Rounds to Residency (from MedSchoolCoach): Recent Episodes

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On Part 2 of our episode with Dr. Mitchell Cohn, he continues his discussion on osteopathy: what makes good and bad research, the politics behind different therapies, and how it’s different from chiropractic.

• [00:51] Science is Ever-Evolving
• [04:30] How We End Up With Bad Information
• [08:48] Politics Behind PRP and Prolotherapy
• [11:05] Difference of Osteopathic Manipulation from Chiropractic Adjustments
• [15:33] Chiropractors are Also Physicians

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On the last episode of Season 4, Chase DiMarco is joined by Dr. Mitchell Cohn, a retired osteopathic physician and author of “Osteopathy and the Zombie Apocalypse: A Career Guide for Pre-Med & Pre-College Students”, to discuss the differences between pain treatment & pain management and his experience with PIT or Perineural Injection Therapy.

• [03:00] Differences in Pain Management vs Pain Treatment
• [08:32] The Different Osteopathic Approaches
• [11:08] Dr. Cohn Explains Perineural Injection Therapy
• [18:07] Stem Cells and Prolotherapy
• [23:45] The Medical Community on Perineural Injection Therapy

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Chase DiMarco talks to Dr. Amy Fogelman, MD. Dr. Amy is a board-certified Internal Medicine Specialist based in Massachusetts. She was a primary care doctor for 18 years before she expanded her career in the medical-legal field given her experience as an internist after seeking a career coach and realizing that she was giving her husband free medical-legal advice. She is passionate about internal medicine and medical education. After close to two decades as a primary care physician in the Boston area, Amy founded MED LAW Consulting in 2018. She pairs expert witnesses to attorneys in legal matters. She also provides training for newbie medical experts who are interested in starting this side gig.

• [01:06] Burnout in Internal Medicine
• [03:17] Dr. Fogelman’s Background and How She Expanded Her Medical Career
• [06:00] Expanding your Career Beyond Clinical Practice
• [10:29] Dr. Fogelman and Her Experience with Harvard Medical Students
• [14:37] How Medical Students Can Impress Their Preceptor
• [18:18] Dr. Fogelman on UpToDate as a Secondary Source in Internal Medicine
• [20:39] Learning to Love Internal Medicine
• [22:38] Delay or Failure to Diagnose as a Medical Expert
• [25:37] The Responsibility in Working as a Team
• [29:34] Which Fields are More Likely to be Sued?
• [30:40] Differences of Being an MD and a Mid-Level Practitioner
• [33:45] Dr. Fogelman’s Words of Wisdom on the Medical-Legal Field
• [35:30] Where to find Dr. Amy Fogelman MD
• [35:58] Rewards and Options in Being a Physician

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Chase DiMarco talks to Dr. Abdullah Chahin who is board certified in both infectious diseases and critical care medicine. He is also an assistant professor and the program director for internal medicine at Brown University’s School of Medicine. He also holds a teaching position at Tufts University School of Medicine. Chase and Dr. Chahin discuss the current state of medical

education, its challenges, and the changes that can be made it to improve it.

• [02:28] Biggest Challenge Facing Today’s Residents
• [05:42] Managing Residents’ Expectations
• [07:35] Residency Application & Medical Knowledge
• [14:32] How can International Medical Graduates Stand Out?
• [20:00] Dr. Chahin’s Advice to Medical Students and Residents

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Chase DiMarco talks to Brenda Thompson, a Graduate Medical Education (GME) expert with over ten years of experience in residency-related accreditation, education, and other similar topics. They discuss assessment criteria for residency evaluations, professional maturity during residency, and the adoption of behavioral assessments in the hospital setting. 

• [01:24] Brenda Thompson’s Background and Roles in GME
• [03:45] Changing Medicine and Medical Education for the Better
• [06:24] The SWOT Analysis During Residency
• [08:31] Comparing the Six ACGME Requirements to the Core EPAs
• [10:15] Assessment Criteria for Residency Evaluations
• [14:45] Residency Orientation and Its Effects on Students
• [18:25] The Adoption of Behavioral Assessment in the Hospital Setting
• [19:40] Positive Attitude and Professionalism During Residency
• [23:20] How to Exhibit Professional Maturity During Residency

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Chase DiMarco talks to Dr. Alen Juginovic, a medical doctor and postdoc at Harvard Medical School, Department of Neurobiology. He is also the author of "Introduction to Sleep Medicine," which focuses on the physiology and pathophysiology of sleep, sleep disorders, and the circadian rhythm. They talk about sleep medicine, communicating science to the general public, and keeping up with scientific literature. 

• [01:09] Challenges Facing Residents in Sleep Medicine
• [06:02] Introduction to Sleep Medicine
• [07:14] The Hot Science Balloon Project
• [09:35] Communicating Science to the General Public
• [13:10] Why Experts Should Explain Their Science to the Layperson
• [14:30] The Role of the Science Experts in Developing Public Policy
• [15:55] How to Keep up with New Scientific Literature
• [19:10] Why Facts Don't Change Our Minds
• [23:40] Fake Science and the Knowledge Crisis
• [26:08] Strategies and Tools for Communicating Science to the General Public
• [28:21] Tips for Pursuing a Career Medicine

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Chase DiMarco talks to Dr. Basil Kahwash, a board-certified allergist/immunologist who manages asthma, allergies, rare immunodeficiency conditions, and targeted biologic treatments. They talk about challenges facing allergy and immunology residents, the advantages of sub-specialization, and choosing the right residency program.  

• [01:07] Challenges Facing Allergy and Immunology Residents
• [06:15] Designated Path to a Career in Allergy and Immunology
• [07:31] Allergy and Immunology Training in Internal Medicine
• [10:56] Interesting Sub-specialties in Allergy and Immunology
• [14:30] Benefits of Choosing a Career in Internal Medicine
• [17:58] The pros of Sub-specializing
• [19:19] Choosing the Right Residency/Fellowship Program
• [22:20] Tips for Pursuing a Career in Allergy and Immunology

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Chase DiMarco talks to Dr. Lindsey Shipley and Dr. Jack Penner from The Clinical Problem Solvers Podcast, a podcast that examines medicine's clinical mindsets and critical thinking aspects. They talk about the process of clinical problem-solving, interview tips on a successful interview season, and the characteristics of an ideal internal medicine resident.   

• [01:55] The Main Differences Between Basic Science and Clinical Learning
• [05:30] Problems Affecting Residents in Internal Medicine
• [11:23] Interview Tips for a Successful Interview Season
• [16:25] Desirable Traits of an Ideal Internal Residency Applicant
• [18:19] Assessing the Process of Clinical Problem Solving
• [21:50] Mastering Foundational Illnesses
• [24:25] System 1 and System 2 Clinical Reasoning

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Chase DiMarco talks to Dr. Alya Khan, an Occupational Medicine Residency Program Director and Assistant Clinical Professor at UC, Irvine. They talk about challenges facing OEM residents, how to stand out during OEM residency applications, and the best-kept secrets in medicine. 

[00:57] Challenges Facing Residents in Occupational and Environmental Medicine

[05:14] What is Occupational and Environmental Medicine?

[08:37] Physician Opportunities in OEM

[10:10] The Shortage of OEM Physicians

[12:50] How to Stand out During OEM Residency Application

[14:45] What to Avoid when Applying for OEM Residency Positions

[18:09] Networking Tips for a Career in OEM

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Chase DiMarco talks to Dr. Frank Okosun, an internal medicine specialist providing evidence-based medical care in both hospital and outpatient settings. He also has a particular interest in chronic disease management and occupational health. They talk about telemedicine, challenges facing residents in internal medicine, and strong residency letters of recommendation.

• [00:50] Challenges Facing Residents in Internal Medicine
• [02:10] Dr. Okusun’s Background in Occupational Health and Safety
• [04:38] Family Medicine Versus Internal Medicine
• [07:22] Internal Medicine: Things you Should Know as a Medical Student
• [08:58] What is Telemedicine?
• [11:40] Tips for Students Applying for Residency Positions in Internal Medicine
• [13:20] Strong Residency Letters of Recommendation
• [15:11] The Competitive Nature of Internal Medicine
• [17:41] Qualities of an Exceptional Internal Medicine Student
• [21:19] Advice to Aspiring Internal Medicine Practitioners

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Chase DiMarco talks to Dr. Barry Julius, an associate radiology residency director at Saint Barnabas Medical Center. He is also the CEO of Dr. Resident, Inc and the chief editor at RadsResident.com. They talk about international medical graduates in the US, finding the right radiology residency programs, and the qualities of an exceptional radiology resident.

• [00:54] Creating Content for Radiology Residents
• [03:10] The Lack of Career Resources for Radiology Residents
• [04:23] Challenges Facing Radiology Residency
• [07:35] International Medical Graduates in the US
• [09:50] How to Stand Out During Match Week
• [13:33] Qualities of an Exceptional Radiology Resident
• [16:30] Factors to Consider Before Settling on Radiology

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Chase DiMarco talks to Dr. Tonya Caylor, a family physician with over 20 years of experience and 12+ years in academics. She is also a certified professional coach working with family medicine residency programs and individual residents. They discuss time management techniques in medicine, embracing feedback during training, and the benefits of gratitude in healthcare.

• [00:54] The Biggest Challenges Facing Residents in Family Medicine
• [02:01] The Joy in Family Medicine
• [03:47] Family Medicine Residents in Alaska
• [05:30] Benefits of Embracing Feedback
• [07:01] The Feedback Sandwich
• [08:25] Key Time Management Techniques in Medicine
• [11:42] How to Develop a Gratitude Practice
• [16:14] Understanding the Thoughts, Feelings, Actions Cycle

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Dr. Forrest Jones talks about end-of-life care, the stigma surrounding doctors in family medicine, and delivering bad news to your patients. 

• [00:50] Getting to know Dr. Forrest Jones
• [04:00] Negative Stigma Facing Generalists in Family Medicine
• [08:29] A Doctor's Guide to End-of-Life Care
• [16:55] How to Deliver Bad News to Your Patients
• [29:35] Dr. Forrest's Advice to Physicians and Medical Student's

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Chase DiMarco talks to Dr. Kelly Casperson a practicing urologist. Dr. Casperson is passionate about female pelvic health and incorporates surgical and non-surgical treatment options in her discussions with patients.

• [00:40] How Dr. Casperson Is Changing Medicine for the Better
• [03:19] International Society for the Study of Women's Sexual Health (ISSWSH)
• [06:28] Advice for Med Students Considering Urology
• [11:04] Female Reproductive Health and Urology
• [12:22] Characteristics of the Ideal Urologist
• [13:08] Fellowships Associated with Urology
• [14:27] Myths, Limiting Beliefs, the Arrival Fallacy
• [17:03] Picking a Good Mate
• [18:21] Dr. Casperson's Podcast: You Are Not Broken

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Dr. Amelia Bueche, founder & program director at Coaching for Institutions, talks about the field of osteopathic medicine, the concept of worthiness, and the application of osteopathic philosophy beyond the clinical setting. 

• [02:52] What is osteopathic medicine?
• [05:52] The concept of worthiness in medicine
• [09:01] The ‘and’ statement in medicine
• [12:30] How to properly leverage the ‘and’ statement
• [16:05] The ‘I am’ exercise
• [19:36] The application of osteopathic philosophy beyond the clinical setting
• [23:06] The main difference between osteopathic manipulation and other forms of medicine

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Chase DiMarco talks to Dr. Greg Rodden about work-life balance during residency, managing student loans, and how living expenses and taxes can affect your residency journey.

• [01:59] Work-life Balance During Residency
• [06:40] Finding Time for Hobbies and Extracurricular Activities
• [12:24] How to Find Reading Time During Residency
• [13:14] Coexisting with People with Different Views from Yourself
• [17:18] Side Gigs and Extra Income
• [18:27] Managing Student Loans
• [24:30] Why Living Expenses and Taxes Should not Affect Your Residency Location
• [26:51] How to Approach Insurance Covers
• [29:07] Transport Costs and Saving Money
• [32:30] Do Resident Doctors Need to Invest?

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Dr. Greg Rodden talks about how to handle anxiety on your first day of residency, build relationships with hospital staff, and how and when to prepare for your step 3 exams. 

• [01:20] What to Prepare for in Your First Day of Residency
• [08:51] Are sub-internships important?
• [11:20] How to create and build relationships with your other team members
• [15:48] How to Handle Your First Day in a Clinic or a Hospital
• [19:20] Educational Material to Utilize While Working Full-time
• [21:24] How to Prepare for Your Step 3 Exams

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Dr. Gregg Rodden, a second-year pediatric resident in Austin, Texas, talks about how to transition into residency, planning and choosing a rotation, and the intricacies of work-life balance during clinical rotation.  

