Author: tims

Categories
General MBBS

How to do Clinical Research as a Medical Student

Now that you have made up your mind to try clinical research, let’s get started! (Still confused? – check out our article on Why you should do clinical research as a Medical Student)

Warning: Doing clinical research as a medical student is not an easy feat. There are going to be times when you are tired of the process. The paperwork, the permissions, and procedures will drive you crazy. Also, there is bio statistics ahead!! Enter at your own risk! Kidding! It is not all that bad, and it’s worth the grind. So let’s get started.

Think about your interests

If you already have a topic in mind that you want to research about, congratulations! You are one step ahead. If you haven’t thought of anything yet, no problem, go to the next step.

Find a guide (Most important)

Finding an appropriate and interested guide is probably the most crucial step. So, choose wisely. Find out the names of the faculty members who are involved with research and have a large number of publications each year. Whether you have a topic in mind or not, approach this guide.

  • Introduce yourself and tell them why you want to do clinical research.
  • Be upfront. If it is for your CV, tell them!
  • If you haven’t thought of a topic yourself, ask your guide if they have something in mind.
  • Joining in existing research is always a good option because it gives you the confidence of doing something on your own.
  • Sort out the authorship from the very start. If you need to be the “first author” on the paper, let them know at the very start – Before you start any work.

Once you have all the details worked out with the guide, they will guide you through the rest of the process. That’s why this is the most critical step.



Steps in doing a research project

 

1.Drafting a protocol

The protocol is an outline if the research that you want to do. It includes an introduction, objectives, inclusion/ exclusion criteria, etc.

 

2.Obtaining Ethics approval

Having an approval of your protocol from an ethics committee adds much value to your research. Most big institutions have an independent ethics committee. Ask your guide.

 

3.Data collection

Once you have ethics approval, you can begin with the data collection. This step is a tiresome and tedious process but should be done meticulously to easy the further steps.

 

4.Analysis

Here’s where the bio statistics kicks in! Hate stats? Don’t worry. You can always outsource a bio statistician. However, we recommend doing it on your own because you gain experience. Learn the basic tests and formula of bio stats. These can be easily found on Microsoft Excel. Use software for your bio stats. Do not go stone age with a paper and calculator! You won’t finish it in this lifetime.

 

 

5.Writing

Now that you have all the stuff that you need, you can begin writing your paper. Go through already published papers. You can find a whole bunch of them on PubMed. See the general pattern in which papers are written and pay attention to the language used.

Keep it easy. Keep it simple.



 

How do I Present?

There are many conferences both national and international. Google conferences and you will find a list. Look for the ones that accept articles from medical students. Presenting your research before sending it to a journal is always a good idea because you are presenting it to your colleagues. Their criticism and questions only help your research better and more complete.

 

How do I Publish?

As always, ASK YOUR GUIDE. Guides are experienced and know which journals will accept which type of research. You can also do an independent Google search and find journals online. Publishing in international journals is always better.

Be ready to have your research rejected by a few journals until it is finally accepted. Remember, it is part of the process.

 

The road from starting any research to finally getting it published is difficult. There is no denying that fact. However, seeing your name on the published manuscript and having people citing the article gives you a sense of accomplishment. A sense of accomplishment that you may not even get from clinical medicine, because your research may be the deciding factor in guidelines regarding patient care in the future.

Through your research journey as a medical student, we urge you to stay as true to your protocol as possible. Do NOT try to manipulate/ forge results as they will only decrease your credibility as a researcher. The joy you get from being true to your research is in fact true joy!

This article has been written by Dr. Rohit Nathani who is an intern at Seth GS Medical College and KEM Hospital, Mumbai, India. He has been actively engaged in clinical research with publications as well as international presentations. You can ask him any questions related to clinical research in the comments section below.

We would love to know your research stories or experiences about conferences you have presented at. Head to our contribute page and stand a chance to get your post featured on our website!

 

Categories
General MBBS

Clinical Research for Medical Students

Most of us join medical school thinking that we will be great clinicians and save lives. The picture that comes to your head is that of a doctor vigorously administering CPR or a surgeon doing a complicated surgery. Although these dramatic thoughts give us the adrenaline rush, there are also a lot of other ways in which you can help and improve patient care. Clinical research is one of these things. Moreover, while you will rarely ever get a chance to perform a CPR or even wash up for surgery, as a medical student, you definitely can partake in clinical research.

What is clinical research?

Wikipedia introduces clinical research as:

Clinical research is a branch of healthcare science that determines the safety and effectiveness (efficacy) of medications, devices, diagnostic products and treatment regimens intended for human use. These may be used for prevention, treatment, diagnosis or for relieving symptoms of a disease. Clinical research is different from clinical practice. In clinical practice established treatments are followed, while in clinical research evidence is collected to establish a newer/improved treatment guideline.

Simply put, clinical research helps you to find answers to the most fundamental questions in medicine.



Why should I do clinical research?

Now, most of us will ask this question. Why should I get involved in clinical research when this is not a requirement during medical school? Why should I overburden myself with more stuff? I already must prepare for entrance test and pass exams! Well, below are a few reasons that may make you think differently.

 

CV/ Resume

The number 1 reason why most medical students think about doing research is to have something on their CV. Be it for your residency application abroad or a job interview, (published) research makes your CV stand out from the rest of the herd. Doing research shows that you are passionate about this subject and are willing to go that extra step even when it is not expected out of you.

 

Curiosity

This should ideally be the number 1 reason medical students get into research. Curiosity. A burning desire to know why something is the way it is. Medical research helps you find answers and challenge the most basic “facts” in medicine.

