Wednesday, March 9, 2011

Shadowing Part 3 : What to do when shadowing

As I mentioned in one of my previous entries, my shadowing advice was so long, I needed to divide it up for ease of use. This is part three, what to do when shadowing. Since some things are OR specific, I am going to divide this into sections.

Part 3a : What to do when shadowing (general)

1) Make sure you are wearing the correct outfit you are supposed to wear.

If you don't know what the doctor wants you to wear, ask.

Business casual is pretty standard if you are going to be seeing awake patients. Think button-down collar shirt with a tie for men, equivalent for women. Nice pants, decent shoes.

No white coat unless you are asked to wear one. I've only had one doctor ask me to wear the white coat. I felt like an idiot. And yes, when someone says white blazer, they mean white coat. You can get one from Scrubs & Beyond.

Only wear scrubs if you are going to spend the day in the OR AND your attending okays this and doesn't want you to just change before you go in. On days I am shadowing in the OR, I just show up to the hospital in scrubs of the appropriate colour (light blue is typical at that hospital). I don't get a locker so I don't have anywhere to put my clothing anyway. I've been allowed to round in scrubs, but I felt out of place. I once heard from the neurologist I shadowed to never wear scrubs outside of an OR because it's disrespectful to the patients. I can kinda see that.

In the OR, you will be wearing scrubs along with a mask, hat, shoe coverings, and eye protection.

2) Be careful of who you listen to.

In the OR, listen to the nurse. When in doubt, ask the nurse. Apparently attending surgeons will do things that will get you as a premed into trouble if you listen to them.

In a private practice, you can probably trust the attending's word. It's still amazing how many of them double check with the nurse. As one of my doctors said about his nurse "She's the one that's really in charge!"

3) Don't ask questions in front of the patients

It could be considered rude.

4) Don't even write notes in front of the patients unless your attending is ok with this.

Also, probably rude. Here is a time when it would probably be ok to write notes, such as when your attending says : "Hey FA, you might want to read up on XYZ." You can probably write XYZ down on the note pad you brought.... you DID remember to bring a notepad right? Just in case you didn't think to do it, I will add it on the checklist just for you.

5) Bring a notepad

Just in case you didn't think about it. By the way, it's faster than typing on an ipod touch, which yes I've had to do that too. That's why I use the notepad now. A neurologist used to call my ipod touch, "my auxiliary temporal lobe." Very funny.

6) Know how to use any medical apps that you have on your ipod/iphone

This of course if only relevant if you have the ipod/iphone/BB or whatever and you have the apps like epocrates. I cannot tell you how many times I had to use epocrates when I shadowed.

7) Put your cell phone on vibrate.

I sometimes forget this one, luckily I'm not that popular so no one calls me.

Part 3b : What to do when shadowing in an OR

1) Don't touch anything blue.

Dark blue generally means it's sterile. Try to avoid that. A decent rule is to stand at least a foot or two away from anything you shouldn't touch.

2) If an attending asks you to come closer, do it even if you are scared to.

The OR is a crazy place and the people have the weirdest sense of humour. If they threaten to throw blood on you if you don't come closer, the best response is to just go closer, not say "You can't hit me from here." Now, they can hit you, they probably won't try though because then the nurse will get upset. But do you really want to take that chance?

3) Don't ask a surgeon why their name is on supplies

Just don't.

4) Do not show fear.

The more scared you act, the more the OR staff will mess with you. It takes a special type of person to do their work and when they decide to be weird, the weirdness really comes out. I could never be a surgeon but I have respect for anyone who can do that type of work. I'm convinced they eat their young.

5) Try to resist comparing the OR to what you've seen in M*A*S*H or Scrubs.

It's hard not to do. First time I saw my attending in a doo-rag, I nearly cracked up. When he started playing music through his ipod, I was biting my lip to keep from laughing. I almost couldn't take him seriously anymore. I was really, really hoping the theme to Scrubs was on his ipod and that it would play.

6) Make sure there is always a place to sit

This is more just in case you feel faint. It can get warm in an OR, plus it's pretty bloody.

7) Ask your doctors (your actual doctors, not the person you are shadowing) if it would be wise to take prophylactic medication if you know you are a queasy person.

