Paradigm Shifts, Puppy Therapy, and Pregnancy

Well, I’m about a month and a half into medical school

It’s been a hectic month and a half.

Last Monday, we had two tests, one of which was a final for the Behavioral Medicine and Development class (BD). The other was the second of three midterms for Molecular Cell Biology and Genetics (MCBG) class. It’s nice to have BD over, and we have one week left of MCGB before anatomy starts. I’m looking forward to it, actually – MCBG has essentially been an intense undergraduate course with a clinical application here and there. While interesting, once we start anatomy I’ll feel like we’re actually getting somewhere. Oh, and after the tests, the school brought in some dogs for the students to pet – “puppy therapy,” they called it. As funny as it seemed, it actually was a bit therapeutic to spend some time with one of the labs!

Before starting medical school, I heard some medical students comment about the paradigm shift that often occurs once you start. In undergrad, those of us who are now in medical school were all neurotic type A folks (ok, that hasn’t changed) who were generally at the top of our class. I don’t say that to boast – we had to be. We had something to prove. Now, though, we’re all together in one room. That means that many of us who used to be at the top are now… average. That’s not a bad thing. It would be an honor to be even in the lower echelons of a class full of people as intelligent and dedicated as my classmates. It’s just different.

I for, one, am still regularly impressed by the quality of my classmates. These people are smart. It’s not infrequently that I get the sneaking sensation that I’m not supposed to be here; that I’m an imposter of sorts. The rate at which these people can acquire and regurgitate large volumes of information, seemingly without effort, never ceases to impress. I’ve generally never been one who could simply hear something once and retain it forever – I need to work at it. Hard. That translates into hours spent studying just to try and stay caught up in things like small group sessions. Of course, I’m sure my classmates are putting in some daunting legwork themselves, but if they are, most of them seem no worse for the wear. Ah well.

On that note, Anki has continued to be a great tool for me. I need that regular, daily repetition to really make things sink in. I wish I would have used it, at least to some extent, in undergrad. I would have retained a heck of a lot more. Its efficacy cannot be overstated, at least in my case.

What to Expect When You’re Expecting

Now for the more interesting news – we found out during the first week of medical school that my wife is pregnant! We’re both very excited, and looking forward to next spring.

When my wife told me that she was pregnant, my first reaction was one of complete excitement. That was quickly followed by a reaction similar to Gary Cooper’s in the film What to Expect When You’re Expecting (not out loud, though!):

After that, though, I felt a very profound sense of… responsibility, I suppose. We are going to raise a child. That is pretty incredible.

Of course, this has been a less-than-optimal time to go through the genetics component of MCBG, where we are learning about all of the chromosomal bad things that can happen to a developing child. They are rare events, of course, but still! It was nice to finish that section of the course.

We both continue to eagerly look forward to a healthy pregnancy and, hopefully, a smooth delivery. My poor wife has had to put up with a busy husband and some pretty nasty nausea. Hopefully that will get a bit better here in a few weeks as she gets through her first trimester. In the meantime.Zofran is awesome. 

The First Week of Medical School

Wow.

That was crazy.

I’ve officially completed my first week of medical school, which is still a little bit crazy to think about. It was a lot of fun, but wow – it was also a very busy week.

Stritch has the curriculum set up in such a way that, at least in the first year, you are taking one “major” class at a time. There are also two “minor,” much shorter classes that occur for a few weeks each during the first year while the “major” class is going on. Underlying all of these classes is a final “doctoring” course known as Patient-Centered Medicine that runs through the first three years. Right now, the “major” class is Molecular Cell Biology and Genetics, affectionately known as MCGB. There is also a “minor” course – Behavioral Medicine and Development, aka BD. And then, of course, there’s PCM.

So far, most days have gone from around 8 am to an average of about 2:30 pm, some days shorter and some longer. One day a week, PCM keeps us around campus until anywhere from 3:30 pm to 4:30 pm, but it usually gets out early. Looking ahead, it seems like the days will be a bit shorter after this first semester ends, which will be nice.

MCBG, the bane of my existence right now, is essentially a review of all of the cell biology, biochemistry, and genetics material we learned (or didn’t learn, as the case may be…) in undergrad. Though the material itself isn’t necessarily new or particularly complex, the sheer amount of material covered is just short of overwhelming. It’s manageable on a day-to-day basis, but is enough to quickly bury you alive if you fall behind. And we have a test after this next week. Should be fun.

