Med School Done Right

Why You Should Stop Apologizing: Playing to Win in Med School

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By Luke Murray

Why You Should Stop ApologizingIn my last post, I urged medical students to stop apologizing, and I spelled out the logic from which these inappropriate apologies originate. What I didn’t do was really drive home why you should stop apologizing.

Some of those reasons could be implied by the text of the last post. For example, communicating to your peers and superiors, “I have unreasonable expectations” – in other words, “I have an inappropriate grasp of reality” – does not make you look intelligent and calibrated.

In addition to making you look unreasonable, it makes the interaction awkward. What are people supposed to say? “I accept your apology?” It’s like hanging around with someone that’s dogging on themselves completely out of context. (“Man, I’m terrible at math.” ….”Umm.. yeah man. That’s rough. Uhh…They’re ready to take our order, so do you know what you want, or should I go ahead?”). Your lack of comfort with yourself makes everyone else around you uncomfortable. (more…)

Stop Apologizing: How to Stop the Expectation of Perfection

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By Luke Murray

Stop ApologizingI can tell he’s nervous before he even opens his mouth. Poor third year.

“The patient is a 58-year-old male with a past medical history of congestive heart failure and…hold on a second…,” he flips over his ragged sheet of collected notes. Still searching, he looks up, “Sorry,” and then back down, scanning the paper back and forth.

“Coronary Artery Disease.” He almost shouts it, as the air in his lungs and the tension in his body release with the expulsion of the words.

“…who presents today with shortness of breath and chest pain since 9am today. His first troponin was .01, second was .02.”

He’s already going out of order. He hasn’t finished giving the HPI (describing the presenting symptoms) and he needs to tell me other relevant PMH and physical exam information before he starts giving lab values. I want to guide him in the proper direction without calling him out, so I interrupt with a question. (more…)

Advice for a Worried Student at Midnight

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By Luke Murray

Advice for a Worried Student at MidnightI was all tucked into bed, dressed professionally in my fleece-tuxedo pajamas (I’m a huge Dumb & Dumber fan). Just as I’m about to fall asleep, my phone rings.11:30 pm.

It’s a pharmacy student in New York. She was in her second semester of her first year, and she was struggling. Despite a strong first semester, she had bombed the first two of the five tests that make up her grades. We talked until past midnight about her situation, but the number one thing that I suggested she do was by far the hardest:

Do Not Freak Out. (more…)

Your Medical School Study Habits Become Your Doctor Work Habits

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By Luke Murray

Your Medical School Study Habits Become Your Doctor Work HabitsIt was Friday afternoon and the morning lectures had just finished. I surveyed the challenge ahead of me: 20 lectures that I had only been through once, another 6 that I haven’t been through at all, and the test was Monday morning…

Time to do the obvious: panic.

In the words of every 13-year-old that’s ever sent a text message: “JK…kinda.”

While I did not physiologically manifest a full blown panic attack, the ‘plans’ I put together were almost totally void of the two things that would make them useful: (more…)

When Giving Your Presentation… “Just Talk”

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By Luke Murray

When Giving Your Presentation Just TalkAs I wrote about in my earlier posts, ‘The Avoidable Cycle of Self-Doubt’ and ‘Give Your Presentation Backwards’, I used to be confused about what I ‘should’ be doing on wards… presentation-wise. Most of the time, I tried to do what I thought they wanted or leaned towards what the textbook said to do, or I hedged my bets by giving more information instead of less, because I was concerned I’d leave something out. I used to read every lab value and every section of the H&P out loud because…that’s what it says in Bates.

The problem was: my presentations were painfully boring because 90+% of what I was saying didn’t matter. And I was spending so much effort and brainpower collecting and reporting every last bit of information that I didn’t have the time (and my team didn’t have the patience to help me) intelligently organize and share the most important part of the H&P – the Assessment and Plan.

None of the residents presented in the classic med student way. They just talked about their patient in a generally organized way. That’s it.

Now in my second year of residency, I’m doing the same. And it’s making me a better doctor.

For example, I had a patient come into the ED last night, he was tachypnic, had increased work of breathing, and I was working him up appropriately but starting to feel in over my head and stuck in a few places, so I called my attending.

This was my ‘presentation’: (more…)

Unbind Your Copy of First Aid

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Love your First Aid book, but wish it was easier to use? We asked one of our blog authors, Luke Murray, to do a quick run-through of how to modify your First Aid book by unbinding, then rebinding, his own copy.

Enjoy!

(Thanks, Luke!)

Recognize the Need to Change Course, and then do it

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By Luke Murray

Recognize the Need to Change Course, and then do itI have lots of different regrets about my time in medical school. I should have tried more things professionally, personally, and socially. I can’t tell you how many nights I sat in my room thinking I would go out that night or call someone up to hang out but thought, “I need to get to bed in a hour so I don’t really have time…” So instead of actually spending time with someone for an hour, I’d watch YouTube videos for the next two hours. In hindsight, I should have made this mistake once or twice, wised up, and then spent that time with friends or even strangers – anything really. But I didn’t, and the naturally isolating experience of medical school remained so for much of my time there. I left a lot of memories and potential friendships on the table during those years.

Another regret has to do with the way I studied. Like my social decisions, I should have known and admitted something was wrong much sooner than I did. I didn’t do well on my first quiz in anatomy just a few weeks into medical school (I failed it, actually). At that time, my strategy was to be as thorough as possible with each pass through the material, to just make sure my eyes saw as large of a percentage of the content as there was for them to see. As an obvious consequence, I only got through the material a couple times (if I was lucky) before a test. I did poorly, again, and then vow that I would study even harder, be even more thorough, next time around. No paradigm-altering changes, just doubling down on an obviously losing strategy, thinking that ‘time spent’ was the only variable that needed tweaking. I continued to stay in the bottom of my class, until my second time through my second year. (more…)

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