So, Boo is awesome, as you all know. It's just this leash training -- you know, the part where we teach her not to pull -- has kind of come to a standstill.
As in, I sometimes wonder if she is any better AT ALL than she was when we got her in December.
Dear readers, we have done everything you suggested.
1) Frequent changes of direction (easier when the sidewalk is more than 8 feet wide, but we go to the park and do it there sometimes)
2) Refusal to move forward should any pulling occur at all
3) Treats! When she actually is calm and walks where she should (which she inevitably interprets as a license to zoom ahead as soon as she receives said treat).
4) The gentle leader -- she even pulls with this! Though, if you wear her out enough and drag her around by the face with multiple direction changes, after about an hour of so she gets the idea and walks like a nice girl. Too bad this doesn't translate to the normal collar.
5) We even got a chain (because of the ghastly drowning/choking noise she makes when panting with the gentle leader on), and it works better than the regular collar, but I am truly afraid that she will decapitate herself.
"She just needs more exercise!" you all chime in.
Dear readers, I KNOW. We tried to sign her up for the dog park, but despite the fact that there is NEVER anyone in there when I walk by during the day, received a terse reply that there is "no room" and that we are on a "very long" wait list, that isn't expected to open up "until October." Oh, and "Good luck finding another outdoor space for your dog to play in this summer!"
Good luck indeed. You want to know where you can shove your empty-ass dog park, lady?
Anyway. So we're back to long walks. Which have been excellent for my waistline (we're minus 4 lbs and counting since December), but not so much for my patience (see: maniacal pulling, above). Add to the fact that I have this sneaking suspicion that when ever anyone else (read: husband and dog walker) walk Boo, I am pretty sure they undo any training I have accomplished.
Grrrrrr......
I am told that all my problems will be solved if we got Boo a sister. I wholeheartedly endorse the idea. However my husband (who is a mess-o-phobe) does not. And I do see where he is coming from, somewhat. On the other hand, he's not the one who sits at home with Boo all day as she clamors for constant attention.
Of course, with a second dog, perhaps they both would be clamoring. But then they would probably also self-entertain, which would be a very cute/awesome diversion from my studying (which is progressing nicely despite my canine distraction).
Oh, and as for obedience classes? Well, we found a class that is probably pretty reputable. But it is all the way across the city at 6:30PM Wednesday nights. It seems nobody offers these things on the weekends. And I do not have access to a car during the week, so that is more or less out of the question.
But also? Boo already sits, stays, lies down, heels off leash (in house only), comes. And does all manner of this in any number of ways in the house every day. What she really needs is some doggy socialization, and to learn to focus her attention on me when there is some sort of distraction (dog, cat, bird, squirrel, plastic bag). I've talked to the doggy trainers and they're all like, "SUUUUUUUREEEE she does all those things (yeah right -- I don't believe you for one minute). Why don't you give me $150 and come to this beginning class where we teach dogs to sit. Since that is exactly what she needs."
No, what she needs is to do this when she is outside being distracted by other dogs. She needs constant practice. And I can tell you that a once a week class? Ain't gonna accomplish any of that.
I guess most owners think their dog is awesome, but really the dog is a total nightmare. I find this assumption really irritating, not to mention a bit condescending. But then, I guess I also think most dog owners are idiots too.
But still, I don't like feeling like I'm being scammed, is what I'm saying. And also, as I mentioned, there's no way I can get to doggy class, which I'm not sure will solve our issues anyway.
Any advice, dear readers? Other than prohibiting the dog walker and husband from walking the dog? The next nearest dog park is about 3 miles away, and is thus probably only an option on the weekends, or maybe evenings during the summer.
(It's ok, you can say, "Get a second dog." I won't mind. Heehee.)
Wednesday, March 31, 2010
Monday, March 29, 2010
Readers want to know!
I have a reader, EG, who has asked me the following question:
How did you get experience as a researcher before your MD-PhD program?
Since I LOVE pontificating about myself, I will tell you.
The short answer is: the job kind of fell into my lap.
The longer, more truthful answer? I'd been thinking about a career doing research for a long time. See, compared to most pre-meds I know, I came at this whole med school thing ass-backwards. Most kids decide they want to be doctors. Then, when being a doctor doesn't turn out to be the eternally intellectually stimulating adventure they thought it would be, they turn to research.
It all started way back in the 90s. When I was in college.
