http://medical-mastermind-community.com The Medical School Podcast has two major purposes: 1) to publish Mastermind Group recordings of experts in various medical education fields, and 2) to prevent physician burnout by teaching wellness in medical education from the peer-reviewed, scientific literature. Doctor Dan recruits the listener into an active role in order to increase awareness about medically underserved populations, sources of stress in medical students and residents, and efforts to remedy the imbalances. Sat, 24 Mar 2012 11:54:59 +0000 en hourly 1 http://wordpress.org/?v=3.2.1 The Medical School Podcast has two major purposes: 1) to publish Mastermind Group recordings of experts in various medical education fields, and 2) to prevent physician burnout by teaching wellness in medical education from the peer-reviewed, scientific literature. Doctor Dan recruits the listener into an active role in order to increase awareness about medically underserved populations, sources of stress in medical students and residents, and efforts to remedy the imbalances. Doctor Dan clean Doctor Dan drdanielwilliams@gmail.com drdanielwilliams@gmail.com (Doctor Dan) 2012 Mentoring the next generation of physicians... medical, school, student, usmle, mcat, premed, pre-med, premedical, burnout, doctor, physician, stress, mastermind, doctor dan, biology, physics, general chemistry, organic chemistry, verbal reasoning, biochemistry, genetics, physiology, anatomy, http://premedicaluniversity.com/wp-content/uploads/2012/03/Picture-16.png http://medical-mastermind-community.com/category/podcast Texas Biweekly, Saturday mornings at 7:00 AM CST http://medical-mastermind-community.com/podcast/usmle-pharmacology-of-antipsychotics http://medical-mastermind-community.com/podcast/usmle-pharmacology-of-antipsychotics#comments Sat, 03 Mar 2012 13:00:06 +0000 daniel http://medical-mastermind-community.com/?p=6771 http://medical-mastermind-community.com/podcast/usmle-pharmacology-of-antipsychotics/feed 0 antipsychotic medication,medical school usmle prep,schizophrenia,usmle pharmacology Episode 83: This is the second in our series of Gold Standard USMLE Audio Revews covering the antipsychotic medications.  Let me know if your medical school uses a systems-based curriculum; if so we'll organize the DVD-ROMs according to your block sche... Episode 83: This is the second in our series of Gold Standard USMLE Audio Revews covering the antipsychotic medications.  Let me know if your medical school uses a systems-based curriculum; if so we'll organize the DVD-ROMs according to your block sche... daniel clean 25:42 http://medical-mastermind-community.com/podcast/respiratory-pathophysiology http://medical-mastermind-community.com/podcast/respiratory-pathophysiology#comments Sat, 18 Feb 2012 13:00:08 +0000 daniel http://medical-mastermind-community.com/?p=3416 http://medical-mastermind-community.com/podcast/respiratory-pathophysiology/feed 0 laryngeal carcinoima,medical school pharmacology,medical school respiratory physiology,respiratory physiology,usmle asthma,usmle pharmacology Episode 82: Sample the Gold Standard USMLE Audio Reviews in this episode - decide for yourself if you like this Pharmacology of Asthma sample from a professional audiobook. If you do, we have an entire collection for every USMLE and medical school you ... Episode 82: Sample the Gold Standard USMLE Audio Reviews in this episode - decide for yourself if you like this Pharmacology of Asthma sample from a professional audiobook. If you do, we have an entire collection for every USMLE and medical school you take! Listen to the podcast here... I. A-a gradient – know how to calculate: Alveolar O2 and arterial pO2 are never the same. The difference between the two is called alveolar arterial gradient. Reasons for it: (1) Ventilation and perfusion are not evenly matched in the lungs. When standing up the ventilation is better than perfusion in the apex, whereas perfusion is better than ventilation at lower lobes. This explains why almost all pulmonary infarctions are in the lower lobes – perfusion is greater there. Also, this explains why reactivation TB is in the apex – TB is a strict aerobe and needs as more O2, and there is more ventilation in the upper lobes (higher O2 content). Normally, alveolar O2 is 100 and the arterial pO2 is 95. So, normally, the gradient is 5 mmHg. As you get older, the gradient expands, but not that much. Most people use their upper limit of normal – in other words, have a very very high specificity of 30 mmHg. If you have an A-a gradient of 30 mmHg or higher there is a problem. It is very high specificity (aka PPV – truly have something wrong). The concept is easy – you would expect the gradient btwn the alveolar O2 and the arterial O2 to be greater if you have primary lung dz. What will do this? Ventilation defects (produces hypoxemia, and therefore prolongs the gradient – dropping the PO2 and subtracting, and therefore a greater difference btwn the two), perfusion defect (ie pul embolus), and diffusion defect. But the depression of the medullary resp center by barbiturates does not cause a difference in A-a gradient. So, prolonged A-a gradient tells you the hypoxemia is due to a problem in the lungs (vent perfusion/diffusion defect). A normal A-a gradient tells you that something outside the lungs that is causing hypoxemia (resp acidosis – in resp acidosis, PO2 will go down). Causes of resp acidosis: pulmonary probs (COPD), depression of resp center (obstruct upper airway from epiglottitis, larygiotracheobronchitis, café coronary (paralyzed muscles of resp), Guillain Barre syndrome, amyotrophic lateral sclerosis, and paralysis of diaphragm. These all produce resp acidosis and hypoxemia, but the A-a gradient will be NORMAL). So, prolonged A-a gradient, something is wrong with the lungs. If A-a gradient is normal, there is something OUTSIDE of the lungs that is causing a resp problem. Few things must always be calculated: anion gap (with electrolytes) and A-a gradient for blood gases – all you need to do is calc alveolar O2. We can calculate the A-a gradient = 0.21 x 713 = 150 (0.21 is the atmospheric O2; and 760 minus the water vapor=713). So, 150 minus the pCO2 (given in the blood gas) divided by 0.8 (resp quotient). So, normal pCO2 = 40, and 40/.8=50 and 150-50 = 100; so, now that I have calc the alveolar O2, just subtract the measured arterial pO2 and you have the A-a gradient. This is very simple and gives a lot of info when working up hypoxemia. II. Upper Respiratory Disease: A. Nasal Polyps: 3 diff types of nasal polyps – MC is an allergic polyp. Never think of a polyp in the nose of kid that is allergic as an allergic polyp. Allergic polyps develop in adults after a long term allergies such as allergic rhinitis – Example: 5 y/o child with nasal polyp and resp defects, what is the first step in management? Sweat test – b/c if you have a polyp in the nose of the kid, you have cystic fibrosis; it’s not an allergic polyp. B. Triad Asthma – take an aspirin or NSAID, have nasal polyps and of course have asthma. They don’t tell you the pt took aspirin and that the pt has a polyp. The aspirin or NSAID is the answer but this is how they will ask the question: 35 y/o woman with chronic headaches or fibromyalgia. daniel clean 31:53 http://medical-mastermind-community.com/podcast/how-the-nrmp-match-day-algorithm-works http://medical-mastermind-community.com/podcast/how-the-nrmp-match-day-algorithm-works#comments Sat, 04 Feb 2012 03:57:55 +0000 daniel http://medical-mastermind-community.com/?p=6751 http://medical-mastermind-community.com/podcast/how-the-nrmp-match-day-algorithm-works/feed 0 eras. electronic residency application service,match day,national residency matching program,nrmp Episode 81: Match Day is around the corner and your certified rank order list is almost due. Do you put every program you interviewed on your list? What happens if you don't get your first choice? Should you put a very competitive place as number 1? - Episode 81: Match Day is around the corner and your certified rank order list is almost due. Do you put every program you interviewed on your list? What happens if you don't get your first choice? Should you put a very competitive place as number 1? At the time I published this podcast (Feb. 3, 2012), certified rank lists were due in 2.5 weeks. This audio podcast explains the way the "magic computer" decides who get's an allopathic residency in the US and who does not. This information is based on the National Residency Matching Program's statement from September 2010 (http://www.nrmp.org/res_match/about_res/algorithms.html); it's been unchanged since then. General principles are outlined in the figure below. Click here to download the NRMP Match Day Algorithm. (http://medical-mastermind-community.com/uploads/NRMP-Match-Day-algorithm.jpg)     daniel clean 30:26 http://medical-mastermind-community.com/podcast/how-to-study-best-on-clinical-rotations http://medical-mastermind-community.com/podcast/how-to-study-best-on-clinical-rotations#comments Mon, 10 Oct 2011 23:18:19 +0000 daniel http://medical-mastermind-community.com/?p=6716 http://medical-mastermind-community.com/podcast/how-to-study-best-on-clinical-rotations/feed 0 burnout prevention,study on clinical rotations,usmle study tips Episode 80: Learn how to maximize your clinical experience for test day. In this episode you’ll learn one of only two study goals during residency. Also, discover which phase of the exam cycle people are neglecting and a new resource that will help you... Episode 80: Learn how to maximize your clinical experience for test day. In this episode you’ll learn one of only two study goals during residency. Also, discover which phase of the exam cycle people are neglecting and a new resource that will help you... daniel clean 43:31 http://medical-mastermind-community.com/podcast/surviving-the-first-month-of-medical-school http://medical-mastermind-community.com/podcast/surviving-the-first-month-of-medical-school#comments Sun, 25 Sep 2011 20:12:41 +0000 daniel http://medical-mastermind-community.com/?p=6681 http://medical-mastermind-community.com/podcast/surviving-the-first-month-of-medical-school/feed 0 first year of medical school,how to survive medical school,medical school study techniques,medical student burnout,medical student depression,pre-matriculation program Episode 79: Experience second-hand what it's like to go through the first month of medical school. This podcast hits the highlights of a live teleconference of our Mastermind Community. Listen in... - In September, 2011, Episode 79: Experience second-hand what it's like to go through the first month of medical school. This podcast hits the highlights of a live teleconference of our Mastermind Community. Listen in... In September, 2011, two Mastermind members that are First Year Medical Students that took time on a Saturday morning to share their early experiences of medical school - while it's still fresh. Watch the entire video here:  Medical School Burnout Prevention (http://medical-mastermind-community.com/med-students/burnout-prevention) Top 10 Tips To Survive The First Month Of Medical School: * Don't think you're unique if it only takes a few hours on your very first day to feel overwhelmed. * Pre-matriculation programs help with establishing relationships before school starts and familiarity/orientation to the facilities. * "The Slump" is alive and well and Medical Mastermind Community membership may not be preventative - only therapeutic when you get on a live teleconference. * Review the Mastermind Study Techniques (http://medical-mastermind-community.com/med-students/how-to-study) (tab #2) the week prior to medical school starting. * Set your overall goal for medical school academic achievement and arrange your social schedule (what's left of it) accordingly. * Self-Testing is an indispensable study technique. (see the Mastermind Study Techniques (http://medical-mastermind-community.com/med-students/how-to-study)program for further details). * I highly recommend the Board Review Series of books for all of the classes for the entire first 2 years' of classes in medical school. * Active learning will help you digest difficult content. * Take notes in a USMLE review book (i.e., First Aid for the USMLE Step 1) as you go through your first 2 years. Don't read the book itself unless it's the week before final exams. * If you can get your hands on old medical school exams (http://medical-mastermind-community.com/med-students/usmle-preparation-exams), use them to complete your learning objectives (see what all is testable) and to practice figuring out why each incorrect answers choice is incorrect. FEATURED RESOURCES: * Mastermind Study Plan (http://medical-mastermind-community.com/med-students/how-to-study?aid=6516&pid=112&sa=0) CHEAT SHEET * PreMed Listener Questions podcast (http://premedicaluniversity.com/listener-questions-that-will-blow-your-mind/)   daniel clean 26:41 http://medical-mastermind-community.com/blog/medical-ethics-102 http://medical-mastermind-community.com/blog/medical-ethics-102#comments Mon, 01 Aug 2011 16:00:41 +0000 daniel http://medical-mastermind-community.com/?p=6635 http://medical-mastermind-community.com/blog/medical-ethics-102/feed 0 medical ethics,parental rights,right of sepulcher,wills Episode 78: Did you know that without a Right of Sepulcher a gay/lesbian partner can be excluded from end-of-life care decisions and even funerals? Medical Ethics for Gay and Lesbian Couples Wills Parental rights Episode 78: Did you know that without a Right of Sepulcher a gay/lesbian partner can be excluded from end-of-life care decisions and even funerals? Medical Ethics for Gay and Lesbian Couples * Wills * Parental rights * Gay/lesbian/unmarried legal issues in time of incapacitation or death daniel clean 22:53 http://medical-mastermind-community.com/blog/medical-ethics-101 http://medical-mastermind-community.com/blog/medical-ethics-101#comments Fri, 01 Jul 2011 16:00:57 +0000 daniel http://medical-mastermind-community.com/?p=6628 http://medical-mastermind-community.com/blog/medical-ethics-101/feed 0 advanced directives,end of life issues,medical ethics,medical power of attorney,release the body at time of death Episode 77: Discover sage advice you can use to counsel your patients with difficult family circumstances, end-of-life issues, and non-traditional "families". Medical Ethics Welcome to Part 1 of this 2-part series of interviews with Attorney Dara... Episode 77: Discover sage advice you can use to counsel your patients with difficult family circumstances, end-of-life issues, and non-traditional "families". Medical Ethics Welcome to Part 1 of this 2-part series of interviews with Attorney Dara Strickland. * Advanced directives * Medical power of attorney * End of life issues * release of body at time of death   daniel clean 36:52 http://medical-mastermind-community.com/blog/what-to-do-in-the-summer-before-medical-school http://medical-mastermind-community.com/blog/what-to-do-in-the-summer-before-medical-school#comments Wed, 01 Jun 2011 16:02:22 +0000 daniel http://medical-mastermind-community.com/?p=6616 http://medical-mastermind-community.com/blog/what-to-do-in-the-summer-before-medical-school/feed 0 Episode 76: Learn from two medicine insiders the best and worst things to do before medical school starts. - Discussion Points: Stories about what we did after college before med school -recognize non-traditional students and paths - Episode 76: Learn from two