• [06:07] How to transition from med school into residency
• [09:20] Preparing for rotations
• [14:23] How to plan and choose a rotation
• [17:01] Gaining the most out of a rotation
• [21:37] Perfecting work-life balance during clinical rotations

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Dr. Stephen Beeson, family medicine physician and two-time best-selling author, discusses clinician excellence and the core competencies important for physicians.

• [00:51] How Dr. Beeson Is Changing Medicine for the Better
• [01:41] Clinician Excellence and What It Entails
• [05:06] Establishing Patient Trust and Connectivity
• [11:39] How to be a Good Colleague
• [16:42] Proper Utilization of Tools and Resources
• [23:13] Dr. Beeson’s Advice to Medical Students and Residents

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Same great guests and content, but a brand new name: Rounds to Residency.

https://findarotation.com/

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Samee Hameed, a fourth-year medical student, talks about health disparities, racial inequality in medicine, and how the future generation of medics can tackle implicit bias and institutional racism. 

• [02:01] Samee’s Journey to Dual Residency
• [03:39] How Medical Students are Changing the World of Medicine
• [06:40] How to Have an Open Discussion with Members of The LGBTQ Community
• [09:10] Health Disparities Within Medicine
• [12:45] Implicit Biases Plaguing the Medical Space
• [15:50] Why Change Needs to Start with Individual Medics
• [17:20] Creating a Platform for People to Participate in a Conversation

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Beth Garbitelli, a 3rd-year medical student at Tufts University School of Medicine, discusses her journey to medicine and her recommendations for building your CV during the COVID pandemic.

• [01:55] From Journalism to Law to Medicine
• [09:27] Changes in Clinical Clerkships During Covid
• [16:56] Longitudinal Clerkships
• [24:49] Recommendations for Med Students

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Dr. Cory Pettit, who scored very well on his USMLE Step 1 and Step 2 exams, shares study tips and resources to excel on exams in medical school.

• [01:01] Why Dermatology?
• [02:33] Studying for Shelf Exams During Clerkship
• [08:54] General Resources & Study Tips for NBME Subject Exams
• [12:33] Resources & Tips for Internal Medicine Shelf Exam
• [15:28] Resources & Tips for Surgery Shelf Exam
• [18:09] Resources & Tips for OB-GYN Shelf Exam
• [20:59] Resources & Tips for Family Medicine Shelf Exam
• [24:09] Resources & Tips for Psychiatry Shelf Exam
• [26:40] Resources & Tips for Neurology Shelf Exam
• [29:05] Resources & Tips for Pediatrics Shelf Exam
• [32:01] Tips for Specializing in Dermatology
• [34:32] The Importance of Internal Medicine Rotations for Dermatology

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Dr. Faustine Ramirez, a 2nd year resident in pediatrics at UCSF and Step 2 Guru, talks about studying for Step 2 – which is likely to become the single most important factor for landing a competitive residency.

• [01:55] Dr. Ramirez’s Study Guru Secrets
• [12:14] Studying in a Clinical Setting
• [16:54] Building Rapport with your Patients as a Student
• [20:15] Building Healthy Habits and Personal Care for Medical Students
• [24:15] The Shift of Importance from Step 1 to Step 2

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Dr. Barbara Hamilton, a radiologist and physician leader, aims to demystify what life is like as a woman in the male-dominated field of radiology.

• [01:19] How Dr. Hamilton is Changing Medicine and Medical Education for the Better
• [02:20] Stats on Diversification Within Different Medical Fields
• [04:40] Special Tips for Women Interested in Interventional Radiology
• [09:49] Resources and Tips for Students on Rotation.
• [14:14] Finding Your Place In Medicine
• [20:35] Things to Look out for During Residency

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Dr. Nisha Mehta discusses changing the culture of medicine by creating open conversations about burnout, work life balance, and financial literacy.

• [01:01] How Dr. Mehta is Changing Medicine for the Better
• [03:08] Physician Side Gigs and Entrepreneurship
• [05:36] Current Health Care Landscape for Women in Medicine
• [09:19] Work Life Balance as a Physician
• [14:59] Personal Finance Affects Work Life Balance
• [19:10] How to Prepare for Radiology Clerkship
• [22:35] How to Study for Radiology Exams
• [24:57] Tips for Choosing Your Medical Specialization
• [28:59] Focus on Being the Best Doctor You Can Be

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Dr. Kathleen Timme discusses health literacy— why you need to have effective communication with your patients, activate the learner, and set yourself up to receive feedback.

• [01:16] How Kathleen Branched Into the GME Spectrum
• [03:22] Health Literacy
• [07:54] The Small Group Teaching
• [12:18] Kathleen's Personal Experience in the Medicine World
• [13:21] Activating the Leaner
• [16:01] How to be a Good Feedback Recipient

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Dr. Sarah Hart-Unger shares time management and productivity tips as well as ways on how to make your CV stand out for residency applications

• [01:27] How Dr. Hart-Unger Is Changing Medicine for the Better
• [03:05] Planning for the Upcoming Academic Year
• [07:01] Clinical Experience and Residency Matching During COVID-19
• [12:10] How to Make Your CV Stand Out
• [19:06] Productivity and Planning Tips

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Dr. Joseph Krainin, MD, FAASM, founder of Singular Sleep, discusses his background in sleep medicine and shares advice for students interested in it.

• [01:12] How Dr. Krainin Is Changing Medicine for the Better
• [06:50] Sleep Disorders in Medical Training
• [10:41] The Varied Pathways in Sleep Medicine
• [14:27] Most Common Sleep Disorders
• [20:44] Advice for Med Students Considering Sleep Medicine
• [22:02] The Future of Sleep Medicine

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Dr. Jeremy Toffle discusses choosing pediatrics as a specialty, supporting parents through his blog, and the changes in clinical medicine during the pandemic.

• [01:06] How Dr. Toffle Is Changing Medicine for the Better
• [05:22] The Difference between University Hospital and Clinical Rotations
• [06:28] The Personality Traits of Pediatricians
• [08:08] The Hardest Parts of Pediatrics
• [09:06] Changes in Clinical Medicine During the Pandemic
• [11:06] Advice for Med Students Considering Pediatrics
• [12:48] Why Dr. Toffle Started Imperfect Dad, MD

Today, Chase DiMarco talks to Dr. Jeremy Toffle, MD. Dr. Toffle is a pediatrician in Nebraska that runs the Imperfect Dad, MD blog. Through this medium, he brings his parenting and medical experience together to let parents know that they are not alone in the struggle. In this episode, Chase talks to Dr. Toffle about choosing pediatrics as a specialty, supporting parents through his blog and the changes in clinical medicine during the pandemic.

Why Dr. Toffle Chose Pediatrics Dr. Toffle has always enjoyed being around children. Following his experience in summer camps and being a camp counsellor, Dr. Toffle became more comfortable with being around kids. Pediatric procedure also drew him to the specialty.

Pediatrics and Personalities Doctors in pediatrics are often stereotyped as bubbly and super-approachable, which is not always the case. Dr. Toffle was partly drawn to the specialty because of the difficulty he experienced getting adult patients to comply with his advice and recommendations. He describes the role of a pediatrician as effectively a middle-man between kids and their parents.

Changes in Medicine During the Pandemic The field of pediatrics has changed in big and small ways in response to the pandemic. Telemedicine and Zoom are being used for wellness checks and the physical examinations are postponed as necessary. Children who are on long-term medications like ADHD meds are most suited for these remote check-ups and there is often no reason for them to physically be in the doctor’s office. Dr. Toffle predicts that healthcare will continue to use telemedicine and Zoom for checkups that permit them to long after the pandemic has passed.

Advice for Students Preparing for Pediatric Rotations and Considering Pediatrics as a Specialty Dr. Toffle thinks it is important for students to understand that children are not “little adults” and that their biology is different. He urges students preparing for pediatric rotations to read up on the developmental milestones and check what their classmates have already learned from their rotations.

Pediatric rotations will not be like any of the other rotations. Coming into the rotations with confidence and an open mind will go a long way. Students should look at pediatrics as a completely different world and a completely different type of medicine compared to everything they have learned.

When dealing with adult patients and their health, there are many lifestyle choices like smoking, diet and physical fitness that need to be considered. Kids are a blank slate and physicians have the rare opportunity of helping their patients earlier on in their lives to get them to be healthier adults.

Imperfect Dad, MD Dr. Toffle started his blog Imperfect Dad, MD early on in the pandemic in an attempt to contribute more at a time he felt parents needed the support. Parents often think pediatricians do everything perfectly when it comes to their children, which is not true. In his blog, Dr. Toffle takes what he knows from his job and being a parent to let other parents know where he has not done a good job. Admitting to his own blunders and flaws takes a lot of weight off parents who feel pressure to be perfect in everything.

Check out Dr. Toffle’s blog Imperfect Dad, MD. Check out his LinkedIn, Facebook and Instagram profiles. Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE! Do check out Read This Before Medical School. Like our FreeMedEd Facebook page and find our Medical Micro Course, Blog posts, and Podcasts at FreeMedEd.org! Feel free to Email any Questions or Comments.

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Dr. Francis Yoo talks about the importance of emotional intelligence in medical practice & applying “attention” and “intention” within a clinical setting.

• [00:53] How Dr. Yoo Is Changing Medicine for the Better
• [03:55] Applying “Attention” and “Intention” Within a Clinical Setting
• [08:00] The Importance of Emotional Intelligence in Student Learning
• [12:43] Emotional Intelligence in the Future of Medical Education
• [16:16] Developing Rapport Between Students and Patients
• [20:09] The Myers-Briggs Type Indicator and the Enneagram Type

“Attention” and “Intention” A major area of focus for Dr. Yoo is the lack of “attention” and “intention” in practice. Applying “attention'' within a clinical setting can be as simple as a student or physician attending to a patient, beyond the strictly clinical aspects of a visit, or an educator attending to a student. “Intention” could involve simply intentionally sharing something useful within those settings.

Dr Yoo. describes “magic” as attention and intention modified by belief, emotion, imagination and clarity.

Emotional Intelligence in Learning and Medicine Emotional intelligence is a vital part of student learning, particularly for medical students. Dr. Yoo describes emotional intelligence as a set of skills that can be acquired and developed, like any other set of skills. Actively learning and using this particular set of skills reminds students that, while they are in a clinical setting, both the patient and student or physician are human beings first. This acknowledgement allows the student to accept that not everything will be perfect and allows them to draw on their other skills to optimise a clinical experience.

The Future of Medical Education Residency programs are facing a challenge in the face of the step exam going pass/fail. They may be looking for other yardsticks to evaluate residents and their competencies. Looking at more aspects of students and their abilities requires more work, especially in the absence of step exam scores, but matching is likely to become more expedient for both the practice and the student. More research will yield better matches for residency programs.

Dr. Yoo has found it valuable to apply the skills he's gained from experience in other areas to his medical practice. These skills include branding and marketing and are not generally expressed requisites for residents but may become more useful as a marker for matching in residency programs.

Helping Students Build Rapport with Patients Dr. Yoo attests that both top-down and bottom-up communication is essential for properly integrating the student in a hospital or private practice and developing an ability to connect with patients. In an ideal clinical setting, the residents, nursing staff and preceptor are aware of the needs of the students and are actively involved in inducting the student into the practice and the culture of the practice. This deliberate human intervention reminds the student of the humanness of a real-life setting. Making either the student or preceptor solely responsible for the integration of the student is unlikely to yield significant results.

MBTI and Enneagrams MBTI and the Enneagram are both models of the human psyche and behaviour. MBTI (Myers-Briggs Type Indicator) is based on the work of psychiatrist Carl Jung on the theory of personality types. The MBTI intends to make Jung’s theory useful and understandable in people’s lives. MBTI is used extensively in personal and executive coaching, as well as team development. The Enneagram is a model which attempts to describe people in terms of types and is based on their motivations and fears.

Check out Dr. Yoo’s website to browse his blog and shop his books. Check out his LinkedIn, Facebook, Instagram, and Twitter profiles.

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE! Do check out Read This Before Medical School. Like our FreeMedEd Facebook page and find our Medical Micro Course, Blog posts, and Podcasts at FreeMedEd.org! Feel free to Email any Questions or Comments.

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Chase DiMarco opens up about recent events that lead to personal anxiety and discusses how students can deal with anxiety and depression during COVID.

• [01:50] Mental Issues Among Medics
• [03:50] Finding Ways to Deal with Your Anxiety
• [04:50] Trigger Events
• [08:52] Seeking Help
• [12:50] How Stress Can Affect us as Learners
• [14:10] The Vicious Cycle That is Anxiety and Depression

The medicine world has often been recognized as a stressful environment that sometimes hurts a medics' performance, physical health, and psychosocial well-being. Throw a global pandemic into the fray, and you'll find that even more medics are falling into a state of either depression or anxiety. Interestingly, medical practitioners are less likely to seek help because of the fear of being stereotyped or judged by their peers.