I had thought I wanted to do research when I was taking sociology classes as an undergrad. But, after taking Sociology of Culture, which was -- I do not kid -- all about how rich people use "culture" to keep the working man down, and how economics is "wrong" because people often choose to spend their time doing things besides work (don't even get me started on this), I kind of became disenchanted with the field.
There, I said it. I love sociology. I really do. But at that moment, they all seemed like a bunch of whiners to me.
Also, while there may have been oodles of opportunities to do sociology research at The University of Chicago, I had no idea how to get involved with it. And anyway, I was beginning to think the field was bullshit.
Still, as I sat in the methods classes that taught us how to design surveys and run focus groups, I found myself thinking, "I could really do this."
Between junior and senior year of college, I had this mini-freak out about med school. I felt like I'd written it off too quickly, and briefly toyed with the idea of doing some biology my senior year. I decided at that time that my senior thesis would be on health or medicine and sociology.
It turned out to be a very auspicious decision.
I was assigned an adviser who did palliative care research (now he does social network studies using the Framingham database and facebook of all things). I had wanted to do some kind of project on race and medical adherence, but alas, he had a data set on hospices. So, I did a project on the predictors of voluntarism in hospices instead.
And the year passed, and I did my project. I never really got into working with this guy -- I always felt like he thought I was kind of stupid -- but I still got my A. And I graduated. And he asked if I wanted to try to publish the paper, but I didn't care so I said no. I was starting my job as a consultant after all. I thought I would never go back to academics.
Anyway, fast forward 4 awful years and 2 jobs later, I found myself jobless in the recession of 2003. I had been *thinking* about the idea of grad school for a couple of years. Ok, 3 years. My interest mostly stemmed from the fact that I found the PhD-burnouts who ended up in business to be infinitely more interesting than the MBAs, and because I liked thinking about things in a way that most people I knew didn't understand or couldn't care less about.
Ok, they weren't stellar reasons. But also, my brain was atrophying out in the warehouse. I couldn't remember how to do algebra to get fractions out of the denominator of an equation, ok? I longed to be able to use my brain again. To solve interesting problems. It's what I've always been good at.
So I started looking for a job. Any job. I needed to feed myself. And every so often I would find a research job -- usually at 50% of the salary I had been making previously -- and I would apply for it. One job asked me what research experience I had. So I mentioned my senior thesis and who I had worked with, and played up my job skills.
Little did I know that a) my adviser had turned out to be a major hot-shot, and b) he had worked in the same research group as the people who had posted the ad for the job.
So I got the interview. And I totally hit it off with both of the PIs, and they more or less hired me on the spot. They were doing some really cool research that as it turns out is somewhat related to what I'm doing now. And they let me basically run the ship. I learned so much at that job! Looking back, it kind of scares me how much autonomy they let me have.
I also went back to talk to my former thesis adviser, and he put the bug in my ear about med school. I think he thought I was younger than I was, because when he found out my age, he kind of waffled back and forth a bit about whether I should still go. But I was sold. I had figured out that you could become an MD and do research, and still have a viable back up career if the research part didn't work out. Having seen a lot of my PhD friends struggle to find jobs -- much less tenure track jobs -- once they finished their PhDs, that was really important to me. And (my mentors told me) if I my plan was to do research, I might as well do it right and get the PhD too.
I guess that makes it sound like it was this big epiphany moment. And it kind of was. But I still told myself, "Ok, a year of biology, and if it goes well, then I'll go to med school." And the same with Physics and Ochem the next year. I was also really lucky to have found these particular mentors as they were incredibly supportive of my decision and were great to work with.
I completed the project a year ahead of schedule, which enabled me to get some publications. And I got good grades and did well on the MCAT, and got into [you know where]. The rest is history.
So do YOU want to know how to get into research? It's all about making connections. Talk to your professors. Set up meetings. Show interest in what your professors do. If they can't pay you, do some work for them for free if you think it will pay off in terms of a relationship or a letter. I wish I had realized this when I was in college. Oh well. I got a lot of valuable work experience instead. And I got here anyway. Just a bit later than everyone else.
How did you get experience as a researcher before your MD-PhD program?
Since I LOVE pontificating about myself, I will tell you.
The short answer is: the job kind of fell into my lap.
The longer, more truthful answer? I'd been thinking about a career doing research for a long time. See, compared to most pre-meds I know, I came at this whole med school thing ass-backwards. Most kids decide they want to be doctors. Then, when being a doctor doesn't turn out to be the eternally intellectually stimulating adventure they thought it would be, they turn to research.
It all started way back in the 90s. When I was in college.
