Wednesday, May 22, 2013

"I'm sorry, I am only a medical student."

     So..........graduation is over. I am officially Dr. Amanda. While I am THRILLED that all of my hard work throughout the past 4 years........actually since the beginning of college (that is how long is takes to complete all of the necessary pre-requisistes for medical school) has earned me that title, I cannot help but feel a little bit of nostalgia for being a medical student. I know that may sound crazy, because all every medical student wants is to be called "doctor," but as the dean of my school reminded us, as our degrees were conferred, the responsibility that comes with the title is enormous. I now confer your degree "with all of the rights, titles, privileges, and responsibilities that come with it" is how he phrased it exactly.
      The next time I walk into a hospital, I will be somebody's doctor. The same is true for every one of the students in my class, and every 4th year medical student in the country. That fact is a little bit scary. A LOT scary actually. I am also 100% sure that it is just as scary, if not scarier, for the potential patients we will treat. During my rotations I used to wish I was the doctor so that I could actually make my own decisions and do my own procedures, but I also found comfort in my go to excuse "I am so sorry, I am not sure/can't do anything. I am only a medical student, but I would be happy to go and speak to the doctor for you."
      That excuse was useful in a multitude of situations, most of them stressful. I loved participating in  patient care, but I was always happy that I was not allowed to make decisions by myself, because that meant that I could not hurt or harm the patient by making the WRONG decision. I always had to check with the resident or the attending before doing anything. I had someone watching over me while I did a procedure, to make sure I did it correctly, or help guide me if I was stuck. Now, my excuse is gone. All bets are off. I am pretty sure they are not going to throw us interns to the wolves-we will (obviously) be working under more experienced residents and attendings. However, we will be expected to make our own decisions and be confident in them. I am pretty sure that I have gained no extra medical knowledge in the past 2 days (days in which my status has been changed from a medical student to a doctor), but I can hope that this will be a situation where there is an extremely sharp learning curve.
      I have not received my schedule yet, but I hope I begin on a service where the patients are not too sick, where I will not have life and death decisions to make on a daily basis. I would love to ease into residency, learn the flow of the hospital, and make friends with the nurses before being placed in a situation with critical patients. Unfortunately, I do not make the schedule, and I do not believe that I will be granted such luck. As a future anesthesia resident, I am required to complete 2 ICU months before the year is over, and I have a strong feeling that I will be starting there. All I can do, is my best. Study in my (extremely limited) free time, and look to more experienced doctors to help me along the way. I am told that this anxiety is extremely normal, and that in a year, when the next set of interns begin, I will feel like a pro. That is very hard to imagine right now, but I am optimistic.
      On another note, after only 9 months of marriage, I will finally be going on my honeymoon to Greece! So, even though I have so many things to post about, I will probably be a bit MIA for the next week an a half. I will be sure to update you guys and post pictures as soon as I return. In the meantime, happy Memorial Day and may this be your best summer ever (one in which you avoid any and all hospitals in the month of July-just kidding).

Wednesday, May 15, 2013

The Physician Shortage

      In case you aren't aware, there will be a huge physician shortage in the upcoming years. The population is living longer thanks to advances in medical technology, but a larger elderly population means that there will also be increased costs and demands for medical care. The U.S. population has grown by 50 million since 1997. According to UPI.com, it is estimated that the shortage of both primary care and specialty physicians will reach 63,000 by 2015 and 90,000 by the year 2020.
      The medical schools have been trying to do their part for the past few years, and many of them have increased the seats in their first year classes. New medical schools have also been opening throughout the country on a yearly basis. The annual Medical School Enrollment Survey conducted by the American Association of American Medical Colleges Center for Workforce Studies estimates that first year enrollment in medical school was projected to reach 21,434 by 2017-2018, which is a 30% increase from first year enrollment in 2002-2003. Unfortunately, the action taken by these schools is not helping to decrease the shortage because there are not enough residency positions available to train these extra doctors.
      As it stands currently, hundreds of medical students did not match into a first year residency position this year. Many people do not know this, but residency positions are funded by Medicare. Medicare and the taxpayer fund $9.5 billion per year to subsidize 94,000 teaching positions at teaching hospitals. Medicaid and other sources fund an additional 100,000 spots. These numbers have not changed since 1997, when The Balanced Budget Act froze the number of Medicare funded spots.
      Obviously, the deans of these growing medical schools are extremely concerned about the future of their graduates. It is not an easy task to get into medical school, and to graduate with around $250,000 in student loans and have no prospective training or job is a travesty for a medical student. It is also detrimental to the population for a potentially great young physician to be denied training.
      According to the Association of American Medical Colleges, the first step to correct the situation would be for Congress to lift the cap on residency training positions. Otherwise, despite the efforts of the medical schools, there will not be a single new practicing physician in the United States. Thankfully, representatives Allyson Schwartz, a democrat from Pennsylvania, and Aaron Schock, a republican from Illinois, have introduced a bill entitled "The Training Tomorrow's Doctor's Today Act" to try to increase the number of training positions in the country. The bill will create 15,000 new spots around the country throughout a 5 year period. Unfortunately, the cost is estimated at $1 billion dollars per year. Sadly, the bill has not moved at all in the house. At the very least, government leaders are trying to work to change the situation, but until they do, there will not be enough physicians to care for the enormous number of patients there will be in the future. So, while America has the knowledge and potential to save the lives of many, until we are able to train more physicians, they will not be able to utilize their skills, and the people of America will suffer.