BD is a more of a “soft” class – not a ton of effort is needed here, although some studying is certainly useful. It’s actually been a fairly interesting class, and this week has covered things like child development, elderly development, death and dying, and women’s health. For the elderly development lecture, the lecturer invited three of his patients who were around 70 years old to come speak to the class. At the start of the lecture, only one gentleman had shown up – one of the others was ill and couldn’t make it, and another was thought to be wandering the campus somewhere (it turned out she had been waiting in the wrong place). After the lecturer gave a brief intro, he brought up the elderly gentlemen and began to ask a few questions, such as “As you entered into this season of life, what surprised you the most?” and “What were some significant changes that you noticed?” Unfortunately, the patient would have none of it and refused to stay on topic. He was a pleasant enough guy, but apparently preferred to joke about how the women his age were too old for him or how the only time he would lie was when he was selling cars. When asked what sage advice he would like to pass on to the young people in the room, he replied lightly, “Eh…they don’t listen anyway!” One could tell halfway through the interview that the lecturer seemed to be regretting inviting this particular guest.

Finally, the other guest arrived and was brought up to the front of the lecture hall. She actually had some great things to say about getting older, how that affected her life, and how she had perceived that her various roles in life had changed. It was a good interview, but the best part was when the lecturer asked what her interactions with technology were like, to which she replied, “I am not internet!" That got a quiet chuckle out of the class. Overall, though, it was very kind of both of them to come in. It was good, at least with the second guest, to hear some of the things that we had been discussing in class come straight from the source, as it were. If nothing else, it made for an entertaining lecture.

In this post, I mentioned that I was planning on using OneNote to take notes in class and Anki to help retain information. So far, both systems have been working very well. OneNote is an awesome way to organize all of the information/handouts/powerpoints/online readings/etc. for each class in one place that is easily accessible, flexible, and extremely portable. Anki has been an excellent learning tool. It takes a little bit of effort to make the cards initially, and one does have to commit to a daily review of any due flashcards to make it truly effective, but I think it will be worth it. In undergrad, I feel like I learned the basic concepts of most things but really tended to cram much of the rest of the information I needed for exams, and then never really thought about the info again. I really want things to be different this time around, and I feel like Anki will greatly help in retaining the information over the long term.

As I mentioned before, most days end around 2:30 pm or so. I usually go home, spend a few minutes with my wife (we decided early on that we would spend at least ten minutes or so together as soon as I walked in the door, just to connect and hear about each other’s day), and then study for 3-4 hours. This usually involves reviewing that day’s lectures, making flashcards, reviewing flashcards, doing any reading, and downloading tomorrow’s lecture materials to OneNote. I try to stop around 6-7 pm for dinner and spend the rest of the evening with my long-suffering wife. Ideally, I have all of my studying done at this point, but there were a couple nights that I had to pick things up again around 10 pm or so and spend another hour or two tying things up. I’m looking forward to the days getting a bit shorter so I can, as a rule, be done by 6:30 pm or so.

It’s been a hectic week, but it’s also been a good week. We are both glad that the weekend is here, and are thoroughly enjoying relaxing and doing a whole lot of nothing as we gear up for week two.

And So It Begins...

The beginning of medical school is quickly approaching, but before Loyola lets us begin the real fun, we had to sit through a week of orientation material. In reality, it’s a pretty good idea – it provides a venue to meet your classmates, get used to the facilities, and generally settle in. It was, however, agonizingly slow at times.

Orientation week kicked off this past Monday with a busy administrative day – getting badges, filling out paperwork, officially registering, figuring out parking, learning the computer systems, getting fitted for our white coats, ensuring that we are not the carriers of any terrible diseases, and so on. The staff at Stritch essentially set up a bunch of booths in the school, gave us a honey-do list, and set us free…which generally translated to most of us aimlessly wandering around hoping that we hit every station that we needed to. The day ended with a barbeque in Miller Meadows, a large forest preserve across the street from the school. It consisted of food, games, and fun times as we got to know some of our fellow classmates a little more.

Tuesday and Wednesday probably the longest days (at least in terms of perceived time). These days were filled with lectures (a lot of lectures…) by some of the staff and faculty at Stritch. On Tuesday morning, many of the professors introduced themselves and their courses. The school provided breakfast and a catered lunch, which was actually pretty good.