I had thought I wanted to do research when I was taking sociology classes as an undergrad. But, after taking Sociology of Culture, which was -- I do not kid -- all about how rich people use "culture" to keep the working man down, and how economics is "wrong" because people often choose to spend their time doing things besides work (don't even get me started on this), I kind of became disenchanted with the field.
There, I said it. I love sociology. I really do. But at that moment, they all seemed like a bunch of whiners to me.
Also, while there may have been oodles of opportunities to do sociology research at The University of Chicago, I had no idea how to get involved with it. And anyway, I was beginning to think the field was bullshit.
Still, as I sat in the methods classes that taught us how to design surveys and run focus groups, I found myself thinking, "I could really do this."
Between junior and senior year of college, I had this mini-freak out about med school. I felt like I'd written it off too quickly, and briefly toyed with the idea of doing some biology my senior year. I decided at that time that my senior thesis would be on health or medicine and sociology.
It turned out to be a very auspicious decision.
I was assigned an adviser who did palliative care research (now he does social network studies using the Framingham database and facebook of all things). I had wanted to do some kind of project on race and medical adherence, but alas, he had a data set on hospices. So, I did a project on the predictors of voluntarism in hospices instead.
And the year passed, and I did my project. I never really got into working with this guy -- I always felt like he thought I was kind of stupid -- but I still got my A. And I graduated. And he asked if I wanted to try to publish the paper, but I didn't care so I said no. I was starting my job as a consultant after all. I thought I would never go back to academics.
Anyway, fast forward 4 awful years and 2 jobs later, I found myself jobless in the recession of 2003. I had been *thinking* about the idea of grad school for a couple of years. Ok, 3 years. My interest mostly stemmed from the fact that I found the PhD-burnouts who ended up in business to be infinitely more interesting than the MBAs, and because I liked thinking about things in a way that most people I knew didn't understand or couldn't care less about.
Ok, they weren't stellar reasons. But also, my brain was atrophying out in the warehouse. I couldn't remember how to do algebra to get fractions out of the denominator of an equation, ok? I longed to be able to use my brain again. To solve interesting problems. It's what I've always been good at.
So I started looking for a job. Any job. I needed to feed myself. And every so often I would find a research job -- usually at 50% of the salary I had been making previously -- and I would apply for it. One job asked me what research experience I had. So I mentioned my senior thesis and who I had worked with, and played up my job skills.
Little did I know that a) my adviser had turned out to be a major hot-shot, and b) he had worked in the same research group as the people who had posted the ad for the job.
So I got the interview. And I totally hit it off with both of the PIs, and they more or less hired me on the spot. They were doing some really cool research that as it turns out is somewhat related to what I'm doing now. And they let me basically run the ship. I learned so much at that job! Looking back, it kind of scares me how much autonomy they let me have.
I also went back to talk to my former thesis adviser, and he put the bug in my ear about med school. I think he thought I was younger than I was, because when he found out my age, he kind of waffled back and forth a bit about whether I should still go. But I was sold. I had figured out that you could become an MD and do research, and still have a viable back up career if the research part didn't work out. Having seen a lot of my PhD friends struggle to find jobs -- much less tenure track jobs -- once they finished their PhDs, that was really important to me. And (my mentors told me) if I my plan was to do research, I might as well do it right and get the PhD too.
I guess that makes it sound like it was this big epiphany moment. And it kind of was. But I still told myself, "Ok, a year of biology, and if it goes well, then I'll go to med school." And the same with Physics and Ochem the next year. I was also really lucky to have found these particular mentors as they were incredibly supportive of my decision and were great to work with.
I completed the project a year ahead of schedule, which enabled me to get some publications. And I got good grades and did well on the MCAT, and got into [you know where]. The rest is history.
So do YOU want to know how to get into research? It's all about making connections. Talk to your professors. Set up meetings. Show interest in what your professors do. If they can't pay you, do some work for them for free if you think it will pay off in terms of a relationship or a letter. I wish I had realized this when I was in college. Oh well. I got a lot of valuable work experience instead. And I got here anyway. Just a bit later than everyone else.
Sunday, March 28, 2010
Swim Meet!
I took a break from grant writing this afternoon (it was a LITTLE break guys -- really!) to do the club swim meet today with my swim buddy A. I was pretty happy with how I did, all things considered.
Here I am doing the 100 free (I'm in the pink). They didn't let us get set before sounding the buzzer, so I ended up starting after everybody else. All things considered I was pretty pleased with my result. You can see that I kind of crap out at the end though. Must get fitter!