With the global suicide stats at an all-time high, it's high time we addressed the mental health issues in a COVID-fatigued society. Although Chase has faced bouts of anxiety since his high school, he has managed them with relative ease. However, a recent trigger event made him feel a little overwhelmed with what was happening around him. This trigger event helped him understand that no matter how small the issue you're facing might be, it has the potential to make you feel anxious or depressed. These triggers can come from anywhere, and it won't matter how insignificant they are; the thing to note is that they affect you, and you need to do something about them.

We unknowingly struggle with mental issues which means some of us seek help when it's too late. These little anxiety triggers are known to build up and eventually blow up, leading to a spike in negative thoughts crisscrossing through a person's mind. The most important step in the healing process is recognizing that you need help.

While different solutions can work wonders for different people, a couple of resources that worked for Chase might also work for you. With the pandemic restricting people's access to physical help, online platforms such as BetterHelp and TalkSpace are known to offer help via text, chat, or video calls. Chase advises people to try and seek help from neutral parties since close friends and family typically have a bias because of the relationship you have with them.

Learners have the most to lose when it comes to dealing with mental health issues. The fact that depression and anxiety can play havoc with one's memory makes it difficult for learners to ingest new material or answer a patient's questions. The mental issues will also affect your sleep patterns, and the longer you wait before seeking help, the longer it will take before you come back to a state of normalcy.

Chase's message for you today is that it might not be you who's battling depression and anxiety, but you might know someone who is. Not everybody has the guts to come out and talk about what's eating them. If you notice somebody acting differently from what you associate them with, be the friend and offer a listening ear, you'll be surprised by how big an impact you can have by just being there. You can also share this episode with them to let them know that they are not alone and that there is help. We live in trying times, and the best way to look out for one another is by being there for one another.

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! Also, do check out Read This Before Medical School.

National Helpline

Psychology Today Therapist Finder

Better Help

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Dr. Qasim Butt discusses nephrology, finances for medical students, & advice for physicians who are taking on nephrology students. Dr. Butt is a certified interventional nephrologist.

• [01:19] Dr. Butt’s Approach to Creating YouTube Videos
• [03:51] Why Interventional Nephrology
• [08:28] From Specialists, to Hospitalists, to Direct Primary Care
• [11:47] Cultivating Medical Side-Gigs
• [17:40] Advice for Physicians Who Are Taking on Nephrology Students
• [20:17] The Importance of Personal Branding

Chase DiMarco talks to Dr. Qasim Butt. Dr. Butt is a certified interventional nephrologist. He also has the popular YouTube channel, Your Kidney, Your Health and is on the board of the Texas Kidney Foundation. They discuss nephrology, physician finances for medical students, and advice for physicians who are taking on nephrology students.

Why Interventional Nephrology As a medical student at St. Georgia’s in the Caribbean, Dr. Butt was unsure of his future specialty. Interventional nephrology was something that he picked up along the way, by making smart decisions at each step of his journey. After graduating, he did his internal medicine rotation from 2005 to 2008 at Louisiana State University Health Shreveport / School of Medicine (LSU). He liked nephrology, despite not loving it. LSU had openings for nephrology residents. So, he applied and got in.

Dr. Butt reminds students that it can be easier to get into a program at a hospital where you already have some experience. This is also where he obtained training for interventional nephrology, which involves putting in catheters, stents, etc. Currently, he alternates between clinical and interventional nephrology on a weekly basis.

Cultivating Medical Side-Gigs Although money is not the most important thing, it does influence our lives. Dr. Butt reminds physicians that their revenue does not necessarily come from one stream i.e. their full-time job salary. For example, nephrologists can participate in dialysis units, and most physicians can obtain medical directorships, which require attending meetings a few times a year.

However, as physicians begin to diversify within their capacity as a physician, they need to acknowledge that they are donning “golden handcuffs.” Golden handcuffs refer to the phenomena of being tied up by a narrow type of revenue. For example, if a physician wants to either leave medicine, or they need to shift addresses, all their streams of revenue could disappear at once. This setup is not necessarily bad, but physicians must be aware of the situation in which they place themselves.

How to Choose a Practice to Join Dr. Butt emphasizes the importance of observing the culture of a practice before joining it. If you are a younger physician looking to join a practice, you do not want to join a practice composed of physicians who are fifty to seventy years old. These older physicians likely have their kids already in college, and are not pursuing a growth model. They are preparing to retire. But you are just starting out, and you want to grow.

Advice for Physicians Who Are Taking on Nephrology Students Nephrologists tend to be highly analytical people. This means that they often struggle to convey complex information in simple language. In order to cultivate the next generation of nephrologists to be passionate about nephrology, preceptors must learn to communicate better to the medical students on nephrology rotations. Dr. Butt tries to make his YouTube videos only three to five minutes long, with fun and simple language, to capture the attention of listeners. Preceptors must take a similar approach, and improve their communication skills.

Check out Dr. Butt’s YouTube channel, and like his videos and subscribe. Check out his LinkedIn, Facebook, Instagram, and Twitter profiles.

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE! Do check out Read This Before Medical School. Like our FreeMedEd Facebook page and find our Medical Micro Course, Blog posts, and Podcasts at FreeMedEd.org! Feel free to Email any Questions or Comments.

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Dr. Dana Corriel, a physician, entrepreneur, and founder of SoMeDocs, discusses the changing paradigms regarding social media in the medical field.

• [02:04] How Dr. Corriel Got Into Social Media Branding & Marketing
• [04:09] Dana’s Most Outrageous Experience as a Physician
• [08:05] General Social Media Guidelines for Students
• [12:18] Factfulness in Advocacy on Social Media
• [16:06] The Importance of Branding and Marketing
• [20:19] Choosing Social Media Platforms to Use
• [26:25] How to Find Out More About SoMeDocs

With social media playing such a big role in our lives, from politics to #MedBikini, it is important for medical students to consider the role of social media in their professional lives. Chase DiMarco talks to Dr. Dana Corriel, a physician, entrepreneur, and founder of SoMeDocs: Doctors On Social Media. We cover changing paradigms regarding social media in the medical field.

General Social Media Guidelines for Medical Students Social media is a powerful tool of communication if leveraged in the right way. However, medical students should do this cautiously because we are steeped in cancel culture. This means that if a medical student says something unethical, everything that they say after that may be affected. Attendings have it a bit easier because they are already established. Just like magazines curate their content, medical students should curate the content that they post on social media to serve their personal and professional goals.

Factfulness in Advocacy on Social Media In an attempt to advocate for a cause or to express thoughts important to them, people tend to share posts that they have not fact-checked, or that they have not fully thought about. Social media can become toxic when we are forced to share posts on a topic, unless we are willing to risk our reputations being smeared. We must not succumb to the pressure of the herd, and be willing to think through topics for ourselves. Individualized takes on issues are very valuable.

The Importance of Branding and Marketing Often, people who do not prioritize fact-checking end up as the most popular influencers. This is because they might be excellent at branding and marketing. Dr. Corriel is passionate about enabling physicians and medical students— people who have the training to base their claims on facts and science — to in turn become excellent at branding and marketing. Whilst people do respect a medical degree, on social media, branding and marketing can hold more clout.

Choosing Social Media Platforms to Use Different social media platforms — LinkedIn, Instagram, Facebook, and Twitter — can be suitable depending on a medical student or physician’s target audience, and what they themselves enjoy. For example, if a medical student or physician is excellent at making videos, YouTube can be a great option. If a medical student or physician is skilled at consistently writing short Twitter posts, and thrive in the often argumentative environment of Twitter, then they can choose Twitter! They should not choose a platform that increases their anxiety, or that they hate. If they are looking for some hand-holding to engage more in social media, then they should consider reaching out to Dr. Corriel , who takes guest moderators for the SoMeDocs Twitter chat every week, and provides lots of guidance.

Learn more about Dr. Corriel Corriel on her website and the SoMeDocs website. Check out her LinkedIn, Facebook, and Twitter profiles. Also, check out the SoMeDocs Facebook group. Be sure to check out SoMeDocs lecture series.

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE! Do check out Read This Before Medical School. Like our FreeMedEd Facebook page and find our Medical Micro Course, Blog posts, and Podcasts at FreeMedEd.org! Feel free to Email any Questions or Comments.

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Brenda Thompson shares advice for residency applications: tips for writing personal statements, requesting recommendations, and navigating rotations.

• [00:48] Brenda’s Background and Roles in Residency Recruitment
• [05:26] The Accreditation Council for Graduate Medical Education (ACGME)
• [10:01] Personal Statements, Letters of Recommendation, and Exam Scores
• [16:29] Tips for Writing About Extracurriculars
• [21:24] How to Handle Clinical Rotations
• [26:30] Social Media, Headshots and Residency Applications
• [29:17] How to Contact Brenda

Chase DiMarco talks to Brenda Thompson, Graduate Medical Education (GME) expert with over ten years of experience in residency-related accreditation, education and other similar topics. They chat about advice for a residency application in 2020, from tips for writing personal statements, and requesting recommendations, to how to navigate rotations

Brenda has often been disappointed when working with medical students who are applying for a residency program. They illustrate the lack of interview preparation and professional development programs in medical school. For example, these students do not know the right kinds of questions to ask during interviews, how to structure their personal statements, or what kinds of materials to upload to ERAS. As an independent GME pundit, Brenda’s aims to help to fill this gap left by medical school education, advising students on how to match into the right residency program in 2020.

ACGME Accreditation Residency programs depend on the ACGME for accreditation. Student performance, including scores are sent by the residency program to the ACGME. If a given residency program has failing students, they risk being placed on probation by the ACGME, or worse, have their accreditation stripped. As such, the admissions committee tries to get the best students to give the program the best chance of maintaining ACGME accreditation. A medical student wants to impress the residency program admissions committee, but the residency program in turn wishes to impress the ACGME.

Personal Statements A medical student’s personal statement, letter of recommendation and board exam scores are crucial components of a residency program application. For the personal statement for your residency application, do not be afraid to get help to refine your letter, and educate yourself on best practices. You have control over this portion of your application. Spelling mistakes are especially unacceptable. Brenda mentions that students often make the mistake of using their personal statements to share what they want from the program, instead of to share what they can offer to the program.

Letters of Recommendation As for letters of recommendation for your medical residency application, it might be better to get a higher-ranking person such as a program director, to write the letter instead of your attending. However, make sure that the writer knows you well, and that they will give you a strong recommendation. It is a major red flag, if nowhere in your letter does the writer use a phrase such as “I highly recommend” or “I recommend without hesitation.” If your letter writer asks you to draft the letter first, then you should use this opportunity to your advantage, and be sure to use the right terminology and information.

USMLE Exam Scores and Clinical Rotations As for exam scores, a major residency application tip that Brenda offers is that if you failed your Step 2 board exam, try to pass your Step 3 board exam before applying for residency and upload this score to ERAS. If your transcript only lists a failed Step 2 exam, then the residency program might be very hesitant to accept you.

If you are applying for residency during COVID-19, the residency program director might understand that you were unable to get into the clinical rotations that you wanted. However, if you do get into a rotation, do your best to get an A, as a grade like a C is a red flag and requires an explanation. If you could not get a clinical rotation in your desired specialty, it is understandable to the residency admissions committee, but be prepared to talk up the specialty in your application. Be very kind to your clerkship/rotation coordinator, because it is very possible that they might end up being your residency program director, and could veto your residency application later on. More generally, be nice to everyone, as the medical world is very small. Being difficult to work with can come back to haunt you years later.

Extracurriculars and Connections to the Residency Program Location Regarding extracurriculars, Brenda urges students to consider the location of the residency program when listing down their hobbies. Residency programs want to maximize the chances that you will accept their offer if you do get in. If you have family connections to the area, then they know that you are more likely to accept the offer. But if you do not have family connections, then hobbies that make sense to the location can increase your ranking. Using Denver as an illustration, listing snowboarding and skiing as your hobbies makes sense, whilst listing fishing and swimming does not. Instead of sending a generic personal statement to all your residency programs, try to tailor each one to the location to which you are applying. Furthermore, the ACGME now has standards for physician wellness, so the residency admissions officer wants to make sure that you are able to achieve these standards.

Connect with Brenda on LinkedIn or email her at GMEpundit@gmail.com. You

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can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE! Do check out Read This Before Medical School.

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Dr. Andrew Tisser talks about communicating with teammates in a clinical setting, selecting a specialty, and how to match into a good residency program.

• [02:14] Teamwork in a Clinical Rotation
• [04:31] How to Choose a Specialty
• [09:42] Tips for Residency Applications
• [12:41] Goal-Setting Strategies
• [16:57] Financial Tips for Medical Residents
• [22:32] Tips to Prepare for a Career in Academic Medicine
• [24:38] How to Contact Dr. Tisser

Dr. Andrew Tisser, an emergency physician and the host of the podcast Talk2MeDoc, and offers physician coaching and career consultation.