medicine insiders the best and worst things to do before medical school starts. Discussion Points: Stories about what we did after college before med school -recognize non-traditional students and paths Did we read anything medical related? -did we feel prepared -what did we wish we did -what was useful or useless Suggested activities for the summer before med school -Move -Spend Time with Your Family -Stay in Shape and Go to the Gym AND -Join a medical mentoring program (Medical Mastermind) -Do some passive learning (USMLE Audio Reviews) -create the file folders in your brain -don't stress -don't read too much -buy the "basics" for med school - First Aid and USMLE Audio daniel clean 49:50 http://medical-mastermind-community.com/podcast/unions-for-medical-students-and-residents http://medical-mastermind-community.com/podcast/unions-for-medical-students-and-residents#comments Tue, 03 May 2011 17:22:24 +0000 daniel http://medical-mastermind-community.com/?p=6495 http://medical-mastermind-community.com/podcast/unions-for-medical-students-and-residents/feed 0 malignant residency programs,Unions for Medical Students and Residents Episode 75: Did you know that resident unions have been forming in recent years? And with success? House Officer Unions Successful Dr. Sklar and colleagues published a report on the first 3 years of progress of a resident union at the University ... Episode 75: Did you know that resident unions have been forming in recent years? And with success? House Officer Unions Successful Dr. Sklar and colleagues published a report on the first 3 years of progress (http://journals.lww.com/academicmedicine/Fulltext/2011/05000/Commentary__Experience_With_Resident_Unions_at_One.10.aspx) of a resident union at the University of New Mexico in Albuquerque. There were definite gains in physician professionalism and unexpected strides toward improved patient care for disadvantaged patients. The resident union actually created a patient fund to help pay for medication, transportation, and other expenses for patients that can not afford it. Why didn't they tell me about this when I interviewed there? Resident Unions Not Unique To America Cruess and Cruess (http://journals.lww.com/academicmedicine/Fulltext/2011/05000/Commentary__Professionalism,_Unionization,_and.9.aspx) published in May 2011 that American physicians will follow a long line of physician unions the closer we get to a government-owned and run healthcare system. What union will you belong to? The Longest Running Resident Advocacy Group The Committee of Interns and Residents (http://www.cirseiu.org/about/Default.aspx) (CIR) has been advocating for residents for over 50 years. They have over 13,000 residents as members and are the largest group of its kind. daniel clean 15:32 http://medical-mastermind-community.com/podcast/do-caribbean-medical-schools-suck-part-2 http://medical-mastermind-community.com/podcast/do-caribbean-medical-schools-suck-part-2#comments Thu, 24 Mar 2011 16:00:27 +0000 daniel http://medical-mastermind-community.com/?p=6229 http://medical-mastermind-community.com/podcast/do-caribbean-medical-schools-suck-part-2/feed 0 caribbean medical schools,cost of caribbean medical schools,problems with caribbean medical shools,quality of caribbean medical schools Episode 74: This is where I ask him the big question - you don't want to miss his answer and the reason he gives for it! Caribbean Medical Schools This is the final reveal! - Take a listen and see exactly why people complain about the quality o... Episode 74: This is where I ask him the big question - you don't want to miss his answer and the reason he gives for it! Caribbean Medical Schools This is the final reveal! Take a listen and see exactly why people complain about the quality of medical students coming from "some" Caribbean medical schools. In summary, this two-part series on "Do Caribbean Medical Schools Suck" has addressed the following points: * The quality of medical training is on par with US Medical Schools * The standard of care is often not based on American culture * The content for licensing in the US is often outdated What do YOU think? Do they suck?   The opinions expressed in this interview are solely those of the interviewee and do not necessarily reflect those of Premedical Solutions, LLC or The Medical Mastermind Community and its members. daniel clean 36:51 http://medical-mastermind-community.com/podcast/do-caribbean-medical-schools-suck http://medical-mastermind-community.com/podcast/do-caribbean-medical-schools-suck#comments Sat, 19 Mar 2011 05:33:13 +0000 daniel http://medical-mastermind-community.com/?p=6223 http://medical-mastermind-community.com/podcast/do-caribbean-medical-schools-suck/feed 0 caribbean medical schools,ecfmg,fmg,img Episode 73: Yes, you read that right! You won't believe your ears on this one... - The opinions expressed by this eye witness do not necessarily reflect the opinions of Premedical Solutions, LLC or the Medical Mastermind Community and affiliates. Episode 73: Yes, you read that right! You won't believe your ears on this one... The opinions expressed by this eye witness do not necessarily reflect the opinions of Premedical Solutions, LLC or the Medical Mastermind Community and affiliates. Our hope is simply to encourage communication and an open dialogue about what is happening in the culture of medical education in the United States in order to best utilize the most valuable resource in medicine - the people. Enjoy. daniel clean 52:43 http://medical-mastermind-community.com/podcast/top-5-time-management-tips http://medical-mastermind-community.com/podcast/top-5-time-management-tips#comments Thu, 03 Mar 2011 16:00:28 +0000 daniel http://medical-mastermind-community.com/?p=6201 http://medical-mastermind-community.com/podcast/top-5-time-management-tips/feed 0 Episode 72: Learn about time inventories, respecting deadlines, goal setting, audio notes and more... Time Management Strategies For Medical School Do a time inventory and schedule time inventories every 3 weeks. Set goals. Episode 72: Learn about time inventories, respecting deadlines, goal setting, audio notes and more... Time Management Strategies For Medical School * Do a time inventory and schedule time inventories every 3 weeks. * Set goals. * Set specific tasks with time frames * Use an organizational system (use David Allen's 2-minute rule) * Physical fitness * Use peak performance times * Clean the clutter in your office, home, and nooks and crannies * Set and respect deadlines * Treat emails and your physical inbox as OTHER people's agenda, not your own * Negotiate your open-door policy * Assign responsibilities during the conversation on the subject, and communicate feedback action steps on-the-spot * Observe meeting start and end times strictly * Manage multiple projects so you can mentally change gears and keep busy * Say "no" to new projects if you can't commit the time necessary, or if it unrelated to your Definite Major Purpose * Reward yourself and alternate pleasant and unpleasant tasks 5 Time Management Strategies: A Physician Interview Interviewer:            On the line with me today is Justin Anderson Anderson from Apollo Audio books. We're glad to have you back. Welcome, Justin.   Justin Anderson:            Hi, Interviewer. Thanks for having me back.   TIME MANAGEMENT TIPS: JUSTIN ANDERSON   Interviewer:            We've enjoyed having you. Today, we're going talk about time management and we want to pick your brain a little bit. And I sent you earlier this week 15 Time Management Tips and you picked your top five and even added one there.   So, what I want to do at this time is let you start off telling us about this top five tips that got you through medical school regarding time management and the very first one being a time inventory. Will you tell us about that?   TIME INVENTORY   Justin Anderson:            As a medical student, you are from day one totally overwhelmed with what you have to cover. And, you know, they all often make that analogy of, it's like, time to take a drink of water from a fire hose. You can't possibly retain everything all the material that you have to get through.   And so, whether it's for your block exams or is it for studying for the USMLE, as the USMLE comes closer. I mean, I would always come and sit down and say, "Exactly, how much material do I need to get through?" And what I learned six months in the medical school is that for me to retain the information, I would have to make it through that information three times.   And so I would sit down and calculate out. Well you can do it two ways. You can either A, if you're a reader, then you sit down and calculate out, how long it takes you to read X number of pages? And you use that to say, "Well, how am I going to get through the material three times?" Or B, if you used audio like I used as a student and I had a, you know, 10 hours of audio that covered pathology. Then, I would say, "Well, I need to go – you get two to three times to take 30 hours."   And the thing is that once you start thinking about how many hours you need to study a day, then once you get a week or two into it, you need to decide, "Am I still on my schedule or am I not on my schedule? Am I getting further and further behind?"   And if you're getting more behind, then what are you going to do? How are you going to adjust your study methods in order to get back on track? If you're doing just right, then that's great.   And I think that times that I really felt that it was the most important to do, a time inventory was just before studying – I mean, just before the USMLE Step 1, because you have that summer break and your not in school – well, at least, we have a summer break.   At that point, we weren't in school. And so I took six weeks off to study, about a week to take the test, and then a week of vacation before I started – before I started the next year. daniel clean 35:31 http://medical-mastermind-community.com/podcast/rural-physician-support http://medical-mastermind-community.com/podcast/rural-physician-support#comments Mon, 28 Feb 2011 16:00:17 +0000 daniel http://medical-mastermind-community.com/?p=6186 http://medical-mastermind-community.com/podcast/rural-physician-support/feed 0 dr. david yale,help physicians,medical mastermind community,remembering medical school,rural physician interviews,rural physician support Episode 71: Listen to this live Mastermind Webinar with rural physician, Dr. David Yale. Learn, first-hand, what it takes to practice rural medicine in the 21st Century. -   - In this episode we are going to meet a rural physician. Episode 71: Listen to this live Mastermind Webinar with rural physician, Dr. David Yale. Learn, first-hand, what it takes to practice rural medicine in the 21st Century.   In this episode we are going to meet a rural physician. He is the real... daniel clean 19:19 http://medical-mastermind-community.com/podcast/your-fatigue-prescription http://medical-mastermind-community.com/podcast/your-fatigue-prescription#comments Thu, 17 Feb 2011 05:14:37 +0000 daniel http://medical-mastermind-community.com/?p=6174 http://medical-mastermind-community.com/podcast/your-fatigue-prescription/feed 0 medical student burnout,medical student fatigue Episode 70: How tired can YOU get in medical school? Find out what to do about it and how to prevent it in this episode of the Medical School Podcast. Medical School Fatigue is a Serious Problem Dr. Linda Clever will tell you what you can do abou... Episode 70: How tired can YOU get in medical school? Find out what to do about it and how to prevent it in this episode of the Medical School Podcast. Medical School Fatigue is a Serious Problem Dr. Linda Clever will tell you what you can do about it in this episode of the Medical School Podcast. Listen in as she discusses her 5 Steps to Renew Your Energy! daniel clean 33:49 http://medical-mastermind-community.com/blog/gold-standard-usmle-step-1-samples http://medical-mastermind-community.com/blog/gold-standard-usmle-step-1-samples#comments Fri, 14 Jan 2011 17:33:22 +0000 daniel http://medical-mastermind-community.com/?p=5993 http://medical-mastermind-community.com/blog/gold-standard-usmle-step-1-samples/feed 0 gold standard USMLE step 1 audio program samples Episode 69: Doctor Dan landed an exclusive interview with the ONLY licensed distributor of Gold Standard USMLE and USMLE Help. Listen here... Want all 200 hours of USMLE Step 1 through Step 3? When you enroll in the Basic Science Years membership, Episode 69: Doctor Dan landed an exclusive interview with the ONLY licensed distributor of Gold Standard USMLE and USMLE Help. Listen here... Want all 200 hours of USMLE Step 1 through Step 3?(http://medical-mastermind-community.com/uploads/girl-listening-to-USMLE-podcasts-160x240.jpg) When you enroll in the Basic Science Years membership (http://medical-mastermind-community.com/blog/the-basic-science-years), you get instant access to the USMLE Help Step 1 Biochemistry audio program, along with our base set of other USMLE Step 1 podcasts. To keep the price low, we'll ship you disks with the USMLE Help Step 1 Anatomy audio program and the entire Gold Standard USMLE audio program over an 18 month series. I'd suggest cutting back on one trip per week to Starbucks, use that money instead to buy these USMLE audio programs, and then get active and listen to them at the gym or while traveling! If you are already beyond the first two years of medical school, you would be better served joining as a Clinical Science Years member (http://medical-mastermind-community.com/blog/the-clinical-science-years). We are in the process of licensing negotiations that would allow you to receive instant access to the entire Gold Standard Foundations of Medicine audio course, with disks containing USMLE Help's Step 2 CK, Step 2 CS, Step 3, and Gold Standard Step 2 of the Boards shipped to you over an 18 month series. This has not yet been worked out, so current Clinical Science Years members enjoy only our base set of MasterMind Podcasts for Step 2 and 3. Compare which membership is best for you: (../uploads/buy-it-now.jpg) daniel clean 36:09 http://medical-mastermind-community.com/podcast/how-to-ace-an-exam-in-medical-school-a-medical-student-interview http://medical-mastermind-community.com/podcast/how-to-ace-an-exam-in-medical-school-a-medical-student-interview#comments Fri, 24 Dec 2010 14:00:05 +0000 daniel http://medical-mastermind-community.com/?p=5768 http://medical-mastermind-community.com/podcast/how-to-ace-an-exam-in-medical-school-a-medical-student-interview/feed 0 ace medical school,larry johnston,medical school tests,Oklahoma State University College of Osteopathic Medicine,study biochemistry medical school,study for medical school,study histology medical school Episode 68: Larry Johnston from Oklahoma State University College of Osteopathic Medicine tells us exactly what he did to ace his medical school Histology and Biochemistry exams. You don't want to miss this one... Episode 68: Larry Johnston from Oklahoma State University College of Osteopathic Medicine tells us exactly what he did to ace his medical school Histology and Biochemistry exams. You don't want to miss this one... (../wp-content/plugins/wp-evp/images/placeholder.png) Medical School Genius About 1 in 3,000 people can be considered genius. But what if genius were defined as the assimilation of opportunity and elite preparation? If that's the case, then the Study Techniques course  in the Medical Mastermind Community