Island Med Student

Okay, so the title of this post is very misleading. I am attending Ross University School of Medicine, and I would like the world to know that I have had a very positive experience with Ross thus far. I have never regretted my decision to attend a Caribbean medical school. But I’ll admit that I am also a “chronic optimist.” I tend to always see the glass as half full, and I very rarely complain about things. However, I receive emails all the time from people who want to know the “dirt” on Caribbean schools. And I received an email a few days ago from a student who asked me to list the “top 10″ things that I don’t like about Ross (in order of importance). This will be a very hard list to create. But here goes:

1) The stigma. As I’ve said many times, there is obviously a stigma associated with attending a Caribbean medical school. However, I must say that I have found this to rarely be a problem (again, my darn optimism!).

2) The large class size. Yes, Ross accepts many students every semester. And for some people, this makes it challenging to “be heard.” But again, I will say that this has never been a negative for me. I’ve almost always found that I’ve gotten the attention I needed…but that leads me to number three.

3) Scheduling clinical rotations can be challenging. Because of our class size, and because of the fact that there are limited clinical spots for us students, it can sometimes be difficult to get individualized attention, and the “best” spots available. But all in all, I must say that I have been “mostly” satisfied with my scheduling, and most of my rotations.

4) The cost. This might be the worst thing that I can complain about. Ross’s tuition and fees is on par with the more expensive U.S. medical schools. And when you add on the additional costs related to traveling, the price really adds up. If I have one regret, it is the astounding amount of student loan debt that I’m facing.

5) Living in Dominica. This one is really difficult for me to count as a negative. For me, this was one of the TOP reasons for choosing Ross. I was truly excited about living in Dominica. But for those people who can’t appreciate the beauty of this wonderful country, I guess they count it as a drawback.

6) There isn’t really a “home base.” Since you spend a portion of your time in Dominica, and then the rest at various sites in the U.S., it can sometimes feel a little discombobulating. For me, this was actually a great advantage. But for others, it can be unpleasant.

7) It’s difficult to place into competitive residencies. Yes, it’s harder for Ross grads (or other non-AMG grads) to place into more competitive residencies. But the reality is that you CAN place, and it does happen. But you may need to work harder and have a better CV than your AMG counterparts.

8 ) Not enough administrative guidance. Since we really don’t have a solid “home base” and because there are so many of us, it can be difficult at times to get good guidance from the school. Although, I’d say in my experience, I have been mostly satisfied with the response I’ve received.

9) Having to repeat semesters. Many people complain about the fact that if you fail one class by even one point, you must repeat the entire semester. While I can understand and appreciate this complaint, I also understand Ross’s policy. If you are struggling with even one class, it means that you really need to get a better hold on your studying routine, and try again.

10) It ain’t Harvard. Nuff said.

Sorry if you were expecting better complaints, but I am just not a good complainer!

Note: I actually had to google “Ross Sucks” and go onto ValueMD to come up with this list!

Check out my post on Medscape to read about my algorithm for choosing a residency program (it’s actually more complicated than this, but this is a good start!)

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Check out my post on Medscape to read my top 10 residency interview tips (it’s very similar to the post on my blog, but there is a poll to take as well!).

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I plan on writing a more official list for Differential post, but I thought I’d share some tips here as well (I’m not allowed to cross-blog).

I received a pretty good response from my residency applications so far. I have already had some interviews, but still have many more to go. Obviously, you don’t have to believe anything I say. I haven’t yet matched, so I could be completely off. However, there are some things that I have picked up on during my interviews so far, and from other sources on the web. I thought I’d make a nice list of tips to share. Read at your own risk!

1) Stay Organized! A very awesome doctor (Katrina!) told me last year to make sure and stay organized during residency interview season. How right she was! I am completely organized to the max, and it has been super helpful. Here are some things I’ve done and recommend doing:
a) Create email folders and sub-folders, if necessary. You will send and receive many emails. Keep them organized.
b) Create a binder for program info. I have a sweet color coded, chronological system set up.
c) Keep all your interview dates on a calendar! I have mine both on paper and electronically, which has worked super for me.
d) Keep all the papers and info they give you. I have mine in a nice expandable file folder system.

2) Research the programs. The more you know about the program, the better decisions you can make, and the better you look on interview day. Almost every program has asked me, “why are you interested in this program, in particular?” If you can’t answer this question, you will look silly!