Teamwork in a Clinical Rotation Dr. Tisser encourages medical students on a clinical rotation to involve everyone on the team, not just doctors. For example, nurses are often better than doctors at tasks such as putting in IVs. If medical students have a free moment during a shift, they should ask the nurses to teach them a skill. This makes nurses feel empowered, and improves the skills of the medical student. Dr. Tisser warns that if you enrage one senior nurse, you are in a lot of trouble because they strongly influence physician opinions.

How to Choose a Specialty In choosing a specialty, Dr. Tisser encourages medical students to maintain an open mind. Medical students should have a comprehensive list of all possible specialties, and then cross things off, always noting the reason that they have excluded a given specialty. It is easy to decide against a specialty based on a bad experience with the attending preceptor, or other coincidental reasons. Instead, exclude specialties based on inherent traits of the specialty that are incompatible with your preferences. For example, if you strongly dislike being in an operating room (OR), then you can exclude a large chunk of specialties, including obstetrics-gynaecology (OB-GYN), and all the surgical subspecialties.

Tips for Residency Applications Dr. Tisser offers two primary tips for how to be competitive for residency, namely 1. get strong letters of recommendation and 2. apply broadly. Regarding 1, be sure to ask your preceptor if he can write you a strong recommendation, rather than just a mediocre recommendation. If not, find someone else to write it. Regarding 2, be open to moving to new geographical locations for the sake of a good residency program.

Goal-Setting Strategies Dr. Tisser advocates the SMART (specific-measurable-attainable-relevant-time bound) framework for setting goals and achieving them. He encourages medical students to look at their past experiences of success and failure. What were the beliefs which led them to successful outcomes? What were the beliefs that led them to disappointing outcomes? Then, attempt to replicate the beliefs from the successful outcomes to the current situation. In addition, Dr. Tisser recommends the technique of writing your goals down as if you had already achieved them (in the past or present tense). Doing this can help you to visualize success, a method which has often been used by successful athletes.

Financial Tips for Medical Residents Dr. Tisser shares three key financial tips for residents: 1. get into a federal loan repayment plan, 2. avoid credit card debt, and 3. get disability insurance. Regarding 1, these federal plans will allocate your payment amount depending on your income. And although private loan refinancing options can be tempting, with all the uncertainty in the US at the moment, it is safer to stick with a federal loan. Regarding 2, it can be difficult, but it is good to avoid this for the sake of your attending years. Regarding 3, if anything were to happen to you, preventing you from practicing medicine, the $5000 a month would be invaluable.

Tips to Prepare for a Career in Academic Medicine To prepare for a career in academic medicine, interested residents and medical students should participate in projects that deal with the science of learning and educating. If such programs do not exist at their institution, the interested student/resident should initiate a program.

Listen to Dr. Tisser’s podcast Talk2MeDoc. Learn more about Dr. Tisser Tisser on his website. Check out his LinkedIn, Facebook, Instagram, and Twitter profiles.

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE! Do check out Read This Before Medical School.

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Dr. Nina Lum shares advice for International Medical Graduates (IMGs) in how to be competitive with US graduates when it comes to landing a residency.

• [01:29] The Ego Problem in Academic Medicine
• [03:51] Why Nina Creates Content for IMGs
• [07:28] Social, Academic and Financial Challenges of IMGs
• [10:17] Why IMGs Should Plan Early for Residency
• [14:45] How to Get a Strong Letter of Recommendation for Residency
• [21:22] How IMGs Should Respond to the New Pass/Fail Step 1 Exam
• [25:52] How to Gain Specialized Experience Outside Clinical Rotations

Dr. Nina Lum is a family medicine hospitalist and the host of the IMG Roadmap Podcast as well as a course and blog.

After completing her residency, Dr. Lum managed to secure a well-paying position, with a block schedule (one week on/one week off). She began to think about the struggles that she faced to get to this point, and she felt sick and tired of watching fellow IMGs stumbling and struggling on three main problems:

1. Writing applications
2. Networking
3. Competing with their US graduate counterparts.

She narrowed down the problem to a lack of information, a lack of specific knowledge, and a lack of mentorship. So, Dr. Lum decided to create content for IMGs.

Also, there are three main challenges faced by IMG students:

1. Social challenges, which include stereotypes and stigmas.
2. Academic challenges, like being assigned to only community-based residency programs, instead of getting exposure from both community programs and academic facilities.
3. Financial challenges, like not having enough money to get the best resources to prepare for an exam.

Dr. Lum encourages IMGs to prepare early on, gathering specialty-specific information before beginning rotations, because later on they will be too caught up with preparing for their board exams.

Dr. Lum has designed a method for getting a good recommendation. Firstly, do two to three rotations in your desired specialty, so that you get more than one or two letters of recommendation for residency. Secondly, before you begin a rotation, understand the flow of your rotation, who you will be interacting with (attending versus resident) etc, so that you feel comfortable and so that you can identify a potential recommendation letter writer. The letter writer should be the highest ranking person on the team — usually an attending.

Thirdly, before you begin the rotation, contact your attending physician and ask them for the resources that you need to read up on to excel at your rotation. For example, the books, sites or research platforms that they use as a reference. This demonstrates that you are eager to learn. Fourthly, during the rotation, show up and be engaged. Volunteer for tasks, even if they are menial tasks. Opt to present your patient, and use question banks to engage in critical thinking. Next, at the end of the first week of your rotation, ask your attending physician what you should do to get a strong letter of recommendation later on.

With regards to the new pass/fail Step 1 Board Exam, Dr. Lum encourages IMGs to continue to prepare as usual. She suspects that there may still be some sort of categorization of students who perform better or worse. But regardless, basic sciences are an important part of a medical education, and students should be intrinsically motivated to learn it.

For IMGs who only decide on a specialty after completing their clinical rotations, Dr. Lum encourages them to participate in clinical observerships or other experiences in their desired specialties. Although it is ideal to do a clinical rotation in your specialty, it is not the end of the world if you do not, and you can pursue observerships. It is important to filter out good versus predatory observerships. A good rule of thumb is to choose observerships that are affiliated with a multidisciplinary teaching program, because these are vetted by the Accredited Council for Graduate Medical Education (ACGME).

Check out Dr. Lum’s e-book The IMG Guide to Clinical Rotations on the US Wards. Check out Dr. Nina Lum’s website which includes IMG-focused blog posts, a podcast and a course. Do also check out her Instagram.

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE! Do check out Read This Before Medical School.

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Renee Davis talks about educational technology in nursing, its benefits, and how it overlaps with other healthcare education designs and platforms.

• [01:11] How Renee Got Into Nursing Education
• [04:03] Renee’s Most Significant Experience in Nursing
• [09:01] How to Use EdTech in Academic Healthcare Education
• [12:58] to Integrate EdTech into Clinical Healthcare Education
• [15:54] Classroom Techniques for Keeping Students Active and Entertained
• [23:30] Educational Software and Educational Apps for the Classroom
• [29:36] Major Problems in Nursing Education

Renee Davis has been a registered nurse for eighteen years. She became interested in a career in healthcare as a teenager, and initially looked into becoming a physical therapist. When her mother encouraged her to look into nursing, she reluctantly agreed. She knew the difficulties of a nursing career from her sister who was twelve years older and a nurse, and she wasn't sure she was cut out for it. Renee soon found that she liked the nursing course material. After working in various nursing specialties, she developed a passion for education during a stint as a home care nurse which involved patient education. Accepting a gig as a clinical instructor was her first step on the path towards a career in nursing education.

As for one of the most significant experiences of her nursing education career, Renee cites an experience she had in Nursing academia. She recalls the first academic class that she taught, where she was shocked to see that most students used laptops or other devices instead of notebooks. This was when she saw the impact and necessity of integrating ed tech in Nursing Education.

Renee often includes interactive activities such as polls, games, and group presentations into her nursing education learning environment. Simply “spewing” information does not work, according to her. Instead, educators must be brave enough to switch from the traditional passive “lecturing” mindset, towards engaging their students in active learning. Educational technology can be a marvelous tool to aid active learning.

Instead of telling students to shut off their mobile devices during class, Renee uses these mobile devices in her activities. Her classes are often interrupted by polls using the Polls Everywhere software. She sometimes implements a flipped classroom model where students are expected to read up beforehand on a topic, and come to class prepared to present on it, or discuss it. Besides Polls Everywhere, Renee recommends other educational software and apps such as Mentimeter for polling and presentations, and Voice Thread and Flipgrid for real-time video discussions between students and teachers. She also recommends Google products such as Google Slides and Google Docs which allow real-time edits.

Although Renee has extensive experience in Education, rather than a clinical setting, she believes that active learning techniques can be implemented in a clinical education setting as well. She cites pre and post-conference meetings, where instructors might give students assignments as good opportunities to incorporate interactive techniques. However, she acknowledges that when actual clinical activities are occurring, it might not be feasible to focus on active learning, because the focus will be patient care.

Renee knows that the major hurdle in incorporating active learning techniques and education technology in healthcare education, is not that instructors simply refuse to change. Rather, the instructors get overwhelmed by the novelty and difficulty of trying something new. She affirms Chase’s recommendation that instructors learn one educational software at a time, maybe once a week or once a month, so as to not get overwhelmed. More broadly, Renee wants to see more openness towards educational technology. Even as she speaks at national conferences, she often has to use presentation applications such as PowerPoint instead of other web-based presentation products, due to WiFi not being guaranteed-she thinks this is an area that needs to be addressed, especially in 2020.

Check out Renee’s LinkedIn profile, website, Twitter page and Facebook page.

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE! Do check out Read This Before Medical School.

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Chase DiMarco gains insights from Dr. Elsie Koh about interventional radiology, goal setting, and leadership skills essential to med students and physicians.

• [02:05] What an Interventional Radiologist Does
• [03:18] How Elsie Began Her Career in Interventional Radiology
• [04:54] Advice for Medical Students When Choosing Rotations
• [06:29] The Importance of Having a Dream/Vision
• [11:17] The Three Types of Goals
• [12:49] Finding Good Mentors and Peers
• [15:31] Tips for Teachers and Preceptors

Dr. Elsie Koh was introduced to interventional radiology during a clerkship in her fourth year of medical school. Interventional radiology involves doing procedures or minimally invasive surgery under the guidance of machinery like ultrasounds, MRIs, and CT scans. This specialization is suitable for students who are interested in tech, enjoy interacting with students, and are good at working with their hands. Although interventional radiology is present in clinical settings, it is also applicable in academia.

Medical students should take the initiative to immerse themselves in different fields rather than relying on luck to give them direction. They should take the time to think about whether or not they are interested in patient contact, research, differential diagnoses, etc. as they choose their medical school rotations, electives, or specialties.

Dr. Elsie Koh believes that the biggest struggle that medical students can face is themselves. Students need to take advantage of online resources and books to cultivate leadership, professionalism, and self-improvement in medicine. She shares an anecdote about Jim Carrey, who would park himself in bookstores to read self-improvement books. As a starving actor, Carrey even wrote himself a check for 10 million dollars and had a vision and belief that his first gig would be for 10 million dollars. Sure enough, three years later, he landed his first movie “Dumb and Dumber” for 10 million dollars.

Although medical students do not need to write checks for 10 million dollars, Dr. Koh emphasizes the importance of having a vision, rather than just focusing on day-to-day work. Write your vision down and repeat it. Do not be afraid to speak out and take initiative to achieve it. Each person should have three types of goals:

1. Immediately achievable goals, such as a daily to-do list.
2. Goals achievable with small amounts of additional effort, like upgrading your Jeep model.
3. Goals that are large, and difficult to achieve.

Each day, we should try to accomplish three tasks related to these goals.

She is also a proponent of finding strong mentors and peers. To be a great leader, you have to be a great follower. Think about someone whose life and career you admire, and emulate them, even if they are not directly mentoring you. As for peers, filter out your friend group to avoid naysayers. Surround yourself with people who attract you with their positive attitudes. The five people with whom you spend the most time will influence you the most.

To be a great preceptor or physician leader, you need to be approachable and to listen to your students. Let your students come back to you with feedback, and even personal criticism — this is the best path to success and effectiveness. Be there for your students, and be attuned to what they need. Walk in humility, and avoid overconfidence.

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE!

Check out the YouTube channel LEAD Physician, by Elsie Koh, MD EMHL, Elsie’s Facebook page, Elsie’s LinkedIn profile, Elsie’s Twitter page, and Elsie’s Instagram

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Dr. Dan Rosenbush talks about #Students_Against_COVID’s database of clinical resources for medical students and the infodemic resulting from COVID-19.

• [01:13] The Purpose of #Students_Against_COVID
• [03:02] How to Curate and Assess Research and Information
• [10:22] The Infodemic & The Limitations of Knowledge
• [16:05] The Mistrust of Professional Health Organizations
• [18:30] Physicians as Effective Information Disseminators
• [20:47] Categories in #Students_Against_COVID’s Clinical Resource Database
• [22:49] The Safe Hands Challenge

Chase DiMarco talks to Dr. Dan Rosenbush, a D.O., a PH, and a first-year family medicine resident at St Margaret’s in Pittsburgh, PA. He is also a team lead for #Students_Against_COVID. Chase and Dan talk about #Students_Against_COVID’s database of clinical resources for medical students, the infodemic resulting from COVID-19, and tips for curating and assessing the research that you read.

