Monday, March 29, 2010

[zt]寄语preliminary surgery的同学

发信人: Lancet2008 (麦叶刀), 信区: MedicalCareer
标 题: 寄语preliminary surgery的同学
发信站: BBS 未名空间站 (Fri Mar 26 20:08:54 2010, 美东)

收到若干xdjm的email和电话,喜忧参半的告诉我,他们将进入Preliminary surgery。
现将自己preliminary surgery 经历的点滴与这些同学分享。

Preliminary surgery 是条曲折的路,是没有搭上到山顶的直通车的后备选择,但如果
把握好,一样可以最终引上大路,到达目的地。

我开始prelim前,听到的都是关于prelim surgery 魔鬼训练的描述:早晨4点多起床,
查房时昏昏欲睡,每天只能睡4-5小时……现在回首我的prelim surgery一年:劳累,
但却从容。除非on call,我基本保证每天睡8小时,并长了10磅体重。

Prelim surgery的疲劳来自3方面:日常工作的劳动强度、陌生医疗体系带来的精神压
力,和应对第二次match的心理压力。

Prelim surgery劳动强度比其他专业要大,但不像传说的那么离谱,尤其现在有80h/
week的duty hour限制,我们比老师辈的人好多了。劳动强度在不同program不尽相同,同一
program不同的轮转医院或科室也不一样。牛校和大的program劳动强度更大
些。一般工作程序不外乎早晨看病人,写病程,向Senior resident请示汇报病人的新
情况,作术前准备,办出入院,看急诊/会诊。intern一般很少有机会参加手术,但会
要求做一些基本床边操作,比如脓肿切开,胸腔引流和central line 等等。熟悉这些
日常工作程序,合理安排时间,另外尽快掌握这些基本操作,提高工作效率后,一般就
能游刃有余了。Prelim surgery year, 我一开始5:15-5:30am 赶到医院,有时忙到6-
7pm 才能回家,但prelim surgery后半年,工作方方面面熟悉以后,我一般6am到医院,
一样及时完成各项工作,经常5pm左右就走人了。(当然也有机会来麦地灌水了:))

刚进入临床,一般要6-8周才能对日常工作知道个所以然,各专业intern都要经历这个
阶段。这段时间的精神压力比体力疲劳更难熬。记得intern 第一天,住院总安排我到
“same day surgery”准备病人,现在我5分钟时间可以搞定的术前病历/小结/签字,
当时花了我2个小时,被住院总臭骂……另外,美国应用的各种敷料、缝线和器械,花
样繁多,各有各的名字和用途,我也是花了很长时间才搞清楚。为了减少这个阶段的煎
熬,象老刀向各位xdjm 建议的,最好提前到program作 observation, 既让我们提前
了解program,更重要的是让program的人了解你,别忘了,2个月后你需要他们的
strong word for match。

第二次match的心理压力对prelim surgery intern是很大的折磨:即想好好表现,展示
自己的能力,尽早为match 创造良好条件,又怕出错,谨小慎微,影响工作能力的发挥
。当时我每挨一次骂,都觉着要被开了。有一次我晚上下班回家后接到一个Attending
的电话要查房,这是一个所有住院医都痛恨的坏脾气,我告诉他我已经signed off to
on call resident,听到的是电话另一端的暴怒”YOU DID NOT SIGN OFF TO ME!”。
我赶紧放下饭碗,赶到医院,陪他查到快10pm。但从那以后这个坏脾气对我尤其好,不
但有时主动让我参加他的手术,还请我周末看拳击比赛。后来得知他还是力主留我作
categorical的主要人物之一。

日常工作之外,建议主动争取和创造机会让program认识你的其他方面能力。进Program
时, 我把作research 时参编的一本关于脏器移植的书,送给PD, 现在这本书成了我
们PGY-3轮转移植外科的必读教材了。另外我match前research 的关门作品,修稿时,
及时添上了“Current address: XXX program”,并送给PD过目......几个月后
interview Categorical 位置时,PD就问了我一个问题:“Will you do research
for me if I keep you in our program?”

回顾那一年的酸甜苦辣,希望对今年preliminary surgery 的同学有所启迪,期待明年
你们的好消息!

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Friday, February 26, 2010

Schiller is stepping down

On Feb 24, Dr. Schiller, my beloved master, announced his retirement from his chairmanship at the staff meeting and a special meeting with resident. He was very positive about the reirement, however, it is still a sad news for me, his protege.