Here I am doing a 50 in a relay at the end. It was only a few minutes after the 100, so I was a little tired.
I also did the 50 fly, but Luca was still in the process of remembering how to use the video function on the camera, so it didn't turn out that well. I need to work on my dolphin kick.
This is us after the meet. Pay no attention to the anonyfied swim suit.
Not bad for someone who's never been on a swim team in her life if I do say so myself!
Here I am doing the 100 free (I'm in the pink). They didn't let us get set before sounding the buzzer, so I ended up starting after everybody else. All things considered I was pretty pleased with my result. You can see that I kind of crap out at the end though. Must get fitter!
Here I am doing a 50 in a relay at the end. It was only a few minutes after the 100, so I was a little tired.
I also did the 50 fly, but Luca was still in the process of remembering how to use the video function on the camera, so it didn't turn out that well. I need to work on my dolphin kick.
This is us after the meet. Pay no attention to the anonyfied swim suit.
Not bad for someone who's never been on a swim team in her life if I do say so myself!
Saturday, March 27, 2010
Too many cooks
There are six people on my grant in addition to me acting as advisers. That's not even including the PhD program adviser who wanted to put his 2 cents in as well. Having a lot of advisers is quite helpful, especially when they confine their advice to their area of expertise. It's when they stray from that area that the advice can get a little.... conflicting.
Here are some of the comments I have received.
"You have too few citations. It makes it look like you don't have good command of the literature."
"You have too many citations. It makes it look like you don't have good command of the literature."
"Use this specific phrasing to describe the model you're going to use. You need to say that you will use a nonlinear model that will be chosen dependent on the distribution of the data."
"What does this even mean? What do you mean you're going to look at the distribution of the data before deciding on your model."
"You should never use bullets."
"I love bullets to set off pieces of text that are important."
"I love text boxes to make the document more readable."
"What is this text box doing here? Text boxes are stupid."
"You should abbreviate acute respiratory failure as ARF. It will save space."
"ARF sounds like barf. Don't use it."
"ARF stands for acute renal failure*. Don't use it."
"I have no idea how you're going to fit everything into this grant."
"You should add more about your training plan."
You get the idea. The trick is using the most useful of everyone's advice to make the grant better (because though I bitch and moan, it is for the most part useful advice), yet weeding out the advice that doesn't work in a way that doesn't piss my adviser off when they read the next draft.
Le sigh. In a week and a half it will be over. Yip yip yipeeeee!!
*For the record, dear non-clinician, it's called acute kidney injury now (AKI). Touche.
Here are some of the comments I have received.
"You have too few citations. It makes it look like you don't have good command of the literature."
"You have too many citations. It makes it look like you don't have good command of the literature."
"Use this specific phrasing to describe the model you're going to use. You need to say that you will use a nonlinear model that will be chosen dependent on the distribution of the data."
"What does this even mean? What do you mean you're going to look at the distribution of the data before deciding on your model."
"You should never use bullets."
"I love bullets to set off pieces of text that are important."
"I love text boxes to make the document more readable."
"What is this text box doing here? Text boxes are stupid."
"You should abbreviate acute respiratory failure as ARF. It will save space."
"ARF sounds like barf. Don't use it."
"ARF stands for acute renal failure*. Don't use it."
"I have no idea how you're going to fit everything into this grant."
"You should add more about your training plan."
You get the idea. The trick is using the most useful of everyone's advice to make the grant better (because though I bitch and moan, it is for the most part useful advice), yet weeding out the advice that doesn't work in a way that doesn't piss my adviser off when they read the next draft.
Le sigh. In a week and a half it will be over. Yip yip yipeeeee!!
*For the record, dear non-clinician, it's called acute kidney injury now (AKI). Touche.
Friday, March 26, 2010
I hate basic science assholes
This is kind of a public service announcement for anyone who wants to do MD-PhD in a non-basic science. Most of the time, we get no respect from our basic science colleagues. Sometimes, that lack of respect is thrown in our faces. It's not that I'm not used to this. Quite the contrary. I'm SO used to it, that I should know better than to attempt to make pleasantries with basic science people.
See below:
I ran into a basic science faculty member at Au Bon Pain while I was buying lunch yesterday. He mentors a lot of MD-PhDs in my program. He asked me what I was up to, so I told him I was working on a grant that is due April 8th.
"Oh! What agency?"
"The [agency where he commonly applies], in fact."