After lunch, a physician at Stritch gave a “First Patient Presentation” where a real volunteer patient came in and sat down in front of a 150+ new medical students, told his story, and allowed himself to be interviewed by the class as a whole with the staff physician moderating and guiding the entire conversation. It was actually pretty cool, and the patient eloquently expressed some kind words of guidance to us as a class regarding our future as physicians and the importance of trust and kindness in the physician-patient relationship.  The day ended with a scavenger hunt put on by the M2s that took the new students throughout the school of medicine and into the surrounding villages, eventually ending (three hours later…) at a bar in Forest Park.

Wednesday was more lectures. The Dean of Stritch School of Medicine, Dr. Brubaker, started off with a warm welcome to the students. She was eventually followed by Dean Jones, the assistant dean of admissions who had welcomed each of us into his office on the interview day. He discussed the composition of the class and some interesting facts about a lot of the new students, which was entertaining.  He is the guy in charge of admissions, and mentioned that he and his staff were now just starting a whole new application season, which was a bit trippy. The rest of the morning was spent with various people introducing all of the resources available to Stritch students, like the gym, student services, and all of the activities we could get involved with at the school, like the Medical Spanish course offered by Spanish-speaking students. After lunch, we had a financial aid presentation (particularly bad timing, I thought – after the long morning and a satisfying lunch, we were all ready for a nap…), and the day ended with a security presentation (where we watched an “active shooter education video” – at least it was more interesting than financial aid). Finally, the University Ministry hosted an Ice Cream Social and held a raffle for various prizes, ranging from gift cards to hospital cafés to school swag. That night, the school bused the students who wanted to go to Wrigley Field for a Cubs vs. Brewers baseball game.

Depending on which orientation group we had been assigned to, about half the class had either Thursday or Friday off. I had Thursday off, which was a nice break. On Friday, we had Basic Life Support training and then some of us had gym orientation. The BLS training, by the way, consisted of way more actual compressions than any BLS class I had had before (usually, it seems like the instructor watches you do CPR on a mannequin for 30 seconds and signs you off. This time….not so much). To top it off, the day was already pretty warm and humid and the room was only barely air conditioned, since the class was held in one of the older buildings on campus. That made for a fun afternoon. That night, though, the Jesuits had a catered BBQ at their home in Oak Park. That was some darn good food.

Finally, on Saturday there was an optional service day. Those who attended met in the atrium of the school, where we were given a brief introduction to Maywood (the suburb of Chicago in which Stritch is located) and its history. Then we all dispersed into various service groups around the village, where we helped hand out food at homeless shelters, organize food pantries, clean up the community gardens, and clean up some of the houses around the neighborhood. It was really a lot of fun and a great way to get to know the area.

But now orientation week is over, and medical school begins – for real – tomorrow. I’m actually looking forward to it. It has been nice to have some time off, but it will also be good to get into somewhat of a routine again. It was great that we were able to move here a couple of weeks before everything started – having some time to settle in and get used to the area has been priceless. Some students just moved in a few days ago – one actually just got married on Friday (that, by the way, would be crazy!). I don’t envy them. But I’m sure we’ll all have a blast, and I think everyone is excited for tomorrow.

Here goes nothing!

Investing Your Money While in Medical School

So you’ve worked hard at your part-time job during undergrad – or maybe you’ve taken some time off to work at a “real job” – and now you have what seems like more money than you know what to do with. In reality, perhaps, it’s not much – but you’ve never had this kind of money before. So what to do with it? Invest it, you say? That’s an easy way to make a buck, right?

But how the heck do you do that?

Well, for starters, before you ever come close to purchasing your first mutual fund or opening up an IRA, stop. Stop and think about the big picture. You have successfully saved up a few grand. Perhaps you’ve worked really hard and have $15,000 or so and are feeling quite good about yourself. Or maybe you have even more.  That’s great. It really is an accomplishment, but that doesn’t mean it’s time to go find the best and brightest stock picks and start wheeling and dealing.