I felt very fortunate to have his blessing, protection and support through my tenure with Mount Sinai, July 2006- June 2010. Our graduation ceremony seemed to be his last as chairman and the host.

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Monday, February 15, 2010

Tongji Medical College at facebook

Guogang Xu, and Yiyan Wang separately created two facebook groups for Tongji Medical College. I joined their cause, and am combining the great groups into one. Within half a week, our Tongji Medical College alumni facebook group has grown exponentially from 50+ to 100+.

A strict membership verification is in place to protect the privacy of our members.

I am amazed!

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Create Pubmed link

I have noticed recent change in Pubmed regarding data retrieval. The current advice from Pubmed help is rather simple: http://www.ncbi.nlm.nih.gov/pubmed?term=lanjing+zhang will be searching lanjing AND zhang in all terms.
For more, please visit http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=helppubmed&part=pubmedhelp

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Wednesday, February 10, 2010

CMG group at facebook(linked out)

It's been established in May 2009. Many news and info for CMG will be posted there.

Find it here

Open to all of the medical graduates of China. Chinese physicians, residents, fellows and students are welcome to join us!

Our goal is to help CMG apply to and excel residency training, and establish and expand their future medical practice. It also serves as a networking platform.

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Saturday, December 12, 2009

[zt]Match experience Stone Soup 石头汤

发信人: littlefatty (little fatty), 信区: MedicalCareer
标 题: 石头汤
发信站: BBS 未名空间站 (Tue Dec 8 11:06:40 2009, 美东)

还有人记得我的石头汤啊。 我当初的意思是对于一般人来说是很难把握一个长远的目标的。长远的目标的往往头绪很多, 而又缺乏衡量的手段,所以人们在征途中往往觉得沮丧,绝望。心情呼上呼下。 而这些又是有害无益的。不如把事情分成一些自己能够掌握的小步骤,然后尽力去做没一件小事,而不去让最终的是非成败左右自己的心情。就象熬石头汤那样,你得找到一个切入点,不论有多底,只要你抓住,用心做事,不沮丧, 不放弃,下一步的机会往往就会出现。

即使机会没有出现, 也不怨天由人,人生总不可能事事如人所愿。能平静地接受失败也是一种美德。

我现在已经开始做GI的FELLOW了。 那碗汤还在慢慢地熬。在此谢谢老刀前辈们的帮助和鼓励
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longbow (12345) 于 (Sat May 19 12:58:13 2007) 提到:
我成绩和版上的大部分人比起来, 真是不值一晒。真的, 我还在这版上没有见过比我分数低的人。

我毕业快十年了, 成绩也只有七八十分。 没有绿卡, 可我最后去了我最想去的医院做内科的住院医. 那家医院的最低要求是85分 in all steps.

我LD总是说, 世上有些人凭本事, 有些人凭运气, 而我就是凭运气的。 其实, 我凭的也是本事。

世上的本事有很多种, 学得好, 考得好, 是本事。 可是, 这个世界是由各式各样的人组成的, 而你自己也是其中之一。 所以我认为把握自己及与人相处的本领, 才是最大的本事。

把握自己, 这样才能在困境中看到自己的长处,冷静的找到一条可行之路,保持乐观,健康的心态, 这是素质。 而人相处的本领就是寻找机遇的本领, 能使你事半功倍,这是本事。 人情通达即学问嘛。

看到很多人来这里问, 我这样的成绩,希望有多大。 其实,每个人的情况多不一样,而这世上又有谁能预料未来呢?诸葛亮都说了“夫難平者,事也。。。至於成敗利鈍,非臣之明所能逆睹也”。 所以我们只是要找出下一步我们需要做什麽, 怎样才能在现有的情况下把下一步做好。就像煮石头汤,一步一步来。 把自己能把握住的事情一定
要做好,自己把握不住的,就不要去担忧了。谋事在人, 成事在天。 既然成事在天,我们有为什麽要为最后的结果焦虑不安呢。就让老天爷去管就好了

我毕业於国内一所很一般的医学院, 当年考G也就是刚刚过2000, 可这并不妨碍我在一月份就开始拿到录取。 我刚到的时候是中国人里面分数最低的, 可我三年半就拿到了博士, 也考完了board。