is exactly what you should do to improve your academic performance. Can everyone ace medical school? Of course not. If everyone had access to the Study Techniques course, it could affect the medical school class' bell curve (http://medical-mastermind-community.com/blog/the-basic-science-years) and that would require a change on the part of the faculty. Of course, for everything teacher may try to make tests difficult in medical school, there are those who seem to figure out their tricks and ace the exam regardless. This podcast interview will introduce you to one of those student that can ace medical schools. Elite preparation or Genius? You decide. daniel clean 42:37 http://medical-mastermind-community.com/podcast/fourth-time-applicant-five-acceptances-what-happened http://medical-mastermind-community.com/podcast/fourth-time-applicant-five-acceptances-what-happened#comments Fri, 17 Dec 2010 18:10:37 +0000 daniel http://medical-mastermind-community.com/?p=5516 http://medical-mastermind-community.com/podcast/fourth-time-applicant-five-acceptances-what-happened/feed 0 did not get accepted into medical school,did not match residency,how many medical schools to apply to,the success story format Episode 67:  Heather De Anda got accepted to her number 1 medical school yesterday and granted us an interview. She shares her "classic mistakes" in previous application years and provides great advice to the struggling premeds, Episode 67:  Heather De Anda got accepted to her number 1 medical school yesterday and granted us an interview. She shares her "classic mistakes" in previous application years and provides great advice to the struggling premeds, though these principles can be applied to all of us - at any level! Classic Mistakes in Medical School and Residency Applications: Here are some classic mistakes (Heather mentioned a few and Doctor Dan added some more...): * Assuming you're competitive * Not applying to enough schools or programs * Not keeping an open mind and positive attitude while on the interview trail * Not asking for, or accepting, help in the different domains of academics, essay writing, mentorship, interview skills and the success story format. * Not thinking of how your experience can benefit others (Mastermind Principle) * Being stingy with your money and not investing in your preparation daniel clean 49:47 http://medical-mastermind-community.com/podcast/a-5th-step-on-a-podcast-the-truth-about-the-u-t-houston-emergency-medicine-residency-program http://medical-mastermind-community.com/podcast/a-5th-step-on-a-podcast-the-truth-about-the-u-t-houston-emergency-medicine-residency-program#comments Thu, 04 Nov 2010 04:15:23 +0000 daniel http://medical-mastermind-community.com/?p=5418 http://medical-mastermind-community.com/podcast/a-5th-step-on-a-podcast-the-truth-about-the-u-t-houston-emergency-medicine-residency-program/feed 0 how to match to a residency,interview trails,malignant residency programs,residency interviews Episode 66: Discover the dark side of medicine with this insightful podcast. Learn a useful tool to help you make decisions when you're burned out. And learn how to find out where Dr. Dan will be interviewing so you can meet him when he's in town! Episode 66: Discover the dark side of medicine with this insightful podcast. Learn a useful tool to help you make decisions when you're burned out. And learn how to find out where Dr. Dan will be interviewing so you can meet him when he's in town! (http://medical-mastermind-community.com/uploads/Karlos-240x179.jpg)The "5th Step" comes from the 12-Step community and is essentially a written tool to help an individual gain perspective on a complex, often emotional, experience. Hmmm, sound like residency? You can follow my journey on Facebook as I travel the country doing 21 interviews at Psychiatry Residency Programs: http://www.facebook.com/#!/pages/Medical-School-MasterMind/112410748822927 daniel clean 13:11 http://medical-mastermind-community.com/podcast/atrophy-hypertrophy-hyperplasia-metaplasia-and-dysplasia http://medical-mastermind-community.com/podcast/atrophy-hypertrophy-hyperplasia-metaplasia-and-dysplasia#comments Tue, 05 Oct 2010 16:30:04 +0000 daniel http://medical-mastermind-community.com/?p=3370 http://medical-mastermind-community.com/podcast/atrophy-hypertrophy-hyperplasia-metaplasia-and-dysplasia/feed 0 adenocarcinoma,als,barrett's esophagus,breast cancer,hydronephrosis,hypopituitarism,lung cancer,prostate cancer,renin Episode 65: This episode covers atrophy, hypertrophy, metaplasia, dysplasia, and hyperplasia. - Listen to the podcast here... Adaptations to environmental stress: Growth alterations A. Atrophy: Episode 65: This episode covers atrophy, hypertrophy, metaplasia, dysplasia, and hyperplasia. Listen to the podcast here... Adaptations to environmental stress: Growth alterations A. Atrophy: Diagnosis: the decrease in tissue mass and the... daniel clean 25:19 http://medical-mastermind-community.com/podcast/contract-negotiations-for-physicians http://medical-mastermind-community.com/podcast/contract-negotiations-for-physicians#comments Tue, 21 Sep 2010 16:30:57 +0000 daniel http://medical-mastermind-community.com/?p=4311 http://medical-mastermind-community.com/podcast/contract-negotiations-for-physicians/feed 0 contract reviews for physicians,demographics of medical practice group,leaving medical practice,medical practice partnerships,physician benefits,physician retirement,physician salary,tail coverage Episode 64: Doctor Dan interviews Kasey Gahler, an independent financial adviser with experience in physicians' financial concerns. Learn how contacts can possibly affect your financial planning decisions in the future. Contract Reviews For Physicians Episode 64: Doctor Dan interviews Kasey Gahler, an independent financial adviser with experience in physicians' financial concerns. Learn how contacts can possibly affect your financial planning decisions in the future. Contract Reviews For Physicians Disclaimer: this is NOT legal advice; always review contracts for legal aspects with your lawyer. Physician Salary * Is the offer competitive with other offers in your geographic area? * Can be determined by: * Yearly American Medical Association book with general ranges per specialty and area; Also the Medical Group Management Association. * Simply talking with others going in to practice * Hospitals/practices using a past/recent contract and replacing the name can be commonplace * The practice may not know your fair market value * Discussion point for later on in the interview process * If too low, can usually be remedied by simply letting the practice know your fair market value Physician Benefits * Health insurance and group Disability Insurance (DI) * Most are pretty standard. * Typically not a "negotiation" point * Remember your group DI is taxable since the practice/hospital is paying the premiums Retirement * Also fairly straightforward * Most practices will help you get to the full amount of pre-tax savings. This can be done through 401K and profit sharing, SEP IRA's, 457 plans, etc. * Some practices allow you to put more away than the pre-tax maximum through deferred compensation, etc. * Most practices and hospitals now have Roth IRA availability. Something to keep in mind for the future. Might have another pod cast on taxation and retirement issues in the future, etc. Physician Concerns About Leaving Their First Practice * About 40% of physicians stay at first practice less than four years * Non Compete/Liquidated Damages - * This is a very often overlooked area of contracts that can affect your family. * Importance depends on whether you plan to practice in this specific area long term. If all of your family are from this area, might be a determining factor in your decision to practice there, if you would leave the area anyway this is most-likely a non-issue and not a point of negotiation. * Can be geographic in nature, monetary in nature but typically a combination of the two * In the past contracts typically stated: "If you leave our practice, you cannot practice within a 50 mile radius, etc. of one of our hospitals". Since this has been difficult to enforce at times, most contracts have moved to the following: "If you leave our practice, and  choose to practice within a 50 mile radius, etc. of one of our hospitals, you will owe us $200,000 or two times your annual salary, etc." These tend to be enforceable by the law. Tail Coverage * Covers your malpractice claims after you leave the practice. * Two different kinds: Occurrence based and claims based (Claims based way more expensive) * Can amount to as much as 2 - 3 times your yearly malpractice premium * Not as big of an issue as in the past as many new employers will help you buy purchasing a "nose" policy at the new practice/hospital * Something to be aware of as it would be financial funds out of pocket if you change practices and most young physicians might not be sitting on that amount of money right away. (Don't want to take out even more loans to leave first employer) Demographics of the Medical Practice Group * Too old -- Could change the way business is done once those partners begin to retire. Force many business decisions in the future with younger partners. Much bigger deal now than it was before the health care bill. Many older physicians starting to retire and sell off practices * Too young  -- Could change the amount of partnership income in the future. More "hands in the cookie jar". Medical Practice Partnership Guidelines * Unmet expectations at partnership is the biggest reasons we see people leave. daniel clean 38:54 http://medical-mastermind-community.com/blog/interview-skills http://medical-mastermind-community.com/blog/interview-skills#comments Fri, 13 Aug 2010 18:00:15 +0000 daniel http://medical-mastermind-community.com/?p=5141 http://medical-mastermind-community.com/blog/interview-skills/feed 0 interviewing skills,medical school interview,residency interview Episode 63: Learn how to ace your interviews for medical school and residency program admissions. Doctor Dan speaks from a lot of experience to bring you this concise volume. From saving money and resting to practicing your Success Stories and being up... Episode 63: Learn how to ace your interviews for medical school and residency program admissions. Doctor Dan speaks from a lot of experience to bring you this concise volume. From saving money and resting to practicing your Success Stories and being up on current events, your mind will be fully armed to take on the all-important task of selling yourself on that fateful day. Introduction to Interview Skills from the Medical Mastermind Community Hello and welcome to the Episode 63 of the Medical School Podcast. I’m your host, Doctor Dan. I’m here to bring you in to the Medical Mastermind Community, a fellowship of hundreds of like-minded medical and premedical students helping each other achieve success in a spirit of harmony. MCAT & USMLE Podcasts We have completed hundreds of hours of science podcasts for every test! From the MCAT and USMLE Step 1, all the way to the USMLE Step 3 and residency board preparation. You have to join the Medical Mastermind Community and listen immediately through the web. Or, download all the MP3’s you want. Simply right-click and save them to your computer. Then, drag them to a Playlist in iTunes or other MP3 player device. They are yours to keep forever. Please note, except for the Lifetime Membership option, all memberships have recurring, monthly dues that must be paid by you until we receive 3rd party funding. Interviewing Skills After you've submitted all of your secondary applications, AMCAS> TMDSAS, & ERAS applications, you've entered The Gap. This is a period of time when all of your work leading up to this point in your career is out of your control. Self-esteem and doubts Fear of not getting emailed or called There are a number of things you can do to prepare, however. Listen to the above podcast to learn all sorts of helpful tips. Click here to download the Medical School and Residency Program Comparison Sheets. (http://medical-mastermind-community.com/member-content/after-your-medical-school-application) daniel clean 1:03:18 http://medical-mastermind-community.com/podcast/integrative-medicine http://medical-mastermind-community.com/podcast/integrative-medicine#comments Tue, 10 Aug 2010 16:30:29 +0000 daniel http://medical-mastermind-community.com/?p=4308 http://medical-mastermind-community.com/podcast/integrative-medicine/feed 0 alternative medicine research,evidence-based holistic medicine,holistic medicine,integrative medicine,natural medicine database,natural standard Episode 62: What is the evidence for acupuncture, Yoga, and vitamin therapy? Doctor Dan interviews Dr. Ronald Stram, founder of the Center for Integrative Health and Healing. Integrative Medicine Training Episode 62: What is the evidence for acupuncture, Yoga, and vitamin therapy? Doctor Dan interviews Dr. Ronald Stram, founder of the Center for Integrative Health and Healing. Integrative Medicine Training After becoming board certified in Emergency Medicine, Dr. Stram did a fellowship at the Arizona Center for Integrative Medicine. Evidenced-Based Holistic Medicine Here are two databases that organize research by the strength of their evidence: * The Natural Standard * Natural Medicine Database daniel clean 40:24 http://medical-mastermind-community.com/podcast/motherhood-in-medicine http://medical-mastermind-community.com/podcast/motherhood-in-medicine#comments Tue, 27 Jul 2010 16:30:42 +0000 daniel http://medical-mastermind-community.com/?p=4305 http://medical-mastermind-community.com/podcast/motherhood-in-medicine/feed 0 dr christy valentine,dr kristie mcnealy,have a baby in medical school,jennifer reich,mommy md's,mommymdguides.com,mommymdguiges,pregnant physicians Episode 61: Doctor Dan interviews co-founder of MommyMDGuides.com, Jennifer Reich. Learn how women physicians balance motherhood with medical practice. Pregnant Physicians It is estimated that some 20, Episode 61: Doctor Dan interviews co-founder of MommyMDGuides.com, Jennifer Reich. Learn how women physicians balance motherhood with medical practice. Pregnant Physicians It is estimated that some 20,000 women have a child at some point in their medical education and as many as 50,00 men and women become parents during this process. Parenthood is clearly an epidemic! Medical Careers Having a child can definitely change your life priorities and, sometimes, cause you to want a different lifestyle. This can lead to a change in medical specialty. Once you look into the eyes of your newborn, your world will change. This is not something to fear, but to embrace! Best Time To Have A Child In Medical School There is no "right" time, which means that ANY time is the right time! See, the responsibilities and stress always seem less desirable when you're talking about someone else's child. When it's yours, it's entirely different. Is it tough? Sure, but you better listen to the podcast and let Jennifer answer that question from a women's perspective. Special Mentions * Jennifer's Posiblog * Dr. Kristie McNealy's blog * Christy Valentine, MD (http://www.mommymdguides.com/profilevalentine.html) daniel clean 20:01 http://medical-mastermind-community.com/podcast/cancer-part-2-usmle-step-1-prep http://medical-mastermind-community.com/podcast/cancer-part-2-usmle-step-1-prep#comments Tue, 20 Jul 2010 16:30:41 +0000 daniel http://medical-mastermind-community.com/?p=3392 