M3, Intern, Fellow: Medical Jargon Unveiled {Old Post}

I’ll be the first to admit that when I was in undergrad I was incredibly confused when people started throwing around terms like: M3, intern, resident, doctor, and fellow. I would usually just nod my head and act like I knew what was going on instead of asking questions. I mean I was pre-med so wasn’t I supposed to know everything there was about being a doctor? I can’t tell you how far from the truth that is. Ask questions, it’s the best way to learn! I was inspired to write this post to clear up some of the confusion that comes along with how physicians are educated because I can remember how baffled I was.

Undergrad

As you study in undergrad you may identify yourself pre-med and your school may actually have a major called pre-med (or a track). Other schools don’t have this, so you could be majoring in anything (Biology, English, etc.) and still identifying yourself as pre-med. Once you graduate you will most likely be earning a Bachelor in Science or Bachelor in Arts (there are tons of other degrees, for example, if you are graduating with a Bachelors in Engineering, but let’s try to keep this simple). In reality, anyone can go to medical school regardless of their major in college, as long as they finish the pre-requisites for entering medical school (each school has their own list of these which you can find on their respective websites).

Medical School

Medical students start identifying as M1’s, M2’s, M3’s, or M4’s. All this means is that they are in their first, second, third or fourth year of medical school. Medical school in the United States is for the most part four years long (with exceptions if you are getting a dual MD, PhD degree). For most schools the breakdown is as follows: M1/M2 years are spent mostly in the classroom learning background knowledge to get them ready for the clinical years. M3/M4 years are the clinical years. Most of the time is spent in the hospital working on patient cases (with the supervision of course) and some time is spent in the classroom. Some people refer to the M3/M4 years as rotations as well. You will be rotating through different departments in the hospital (or clinic setting) such as Pediatrics or Internal Medicine, to get a taste of everything. This exposure helps students decide what they would like do go into for their residency. After the four years of medical school and upon successful completion of all your school’s requirements you will be granted a doctor of medicine degree (MD) of doctor of osteopathic medicine degree (DO). So, now you are technically a doctor.

 Post-Medical School

Now that you have a medical degree, you still need practice and more experience to become more qualified. Once you have graduated medical school you will be going on to complete your residency. This is basically a hands-on training in a specific area of medicine, for example, Pediatrics. Residencies vary in length, lasting anywhere from 3-7 years. A family medicine residency typically is 3 years, while a surgery residency can be much longer. Now that you are in residency, we shall call you a resident. But, wait, this gets more confusing because people sometimes refer to residents (especially first-year residents) as interns. Being an intern means that you’re basically a new resident. After you have completed your residency you can either become a fellow, attending, or go onto additional residencies if you choose. A fellow is someone who has already completed a residency, for example in Pediatrics. You could then go on to complete a fellowship in Child Abuse Pediatrics. Check out this link for more examples of fellowships: https://services.aamc.org/eras/erasstats/par/. If you decide to not do a fellowship, you will be termed an attendingphysician. As an attending you will be in charge of residents and in most cases have the “final” say on cases. Obviously you will be taking input from residents and other attendings, but you may be ultimately held responsible for the patient. If you aren’t going to do a fellowship or continue on to be an attending, you may decide to get another board-certification. I know plenty of physicians who completed residencies in multiple specialties (Internal Medicine and Pediatrics is a big one because some hospitals offer a combined residency program!). 

Phew….that was a lot of info and it really only covers the bare minimum. I myself have been learning a lot as I’ve gone through being pre-med and in medical school about all of this medical terminology. This got me thinking, why in the world do we expect our patients to understand this? Seriously, this terminology is not common sense. It is OUR responsibility to educate our patients and make it clear our position.

 When you introduce yourself to patients be sure to give your full name and your position. For example, I could say, “Hi, my name is Aleah Chang and I’m a second year medical student at Oakland University William Beaumont School of Medicine.” Be sure if your position is a bit confusing to clarify it! For example, if you are a fellow explain that this means you have already completed four years of medical school and X years of residency training. Now, you are doing additional training in a specific area.

Patients will really benefit by understanding this, because honestly it makes you easier to trust! I don’t think patients mind helping medical students learn, but they may mind if they are lead to believe you are a doctor when you aren’t! Most patients aren’t going to ask what an intern is or what a resident is, so it’s your job to provide them with this information.

Pocket list:

 Pre-med: Most likely still in undergrad and will apply to go to medical school afterwards.