First, if you are about to start the medical school application process, you have a lot of costs ahead of you. Your AMCAS application, secondaries, a suit, airline tickets, taxis, food, hotels – all of these things cost money. Quite a chunk of change, actually. If you’ve made it through the process, awesome – but don’t forget you probably have to move to medical school. Moving is expensive. You’ll probably have to buy new furniture, put down a security deposit, and perhaps even your first month’s rent – all before your loan money arrives in your bank account. Once all that is taken care of, what if your car breaks down? What if you trip, fall, break your ankle, have terrible insurance, and get slammed with a huge medical bill? What if [insert unlikely but costly scenario here]? Obviously – hopefully – none of those things will happen. But it’s smart to be prepared. Which leads me to the first step you should take with your grand riches – allocate some of it to an emergency fund.

An emergency fund is for…umm…emergencies. You probably guessed that. But not the “Oh darn, I really need that cool new computer/car/video game/whatever” kind. More like the, “Oh darn, my car just gave up on life and now I need a new one” or “Oh darn, something bad happened and now I need to support myself from my savings for a few months.” It’s generally recommended that you have enough money in your emergency fund such that, if needed, you could support yourself for about 3-6 months. Once you build it up, you put it in your savings account (or higher-interest online savings account, such as Ally Bank, or perhaps put two-thirds of it in a CD ladder with reasonable early-withdrawal penalties) and leave it there until it’s needed. If Mr. Murphy strikes and finds you with your pants down (or at least without an adequate emergency fund), that could be financially catastrophic for you.

In addition to having a solid emergency fund that you can fall back on to cover unforeseen expenses, you should also have a handle on your budget. Live below your means. It’s often said that it’s best to live like a student now so you can live like a doctor later, instead of the opposite scenario. That doesn’t mean you will be eating Top Ramen for the majority of the next decade, but it does mean that you should be financially wise with your resources. Figure out your emergency fund, figure out how much you can spend each month to stretch your loan money for the year, factor in rent and utilities, figure out how to cut costs in certain areas if needed, and don’t spend more than your monthly allowance. It’s really not all that difficult to figure out. The hard part is sticking to it.

Ok, you say. I’ve done all that. I’ve got a great emergency fund, I’ve developed a picture-perfect budget spreadsheet in Excel, and I follow it to the letter. I’ve got money left over, and I still want to invest. Now what?

The first step is learning about the world of investing. I’ve posted before about some resources that you could read to learn a bit, but I’ve reposted some relevant links below for your convenience, and added a few new resources.

The White Coat Investor

This is a great resource for medical students and residents in particular, but also for anyone interested in investing. It is written by an emergency medicine physician, and has a lot of great info about all sorts of things. I would highly recommend reading all of the articles linked in his “First-Timers!” section from top to bottom.

The Motley Fool

What is the difference between a Roth IRA and a traditional IRA? What’s a 529? How do mutual funds work? The answers to these questions and more can be found here. I recommend reading at least through all of the articles under the tabs “How to Invest” and “Retirement” to get a general idea of what’s going on. One word of caution: This site offers a lot of great free content, but has to make money somehow. This often comes in the form of “hot stock tips” newsletters and what not. Ignore these.

The Bogleheads' Wiki and The Bogleheads' Forum

Don’t be thrown off by the strange-sounding name – this wiki and the associated forum are one of the one of the best resources online for learning about investing and finance. Spend some time here – it will serve you well in the future. If you have any questions, ask away in the “Help with Personal Investments” subforum – you can get answers within minutes from many wise individuals, including those who have authored some of the most common-sense investment books available today.

Morningstar.com’s Investing Classroom

If you really want to learn the nitty-gritty details about stocks, mutual funds, bonds, etc., this is the place to go. It takes some time – I’m still not done yet – but going through their free classes is an excellent way to learn some of the finer points of investing.

In addition to the above websites, I recommend getting your hands on some quality books.

The Bogleheads’ Guide to Investing

This is an excellent starter book that outlines a basic philosophy of investing that I believe will serve any reader who is in it for the long haul very well. I highly recommend getting your hands on a copy of this book and reading it. Once you are done here, you might want to grab a copy of their next book…

The Bogleheads’ Guide to Retirement Planning

This excellent work details the various nuances of planning for retirement, including the various kinds of vehicles you can use to stock away tax-advantaged cash. Honestly, if you read the above links you’ll probably get a pretty good handle on most of the basics, but you might want to consider adding this one to your collection at some point. That said, I do highly recommend their Guide to Investing. 