#Students_Against_COVID began earlier this year as the result of a Twitter post by a medical student in Michigan, asking how people were using their time to combat COVID. Dr. Rosenbush communicated that he had been working on clinical education and information dissemination at his medical school. As a result of this interaction, #Students_Against_COVID was formed. It is a movement comprised of 175+ volunteers, 36+ languages and massive student organizations from over 45+ countries, joining forces with one aim in mind: to help respond to the COVID-19 pandemic.

One of the resources that #Students_Against_COVID provides is a single-page coronavirus clinical resources database for medical students. The coronavirus database includes recommended COVID resources, links to relevant professional organizations, clinical guides, research collections, volunteer opportunities, guides for special populations such as the homeless, and more. The members of #Students_Against_COVID curate and update the information on the page.

During the curation process for the COVID database, the students use several rules of thumb:

1. Look for articles from well-respected authors, journals, or organizations.
2. Look at how well an article fits with the trend of prior research.
3. Familiarize themselves with statistical reporting to allow more accurate interpretation of the results.
4. Think about how the study fits into the bigger picture and how it influences patient treatment.

Overall, Dr. Rosenbush recommends that medical students cultivate the skill of accurately interpreting research, and delve more into fields like epidemiology and statistics.

For the public more generally, there has recently been an “infodemic” – lots of information is being transmitted, especially due to social media, but not all the information is of high quality. Dr. Rosenbush emphasizes that the public must understand that every piece of information or research has its limitations. This is built into scientific studies, where almost every paper has a section detailing limitations. However, information shared on social media is often shared with disproportionate confidence.

Although all information is limited, Dr. Rosenbush encourages people to look to professional organizations. These organizations have a track record of and a strong background in providing quality information, and for interpreting quick-moving data, like COVID dat. It is unlikely that these organizations have nefarious aims. Chase and Dr. Rosenbush also agree that physicians are in a unique position to provide clinical education about coronavirus to their patients, who have a relationship with them and trust them.

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE!

Additionally, check out http://www.sacov19.com/ for access to the clinical resource database mentioned in this podcast, and for other student initiatives. You can also access the American College of Physicians (ACP) Physician’s Guide to COVID-19. For resources on interpreting COVID news, check out The COVID Tracking Project. For information on scientific research regarding COVID, check out the NIH page on coronavirus.

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Dr. David Rogers talks about why mentorship is important in medical school, tips for finding a mentor, and what to expect from the relationship.

• [01:10] Dr. Rogers’ Background in Education
• [02:55] How Mentors & Mentees Can Energize One Another
• [06:23] Mentorship Constellations or Networks
• [12:34] The Three-Person Team Mentorship Model
• [18:27] Developing a Good Mentor-Mentee Relationship
• [21:59] Finding a Mentor
• [28:28] Unhealthy Mentor-Mentee Relationships

Dr. Rogers talks about the reciprocal nature of a mentoring relationship. A good mentor energizes – and is in turn energized by their mentees. Mentees must realize they are integral and valuable to the process. And mentors must take an interest in their mentees, knowing that it is a privilege to guide and spend time with them.

Especially during the times of COVID-19, it can be difficult to find a single mentor who is directly related to your interests and background. Dr. Rogers himself recalls struggling to find a mentor who was involved in teaching and education, which was his area of academic interest in medical school. Instead, he recommends expanding your idea of mentorship and seeking out a network, or a “mentorship constellation” of people from various backgrounds.

Dr. Rogers supports the three-person team mentorship model, consisting of the mentee, a peer mentor, and a senior mentor. The senior mentor should be contacted only several times a year and can help make big career connections. The peer mentor can work more closely with you. For example, they can provide advice on transitioning from medical school into residency.

Finding peer mentors does not have to be a formal task. Instead, you can ease into it without making an official request. You can also ask your dean for help in finding a peer who might be interested. For senior mentors, it is best to avoid asking them directly if they will be your mentor. Instead, ask something like “can I touch base with you a couple of times a year?” This increases the likelihood that the senior mentor says yes because they do not have to worry that you will be constantly pinging them.

Dr. Rogers gives several tips for developing a good mentor-mentee relationship:

1. It is better if the mentee drives the relationship, such as setting up appointments or preparing questions,.
2. The mentor should cultivate the medical ethic of beneficence and a strong desire to see their mentee succeed.
3. The mentor should be transparent and should be willing to share their mistakes, as well as their successes. As Dr. Rogers says, “make your own mistakes. Don’t make mine over and over again.”

Dr. David Rogers is a Professor of Surgery and Pediatrics, Senior Associate Dean of Faculty Affairs & Professional Development, and Chief Wellness Officer for the School of Medicine at the University of Alabama Birmingham.

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE!

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Chase DiMarco chats with Dr. Bradley Block, who is an ear, nose and throat (ENT) specialist based out of New York and host of the Physician’s Guide to Doctoring podcast which covers “everything doctors should have been learning when they were busy learning the Krebs cycle.” Speaking from the perspective of an attending physician who has mentored many residents, Brad breaks down the experience of being an ENT resident, common struggles, and tips to become a better ENT.

[01:21] Brad’s Most Outrageous Observation in Academic Medicine

[04:29] Brad’s Background

[08:41] Common Struggles of ENT residents

[13:13] Tips for Residents

[19:19] Important Learning Experiences for ENT Residents

[22:28] Brad’s Biggest Desired Change in Medicine in the Next 5-10 Years

[28:18] Further Resources

In terms of the struggles of ENT residents, the first is that learning how to treat ears is very difficult. It takes considerable skill to learn how to tell the difference between a healthy versus infected eardrum, for example. This is especially difficult when dealing with children, who are a large proportion of patients, because children tend to wriggle, and have very small ears making diagnosing ear infections even more tricky. One tip to overcome this is to practice detecting ear infections in adults first, which will make it easier when you have to treat children. Another struggle is determining where you are in your educational journey. There are three stages to become a successful ENT:

1. Becoming an effective information collector
2. Arriving at diagnoses
3. Making management decisions.

Perfecting the first stage involves learning how to only focus on important information, and leaving out irrelevant facts about the patient. Perfecting the second stage involves learning how to use the facts to arrive at a diagnosis. And the third stage involves thinking about how to further treat the patient. For example, should you perform further tests? Should you prescribe a particular drug? Only by developing an awareness of where you stand amongst the three ENT learning stages can you take steps to move on to the next.

Brad's advice for otolaryngology residents in particular, is to dive into surgery, which is often the most difficult set of skills to learn as an ENT. Honing these skills can be key to becoming a successful otolaryngologist. By diving into surgery, the attending physicians become more comfortable with you, you get more skilled, and in turn the attending physicians become even more comfortable with you. A feedback loop. For medical students, those preparing for residency & residents more generally, Brad urges them to improve their soft skills such as how to interact with patients, getting the patient information that is relevant to a diagnosis, cultivating a good relationship with your preceptor etc. Brad also urges humility, and a willingness to listen, learn and improve. He recalls being defensive when people advised and criticized him earlier in his career — and strongly advises against this.

When asked about the biggest change that he would like to see in medicine in the next five to ten years, Brad emphasized that education should be evidence-based. Instead of urging students towards the rote memorization of facts, Brad proposes a different approach: 1. determine the definition of a “good” doctor and 2. develop materials that help students to achieve this definition. For example, teaching them how to interact with patients, how to be aware of their potential biases towards patients from a given socio-economic background, and how to become more effective and efficient learners all around.

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Mnemonist Mastermind FB Group today and learn more about study methods, memory techniques, and MORE! Do also check out Dr. Bradley Block’s podcast, The Physician’s Guide to Doctoring.

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Chase DiMarco talks with Dr. Charmaine Gregory, nocturnist emergency physician, host of the Fearless Freedom with Dr. G podcast, and co-author of several books including the Chronicles of Women in White Coats. Charmaine shares tips for navigating an emergency medicine rotation and tips for building constructive student/preceptor relationships.

[4:10] Charmaine’s Background in Emergency Medicine Education

[5:58] Tip 1: Assume the Most Dangerous Entity

[8:36] Tip 2: Ask the Right Questions

[10:28] Tip 3: Build Rapport with Patients

[14:14] Common Obstacles

[17:18] Student/Preceptor Relationships

[25:23] Recommended Resources

Charmaine’s first tip is that students should ask the following question:

What is the most dangerous entity that is associated with this particular chief complaint?

Unlike other specialties, which often require a broad understanding of a patient’s case and a slow & careful diagnosis, emergency medicine is a “high-stakes, low-data” business. Students must assess the situation quickly, and take steps to prevent things that could kill or adversely harm the patient in the short-term.

However, the “chief complaint” in Charmaine’s recommended question is not necessarily what patients say when they first come into the ER. This is why she urges students to learn how to ‘ask the right questions.’ Often, this means keeping questions open-ended. This is to avoid biasing the diagnosis towards the first thing that a patient says and to try to get to the true chief complaint.

Finally, as a third tip, students must learn to build rapport with patients, because this is the best way to get accurate information from them. Common tips to build rapport include utilizing the patient’s name, keeping eye contact and prioritizing a warm interaction.

With respect to student/preceptor relationships, students should “just ask” if they are uncertain of their performance or of preceptor expectations. This is a good way to prevent surprising results at mid-rotation evaluations. From the perspective of preceptors, they should give feedback consistently, preferably after every shift. This encourages students to reflect on their performance and conduct “intentional learning.” Another tip that Charmaine gives to preceptors is to use the “teach back” technique. Every time a preceptor explains something to a student, the student should be able to teach it back to the preceptor.

We hope that this podcast has given you some information and confidence to prepare for your emergency medicine rotation! Here are some additional resources that you can use to continue equipping yourself for this rotation:

Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 9th Edition [Book]

Emergency Medicine Secrets [Book]

Fearless Freedom with Dr. G [Podcast]

The Chronicles of Women in White Coats [Book]

Charmaine’s Website, Instagram, Twitter

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Student Mentor FB Group to ask questions and receive guidance related to clinical rotations and clinical knowledge!

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[7:03] Work-Life Balance

[9:04] Personality - Physician, Know Thyself

[12:10] Academic Material

[13:21] Clinical Procedures

[15:00] A Responsibility to Love Your Work

[24:01] Financial Compensation

[25:47] Further Resources

Students often wonder how to select a medical specialty. What will fit with their personality, their lifestyle, and be enjoyable? Well, today we are joined by Dr. Brent Lacey. He is a gastroenterologist and the founder of the Scope of Practice which helps physicians gain business knowledge and financial independence. Today we are going to investigate some of the questions every student should answer when considering their future specialty.

As a medical student, Dr. Lacey asked residents how they chose a specialty and had many residents reply that it's simply what they like to do. He found these kinds of answers unsatisfactory, and longed for a clearer roadmap and more concrete criteria for choosing a specialty. It is important to break down any justification for choosing a specialty into its component parts, to determine which criteria are valid versus less valid.

Dr. Lacey deems factors such as work-life balance and salary to be less important criteria in deciding on a specialty. A person has the agency to regulate these two factors regardless of their chosen specialty. In other words, these two criteria are person-dependent, rather than specialty-dependent. Rather, Dr. Lacey places an emphasis on three key specialty-dependent criteria: 1. affinity for performing the clinical procedures central to a specialty, 2. affinity for reading the academic content & papers of a specialty and 3. affinity to the personalities of people who tend to work within a given specialty.

Dr. Lacey says that a specialist should ‘love 99% of what they do, but not hate the remaining 1%.’ Citing how he overcame his initial aversion to treating patients with Irritable Bowel Syndrome (IBS) as his remaining 1% within gastroenterology, Dr. Lacey explains that physicians have a responsibility to themselves and to their patients to “bloom where they are planted.” Physicians should never settle for hating even 1% of their daily tasks as a specialist. If this is impossible, the specialty should be ruled out. To help students to tease out the 99% and 1% of a given specialty, Dr. Lacey recommends this strategy: as many people as possible within a specialty to tell you the best and worst thing about their specialty. Then, think about your own aptitude in navigating and appreciating the most challenging aspects of a specialty.

Students should use the various resources available to medical students who are trying to decide on a specialty, such as looking to one’s advisors, national medical societies and other books and materials. For resources on navigating being a physician in the real world, check out the Scope of Practice website. As Dr. Lacey stresses in today’s show, “if you want to be a leader, you’ve got to be a reader.”

Check out The Scope of Practice Podcast, Dr. Lacey’s curated Reading List, and these articles on Early Career and Young Professionals Resources and Choosing the Right Specialty!

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Student Mentor FB Group to ask questions and receive guidance related to clinical rotations and clinical knowledge!