M1: First-year medical student, studies mostly in the classroom setting

M2: Second-year medical student, studies mostly in the classroom setting

M3: Third-year medical student, studying and working in the hospital setting

M4: Fourth-year medical student, studying and working in the hospital setting

MD/DO: Doctor, has completed four years of medical school, also called physician

Resident: finished medical school, is a doctor, now doing extra training

Intern: finished medical school, is a doctor, now doing extra training (most likely in very first year post-medical school)
Fellow: finished medical school and residency training, is a doctor, now doing additional training

Attending: top of the food chain, is a doctor, completed medical school and residency, leads residents

Another quick note is that in most schools/hospitals medical students should be wearing a short white coat (ends near the hip). Anyone who has graduated medical school (intern, resident, attending, fellow) will be wearing a long white coat (ends near the knee).

I plan to do another post on clearing up qualifications of different providers (ie nurses, doctors, PA’s, techs, etc) in the near future so stay tuned!

Questions? Suggestions? Comment below!

All Eyes On You {Old Post}

 As September begins so does interview season. Interviewing, whether its one on one or in the multiple mini interview setting can be intimidating. The best thing to do to calm your nerves is to go into an interview prepared. This can mean practicing with friends or family prior, learning about the interview style/setup, or reviewing your application a few times. Let’s talk about the two main types of interviews and some tips for good interviewing.

Traditional interview

So, this is probably what you’d think of when thinking of interviewing for a job. You will meet one on one with a professor, physician or other faculty member (all the way up to deans) and be asked a series of questions. Some schools have interviewers that conduct the actual interview in a more conversational manner. Even though this may seem more relaxed be sure to keep it professional at all times. Other schools may have a more formal format set up with just a straight Q & A back and forth between the interviewer and interviewee. From my personal experience, most questions have to do with different experiences listed within your application. Some other questions may include ethical based ones or what your goals will be when you are a physician. I never got anything too tricky luckily.

 Multiple Mini Interview (MMI)

This is a newer format that many schools are adopting. The most common set up includes different rooms or stations with separate interviewers at each. Different schools will each have their own unique way of setting this up, which is why it can be confusing when preparing. I’ll give you an example of how two of mine were set up so you have a better idea.

At X medical school there was 10 stations, each in a different closed room. All of the interviewees stood outside of one of the rooms and would eventually rotate through all of the rooms. An admissions worker would ring a bell and we had 60 seconds to read the prompt that was hanging on the door. During this time, we could take notes on a piece of paper. When the second bell rang we knocked on the door to meet our interviewee. This person was either a faculty member, medical student or professor.  We had 10 minutes to answer the question. When time was up we thanked the interviewee, left the room and began at the next room. So, these interviews were basically all one on one and were in a closed room, which helped eliminate some of the pressure.

At Z medical school there were 8 stations, all at different tables in a large banquet hall. So, I could see all of the other candidates interviewing and vice versa. We had a similar set up in which someone rang a bell, we had about a minute to read the prompt and then could start talking whenever we wanted to the interviewee. We had about 7 minutes to answer the question before we moved on to the next station.

As you can see the general format is similar between both school X and Z, but there are small differences in how each session is run.

How did I prep for my interviews?

I am a huge reader so, prior to my interviews I ordered two books off of Amazon.

1. How to Ace Your Medical School Interviews: 224 Sample Questions and Answers with Insight on the Interviews and Premed Process

http://www.amazon.com/How-Your-Medical-School-Interviews/dp/1483651673/ref=sr_1_1?s=books&ie=UTF8&qid=1442180090&sr=1-1&keywords=how+to+ace+your+medical+school+interview

 2. Ace Your Medical School Interview: Includes Multiple Mini Interviews MMI For Medical School

http://www.amazon.com/Ace-Your-Medical-School-Interview/dp/1492346098/ref=sr_1_6?ie=UTF8&qid=1442177022&sr=8-6&keywords=medical+school+interview+book

After reading these I felt very prepared as far as knowing what types of questions may come up. I spent time thoroughly reviewing my primary and secondary application for each school. I researched each school by browsing their websites. I also interviewed at a few schools at which I had friends attending, so I gave them a call and asked for some tips.

I’ve always felt that I had decent social skills and have had experience interviewing for jobs throughout high school and college, so I didn’t feel the need to attend any mock interview sessions. That being said, I would strongly recommend actually doing this. School career centers or other pre-medical geared entities may have a lot to offer in terms of interview tips.

 Aleah’s top tips

1. Remind yourself that the interview goes both ways. Even though they are interviewing you, keep in mind how your interview day goes. You wouldn’t want to attend a school that isn’t a good fit both ways.

2. Come professionally dressed. If you aren’t sure if something is acceptable, it’s not. They expect business attire, which means full suit. It is incredibly noticeable when someone comes in with an unprofessional outfit.

3. ALWAYS be on your best behavior. Even though schools may tell you when you are with students you can relax a little bit, don’t get carried away. Students can report things they find particularly offensive (you talking badly about other applicants, the school, etc) if they feel strongly about an interviewee.