"Oh! Who's lab are you in, again?"
"Um, I'm an EPIDEMIOLOGY student. I have a cubicle. Not a lab."
Looks skeptical. "Oh. What's the grant on?"
So I started telling him what it was about. After about 15 seconds he cuts me off.
"What kind of grant is this?"
"An F30."
Raises eyebrows, snorts, starts turning away, "Yeah? Well good luck with THAT." Walks quickly away.
So, I understand the skepticism to a degree, since pretty much all basic science researchers I know think that anything other than basic science research is bullshit.* But if these basic science people ever actually read a) the program announcement that their funding agencies put out, or b) the mission statement of the funding agency, they would see that they welcome grants in Epidemiology, Population Sciences, and Health Services. They say they WANT applications from people who are doing qualitative methods, analyses of big databases, etc.
Replaying this interaction in my head, I imagine the conversation ending with me "accidentally" spilling my hot soup all over hiscrotch shirt. "Oopsie!" I say, turning and skipping away.
So, basic science person, why must you behave like a giant jerk? I don't give a crap about the kind of research you do, but I still pretend to be interested when YOU tell ME.
*Actual word used by a faculty member regarding my research when I was interviewing here.
See below:
I ran into a basic science faculty member at Au Bon Pain while I was buying lunch yesterday. He mentors a lot of MD-PhDs in my program. He asked me what I was up to, so I told him I was working on a grant that is due April 8th.
"Oh! What agency?"
"The [agency where he commonly applies], in fact."
"Oh! Who's lab are you in, again?"
"Um, I'm an EPIDEMIOLOGY student. I have a cubicle. Not a lab."
Looks skeptical. "Oh. What's the grant on?"
So I started telling him what it was about. After about 15 seconds he cuts me off.
"What kind of grant is this?"
"An F30."
Raises eyebrows, snorts, starts turning away, "Yeah? Well good luck with THAT." Walks quickly away.
So, I understand the skepticism to a degree, since pretty much all basic science researchers I know think that anything other than basic science research is bullshit.* But if these basic science people ever actually read a) the program announcement that their funding agencies put out, or b) the mission statement of the funding agency, they would see that they welcome grants in Epidemiology, Population Sciences, and Health Services. They say they WANT applications from people who are doing qualitative methods, analyses of big databases, etc.
Replaying this interaction in my head, I imagine the conversation ending with me "accidentally" spilling my hot soup all over his
So, basic science person, why must you behave like a giant jerk? I don't give a crap about the kind of research you do, but I still pretend to be interested when YOU tell ME.
*Actual word used by a faculty member regarding my research when I was interviewing here.
Neurosurgery
Now, bearing in mind that I LOVED my 2 weeks on Neurosurgery. It was one of my favorite rotations of the year. I loved the attendings, and liked a lot of the residents, and got to participate in and observe really interesting surgeries. If I didn't require sleep (or a life outside the hospital), I'd have totally been into this specialty.
However I do. Thus there will be no neurosurgery in my future.
But then I saw a friend of mine on facebook had just matched into Neurosurgery. He was always the sweetest, most soft spoken, nice guy.
When I read his status, announcing where he had matched, a few thoughts ran through my head:
"Are you INSANE?"
"Well, it was nice knowing you. See you in 7 years."
"But but but.... you're so NICE!"
"WHY????"
I refrained from posting these because, well it seems a little inappropos and mean to do so after he already matched. But geez! They're the ones who are Q3 THEIR ENTIRE 2ND YEAR at the residency program affiliated with my hospital.
It's just nuts, I'm telling you.
But then, my husband tells me that he was always the one who would be working in the lab for 14 hours straight day after day. He seemed to flourish on that kind of thing. So maybe this will be a good fit for him.
However I do. Thus there will be no neurosurgery in my future.
But then I saw a friend of mine on facebook had just matched into Neurosurgery. He was always the sweetest, most soft spoken, nice guy.
When I read his status, announcing where he had matched, a few thoughts ran through my head:
"Are you INSANE?"
"Well, it was nice knowing you. See you in 7 years."
"But but but.... you're so NICE!"
"WHY????"
I refrained from posting these because, well it seems a little inappropos and mean to do so after he already matched. But geez! They're the ones who are Q3 THEIR ENTIRE 2ND YEAR at the residency program affiliated with my hospital.
It's just nuts, I'm telling you.
But then, my husband tells me that he was always the one who would be working in the lab for 14 hours straight day after day. He seemed to flourish on that kind of thing. So maybe this will be a good fit for him.
