Much of the entire self-help book market is predicated on the idea that copying the habits of successful people will make you successful. This is untrue.1 This isn’t to say that no one benefits from shared wisdom, but while someone else’s methods may work for you, the most important thing to know about other peoples’ success is that it is theirs.Read More →
Using the official 2014-15 “USMLE Step 1 Sample Test Questions,” (cached version here) I’ve written explanations and take home points for each of the 138 questions (the “Free 150”). The 2015-16 set has no new questions (a few have actually been removed), so this is still current. I can’t reproduce the questions themselves of course as they’re uber-copyrighted.
An asterisk means it’s a new question (of which there are around 84). The questions and explanations for last year (2013-14) can still be found here.
The new 2016 set is out and has around 50 new questions, which are discussed here.
QuantiaMD, the “social learning and collaboration platform that helps physicians,” is now temporarily paying people $10 to sign up. I assume with the rapid growth of Sermo (which has been paying doctors to join for a while now), they’re getting a bit more desperate to compete.
Click the link, confirm your “clinician status,”2 and you earn 10 Q-points, which you can redeem immediately for a $10 Amazon gift card. Finish up your profile (another two minutes), and you’ll have 16 Q-points. Accumulate your Q-points (by referring/harassing your friends and completing the [often pretty good] educational activities), and you can redeem at a higher rate (45 for $50 and 80 for $100).
The short presentations they choose for the Q-point opportunities are usually interesting and often deal with the non-clinical aspects of medicine that most people probably need more exposure to. Also, you can click through them at your own pace (getting the gist and the points in mere moments if you so choose).
I should note that medical students can still join and earn Q-points, they just aren’t able to redeem them for gift cards until graduating and confirming as below.
More information on QuantiaMD, Sermo, and other paying survey opportunities for “clinicians” can be found here.
Update 11/2015: Essentially, things have gotten cheaper (crazy!). New costs reflected below.
Update 1/2016: I wrote a JP exam review book (more info here), which you could buy.
Update 9/2016: DPS numbers are no longer a thing, because Texas finally realized it was stupid to essentially duplicate the DEA number everyone needs to have anyway.
As with most things that really matter, the website, process, and wait for obtaining a medical license in Texas is less than ideal.2 And then, once you have paid for and subsequently obtained your medical license, you will still have to wait your DEA number (if you don’t already have one) before you can actually do much with it. The whole process from start to finish will likely take you somewhere in the neighborhood of six+ months.
Applying for your license
The application checklist is exhaustive and wordy to the point where a run-of-mill US-trained physician may not be sure if they’re eligible. In Texas, you must have completed your internship (but not your residency) prior to applying for your medical license. As part of the application process, you will need to supply both proof of both your USMLE Step 3 success and a “Form L” from your internship or residency signifying your successful completion of this task. So, if you take Step 3 during your intern year, you can apply for your license on July 1 of your PGY2 year. You also need to pay for, take, and subsequently pass the Texas Medical Jurisprudence exam. Of course, you can’t do that until you fork over the initial application fee.
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Yesterday I read and finished the short novel Steps, which had been recommended to me specifically because it is composed entirely of short vignettes. What I didn’t know at the time was that Steps, which was published in 1968, won the National Book Award for Fiction, and that its author, Jerzy Kosinski, was a Polish Jew whose family survived the Holocaust by posing as Catholics with the help of sympathetic local villagers in central Poland. Like Primo Levi, he also committed suicide later in life.
The vignettes in Steps are anchored by an extremely uncomfortable and disturbing eroticism. The prose is elegantly terse. Details of character and plot are obfuscated by the allegories of the individual vignettes, but the narrative arc does at times become more distinct. The book left me feeling disturbed, confused, and thoughtful. It’s quietly poetic without being indulgently lyrical.
Oddly, as a coincidence of sequence, in my mind Kosinksi’s unyielding depiction of amoral sexuality and intimacy as power is an even starker than it might otherwise be. Because last week I read Veronica Roth’s completely unrelated Divergent series, an about-to-be-a-huge-movie YA dystopian [romance] trilogy. In Roth’s series, every plot point is punctuated by breathless descriptions of heavy petting. Innocent, if dangerously co-dependent, one-in-a-lifetime “true” love.
If a young adult romance is predicated on an idealized version of what we want love to be or think love is, then I’m not sure exactly how to describe Kosinski’s counterpoint.
The Story Shack has republished my story “You read about local politics and hate the sox” with an accompanying illustration by artist Mike Young. I love this site, and I consistently love seeing what the artists do with their assigned stories. It’s such fresh, inspiring stuff.
From the official 2013-14 “Step 1 Content Description and General Information” booklet (archived here), I’ve listed the correct answer for each question with a brief explanation ± take home points. I can’t reproduce the questions themselves of course as they’re copyrighted.
The newest set of official questions (2014-2015) has been released. My explanations can be found here.
For those who have done the more recent set, a list of the questions unique to the 2013-14 practice materials are found in this footnote.2
Researching ways to get things done (or keep New Year’s resolutions) is like scouring the web for distraction-free writing apps when you’re supposed to be writing. Just because its a related task doesn’t make it anything other than procrastination and self-sabotage. I’ve tried Evernote and Day One and Wunderlist and it seems like every other great app that was supposed to fix me. And they’re all great. But I’ve come to the conclusion–and acknowledged the obvious–that no app or process is going make you do something that you’ve been putting off. You have to make you do that.