Some general main points of the sources above are summarized below:

Avoid Individual Stocks

You are not an expert stock-picker, and the market is smarter than you are. You can’t beat it consistently. No one does. But if you try to time the market, you will underperform it. And you will likely do that fairly consistently.

If You Can’t Beat ‘Em, Join ‘Em

Why limit yourself to a few poorly-chosen stocks? Why not just buy them all? This is where index funds come in. These are mutual funds that attempt to replicate a market index, such as the S&P 500 – a fund that is composed of stocks of many of the larger companies in the U.S. You can take that even further and buy an index fund such as the Vanguard Total Stock Market Index Fund, an index fund that essentially covers the entire spectrum of the domestic market – big companies, small companies, and everything in between. If you buy this fund, you are essentially buying over 3500 different stocks. Try doing that on your own. Round out your portfolio with funds like the Vanguard Total International Stock Index Fund and the Vanguard Total Bond Market Index Fund. Do that, and you’ll essentially own the entire market.

The beauty of low cost index funds is that, over time, you will get at least market returns. Actively managed funds (mutual funds that are essentially run by a single manager or group of managers) try to beat the market by buying and selling certain funds according to where he/she/they think the market is going. Which might sound good in theory. But in reality, in any given year, actively managed funds underperform the market over two-thirds of the time. Of course, that means that one-third of actively managed funds are beating the market. That’s great, but those funds are changing every year, and there’s no way to know who will be the next winners – or losers. Investing is not a game of winning and losing, though – it’s a game of not losing. By getting at least market returns, you are guaranteed to not lose.

Determine Your Asset Allocation

Your asset allocation (AA) is essentially how much of your money you put in different areas of the market. For example, you will have to decide how much money you will invest in, say a Total Stock Market index fund versus a Total Bond Market Index Fund. A good general rule of thumb here is that your 110 minus your age equals your equity (or stock) allocation. So, a 30 year old investor might invest 80% of his money set aside for investing into stocks via index funds and the remaining 20% in fixed-income securities, perhaps via a Total Bond Market index fund. It’s generally recommended to have at least some type of fixed income allocation. Over time, this acts as a hedge against market downturns and can even increase your overall returns as stocks might go one direction and bonds in another in varying market environments.

An easy way to choose and maintain your asset allocation while also investing your money wisely (especially if you could care less and would rather have a hands-off approach) is to simply buy a Target Retirement fund, such as the ones that Vanguard offers here, or a LifeStrategy Fund, which can be found here. These funds invest in all of the funds I mentioned above, thereby allowing to you cover the entire market in one fell swoop that you never have to think about again, if you don’t want to.

Invest for the Long Term

Investing your money in the market comes with a certain degree of risk – namely, at certain times, you might actually lose money. But the general trend of the market is up, and if you keep your head on straight and don’t sell your investments in a panic (thereby locking in your losses), you will, over time, regain your lost money and then some. All that takes time, though. Don’t invest any money in the stock market that you will need in the next 7-10 years. Short-term goals are better suited to CDs and high-interest (relatively speaking…) savings accounts.

Now what?

So how do you buy these funds? I won’t go into too much detail here about the different ways you can invest (e.g. via Roth IRA, Traditional IRA, 401(k), 403(b), taxable accounts, etc. – that’s what the above resources are for!) except to say that, for someone just entering medical school, the best investment option (if indeed it is appropriate to invest in the first place) is probably via a Roth IRA. Think of a Roth IRA (or any of the vehicles mentioned above) as a bucket in which you hold various types of investments, such as stocks, bonds, etc. A Roth IRA is not an investment in of itself. Each different bucket has different benefits. In this case, you contribute to a Roth IRA with post-tax money, but all of the money you earn within that “bucket” will be available to you in retirement tax-free. Additionally, the money that you contributed can be withdrawn without penalty, which may prove helpful in a time of extreme need.

The catch, of course, is that you need earned income to be able to qualify for contributions to a Roth IRA. That means that if you haven’t earned at least as much money as you plan you contribute in the past tax year, you are out of luck. But don’t let that stop you. Spend time now pouring over the resources above and learning about all of this now. Becoming familiar with sound investing principles now will pay off in a huge way later. Good luck to you in your journey, and feel free to post any questions you might have in the comments section below.