Thursday, March 25, 2010
Documentation
You want to know what I've been up to this week? I've been up to my eyeballs in grant documentation.
"Oh, you're writing the grant?" You ask. No, that part is on hold until I discuss the comments I received on this version with my mentor tomorrow. Right now I'm trying to get all that OTHER stuff for it done. I get to re-work the grant over the weekend in between writing the 15 bazillion other documents that must also get done. (Let's not even mention the busy-work class assignments I have to do.....)
Behold, the documents I must create for this mf-er.
Project Abstract
Project Narrative
Bibliography – cut and paste when grant is done
Facilities & Other Resources (I-61)
Equipment
Other Attachments:
List of Referees (I-61)
Sponsor Information (I-62), (6 page)
List of Collaborators and Dissertation Advisors (I-63)
Letters of support from collaborators (?)
Biosketch for PI (me) (I-67)
Senior Key People: (I-69)
Biosketch for sponsor
Biosketch for dissertation advisor
Biosketch for other dissertation advisor
Biosketch for qualitative research methods person
Biosketch for survey person
Biosketch for biostatistician
Cover Letter (I-74)
Research Training Plan:
Specific Aims (1 Page)
Research Strategy (6 Pages)
Protection of Human Subjects (I-85)
Inclusion of Women and Minorities (1_85)
Targeted/Planned Enrollment (Aim1, Aim2, Aim3) (I-85)
Inclusion of Children (I-86)
Vertebrate Animals (NA)
Resource Sharing Plan (NA)
Respective Contributions (I-89) (1 page)
Selection of Sponsor and Institution (I-89) (1 page)
Responsible Conduct of Research (done)
Goals for Fellowship Training (I-92) (1 page)
Activities Planned Under This Award (I-92) (1 page)
Doctoral Dissertation and Research Experience (I-92) (2 pages)
Appendix:
Surveys to be used in this study
Guidelines for Minimizing Respondent Burden During the Interview Process
Letters of Reference:
Person 1
Person 2
Person 3
Person 4
That's 36 documents total. Yes, you counted correctly. A mere 2 of them have anything to do with the science behind the grant.
Oh, and if you think that the biosketches are done by the people they're about? Think again. The NIH added a "personal statement" component that needs to be part A of each biosketch, which must be customized to the grant. Guess who gets to write that.
(We won't tell everyone who wrote the rec letters too, because that would be unethical.... Well I guess it's ok if all you provide is a "template." What's tough is making your "template" seem sufficiently different for each person you provide it to, so they don't "adapt" it too similarly....)
Feel free to use this list for yourself if you have to write an F30 in the future. Because it took me 6 weeks just to figure out what I needed to produce, to say nothing about figuring out what each of these documents actually *was.* I don't think that anyone else should have to go through that. The numbers in parenthesis are the page numbers in the SF-424 with the corresponding directions.
"Oh, you're writing the grant?" You ask. No, that part is on hold until I discuss the comments I received on this version with my mentor tomorrow. Right now I'm trying to get all that OTHER stuff for it done. I get to re-work the grant over the weekend in between writing the 15 bazillion other documents that must also get done. (Let's not even mention the busy-work class assignments I have to do.....)
Behold, the documents I must create for this mf-er.
Project Abstract
Project Narrative
Bibliography – cut and paste when grant is done
Facilities & Other Resources (I-61)
Equipment
Other Attachments:
List of Referees (I-61)
Sponsor Information (I-62), (6 page)
List of Collaborators and Dissertation Advisors (I-63)
Letters of support from collaborators (?)
Biosketch for PI (me) (I-67)
Senior Key People: (I-69)
Biosketch for sponsor
Biosketch for dissertation advisor
Biosketch for other dissertation advisor
Biosketch for qualitative research methods person
Biosketch for survey person
Biosketch for biostatistician
Cover Letter (I-74)
Research Training Plan:
Specific Aims (1 Page)
Research Strategy (6 Pages)
Protection of Human Subjects (I-85)
Inclusion of Women and Minorities (1_85)
Targeted/Planned Enrollment (Aim1, Aim2, Aim3) (I-85)
Inclusion of Children (I-86)
Vertebrate Animals (NA)
Resource Sharing Plan (NA)
Respective Contributions (I-89) (1 page)
Selection of Sponsor and Institution (I-89) (1 page)
Responsible Conduct of Research (done)
Goals for Fellowship Training (I-92) (1 page)
Activities Planned Under This Award (I-92) (1 page)
Doctoral Dissertation and Research Experience (I-92) (2 pages)
Appendix:
Surveys to be used in this study
Guidelines for Minimizing Respondent Burden During the Interview Process
Letters of Reference:
Person 1
Person 2
Person 3
Person 4
That's 36 documents total. Yes, you counted correctly. A mere 2 of them have anything to do with the science behind the grant.