http://medical-mastermind-community.com/podcast/cancer-part-2-usmle-step-1-prep/feed 0 cachexia,cancer grade versus stage,colon cancer,most common causes of cancer,paraneoplastic syndromes,xeroderma pigmentosa Episode 60: This is Part 2 of the very long Cancer Podcast. Dr. Dan covers Grade versus Stage, paraneoplastic syndromes, and a high-yield list of the most common causes of the various cancers. Cancers and Associated Diseases - Part II - Episode 60: This is Part 2 of the very long Cancer Podcast. Dr. Dan covers Grade versus Stage, paraneoplastic syndromes, and a high-yield list of the most common causes of the various cancers. Cancers and Associated Diseases - Part II Xeroderma pigmentosa – sun exposed areas, auto recessive, can cause all skin cancers (BCC, SCC, and melanomas), and the defect is in DNA repair enzymes. Other DNA repair defects are associated with BRCA1 and BRCA2, p53, they splice out the defects, this group is called the chromosomal instability syndromes – Wiskott Aldrich, Blooms, Ataxia Telangiectasias, and Fanconi’s, all have probs with DNA repair. Basic rule of thumb for BCC and SCC: * Upper lip and up is basal cell carcinoma; * lower lip and down is squamous cell (therefore, lesion on lower lip = sq cell; lesion on upper lip = basal cell) Example: inside nose is BCC, b/c above the upper lip Example: keloid – sq cell carcinomas and 3rd degree burns and sq cell carcinoma developing in areas of drainage from the sinus and ulcer that doesn’t heal from antibiotics. So, wherever there is constant irritation, and division of cells related to irritation, there is an increase susceptibility to cancer. This does not hold true for scar cancer tissue related cancers of the lungs or adenocarcinoma (just applies to things on the skin – ie burns and draining of sinus tracts). Only bacteria assoc with cancer? H. pylori – adenocarcinoma and low grade malignant lymphomas. XII. Grade vs Stage A. Grade = what does it look like? The term well differentiated means that the tumor is making something like keratin or glands, and if it’s identifiable it’s called low grade. When the cells are anaplastic, poorly differentiated under the microscope, and if you cannot tell what it is, then it’s called high grade. Example: sq cell carcinoma can see keratin pearls; can ID it, so it’s a low grade cancer. Example: see gland like spaces, can ID so its low grade B. Stage = (TNM) MC staging system; goes from least imp to most imp (TNM) Example: breast cancer with axillary node involvement; therefore, the N=1, but the “M” is worse, b/c it indicates that cancer has spread to other organs like bone, etc. Just b/c it goes to lymph nodes doesn’t mean it is the most imp prognostic factor. T=size of tumor; if tumor is over 2 sonometers, it has a chance of mets N=nodes (next most imp for prognosis) M=mets outside of nodes (most imp prognostic factor) Stage is more important than grade for prognosis; and within staging, M is the most imp factor for prognosis. Example: pt with prostate cancer, which of following has it the worst? The answer choices were cancer limited to prostate, it went into seminal vesicles, it involved the wall of bladder, went to lymph nodes, or bone? Answer = bone (bone represents the “M” of the TNM system – this is stage 4 by definition=mets) Example: a slide of a colon cancer and a lymph node: what is most important – size of tumor or lymph node involvement? Lymph node. If it was also in the liver, what is most imp? Liver specimen is the most imp prognostic factor. XIII. Host defenses – most important is Cytotoxic CD8 T cell Others – NK cells, Ab’s, macrophages, type 2 HPY. In hospital, they look for altered MHC class I Ag’s in the cancer pt, b/c cancer wants to kill T cells; they do this by putting in perforins, which activate  caspasases, and this leads to apoptosis (the signal, from the perforins, activate the caspasases, which have proteases, which break down the nucleus and mitochondria, and cell dies, without any inflammatory infiltrate). XIV. Other diseases seen in malignancy: A. Cachexia – cause is TNF alpha; it is irreversible. Once you see a pt with disseminated cancer about to go into catabolic state, can give then total nutrition, but still won’t help. (Will not get muscle mass back, and this is due to TNF-alpha) B. Many hematologic causes of anemia seen in malignancy daniel clean 30:02 http://medical-mastermind-community.com/podcast/plastic-surgery-specialty-options http://medical-mastermind-community.com/podcast/plastic-surgery-specialty-options#comments Tue, 13 Jul 2010 16:30:45 +0000 daniel http://medical-mastermind-community.com/?p=4298 http://medical-mastermind-community.com/podcast/plastic-surgery-specialty-options/feed 0 beverly hills,burn fellowship,cosmetic surgery,plastic surgery,plastics fellowships,trauma surgery fellowship Episode 59: Doctor Dan interviews Dr. Fardad Forouzanpour, a Cosmetic Surgeon. Dr. Fardad is a Board-Certified surgeon and one of only three physicians authorized to run his own Surgical Fellowship in Southern California. Episode 59: Doctor Dan interviews Dr. Fardad Forouzanpour, a Cosmetic Surgeon. Dr. Fardad is a Board-Certified surgeon and one of only three physicians authorized to run his own Surgical Fellowship in Southern California. He has trained surgeons from all over the world. Dr. Fardad is also the inventor of the Umbilical Locator which was designed to help plastic and cosmetic surgeons locate the umbilicus when performing abdominoplasties. Plastic Surgery Fellowships Traditional Plastic Surgery This is the most well-known. It covers a lot of burns and reconstructions, even trauma. Cosmetic Surgery As the name implies, this separate fellowship opportunity allows surgeons to focus on mostly elective, aesthetic surgeries and procedures. Most patients pay cash, are often quite needy, and aren't affected by the Health Care Reform. Words to the Wise: * Choose a specialty that you feel comfortable with, even if you had previously wanted to do something else. * Don't do procedures unless you're fully trained to do them and deal with the complications. * Not all surgeons' personalities fit well with the often wealthy clients that have elective cosmetic surgeries. daniel clean 26:59 http://medical-mastermind-community.com/podcast/mind-body-medicine-and-alternative-health-approaches http://medical-mastermind-community.com/podcast/mind-body-medicine-and-alternative-health-approaches#comments Tue, 06 Jul 2010 16:30:30 +0000 daniel http://medical-mastermind-community.com/?p=4295 http://medical-mastermind-community.com/podcast/mind-body-medicine-and-alternative-health-approaches/feed 0 accupuncture,integrative medicine,malpractice litigation,medical decision making,meditation Episode 58: Doctor Dan interviews Oleg Reznik, M.D., author of The Secrets of Medical Decision Making. He is an expert in Mind-Body medicine and is currently faculty at The American Institute for Mental Imagery. Medical Decision Making Episode 58: Doctor Dan interviews Oleg Reznik, M.D., author of The Secrets of Medical Decision Making. He is an expert in Mind-Body medicine and is currently faculty at The American Institute for Mental Imagery. Medical Decision Making When we seek medical advice we’re hoping that a physician will always offer us what is in our absolute best interest. Indeed many physicians attempt to do that and some actually do. It is my perception however that great many physicians are bound by what I would call the Four Corners of the Medical Box. Physician Pressures: * Fear of litigation * Financial and time pressures * Guidelines of Health Care Authorities * The current Medical Model What propels a physician to leave this box by going beyond the boundaries of personal security? The Medical Decision-Making Solution: * Genuine compassion * Desire to do what is in patient’s absolute best interest * Courage to take the necessary risks. daniel clean 22:21 http://medical-mastermind-community.com/podcast/edema http://medical-mastermind-community.com/podcast/edema#comments Tue, 29 Jun 2010 16:30:35 +0000 daniel http://medical-mastermind-community.com/?p=3376 http://medical-mastermind-community.com/podcast/edema/feed 0 albumin,anaphylactic edema,cirrhosis edema,heart failure edema,hypoalbuminemia,interstitial space,lymphedema,mastectomy swelling,nonpitting edema exudates,oncotic pressure,pitting edema,transudates Episode 57: In this episode, Doctor Dan discusses types and causes of edema, Starlings forces of oncotic and hydrostatic pressure, and gives relevant clinical examples that demonstrate each type. - Listen to the podcast here... Episode 57: In this episode, Doctor Dan discusses types and causes of edema, Starlings forces of oncotic and hydrostatic pressure, and gives relevant clinical examples that demonstrate each type. Listen to the podcast here... Fluid and Hemodynamics I. Edema – excess fluid in the interstitial space, which is extracellular fluid (ECF); this is outside the vessel. A. Types of Edema 1. Non-Pitting edema Increased vessel permeability with pus in the interstitial space (pus=exudates). Lymphatic fluid is another type of non-pitting edema. Blockage of lymphatics leads to lymphatic fluid in the interstitial space. Pits early, but eventually becomes nonpitting. Exudates and lymphatic fluid does not pit. 2. Pitting edema Transudate with right heart failure, swelling of the lower extremities, fluid in the interstitial space. Transudate does pit. 3. Three causes of edema: Exudates, lymphedema, and transudate. Transudates are the only one that has pitting edema. B. Transudate/Pitting Edema Transudate deals with Starling forces: 1. What keeps fluid in our blood vessels? Albumin, and this is called oncotic pressure. 80% of our oncotic pressure is related to the serum albumin levels. Anytime there is hypoalbuminemia then we will have a leaking of a transudate (protein of less than 3 g/dL) leaking into interstial space via capillaries and venules (pitting edema). 2. Normally, hydrostatic pressure is trying to push fluid out. Therefore, in a normal person, oncotic pressure is winning. Therefore, a decrease in oncotic pressure and an increase in hydrostatic pressure will lead to transudate (pitting edema). 3. Albumin is made in the liver. With chronic liver dz (cirrhosis), have a decreased albumin level. Can you vomit it out? No. Can crap it out (malabsorption syndrome), or can pee it out (nephrotic syndrome), can come off our skin (3rd degree burn b/c losing plasma), another possibility of low protein ct (low-intake) is seen in kids – Kwashiorkor – kid has fatty liver and decreased protein intake, leading to low albumin level. 4. Examples of clinical edema: a. Person with MI MI 24 hrs ago and he died and he has fluid coming out– transudate b/c increased hydrostatic pressure and left HF due to MI so things backed up into the lungs. B/c the CO decreased, the EDV increases and pressure on left ventricle increases, and the pressure is transmitted into the left atrium, to the pul vein, keeps backing up, and the hydrostatic pressure in the lung approaches the oncotic pressure, and a transudate starts leaking into the interstitial space, which leads to activation of the J receptor, which will cause dyspnea. Leads to full blown in alveoli and pulmonary edema, which is what this is. b. Venom from bee sting On arm leads to exudate due to anaphylactic rxn (face swelled), with histamine being the propagator, and type one HPY, causing tissue swelling. Rx – airway, 1:1000 aqueous epinephrine subcutaneously c. Cirrhosis of liver With swelling of the legs: transudate, mechanism: decreased oncotic pressure b/c cannot syn albumin, and increased hydrostatic pressure b/c portal HTN; there is cirrhosis of the liver, and the portal vein empties into the liver; in this case, it cannot, and there is an increase in hydrostatic pressure, pushing the fluid out into the peripheral cavities (so there are 2 mechanisms for ascites). Pitting edema in legs: decreased in oncotic pressure. d. Right heart failure Pt with dependent pitting edema: pt has right heart failure, and therefore an increase in hydrostatic pressure; with right heart failure, the blood behind the failed right heart is in the venous system; cirrhosis of liver is due to decrease in oncotic pressure. e. Modified radical mastectomy With nonpitting edema: lymphedema. Other causes – w. bancrofti, lymphogranulomon venarium (subtype of chylamdia trachomata– scarring tissure and  lymphatics, leading to lymphedema of scrotum lymphatic). daniel clean 9:24 http://medical-mastermind-community.com/podcast/u-t-houston-medical-school-work-life-program http://medical-mastermind-community.com/podcast/u-t-houston-medical-school-work-life-program#comments Tue, 22 Jun 2010 16:30:37 +0000 daniel http://medical-mastermind-community.com/?p=4277 http://medical-mastermind-community.com/podcast/u-t-houston-medical-school-work-life-program/feed 0 medical school life balance,physician burnout,physician counseling,physician wellness Episode 56: Doctor Dan interviewed Sam Hester from the Work-Life Program at the University of Texas Medical School at Houston. Work Life Balance in Medical School VISIT THE UT WORK LIFE WEB SITE WorkLife Balance Free, confidential articles (3, Episode 56: Doctor Dan interviewed Sam Hester from the Work-Life Program at the University of Texas Medical School at Houston. Work Life Balance in Medical School VISIT THE UT WORK LIFE WEB SITE (http://publicaffairs.uth.tmc.edu/worklife/index.html) WorkLife Balance Free, confidential articles (3,000) and resources to assist employees with balance in their work and personal lives. Relocation Counseling Cross-country or across the street moves are made easier with a wealth of free information. Assistance for every phase of your move is just one call or click-of-the-mouse away. Child Care Research shows that if you have a break in your child-care provider, it takes about 17 hours to find a replacement, with much of that necessitated during the business day. The WorkLife Program can provide you with a number of licensed child care providers nationwide to mach your particular child’s needs. Elder Care In the next 5 years, about 50% of the working population will be involved with the care of an elderly person in their life in some way. The WorkLife Program provides free comprehensive and ongoing Elder Care Needs Assessment, Planning, and Resource Services information for any location in the United States. Wellness In an effort to keep your employees on the job and as productive as possible, along with the skyrocketing costs of health care, the WorkLife Program can tailor a specific wellness program to meet your company’s needs. We can provide on-site seminars in stress management, and smoking cessation, as well as establish an on-site fitness/coaching program. daniel clean 13 http://medical-mastermind-community.com/podcast/how-to-share-your-faith-in-medical-practice http://medical-mastermind-community.com/podcast/how-to-share-your-faith-in-medical-practice#comments Tue, 15 Jun 2010 16:30:48 +0000 daniel http://medical-mastermind-community.com/?p=4274 http://medical-mastermind-community.com/podcast/how-to-share-your-faith-in-medical-practice/feed 0 cmda life support podcast,doctor's prayer,pray with patients Episode 55: Doctor Dan was interviewed by the head of the Christian Medical and Dental Association, a strong organization that hosts meetings on most medical school campuses. CMDA's Life Support Podcast Episode 55: Doctor Dan was interviewed by the head of the Christian Medical and Dental