My doctors knew I was very queasy and said I was going to be fine and gave me some suggestions on how to avoid fainting and avoid vomiting. I was on so much medication the first time I shadowed in the OR, that there was no way I could have passed out or vomited even if I wanted to.

Back to the main Shadowing page

Shadowing Part 2 : Tips on contacting people

As I mentioned in one of my previous entries, my shadowing advice was so long, I needed to divide it up for ease of use. This is part two, some tips on how to approach contacting people. This might be a little out of order, from how a lot of people do it, but I've never been like normal people.

Part 2 : Tips on contacting people

1) Keep track of who you've contacted, where you found their contact information, who you have to contact still, and who you've already contacted, etc

This is unlikely to come in useful at first but when one has started to contact a lot of people, you will realise how useful it is provided you started early. I have three computer files related to shadowing.

The first is a word document which includes all the people I haven't contacted yet and it includes the website I found them, their contact info, their name, practice information (if available), etc. If I find someone that I think might be good to shadow, I copy their info and put it in my Word doc so I can contact them later.

The second file is an excel sheet and I use this to keep track of who I've already tried to contact. The Excel sheet lists their last name, their specialty, their reference, method of contact, month of contact, and most recent response. This has made my life much easier as far as assuring I don't accidentally bother the same people. And to make my life even easier, I have it colour coded and sorted.

The third file is just a list of all the dates I shadowed, the person I shadowed, the specialty, and the times. I have things automatically added up and cross listed to another sheet which has specialty aptitude rankings, my feelings about the specialties, etc. (Yes, I know I am OCD, but who are you to judge?)

2) Make a CV

Some of the doctors have been requesting a CV (Curriculum Vitae). Have one ready. Ideally, you already learned to create one. If you don't know how to create one, here is a collection of links that could help you :

3) Contact people in the way that feels most comfortable for you.

Personally, I prefer contacting people by email. Not only can the doctors respond whenever they can, you know it is less likely to be screened by someone at the front desk. Of course you also run the risk of having a defunct email address or your email could be caught by spam filters or whatnot. I also think it's easier to do email at first because I can send out three emails in 10 minutes and that includes the time it takes to update my files.

4) Know what you are going to say.

I have a little email script I have already written up as an introduction. It is about two paragraphs and includes how I found their contact information, who I am (a few sentences about myself and my educational background), and if they allow students to shadow them. Sometimes I will even add a line or two about a connection I have to their specialty (for example, when I called the neurologist's office, I also disclosed that I have mild controlled epilepsy so I think highly of neurologists for saving my sanity.)

5) Have an answer for why their specialty.

I was asked by one doctor to write an essay on why family medicine before he would answer if I could shadow him. I already gave him a few sentences about why I was interested in learning more about it, but I was asked to write a longer essay.

6) If you have a medical phobia, use it to your advantage.

I had the medical phobia from hell and I'm not afraid to mention that to doctors I shadow. It isn't every day that they run across a premed who is terrified of doctors. This gives them a chance to legitimately help a student in an actual medical/psychological sense as well as an academic one.

Back to the main Shadowing page

Shadowing Part 1 : Where to find physicians to shadow

As I mentioned in one of my previous entries, my shadowing advice was so long, I needed to divide it up for ease of use. This is part one.

Part 1 : Where to find physicians to shadow

1) Ask your own doctors if you can shadow them.

One of the first things I did when I decided I wanted to shadow was ask my own doctors. A lot of people make this suggestion and by far it is the easiest to do since they hopefully already know you and think well enough of you.

I have four doctors and I get along very well with three of them, so I asked my plastic surgeon, my neurologist, and my family doctor. My family doctor and my neurologist declined because I was their patient. It would apparently interfere with their objectivity.

However, my plastic surgeon could NOT have been more enthusiastic. I've shadowed him several times now. Now there is a restriction on what hospital I can shadow him in so it's hard for me to do anything but shadow a few hours at a time. (Apparently the usual places he works out of don't allow any students at all, not even medical students.) Even though I'm only able to catch a surgery or two per day when I am shadowing, it's been a good experience since it was ALL OR time. Not only did I get to see him work, but also got a little taste for anesthesiology. As of the time of this initial writing, I have 25 hours with him. This included some of my most memorable experiences.