Prepping for the future

Doing research in your Undergraduate will help you gain experience and make you aware of the technicalities and the elaborate process which is involved in a research. This experience will make your path easier for the future research you will have to do compulsorily as a part of your postgraduate training in India.

Also, you never know what might interest you and research can become a part of your career, considering that India needs to start inculcating the value of research in its future generations of medical students.

 

Prestige

Having research papers in your name is something highly prestigious. We’re not saying any research, rather “quality” research that has meaningful use in patient care. When you research a particular field for long enough, you become one of the pioneers in the field. You become an authority on that topic because research makes you thorough with the subject.

 

An opportunity to present your research to the world

When you conduct research, you can apply to various conferences that are related to your topic of research. There are more and more conferences for medical students across the world. Yes! You can present your work both nationally as well as internationally. These conferences broaden your vision as a medical student. They give you the opportunity to interact with and be critiqued by colleagues from different backgrounds. Talk about networking and personal development!



 

Scholarships

There are several government and private scholarship opportunities available for medical students who conduct research. The government encourages research because when you do quality work, you become your country’s pride.

 

 

Are these reasons convincing enough? Are you considering giving it a shot? “But I have never done anything like this before? I don’t even know the R of research!”

Don’t worry! we have an entire article on how you can research as a medical student. Check out our article on How to do clinical research as a Medical Student for a step-by-step guide.

This article has been written by Dr. Rohit Nathani who is an intern at Seth GS Medical College and KEM Hospital, Mumbai, India. He has been actively engaged in clinical research with publications as well as international presentations. You can ask him any questions related to clinical research in the comments section below.

We would love to know your research stories or experiences about the conferences you have presented at. Head to our contribute page and stand a chance to get your post featured on our website!

 

Categories
Electives USMLE

6 Clinical electives WITH Step 1 scores for IMGs (2018-2019)

Are you one of the few international medical graduates (IMGs) who have their USMLE Step 1 scores before they apply for electives? Still wondering what advantage you have over those who haven’t yet got their Step 1 scores? Well, this is the perfect post for you. This infographic will give you a concise overview of the places you can apply for Clinical Electives with Step 1 scores (for IMGs) along with the basic requirements. (No VSLO required)

So answering the question of the benefits of having your USMLE Step 1 scores before applying for clinical electives:

  • You can apply to these elective programs that are not open to those without Step 1 scores.
  • Many of these programs are FREE of cost. Time to save up on those dollars!
  • Each of these universities is highly ranked in the country for providing quality medical care, giving you an opportunity to work with the best minds in the field.

Still haven’t got your Step 1 scores? We have a list of 8 clinical electives without Step 1 scores or VSLO. All these programs are open to IMGs. So, hurry up and get your elective applications ready!

Don’t forget to check out our article Clinical electives in USA : A complete guide
If you are still unsure about why should you do clinical electives in the US, we have an answer for you here!

Find more USMLE related articles on our website!

This article has been written by Dr. Rohit Nathani who is an intern at Seth GS Medical College and Kem Hospital, Mumbai, India. If you have any questions you can ask him in the comments section below.

Share this article with your USMLE buddies and help them out!

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Categories
Relatable

A “moment” to gift yourself this Doctors’ Day

The practice of medicine is loaded with emotions. A patient experiences fear, anxiety, anger, sadness and joy when they interact with physicians. This is probably what comes to our mind when we think about emotions in the medical field. But do we, as doctors, know how we feel?

With every case brought into the emergency room, or, with every surgery taking place in the operation theater, there is so much that goes on in our hearts and minds.

From hope that we can help our patient, to despair if things go wrong. From the fear of making a mistake to having the courage to use the scalpel. From the joy of placing a baby in its mother’s hands to the sorrow of having to tell a family that their loved one is no more. We experience it all! There are a myriad of emotions that we face with every patient interaction that we have. I guess all these emotions ultimately lead us to feeling burnt out.

We are expected not to participate in these emotions so that the accuracy of our clinical judgement is unhampered. We are expected to be empathetic as well as detached at the same time. This is considered to be the “secret of the ideal physician.”

But it’s easier said than done. We are the same as everyone else, we also have emotions but our profession requires us to be skillful while dealing with our patients feelings (and ours!). In fact we have to let go of what we are going through in our personal lives because the well being of our patient is paramount. Whether it is losing a loved one, a broken marriage, or your child saying their first words, nothing can get in the way of patient care.



People think maybe we just get used to all the suffering, to all the life and death that happens around us each day. Well, let me tell you it does not become easier with each passing day. Not after 10 years, not after 20. We relive every emotion as though we experience it for the first time.

No one really teaches us how to deal with all these emotions. Med school gives us clinical knowledge and skills, life saving procedures but not a guide to our emotions. We learn how to deal with all these emotions the hard way. Sometimes, so overwhelmed by them, we can’t take it anymore. I guess this is one of the reasons for the rising incidence of depression and suicide among doctors and medical students.

May be this Doctor’s Day it is time for us to take a step back and hit the pause button in our emotion filled lives (obviously not if you’re performing CPR right now!). This doctor’s day let us gift ourselves this moment to feel and understand each emotion that life throws our way. Understanding our emotions will give us the power to use them to drive us forward. Let us take this moment to smile and pat ourselves on the back. After all it is not easy being a doctor.

Happy Doctors’ Day!

– Dr. Shreya Sodhani

-Dr. Rohit Nathani

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Categories
MBBS Pre Med

MBBS in India – Things you MUST know before starting Medical School in India

What is MBBS in India like? How is the life of a medical student in India? What books should I read? What about the hostel? What….? Wait, Hold it right there! We have answers to most of your questions.

 

What does MBBS stand for / What is MBBS?