我参加今年的match,拿到5个interview。 3个pathology, 2个IM。面试其实和谈恋爱一样,太木纳, 太热情, 都不好。有些人在面试的时候急切想知道PD的看法, 见interviewer就狂拍, 见interviewees就想套别人的底细。其实这又何必。 就和追女孩子一样, 跑的最勤的, 最帅的并不一定是胜利者。 矜持一点, 有点素质好不好。

三月份的我没有match上, 我老板也没有钱了。 我要找新的实验室, 要计划抽时间做observation 。这是我最困难的一段时间。我找到了新老板,告诉他我的计划。和他商量定了我的工作安排。然后我就找我们学校的Pathology 和 family要求做observation。

我们的IM根本就不给observation。 Pathology按道理也不给做。 但我找到他们的PD,没有要求做observation。 我问他能不能旁听他们的morning lectures。 开始旁听后我就和他们的attending以及senior residents 混熟了, 然后, 我就说我去你们实验室看看嘛, 这样, 就算是拿到了observation。

Family 的人倒是挺热情的, 二话没说就给了observation. 这样, 我周六, 周日,周一上午在 Family,周三, 周五在pathology。

做observation 时候, 多和大家聊聊, 不懂得就问, 有时候遇到他们也不清楚的时候, 你可以主动要求去查文献, 然后在第二天做一个小talk。 这样一来二去, 他们就会把你看成自己人了。


以前rank我的几个program的PD都对我印象不错, 四月底的时候, 我给他们发了email, 问他们有没有openings。 很幸运,到此, 石头汤就煮好了。

LD一直说我运气。 其实着又何尝不是我努力的结果。 其实即使没有这个机会, 我也一定能在8,9月的时候把我们学校的pathology 或family 的outside match 搞定。

很多开起来不可能的事情,你要是能象庖丁解牛一样把它分解开,一步一步慢慢来,就像煮石头汤那样,成功也许就离你不远了。

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[zt]A story of not getting matched

EcoRone (中坑) 于 (Sat Mar 21 12:48:13 2009) 提到:
http://www.usmleforum.com/files/forum/2009/4/394667.php

2006 graduate, 95, 97, cs passed, all in first attempt, had 5 nterviews..MPH
..some research experience..no publications yet..working on it..and no USCE.
.did not match..tried for scramble..2 programs called..they said that they liked me..but said they cant sponsor visa..its so...irritating..tired of this near misses

What do you think..My analysis for me not getting matched is this..I hope it helps future applicants also..
1. Scores are not everything..they are very..very..tiny addition to your CV.
2. USCE is everything..
3. Programs actually read Personal Statements..I always thought my PS sucked..but I had prepared it at last min cause when we were about to apply, I had to evacuate due to a hurricane..
4. On the same note, I applied on Sep 8th..which is a very huge mistake..everything should go on the first day..no matter what happens..
5. Get everything by September..Whatever you do later..is a waste..Programs dont consider that..That I saw in my interviews..I built my CV mainly after September..I dont think programs remembered me talking about my research and all..
6. Dont count NY programs on your rank list..you cannot trust them..They interview too many people..you will be lost in the crowd unless you personally know someone there..I had 4 NY interviews.
7. Dont trust any letters which come that say they ranked you high.
8. Scramble is a waste of time for the most part. They are mainly looking for AMGs. I had 2 interviews..one today..can you imagine..they called me today..and said..oh..so sorry we liked you but we dont offer visas
9. Life does not suck..cause life goes on..even if you dont get matched..and you can expect bigger and better next year.
10. NY programs want Step 3. Even if you have average scores with Step 3.. you are better placed than a person with good scores and no step 3.
11. When you see on the website that a program has certain criteria to apply, If you dont meet the criteria, dont apply. Its a simple waste of money. I had applied to a place like that, I knew that they dont accept people without one year of clinical experience..I used to go there everyday to morning reports and case conferences after getting permission. I spoke with the PD. But finally, they just followed their criteria, they did not call me for an interview. I think there will be lot of stories where this is not true..but this is the rule..

The whole point of my lengthy discussion is ..Research your Programs..Dont go blindly by the IMG friendly list available..thats what I did. I did not apply to so many programs which were not on the list but were very IMG friendly. By the way, i applied to 160 programs..some of which i regret now. .Yale, Harvard..I did not realise that I was wasting 25 dollars every time I clicked on a program.

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Callmeman (麦地差生) 于 (Sat Mar 21 18:18:51 2009) 提到:

USCE=United States Clinic Experience
这是我这种补考过的人的最后稻草

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