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In today’s episode Chase DiMarco talks with Dr. Jack Ende, Professor of Medicine at Perelman Medical School at the University of Pennsylvania. Jack was previously the President of the American College of Physicians and Series Editor of the seven-volume ‘Teaching Medicine’. He joins us today to discuss the theory and practice of teaching academic medicine, along with how students and preceptors can improve clinical interactions.

Jack always had a fascination and appreciation for his teachers and their process. Once he started on his medical education path, he found the opportunity to work in teams and the informal teaching style that medical education afforded more enjoyable than other, more rigid types of education.

The greatest takeaway from his own mentors has been the importance of having an organized vision for your teaching goals. This helps you to stay focused. Jack continues by discussing the various struggles students face coming into a clinical setting. The transition is abrupt and structure unclear, so it can be hard to know what is expected of you. Students should understand that the focus should be on the patient.

Speaking further about his organized vision approach, Jack explains that it acknowledges the impromptu nature of medical education, but should still retain an overarching structure. The goal should be to empower students and the focus should be on the process, not the product.

There are challenges to clinical teaching. The content can often be broad, students are at different learning levels and the environment is often distracting. Jack believes the emphasis should be on bedside diagnosis and physical exams. Students should be engaged and involved, so forge both intellectual and human connections with your students. There are no shortcuts or easy answers, but nothing takes precedent over patient care.

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Student Mentor FB Group to ask questions and receive guidance related to clinical rotations and clinical knowledge!

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In today’s episode, Chase DiMarco talks with Renée Hendriks, a PhD candidate at the Center of Innovation for Medical Education at the Leiden University Medical Center. Renée has done a great deal of research into MOOCs (Massive Open Online Classes) and what makes them effective. Together they discuss the evolution of online learning, the importance of course design and the future of the medium for medical education.

When it comes to online learning, it is becoming more prevalent and Renée saw a need to look at its effectiveness. Chase talks about the push back he has seen against online learning and Renée acknowledges this by explaining that with proper design and implementation, online courses are just as effective as face-to -face learning.

Speaking about her research, Renée tells us that she has examined 33 different medical MOOCs on a variety of subjects to see what they offer. As well as quality, range of topics and assessment methods, she noticed that they often had teaching modes that facilitated construction of knowledge. This is something often missing in other MOOCs.

An important factor in any MOOC is creating active learning. Renée believes that to be effective, the courses have to include activation and motivation. There is also scope for creating greater personalization of learning experiences through student data analysis.

Staying on the topic of student issues, Chase and Renée end the episode by discussing how utilizing the 11 principles of course design can allow for educators to create engaging, trackable learning. Renée hopes that the future of education is geared towards a greater emphasis on self-regulated learning to create a strong knowledge base.

Find Renée’s article here:

Twelve Tips for Integrating Massive Open Online Course Content into Classroom Teaching

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In today’s episode, Chase DiMarco talks with William Davis, PhD, Assistant Professor of Science and Technology Studies and Chair of the Humanities and Social Sciences Department at California Northstate University College of Health Sciences. Together they discuss the role of technology in medical education, how to improve the scope of disciplines included in teaching and improving the patient/practitioner relationship.

Students sometimes come to study medicine expecting they won’t need social sciences. This leads to a discussion about the need to expand educational boundaries. William says there should be an interdisciplinary and collaborative approach to teaching between departments to allow an integrated teaching approach.

Due to the nature of the MCAT, William believes that students focus only on a very narrow spectrum of learning. This can lead to a flattening of patients, reducing them to charts as opposed to the three-dimensional people they are.

There is a need for communication between educational tiers, which William breaks down. A greater efforts to understand other departments and disciplines to create a more rounded teaching approach is ideal. There is not one solution for expanding communication but there should be a balance between standardisation and individuality.

William and Chase go on to talk about the patient care setting in Health 2.0. They discuss the use of scribes in a medical setting and how saleable and reliable it can be. Is it worth the trade offs to create better patient/physician relationships?

Staying on the topic of technology, William and Chase end the episode by discussing how to successfully create online learning spaces. Both agree that interactivity and attention to course design are paramount to overcome the danger of passive learning. William hopes that this is a conversation that can continue and that educators can take into account what students want and need.

Find Williams’ article here:

A Gathering Crowd: Intelligence and Medicine

Contact William here:

William.Davis@cnsu.edu

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In today’s episode, Chase DiMarco talks with Dr. Nicole Washington. Nicole joins Chase to discuss some difficult and uncomfortable topics that we all have to confront. This episode will focus on the issues of race, racism and representation within the healthcare and education systems.

Originally from Louisiana, Nicole moved to Oklahoma to attend medical school 20 years ago. Nicole's previous experiences in education had been significantly more diverse but now, out of 90 students in her class, there were only 2 black students.

Nicole talks about the constant need to evaluate the attitudes of others towards her. She goes on to describe her experiences with patients who either don’t want her to treat them or assume she is there to clean the hospital room just because of her race.

Nicole and Chase go on to discuss how to avoid performative activism and encourage not only diversity, but inclusion. For Nicole, it is necessary that administrations and companies start intentionally widening their search pools. People also need to understand their own biases and learn to prevent them from influencing decision making.

Chase then asks how people can be better allies within the healthcare system. Nicole explains that just like in medicine, people should research and get a basic understanding of the issues. Show that you are actively working to support people of color by independently seeking and understanding cultural differences.

Nicole and Chase end this episode by discussing how this is not just a political issue, rather it affects all aspects of our society. People in the healthcare industry have to acknowledge going forward that the current climate has an effect on the physical and mental health of black and POC patients, physicians, and students. Healthcare professionals should be asking uncomfortable questions to create better treatment plans. Everyone has to understand what privilege means, their level of privilege, and avoid assumptions to improve healthcare and education.

Resources

Anti-Racist Resources: Compilation 1, Compilation 2

Medical Apartheid

Why Are All The Black Kids Sitting Together

You can also find out more about Dr. Nicole from her website and if you are in the area feel free to join the Oklahoma Black Physician Alliance to learn more about how you can help in the community!

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Welcome to the SECOND SEASON! It's been an interesting experience gathering topics for these episodes due to the rapidly changing medical education and social realms. This season of the 1-Minute Preceptor Podcast is going to bring you the same valuable clinical rotations and clerkship advice, but with a much broader view of what it means to succeed in your clinical experiences.

If you are looking for advice for specific clerkships, advice for Letters of Recommendation, or resources to succeed in your studies we still got you! In addition, we will touch on topics such as leadership, mentorship, and professionalism in clinical medicine. We will also bring in brave guests to discuss social topics relevant to academic medicine and societal changes that we may all help shape.

If you want to find out the best advice for your 3rd and 4th years in medical school, early residency, or improve on your skills as a preceptor you have come to the right place!

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Dr. Ryan Neuhofel is a family physician based out of Lawrence, Kansas. He is also the past President of the Direct Primary Care Alliance which advocates for a stronger community and physician-led mentorship through DPC medicine. He likens DPC to the “Costco” of primary care with an emphasis on disease prevention.

Dr. Neuhfel states that having his own clinic allows for greater freedom and time to keep updated on education and medical resources. Networking and learning from each other is also a great way to maintain education. This model of clinical practice allows for “true primary care” through regaining physician autonomy and limiting outside interference. More time allows for a greater patient story and to deep think about the patient's experience and healthcare concerns. Jumping into testing is not always the best path. Being outside of a hospital setting also adds additional responsibility, such as when to send a patient to the Emergency Department.

DPC physicians have more personal time and patient time. This also translates into better patient experiences, more time for continuing education, and more time for friends and family. Future preceptors interested in DPC also have a strong network and support from others in the community to assist with knowledge acquisition and updating. Current physicians can find DPC physicians in a wide array of social media locations, podcasts, and within the DPC Alliance.

DPC is a great transition for medical students and allows them to go from foundational knowledge to clinical diagnosis and medicine. They have more time to discuss the pathophysiology of a current patient with their preceptors. This can be a great, low-stress bridging experience in a learner's medical education. Students can join the DPC Alliance for free and even join their Mentorship Program. Finding a great clinical experience is one of the most important standards a student can set for themselves to progress to the next stage.

Ryan suggests that a strong preceptor should talk out loud to their students and explain the thought process. Getting this type of direct insight into the physician's clinical paradigm can add great value and act as a guide for students. And ask questions! There is no better way to get direct feedback then to ask well thought out questions to your preceptor at the right times.

Resources

DPC Alliance

DPC University

DPC Mentorship Program

Connect with Dr. Ryan Neuhofel on Twitter!

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Dr. Gerald Diaz joins us today with his vast experiences in clinical medicine and medical education. He began his medical journey in an anesthesiology residency before settling in as an internal medicine physician. He also has a passion for medical education and is a co-founder of GrepMed, an online medical image repository. he has formed a crowdsourced education platform for referencing clinically relevant medical images.

Gerald believes that one skill that is very underappreciated in medical education is the ability to read a chest x-ray. Though one of the most common imaging formats a student or physician will find, it is still very easy to overlook non-common findings. Felson's Principles of Chest Roentgenology is a recommended resource for both students and physicians wishing to increase their skills.

Students should also be enthusiastic and enjoy the time they have in the clinical setting. This is a time for learning and professionalism, but also a time for fun and building social bonds! Dr. Diaz also recommends practicing your presentation skills as often as possible. Giving a strong presentation to your attending will help a student shine and increase preceptor confidence. Likewise, a poor presentation may make the preceptor second-guessing your ability to move on in your education. Lastly, make sure to ask for a “strong” letter of recommendation. Not specifying this feature may lead to a preceptor writing a mediocre letter.

Future preceptors and educators should really have a desire to be there and interact with their colleagues. The day to day activities can be very time-consuming and stressful. Without a passion to learn and teach, these responsibilities can quickly lead to decreased enjoyment. There is definitely a “lifestyle aspect to academic medicine.” Proper goals and expectations can greatly influence the future outcomes of this educational environment.

A common complaint Dr. Diaz hears is that preceptors that micromanage are less effective and less appreciated by their students. Keeping up to date on the literature is also a necessity for all clinical instructors. Failing to do so when information is so readily available is unsafe and demonstrates a lack of professionalism or enthusiasm on the part of the preceptor.

Failure to set expectations up front as an attending can lead to uncertainty in the clinical environment. Gerald notes that even a brief 1-page summation of expectations can go a long way in clearing up any confusion.

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Josh Umbehr is the CEO of Atlas MD and a family physician in direct primary care. With over ten years of clinical education experience, he has many useful pearls on how to approach primary care education. He also covers a lot of business negotiating and business of medicine education material in their clinical rotations. Healthcare revolves around money and physicians should be well educated in many of the business aspects that they may be involved in.

In primary care, there are standard inpatient costs and times associated with them. However, with a non-insurance-based practice, physicians and students may have more time for patient discussion and forming stronger connections. There are often richer experiences available to students by running many of their own labs and procedures in comparison to insurance-based primary care clinics. The model allows for more flexibility, according to practitioners.

Strong preceptors are talented at phrasing their questions in the right. They take the time to educate their medical students and avoid “read my mind” questions. They help guide the learner past the textbook and how to find answers on their own. Clinical preceptors must also avoid using their learners as work-horses in order to maintain their busy schedules. There are many potential learning experiences that can occur each day and knowing which ones will benefit the student the most comes from experience. Although medical students must learn proper filling out and filing paperwork, this is not always a great learning opportunity.

Josh also states that an added benefit to learners and patients in the direct care model is that of time for decision making. There is much more time to decide if a patient should be referred out or if this is something that can be handled in-house and potentially lead to substantial savings. The other end of this is that it can be anxiety-provoking at times when patients are in a gray area. However, the decision options can be discussed more thoroughly in a DPC setting than in many insurance-based settings.

Dr. Umbehr recommends that students focus on a few key principles when they are on clinical rotations in primary care.

• Professionalism and leading by example is not only the ethical thing to do but also builds trust and helps to lead patients to be more honest with healthcare professionals.
• Keeping an open mind can greatly benefit learners. This can allow them to find answers that may not be top of the list or solutions outside the box. This can also allow them to listen and not simply “wait for their turn to talk.”
• Developing technology skills and communications also greatly impact the efficiency of our clinical training and should be a top consideration.

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Dr. Daniel Hochman is a board-certified psychiatrist with a private practice in Austin, TX. He is the creator of a revolutionary online addiction recovery program, selfrecovery.org. Dr. Hochman advocates for using strategies proven through hard science and describes them in ways that are easy to understand and incorporate into one’s life. In this episode, we will discuss how addition and recovery for patients and medical personnel is changing and the resources available to everyone.

He believes that good instruction fosters development. Those interested in clinical education must be able to analyze a student's abilities in a non-judgmental manner and reach them on a personal level. Knowing what is going on in an individual's life, including your medical learners, it the best way to truly assess the individual as a person. He believes creating an inviting and enjoyable environment is much more beneficial than a hyper-competitive one. The carrot. Not the stick.