4. Send thank-you notes. To do this, make sure you get a card or contact information from your interviewer before you leave. For MMI’s sending one thank-you note to the office of admissions will suffice.

5. Come to interview day with a few questions about the school. I think it’s always impressive when students ask about different elements of the school because it shows their genuine interest.

6. Do not act as if any interview you go on is for a “safety school.” You don’t know the outcome of your applications yet, so put your game face on. Every interview is a chance for you to get your dream job.

On current life things….

This past weekend was full of relaxing post-renal exam. On Friday I caught up with some things around the house and fell asleep early. Saturday I woke up at 630 AM to get ready for the first University of Michigan home game. We headed to Ann Arbor to spend time with friends and celebrate the big game. Saturday evening I was back at home watching Grandma’s boy with B (I know this movie is quite odd…). Today we went out to breakfast with two friends from college, went shopping at Great Lakes Crossing and I plan on getting caught up with some school work. We started our GI unit on Thursday!

Exam Day & Brunch {Old Post}

 Yesterday we finally took our renal final exam so I wanted to share my pre-exam tips!

–> Eat a healthy breakfast. In the morning I made a blueberry, peach, banana smoothie to start my day off. I just ordered the Ninja brand blender to make this whole process easier, so I’ll let you all know how it works! I also personally don’t drink coffee the morning of exams because it really irritates my stomach.

–> Sleep a full 8 hours (or more). I’m generally really good at getting a full nights rest, but on test day this is especially important. You want your mind to be sharp and fully alert.

 –> R-e-l-a-x the night before. I know this is hard for a lot of people to do because of test anxiety, but in my opinion there is no amount of last minute cramming that will truly help my cause. So, instead I watched the movie Fury with B. It is about WWII and was quite good. It reminded me of how lucky we all are to be living in a safe environment. There are so many people in terrible situations that fear for their safety on the daily. This helped me at least keep my exam in perspective (aka it’s not that big of a deal and it is a privilege that I got to take it).

 –>  Talk things out with a friend. Even though many of us are tempted to study alone thinking we will be more productive, it’s useful to go over concepts with somebody. Sometimes other people pick up on small details that you missed or focus on different topics. This is something that has gotten a little harder for me to do now that I live farther from my school (and friends).

–> Don’t sweat what everyone else is doing. Someone studied 17 hours today and read over all of the first aid prep books, who cares? If you have a clear study plan that is working, keep on keeping on. Don’t get bogged down by what everyone else is doing.

–> Take a deep breath. You’ve prepared for the exam and put in the hard work of learning the material. Now, all you need to do is regurgitate that knowledge.

 –> Surround yourself with people who lift you up. The last thing you need is someone to suck up all your energy. When I do study with other people I make sure they are the type to help keep me motivated and are as passionate about learning as I am.

Post exam I always feel so free! We got lucky and had an entire day off post-renal exam. I decided to go out to Black Lotus with friends last night to celebrate and went to brunch this morning at a place called Toast in Birmingham (it’s amazing). This morning something awesome happened. After we ate breakfast I asked the waitress for our bill and she told us that the man who sat near our table in the restaurant had paid for our entire tab. As a broke medical student this was awesome! It’s amazing how generous people can be. This random act of kindness made me so happy — thank you random Toast man, we love you! Hoping to pay it forward in the near future. The rest of the day will probably consist of putting my life back together (chores, errands, etc) and relaxing this evening.

Making It Work {Old Post}

As promised, I will be writing about my personal tips on how to stay happy in your relationship during medical school (and before). My boyfriend and I met while we were both attending the University of Michigan for undergrad. We had mutual friends and met through them my sophomore year (his junior year). I had invited him to an event and we really hit it off. After dating for a year he graduated and actually moved to Florida for a job. Luckily, after a year of doing long-distance he moved back to Michigan before I started medical school.

We settled into a small apartment about 15 minutes from my school. I’m happy I moved to school a few months before we actually started up because I had plenty of time to organize and make the space my own. I’m a strong believer in the need to be comfortable in your own home in order to be happy. Some places just don’t feel like home and until they do you can’t ever really be at peace. My first year was a complete whirlwind. Not only did I have to learn how to succeed in medical school, but I also had to learn how to live with my boyfriend.

 First and foremost, I am very lucky that my boyfriend is incredibly compassionate, forgiving and flexible. If you are going to be in medicine you truly need a partner that is very patient. There are going to be a lot of bumps along the way, but if you’ve found the right person, it won’t be anything you can’t handle. Below are some tips from my own personal experience:

1. Tell your partner what you need, don’t keep them guessing. I made this mistake at first believing that B could read my mind. When I finally learned, I just told him exactly what I needed. One of the big things I asked for was support during the week prior to my exams. I needed him to basically take care of me and the place (cook, clean, pack lunches, do laundry). Luckily, he has always been willing to help out around the house. By asking him to do these things for me I can concentrate on my studies that week. As a “trade” during non-exam weeks I try to do more of the household chores and cooking.