Association, a strong organization that hosts meetings on most medical school campuses. CMDA's Life Support Podcast I originally invited them to our podcast and they decided to air it on their own podcast series called Life Support (http://www.cmda.org/AM/Template.cfm?Section=Life_Support1). We talk about sharing your faith, staying nurtured, and being Christ's light in the dark halls of training hospitals. daniel clean 18:51 http://medical-mastermind-community.com/podcast/cell-cycle http://medical-mastermind-community.com/podcast/cell-cycle#comments Tue, 08 Jun 2010 16:30:41 +0000 daniel http://medical-mastermind-community.com/?p=3367 http://medical-mastermind-community.com/podcast/cell-cycle/feed 0 cancer regulation,desmin,g phase,keratin,labile cells,m phase,s phase,spectrin,spherocytosis,ubiquitin,uibiquitination,vimentin Episode 54: Learn about the spectrin defect causing spherocytosis, the ubiquitination of damages intracellular constituents, different types of cells, regulation of the cell cycle, and cancer drugs. - Listen to the full podcast here... I. Episode 54: Learn about the spectrin defect causing spherocytosis, the ubiquitination of damages intracellular constituents, different types of cells, regulation of the cell cycle, and cancer drugs. Listen to the full podcast here... I. Cell Membrane Defects A. RBC membrane defect: Spherocytosis is a defect in spectrin within RBC cell membrane; if you can’t see a central area of pallor (if you don’t see a donut) then it’s a spherocyte. Absence of spectrin with in the RBC does not allow the RBC to form a biconcave disk; it is defective, and therefore forms a sphere. B. Ubiquitin – stress protein. High ubiquitin levels are associated with high levels of stress. Some of the intermediate filaments (keratin, desmin, vimentin) are part of the superstructure of our cells (“frame of the cell”, upon which things are built). When these intermediate filaments get damaged, the ubiquitin marks then for destruction. The intermediate filaments have been tagged (ubiquinated) and marked for destruction. Some of these products have names, for example: there are open spaces within the liver tisse, these spaces are fat and they are probably due to alcohol. The ubiquinited products of the liver are called Mallory bodies. These are the result of ubiquinated filaments called keratin and these are seen in alcoholic hepatitis. Another example: Silver stain of neurofibilary tangles – Jacob crutzfelt and alzheimers dz. Tau protein is associated with neurofib tangles; this is an example of a ubiquinated neurofilament. Example: Substantia nigra in Parkinson’s Dz – include inclusions called Lewy bodies, neurotransmitter deficiency is dopamine. Lewy bodies are ubiquinated neurofilaments. Therefore, Mallory bodies, Lewy bodies, and neurofib tangles are all examples of ubiquintation. II. Cell Cycle- A. Different types of cells: 1. Labile cells – cell where the division is via a stem cell. Three tissues that has stem cells: bone marrow, basement membrane of skin, and the base of crypts in the intestine. These cells have the tendency of being in the cell cycle a lot. In pharm: there are cell cycle specific and cell cycle nonspecific drugs. The cells that are most affected by these drugs are the labile cells b/c they are in the cell cycle. Complications of these drugs are BM suppression, diarrhea, mucocidis, and rashes on the skin (there are stem cells in all these tissues!). 2. Stable cells – in resting phase, Go phase. Most of parenchymal organs (liver, spleen, and kidney) and smooth muscle are stable cells. Stable cells can ungo division, but most of the time they are resting, and something must stimulate them to get into the cell cycle and divide – ie a hormone or a growth factor. For example: estrogen in woman will help in the proliferative phase of the menstrual cycle. The endometrial cells are initially in the Go phase and then the estrogen stimulated the cells to go into the the cell cycle. Therefore, they can divide, but they have to be invited by a hormone or a growth factor. 3. Permanent cells – can no longer get into the cell cycle, and have been permanently differentiated. The other types of muscle cells: striated, cardiac and neuronal cells. Only muscle that is NOT a permanent tissue = smooth muscle; hyperplasia = increase in #, while hypertrophy = increase in size. Would a permanent cell be able to under hyperplasia? NO, b/c that means more copies of it. Can it go under hypertrophy? Yes. A smooth muscle cell can undergo hyperplasia AND hypertrophy. B. Different phases of cell cycle: 1. G1 phase: The most variable phase of cell cycle is the G1 phase. Compare with menstrual cycle: The most variable phase is the proliferative phase (not the secretory phase). The prolifertive phase varies with stress; however, once ovulation has occurred, it is 14 days. Therefore, proliferative phase is analogous to G1 phase of the cell cycle b/c it can be shorter or lengthened; none of the other phases (S, G2, and M phase) changes, daniel clean 18:19 http://medical-mastermind-community.com/podcast/interview-with-a-transplant-patient http://medical-mastermind-community.com/podcast/interview-with-a-transplant-patient#comments Tue, 01 Jun 2010 16:30:17 +0000 daniel http://medical-mastermind-community.com/?p=4271 http://medical-mastermind-community.com/podcast/interview-with-a-transplant-patient/feed 0 heart transplant,immune suppression,lung transplant,mark black,transplant patient marathon runner Episode 53: Meet Mark Black: double organ transplant recipient, marathon runner turned motivational speaker. Boy, does he ever have some insight directed towards medical students. Congenital Heart Defect Podcast Cardiac Surgeries Episode 53: Meet Mark Black: double organ transplant recipient, marathon runner turned motivational speaker. Boy, does he ever have some insight directed towards medical students. Congenital Heart Defect Podcast Cardiac Surgeries His surgeries started at one day old for a congenital heart defect. Ventricular Arrhythmias By the age of 21 he had frequent ventricular tachycardia and was at risk for sudden cardiac arrest. He had a heart and two-lung transplant and ran his first half-marathon and 2.5 years until he ran his first full marathon. Now 3 are in his rear-view mirror. Patient Opinion of Medical Students Listen to the podcast to discover what advice he has for medical students! He spent a lot of time in hospitals, up to 6 months at a time growing up. Many places were teaching hospitals so his insights are very enlightening. He authored a book titled Live Life From The Heart. To support him and order his book, visit Mark Black Speaks. daniel clean 31:10 http://medical-mastermind-community.com/podcast/chronic-fatigue-syndrome-and-fybromyalgia http://medical-mastermind-community.com/podcast/chronic-fatigue-syndrome-and-fybromyalgia#comments Tue, 25 May 2010 16:30:42 +0000 daniel http://medical-mastermind-community.com/?p=4266 http://medical-mastermind-community.com/podcast/chronic-fatigue-syndrome-and-fybromyalgia/feed 0 chronic fatigue syndrome,fibromyalgia,hypothalamic dysfunction,insomnia,SHINE protocol Episode 52: In this episode, Doctor Dan interviews Dr. Jacob Teitelbaum, a physician who got Chronic Fatigue Syndrome as a result of a viral infection while in medical school. Chronic Fatigue Syndrome: Episode 52: In this episode, Doctor Dan interviews Dr. Jacob Teitelbaum, a physician who got Chronic Fatigue Syndrome as a result of a viral infection while in medical school. Chronic Fatigue Syndrome: CFS can  result from a variety of causes and is most commonly idiopathic. The condition can be devastating, as Dr. Teitelbaum describes in this interview how he went from Medical Student to homeless on a park bench, where he truly learned about Chronic Fatigue Syndrome. How to diagnose chronic fatigue syndrome: * Truly listen to your patient * Document insomnia despite extreme fatigue * More than 3 months in duration * Severe, disabling fatigue How to treat chronic fatigue syndrome: Use the SHINE protocol, shown to provide relief for 91% of patients: S - Sleep 7-8 hours per night using medication toward the goal of restorative sleep. H - Hormonal support I - Infections: diagnose and treat underlying or secondary infections during this immune-suppressed period N - Nutritional support E - Exercise as able. To learn more, visit www.Endfatigue.com (http://www.Endfatigue.com). daniel clean 56:51 http://medical-mastermind-community.com/podcast/tissue-repair-and-inflammation-highlights http://medical-mastermind-community.com/podcast/tissue-repair-and-inflammation-highlights#comments Tue, 18 May 2010 16:30:09 +0000 daniel http://medical-mastermind-community.com/?p=3374 http://medical-mastermind-community.com/podcast/tissue-repair-and-inflammation-highlights/feed 0 acoustic neuroma,agglutanins,astrocyte,central nervous system,cryoagglutinins,effect of myocardial infarction,erythrocyte sedimentation rate,esr,kidney hypoxia and injury,left shift,metamyelocyte,myeloblast Episode 51: Doctor Dan covers tissue repair and cellular response to injury in the kidney, lungs and nervous system. Also, get a quick review of inflammation in general to keep your memory fresh. - Listen to the podcast here... I. Tissue Repair Episode 51: Doctor Dan covers tissue repair and cellular response to injury in the kidney, lungs and nervous system. Also, get a quick review of inflammation in general to keep your memory fresh. Listen to the podcast here... I. Tissue Repair Scar tissue (b/c its permanent tissue); scar tissue (fibrous tissue) does not contract; therefore, if you have more scar tissue to free wall of left ventricle will lead to decreased Ejection Fraction, which is Stroke Volume divided by the End Diastolic Volume. EF = SV/EDV A. Response of Kidneys to Injury: Kidney will form scar tissue; medulla is most susceptible to ischemia (b/c least amount of blood supply). What part of nephron most susceptible to tissue hypoxia? 2 places: 1. Straight portion of prox tubule b/c most of oxidative metabolism is located there, with brush borders – this is where most of reabsorption of Na, and reclaiming of bicarb is there. 2. Medullary segment of thick ascending limb – where the Na/K-2Cl pump is – which is where loop diuretics block. The Na/K-2Cl pump generates free water. The two type of water in urine: obligated and free. If the water is obligated, then the water is obligated to go out with every Na, K, and Cl (concentrated urea). Basically 20 ml’s of obligated water for every Na, K, Cl (it’s obligated) via Na/K/2Cl pump. The ADH  hormone absorbs free water b/c the pump generates free water. Let’s say you absorb one Na, how much free water is left behind in the urine? – 20 mls; then reabsorbed another K, that is another 20, so its up to 40; another 2 Cl’s are reabsorbed which is another 40; therefore, for absorbing one Na, one K, and 2 Cl’s, you have taken 80 mls of free water from the urine – this is free water that is generated; its is this pump that loop diuretics block, which is in the thick ascending limb of the medullary segment. B. Response of Lungs to Injury: Lung repair cell is type II pneumocyte (can also repair type I pneumocytes); it also synthesizes surfactant. C. CNS Repair cell is the astrocyte; the astrocyte proliferates (b/c it’s a stable cell, not a neuron), that can proliferate and produces protoplasmic processes – called gliosis (rxn to injury in the brain, which is due to astrocyte proliferation); this is analogous to fibroblasts laying collagen type 3 in the wound. D. PNS Wallarian degeneration is the mech of axonal regeneration. In PNS, have Schwann cells, while in the CNS, have oligodendrocytes (both make myelin). Tumor Schwann cell = schwannoma; if it involves CN VIII it is called acoustic neuroma. What genetic dz that is auto dominant has association? Neurofibromatosis. II. Extra Side notes and Review of Inflammation: A. ESR Putting whole blood into cylinder and see when it settles. The higher the density, or weight, therefore settle pretty quick and therefore have a increased sedimentation rate. When stuck together and looks like coins = roulouex. When aggregated together = increased sed rate, which is increased IgG and fibrinogen (includes every acute and chronic inflammation there is. * What causes RBC’s to clump? – IgM, b/c the neg charge normally keeps RBC’s from stick to e/o. * IgM is a lot bigger; cold agglutinins are associated with IgM ab, leading to agglutinin. This is why in cold whether, you get Raynaud’s phenomenon (lips, nose, ears, toes, fingers turn blue). The IgM ab can cause cold agglutinins, leading to ischemia. * Another type of clumping of IgM are Cryoglobulins – Ig’s congeal in cold weather; IgM ab’s do the same thing. High assoc of hep C with cryoglobulins. * Multiple myleoma = increased esr b/c increased IgG; with waldenstroms, will see increased IgM (Waldenstrom’s Macroglobemia). B. Acute appendicitis Get CBC, and want to see absolute neutrophilic leukocytosis, meaning that you have an increase of neutrophils in the peripheral blood; also looking for toxic granulation, and a LEFT SHIFT. Assuming you start from myeloblast on the left, daniel clean 14:53 http://medical-mastermind-community.com/podcast/strategies-for-usmle-exam-day http://medical-mastermind-community.com/podcast/strategies-for-usmle-exam-day#comments Tue, 11 May 2010 16:30:32 +0000 daniel http://medical-mastermind-community.com/?p=3755 http://medical-mastermind-community.com/podcast/strategies-for-usmle-exam-day/feed 0 abim podcast,agfm podcast,anatomy of a test question,examination day tips,questions that don't count,residency podcast series,test taking strategies for the usmle boards,time management during a test,usmle practice questions,usmle study groups Episode 50: This is the first guest series lecture targeted for residents, but these "Test Day" strategies apply for the USMLE, MCAT, and every shelf exam you'll ever take. Test Taking Strategies For The Boards Episode 50: This is the first guest series lecture targeted for residents, but these "Test Day" strategies apply for the USMLE, MCAT, and every shelf exam you'll ever take. Test Taking Strategies For The Boards The United States Medical Licensing Examinations, ABIM (http://www.abim.org/), and ABFM (https://www.theabfm.org/) focus their content for the general, undifferentiated medical practitioner (GUMP). Board exams are designed to separate out good from bad test takers. It is assumed that all are adequate clinicians. Study guides are better than reviewing recent literature (within the last 5 years). USE PRACTICE QUESTIONS and STUDY GROUPS - not text books. Rule based questions are thrown out of the test development pruning process. The questions have to be answerable from information contained within the question. Therefore, you'll be selecting the "single best answer" practically all the time. The diagnosis, treatment, or risk factors are always pulled directly from the question stem and are needed to jive with the correct answer. Including images in the test is expensive and are, therefore, are very important for the correct answer. It may be a normal chest x-ray, but that information will be important in the thinking process required to arrive at the correct answer. Questions That Don't Count Towards Your Score 15% - 20% of your questions are being "tested" and aren't being considered for your score. They are being live tested to see if the question is a discriminative question. That is, does everyone get it right or