In Daniel’s mind, certain actions by a preceptor or student can tell a lot about their personality. Those that lack respect or are abrasive in their interactions are going to struggle in medicine and in life. It signals that they may not have a true interest or calling in the field in front of them. These traits are also much more difficult to alter later on, which can lead to persistent conflicts in the workplace.

On the other hand, a student that makes a lot of mistakes but is applying their full effort does not ring as such a problem in his mind. This individual may be lacking some skills now. However, those can be more easily developed than altering one’s personality and outlook on life. Those that try and put in the effort have what it takes to be a successful clinician.

Students can also stand out in their psychology clinical rotations by showing up prepared. Know what you want to do, what you know, and where you need to go. Having this plan and sharing it with your preceptor can assure you are both on the same page. Also, when asking for a strong letter of recommendation these skills and personality traits will allow the preceptor to recognize you more and use those experiences in your letter.

For more information on Dr. Hochman’s materials, consider taking his free 6-Day Habit Challenge. You can also receive a 10% discount on his other courses by using the code “oneminute” during your purchase. His other courses include:

https://www.selfrecovery.org/addiction-recovery-toolbox/

https://www.selfrecovery.org/enroll

https://www.selfrecovery.org/addiction-toolbox-for-providers/

https://www.selfrecovery.org/addiction-toolbox-for-friends-and-family/

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Dr. Brian Dooreck is a private practice gastroenterologist in south Florida. He actively produces “Lunch with Dr. Dooreck” educational videos for the LinkedIn community and has 11 years of clinical education experience. Today, he will teach us about the concerns with teaching general education, specialty-related obstacles in education, and simple recommendations for learners and patients to follow for a healthier self.

Gastroenterology is an exciting mixture of procedures and follow-ups that gives practitioners and medical students a variable clinical experience. With specialties heavy in procedural tasks, the “see one, do one, teach one” model is still a great educational paradigm to follow. It covers not only the gastrointestinal tract but also many aspects of the hepatobiliary systems as well. Due to the broad coverage, it is a profession that almost everyone can relate to in some manner or another. After all, who hasn’t had an upset stomach or GI distress?

In GI, there are many fluids involved in the exams and procedures conducted. Dr. Dooreck emphasizes that the number one rule in safety is using your personal protective gear. Viral transmission of disease is a rare but important transmissible disease to be conscious of in this specialty. However, a preceptor should also focus on the conceptual knowledge of the students under them. The anatomy and physiology involved in these organ systems can easily be overlooked by students focused on board exam material.

Brian also wants to point out that medicine is an interactional dialogue between colleges. Teaching medicine should hold many of the same guidelines. In this way, teachers and students are closer to equals and can foster earnest and collaborative decision making and discussions.

Students would benefit greatly from having a genuine interest in the specialty if they desired a clinical experience in GI. Attending the procedures and taking initiative to learn specialty-related materials on one’s own time can allow a student to shine. Going home with a list of questions and topics to explore allows for active engagement in one’s own studies as well. Watch procedures online (such as from JOMI) to learn on your own time. Demonstrating commitment and effort are key requirements to attaining a strong letter of recommendation from your clinical rotations.

You can check out more from Dr. Dooreck via his website or by connecting with him on LinkedIn.

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Dr. Jeff Smith is a former residency director and current voluntary faculty member and assistant clinical professor at UCSD. He is an orthopaedic trauma surgeon and surgery coach that uses the 8 PRACTICEs of Highly Successful Surgeons to create a lifestyle-friendly practice. He also focuses on physician and student burnout and advocates for increased education around these topics.

Dr. Smith noticed during his education that the old methods of clinical medicine and education are not always as productive as traditionally thought. Instructing to do it one way because that is what the instructor did does not allow for personal development and growth. Updated models of adult education, being a proper role model, and those that do not give answers but assist learners in finding answers likely provide the greatest educational benefit.

Some preceptors may not maintain their education as well as others leading to older techniques being performed. Outdated information is not only a potential detriment to the medical student and resident under the preceptor’s guidance, but also may lead to patient care concerns. Staying updated on the medical literature and listening to your medical students – who may be more aware of recent educational trends – can be a great way to keep knowledge validated.

Learners may wish to be wary of anecdotal comments of preceptor abilities and online recommendations. These are often heavily biased and provide little relevant data to a medical student. Remember, learning can be overwhelming at times and part of the struggle is to learn your own methodology and clinical approach. Preceptors that are not providing you structured guidance – without giving answers – may be doing you a disservice.

Teachers thrive on the fact that you are gaining information and learning during your time with them. Make sure to be active and let to preceptor know what improvements you are noticing in your own studies. In the end, mindful awareness and effort throughout your rotations are key to a successful educational experience. Put in the effort and clarify all expectations with your preceptor. Pave your own way to success.

You can contact Jeff via email and visit SurgeonMasters.com for more information on his 8 PRACTICE Techniques.

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Dr. Tom Biernacki is a Residency Director in podiatric medicine. Similar to MD (allopathic physician) and DO (osteopathic physician) degrees, the DPM degree requires four years of medical school. They also have a mandated three-year residency, which is similar to many specialties in MD/DO pathways. It holds the most overlap with the medical specialty of orthopedics. However, podiatry handles many chronic diseases of the foot and ankle without the emergency and trauma care scenarios that an orthopedic surgeon may.

He states that preceptors that are patient and understanding with their students provide a greater support structure and more clinical education benefit. Those that are frequently angry, hurried, and condemning of their students are still in existence, and it may be difficult for a student to navigate these educational environments. Retention of information from these poor preceptors will likely be hampered by this negative learning avenue. Compassion for your students ultimately leads to better education and often better patient care.

He cautions residents and new preceptors not to move too fast in their clinical practice. It is easy to see the seasoned and experienced physicians moving efficiently and swiftly and wishing to do the same. Much of this comes with experience and it’s more important that every clinical educator and physician moves at their own pace. Speed can lead to patient safety concerns and other mistakes. It’s alright for physicians to admit when they need to gather their thoughts, when they need a break, and when they need help.

Dr. Biernacki also recommends that students show humility to their preceptors, other students, and the staff. No one appreciates a student that shows off and attempts to demonstrate superior knowledge to other staff members. This attitude and work ethic reflects more poorly on the student than poor grades or weak exam scores. Being open to learning is the key to being a great student, as is supporting your team and colleagues. People skills and professionalism are increasing in importance during residency selection process as well. And, as always, remember that “perfection” is not the goal. Enjoy your clinical experiences and you will derive much greater total benefit from the time spent.

Students are there to learn, but Dr. Biernacki warns that some students may incorrectly think that asking many questions counts as academic engagement. This can become problematic and interrupt the day's routines. It is important to not become a burden to your preceptor or others around you. When you make your preceptor's job easier that allows them more time to focus on your education and guidance as well. If listeners and readers were to take one thing away from this interview it would probably be this: “be a pleasant person to be around.” This can go very far in displaying a positive work ethic and forming a support system with your colleagues.

Resources

www.michiganfootdoctors.com

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Dr. Kenneth Fisher practiced as a nephrologist for 31 years, is the author of multiple books related to healthcare including most recently Understanding Healthcare: A Historical Perspective, and is Co-Founder Michigan Free Market Medical Association. Kenneth believes in a medical system without the middleman and with greater price transparency. Medical expenses would be paid by cash and healthcare accounts as opposed to medical insurance.

In clinical education for nephrology, the main focus is on patient care in a hospital setting. This can be through private practice or as an employee for the hospital. A preceptor interested in this specialty should be concerned with the quality of their ability and desire to teach the medical student. Understanding the thinking patterns of the student’s thought process is a key skill to develop. A preceptor must also be careful in double-checking all student work and assessments. Pharmacology and pathophysiology of kidney disease is a complicated mesh and overlooked data can lead to disaster.

Preceptors teaching in contemporary medical education need to make the learning environment conducive to deep thought. Inspiring students to come up with great questions is beneficial to both the student and more engaging for the preceptor. Electronic health records are a great impediment to the time allotted for student education. Encouraging more discussion about the student thinking process can build the knowledge base for the student and alert the preceptor into knowledge gaps.

Students learning in contemporary clinical medicine need to be aware of the complexities of modern medicine. With the system as is, time constraints that may be involved, and dedicated time needed for data entry students may have less time to learn. For nephrology, it is important to have a firm grasp of pathophysiology. Being aware that the learning environment may not be conducive to learning all clinical skills and techniques can also help students early in their education. This can lead to better communication about expectations between the student and the preceptor.

When considering asking a preceptor for a letter of recommendation, Dr. Fisher states that your performance is the number one indicator to consider. If you have performed well throughout your rotation, consider asking for a LoR from your preceptor.

For more information, feel free to contact Dr. Fisher via Twitter and download his free E-book. You can also find more on the Michigan Chapter, Free Market Medicine Assoc and find Kenneth’s books on his Amazon page or FreedomInHealthcare.org.

Our HOLIDAY SALE is still going on for a few more weeks! Get your discounted copy of Read This Before Medical School now! It is a great gift for peers, family, and students!

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Dr. Cindy Duke is a board-certified OBGYN and a reproductive endocrinologist based out of Nevada. Reproductive endocrinology is a specialization that focuses on the first twelve weeks of pregnancy and complications in that time frame. It is also an OBGYN specialty that works with both male and female patients. It allows medical students and physicians to see a patient base they would usually not see in a core medical clerkship such as those wishing to freeze eggs and sperm or about to undergo gender reassignment surgery.

She precepts a wide variety of clinical students from MD/DO students to nursing students. Medical students rotating through will often have problem-based learning (PBL) coursework that helps to supplement their clinical training and problem-solving skills.

She believes strongly that a preceptor should be a clinical educator with a passion for the training they will be implementing. Those that are obligated to precept may lack this intrinsic motivation and the clinical rotation may suffer for all parties involved. It can be a very rewarding experience and the preceptor may learn as much as the student. Also, setting aside time at the end of each day to go over student questions and discuss complicated patients is a great benefit to the learning environment. This offers students a “safe space” to ask questions without judgment.

For physician and patient safety, it is important to let the medical student know what to expect in a medical specialty learning environment. Explaining the unique precautions to that clinic or prohibited actions ahead of time is a proactive measure for everyone’s safety. Lastly, facilitating the opportunity for medical students to experience those tasks that are allowed create a safe medical and learning environment.

Cindy recommends that medical students rotating in any OBGYN rotation or specialty become very familiar with female reproductive cycles. Knowing the menstrual cycle, hormonal fluctuations, and how to influence or alter these cycles is a keystone of reproductive endocrinology. Prior to clinical rotations, she encourages medical students to think of three questions or topics they are interested in regarding the clerkship. This allows a preceptor to be aware of this opportunity if it arises and share it with the student.

When asking for Letters of Recommendation, a medical student that is enthusiastic when asking is going to have much greater success. Cindy points out that a student may want to use a script. Stating, “here are some things I really liked about my rotation with you” will give the preceptor information on which to base their LoR. You do not need to feign interest in the specialty if you do not plan to go into that specialty. You can also ask a preceptor to write a general letter at any point. Then, when a medical student decides on a specialty, contact the preceptor and ask if it can be tailored to that career path.

Dr. Duke is also the host of the GriPSSI Podcast! Catch new episodes to get into the mind of a fertility clinic physician.

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Residency program director, author, entrepreneur, and family medicine physician, Ted O’Connell, joins us today to discuss precepting of both medical students and residents in a variety of medical settings. He has many years as both a clinical educator as well as authoring educational review textbooks for students. His free question bank allows students to study medically relevant topics without the burden of extra expenses.

Ted acknowledges that a preceptor must have a strong desire and interest in teaching. Without this drive, it can be very difficult to adequately assess students and convey knowledge to their current level of comprehension. Keeping up with Faculty Development materials available within and outside of your institution can help keep updated on educational processes. He also believes that is it vitally important for students and preceptors to discuss their expectations for a clinical rotation in advance to provide a foundation for the medical experience.

A student that is proactive in their clinical education will gain the most benefit from their time. This can even begin BEFORE the clinical rotation begins by reaching out to the Rotation Coordinator for advice and researching potential residents and attendings one might have. Doing a little research on their interest can open up the conversation later on and provide an avenue for closer bonds to be formed.

Being proactive with patient care is also a student's strength that can increase the preceptor’s view of the student’s competency level. Reading the patient history and other records ahead of time allows students to demonstrate more ownership of their patients. This not only can save the preceptor valuable time, but you may catch a routine lab draw or vaccination that could have otherwise been missed.

Students can prepare for clinical rotations by pretending they are on an isolated island and only they can save the patient. This may allow for more independent thinking and less reliance on residents or attendings for answers. They can also think aloud and explain their thought process as well, which allows for more exact feedback from their clinical preceptor. Independence in clinical tasks, being proactive, and following up on patients you have seen are things preceptor’s look for when a student asks for a Letter of Recommendation as well.

