department dishes out for physicians. Now the only thing left is to learn the material for the test. The test itself is a two-day exam with clinical scenarios relating to general medicine. It’s run by the National Board of medical examiners, but is actually administered by the folks at Prometric. (I’ve taken MSCE’s and IBM AIX licensure exams by them in the past, as well as Step 1/2 exams).

I haven’t decided how to prepare for the exam. I haven’t purchased any books yet, nor have I the urge to. The exam itself was $690, and the NY State Dept charged me $735 to make sure I’m not a villian.  What a rip.

However, since I’m not necessarily in the mood to do any group studying, I might try to use some spaced-repetition software to help some of the material sink in my head.  Read more…

computing usmle, work

Pharma goodies...okay, maybe not the French chocolate cookies

I’m going to miss the days when big pharma showered gifts embroidered with their logos to doctors. Ever since the voluntary ban on branded gifts, pharma has ceased to supply our department with pens. The resident area still has several left, but our stash is rapidly depleting. Given my hospital’s  hybrid documentation system, my pens actually run out of ink every 2 weeks, assuming I don’t lose it or contaminate it in a C. diff patient room.

Sure, I understand the ethical problems of product placement, especially if pharma is giving us mugs, napkins, mp3 music players, bags, flash drives, and whatever-else-you-least-think-is-excessive…but pens? Who cares if I have my pen advertises a monoclonal antibody? In fact, some branded pens are decent writing implements–they don’t clump out dried ink like those crappy bank pens. Read more…

medicine pharma

I hate writing progress notes. Sure, they’re essential to document to a patient’s hospital course, but most of the note is repetitive. Even worse, my hospital uses a hybrid medical record system.  The computerized portion stores all laboratory values and initial consults. The daily progress notes by the primary team and consults are all handwritten.  The nursing pods usually have only one or two computers, one of which is always used by nursing to view people.com and perez hilton.  Thus, every morning I vie for that lone open computer while fumbling through illegible chickenscratch.  Do we regress that quickly from grade school? And clearly I’ve discovered that penmanship doesn’t correlate with hand dexterity- surgeon scribble is no better than internist scribble. I’m no calligrapher, but at least I make an active effort to be legible.

This cycle repeats for each of the 8-12 patients every morning for 4 week blocks at a time. That’s enough to push anyone into insanity, or any cynical housestaff to reinforce his jaded outlook on the medical system.  And if slovenly human behavior doesn’t do it, the computers like to seize and go into endless reboots daily around 6am – 8am.  That’s hospital IT (information technology) for ya.

medicine inpt medicine, rant

I pay too much attention to the magazines on the back of airline seats. If you’re fortunate, there are usually the standard three items: (1) a magazine by the airline company, which usually features a random city that belongs in its flight path, assorted in-flight amenities offered, and exercises you can practice to prevent blood clots from forming on your legs (2) a thin cardboard insert detailing the make and model of the aircraft, and (3) Skymall magazine.

typical Skymall cover

Ah yes, Skymall magazine.

Read more…

Uncategorized airlines, life, magazines, skymall

Despite all the recent political “change”, I certainly don’t think that our society is rushing to become “nicer” people, nor does it appear that we have any urgency to do so in the near future. As I recall, President Obama had even commented on stamping out evil in his acceptance speech. We are actually on our way to be bullies.  In any case, I think it’s hilarious how euphemistic we are at assigning titles to jobs, especially in the hospital.

Janitor = Environmental Services.

Chief Resident: We have to lock up the Keurig coffee packets, because environmental services (ES) has been using ours.

Me: ES? (What? Health Inspectors stealing our coffee? How often does that happen?)

…[pause]…

Me: Oh, the janitors are stealing our stuff.

K-cup coffee pods...the ones the hospital janitors are stealing

Janitors should be janitors, just like the Janitor on Scrubs.  I get the derogatory connotations, but hell, apparently interns aren’t considered residents to some people (prior article).

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medicine euphemisms, politics