wrong? If so, it will be thrown out. This process takes about 1,5 - 2 years to vet questions in this way, so very recent articles CAN'T be included. Repeated Questions Almost 20% of the test is repeated annually. Therefore, read remembered questions and get extra points. Anatomy of a Test Question Question Stem Most of it is unnecessary information. Lead-In The last sentence is the actual question. Correct Answer There is only one. Distracters Incorrect answers often have some truth in them. Putting all this together, if you get a question, look at the picture first. Then look at the Lead-In. Look for magic words: (download the complete list of "magic words") * Ashkenazi Jews and Gaucher's Disease * "Plop" on auscultation - myxoma * Tearing chest pain - dissection * Pt. works with animals - Tularemia * Demographics are always specific for the clinical pattern consistent with the correct answer. * http://medical-mastermind-community.com/pre-med/usmle-step-1 Absolutes are "always" wrong Words such as never, always, everyone, etc. These statements are way too broad to be true most of the time. Time Management * Spend 1-2 minutes on a question. Don't waste your time. * Save calculations for the end, unless you are very quick with 2x2 tables in biostatistics. If you recognize nothing, guess. * Half of the test will have to answers that you'll think about. The good distracter is partially correct. Examination Day Tips * Wear layered clothing, so you can peel them off. Don't get cold! * Don't study for 1-2 days before the test. * Don't study during the breaks. * Get plenty of rest. No sedatives or alcohol. Stay up late 2 nights before so you can sleep well the night before the exam. * Don't change answers. It's a 55-45% sway. Stick with your first gut instinct. daniel clean 24:46 http://medical-mastermind-community.com/podcast/inflammation http://medical-mastermind-community.com/podcast/inflammation#comments Tue, 04 May 2010 16:30:03 +0000 daniel http://medical-mastermind-community.com/?p=3372 http://medical-mastermind-community.com/podcast/inflammation/feed 0 acute inflammatory mediators,arachidonic acid metabolites,chemotaxis,chronic granulomatous disease of childhood,chronic inflammation,cluster designations,complement system,emigration,g6pd deficiency,hypersensitivity reactions, Episode 49: The original recording is very long for this topic because it covers, inflammatory mediators, phagocytosis and opsonization, complement and arachadonic acid, and cluster designations. - Listen to the podcast here... I. Episode 49: The original recording is very long for this topic because it covers, inflammatory mediators, phagocytosis and opsonization, complement and arachadonic acid, and cluster designations. Listen to the podcast here... I. Acute Inflammation A. Cardinal signs of inflammation In the scenario with a bee sting: you will see redness (Tubor). The king of vasodilators is histamine and it vasodilates the arterioles. Therefore, histamine is responsible for the redness of acute inflammation (i.e., bee sting), and is working on arterioles. Now if we felt the area, it will be warm (Calor = heat), this is due to vasodilating the arterioles, which is caused by histamine. For example in endotoxic and septic shock, the skin is warm b/c you are vasodilated. Tumor is a raised structure caused by histamine. Histamine can lead to increased vessel permeability in the venules; is arterial thicker than venules? Yes. The venules are very thin; they basically have an endothelial cell with a basement membrane, all you have to is drill a hole through the BM and you are out. Therefore, increased vessel permeability occurs at the venule level, not the arterial level. Histamine contracts the endothelial cells, and leaves the BM bare, leading to increased vessel permeability, producing an exudate, and swelling of tissue, hence tumor of acute  inflammation. The area may hurt (Dolor = pain) but histamine does not have anything to do with this. Bradykinin is part of the kininogen system between factor 11 and Hageman factor 12. So when you activate the intrinsic pathway, you automatically activate the kininogen system. When you activate factor 12 (Hageman factor), it will activate 11 and the whole kininogen system. The end product is bradykinin. ACE inhibits the degredation of bradykinin, therefore complicating the clinical condition with angioedema. Also inhibit metabolism of bradykinin, which increases vessel permeability, producing the angioedema (swelling of the tissues). How bradykinin produces cough is not really understood. Bradykinin and PGE2 cause pain (dolor) and is the only one out of the four Latin terms of acute inflammation that is not due to histamine release. B. Steps involved in Acute inflammation (this the normal sequence in acute inflammation): 1. Emigration: Includes margination, pavementing, rolling, adhesion, and transmigration Neutrophils in  circulation start to become sticky b/c of adhesion molecule synthesis. Endothelial cells begin to synthesize adhesion molecules. Eventually, neutrophils will stick to endothelial cells, these steps are called pavementing or margination. Then neutrophils look for bare basement membrane on the venules and then they drill a hole through it via type 4 collagenase. Cancer cells also have type 4 collagenase, that’s how they metastasize. Cancer cells attach to endothelial via adhesion molecules, usually against laminin in BM, and they have collagensae to get through the BM, therefore, cancer cells are pretty much like a neutrophil when invading tissue. 2. Chemotaxis: When they pass BM of small venules, they emigrate but they have to know what direction to go. They get directions in a process called directed chemotaxis. C5a and LT-B4 (leukotriene B4) are the chemotactic agents. These chemotactic agents are also involved in making adhesion molecules on neutrophils). Therefore, they make adhesion molecules AND give direction by acting like chemotactic agents. 3. Phagocytosis via opsonization: a) Example: in an acute inflammation with staph aureus, the bacteria are being processed by opsonins, which immobilize the particles on the surface of the phagocyte. The two main opsonins are IgG and C3b. They help with phagocytosis. b) Example of an opsonization defect: Brutons agammaglobinemia: an x-linked recessive dz, where all the immunoglobulins are missing, including IgG. Therefore, MCC death in these patients is due to infection because they cannot opsonize things. daniel clean 20:33 http://medical-mastermind-community.com/podcast/interview-with-napoleon-hill-foundation-educator-judy-williamson http://medical-mastermind-community.com/podcast/interview-with-napoleon-hill-foundation-educator-judy-williamson#comments Tue, 27 Apr 2010 16:30:51 +0000 daniel http://medical-mastermind-community.com/?p=4162 http://medical-mastermind-community.com/podcast/interview-with-napoleon-hill-foundation-educator-judy-williamson/feed 0 medical mastermind community,medical student mastermind groups,physician mastermind groups,premedical student mastermind groups Bonus Episode: Learn about Mastermind Groups from the Education Director for the Napoleon Hill Foundation World Learning Center. Napoleon Hill Foundation Podcast - Judy Williamson - World Learning Center Bonus Episode: Learn about Mastermind Groups from the Education Director for the Napoleon Hill Foundation World Learning Center. Napoleon Hill Foundation Podcast Judy Williamson - World Learning Center I'm very grateful that she donated some time and guidance to our Medical Mastermind Community. After all, I organized our community as a Mastermind organization after reading Napoleon Hill's Think and Grow Rich, which I highly recommend, and at the behest of my mentors. Authentic Community Because you are an inquisitive type, here are the research articles I refer to in the interview regarding Authentic Community. * Healer's Art Community This paper references the next one and renders their community less effective than a Mastermind: * The Healer's Art's ill-informed definition of what makes up the most effective Community. (page 139, 2nd paragraph says "shared expertise", opposite of Napoleon Hill's philosophy. Want to listen to a live Mastermind Meeting? Listen in to me on the next Medical Mastermind Community teleconference. You must first join the Community, then you can login to access the conference call instructions here. When is the next meeting? Add our Google Calendar to yours and receive automatic email reminders. daniel clean 54:21 http://medical-mastermind-community.com/podcast/the-health-care-reform-bill-h-r-3590 http://medical-mastermind-community.com/podcast/the-health-care-reform-bill-h-r-3590#comments Mon, 26 Apr 2010 21:23:16 +0000 daniel http://medical-mastermind-community.com/?p=4280 http://medical-mastermind-community.com/podcast/the-health-care-reform-bill-h-r-3590/feed 0 broken health care system,future of phsician careers,physician suicide prevention Bonus Episode: Learn exactly what is in the Health Care bill. In this video, Dr. Dan explains exactly how he will unveil the full contents of the Health Care bill so that you don't have to read it yourself. - Unbiased Bonus Episode: Learn exactly what is in the Health Care bill. In this video, Dr. Dan explains exactly how he will unveil the full contents of the Health Care bill so that you don't have to read it yourself. Unbiased Actually bipartisan (is that still possible?) Register for the conference: (https://www.paypal.com/en_US/i/scr/pixel.gif) Page 183   Establishment of Community Health Insurance Option (CHIO) Page 204  At least 85% of money must go toward actual health care costs Page 132  Establishment of Small Business Health Options Program (SHOP) Health Care Reform Bill That’s right, I’m reading the entire 2,409 – page health care bill in preparation for this year’s conference. Which new government program is poised to replace the Health Insurance industry? Find out at May 29-30, 2010 in Dallas, Texas. How will Health Care Reform affect medically underserved communities? Dr. Robert Bowman, M.D., a foremost expert in Health Disparities, will present a thorough case for the medically underserved patients in the U.S. that led to such sweeping reform. Register for the conference: (https://www.paypal.com/en_US/i/scr/pixel.gif) daniel clean http://medical-mastermind-community.com/podcast/apoptosis-necrosis-and-calcification-usmle-step-1-mp3s-notes http://medical-mastermind-community.com/podcast/apoptosis-necrosis-and-calcification-usmle-step-1-mp3s-notes#comments Tue, 20 Apr 2010 16:30:09 +0000 daniel http://medical-mastermind-community.com/?p=3082 http://medical-mastermind-community.com/podcast/apoptosis-necrosis-and-calcification-usmle-step-1-mp3s-notes/feed 0 apolipoprotein,apoprotein,caspase,dry gangrene,dystrophic calcification,emboli,fat necrosis,fibrinoid necrosis,glycose aminoglycans,granulomatous disease,hyaluronidase,ischemia Episode 48: In this episode, you'll learn about cell death, types of necrosis and lots of examples of pathophysiologic states that exemplify each condition. - Listen to the podcast here... Apoptosis - Programmed cell death Episode 48: In this episode, you'll learn about cell death, types of necrosis and lots of examples of pathophysiologic states that exemplify each condition. Listen to the podcast here... Apoptosis - Programmed cell death Normal functions of apoptotic genes – “programmed to die” (theory). (1) embryo – small bowel got lumens from apoptosis. (2) King of the body – Y c’some (for men); MIF very imp b/c all mullarian structures (uterus, cervix, upper 1/3 of vagina) are gone, therefore, no mullarian structures. MIF is a signal working with apoptosis, via caspasases. They destroy everything, then wrap everything in apoptotic bodies to be destroyed, and lipofuscin is left over. (3)For woman – X c’some; only have one functioning one b/c the other is a barr body. Absence of y c’some caused germinal ridge to go the ovarian route, therefore apoptosis knocked off the wolfian structures (epidydymis, seminal vesicles, and vas deferens). (4) Thymus in anterior mediastinum – large in kids; if absent, it is DiGeorge syndrome (absent thymic shadow), and would also have tetany; cause of thymus to involute is apoptosis. (5) Apoptosis is the major cancer killing mechanism. (6) Process of atrophy and reduced cell or tissue mass is due to apoptosis. Ex. Hepatitis – councilman body (looks like eosinophilic cell without apoptosis) of apoptosis (individual cell death with inflammation around it). Just needs a signal (hormone or chemical) which activate the caspases, and no inflammation is around it. Apoptosis of neurons – loss brain mass and brain atrophy, and leads to ischemia. Red cytoplasm, and pycnotic nucleas. Atherosclerotic plaque. Therefore, apoptosis is involved in embryo, pathology, and knocking off cancer cells. IV. Types of necrosis – manifestations of tissue damage. A. Coagulation Necrosis: Results often from a sudden cutoff of blood supply to an organ i.e. Ischemia (definition of ischemia = decrease in arterial blood flow). In ischemia, there is no oxygen therefore lactic acid builds up, and leads to coagulation necrosis. Gross manifestation of coagulation necrosis is infarction. Under microscope, looks like cardiac muscle but there are no striations, no nuclei, bright red, no inflammatory infiltrate, all due to lactic acid that has denatured and destroyed all the enzymes (cannot be broken down – neutrophils need to come in from the outside to breakdown). Therefore, vague outlines = coagulation necrosis (see color change in heart). Pale vs hemorrhagic infarctions: look at consistency of tissue. Good consistency = grossly look pale: infarct: heart, kidney, spleen, liver (rarest of the organ to infarct b/c dual blood supply); ie coagulation necrosis. Example of a pale infarction of the spleen, most likely due to emboli from left side of heart; causes of emboli: vegetations (rarely embolize in acute rheumatic endocarditis); infective endocarditis; mitral stenosis (heart is repeatedly attacked by group A beta hemolytic streptococcus); and clots/thrombi. The worst arrhythmia associated with embolization in the systemic circulation is atrial fib b/c there is stasis in the atria, clot formation, then it vibrates (lil pieces of clot embolize). B. Gangrenous Necrosis: dry and wet gangrene: Picture of a dry gangrene – not wet/no pus. This commonly occurs in diabetic’s with atherosclerosis of popliteal artery and possible thrombosis; (dry gangrene related to coagulation necrosis related with ischemia (definition of ischemia = decrease in arterial blood flow), which is due to atherosclerosis of the popliteal artery. Pathogenesis of MI: coronary thrombosis overlying the atheromatous plaque, leading to ischemia, and lumen is blocked due to thrombosis. MCC nontraumatic amputation = diabetes b/c enhanced atherosclerosis (popliteal artery = dangerous artery). Coronary is also dangerous b/c small lumen. In wet gangrene, it’s complicated by infective heterolysis and consequent liquefactive necrosis. daniel clean 20:01 http://medical-mastermind-community.com/podcast/princeton-review-for-the-usmle-step-1 http://medical-mastermind-community.com/podcast/princeton-review-for-the-usmle-step-1#comments Tue, 13 Apr 2010 16:30:13 +0000 daniel http://medical-mastermind-community.com/?p=3349 http://medical-mastermind-community.com/podcast/princeton-review-for-the-usmle-step-1/feed 0 caribbean medical school usmle step 1 review,ecfmg,img,princeton review for medical