3) Dress professionally. Wear a suit. Use common sense here. No chest hair showing, no huge gold dollar sign necklaces, no hooker make-up. Note: I love hooker make-up just like the next girl, but it just doesn’t work in this setting.

4) Be on time. Seriously, I can’t emphasize this enough. Leave WAY early to get there in time. Expect traffic delays and build in time for them.

5) Be prepared for questions. There are many great resources on the web with lists of common residency interview questions. You should try and go though most of them and come up with an idea of an answer. You don’t need to memorize every single question, but you should be prepared to answer the commonly asked ones.

6) Ask questions! It’s not a bad idea to make a list of questions about the program in advance. Trust me, you will hear “do you have any questions?” one hundred million times on interview day. If you don’t have any questions at all, you look like you’re not really interested in the program.

7) Write thank you notes to your interviewers. Either electronic or paper, or both.

8 ) Know your strengths and weaknesses. Be able to give examples of both. Know how to sell yourself. Be confident about yourself as a candidate!

9) Have water accessible during the interview. Maybe this is just me, but I tend to get super dry mouth when I’m interviewing. I always make sure to have a cup or bottle of water nearby. I learned this lesson the hard way.

10) If you are really interested in a program, go back for a second look. This helps you remember the program, and shows that you are truly interested!

I hope this list helps some folks out there! I will likely be adding some more items to this list as time goes on. Good luck to everyone who is interviewing right now!

Check out my post on Medscape to read my list of top 10 mistakes to avoid making in clinical rotations.

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In addition to the information I posted about studying for the USMLE Step 2 CK, I thought I’d share with everyone my opinion (and the opinion of other students I’ve met) about which books are best for each core rotation/clerkship.

Internal Medicine: Step-Up to Medicine (Step-Up Series)

Surgery: Surgical Recall, North American Edition (Recall Series)

Obstetrics/Gynecology: Blueprints Obstetrics and Gynecology (Blueprints Series)

Psychiatry: Blueprints Psychiatry (Blueprints Series)

Pediatrics: I haven’t had peds yet, so I don’t want to put this info up yet. I will update this once I take peds, or get good opinions from other students who have completed it!

This is a post I have been meaning to write forever. It would probably be better if I had written this a long time ago, when I was still in Dominica (as everything would be fresh in my mind, and the resources there would be the same), but nevertheless, I feel like it might be helpful for me to list some things.

Here is my disclaimer: things might have changed in Dominica since I was there (from 2006-2008). Also, let me say upfront that what you decide to bring really depends on the type of person you are. If you don’t really care so much about brand name items, and you are willing to pay a little more or less, you really don’t need to bring that much. If you are the opposite, you should bring more. I only brought two suitcases, within the weight limit, and was pretty much okay. You will have to decide for yourself what you really need.

Here are my suggestions (in somewhat order of importance):

1) ALL computer/tekmology related items that you need. This includes laptop, cables, camera, iPod, headphones, jumpdrive, etc. Technology items are expensive and very hard to come by in Dominica. Bring everything you might need.

2) Clothes. This is rather obvious. There are clothes available, but not necessarily the ones you would like. Bring plenty of t-shirts/tank tops, shorts, flip flops, underwear, etc. Dominica is HOT. You will need to dress accordingly. But you should also bring a pair of jeans, and a sweat shirt, etc., as the classrooms and library tend to be very cold. Bring some shoes that you can hike in (I highly recommend hiking), and a few work-out outfits for running, going to the gym, etc. Also bring some swimwear and at least one nice outfit, with shoes, for your white coat ceremony. You will need dress clothes for ICM and stuff like that, but not until your 3rd semester on.

3) Toiletries. If you can’t live without a special type of deodorant, make-up, or face lotion, bring it with you. If you don’t mind using whatever is available, you will be able to find other substitutes in Dominica.

4) Medicine. Although there are pharmacies and such, it’s not a bad idea to bring a supply of any medications with you if you can. It just makes things easier.

5) Food. If there are items that you CAN’T live without, bring them with you. Dominica has plenty of food, but maybe not the selection that you’re used to in the States or Canada.

6) Books. This is a complicated issue. It depends on if you decide to buy your books in advance, or buy them once you get on the island. In retrospect, I think I would have bought them in advance on Amazon and had them shipped, but this really just depends on what your needs are.

7) School supplies. You will be able to find almost any type of binder, highlighter, notebooks, etc., at the RossU bookstore. However, they will be much more expensive there. If you want to pay less, you should buy these in advance.