Moving, Exploding Toilets, Pushing Cars, and More…

Well, it’s official. After 2,100+ miles, nine states, and thousands (ok, not really…) of heavy boxes and infernally heavy entertainment centers, my wife and I officially reside in the Chicago area. We managed to find a rental house reasonably close to the school – with a washer and a dryer, which is a huge plus, and quite rare for the area, I might add. Now we’re just unpacking some of the last few boxes, and our house is finally starting to feel like a home.

So far, the house has been great, with a few minor exceptions and one not-so-minor exception. The latter occurred late at night a few days ago – I had just finished taking a shower when I stepped out into a puddle of water on the bathroom floor. My first thought was, “Dummy, you didn’t close the curtain all the way.” I began to mop up the water with a towel, but started to notice that, gee, there was a lot. And it kept coming. There was no obvious flow from any one area, but after checking the tub and sink with no obvious findings, I narrowed the source down to underneath the toilet. We had noticed earlier that the toilet seemed a bit unsteady, and I thought that perhaps the wax ring was old and had finally failed. So, I turned off the water to the toilet and began trying to drain it of water, first by flushing it. This, unfortunately, didn’t work, as the toilet seemed to be backed up. Darn.

I went back to mopping up some of the water for the time being, just to get it up off of the floor. I was running out of towels, though, and figured I would eventually need some more. I didn’t want to grab any towels I wasn’t supposed to use to mop up toilet water. I went into our bedroom to check with my wife, but she had already fallen asleep – it had been a long day of unpacking already. I didn’t want to wake her if I didn’t have to, so I went back to mopping. Eventually, though, I really needed more towels. So, I wandered back into the room and tried gently shaking her. She was out – totally in REM sleep. I tried shaking her again and speaking softly – I didn’t want to startle her awake (i.e. “We have an EMERGENCY!!! Get up now!!!), so I started with, “Well, it looks like we have the first problem in our new house; our toilet seems to be leaking water.” After a bit, she slowly awoke, looked up at me dreamily, and sighed, “I looove you…” and started to drift off again.

Well, this wasn’t working.

I gently shook her again and repeated myself. She began to awake again, looked up at me (obviously only half-awake), and this time mumbled cheerily, “Why do you say silly stuff like that?”

Sigh…

On the third try, she finally registered what I had said and got up to help me get some towels. Unfortunately, water was still seeping out from under the toilet. So, since the toilet couldn’t flush, I used a coffee mug to scoop water out of the toilet and the tank. I couldn’t get it all, though, and what was left would eventually end up on the floor. The toilet had to come off. So, I unscrewed the bolts on the floor and lifted it into the tub. Now, I could see that the wax ring was indeed shot but that there was also a plug somewhere down the line – water was backed up to the point where it was level with the floor.

It was slowly draining, which was good – that meant this could wait until morning. So I asked my wife for a hand towel that she never wanted to see again and stuffed it down the drain to keep the sewer smell out of the house.

In the morning, the landlord called the plumber. After the plumber spent some time rodding the pipes out through the opening for the toilet, he walked out of the bathroom mumbling, “This is a problem…” That was reassuring…

He went and grabbed his handy-dandy pipe video camera – essentially an endoscope for drains. It was pretty cool to see the inside of our pipework, actually, and he was able to localize the problem: a small clump of fine roots had grown into the drain, creating a catch for things like toilet paper and…other things... eventually leading to a clog. Over time, this reached the “clogging threshold,” which in turn created enough pressure in the pipes to cause the wax ring under the toilet to fail, which resulted in the seeping toilet water I stepped into when I finished showering.

Yuck.

Anyhow, he rodded it out as best as he could, and recommended copper sulfate to send down the hatch occasionally to kill the root buildups. If we could avoid digging up the pipes, that would be best for all parties involved. We’re crossing our fingers, and plan on flushing that stuff down religiously.

That wasn’t the end of our troubles, however. Today, my wife and I were running some errands. We got our Illinois licenses and plates (the DMV is always an adventure…a three-hour one, in this case. It also involved taking a written driving test, which was fun...), went shopping, went to the bank, and on the way to our last stop our car started making a really loud, ominous clicking sound. Apparently it had made it across the country and was sick and tired of us driving it here and there… It actually sort of sounded like it was trying to pretend like it was a diesel-fueled vehicle, which it most definitely is not.