MBBS which stands for Medicinae Baccalaureus (Bachelor of Medicine), Baccalaureus Surgery is the basic undergraduate degree needed to practice allopathic medicine in India.

9 semesters, 1 year of internship, 5.5 years and 19 subjects!

MBBS in India is divided into 9 teaching semesters or 4.5 years, followed by a compulsory rotatory internship of 1 year, making it a total of 5.5 years. In these 5.5 years, you’re expected to know 19, yes 19 subjects! So, onto the next question.

 

Subjects covered in MBBS in India.

MBBS in India requires you to master 19 subjects, as mentioned before. (Well, I guess mastery over here means “atleast know the important stuff”)

  • Anatomy
  • Physiology
  • Biochemistry
  • Pathology
  • Pharmacology
  • Microbiology
  • Forensic Medicine and Toxicology
  • Community Medicine
  • Ophthalmology
  • ENT or Otorhinolaryngology
  • General Medicine
  • Dermatology
  • Psychiatry
  • Surgery
  • Anesthesia
  • Radiology
  • Orthopedics
  • Obstetrics and Gynecology
  • Pediatrics

Exhausting list, isn’t it? It is a long and arduous journey and one that requires tremendous patience and positivity. But the good thing is that these subjects are divided over four and a half long years.

 

What is the distribution of subjects in MBBS in India?

Year 1 (1 year long/2 semesters): Anatomy, Physiology, Biochemistry

Year 2 (1.5 years long/3 semesters): Pathology, Pharmacology, Microbiology, Forensic Medicine.

Year 3 (1 year long/2 semesters): Community Medicine, Ophthalmology, ENT

Year 4 (1 year long/2 semesters): Medicine and allied (Dermatology, Psychiatry), Surgery and allied (Anesthesia, Radiology, Orthopedics), Obstetrics and Gynecology, Pediatrics.

 

Where to study from?

Each of these subjects have multiple ‘standard’ textbooks to read from. As long as 5.5 years seem right now, when you have to read these subjects, you’ll wish you had double the time.

Though it is very difficult for us to tell you what to study from where, here are a few guidelines.

Reference book

MBBS in India : Standard Textbook

This is a book intended to be consulted for information on specific matters.

These books generally have a lot of in depth information about topics and even if they’re great for understanding, it may not always be possible to completely or even necessary read the subject from these books.

For example: Gray’s Anatomy for Anatomy, Guyton for Physiology, Harrison for Medicine, Love and Bailey for Surgery.

That being said, there are a few students who stick to these books and are even able to formulate answers based off information in these.

We recommend you give it a shot, see how much time it takes you to read it and if you’re able to retain it well enough to write long answers during exams.

However, these are the books you should definitely turn to if you have any doubts regarding basic concepts. They are relatively expensive and can be used from the college library.

Go-To Textbook

As the name suggests, these are the books students generally rely on for exams and a concise overview of the subject. They are not very detailed, but have most points that help you understand the basic of the topic.

Also, it is easier to formulate answers from these books. We suggest you right down important points from reference books into these go-to textbooks so that every time you revise, you are only referring your go-to book

Apart from these, different subjects will have supplementary books, like an atlas for anatomy or various clinical textbooks for the clinical subjects.

How is the hostel life in Indian Medical Colleges?

For many of you this is going to be a new experience. But, something you should definitely try. Think of it like being on the sets of 3 idiots. Got an idea? If not, check out our article on MBBS Hostel Life to get a clearer picture.

When will I start seeing patients?

That’s why you want to become a doctor right? Seeing patients? You’ll see plenty of patients ( think of them as your greatest teachers) through this long journey.

Besides the classroom teaching, you will be expected to attend clinical postings daily, from 3rd semester onward (that is, start of 2nd year) in the hospital associated with your medical school.

Here, you will interact with patients and learn the practical aspects of medicine like history taking and physical examination. Bedside medicine as a concept is slowly becoming extinct, but any good doctor will be able to tell you that the patient and his physical examination can give you clues to the diagnosis about 80-90% of the time.

Use this time wisely and try to interact with as many patients as possible.

Present cases to your senior residents and teachers and get their feedback about how you could do better. It is great practice and the more you do it, the better you’ll be at it. Learn the vernacular language and remember to introduce yourself and what you are going to do. Always follow basic ethics.

Remember, the patient and their comfort is paramount. Even if it is for the sake of ‘learning’ it is unacceptable to make the patient feel uncomfortable at any point.

Most of these postings will have some sort of an exam at the end of the posting the marks of which contributes towards your internal assessment.



And how about Internship?

If you thought the difficult part was over, think again. Internship is a compulsory 1 year period where you are required to rotate in the various clinical departments and work as part of the treating team.

As interns, you are expected to examine patients independently and perform procedures like blood draws, insertion of catheters and prescription of basic medications (Under a guide).

It is truly an enriching experience and if performed sincerely can help you experience first-hand the nuances of the various fields of medicine and thus help you make an informed choice if you do decide to pursue a postgraduate course.

 

Okay this is too much info. Is this grind worth it?

Well, we’re gonna be honest with you.

If you don’t curse yourself for doing MBBS in India and dream about alternate careers every few weeks, you’re probably not doing MBBS right.

It is frustrating, especially when you see all your other friends graduate, start jobs, go abroad and do fancy things and just lead happier lives in general.

You will miss out on a lot of friend hang outs, family functions, important birthdays and anniversaries. Your friends will call you boring and you will lose touch with a lot of your non medico friends.

You will hear and maybe even witness doctors getting beaten up and question why you’re even putting in all this hard work. Guess what? This is just the beginning. (Want to know how to safeguard yourself? Check out our article The [Ultimate] Survival Guide for Violence against Doctors)

After completing MBBS in India you’ve to get into a post graduate course (which is an altogether different battle) and then maybe pursue a superspeciality. That’s at least another 6 years more.