8 ) Heavy duty flashlight and umbrella. It’s not that you can’t find these in Dominica, but it’s probably easier if you just bring them with you, as you will need them every day!

9) Battery operated clock. If you have an iPod, I highly recommend the iHome. You can buy clocks in Dominica, but it’s not a bad idea to have one from the outset.

10) A good pair of scissors and a can opener/swiss army knife. For some reason, these are hard to come by in Dominica.

11) Bug spray. You can find it there, but if you like, you can bring it with.

Okay, now here is where my advice is different from other lists I’ve seen online. I really don’t think you need much more than the above items. Obviously, if there are other items that you CAN’T live without (favorite stuffed animal, photo of your loved one, a pet rock) you should bring those as well. However, I don’t necessarily agree with other lists I’ve read. You don’t “have” to bring everything under the sun with you. You can find plenty of things in Dominica. You don’t need to bring pots and pans with you, unless you are very specific about the kind you need. Again, as I said above, you can find many things in Dominica, just perhaps not to the standard you’re used to. But for me, that was part of the fun! Why go to a new country and live there for two years without experiencing what they have to offer?

Anyway, that’s my list. Much shorter than most, I know. Please feel free to add, subtract, or comment!

Med school isn’t the only place to learn about the art of medicine. There are many colleges, universities, and other institutions that offer free online medical courses and education resources to self-learners around the world. Here are 10 free resources to explore in your spare time:

MIT OCW – The Massachusetts Institute of Technology offers more than 50 free health science and technology courses through the school’s OpenCourseWare (OCW) program. Courses typically include lectures, reading lists, assignments, exams, and other self-study materials.

JHSPH OCW – The John Hopkins Bloomberg School of Public Health also offers free courses to self-learners through their OCW program. Courses cover a wide range of public health and medical topics, including child health, adolescent health, public health, mental health, aging, chronic diseases, infectious disease, nutrition, and health policy.

Open Michigan – The University of Michigan provides several free medical courses that are open to everyone with an Internet connection. The school also offers courses in nursing and dentistry.

LearnersTV – LearnersTV provides hundreds of free medical lectures from colleges and universities around the world. Lecture categories include immunology, bacteriology, virology, parasitology, mycology, infectious disease, anatomy, physical examinations, and neuroanatomy.

Health Sciences Online – This virtual learning center provides high quality courses and references for medicine, public health, pharmacy, dentistry, nursing, basic sciences, and other health sciences disciplines. The center currently offers more than 50,000 hand-selected resources.

GFMER – The Geneva Foundation for Medical Education and Research offers hundreds of free education resources on their website. Resources include free medical journals, databases, books, and professional publications.

Medscape – Medscape is a free online resource for specialists, primary care physicians, and other health professionals. Offerings include articles, journal commentary, book reviews, medical news, free textbooks and medical journals, conference coverage, and medical practice information.

eMedicine – More than 10,000 physicians contribute to this clinical reference from Web MD. The online reference includes nearly 7,000 medical articles.

Medical Animation Library – This online library from the University of Pennsylvania hosts medical animations that can be viewed with free video players. Animations cover a wide range of medical topics. Each animation includes a short explanation of the topic to help viewers understand what they are seeing on the video.

SlideWorld – Designed specifically for medical professionals, this online library contains more than 7 million PowerPoint slide presentations. Slides are sorted into 20 medical topics and are easy to find using the site’s search features.

Guest post from education writer Karen Schweitzer. Karen is the About.com Guide to Business School. She also writes about top online colleges for OnlineCollege.org.

I was inspired by an article that a very nice doctor just sent to me, to write about the contents of my white coat, and what I bring to clinical rotations. A study found that there was a direct relationship between increasing seniority and decreasing weight of one’s white coat. Anecdotally, I have found this to be very true. I remember my very first day of surgery, coming onto the wards with overflowing pockets of all kinds of medical equipment and books, which weighed me down to so much that it was a chore going up and down the hospital stairs. I’ve since modified both the contents of my white coat, and the book bag that I bring along with me to the hospital. It changes based on the rotation, of course, but here is what I plan on bringing to my first night of emergency medicine in less than six hours:

Contents of White Coat:

