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Guest post from education writer Karen Schweitzer. Karen is the About.com Guide to Business School. She also writes about online schools for OnlineSchool.net.

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Gel Health will explore the patient experience – how to improve it, and who’s doing it, in a variety of organizations and companies. Like any Gel conference, we’ll tackle the theme from a broad array of perspectives.

A good primer on patient experience is this video of Bridget Duffy’s talk at Gel 2008

Gel Health will be held on Thursday and Friday, October 22 and 23, 2009 at Scandinavia House, Park Avenue and 38th Street in Manhattan.

Gel Health tickets are available at for $499.

The Gel (Good Experience Live) conference series, a seven-year-old event curated by Mark Hurst, is launching a new healthcare event – Gel Health – a conference focused on the patient experience.

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I recently watched this video, published by the American Academy of Orthopaedic Surgeons. It struck me as a perfect example of the kinds of habits I see being developed by many kids these days. What are we teaching our children?

When I think about by own habits as an adult, I can’t help but think back to my own childhood. I grew up on a farm in rural Virginia. My family’s farm produced a lot of the food I consumed. We grew fruits and vegetables to eat, milked goats for most of our dairy needs, and had a few chickens who provided our eggs. My mother instilled good eating habits in me as a child. She made her own ice cream, dried her own fruit, and made many other yummy foods from scratch. At the time, it didn’t seem like a big deal to me. It was just how things were.

I grew up in a house with three other sisters. We were all very active from a young age. When we weren’t helping plant seeds, shoveling manure, or shucking corn, we were running around in the fields, or covering each other with mud. We had access to no, or very little television for most of our childhood. The Internet didn’t exist. There was no reason to play a “virtual” game of baseball on a video game console. For us, a game of baseball meant gathering sticks, leaves, walnuts, and of course, our imagination.

But now I’m an adult, and I’m a poor student living in New York City. I don’t have room in my studio apartment for a garden, goats or chickens (and my dogs refuse to produce milk or eggs). I no longer have a huge field of grass to run through. But I realize that the habits I developed as a child made a huge impact on my lifestyle. I still try to eat fresh fruits and vegetables when possible. I prefer to walk to get around, I take the stairs instead of the elevator, and I am a regular visitor to parks.

So, what does this all have to do with medicine? In my opinion, everything. While access to healthcare services, medications, and health insurance are obviously immensely important to overall health, there is no substitution for a healthy lifestyle.

I have so much I’d like to say about all this. There are so many variables involved like healthcare access, resources, socioeconomic status, and race, but I don’t have the space to go into all of them in this short blog entry.

One thing that I will say, though, is that socioeconomic status can have a myriad of influences on one’s own health. Education, income, and race are all factors that influence the ultimate health outcomes of different people. If a mother has to work two full-time jobs to support her single parent family, she might not have the time or money to prepare healthy meals for her children. The examples are endless.

I consider myself to be a lucky gal. As a child, I sometimes resented my mother for not allowing us to eat processed cheese or watch cable television. But now as an adult, I realize how much I am in debt to her for everything she did. If I ever have children of my own, I hope to be able to pass the same values on to them. And although they might resent me for not allowing them to play video games at McDonalds, I hope that one day they might actually thank me.

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I received a nice email from an interested student, and I thought my reply might be nice for others to read, so I’m posting it here.

So, are there enough residency spots (in the U.S.) for IMGs (international medical graduates)? Well, before reading this post, you might want to first read my post about whether or not Ross University graduates can get a good residency spot. You can read that here.

Now, on to the more specific question.

Here is the actual email I received:

How do you feel about future Ross graduates’ ability to competitively
match? As you may know, US schools are increasing enrollment yearly (as are
carib schools) and I’m afraid that will affect our chances of matching 4 yrs
later. (I would be starting Jan 2010 after MERP btw). Based on the NMRP
2009 Data, 93.1% of US MD grads matched, vs a mere 47.8% of US FMG. The %
from 2005 -2009 for FMG matching is generally decreasing, considering
amount of increased enrollment on both sides.

I assume that most of the FMG who matched came from the big carib schools.
Would you happen to know what % matched this year from Ross? And do you
feel that the odds will be problematic for those entering now? (i.e., more
pressure to score higher for lesser or more competitive residency seats,
etc.)

Thanks for your time and energy posting helpful info on your site!

Okay, to address the first concern/question. Yes, I am very aware that both U.S. and Caribbean schools have been increasing their enrollment. Actually, the AAMC realized a few years ago that the nation is facing a shortage of physicians. To address this problem, they asked that U.S. schools increase their enrollment, and encouraged the creation of additional medical schools. This is great, but there is an obvious problem. It’s fine and dandy if more students start graduating from medical schools. However, if there are not enough residency spots to handle these graduates, we are in trouble. Acknowledging this problem, the AAMC has been actively trying to expand the number of residency positions available. You can read about one of the bills they have backed to increase residency spots here.

So, yes there is an issue with expanding the number of medical school graduates without also expanding the number of residency positions. I think the AAMC is making some progress towards rectifying this issue. However, how successful they will be, and how this will affect the competitiveness of residency positions (and in particular Caribbean graduates) remains to be seen. I prefer to remain optimistic, but the reality is that no one is actually sure what will happen over the next few years.

To address the second question of the emailer, about IMGs matching less in recent years, I will ask you to see this data (page 4 in particular) published by the NRMP. In 2009, 93.1% of U.S. allopathic med school seniors successfully matched. In contrast, only 47.8% of IMGs (from the U.S.) successfully matched. This number has decreased from 54.7% in 2005. I don’t really have a good answer for why this has occurred. However, I will hazard a guess and say that it could be to the number of Caribbean med schools popping up in recent years. There are more schools, and many of them might be pumping out unqualified students, who end up not matching, and bring down the percentages. I have no data to back this up, so feel free to not believe me.