Oh, and if you think that the biosketches are done by the people they're about? Think again. The NIH added a "personal statement" component that needs to be part A of each biosketch, which must be customized to the grant. Guess who gets to write that.
(We won't tell everyone who wrote the rec letters too, because that would be unethical.... Well I guess it's ok if all you provide is a "template." What's tough is making your "template" seem sufficiently different for each person you provide it to, so they don't "adapt" it too similarly....)
Feel free to use this list for yourself if you have to write an F30 in the future. Because it took me 6 weeks just to figure out what I needed to produce, to say nothing about figuring out what each of these documents actually *was.* I don't think that anyone else should have to go through that. The numbers in parenthesis are the page numbers in the SF-424 with the corresponding directions.
Wednesday, March 24, 2010
Nerd
There are still nerds at the University of Chicago.
Thank god.
I was beginning to worry that in their quest to attract more, um, well adjusted students, who prefer socializing to studying, the administration had forgotten our roots.
I needn't have worried.
Thanks to my friend Max Grinnell for bringing this article to my attention.
Thank god.
I was beginning to worry that in their quest to attract more, um, well adjusted students, who prefer socializing to studying, the administration had forgotten our roots.
I needn't have worried.
Thanks to my friend Max Grinnell for bringing this article to my attention.
Door knob
I just yelled at the door knob of my office door because my mouse cord kept getting caught on it as I was moving my laptop from upstairs (where I hide to avoid the temptations of the internet) to downstairs (where I work when I need the internet for whatever I'm doing).
I put my laptop down and Boo was lying on the couch cowering in the corner. I mean, she was SHAKING, and her ears were flat back against her head. She looked so scared!
I guess she thought I was yelling at her.....
:-(
I felt so guilty!
I suppose Mommy needs to learn not to yell at door knobs now. That might be a tough habit to break.
I put my laptop down and Boo was lying on the couch cowering in the corner. I mean, she was SHAKING, and her ears were flat back against her head. She looked so scared!
I guess she thought I was yelling at her.....
:-(
I felt so guilty!
I suppose Mommy needs to learn not to yell at door knobs now. That might be a tough habit to break.
Health Care Reform
You want to know what I'm worried about?
I worry that since insurance companies have to cover everybody, and that they are prohibited from charging you more than 8% of your income...
a) All such insurance plans will cost 8% of your income
b) Since all people will be required to have insurance, this will amount to an 8% tax
c) That given the insurance will be relatively cheap, reimbursements for general internists and family practitioners will be so low that many doctors won't accept the insurance. Kind of like what has happened with Medicare as they have cut reimbursements to doctors.
d) And that as a result, even if you have this nominal insurance, you won't be able to get in to see a doctor anyway.
On the other hand, at least if you get hospitalized, you might not lose ALL of your savings....
I also worry that requiring businesses with 50 or more employees to cover their employees will cause a lot of them to:
a) fire enough employees to keep them below the #50
b) not hire more employees to keep below the #50
c) go out of business because they can't afford to pay for insurance for their 50+ employees
Hopefully this will be offset by more people being able to financially justify going into business for themselves because they won't have to worry about insurance.
But then, if the insurance being offered is so low quality, and no outpatient doctor will take it because it is a money loser, I wonder whether most middle class people who want to work for themselves will really see it as a viable option.
I also worry about this tax on "luxury" insurance. I think my husband may get this type of insurance at his job, and it is pretty nice. I am not excited to see the erosion of his (and my) benefits. Good insurance costs money. Crappy insurance passes medical costs onto consumers and denies people care. I'm not sure how much getting rid of this "luxury" insurance will really help anyone. I guess it's ok if we're talking about hurting "rich" people, though, right? Oh wait, the janitor gets the same insurance at the company my husband works for.
Given these facts, I am not excited to have a large increase in my taxes to pay for a program that may not even work. That may hurt the economy. That actively hurts people.
On the other hand, I agree with the principle that people should not be rendered destitute by a single hospitalization.
I just don't know what the ramifications of the program we passed are going to be. Maybe it will go well? But they're not even going to require government employees to use this new insurance plan, so that tells me that even politicians kind of think it sucks.