That said, isn’t there some simple system that will help me keep these goals front and center, something that will help me actively remember the things I want to do without buying into some time consuming “lifehack”? A short while ago, I rediscovered something I read last year on Lifehacker. It’s called Don’t Break the Chain, and it’s something Jerry Seinfeld is famous for on the internet (in addition to being Jerry Seinfeld). It goes like this:
He told me to get a big wall calendar that has a whole year on one page and hang it on a prominent wall. The next step was to get a big red magic marker.
He said for each day that I do my task of writing, I get to put a big red X over that day. “After a few days you’ll have a chain. Just keep at it and the chain will grow longer every day. You’ll like seeing that chain, especially when you get a few weeks under your belt. Your only job next is to not break the chain.”
“Don’t break the chain,” he said again for emphasis.
It’s so simple. It doesn’t involve anything really. You can get a big calendar, but you don’t really have to. You just need some way to see your chain. After you do it long enough, your habits will be ingrained and you won’t even need that (but you’ll still have the satisfaction of seeing the ever-growing representation).
Then I realized that I’ve been using this method for a long time without realizing it. I’ve been posting a story on Twitter every day for five years. With the exceptions of my wedding, some international travel etc, I’ve never missed a day.2 And it works. The single most motivating force behind every night’s story is that fact that there is an unbroken chain of stories behind it. I’ve recently begun using DBTC formally to test out some resolutions, and again I’m continually surprised by how effective it can be given that it seems geared for an elementary school child.
I’m not a big wall calendar kind of guy. I really like chains.cc, which is the cleanest most pleasant website for this purpose. The website is free, and you can of course use it on your phone. For a more native phone experience, the Chains.cc app is my favorite out of all of the options on iOS:
- Clean design with different graphics for each chain
- Easy and pleasant to use and navigate
- Can handle multiple chains, with unique graphics and colors for each
- Allow you to mark previous days when you haven’t had a chance to mark them (don’t cheat!). This a must-have feature if you want to use chains to represent bad habits you want to break.
Goals.io is a little more cluttered but actually more powerful (and free) alternative. It allows weekly goals in addition to daily ones, as well as one time and progressive/nebulous goals. Unfortunately, it doesn’t let you backdate anything so you can’t migrate chains you’ve been keeping on paper or in other apps. Part of me also thinks this flexibility may add too many dimensions to what is otherwise a system as simple as it gets. That said, I do like the idea of weekly goals. Some goals can’t or shouldn’t be done on an everyday basis.
Analog is good though, so I’ve created a minimalistic letter-sized 2014 DBTC calendar that begs to be marked and can be put in a binder, in your desk, or on your wall.
Most radiology books make for a terrible and overwhelming introduction to radiology for medical students or non-radiologists. The physics. The detail. The long lists of differentials and rare conditions. A clinician with limited time is best served with having a grasp of the different radiologic modalities, their limitations, and the proper exams to order to answer a particular clinical question. After all, clinicians—unlike radiologists—have the opportunity to correlate clinically.
Next, interpretation of plain films can be an essential skill. This is particularly true of chest x-rays in practice contexts where wait times are too long to guide clinical management. Surgeons of various types will find differing degrees of imaging knowledge to be relevant, particularly for operative planning.
Below is a brief list of high quality free online resources as well as a handful of excellent print books.
General introductory texts for medical students and non-radiologist physicians:
Learning Radiology: Recognizing the Basics
Learning how to interpret chest films yourself
Look no further than the very readable Felson’s Principles of Chest Roentgenology
Free online resources
There are a seemingly limitless number of free online radiology resources, far far too many to even approach. For an example of an extensive list, see Radiology Education.
Here is my significantly briefer list of excellent general radiology resources for medical students, whether you’re interested in the pursuit of knowledge or the pursuit of a career in the field. Everyone has to start somewhere.
- The Radiology Assistant is probably my favorite, very readable and concise.
- Radiopaedia is the wikipedia of radiology. Articles are pretty terse, but when you see a finding or diagnosis and want to have an explanation, this is where to look (e.g. what the heck is “ground glass“?)
- University of Virginia’s Introduction to Radiology online tutorial series is one of the best and even covers some more esoteric modalities (like cardiac MRI).
- CaseStacks has lots of great paid cases to learn bread and butter for a decent price (and 15% off with code benwhite) but they also have some great free anatomy content.
- Learning Radiology is a massive resource with lots of cases. The design is somewhat overwhelming and cluttered, but don’t let that discourage you.
- Lieberman’s eRadiology is another nice, big, well-organized resource, including a lot of lectures, powerpoints, cases, imaging workup algorithms, etc.
- HeadNeckBrainSpine was easily the best resource for learning neuroanatomy, but it uses Flash, which makes it unusable on most university computers.
- And my final far-reaching inclusion is Radiology Resources for Medical Students, which is also solid but requires a bit too much clicking to get around the lessons.
Keep your eyes open
For anyone with plans to enter radiology as a career, know that you will almost certainly learn more radiology in your first two weeks of training than you could hope to amass during medical school or internship. Knock yourself out, but don’t forget this is your last chance to be exposed to the unadulterated breadth of clinical medicine.
If you have a book fund and want some good reading geared toward beginning radiologists, then you might find this post helpful.
If you’re a specialist (pulmonologist, urologist, etc) and are looking for more focused resources divided by section or modality, then see this compilation.
How do you succeed during your third year of medical school? How do you do well in your clinical clerkships? How do you “honor” a rotation (and since when is honor a reverse transitive verb)?
Now, there are entire books
Of course, common sense is your most important tool for third year, so don’t discount that out of hand either.
The bare minimum, most essential advice for third year is as follows:
- Be on time
- Don’t be a dick
- Use common sense
- Be flexible