school,usmle online princeton review,usmle step 1 Episode 47:  This week I interviewed Carvell Nguyen, MD, PhD from Princeton Review. He is a Master Trainer for the USMLE. - Listen here for the full podcast... - For 15 years, Dr. Nguyen has been teaching for Princeton Review - ever since he took... Episode 47:  This week I interviewed Carvell Nguyen, MD, PhD from Princeton Review. He is a Master Trainer for the USMLE. Listen here for the full podcast... For 15 years, Dr. Nguyen has been teaching for Princeton Review - ever since he took his MCAT! Now, he travels the globe training Princeton Review's trainers and teaching thousands of international medical students in Mexico, the Dominican Republic, Caribbean, and Puerto Rico. There are several options that Princeton Review offers for the USMLE: US Nationals: * USMLE Step 1 Classroom Course: 7 hours of classroom instruction of Step 1 highlights to master, which includes their online review and Q-bank * USMLE Online Review, which includes the Q-bank * USMLE Q-bank "The biggest difference is the intensity of the classroom instruction." International Medical Students: * 150-hours of classroom instruction over 6-8 weeks! * Same Online review and Q-bank options are available Dr. Nguyen's top 3 recommendations for the second year medical schools: * Have a good study strategy, including using multiple senses to learn (http://medical-mastermind-community.com/pre-med/cd-of-the-month-club). * Have a good study schedule (http://medical-mastermind-community.com/pre-med/cd-of-the-month-club). * Emphasize quality of  conceptual understanding the material more than the average student, not only the quantity. daniel clean 25:12 http://medical-mastermind-community.com/podcast/free-radicals-usmle-step-1-mp3s-and-lecture-notes http://medical-mastermind-community.com/podcast/free-radicals-usmle-step-1-mp3s-and-lecture-notes#comments Tue, 06 Apr 2010 16:30:20 +0000 daniel http://medical-mastermind-community.com/?p=3076 http://medical-mastermind-community.com/podcast/free-radicals-usmle-step-1-mp3s-and-lecture-notes/feed 0 bronchopulmonary dysplasia,folate,folate reductase,fulmanant hepatitis,glutathione,hydroxyl free radicals,leukoverin,methotexate,mucamyst,n-acetylcysteine,tylenol overdose Episode 46: Learn all about bronchopulmonary dysplasia's pathophysiology, tylenol overdoses and treatment, and hydroxyl free radicals. - Listen to the podcast here... Free Radicals The liver’s brownish pigment is lipofuscin (seen on gross pic; c... Episode 46: Learn all about bronchopulmonary dysplasia's pathophysiology, tylenol overdoses and treatment, and hydroxyl free radicals. Listen to the podcast here... Free Radicals The liver’s brownish pigment is lipofuscin (seen on gross pic; can also be hemosiderin, bilirubin, etc; therefore need to have a case with the gross pic); end products of free radical damage are lipofuscin b/c certain things are not digestible (include lipids). A. Definition of free radical A compound with unpaired electron that is out of orbit, therefore it’s very unstable and it will damage things. B. Types of Free Radicals: 1. Oxygen: We are breathing O2, and O2 can give free radicals. If give a person 50% O2 for a period of time, will get superoxide free radicals, which lead to reperfusion injury, esp after giving tPA when trying to rid a damaged thrombus. Oxygentated blood goes back into the damaged cardiac muscle=reperfusion injury. Kids with resp distress syndrome can get free radical injury and go blind b/c they destroy the retina – called retinopathy prematurity; also leads to bronchopulmonary dysplasia, which leads to damage in the lungs and a crippling lung disease. 2. Hydroxyl Free Radicals Water in tissues converted to hydroxyl free radicals, leading to mutations in tissues.Complication of radiation therapy is CANCER (MC cancer from radiation is leukemia, due to hydroxyl free radicals). Fe2+ produces hydroxyl free radicals b/c of the Fenton rxn. This is what makes Fe overload diseases so dangerous, b/c wherever Fe is overloaded, leads to hydroxyl free radicals which will damage that tissue (therefore, in liver leads to cirrhosis, in heart leads to restrictive cardiomyopathy, in pancreas leads to failure, and malabsorption, along with diabetes). 3. Tylenol (aka acetaminophen): MCC drug induced fulminant hepatitis b/c free radicals (esp targets the liver, but also targets the kidneys). Cytochrome P450 in liver metabolizes drugs, and can change drugs into free radicals. Drugs are often changed in the liver to the active metabolite – ie phenytoin. Where in the liver does acetaminophen toxicity manifest itself? – right around central vein. Treatment: n-acetylcysteine; how? Well, the free radicals can be neutralized. Superoxide free radicals can be neutralized with supraoxide dismutase (SOD). Glutathione is the end product of the hexose/pentose phosphate shunt and this shunt also generates NADPH. Main function is to neutralize free radicals (esp drug free radicals, and free radicals derived from peroxide). Glutathione gets used up in neutralizing the acetaminophen free radicals. Therefore, when give n-acetylcysteine (aka mucamist); you are replenishing glutathione, therefore giving substrate to make more glutathione, so you can keep up with neutralizing acetaminophen free radicals. (like methotrexate, and leukoverin rescue – using up too much folate, leukoverin supplies the substrate to make DNA, folate reductase). 4. Carbon tetrachloride: CCl4 can be converted to a free radical in the liver (CCl3) in the liver, and a free radical can be formed out of that (seen in dry cleaning industry). c. Effect of NSAIDS on the Kidney Aspirin + Tylenol = very bad for kidney (takes a long time for damage to be seen). Free radicals from acetaminophen are destroying the renal medulla *only receives 10% of the blood supply-relatively hypoxic) and renal tubules. Aspirin is knocking off the vasodilator PGE2, which is made in the afferent arteriole. Therefore Angiotensin II (a vasoconstrictor) is left in charge of renal blood flow at the efferent arteriole. Either sloughing of medulla or destroyed ability to concentrate/dilute your urine, which is called analgesic nephropathy (due mainly to acetaminophen). daniel clean 9:02 http://medical-mastermind-community.com/podcast/preventive-medicine-for-the-usmle http://medical-mastermind-community.com/podcast/preventive-medicine-for-the-usmle#comments Thu, 01 Apr 2010 16:30:42 +0000 daniel http://medical-mastermind-community.com/?p=4157 http://medical-mastermind-community.com/podcast/preventive-medicine-for-the-usmle/feed 0 preventive medicine,usmle step 2 podcast,vaccine programs Episode 45: Sample this preventive medicine from the USMLE Audio Series at Medical-School-Podcast.com Preventive Medicine Preventive medicine, basically, has three tasks – screening, counseling, and immunization. Episode 45: Sample this preventive medicine from the USMLE Audio Series at Medical-School-Podcast.com Preventive Medicine Preventive medicine, basically, has three tasks – screening, counseling, and immunization.  We are going to be focusing on screening and immunization.  About 15 minutes we'll go over some screening principles, 15 minutes we'll go over some principles regarding immunization. Primary Prevention So when you talk about preventive medicine and prevention, you can talk about it and think about it as primary prevention, secondary prevention, and tertiary prevention.  In primary prevention, you are actually working on reducing risk factors before a disease or a condition has occurred – so, immunizing somebody so they don't get tetanus, you know, treating somebody who doesn't have coronary artery disease with hyperlipidemia therapy to prevent them from getting heart disease. Secondary Prevention Secondary prevention talks about detecting a disease or a condition to improve prognosis – to do a mammogram to get an early stage breast cancer where that disease will be treatable and curable. Tertiary Prevention Tertiary prevention is another concept we don't think about that much, but that would involve reducing risks of getting a second event.  So, if somebody has coronary artery disease, you put them on a high dose hyperlipidemic therapy to prevent their – or reduce their incidence of getting a follow-up disease. There are a number of terms that you need to know in preventive medicine – that are listed up here.  These are covered very nicely in your book in chapter four.  And I believe Dr. (Stoller) will be reviewing some of these at the end of the day as well.  So, I'm not going to touch on these. Screening Tests So let's talk about screening.  What are the general principles of screening?  Well, the disease that you're screening for or condition should be important – meaning it should have a significant morbidity or mortality.  It should also be common.  It should have a high prevalence and a high incidence.  The disease that you screen for, you should be able to treat.  And the tests that you use to screen should be accurate, getting at the sensitivity, specificity, and predictive value. Costs of Screening And, finally, the screening tests should have a reasonable cost, not only financial in regards to quality of the life you'll save, but also to the patient.  A screening test should be a low-risk test. So when you look at the – number one – two causes of mortality in United States in 2002, you can see that the big players are heart disease and cancer.  So these are the ones who we would want to screen for the most.  And, obviously, the age where you screen somebody or practice preventive medicine varies.  So, obviously, in your older population, heart disease and cancer will be much higher on the list, whereas in your younger population, accidents, suicide, homicide, unfortunately, has a higher prevalence. This very interesting slide shows the change in the United States death rates by cause between the years 1950 and 2002.  You can see that there has been a marked decrease in the rate per thousand deaths for heart disease, cerebral vascular disease, and also infection disease.  But the curve or the bar graph for cancer is relatively flat. So let's talk about, briefly, a couple of slides about cardiovascular screening.  We don't have time today, but I think this will be covered at other sessions during the course about screening for blood pressure, lipid guidelines, diabetes guidelines. EKG Screening? I wanted to just make sure that you are aware.  According to the United States Preventive Services Task Force, if you have a 40-year-old patient who comes in without any risk factor who is healthy, there is no indication to do routine stress test screening or really routine EKG. Another thing that you should be aware of is a new recommendation that came out this past year – I believe, daniel clean 30:43 http://medical-mastermind-community.com/podcast/goljan-usmle-step-1 http://medical-mastermind-community.com/podcast/goljan-usmle-step-1#comments Tue, 30 Mar 2010 16:30:50 +0000 daniel http://medical-mastermind-community.com/?p=3056 http://medical-mastermind-community.com/podcast/goljan-usmle-step-1/feed 0 2-3 dpg,anaerobic glycolysis,anemia,bohr hemoglobin curve,carbon monoxide poisoning,cytochrome oxidase,diffusion defect,hypoxia,methemoglobin,na/k pump,oxygen content,perfusion defects Episode 44: Welcome to this bi-weekly series of Goljan-inspired USMLE review MP3's. I'll go through my personal notes that I used to prepare for Step 1 first, then Step 2 Clinical Knowledge. My style is more direct, Episode 44: Welcome to this bi-weekly series of Goljan-inspired USMLE review MP3's. I'll go through my personal notes that I used to prepare for Step 1 first, then Step 2 Clinical Knowledge. My style is more direct, no stories or shame on you if you're not studying enough. Get access to all of the MP3's and high yield notes by joining Medical-Mastermind-Community.com and study on-the-go! Listen to the sample here... I. Hypoxia = inadequate oxygenation of tissue (same definition of as shock). Need O2 for oxidation phosphorylation pathway – where you get ATP from inner Mito membrane (electron transport system, called oxidative phosphorylation). The last rxn is O2 to receive the electrons. Protons are being kicked off, go back into the membrane, and form ATP, and ATP in formed in the mitochondria. A. Terms: 1. Oxygen content = Hb x O2 satn + partial pressure of arterial oxygen (these are the 3 main things that carry O2 in our blood) In Hb, the O2 attaches to heme group (O2 sat’n) Partial pressure of arterial O2 is O2 dissolved in plasma. In RBC, four heme groups (Fe must be +2; if Fe+ is +3, it cannot carry O2). Therefore, when all four heme groups have an O2 on it, the O2 sat’n is 100%. 2. O2 sat’n is the O2 IN the RBC is attached TO the heme group = (measured by a pulse oximeter) 3. Partial pressure of O2 is O2 dissolved in PLASMA  O2 flow: from alveoli through the interphase, then dissolves in plasma, and increases the partial pressure of O2, diffuses through the RBC membrane and attaches to the heme groups on the RBC on the Hb, which is the O2 sat’n. Therefore – if partial pressure of O2 is decreased, O2 sat’n HAS to be decreased (B/c O2 came from amount that was dissolved in plasma) B. Causes of tissue hypoxia: 1. Ischemia (decrease in ARTERIAL blood flow ……NOT venous). MCC Ischemia is thrombus in muscular artery (b/c this is the mcc death in USA = MI, therefore MI is good example of ischemia b/c thrombus is blocking arterial blood flow, producing tissue hypoxia). Other causes of tissue ischemia: decrease in Cardiac Output (leads to hypovolemia and cardiogenic shock) b/c there is a decrease in arterial blood flow. 2. 2nd MCC of tissue hypoxia = hypoxemia Hypoxia = ‘big’ term Hypoxemia = cause of hypoxia (they are not the same); deals with the partial pressure of O2 in the tissues. 3. Arterial O2 (O2 dissolved in arterial plasma, therefore, when the particle pressure of O2 is decreased, this is called hypoxemia). C. Here are 4 causes of hypoxemia: 1. Resp acidosis (in terms of hypoxemia) – in terms of Dalton’s law, the sum of the partial pressure of gas must = 760 at atmospheric pressure (have O2, CO2, and nitrogen; nitrogen remains constant – therefore, when you retain CO2, this is resp acidosis; when CO2 goes up, pO2 HAS to go down b/c must have to equal 760. Therefore, every time you have resp acidosis, from ANY cause, you have hypoxemia b/c low arterial pO2; increase CO2= decrease pO2, and vice versa in resp alkalosis). 2. Ventilation defects – best example is resp distress syndrome (aka hyaline membrane dz in children). In adults, this is called Adult RDS, and has a ventilation defect. Lost ventilation to the alveoli, but still have perfusion; therefore have created an intrapulmonary shunt. Exam question: pt with hypoxemia, given 100% of O2 for 20 minutes, and pO2 did not increase, therefore indicates a SHUNT, massive ventilation defect. 