 2. Talk about your dreams and goals. Once your partner is on the same page as you about long-term goals they will have a better understanding of why you put in the work on a day to day basis. I’ve told B my future goals of becoming an amazing family doc, writing a book, and teaching one day. Listen to your partner’s goals too. I’ve noticed some people aren’t as laser focused as medical students are. I’ve always known what I wanted and that’s just been the way it’s been. My partner isn’t as certain about his future, so it’s always a good thing to explore their goals and dreams. Let them know that it’s okay not to know (we future docs are just very, very focused).

 3. Use your partner as a standardized patient. I’m not joking. Prior to my OSCE (Objective Structured Clinical Examination) I asked B to be my patient. I took his vitals, practiced a pulmonary exam on him and attempted to take a history. Although he got annoyed at times of me percussing his posterior thorax, we still had alot fun. Learning doesn’t always have to be lonely.

4. Try not to get upset when they do things without you. I tend to feel left out when B hangs out with all of our friends, while I’m stuck at home studying. Although this is one of the downsides about being in medical school, you have to remember that your partner deserves to do everything and anything that makes them happy. Even though I’m missing out, I always ask B for updates on what he’s doing with friends and for lots of pictures! It makes me happy to see him happy.

5. Carve out alone time. I tend to jam pack my schedule with meetings, events and get togethers when I’m not studying. Don’t forget that your partner needs attention too. This is one especially important thing when you live together. Even though you are sharing space, it doesn’t mean you are spending time together. For example, many nights I’m studying in my study room, while B is playing video games. Plan nights that the two of you can have dedicated time together. This could be a wine and movie night or dancing in the living room to sappy songs.

 6. Don’t compare where you are at in your relationship to everyone else on the internet. I swear I see an engagement notice popping up in my feed every other day. My friends are having babies and buying houses! Medical students will undoubtedly take an alternative route. Some of my classmates are married, but most I would say don’t have that in the cards due to mounting student debt. It’s great to talk about your future including marriage, kids, and where you want to live. Just remember that you are putting in the time now to be happy for the rest of your life. I’d much rather postpone my marriage a few years than sit in a desk job that I absolutely hate.

7. Celebrate their accomplishments. As a medical student, I guarantee you are doing awesome things and learning about some of the most incredible things. Don’t forget that your partner is most likely reaching their goals too. Make them dinner when they get a new job or treat them to a massage when they finish a presentation at work.

8. Tell them when you love something that they do. One thing I love that B does is he always leaves me notes on my white board to come home to. Sometimes they are silly and sometimes they are just plain cute. It always puts me in a good mood to come home to that. Showing appreciation is a hugely important part of a successful relationship.

9. Never go to bed mad. This is one of my rules of thumb. Every couple fights and when they do people tend to blow up on each other and walk away. I’m all for taking a “time out” and cooling down, but I never go to bed mad. I think this is something that inevitably leads to a topic being pushed down and buried, only to resurface later. If and when B and I fight we always try to talk things out and go to bed on a positive note.

10. Let them grow. The worst relationships I’ve seen are the ones in which one person holds another person back from their true potential. I’m blessed to have someone who always supports my career aspirations and allows me to truly be exactly who I want to be. I never feel tied down and I’d never want to make him feel that way either. Even though you are in a relationship it’s important to have some separate hobbies, goals and friends. Let each other be individuals as well as a cohesive unit.

11. Lastly, support each other but also know when to call each other out. Some couples live by a “back me up no matter what” motto and I definitely don’t. I would much rather have B tell me when I’m wrong so I can learn from my mistakes and grow as a person, than for him to just follow what I do and say no matter what. Accepting and understanding why you can (sometimes) be wrong is a large part of blossoming as an adult. Make each other better and celebrate your differences in opinion, rather than being carbon copies of each other.

Now, on to the turkey drop. What is it? So, the turkey drop is what medical students call Thanksgiving break. Often, people who came into school in relationships and are long-distance will go home and will break up. Hence the name, turkey drop. Okay, so I know breaking up is very hard emotionally, but just try to remember that it’s better now than later. If you and your partner can’t make it through the first few months of medical school you probably won’t make it through board studying, residency, babies and lots of other life things. Attempt to see it as a blessing in disguise. Trust me, there are plenty of other people out there. If you are taking a break up poorly, remember to reach out to your classmates and upper classman. Chances are they are going through similar things. Above all remember that you are in medical school, which automatically makes you bad ass. Don’t waiver on your dreams just because of a failed relationship. Use it as a learning experience on how to choose your next significant other.

Well, back to studying renal for me! We have our final exam on Tuesday!