However, when looking at the matching rate for IMGs (47.8%), I will ask you to look at another number as well. In 2009, 17.2% of U.S. IMGs actually withdrew from the Match, versus only 1.9% of U.S. allopathic seniors. Again, I will guess as to why this happened. There is a chance that some of these IMGs ended up getting a pre-match (only IMGs have this option), and hence withdrew from the Match. This could be correct, or I could be way off. But it’s my guess. And this obviously is skewing the data.

As for the percentage of Ross graduates who matched in 2009, I’m sorry but I don’t have that number. I know that all my friends matched, but that is obviously not a good sample size!

Anyway, I hope this helped answer your questions. Please feel free to correct me or ask any more questions!

Note: No, you’re not going crazy. The photos above have nothing to do with this post. I am tired and desperate and just picked some random iPhone photos. “My bad.”

Many medically related blogs have begun posting “tweets” from a variety of sources. Some people even go as far to say that Twitter micro-blogging might eventually replace the conventional blogs entirely. I’m not so sure about that.

In the news recently, surgeons at Henry Ford Hospital in Detroit have been “twittering” surgeries live. Surgeons have twittered kidney surgery, brain surgery, and are posting more and more every day. Several other hospitals have also started twittering surgeries and other procedures.

There are obviously a lot of issues here. Some people are all for this new trend, and think that Twitter has created a new, and possibly better way of teaching medical students. Even if you’re not inside the OR, you can still follow the steps of a surgery, and you get to hear about the decisions that the surgeons have to make, and what goes through their minds during surgery. It provides a whole new perspective.

In addition to teaching, it provides the family with real-time feedback during the surgery. No longer is it necessary for the family to sit anxiously in the waiting room for the surgeon to come out and update them on the status of their loved one.

Some people are very against this new trend, however. One of the criticisms is that surgeons should be more focused on the surgery, rather than the twittering. But from what I’ve read, there is always a senior surgeon with the patient at all times, and they trade off on who actually does the updating.

There are also patient confidentiality issues. Patients always have to give permission to allow the surgeons to publish the surgery. But other types of medical twittering bring up more confidentiality issues.

Inspired by this concept, I recently decided to twitter my entire 12-hour night call on my family medicine rotation. Obviously, when I was busy with patients, I was unable to update. But I tried to update afterwards as soon as I could. So, here is a Twitter snapshot of my shift (there are a lot of random thoughts, so feel free to skip to the end if you get bored):

6:30 p.m. – On my way to hospital for night call. Yippee!
7:00 p.m. – In rounds now. Always find your surgeon!
7:32 p.m. – Patient died and came back!
7:46 p.m. – 71-year-old mean man presents to ED…
8:00 p.m. – One hour down, only 11 more to go, and no admissions yet.
8:34 p.m. – Admitted a patient with chest pain and nausea… I’m thinking ACS, costochondritis or GERD…
9:36 p.m. – SWAMPED! Just admitted 3 patients back to back… did a stool guiac.
10:20 p.m. – Patient has rales, pitting edema and positive Babinski… what’s wrong?
12:08 a.m. – I haven’t eaten in over 12 hours. I’m starting to feel the effects.
12:47 a.m. – Just helped stop a patient from attacking the resident because she was Muslim.
2:30 a.m. – Sustenance, finally!
3:00 a.m. – There’s nothing like hanging out at Dunkin Donuts at 3 in the morning!
3:40 a.m. – Brain is showing signs of sleep deprivation… if only I had slept last night.
3:45 a.m. – My nose has elves in it and a resident stole my penlight.
4:00 a.m. – Espresso + step up to medicine book + empty room + black eyed peas = strange fun
4:15 a.m. – “Is this real life?”
4:32 a.m. – I think I have liver spots.
4:44 a.m. – Ativan is your friend. Never turn your back on your friends.
4:58 a.m. – The title of the section of the book I’m reading: diarrhea pearls
5:14 a.m. – Dead Kendra walking…
5:21 a.m. – Sitting in the hospital lobby with homeless people. All my patients are sleeping.
5:37 a.m. – Drunk guy in ER pukes on me and says “I want my free phone call.” I said, “this is not jail!”
5:44 a.m. – Bored again and decompensating.
5:57 a.m. – I think I just pulled up the anchor on the reality boat.
6:00 a.m. – If no more admissions, I can leave in an hour. For goodness sake do NOT come to my hospital!
6:05 a.m. – Walking laps around deserted floor of hospital. Kinda creepy, but keeping me awake.
6:15 a.m. – Walking through ED always gives me a lot to be thankful for!
6:17 a.m. – I would be much happier right now if I were in scrubs.
6:21 a.m. – I wonder if you can OD on twittering.
6:30 a.m. – 30 minutes and I can go home if no new admits. Thinking about blocking ED entrance.
6:50 a.m. – 10 minutes to go. I just had a flat out hallucination.
7:05 a.m. – FREEDOM! The sun also rises….

Congrats if you made it to the end of my tweets! It’s kind of interesting for me to go back and read this in my now fully rested state. It gives me a fun perspective on what was not entirely a fun night.

My tweets are obviously not in the faintest bit as exciting as real-time surgeries. But hey, I made no promises! Anyway, what do you all think? Is twittering in medicine a good thing or bad?

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