We pulled over and I popped the hood. My ever-so-patient wife hopped in the driver’s seat and give it some gas while I looked into the innards of the vehicle. It sounded like it was coming from the serpentine belt, possibly one of the pulleys…maybe the tensioner? We got back on the road and I was debating with myself about trying to take the belt off, figure out which pulley it was, replacing it, and putting the belt back on, when the car started smoking at a stop light. I turned it off, figuring I would let it cool for a second and turn it back on when we got a green light…but the green light came and the car wouldn’t turn back on. Darn it. It sounded like the battery had died, which is also a possibility – but now? Maybe it was the alternator...or maybe the car was just saying, “Take this, fools!” Regardless, my aspirations of fiddling with the vehicle quickly dissipated. My wife hopped in the driver’s seat again and I got out and pushed the car into a nearby parking lot. We called a tow truck (thank God for AAA!!) and had it towed to an auto shop near our house, where it will reside until tomorrow (hopefully no longer than that…).

Ah well… I guess it’s better that all of this happens now than right before a big test later. Otherwise, though, things have been going very smoothly – the drive over was great, the moving went smoothly, and we’ve found some great deals on Craigslist for various pieces of furniture. We’re excited to finally be here, and looking forward to finally beginning this next chapter of our lives together.

Surprise!

So yesterday I had a mystery package arrive in the mail. I currently live in an apartment complex, and any relatively large packages are dropped off at the front office. My wife had picked it up last night and set it inside our apartment – it was addressed to me, but I didn’t recall ordering anything.

This morning, I finally opened it up. I figured that perhaps it was a book or something I had ordered and forgot about—as a fairly avid reader, this was not beyond the realm of possibility for me! I noticed that it was a bit light for a book, though. As I reached inside the box and pushed aside the packaging material, I was surprised to see a brand new 3M Littmann Cardiology III Stethoscope staring back up at me!

 

My first thought was, “Well, maybe it’s from the school?” But this was nice…probably too nice for the school to be sending out to students. Then I noticed that my name was engraved on it...and then I finally noticed the message included in the box, wishing me good luck in medical school from the doctors that I had worked with for two years as an emergency department scribe. Awww….

I had a great experience scribing with them, and this gift was greatly appreciated. I’m sure it will be put to good use.

How to Spend the Summer before Medical School

(Hint: Don’t pre-study.)

(Seriously.)

So, you’ve made it into medical school. And’s it’s summer. No more required resume-building activities, no more endless hours staring at a lecturer droning on and on about something you’ll never need after passing the next test, no more….oh, wait. I guess there’s more of that to come.

But not just yet. For now, the day is yours. So how should you spend it?

Don’t pre-study.

Listen. I get it. We’re all premeds, and by definition, we are generally all highly neurotic. We don’t really think we need to know all there is to know before medical school, we just want to “be prepared” or “be ready to jump in” when school rolls around – especially if we’ve been out for a little while. So why not just casually glance through Rohen’s or perhaps start reading Bate’s Guide to Physical Examination & History Taking while falling asleep? Can’t hurt, right?

Well, perhaps not. But when you actually have to read those books later, you’ll be kicking yourself for not taking advantage of your free time when you had the chance. Take the advice of multiple medical students, residents, and attendings who echo the repeated refrain: Don’t pre-study.

So, now that that required intro is out of the way, what should you do with your now-plentiful (hopefully!) free time? For some of us, we still need to work. Money, as your mother might have taught you, doesn’t grow on trees (but if you do find a money seed, please contact me). You’re still living, which means you need to live somewhere, eat, and pay for transportation to get to and from wherever you're going. That said, you likely worked during school, and you’ll quickly find that coming home from work to a bunch of homework is entirely different than simply working and coming home to significantly fewer responsibilities. As a bonus, your free days are often actually free, rather than periods of catch-up studying for the next exam or what-have-you. Ah, the glory…

So what to do? A couple things. For starters, while it’s generally a bad idea to pre-study, most of us are excited for what’s to come and want to do something related to medical school. So perhaps you could spend some time figuring out how you are going to study. Consider your past study habits and how they’ve worked for you, and then consider the format of your upcoming classes and consider how your habits might translate or need to be changed. Are you a book learner? Do you do best drawing things out? Studying in a group? Going to lecture? Some combination of the above? Peg your learning style now, so that you can begin studying efficiently when school starts in a few weeks.