Read more of Dr. O’Connells work on his blog, including: Ten Actions to Ace Your Outpatient Rotations and How To Ask For A Great Letter Of Recommendation.

Ted is also the co-founder of the FREE content at Exam Circle and the CCO of InsideTheBoards. Try the All Audio Q-Bank for iOS to study on the go!

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Jason Mizell a colorectal surgeon and clerkship director from the University of Arkansas and has been running a Business of Medicine course for several years. Like many students, Jason started off with a desire for one specialty (pediatrics) and ended up discovering that another option was much more enjoyable for him. He emphasizes that this is very normal so students should keep an open mind and accept all challenges and opportunities that arise.

Preceptor’s understanding of their student's future goals and expectations can greatly influence the student-preceptor dynamic during clinical rotations. For instance, Jason realizes that only a small percentage of students will be going into a surgical specialty and as such he focuses his teaching content on more general needs. He also points out that there are significant differences in pre-clinical and clinical medicine which students need to be transitioned into (i.e.: colleague consults).

When discussing medical topics with medical and healthcare students, preceptors that think-aloud give the student insights into the thought process of clinical medical professionals. They can help students during their medical externships by pointing out the nuances that may otherwise be missed. Proper assessment of student competence and oversight are also extremely important not only for the educational environment but also for patient care.

A medical preceptor that sets their expectations for the students early is vital for an efficient learning system. In fact, UAMS created its own internal app that allows for constant access to learning objectives and expectations for each medical service which is easily accessible and updated. Also, letting the student take the driver seat during their clinical rotations is a great way to guide them while allowing open-ended reciprocity of ideas.

Medical and clinical students preparing for surgical rotations should prepare by researching the particular surgery and being aware of the patient history beforehand. Thinking about the situation as if the preceptor is not there, making decisions, and preparing for potential complications is a great way to stimulate one’s thought process pre-op. Lack of effort or interest is easily noticeable by the preceptor and will likely lead to a poor experience for all parties involved. Your activity and interest, as well as personal interactions with patients and preceptors, will greatly influence your Letter of Recommendation as well.

You can gain more insights into Jason Mizell’s Business of Medicine topics on The White Coat Investor Blog and Podcast as well as Doctor Money Matters and Doctor’s Unbound. For research on financial education in medicine, please read Jason’s article, Money matters: a resident curriculum for financial management.

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Rural family medicine and primary care hold many unique abilities for physicians and students. In fact, Dr. Errin Weisman is able to complete not only the normal primary care activities through her clinic, but some procedures that might otherwise be relegated to microbiology, histopathology, dermatology, surgery, or OBGYN practice. This has given her a unique perspective on modern medicine in different geographic and demographic environments.

Current and future preceptors in these community centers have much to be cautious of. Imposter syndrome and burnout can impede on, especially when there is less professional support to fall back on. Self-care and being mindful of one’s current moods and thoughts are undeniably beneficial to physicians in these instances. When more help is needed, virtual meetups and life coaching can step in to add the desired support structure (which Errin provides for physicians and students).

When teaching, giving students the opportunity to learn with guided mentorship can be mutually beneficial. It saves the preceptor’s time by decreased hand-holding, but it also allows the student to work through a problem on their own. They can develop creative thinking skills as they relate to the clinic. However, the “blame and shame” model of education is antiquated and often provides little benefit. It is usually best to avoid this type of negative preceptor-student interaction.

Errin recommends that students that would like to engage in rural medicine networks and opportunities should consider reaching out on social media. Those active on social media or in education circles are more likely to accept students and interact with them. Students must be truly interested in learning but also keep an open mind as there is no such thing as perfection. In the end, the student and preceptor are a team working within the healthcare system, so an unengaged student is not going to excel in a rotation in her clinic.

When interacting with patients, sometimes jumping in headfirst is very helpful. This decreases the workload on preceptors needing to explain everything and gives the student a greater feeling of autonomy. However, a poor patient presentation can make a student’s work worthless. Do work to improve your presentation skills and ask for advice when needed.

You can reach Dr. Errin Weisman on LinkedIn. Do check out her website, TruethRxs, and her podcast, Doctor Me First!

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In Part 2 with Dr. Neel Desai, he advocates for students to continue to learn how to learn. The material, the science, and the medicine will continue to evolve and change. It is more important that you learn how to absorb materials better, faster, and for longer periods of time than to know everything there is to know right at this moment. He also wants students to focus on being Happier, Healthier, Wealthier, and Wiser. This is a theme that you will also hear via his contributions to the Happy Doc Podcast. Medical students should focus on developing other aspects of their life as well during their clinical rotations.

For students, it is important to get on the same page as your preceptor. Neel likes to know what type of educational medium the student most frequently uses so that he can “speak their language” so he can better tailor the content to the student. He also advises students to reach out to potential mentors, creatives, and thinkers. By developing these networks early on – and possibly creating your own content to begin fostering your online reputation – students can form mutually beneficial cooperatives with those in fields of interest.

For those interested in a strong Letter of Recommendation for Residency, see this opportunity from the eyes of the preceptor. If, when you leave, a patient praises you to the physician that will leave a lasting positive impressing on the preceptor. The reverse is also true. Finding resources that are useful to you, and personally curating your own curriculum is quickly becoming best practices in medical education as well.

You can reach Neel via email or @TheHappyDoc on social media.

Looking for an educational resource for yourself or someone you know? Try my new book, Read This Before Medical School. You can download our free “Essentials of” eBook to see if this material may be a good fit for you!

For you clinical rotations platform, save FindARotation.com in your Bookmarks and download the FindARotation mobile app for iOS and Android (when it becomes available).

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Dr. Neel Desai is a co-founder of MedFlashGo and a contributor at the Happy Doc Podcast. His training in family medicine has been a unique experience and has helped to shape his views on academic medicine and healthcare. He prefers to be proactive than reactive in his role as a primary care physician and wishes to empower patients with tools and education. He argues that the current model of healthcare is outdated and advocates that we start Teaching, Learning, Creating and Practicing medicine in the century we live in.

One of the most important keys to take away from Neel’s medical and educational philosophy is to show humility. All too often physicians – and even students – may take on a paternal role or let their ego get in the way of their patient interactions. Cynicism is all too common in healthcare due to the stresses we all endure. Checking one’s ego at the door and truly listening to one another and to our patients is the only way to move to a more patient-centered and be true to our calling in healthcare.

One last point to remember is that we need to enjoy every aspect we can from each rotation. Even if we do not see ourselves in that specialty or profession in the future, there is valuable information to be gained if we stick with an open and positive mindset. You also never know what curve-balls life may throw at you or a loved one. Absorb all of the information you can while you can. You may not have another opportunity to do so.

You can reach Neel via email or @TheHappyDoc on social media.

Looking for an educational resource for yourself or someone you know? Try my new book, Read This Before Medical School. You can download our free “Essentials of” eBook to see if this material may be a good fit for you!

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Dr. James Gomez is board-certified in Obstetrics & Gynecology in the Chicago area and has been a clinical educator for over 10 years. As a community physician, he handles both in-clinic patients and prenatal care as well as hospital deliveries and surgeries. This specialty uniquely borders between primary care, surgery, and other subspecialties depending on each physician’s scope of practice.

Preceptors in OBGYN (OB/GYN) often have a particularly sensitive population and special care is often needed when preparing students for the patient population. They must also assess their students for their level of knowledge and interest in order to best plan how to approach the individual's clinical education. Proper mentorship is key. Gaining the respect of one’s students is never a bad idea, and being too strict is unnecessary. However, Dr. Gomez cautions that boundaries must be set between the student and preceptor in order to keep a professional and proper learning environment.

Medical students are required to participate in several weeks of clinical education in OBGYN for their core rotations. They may also choose to gain more experience in OBGYN during their elective rotations. Students that show an interest in the topics and patients likely to present in this clinical setting are likely to more involved and gain the attention of their preceptor. A student is expected to gain basic ultrasound technical skills, read the US monitor, monitor lab and hormone changes, and follow these assessments to a diagnosis and treatment plan.

Some key takeaways would be:

It has to make sense. Not all lab results and patient's signs or symptoms add up to the typical case. Atypical presentations are much more common in the clinic than on the boards.

Develop a preceptor-student bond and get on the same page. The relationship between clinical preceptor and student may be strained and distant or maybe inappropriately close. Make sure to foster a healthy learning environment.

Be active with your education. Forcing a preceptor to repeat his/herself multiple times may demonstrate a lack of interest by the student and strain the rest of the medical externship.

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Dr. Allison Edwards is the owner of Kansas City Direct Primary Care. Though she works in the community, she still hosts students from the University of Kansas and other locations at her clinic. DPC is a movement as well as a clinical environment that is designed to eliminate the middle-person and reduce costs for patients. Direct Primary Care provides a low-volume yet diverse learning experience and is great for shadowing or students requesting a break between intense rotations.

DPC preceptors are unique in that they are entrepreneur-physicians to a greater degree than hospitalists. As small business owners, they navigate the two complex worlds of medicine and business. DPC physicians are also free from the hospital and administrative constraints other physicians are regulated by. This potentially allows preceptors and students to run more tests and provide in-house support that a hospital setting may pass off to a tech. There is a great focus on learning how to learn now so that students can use these critical thinking and technical skills more effectively later.

Students interested in a Direct Primary Care clinical rotation must be concerned with time-constraints and customer service. Though there is generally lower volume at DPC clinics, patient time expectations (more so than hospital time restrictions) are of paramount concern. Customer satisfaction is an important consideration in all small businesses.

Students should prepare for their externships by being open-minded and energetic. They should plan for downtime and have a general plan for self-directed studies. Showing passion and being proactive are great ways to assure a student's Letter of Recommendation will display their strengths and ambitions. Also, students that remain humble and understand they are still learning will benefit more from their clinical experience than those that are abrasive or overstep their boundaries. The preceptor-student relationship is that of a dynamic team. Understanding each person’s level in the hierarchy and personal limitations provide a smooth transition of knowledge from one individual to another.

Most links related to DPC:

DPC Alliance

DPC Frontier (map of local DPC clinics)

Atlas.md & Bagel.md (EHRs that serve DPC)

D4PC Foundation (host of the Nuts & Bolts Conference)

AAFP’s DPC Toolkit

HintHealth DPC Software

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Dr. Bruce Morgenstern is the Vice Dean of Academic and Clinical Affairs at Roseman University College of Medicine and President for the Alliance for Clinical Education (ACE). His medical history as a board-certified pediatric nephrologist led him on his path to becoming the Clerkship Director for Pediatrics at Mayo, working with The Council on Medical Student Education in Pediatrics (COMSEP), and he eventually became the President of ACE which collaborates with numerous medical education associations.

Preceptors: Dr. Morgenstern believes in medical education and the importance of precepting for healthcare students. Physicians should be encouraged to seek out faculty development training if available to them if they wish to continue to progress in their mentorship roles. However, the most important aspect of any student-teacher relationship is setting clear expectations early on. He also confirms the importance of a basic education model, such as the one-minute preceptor model, in medical education. Though many preceptors may not be aware of the exact model, they often implement a similar structure into their educational environment.

Students: Dr. Morgenstern feels students should also express their level of education to preceptors early on. This helps to facilitate material being disseminated in a manner appropriate for each individual’s level of education. Students that lay out their hopes for the rotation or that discuss topics they would like to learn more about are more likely to receive specific training. Those that don’t may fall the wayside.

When asking for a Letter of Recommendation (LoR), it is best to ask a preceptor that knows the “unwritten code” of a strong letter. Many physicians may have good intentions, but do not always know what current residency directors are looking for. Also, do not ask “will you write me an” LoR, but instead specify that you are looking for a “strong” LoR. This can make all the difference in the preceptor's interpretation of your desire for that field and the letter.

Keep updated with education meetings via the ACE Calendar.

For more education information, check out the Medical Mnemonist Podcast or other shows in the network via the InsideTheBoards (ITB) website. For those earlier in their education, we recommend our book, Read This Before Medical School. For board-review and q-bank questions, iOS users can download the freemium ITB Audio Q-bank or join the conversation via the ITB Slack Community!

*Please note my mistake in calling it the Alliance for Clinical EducatORS in the audio when, in fact, it is the Alliance for Clinical EducatION.

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Brought to you by the co-author of Read This Before Medical School: How to Study Smarter and Live Better While Excelling in Class and on your USMLE or COMLEX Board Exams, this show will bring you interviews from medical educators in the clinical sciences.

Wondering how to ask for Letters of Recommendation or how to best prepare for an upcoming clinical experience? This show will prepare you for your upcoming clinical rotations and make sure your externship experiences are fulfilling. Following the 1-Minute Preceptor Model, we explore how different preceptors in different clinical scenarios approach students and their education.

Stay tuned for the many great physicians we have interviewed and be sure to share this with your friends and Subscribe!