Tuesday, May 14, 2013

Theory Sample Sale

      It has been WAY too long since I have posted anything. SORRY! I have been in Florida for the past week visiting friends and family. I am trying to make the most of my freedom because very shortly, free time will be a thing of the past. Anyway, I arrived back in NYC today for...........the theory sample sale!!!! I cut my trip short to fly home for it. JUST KIDDING. I was actually coming home today anyway, the timing just happened to work in my favor. Sample sales are one of the great perks of living in NYC, and Theory is one of the best.
      The sale takes place 2x a year in both December and May, and it can be hit or miss. Sometimes I walk out with armfuls of clothing, and sometimes I do not buy anything. Last May I bought the suit that I wore on all of my residency interviews. This year, they have leather coats (among other things)  for just $299 (currently being sold for $1285 in Bergdorf's). If you have time stop by 261 W 36th Street, 2nd Floor anytime through Sunday. The hours vary by day, but they generally open around 10 and close around 7. Here is a link: Theory Sample Sale with the details. Enjoy!
     

Friday, May 3, 2013

My New Food Steamer

      After a weekend of eating debauchery that included donut ice cream sandwiches and deep fried hamburgers (no joke), my jeans and I agreed that I needed a week of clean, healthy, low-calorie eating. Enter my new favorite contraption- my food steamer. I never really thought about purchasing a food steamer. I thought steaming food involved a big pot of boiling water, a lot of effort, and a big mess. Frankly, I didn't know that there were devices you could buy especially to steam food. As it turns out, there are devices you can buy for EVERYTHING. Anyway, when I got engaged, Matt and I received a food steamer as a gift. I did not think much of it until recently, when I was "shopping" in the pile of gifts we store at Matt's parent's house and came across it. I thought it looked interesting, so I grabbed it. It has become my new best friend.
      As it turns out, steaming enables food to retain more vitamins and minerals than other ways of cooking. It also naturally draws out the flavor in meat, fish, and vegetables without adding extra calories. The best part is, if you have a food steamer it requires very little effort on your behalf (exactly the way I like to cook) to make a delicious, low-calorie, high-flavor meal. All you have to do, is fill the bottom of the steamer with water, plug it in, put in the number of minutes you would like the food to cook for (and it comes with a manual that tells you how long to cook each type of food for), and that is it. Done.
      The steamer I have is the Hamilton Beach Digital Steamer. I am pretty sure mine came from Bed Bath and Beyond, but it is currently being sold on amazon for a cheaper price. Here is the link: Digital Steamer (to make your lives easier). It has two tiers, so you can cook different types of food at once, or you can take one tier out and cook one thing. It is so easy to use. Their slogan could have been "steaming for dummies." You can also program it to cook while you are not there and it will even keep the food warm until you are ready to eat it. It also doubles as a rice cooker. When I am done "cooking," and I put that in quotes because it requires so little effort I can barely call it that, I throw all of the parts in the dishwasher. I highly recommend this steamer, and steaming in general. It is definitely an under-utilized way to cook great food- and as an added bonus, both your mouth and your waistline will thank you.