I had often heard that being an intern was a far more enjoyable experience than being a med student. Hearing stories of long hours, stressful decisions, and overworked interns, I found that hard to believe. Granted, as a pediatric intern, my experience is different than a surgical or even internal medicine intern— yet I now understand the benefits of transitioning to a resident.
Our rapidly digitized and regulated medical system has the unfortunate side effect of cutting medical students out of patient care. My former med school used a robust EMR system. It disallowed easy entry of student orders. Furthermore radiology prelim reads went directly to interns, and daily lectures usually cut into crucial patient care. However med students are, in my opinion, unfairly tasked with following and presenting a patient’s hospital course. They round, gather numbers, read results, and review radiology studies. Unfortunately this is a practice, more of reading of the day’s events, than a recap of an experience they were involved in. The system is designed to handicap their ability to truly assume an autonomous role in a patient’s care.
In theory residents should keep their students updated in the latest events and involve them in the decision making process. This is a practice easier said then done. Despite these hurdles, I had wonderfully talented and caring residents during med school. Many of them overcame barriers in the system to actively engage me in patient care. They recapped their orders, filled me in on radiology studies, and “ran the list” with me to make sure I was up to date. Certainly having these residents in the past has pushed me to pay back this educational debt. While medical students may face logistical hurdles– they are bright, eager, and resourceful. It is worth the extra time and energy to involve them in every facet of medical care. I as find the balance between efficient patient care and medical student teaching, I hope that the many hurdles our system fade.
A New Website to Help Guide Medical Students Through the Residency Application Process.
My fiancee and I worked over the last several months to craft a website to make the residency application process easier. As we went through the many steps ourselves, we found that there was a gap in information— between sites with too little information and those with every detail covered. Our goal was to take the best websites and pull their advice then inject our own suggestions. Hopefully our site will help reduce the complexity of the entire process as well as evolve as we get more feedback. Please contact me if you have any suggestions. (firstname.lastname@example.org)
Here’s a quick set of pictograms I did for an app a team of us are submitting for a competition. The app deals with Personal Protective Equipment (PPE) and pesticide safety in agricultural areas. We didn’t have enough time for our app developer to code it but we’re throwing together an animated mockup.
Something a Little Different
After letting my Wacom tablet collect dust for the last several months, tonight I finally decided to start drawing agin.
I’ve been following Shane Burcaw of LAMN for a little while and I wanted to make a small tribute piece. Shane is a 20 year old with SMA (spinal muscular atrophy) who has a wonderfully lighthearted outlook on life. He also happens to be an active member in the muscular dystrophy world. He just launched his nonprofit laughingatmynightmare and is showing no signs of slowing down.
Though I don’t know Shane personally, he reminds me of the many wonderful patients and families I had the pleasure of seeing as part of my neuromuscular fellowship last year.
So here’s a drawing I put together tonight of Shane looking tough in a pretend cape—something I wouldn’t be surprised to see him post on his own tumblr site.
I’m not one for inspirational text prints but I thought I’d post a little re-do of one of my more popular pieces (Gemfibrozil).
I’m sure most of us have experienced the painful sensation in our ears when flying, but why do our ears hurt and why do you feel them pop?
It all boils down to unequal pressure between our external auditory canal (arrow) and middle ear (#2)—and the membrane that is caught in the middle—the tympanic membrane or eardrum (#1).
Rapid changes in altitude change the pressure the outside of the eardrum, but the middle ear doesn’t respond as quickly. The eardrum is a highly innervated (by cranial nerves V, IX, X) and thus is highly sensitive membrane. Differences in pressure cause the membrane to distort either in or out and subsequently cause pain.
So what about the popping sensation? The middle ear is connected to the nasopharynx (#4) (i.e. the back of the nose/upper throat) by the eustachian tube (#3). This tube is usually closed—however when we swallow it opens briefly which allows the pressure to equalize and your hear and sense the pressure dropping in your middle ear.
I’ve been quite absent on tumblr since I’ve been running around the country interviewing. Since I’m now done with boards (at least until step 3) I thought I’d start up a new project to kick start my drawing again. Though I know many of your are medical students, I wanted to focus on a project explaining more mundane medical phenomena. Perhaps once a week I’ll try to post a small drawing and explanation of a simple medical problem or condition. I’ve always been interested in medical education, especially how medical professionals educate patients. Since my one year research year in focusing on neuromuscular diseases, I’ve thought a good deal about how to best represent complex medical ideas. Hopefully this project will get me thinking more about this concept.
Anonymous asked: Hi Steve, First of all, your art work is great. I really wanted access to that lipoprotein graphic that you did; the gastric subway is very useful of course. I'd really like high-resolution versions of these and the rest of your work if you are interested to monetize them or share in anyother way. I hope you'll nourish and nurture your talents further in life and share them with the world. Thanks.
Thanks! Shoot me an email and we can chat. I can’t post links in tumblr mail but you can head over to my website—my email is listed there in the about section.
Sorry I’ve been MIA but I’ve been wrapped up in some projects. One of the really exciting project is working with a medical boards review book series to oversee a revamp of their medical illustrations. I’m trying to find individuals who are interested in medicine and illustration. Preferrably I’m looking for medical students with an eye for design, or medical illustrator students with a strong science background. If you know anyone I’d love to talk with them further.
Hope to hear from you.