Is it worth it? We say – absolutely!

All said and done, being a doctor is one of the most noble professions and the respect that you garner in the society with that two letter prefix of Dr. is beyond comparable.

“The stethoscope is the most expensive jewelry, for it costs you your youth.”

This is one of the few jobs in the world that can give you a sense of fulfillment, that you’re actually doing something to alleviate human suffering and make this world a better place. It is long, but it teaches you that we are meant to be students for life.

After all this, you still won’t know everything, and that is perfectly okay! What matters is your will to keep learning from your mistakes and be open to new information.

You may lose a few friends, but you will make new and long lasting friendships. (Want a little sneak peek into what your F.I.R.E.N.D.S will be like? Find out in the MBBS version of FRIENDS) It is going to be a fun journey, good luck and welcome aboard.

As new medical students, we welcome you to The Indian Medical Student Family.

This website is made by medical students, for medical students. You will find everything related to MBBS in India and much more here.

P.S Don’t forget to share this article with your other friends on Facebook, after all we’re one big family!

You can know more about us here. You can also contribute your experiences and share similar articles through our contribute page. Subscribe to the blog and stay updated!

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Categories
Relatable

Interns’ Strike 2018 : Why I deserve more than 6k.

Who am I?

I am a medical intern. After clearing one of the toughest entrance exams in the country (NEET UG), I got into medical school.

While my colleagues in other fields graduated and started getting “on campus” placements, I was in the library, trying to decode diseases. Trying to understand the human body, so that some day my knowledge will help save someone’s life, or in the very least, bring a smile on someone’s face. But I didn’t mind that. I loved this subject and learning about medicine gave me joy.

So, after going through 4.5 years of medical school, constantly studying and giving exams, I was told that I can now prefix my name with ‘Dr.’ – a milestone that every medical student dreams about. Excited, I put up my Facebook status telling the world that I too have completed my formal classroom and clinic teaching.

It was time to start my internship. Something all my friends from other streams did in their summer vacation. I was fascinated by the work experience and the pay they got during their internship.

That’s the basic background on how I came to be a medical intern.

 

How much am I paid currently?

Rs. 6,000 a month. (Yes! you heard that right. Rs. 6,000)

 

How much do interns in other states get paid?

This number varies as per the state. For example, Assam Rs. 20,000, Bihar Rs. 15,000, etc. The stipend in Maharashtra is the lowest in the country. Since the Maharashtra Government loves to maintain its position at the extremes, we are charged the highest fees during our MBBS – Rs. 78,000.

Why does the government charge us the highest fees and pay us the lowest stipend?

 

What happens to the Rs. 6,000 (minus administrative fees)?

For convenience sake, let’s take a round figure of Rs. 6,000/month, that’s Rs. 200 a day (around $3) slightly above the international poverty line $1.90/day. YAY!)

I am supposed to manage expenses for food (x3 meals), travel and accommodation. Just the basic requirements, that are barely fulfilled. Not to mention I am also a 21st century millennial who likes to eat out occasionally, go out with friends, etc. ( but who cares right?)

Belonging to a middle-class family, my parents can afford to pay for these miscellaneous expenses. But what about those who cannot? And even if they can, everyone has the hope that someday they will earn and be able to support themselves (maybe even save a little?).

One of the reasons why we never learn about saving and investing (essential skills these days) as medical students –

We barely have enough to spend for our daily needs, forget saving!

 

Let’s get a better understanding of the Life of an MBBS Intern.

 

What work do I do?

Internship is supposed to be a “learning experience”. The time when you learn to practically apply the knowledge you have amassed over the years. But, our internship is nothing like that!

What internship actually teaches you

  • Collect blood
  • Insert IV lines/ Catheters
  • Fill out forms and trace reports
  • Follow orders
  • Follow more orders
  • Do not question, do not think, just do what you are told to do!

Where’s the learning and experience in this? By the end of internship I am just an over qualified phlebotomist/ nurse who knows how to follow orders. I cannot treat a patient independently with confidence by the end of internship.

What was the point of learning the science when I can’t practice the art?

My work hours?

My average work week is 6 hours a day for 5 days and one day emergency duty of 24 hours.

That means a 54 hour work week (Something that is nearly always exceeded. ATLEAST 60 hours to tell you the truth).

 


My working conditions

Since patient care will suffer (and I won’t get internship completion) I continue to do the menial jobs I am forced to do.

Because collecting blood is 90% of my work, I am constantly exposed to the threat of acquiring infections.

Combine stress, burnout, lack of sleep and countless patients piling up- we have for ourselves the perfect recipe for “a needle stick injury”. That means sometimes having to take HIV medicines for a month. Ask someone who has taken these medications. They make you really sick, nauseous, sometimes even worse. And do I get any compensation? NO! I still show up for work.

TB is a huge problem facing this country. Yes! I am exposed to it daily. Not only TB, my entire work environment is a bio hazard. There is disease all around me. Talk about high risk environments.

Add to that, I am constantly under the threat of being beaten up while doing my job.

But I am a doctor and I am supposed to deal with that. Right?

 

Even after working so much, do we have the rest of the time for ourselves?

Apart from managing all the workload and frustration that internship is, we somehow must find time to study during the rest of the day (or night). If you thought that NEET (UG) was one of the toughest exams, we must now prepare for something way tougher. Don’t even get me started on how we prepare for 19 subjects for our postgraduate entrance!

 

To summarise

  • I am a medical intern
  • I work for 60hrs a week on an average
  • I do all the ground level work.
  • Although there is a structured program for interns it is not being implemented.
  • I work in a high-risk environment and am exposed to life threatening diseases daily.
  • I am paid less.