1) Stethoscope – a necessity
2) Reflex Hammer, Tuning Forks – I always bring my reflex hammer, but tuning forks aren’t really necessary for rotations like cardiology
3) Pen Light – very good to have
4) At Least 2 Black Pens, and One that has a Color – necessities
5) Small Notepad – a necessity
6) Maxwell Guide – a lifesaver for every rotation
7) ACLS Guides and EM Handbook – a good idea for an emergency medicine rotation, replace with other handbooks for other rotations
8 ) Cash – VERY important to have for vending machine, coffee, water, etc.
9) Alcohol Wipes – very handy, I usually also carry gloves, guaiac cards, and other necessities depending on the rotation (for surgery – gauze pads, medical tape, etc.)
10) Gum, Protein Bar, Candy – lifesavers!!!
11) Chapstick – a requirement for me…I talk a lot!
12) Tourniquet – these are always in short supply at my hospital, so I carry one with me
13) ID Badge – a requirement
14) Cell Phone / PDA – perhaps THE most important item, not only for communication, but for accessing information. My iPhone replaces the need to have eight billion various books. I have tons of medical, pharmacological, and other info at the touch of a finger!
15) Water Bottle – not seen in photo, but a requirement for me

In addition to the stuff I carry around in my pockets, I bring a few other things along with me to the hospital to store in my locker.

Contents of Book Bag:

1) Scrubs – a requirement for some rotations
2) Black Bag with “Extra” Medical Tools – I keep a sphygmomanometer, ophthalmoscope, otoscope, etc. with me in my bag, just in case there isn’t one available. You may laugh, but I’ve had to use my sphygmomanometer on more than one occasion!
3) Sunglasses – an especially handy item when leaving the hospital at 9:00 a.m. post-call
4) Wallet – duh
6) Keys – duh
7) “Extra” Reading Material - if I actually do have any downtime, I sometimes pass the time with good ole fashioned reading
8 ) Antibacterial Lotion – I love this stuff!
9) Medications – not in photo, but I usually bring some ibuprofen, tampons, cold meds, etc., as needed
10) Food – also not in photo, but I occasionally will bring food along with me. The hospital I’m usually at is surrounded by 24 hour food stores, so I frequently just eat something I buy.

There you have it! This is a what I almost always bring with me to clinical rotations. I hope this helps some of you who are just starting your clinical rotations. Old fogies, feel free to add to the list!

I have received many emails asking me about the above question, so I thought I’d share my limited insight. As always, please accept my disclaimer: I am in no way an expert on studying for anything. I only know what has worked well for me. I did not completely kill the Step 2 CK, but I did well. Study at your own risk!

Okay, now that we have that over with, here are answers to some questions:

1) Which books should I use? Well, I used various books to study during each of my core rotations. Perhaps I’ll post that info another day. But for the Step 2 CK, I basically just used First Aid for the USMLE Step 2 CK (First Aid USMLE)
and Step-Up to Medicine (Step-Up Series). There are a million other books that people have found useful, but these worked well for me.

2) Which question banks should I use? I swear by USMLE World for the Step 2 CK. Do every question. Do them over and over until you get them right. Read every explanation, even if you get the answer correct. They are wonderful.

3) What other tests can I use? I did the four practice exams available on the NBME website. They are great. My score on the real exam was very close to what I got on the practice exams. Do them, do them, do them!

4) What core rotations do I need to have completed to take the USMLE Step 2 CK? Well, you technically don’t have to have completed any of them, unless your school has special requirements. However, I think the best case scenario is to have completed all of them. Every core rotation contributes to the Step 2 CK. Everyone told me not to worry, because it really didn’t matter if I had completed a rotation or not. However, I took the CK without having completed ob/gyn or pediatrics, and I ended up doing not as well on those two areas. I am a hands on type of learner, so I think not having real life exposure made it difficult for me to learn the material. However, some people learn better with books or they can memorize. Maybe then it’s not as important. But the problem for me was that my schedule just couldn’t accommodate. I needed to get my CK scores for my residency application. If that hadn’t been an issue, I would have delayed taking the CK until I completed ob/gyn and pediatrics. But that wasn’t possible, so I took it in advance. You have to look at your own situation and make your decision based on that.

5) How much time did you take to study? Well, that’s sort of complicated. I mean, I studied each particular subject some while I was doing my cores. I also started doing USMLE World questions many months in advance. However, I didn’t really hit the studying hard until the last two months before the exam. This was plenty of time for me. But I am a fast reader, and fast test taker, and I was doing electives, which allowed me plenty of time to study. Again, you have to figure out how much time you will need based on your schedule and other variables.

Okay, that’s all I can think of for now. As always, please comment or email me if you have any other questions, changes, or additions, and I will add them to the list!