3. Perfusion defects – knock off blood flow MCC perfusion defect = pulmonary embolus, especially in prolonged flights, with sitting down and not getting up. Stasis in veins of the deep veins, leads to propagation of a clot and 3-5 days later an embolus develops and embolizes. In this case, you have ventilation, but no perfusion; therefore there is an increase in dead space. If you give 100% O2 for a perfusion defect, pO2 will go UP (way to distinguish vent from perfusion defect), daniel clean 20:01 http://medical-mastermind-community.com/podcast/osteopathic-residency-match-statistics-and-career-options http://medical-mastermind-community.com/podcast/osteopathic-residency-match-statistics-and-career-options#comments Mon, 29 Mar 2010 16:30:38 +0000 daniel http://medical-mastermind-community.com/?p=2746 http://medical-mastermind-community.com/podcast/osteopathic-residency-match-statistics-and-career-options/feed 0 ABMS,acgme,aoa,caribbean medical school,ecfmg,img,international medical graduate,osteopathic medical school Episode 43: Learn about the 5 residency options for osteopathic students, osteopathic board certification, malignant residency programs, and the full NRMP Match and Scramble Course. - Watch the full video podcast here... Episode 43: Learn about the 5 residency options for osteopathic students, osteopathic board certification, malignant residency programs, and the full NRMP Match and Scramble Course. Watch the full video podcast here... There are two certifying agencies for Osteopathic and Allopathic residency programs: •AOA: American Osteopathic Assn. (osteopathic D.O.) •ACGME: Accreditation Council for GME (allopathic M.D.) Here are the 5 different pathways Osteopathic medical students have to choose from: 1.AOA Residency (internship incl.) 2.AOA Prelim. (mostly at same institution) 3.AOA Traditional Internship (stand-alone) 4.ACGME (internship) 5.ACGME (residency) AOA approval for an allopathic internship? Yes, it is possible to get AOA approval for doing ACGME (allopathic) internship. This is useful for students who still want osteopathic board certification. In 2006, there were only 90 dual ABMS-AOA programs out of over 8,000 allopathic residencies. Download the full JOAO report and full AAMC report here. From July 2007 to December 2007: –1,603 D.O. petitions –1,217 (76%) approved –369 (23%) pending completion ____________ –99% total –<1% denied or withdrew app. In 2007, there were 3,103 D.O. graduates. This was the first time that number surpassed 3,000. Add in about 70 previous grads and you have the full residency application pool. Therefore, 3,173 for 2007, the most recent full data set released by the AOA. If you assume that all of them applied to either an AOA or ACGME program, then use ACGME data to complete the picture. AOA doesn't release all the necessary data, so I've made some calculations of my own: OVERALL D.O. MATCH RATE: 76% match rate of D.O. grads and previous grads match at either AOA or ACGME. •3,173 applicants to AOA + ACGME •1,136 matched allopathic with ACGME - 68.8% (69.9%, 2009) •1,267* matched osteopathic with AOA - 62.2% COMPARISON OF D.O.'s TO OTHER BACKGROUNDS MATCHING ALLOPATHIC: •Overall allopathic applicants - 71.4% •US Allopaths Grads/Students - 93.1% •US Osteopaths Grads/Students - 69.9% •US Nationals at International Medical Schools - 47.8% •International Medical Graduates 41.6% For further reading, click here. daniel clean http://medical-mastermind-community.com/podcast/residency-scramble http://medical-mastermind-community.com/podcast/residency-scramble#comments Sun, 28 Mar 2010 16:30:01 +0000 daniel http://medical-mastermind-community.com/?p=2737 http://medical-mastermind-community.com/podcast/residency-scramble/feed 0 ecfmg,eras,eras match,nrmp,residency scramble,unfilled residency positions Episode 42: Learn how to get insider access to the FULL version of this Match and Scramble Course. Doctor Dan unveils intimate parts of his medical education journey and gives Mastermind members exclusive access to behind-the-scenes video tutorials on ... Episode 42: Learn how to get insider access to the FULL version of this Match and Scramble Course. Doctor Dan unveils intimate parts of his medical education journey and gives Mastermind members exclusive access to behind-the-scenes video tutorials on the Scramble and Electronic Residency Application Service. Watch the full video podcast here... Every year there are over a hundred vacant residency positions after the match. Watch the Anatomy of a Malignant Residency Program course to figure out why some of these programs don’t fill. At exactly that time, the Scramble begins – the stressful cramming full of all these programs nationally, simultaneously. Practically speaking, the programs themselves get flooded with inquiries: •University email servers CRASH •Fax machines are busy and run out of ink, with people faxing 15-20 pages each of required documents. •The phone systems JAM. •The unprepared applicant suffers! Here's a great solution to this problem that you can employ BEFORE the match. Medical Mastermind membership gives you a 20% discount to www.ElectronicResidency.com: •Pre-Load all relevant documents into their software •Send cover page with relevant facts, not 20 pages to jam the system •Last year, submitted 500 applicant summaries by 12:05 PM with 97+% deliverability! daniel clean http://medical-mastermind-community.com/podcast/img-requirements-for-us-residencies http://medical-mastermind-community.com/podcast/img-requirements-for-us-residencies#comments Sat, 27 Mar 2010 16:30:54 +0000 daniel http://medical-mastermind-community.com/?p=2733 http://medical-mastermind-community.com/podcast/img-requirements-for-us-residencies/feed 0 aamc,ecfmg,eras,how to apply to us medical residencies,img,nrmp Episode 41: In this video podcast Doctor Dan unveils hidden residency program requirements that affect previous graduates and those that attended medical schools outside the United States. Also, there is a 4-step process for how to apply to U.S. Episode 41: In this video podcast Doctor Dan unveils hidden residency program requirements that affect previous graduates and those that attended medical schools outside the United States. Also, there is a 4-step process for how to apply to U.S. Residencies if you don't have U.S. citizenship or a green card. Watch the full video podcast here... We're down to the 5th reason residency applicants don't match every year: * Not enough interviews * Ranking unvetted programs * Failure to certify the Rank Order List * Competitiveness (USMLE scores, med school performance) * Incomplete documentation If you are a green card holder, then you have nothing to worry about. If you require a visa, then you need to get either: • a J1 sponsorship from ECFMG, or •residency program to sponsor you with an H1 visa. 4 Step Process For IMG's Entering U.S. Residencies: 1. Get Permission To Register for United States Medical Licensing Exam (USMLE) –Have your credentials transmitted to ECFMG so that you can get the ok to take the USMLE exams. –When the credentials are verified by ECFMG, you can register for the exams at ECFMG.org using the IWA link: https://secure2.ecfmg.org/emain.asp?app=iwa (https://secure2.ecfmg.org/emain.asp?app=iwa) 2. Register for the USMLE Exams: http://www.nbme.org/ (http://www.nbme.org/) 3. Prepare for the USMLE Exams: • USMLE Step 1, Step 2 Question Banks • Complete MCAT Video Lectures • U.S. Medical School Exams • U.S. Medical Student Class summaries All are now available with Mastermind membership. 4. When done with the exams and now ECFMG certified, then you can apply for residency. –Get the “token” from ECFMG.org –Register through ERAS: http://www.aamc.org/programs/eras/programs/registration/start.ht (http://www.aamc.org/programs/eras/programs/registration/start.htm)m (http://www.aamc.org/programs/eras/programs/registration/start.htm) –Register with the NRMP: https://services.nrmp.org/r3/home/login/login.cfm (https://services.nrmp.org/r3/home/login/login.cfm) daniel clean http://medical-mastermind-community.com/podcast/usmle-competition-residency-specialty-fill-rates http://medical-mastermind-community.com/podcast/usmle-competition-residency-specialty-fill-rates#comments Fri, 26 Mar 2010 16:30:07 +0000 daniel http://medical-mastermind-community.com/?p=2723 http://medical-mastermind-community.com/podcast/usmle-competition-residency-specialty-fill-rates/feed 0 eras,how competitive residencies are by specialty,match day,nrmp,residency match,rmedical residency competition,usmle scores needed for residency application Episode 40: Every year there are empty residency positions left over after Match Day. In this video podcast, learn the average USMLE scores for matched and unmatched NRMP applicants, as well as how competitive different residencies are. - Episode 40: Every year there are empty residency positions left over after Match Day. In this video podcast, learn the average USMLE scores for matched and unmatched NRMP applicants, as well as how competitive different residencies are. Watch the full video podcast here... In the last 18 years, competition has been rising: –1,100 new residency positions –10,300 increase of applicants (http://medical-mastermind-community.com/uploads/increasing-residency-competition-usmle-240x177.jpg) Interestingly, 53% of applicant growth comes from non-US medical schools (Download the full NRMP report). (http://medical-mastermind-community.com/uploads/increasing-residency-applicants.jpg) (http://medical-mastermind-community.com/uploads/increasing-residency-applicants-240x145.jpg) With rising competition, higher USMLE scores are expected over time. Here is a snapshot of current USMLE scored for matched and unmatched US and IMG residency applicants: (http://medical-mastermind-community.com/uploads/usmle-scores-for-residency-applicants-and-matched-239x114.jpg) Another question I get a lot is about the relative competitiveness of different medical specialties. (http://medical-mastermind-community.com/uploads/comparison-of-residency-specialties-competitiveness-187x240.jpg) daniel clean http://medical-mastermind-community.com/podcast/how-to-rank-medical-residencies http://medical-mastermind-community.com/podcast/how-to-rank-medical-residencies#comments Thu, 25 Mar 2010 16:30:10 +0000 daniel http://medical-mastermind-community.com/?p=2716 http://medical-mastermind-community.com/podcast/how-to-rank-medical-residencies/feed 0 ecfmg,eras,img,international medical graduates,nrmp Episode 39: Choosing your favorite residencies can be a very tough decision. Everyone has different priorities, but most of them revolve around a handful of central themes. Learn how to make sure that your deliberation isn't wasted as Doctor Dan shows ... Episode 39: Choosing your favorite residencies can be a very tough decision. Everyone has different priorities, but most of them revolve around a handful of central themes. Learn how to make sure that your deliberation isn't wasted as Doctor Dan shows you how to certify your rank order list. Watch the full video podcast here... How do people decide their residency rank order list? •Family •Location •Training •People –Research –Money –Career opportunities There is a deadline to "certify" your Rank Order List (ROL), so do it weeks early! Your NRMP dashboard should look like this when you are logged in. Don’t relax until you see this: (http://medical-mastermind-community.com/uploads/certified-rank-order-list1-240x124.jpg) daniel clean http://medical-mastermind-community.com/podcast/residency-program-requirements http://medical-mastermind-community.com/podcast/residency-program-requirements#comments Wed, 24 Mar 2010 16:30:24 +0000 daniel http://medical-mastermind-community.com/?p=2709 http://medical-mastermind-community.com/podcast/residency-program-requirements/feed 0 ecfmg,eras,img,international medical graduates,nrmp Episode 38: This video podcast discusses hidden residency program requirements which cause many thousands of wasted fees to be spent by International Medical Graduates every year. These can even apply to U.S. Episode 38: This video podcast discusses hidden residency program requirements which cause many thousands of wasted fees to be spent by International Medical Graduates every year. These can even apply to U.S. Nationals that go to Caribbean medical schools or those that have non-traditional residency pathways. Watch the full video podcast here... So far in this NRMP Match and Scramble video podcast series, we've started discussing the Top 5 Reasons Not To Match to a residency: * Not enough interviews * Ranking unvetted programs * Failure to certify the Rank Order List * Competitiveness (USMLE scores, med school performance) * Incomplete documentation Every year applicants don't take the time to investigate hidden program requirements. This is especially harmful for International Medical Graduates. •ERAS profits from each school chosen •Many schools have different requirements •They don’t tell you what they are You can learn limited information about the programs’ requirements ahead of time from the AMA’s Frieda Online site: https://freida.ama-assn.org/Freida/user/viewProgramSearch.do (https://freida.ama-assn.org/Freida/user/viewProgramSearch.do) There are lots of requirements that aren't listed publicly. Here is a sample of the rest of the requirements, provided as a courtesy by www.ElectronicResidency.com. Members of the Medical Mastermind Community get a 20% discount to this site AND www.MatchAResident.com. (http://medical-mastermind-community.com/uploads/img-residency-program-requirements-240x208.jpg) daniel clean http://medical-mastermind-community.com/podcast/time-sensitive-announcement http://medical-mastermind-community.com/podcast/time-sensitive-announcement#comments Tue, 23 Mar 2010 19:56:18 +0000 daniel http://medical-mastermind-community.com/?p=3768 http://medical-mastermind-community.com/podcast/time-sensitive-announcement/feed 0 medical school conference,register for 3rd annual medical school life conference Have you registered for the 3rd Annual Medical School Conference in Dallas, this Memorial Day? May 29-30th at the Wyndham Hotel at Dallas Love Field. We have a lot of Sponsors for the event and registration is an optional $35 if you you want the ... Have you registered for the 3rd Annual Medical School Conference in Dallas, this Memorial Day? * May 29-30th at the Wyndham Hotel at Dallas Love Field. * We have a lot of Sponsors for the event and registration is an optional $35 if you you want the Printed Handouts. REGISTER HERE See you there, Doctor Dan daniel clean http://medical-mastermind-community.com/podcast/number-of-residency-applications-needed http://medical-mastermind-community.com/podcast/number-of-residency-applications-needed#comments Tue, 23 Mar 2010 16:30:33 +0000 daniel http://medical-mastermind-community.com/?p=2704 http://medical-mastermind-community.com/podcast/number-of-residency-applications-needed/feed 0 cost of residency application,cost of the residency match,eras cost,nrmp cost,number of residencies to apply to Episode 37: This video podcast will explain how many residency programs you should apply to based on your categorical background (allopath, osteopath, Caribbean, IMG, etc.) Based on the match rates of each category, Episode 37: This video podcast will explain how many residency programs you should apply to based on your categorical background (allopath, osteopath, Caribbean, IMG, etc.) Based on the match rates of each category, general guidelines have emerged on the optimal number of applications needed to give you a statistical advantage to match to one program. Watch the full video podcast here... CATEGORY                                  NUMBER OF APPLICATIONS  RECOMMENDED US Allopaths                               20-30 US Osteopaths                            50-75 US Intern'l/Caribbean             100-120 IMG's                                              150-250 The cost of these applications is typically high. •20-30 schools – US grads, $270 (base cost of 30 programs, then $25 each) •75-100 Schools – US IMG’s, $2,260 •150 schools – Non-US IMG’s - $3,360 daniel clean