If our law states the minimum wages for skilled labour is Rs. 24,000, why are we paid one fourth? Are we not skilled enough?

 

What am I asking for?

Short Term

  • Increase in the stipend

Long term

  • A structured teaching program (that is actually implemented)
  • Fixed work hours
  • Better working conditions

If someone still feels our stipend should not be increased, I have just one question to ask you.

“Would you do it?”

 

Yours sincerely,

Intern (M.B.B.S)

P.S Doesn’t matter who I am. If this resonates with you too, share it and let the world know your story.

Interns (Fight for your present)

MBBS Students (Fight now for a better future)

Residents (Fight for your past)

Share the article with the #InternsUnited. Tag our Honorable Chief Minister @devendra.fadnavis and Honorable Health Education Minister @girishmahajanofficial . Please look into our concerns.

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Categories
Relatable

Which F.R.I.E.N.D.S character are you? [The MBBS Version]

“MBBS” – while technically this acronym stands for Medicinae Baccalaureus, Baccalaureus Chirurgiae (I bet most of you didn’t know that!), for many of us, MBBS is an emotion. An emotion that is hard to define, but it is for sure, a pleasant one. When someone asks you about your MBBS days, no matter how frustrating you may have found it at that point in your life, it will always bring up a lot of sweet memories.

But all these memories would be incomplete without your friends in them. In fact, you made these memories WITH your friends – those idiots with whom you spent five and a half years of your life.

Although each one of us thinks “our group” was unique, we all have friends that fit each of these F.R.I.E.N.D.S stereotypes (Yes! These were the personality descriptions from the original F.R.I.E.N.D.S script)

The Ross

Intelligent. Emotional. Romantic.

 

 

He’s good at studies, the hell yes! He gets that distinction in Medicine and Surgery. He’s got the girl (yes, he does go ‘on a break’ but gets into another serious relationship very soon). And he loves what he’s doing. Basically the “know it all”. Remember, he is always aware of what is going on around him UNAGI!

 

The Rachel

Spoiled. Adorable. Courageous yet Terrified of the world.

 

 

The modern city girl. She has never stayed away from home. MBBS is quite a shocker for her. She’s the one who complains about everything! The hostel food, the bed, the bed bugs, the toilet, the people, MBBS is so tough, I want to go home to my parents. But, she does learn how to adapt to situations in due and is loved by all in spite of her tantrums. She has the best fashion sense and her make up will be on fleek even for a that 8 am lecture.

 

The Monica

Smart. Cynical. Defended. Very attractive. Had to work for everything she had.

 

 

This girl in your group wants everything to be PERFECT! (Call it an OCD : after all we must sound like doctors, right?) Her class notes could pass of as a legit published textbook. Even her markings (color coded as per importance) in Harrison’s look like pieces of art. Admit it, we all have that girl in our group.

Their hostel room is the meeting place for all the gossip sessions – be assured you will be served great Coffee and Maggi (after all, she is the best chef).

They can be pretty headstrong and sometimes, could get into trouble because of all the stubbornness.


The Joey

Handsome. Macho. Smug. Loves women, sports and more women.

 

 

He organises the college fest. The girls are crazy for him, he is crazy for girls! He steals pretty much all the limelight all through the year. Except exam time! That’s when they turn to our Monica and Ross for quick fixes.They will study last minute from books you haven’t even heard of before. But, they pass. Next year begins and they are back in their game! They are very affectionate and fiercely protective of their friends. But keep in mind, THEY WILL NOT SHARE THEIR FOOD WITH ANYONE!

 

The Chandler

Droll. Dry. A curious observer of everyone’s life. Sarcastic.

 

 

They love cracking lame jokes and laughing at them too when all you can do is frown. You never know when they are (not) being sarcastic. They are not all that great at scoring marks, but, they wing it along. The Chandlers of your group are the ones who will just not smile in the millions of pictures we take.To quote the original FRIENDS script, they survive by way of their sense of humour. And snacks.

 

The Phoebe

Sweet. Flaky. A good soul.

 

 

The goofy one, weird one, they’re the ones we would medically label “Schizotypal”. They live in their own world. They don’t care much about the rat race. They are happy to just be here. And, who can forget their fun flirting and weird comments. They are spontaneous and creative – a skill that is very useful during vivas (Princess Consuela BananaHammock). They make up the best rhymes and jingles and generally provide you with an easy and sure shot way of remembering all those mnemonics.

 

Think about it. There will be people in your group who fit most of these categories. If you have identified your very own F.R.I.E.N.D.S, let them know! Share this article on Facebook and tag them in the comments.

P.S Don’t let them know which character they are. Let them keep guessing! 😛

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Categories
Step 2 CK USMLE

How I scored a 260 on the USMLE Step 2 CK

Step 2 CK experience 260

We have with us today Dr. Priyanka Lakshmanan sharing her USMLE Step 2 CK experience. Dr. Priyanka has always been academically strong. After scoring 267 on her USMLE Step 1 (Find out how I scored 267 on the USMLE Step 1), she managed to get a whopping 260 on her Step 2 CK. Below is her step-by-step guide on how you can crack this exam, all relevant for The Indian Medical Student.

STEP 2 CK: The Journey and the Real Deal.

I am an IMG (International Medical Graduate) and very recently graduated. I took my USMLE Step 1 examination in my 3rd year of medical school (2015) and my Step 2 CS in April 2017.

I planned to wrap up Step 2 CK during my internship. I returned to India after 2 months of USCE  (United States Clinical Experience) and taking my Sep 2 CS by the end of April’17. After taking almost a month to get over the jet lag and trying to figure internship out, I decided to start prepping for CK.

