Patient Safety and Quality Improvement for IMGs: High Yield Takeaways


By Edison Cano

In my last post, we started talking about the importance of PSQI. In this post, I want to emphasize some High Yield PSQI topics and how you might see them on boards and on the wards. These are based on the Patient Safety Primers from the Agency for Healthcare Research and Quality, if you would like to dive deeper.

Safety Culture
Building a safety culture has become the cornerstone of PSQI, and it centers on creating and encouraging a commitment to safety at every level. Key parts include a “blame-free” environment, in which errors or events can be openly discussed and addressed. No yelling, no blaming! Board questions here usually center on a mistake someone made. Look for answers that are straightforward and unassuming. Sometimes this means admitting you made an error or anonymously reporting an error or almost event. Be careful not to assume anything about your team. Think twice about anything that says, “It must have been…” (more…)

Master Step 1 by Becoming an Incremental Learner


By Mark Ard

Step 1 was a beautiful beast. That was my original thought as I scoured the internet for pearls of wisdom about this majestic milestone. Shortly into first year, still before our first round of exams, I could explain the logistics of the test and the statistics of students’ performance for various specialties, even its r-value compared to the MCAT. Clearly, I knew thyne enemy. But I wanted more; I wanted to know the mindset necessary to put in the grueling work ahead, to learn how to avoid burn out, and mostly to enjoy being a student.

In my search for guidance, I discovered chess master and former U.S. Junior Champion Josh Waitzkin, inspiration for the movie “Searching for Bobby Fischer.” In his book, “The Art of Learning,” Josh gets at the core of how to approach study and intellectual growth while maintaining wholeness and a lifelong love of learning.

He explores the concept of “entity vs incremental theorists” as formulated by developmental psychologist Carol Dweck. Just like chess students spend countless hours learning the fundamental concepts of the game and incorporate their growing body of knowledge into practice to dominate the board, so second year medical students dive into review books and question banks, testing their mettle against NBME exams until one final eight-hour display of mental aptitude and endurance on a board of their own. Hopefully, understanding the difference between these two thinking types will help you progress on your journey towards Step 1 mastery. (more…)

Patient Safety and Quality Improvement for IMGs


By Edison Cano

Patient safety and quality improvement (PSQI) questions are some of the dreaded changes that were announced for the USMLE exams months before. PSQI gained global attention several years ago and constant research is leading to improvements in the delivery of care all around the world. Assuring excellence in the delivery of care is paramount in medical practice and is the reason why this dynamic field has fallen under the scope of the boards.

Learning PSQI will demand extra time for Step 2 CK and Step 3, especially for international medical graduates. The most challenging part to studying has been finding a condensed review of PSQI, however I want to share some basic concepts that will serve as a starting point for you to tackle PSQI. (more…)

“‘Twas the Shift Before Christmas”: A Holiday Ode to Med Students


Happy Holidays

By the First Aid Team

‘Twas the shift before Christmas, when all through the wards
Not a creature was stirring, they were studying for boards;
The stethoscopes were hung by the front desk with care,
In hopes that the First Aid Team soon would be there;

The med students were waiting all snug in their scrubs,
As they took a few minutes to inhale some bad grub;
And doctor in her ‘kerchief, and I in my mask,
Had just settled in for a long surgical task,

When out in the parking lot there arose such a clatter,
I sprang from the OR to see what was the matter.
Away to the pit I flew like a flash,
And ran into a big guy with a skid and a crash.

His eyes — how they twinkled! He breathed a deep sigh!
His face was so red, his BP clearly too high!
Still, behind him soon did appear,
An ambulance-sized sleigh loaded with Step study gear.

He spoke not a word, but went straight to the ED,
And asked the head nurse to refill his ARB,
Then, laying his finger aside of his nose,
And giving a nod, up the elevator he rose;

He strode through the wards, passing out Qmax and Flash Facts galore,
While gunners ran beside, shouting wishes for perfect Step exam scores.
The rest of us gaped and grinned as we grasped,
A free, three-month subscription to Step 1 Ultimate and Express.

This guy was laughing and happy, a right jolly old elf,
And I knew when I saw him, I’d pass my next shelf;
With First Aid for the USMLE books, I’d have knowledge in my head,
And with such great study guides, I had nothing to dread;

He passed out his last batch of study tools, and sprang to his sleigh
Turned on the siren and fired up the bay;
I heard him exclaim, ere he drove out of sight,

Military Medical School Made Simple


By Tim Durso, 2D LT, USAF

Military Medical School Made SimpleI get a lot of questions about what exactly it means to be a medical student on military scholarship. There are plenty of official resources that you can find (just google Health Professions Scholarship Program), but I thought it might be a good idea to give a brief overview as a student currently in the process.

First of all, you might be wondering when and how to start the application process. I started early in my second semester of senior year of college by contacting a recruiter directly. This allowed me to gather the necessary paperwork and schedule training before medical school started. If I’ve learned anything from being a government employee so far, it never hurts to get a head start on a paperwork process. That’s not to say you can’t start later, or even after you’ve started medical school, because you definitely can. Remember, though, that a four-year HPSP scholarship carries with it a signing bonus that a shorter scholarship wouldn’t.

If you’re thinking about contacting a recruiter but don’t know what to expect, here’s a quick run-down of what you’re getting yourself into. The nuts and bolts: The military (in my case, the Air Force) pays for tuition, required books, and testing fees. In addition to the signing bonus for a four-year scholarship mentioned earlier, I receive a monthly stipend for living expenses. In return, after my residency, I will serve in the Air Force as a physician for four years of active duty and four years of reserve duty (with a whole bunch of caveats which are beyond the scope of a blog post). (more…)

Let’s Crash Course the Ebola Virus: Medical Student Edition


By Joe Savarese

Lets Crash Course the Ebola Virus - Medical Student EditionUnless you truly have been living in a hole studying for exams, you have probably noticed that the media has run daily headlines about Ebola scares and fears of future epidemics. So I thought, as a medical student, what should I know about Ebola if a friend, relative, or patient asked for information? (or what if it showed on an USMLE exam?)

Here’s the crash course..

The Ebola Virus is part of the Filoviridae family, meaning it’s a helical single-stranded negative-sense RNA strand. (Remember a negative-stranded virus must carry with it a RNA-dependent RNA polymerase for infectivity).

Marburg virus is in the same class and is very similar to Ebola since both present as fatal hemorrhagic fevers. The Marburg virus has a natural reservoir in monkeys, while unknown in the Ebola virus, it is believed to be in bats. Most outbreaks of Ebola thus far have occurred in Sub-Saharan Africa such as Uganda and the Democratic Republic of the Congo. (more…)

A Message from the Editor


I am pleased to fill some impressive shoes. Dr. Walter Wiggins had an amazing tenure as editor of the USMLE-Rx Web Team, and I encourage readers to check out some of his work (use the search box, and search by “Walter Wiggins”). His leadership as a student, author, and father has inspired everyone with the First Aid Team as well as readers from around the world. I also thank Dr. Tao Le for his mentorship and reminder that medicine is a profession encompassing all aspects of patient care, including equipping future generations to succeed.

The First Aid team has produced material on almost every subject ranging from the Basic Sciences to specialty boards like Orthopedics (a personal favorite). And of course, the ubiquitous and ever-evolving First Aid for the USMLE Step 1 (that’s the newest edition, keep an eye out for it!). This blog has enjoyed the opportunity of discussing equally broad subjects from app reviews to odes just begging for an acoustic overlay. We’ve discussed finances, depression and burnout, and the general work-life balance. (more…)

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