A License to Heal: Random Memories of an ER Doctor

A License to Heal: Random Memories of an ER Doctor, by Dr. Steven Bentley, is a very interesting read for anyone interested in a career not just in medicine, but also in my favorite field: Emergency Medicine (EM). The author started his career as a board certified physician in EM in the late 1970’s in North Carolina. His “random memories” are just that...they are his reflections of the past laid out in a somewhat linear order from medical school, his internship, residency, and throughout his career as a doctor. Dr. Bentley went into medicine to “escape the poverty that I had known as a child” and to be one of the “good guys” in white coats. Bentley suffered from chronic bronchitis and sinus infections as a child because of a genetic condition known as Kartagener’s Syndrome. All his internal organs in his body are in reverse of a “normal” body. Which literally means that you would listen to the heart on the right side of his body. This condition occurs in 1 our of 32,000 live births, and is something most people only read about in textbooks. Thus throughout his life, Dr. Bentley had multiple opportunities to be helped by the “good guy” doctors.

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Step 1 Is Coming

With Step 1 just over 10 weeks away, I think it is time to get pumped. Coming off Spring Break, I know that I could use some encouragement. "The Man in the Arena" was a speech delivered by Teddy Roosevelt almost 104 years ago in Paris, France. The most famous portion of the speech goes something like this:

It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.

Excuse me, I have to go run through a brick wall...then I will resume Step 1 studying.

The White Coat Investor Book Review

Dr. James Dahle is an Emergency Medicine physician who practices in Utah. He also is the owner and editor of The White Coat Investor, which is one of the most successful and widely-read financial blogs out there. Dr. Dahle wants to help physicians get a "fair shake" on Wall Street, and his website/book are tailored for those working in healthcare: medical students, residents, practicing physicians, dentists, etc. I was lucky enough to receive two signed copies from the author (one of which I will be giving away!), however this is an honest review as we have no financial relationship. 

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What Is A Clinical Vignette?

The USMLE Step 1 is becoming more and more clinically oriented. To be honest, I can't really argue with this change. The point of medical school is to produce clinicians, not robots that spit out rate-limiting enzymes (although there are plenty of questions about those too). After sampling a couple question banks this school year, I would estimate that 75% of questions involve a clinical vignette. Before medical school, I am pretty sure I had never even heard the words clinical vignette or pathognomonic so if you are also unfamiliar with the terms, read on! The word "vignette" is of French origin, and literally means "little vine." It was first used to describe the ornate illustrations that began chapters in books. However, in the medical field, a clinical vignette refers to a short report that describes a patient and disease process. Included in the write-up are patient demographics, presenting symptoms, physical exam findings, and laboratory results. The writers of Step 1 also like to include a bunch of information that is useless (so called "distractors").

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American Medical Student Research Journal

A week ago, I was approached about a "journal by medical students, for medical students," and this immediately piqued my interest. With the majority of published research placed behind pay walls and becoming increasing esoteric, I am all for a new research publishing model. The following is a guest post by Nadine Kaskas, the Editor-in-Chief of the American Medical Student Research Journal (and current 3rd year at Louisiana State University Health Shreveport School of Medicine). 

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