Now here is the tough part.

A lot of people have their own “recipe for success” if I may call it, for this exam. I felt that people had more unanimous opinions about resources to be used for Step 1. But for CK, one shoe does not fit all sizes and that is something I certainly want to get out of the way before I go into details of my prep.

SOURCES USED (In NO particular order)

[Number of stars is directly proportional to relevance)

  • Kaplan Notes for Step 2 CK **
  • Step Up to Medicine 4th Edition ***
  • MTB for Step 2 and Step 3 ***
  • Online med-ed for videos **
  • U World for Step 2 CK *****
  • First Aid for STEP 1 ****
  • Behavioural Sciences Kaplan Step 1 ****
  • Up-to-date (summary and recommendations) *****
  • U World self assessments 1,2 *****
  • NBME 6,8 ****
  • CMS family medicine forms 1,2 ***
How to Crack the USMLE Step 2 CK

The Journey

I am going to divide my prep into 4 phases for ease of understanding. You need not go through all these phases. This is solely my experience.

Phase 1 (June ‘17-July ‘17): The Slow Coach

This is the part where I had absolutely no direction. I was reading random resources to figure out the content and orient myself to it.

I did the whole of Ob/gyn, 70% of internal medicine, and parts of pediatrics from the Kaplan notes. This was also the time I started reading Step Up to Medicine and usually had a discussion with a friend at the end of every chapter. I was not very consistent during this part (because of my postings, birthday month, a vacation).

I was also watching the online med-ed videos (available free of cost at onlinemeded.com) for topics that I felt were foreign to me or things that weren’t my strong point. This stretched out till about mid-july when I realized that it was time to pull out the big guns.

Phase 2 (July ’17 – October’17) : Enter U World

Here is where I started with my U World. I purchased the 6 month subscription which for me was a huge mistake since I ended up pushing my exam. Nevertheless, I started solving the Q bank.

Internal Medicine was the subject I started with and I decided to solve system wise (CVS, GI, ID so on and so forth). After every test (Timed mode), I would review the test and write almost everything down from the explanation. This was where I did not understand the amount of time I was losing and how impractical it was.

It took me almost 3 months to wrap 2 subjects (Int Med and Ob/gyn) from U World and that is when I decided to shift gears.

Phase 3 (Nov ’17 – Feb’18): When the synthyroid kicks in

This is when I stopped writing stuff and started reviewing on screen. It made the whole process so much faster without really affecting my level of retention. I thought I was doing a decent job (given my medicine postings at the time).

Things seemed to be going fine until mid-February where I lost my momentum yet again (Thanks to pre-convocation, convocation, post-convocation, running around for signatures). I had finished about 90% of U world by this time, but I really wanted to get done with it so that I could reset the Q bank and re-do it.

By the end of Feb’18, I was done with 100% of the Q bank and I restarted the whole of U world in the first week of March. By the second week, I picked up speed yet again. This time around, I was solving random tests (not system wise) in the timed mode.

This is also the phase where I took some time off to read bio statistics from Kaplan for Step 1 and watch any videos for concepts that were unclear.



Phase 4 (March’18-April’18): The Last Lap

I wrapped up U World for the second time by the 2nd week of April (bear in mind that I had to extend my subscription). When I was solving U World for the 2nd time, I had marked a fewer number of questions to review at a later date.

I also added all important tables and portions of the explanations that were super relevant to the “Flash-cards” feature for quick revision and this certainly made a lot of difference to my prep.

By the 3rd week of April, I was done with my self -assessments and I spent my last 10 days before the exam revising the marked questions and the flashcards.

My Assessments (Listed in the order in which they were taken)

  1. U World (Total Average)
    • 1ST time: 78%
    • 2nd time: 91%
  2. NBME 6: 247
  3. UWSA 1: 267
  4. NBME 8: 268
  5. UWSA 2: 263

Things to take away

  • Allocate your time wisely.
  • U World is the MOST important learning tool for the main exam.
  • The complexity, length and pattern of the questions in U World is a decent estimate of the real exam. So try and do it as many times as possible (I feel that for most test-takers out there, solving the Q bank twice should be sufficient.)
  • Try and understand concepts behind the explanations. Figure out what went wrong rather than being fixated on the right answer.
  • Re-solving the Q bank is not to memorize the answers. It is to get more thorough with the content and the concepts.
  • A major chunk of the exam focuses on diagnosis and management. So while doing tables or flow charts, pay special attention to those parts as they become extremely important and are the deciding factors.
  • The exam does not really test you on your capabilities to identify the symptoms of a disease or what gene mutation causes a particular disorder (sparing a few questions).The exam is mainly directed to test your capabilities to manage a given condition.
  • More often than not, you will find yourself confused between 2 options. At this point, try your level best to figure out why one of those choices cannot be the answer. It is not as easy as it sounds and it becomes imperative to leave a margin of error because clinical judgement varies among physicians (and hence among the people who frame these questions).
  • This exam is all about protocols, so adhere to them. There is a reason they exist (most of them are supported by clinical trials).

Besides U world, there are a million other resources out there and I probably am not aware of a lot of them. But instead of reading a hundred different things,

Try and use a limited number of resources to the fullest.

The REAL deal: 260

(For those who are wondering about the discrepancy in my NBME 6 score and the rest of my assessments, I guess my score was on the lower side probably because I had just started my UW for the 2nd time and had not revised a lot of topics. That combined with my exceptional ability to over think accounted for this difference)

Among my assessments, I felt that UWSA form 2 was the closest in terms of correlation to the main exam.