I think part of the reason my surgeon said ok was simply because he was a surgeon. Most people are not going to have super long term relationships with their surgeon, not like they would have with their PCP. Also, I think surgeons like to show off.

2) Ask your doctors for contacts that might be willing to let you shadow.

Of my doctors who wouldn't let me shadow, one (family) refused to give me any suggestions of others to shadow, but the other (neurologist) was incredibly helpful.

I was big on wanting to shadow a neurologist because all my aptitude tests showed my ability to do neurology to be fairly high ranked (actually the highest), plus I am starting to become an expert on a few neurological disorders that plague my family, so it was a logical choice. My neurologist passed me on to a friend of his who let me shadow him for 36 hours. That was, so far, the best overall shadowing experience. It was a very informative look of how things work "behind the scenes" at a doctors office. I was able to obtain a pretty good letter from him from what I understand which I can use for some schools.

Once my neurologist (as in my own neurologist not the one I shadowed) realised I was looking to go into medicine and wasn't just shadowing a neurologist to be a stalker, he helped me shadow a nephrologist (~6 hours) and keeps trying to track down other doctors for me like I have an upcoming few days with Infectious Disease that he arranged. His office is even calling the other doctors on my behalf. I think that is really going above and beyond for your patients. Someone is taking that part of the Hippocratic Oath a little too seriously. LOL.

Also my plastic surgeon tried to help me shadow other surgeons to get some variety, but unfortunately those haven't worked out yet. I'm not too sad, after all, I have a good amount of time in the OR. More than a lot of people.

3) Ask the doctors you shadow for contacts.

I know, this is related to #2, but I bet most people don't even think about it.

The neurologist I shadowed also gave me a list of possible primary care doctors who might let me shadow. I still have to go through the list. It's about a dozen doctors, but I am told I can use his name to get in the door.

4) Find a mentor list and start emailing/calling

I started with the DO Mentor list. I contacted every DO within a several hour drive of me and not once has one responded. From what I hear on SDN, a lot of other students have that problem. Seems to be really hit or miss. If you really want to shadow a DO, try it. Just be sure to not put all your eggs in one basket.

If you have an interest in shadowing a specific type of doctor I would recommend trying to find the local society for whatever specialty you are interested in. (For those in Georgia, I recommend this page : Georgia Medical Societies to get the entire list of societies in Georgia, then do a search on the name of the society you are interested in. The phone numbers on the page are somewhat out of date so don't bother calling them). See if the organization has a mentor list somewhere. If they don't, try contacting a staff member and have them ask some doctors to see if someone would be willing to take you on.

I used a mentor list at the Georgia Academy of Family Physicians and simply emailed people on the list to see if they allowed premeds. I found a "family doctor" who identifies exclusively as an obgyn and pediatrician who would let me shadow for a day. I met a few others who were very willing, but red tape is making it a challenge. One of those who was very willing to help but couldn't because of red tape, passed me on to a staff member at the Academy who found three or four mentors for me for family medicine. I spent about 60 hours with one of the doctors I met this way.

5) True Cold Contacts

As I am LGBT, I wanted to find someone who did LGBT health so I found local LGBT doctors at the Gay Lesbian Medical Association's "Find a Provider" list and started emailing. Of all the contacts I have tried to make, these have been the most responsive (only one person did not email me back). One has been very helpful by giving me advice, reading my statement, and providing phone numbers to other doctors who might allow me to shadow. (He would have been happy to help me himself with shadowing but there was no room in his office.) Another doctor from the find a provider list... just wow. It is hard to imagine a better person to shadow since everything I ever wanted in a mentor is in one package. He is the only person who was affiliated with a teaching hospital and he ranks as my overall second best shadowing experience. (He loses points only because 1. his medical students scare me when we are on rounds, 2. his schedule is absolutely crazy, and 3. the theme to Scrubs automatically plays in my head on autorepeat in my head for the entire 2 hour drive to him regardless of what I do. Other than that, he rocks.)

I also tried contacting other offices which I found through other means, such as google, but so far those have not been successful. I also found a very long list of DOs in my state through the Georgia Osteopathic Medical Association and depending on how things work out, I might use that list when I am looking for another set of people to shadow. It's much longer than the DO mentor list and I'm sure other states have a similar osteopathic organization.