For example: I like to solo-study. I don’t exactly like studying in a group, but I don’t mind it – as long as I’ve gone over the material at least once and have a general grasp of it. I can then use the time to help others learn it, which has the double-whammy bonus of 1) helping them and 2) reinforcing the material for me. But generally, I’m a bit of a loner in that regard.

Also, I like flash cards. I used them frequently in undergrad and while studying for the MCAT with great success. For material that I want to have down cold, these are my go-to tool. But they are a pain to make and store, and I now have a bunch of old flashcards that I’ll never look at again but I just can’t bring myself to throw away…

Solution? While perusing the internet, I came across a link to a blog by user who goes by the name of Dr.Willbe. In this post, he provides a great overview of some relevant first year tips, one of which involves using a spaced-repetition program called Anki. He goes into further detail about the program here, and since he’s done such a great job of distilling it into an understandable post, I’ll refer you there for further information if you’re curious (Update: I've written more about Anki here). Anki isn’t for everyone, and there are other options (like Gunner Training or the new-and-improved Firecracker) for those who want flashcards but don’t want to make them.

Also, during undergrad, I largely took notes by hand. I personally didn’t own a laptop until the last semester of my senior year, and then only bought one for medical school. After using it to take notes for a couple of extra-credit guest lectures (those are always nice…), I had a hard time going back to hand-writing my notes for my regular classes. It doesn’t help that my hand writing could easily be confused with the marks a chicken would make on the ground if it were to accidentally step in wet paint. So it was a no-brainer that I’ll be using a laptop for notes in medical school. The question then became exactly how I would go about it? Microsoft Word (or Pages, for you Mac users)? That would work….but then I discovered OneNote. Perfect. An easy, flexible way to take notes and access them anywhere.

Of course, figuring all this out certainly didn’t take the whole summer. What else can you do? Obviously, spending time with friends and family is important. For many of us, we will be moving away and even if we aren’t, we will be much busier than we are now, thus potentially reducing the amount of quality time we can spend with loved ones. If you are married, talk with your spouse about this now and be sure that all parties know what’s about to happen. But at the same time, just because you are in medical school doesn’t mean you get to ignore everyone – especially your spouse. Decide now that, while you will strive to do well, you will have boundaries and accept that there will be days where you won’t be able to study as much as you might like because it’s now time to be done and go spend time with your loved ones.

Another thing you can do during the summer is to adopt a hobby or learn about something new. Personally, for example, I had always been somewhat curious about investing, finance, and all that that entailed but never really sat down and learned about it. That’s changed this summer—I’ve had a great time reading books, online resources, and various forums about investing, and have learned a ton (but of course, I still have much to learn). In fact, I’ll probably be posting about relevant issues for medical students and residents in the years to come. This is one of those things that is better to learn sooner than later.

For those who are interested, here are a few places to get started (Update: I've written more about this topic too, which can be found here):

The White Coat Investor

This is a great resource for medical students and residents in particular, but also for anyone interested in investing. It is written by an emergency medicine physician, and has a lot of great info about all sorts of things. I would highly recommend reading all of the articles linked in his “First-Timers!” section from top to bottom.

The Motley Fool

What is the difference between a Roth IRA and a traditional IRA? What’s a 529? How do mutual funds work? The answers to these questions and more can be found here. I recommend reading at least through all of the articles under the tabs “How to Invest” and “Retirement” to get a general idea of what’s going on. One word of caution: This site offers a lot of great free content, but has to make money somehow. This often comes in the form of “hot stock tips” newsletters and what not. Ignore these.

The Bogleheads Wiki and The Bogleheads Forum

Don’t be thrown off by the strange-sounding name – this wiki and the associated forum are one of the one of the best resources online for learning about investing and finance. Spend some time here – it will serve you well in the future. If you have any questions, ask away in the “Help with Personal Investments” subforum – you can get answers within minutes from many wise individuals, including those who have authored some of the most common-sense investment books available today.

Morningstar.com’s Investing Classroom

If you really want to learn the nitty-gritty details about stocks, mutual funds, bonds, etc., this is the place to go. It takes some time – I’m still not done yet – but going through their free classes is an excellent way to learn some of the finer points of investing.

So there you have it—a number of free, easy ways to learn about investing. Again, this is one of those things that will serve you well if you get a handle on it sooner than later.

In sum, there are a number of ways to spend your summer. Above all, though, be sure to spend time doing things you enjoy with those you love – that’s definitely something that you won’t regret later.