Before I end this post, I have to take a moment to mention the patient safety notes from Kaplan for Step 2 CK (Behavioral sciences). Definitely try and go through his section from the book once close to your exam as some of the concepts may be tested on the main step.

Happy CK diaries to all!

-Dr. Priyanka Lakshmanan

(Seth GS Medical College, Mumbai)

Dr. Priyanka is now doing clinical rotations in the US. She plans to apply this year for interviews. We wish her all the best! If you would like to ask her questions related to this article, proceed to the comments section below.

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Categories
Relatable

The Emotional Playlist of the Indian Medical Student

Every medical student has a playlist of songs which they wish would be the background music to the drama that the life of the Indian medical student is. Whether you sing along to it off-key or bear that droning in your head just as you bear your burden, you can’t help but agree with this fun playlist of songs that you’ll relate to in situations that are so common in medical colleges!

1. When you realize the struggle isn’t over even after NEET (UG) (“Ae Zindagi Gale Laga Le”- Dear Zindagi  Soundtrack)

 

“Ae Zindagi Gale Laga Le, Hum Ne Bhi, Tere Har Ik Gam Ko Gale Se Lagaya Hai, Hai Na?”

 

Our parents, our teachers, our friends, everyone assured us- ’12th karle, fir aish hi hai.’ God, no! When the textbooks of Anatomy hit us on our face, we get slapped with the rude shock that MBBS is- a never-ending struggle to keep up with the syllabus without going into a mental breakdown. Needless to say, you are prepared to hear the same thing before NEET (PG), before the onslaught of residency starts, and the cycle begins again!

 

2.When the senior giving you ‘super IMP questions’ for the exam disappears suddenly (“Abhi Na Jao Chhod Kar”- Hum Dono Soundtrack)

“Abhi Naa Jaao Chhod Kar,

Ke Dil Abhi Bhara Nahi…”

This song leaves you with a forlorn feeling, mainly because the day before the exam, a senior leaving you, leaves you with a feeling akin to heartbreak. If not for these imps, an all-nighter would be futile, no? Without the support, HOW WILL YOU EVER PASS?

3. When the university exam blues finally hit you (“Aal Izz Well”- 3 Idiots soundtrack.)

“Dil Jo Tere Baat Baat Pe Ghabraaye,

Dil Pe Rakh Ke Haath Use Tu Fusala Le…

Arey Bolo Aal Izz Well!”

 

This quintessential motivational song that calms down palpitations with just 3 words, albeit wrongly pronounced, has undoubtedly helped us calm our nerves. Be it trembling hands while writing the paper or stuttering answers during vivas, this mantra has the power to make you automatically feel better- Although The Indian Medical Student doesn’t guarantee the effects, do let us know if it worked for you!

4. When you finally diagnose yourself with the rare condition called love (“Pehla Nasha”- Jo Jeeta Wahi Sikandar Soundtrack)

“Pehla Nasha, Pehla Khumaar,

Naya Pyaar Hai Naya Intezaar…”

 

Unfortunately, medical students aren’t very good at diagnosing themselves with this entity called “Pyaar.” Sleeplessness, loss of appetite, a certain predilection for a certain somebody and a new-found appreciation for hidden nooks and crannies- yes, that’s love. Amid exams and books, it’s difficult to find someone for you, but when you get that “entangling of stethos” moment and surreptitious glances across the library, grab it and never let it go!

5. When you diagnose a patient correctly (in your head) (“Aaj Mein Upar” – Khamoshi The Musical Soundtrack)

“Aaj Mein Upar, Aasmaan Neeche,

Aaj Mein Aage, Zamaana Hai Peeche…”

Do a little jig in your head! Go on, do it! Even if the patient only said that he had pain in the abdomen, YOU JUST KNEW IT, that it was gallstones. You are on your way to be an excellent clinician, never mind that there could have been many differentials for the same… That’s okay! You deserve some applause in the dreary life of a medical student, hai na?

6. When you’re the only intern on duty, and your existence has ceased to have meaning (“Jag Soona Lage”- Om Shanti Om Soundtrack)

“Jag Suna Suna Lage,

Koi Rahe Na Jab Apna…”

Sleep. Hunger. Isolation. You’ve fought it all. Being an intern is as good as a Hunger Games venture, without of course the bloodshed- oops, no! Even blood gets spilled during collections! When you thought that being an intern will be a learning experience, chann se tumhara sapna toota… Moreover, when you were left alone to handle the entire collection and simultaneously handle so many duties, jag soona ho hi gaya! Haaye, yeh beraham duniya!

7. When God blesses you with a sweet and helpful registrar: (“Yeh Tumhari Meri Baatein”- Rock On Soundtrack)

“Yeh Tumhari Meri Baatein,

Hamesha Yuhi Chalti Rahe…”

 

You can’t help falling in love with your registrar. It’s undoubtedly a match made in heaven, when your registrar helps you in your collections, signs on your journals readily,  teaches you when no one else even bothers to look in your direction, and in general is benevolent towards the lot of you. You hum happily under your breath- “Yeh Hamari Mulakaate, Hamesha Yuhi Chalti Rahe, Beete Yuhi Apne Saare Din Raat!”

 

Of course, there exist so many songs and so many moods! After all, 5.5 years of MBBS is filled with emotions and memories that will remain with you forever! Be it making lifelong friendships or learning life lessons, MBBS changes your life in myriad ways!

Here’s a song for when you’ll look back at MBBS and feel like “those were the best days of my life” 

“hum rahe ya na rahe, yaad aayenge yeh pal” by KK!

 

We would love to know which song you relate to the most or want to add to this playlist!