Back to the main Shadowing page

Family Aerospace's Shadowing Tips Table of Contents

Originally posted June 26 2010 on SDN

I've only been on SDN a relatively short time, but it seems people don't use the search function. Maybe if I can put together everything I've learned, someone will find it useful. I don't know, but it's worth a try.

As many of you know, medical schools are strongly recommending, or even requiring, physician shadowing. Some of them even specify a minimum amount of hours. I was told a few schools say 40 hours minimum, 60-80 to be competitive so those were the numbers I had in mind. They also like seeing primary care. The most complicated thing I've seen has been one school (I forget the name right now) who wanted to see surgery, primary care, and a medical specialty. What a pain in the butt, right?

I've been very lucky to get a pretty significant amount of shadowing hours (as of Oct '10, 150+ hours with more scheduled over multiple specialities) and I wanted to tell everyone how I was able to get them since I had a horrible start. I also wanted to tell people about methods that simply didn't work for me in the interests of completeness. Like so many things, your mileage may vary.

I will also include some other things I've learned while shadowing and other miscellaneous tips. Since this original entry ended up far, far too long, I’ve decided to spare you all and divide it into separate blog entries so you can go right to whatever you are interested in.

Here are the parts I have so far.

* Where to find physicians to shadow
* How to contact people
* What to do when shadowing

Family Aerospace's Suggestions on Medical School Personal Statements

Originally posted June 2010 on the SDN blogs.

Look, I've read a lot of personal statements from everything from high school, college, medical school, graduate school, and I think there have been some law school ones in there. I have seen writing that has really ranged from "How did this person get into college?" to "This person needs to not become a doctor and instead become a professional writer."

Since this is SDN and I assume many of you are aiming for a career in medicine, I want to give you guys some pointers on some of the things that have driven me crazy in the 150+ medical school personal statements I've read. Sorry for the non ideal formatting. Stupid HTML.

  1. Please, for the love of all that is holy, answer "Why Medicine?" (If you're a non-trad, you not only have to answer "Why Medicine?" but also "Why now?") You would not believe how many personal statements fail to address this. As I've told multiple people, take a pad of paper and go to a park somewhere. Write "Why Medicine?" at the top of a sheet of paper. Sit quietly and write down what your heart tells you. Use that to help you write your draft. When I did this, I realised I had a much better reason to become a doctor than I thought I did and my personal statement is really just an extremely polished version of my journal entry for "Why Medicine?". Further down on this post I mention some poor things I have heard for "Why Medicine?"
  2. Please use your own voice. Don't try to sound intellectual or as if you swallowed a dictionary. I want to be able to read your statement and hear your voice come through as if you are sitting in my office talking to me. Although we may not admit it, readers judge you on how you write. Think of it, when was the last time you enjoyed a story where the writer was grandiloquent and supercilious?
  3. This goes along with the dictionary comment, but please know the meaning of the words you use. Every word, even synonyms, carry with them a certain meaning in a certain context. Make sure you use the correct word. This is what makes writing both an art and a science.
  4. Please don't use more words than is necessary. Adverbs and adjectives should be used sparingly. This is an essay with a character limit, not a novel. Make sure every character matters. This is another reason why it is good to assure the use of the correct word for the meaning you are trying to convey.
  5. There are very few people who can successfully pull off the "flashback" as an opening and make a good transition to the rest of your essay. I assure you, you are probably not one of them. You can certainly try though.
  6. While I appreciate imagery as much as the next guy, don't overdo it. Remember that suggestion about using too many words? It's fluff.
  7. Please save the drama for your mama. Also a paper cut is not a severed artery. I'm just sayin'.
  8. Make yourself stand out if you can. If you've read enough personal statements, you will see that everyone is saying the exact same thing, often times in the same few words. After a while it gets monotonous. You don't have to cure cancer, but you do have to do something to stand out. You want the adcomm to say "Oh the essay that talked about doing first aid when hiking that's Mr/Ms Smith," not "That was applicant 4701."
  9. Unless your economically disadvantaged background is specifically relevant to the story of "Why Medicine," don't waste your characters on it! You have ~1300 characters in the ED section. Please put it there.
  10. Please don't give me a laundry list of your activities. If one of your activities really helps you to answer "Why Medicine?" then you can mention it. Telling me that you did research on whether or not a snozberry really does taste like a snozberry doesn't help me figure out why YOU want to be a doctor. It just tells me you worked on snozberries. The AMCAS gives you 15 slots for EC activities such as research, teaching, etc. Put your information there unless it really, really, really honestly helps you answer the question. We can see through the BS.
  11. Mentioning TV shows is fine, but I really hope there is something more than "I watched ER once and I LOVED it and decided from then on I wanted to be a doctor." Go off, spend some time in the ED. You can say the show inspired you to learn more about the reality, but use the reality as your focus.
  12. Pls dun't rite lkie dis. Unless you are on icanhascheezburger, grammar checker and spell checker are your friends. That being said, some of my favourite joke "personal statements" have been in lolspeak (although my absolute favourite was a non-lolspeak poem).
  13. Yes you can write about controversial issues assuming it helps you answer why medicine.
  14. You can even write about negative things and poor experiences so as long as you can spin it into a positive.
  15. To the LGBT community, YES you can come out in your personal statement. BUT please have a reason for doing so. Do you want to help the LGBT community? Did your grades suffer a little because you were homeless for a few years because your parents couldn't accept you? Did you watch a friend die because they were turned away from the doctor's office because they were gay?
  16. To my Non-Trads : One of the biggest problems non-trads have is that they are trying to fit the "formula" of the personal statements of trad students. Not only is the formula a pretty bad formula to start with (plus the formula was created by other premeds who may or may not get into medical school so I'm not sure their advice is even relevant), but the NTs have so much more to work with! Trying to shove an NT life experience in a trad based statement formula is like trying to shove a square peg in a round hole.
  17. The statement needs to be set aside for a few days and then revise it.
  18. Have lots of other people read it. Revise it. Repeat as necessary.