(Has anyone been able to decipher that horror film soundtrack that starts in your head when a patient starts heaving and you know that he’s going to vomit on you? I know, too specific, no? Not that it’s happened to me, but if you do find that out, let me know in the Comments Section below…)

 

– Devanshi Shah

Final year medical student

Seth GS Medical College and KEM Hospital, Mumbai

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Categories
General

The Ultimate Survival Guide for Violence Against Doctors

Disclaimer: The aim of this article is not to decide whether it is the Patients, Doctors, Media or the “Gormint” who is responsible for the rising cases of violence against doctors in India. Rather, we hope to provide a guide that can be followed, to prevent and deal with such instances of violence against doctors. 

There was a time when doctors were considered next to “God” and treated with utmost respect. However, with the turn of events in our country today, doctors are being rounded up and beaten just like the ‘palindrome of god.’

Our super-powers of quick judgment,skills and empathy, help us deal with our patients on a day to day basis. But, we do need to add one to the list – self-defense.

There have been plenty of episodes of doctors facing violence, and not even one of the knee-jerk strikes has led to any change in the scenario. As medics, we are already the smart ones among humans.

It’s high time that we are smart enough to save ourselves and avoid the ICU bed because the conditions are not likely to be any different.

[The Ultimate Survival Guide for Violence Against Doctors]

You are not God!

Remember that time the patient in the ward told you,

“Beta aap toh humare liye bhagwan jaise ho (Son, you are like God for us)”

All of us have heard this compliment at some point during our lives as medical students/ doctors. Felt good, didn’t it? Now consider, the same patient gets their son gasping to the Emergency Department. You try your best to resuscitate the boy. Alas! That life could not be saved. However, you were “like God” right? You did accept it, remember? That, right there, is breaking the trust that the relatives had in you. This broken trust is often vented out as anger leading to the catastrophic set of events that ensue.

We need to establish this from the very start. We are as human as the patient, and we will try our best as a fellow human being to save the patient’s life.

So the next time, somebody calls you God-like, hasten to remind them that you are just another highly qualified human doing their job.

 

The harbinger of bad news

Majority of instances of violence against doctors happen at the time a patient is declared dead. You will have to do this at some point in your career. Declaring death is a difficult job, because it entails proper counseling and explaining to relatives scientific things at a time when they have just lost their loved ones. Here’s how you can go about it:

Inform Security

Always, always inform the security before you declare a patient dead. I know those malnourished a-muscular men are not worthy of being called security, but they’re your best bet. After all, Captain America was just Steve before becoming Captain America. Don’t doubt their strength, they already do.

Chose the right setting

Do NOT declare deaths in the ward. Take the relatives to a quiet place (like a side room). Make them comfortable. Provide them with a glass of water.

Call the Senior

Do not rush into a situation that you are not confident of handling. If you are not sure about how it is done, there is no shame in calling a senior doctor to help you. It is wise to observe how others do it a few times before you go ahead and break bad news independently.

 

Learn to say NO

You are the doctor, and you have the right to reject treatment to a patient when you know the relatives are potential troublemakers. I know it’s moral obligation to help people as doctors, but you can only do that as long as you are alive.

*This may not always be possible. For example, in any set up, you may be required to provide emergency medical care to every patient*

 


Someone more qualified? Refer.

Since medicine is evolving at such a rapid pace, it is impossible to know everything. If the facility has a more qualified specialist (example a cardiologist), immediately refer the patient. Don’t attempt to treat something you are not trained to.

 

Mob Control

Avoid having multiple relatives. This is not your job and you can’t do much about it. It is the job of the ‘security’ and the ‘hospital administration,’ but you can remind them time and again because laaton ke bhoot baaton se nahi maante.

 

Look for STAMP

Violence against doctors is now a well researched field. It is often easy to predict when a patient or their relatives can turn violent. Look for these useful indicators:

  • Staring or lack of eye contact
  • Tone and volume of voice
  • Anxiety levels of the patient
  • Mumbling
  • Pacing

If you notice the signs mentioned above in a person, be on high alert. Immediately keep the security on standby and get your seniors to help you handle the case further. Stay Alert!

 

Communicate, communicate, communicate

Be empathetic, explain everything about the procedure that you intend to do. Take a written informed consent. The condition of the patient, the prognosis, the risks involved- talk out everything! This can be the most important part not only in saving yourself but also in satisfying the family because, in the end, everyone has morals or some societal values, however uneducated or ignorant they may be. You need to appeal to that sense and leave them with the confidence, that you did your best for the patient.

 

Create your own alarm systems

Tired of asking the hospital administration to install alarm systems?

Be the change you want to see.

Create an SOS WhatsApp group with all the residents. No good mornings, no recipes, no adult jokes. This group is STRICTLY for emergencies. If you notice the situation getting out of hand in any part of the hospital, quickly drop a text stating your location. Our sheer numbers are enough to stare down any mob.

Play Kung Fu Doctor

Learn self-defence, karate, Kung-Fu, kushti, kickboxing- doesn’t matter if you’re thin or fat. If a panda can become a Kung-Fu master, so can you. If all the above measures fail, and you find yourself in a situation where you think violence is imminent, follow your gut! If you think you can block a few blows and land some, go for it! It’s self-defense. However, if you are surrounded by a mob, there is no way you can overpower so many people. In that case, run! Always make sure you have an exit planned in case things go south.

 

So that was our Ultimate Guide for Surviving Violence against doctors. Have suggestions you would like to add? Comment below.

-Dr. Saad Ahmed and Dr. Rohit Nathani

(The Indian Medical Student Team)

If you liked this survival guide, share it with your fellow medical students. It may save their lives.

We would love to receive similar articles from you or know about your experiences. You can send in your article from the Contribute page and stand a chance to feature on our blog!

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