Here are some reasons that I have seen listed for "Why Medicine?" which I think are poor reasons
  1. Good grades - I know, you're probably very smart like all the other people on SDN. The adcomms know how smart you and everyone else are. With good grades you can do whatever. The question is WHY MEDICINE?
  2. Love science - Well I would hope you like if not love science. So why an MD/DO and not a PhD in science?
  3. Help people - there are about a zillion other jobs that also help people. Nurse comes to mind. Teacher comes to mind. Police. Firefighter. Why do you want to be a doctor?
  4. Prestige - I'm sorry, if this is the real reason, you need to make sure I know where you are practicing because I don't want you as my doctor.
  5. Money - See my comment to prestige.
  6. "To get chicks" - you think I'm kidding, but I have actually seen statements that said that in those EXACT WORDS. I don't know what bothers me more, calling a woman a "chick" or the fact you're applying to medical school for all the women who you think are going to be flocking over your butt.
  7. "Medicine is all I know" - I think this reason terrifies me more than anything I have ever heard in my life. Medical school will teach you medicine, your life and your experiences prior to medical school will help you learn to be a human being which you will need to learn prior to becoming a doctor. Go out, do something, explore the world, then come back and tell me why medicine.

Diversity Essays (added Jan 2011)

I've been giving some thoughts on diversity essays and this section is an edited version of a comment I posted to a forum question.

A diversity essay should reflect how YOU contribute to the diversity of the school. Everyone is not the same, but no one is completely unique either. Here are some things to think about. This is far from exclusive and by all means if you come up with something that isn't on the list, please PM me and I'll add it if it is appropriate.
  1. Are you non-trad? - Non trads contribute to diversity by default due to their life experience
  2. Are you married?
  3. Do you have kids?
  4. Were you disadvantaged growing up?
  5. Were you/are you from the country? - When I say this, I am referring to actually living in a rural area, not just attending school in one.
  6. Are you a first generation college student? - Remember med students are still primarily from educated families.
  7. Are you disabled?
  8. Are you a racial minority?
  9. Are you a religious minority? - I personally would be wary about using this one, but I'm just putting it out there.
  10. Are you LGBT?
  11. Did you have any work experience that other applicants are unlikely to have?
  12. Did you spend a lot of time in a foreign country?
  13. Do you speak other languages fluently?
  14. Did you major in a non-science?


It seems that the lovely folks over at the Student Doctor Network are disabling all the blogs so I am transferring my advice blog over here. 

Stay tuned!.