I just don't know. I guess I'm glad that *something* happened, but I hope it doesn't completely crater the economy.
I worry that since insurance companies have to cover everybody, and that they are prohibited from charging you more than 8% of your income...
a) All such insurance plans will cost 8% of your income
b) Since all people will be required to have insurance, this will amount to an 8% tax
c) That given the insurance will be relatively cheap, reimbursements for general internists and family practitioners will be so low that many doctors won't accept the insurance. Kind of like what has happened with Medicare as they have cut reimbursements to doctors.
d) And that as a result, even if you have this nominal insurance, you won't be able to get in to see a doctor anyway.
On the other hand, at least if you get hospitalized, you might not lose ALL of your savings....
I also worry that requiring businesses with 50 or more employees to cover their employees will cause a lot of them to:
a) fire enough employees to keep them below the #50
b) not hire more employees to keep below the #50
c) go out of business because they can't afford to pay for insurance for their 50+ employees
Hopefully this will be offset by more people being able to financially justify going into business for themselves because they won't have to worry about insurance.
But then, if the insurance being offered is so low quality, and no outpatient doctor will take it because it is a money loser, I wonder whether most middle class people who want to work for themselves will really see it as a viable option.
I also worry about this tax on "luxury" insurance. I think my husband may get this type of insurance at his job, and it is pretty nice. I am not excited to see the erosion of his (and my) benefits. Good insurance costs money. Crappy insurance passes medical costs onto consumers and denies people care. I'm not sure how much getting rid of this "luxury" insurance will really help anyone. I guess it's ok if we're talking about hurting "rich" people, though, right? Oh wait, the janitor gets the same insurance at the company my husband works for.
Given these facts, I am not excited to have a large increase in my taxes to pay for a program that may not even work. That may hurt the economy. That actively hurts people.
On the other hand, I agree with the principle that people should not be rendered destitute by a single hospitalization.
I just don't know what the ramifications of the program we passed are going to be. Maybe it will go well? But they're not even going to require government employees to use this new insurance plan, so that tells me that even politicians kind of think it sucks.
I just don't know. I guess I'm glad that *something* happened, but I hope it doesn't completely crater the economy.
Monday, March 22, 2010
It's funny
About a year ago, I got my panties all in a bunch over my basic science classmate who asked me, "If I take A statistics course (emphasis mine), will I be able to do clinical research?"
I was really offended. One? Just one stats class? I would never have said to her, "If I learned how to do a Western Blot, can I do cell biology?" I just couldn't believe her arrogance.
Anyhow, I've come to the point where I can just laugh at the whole thing. Why? Because a year into my PhD program and with a year of biostatistics behind me, I have learned just how little I know about statistics. Today I was talking with my statistician about using generalized estimating equations to account for multilevel clustering in my data, and I was thinking to myself, "I'll bet my friend has no idea that this even exists."
I mean, I'm going to have to take ANOTHER ENTIRE YEAR of stats to be able to remotely do a competent job at my analysis, with the help of my statistician. I mean, I guess if all my friend wants to run are t-tests, then she can get away with one or two classes. But even then there's controlling for confounding, interaction, not to mention model building etc. etc. etc. that actually takes some skill to learn how to do, no matter what kind of project you're involved with.
And of course, this is to say nothing about all you have to know to competently design a study or collect data. I mean, let's not even go there.
Anyway, I suppose I ought to get used to questions like that. A lot of people still don't know what epidemiology is, and I guess I'll just have to teach them.
I was really offended. One? Just one stats class? I would never have said to her, "If I learned how to do a Western Blot, can I do cell biology?" I just couldn't believe her arrogance.
Anyhow, I've come to the point where I can just laugh at the whole thing. Why? Because a year into my PhD program and with a year of biostatistics behind me, I have learned just how little I know about statistics. Today I was talking with my statistician about using generalized estimating equations to account for multilevel clustering in my data, and I was thinking to myself, "I'll bet my friend has no idea that this even exists."
I mean, I'm going to have to take ANOTHER ENTIRE YEAR of stats to be able to remotely do a competent job at my analysis, with the help of my statistician. I mean, I guess if all my friend wants to run are t-tests, then she can get away with one or two classes. But even then there's controlling for confounding, interaction, not to mention model building etc. etc. etc. that actually takes some skill to learn how to do, no matter what kind of project you're involved with.
And of course, this is to say nothing about all you have to know to competently design a study or collect data. I mean, let's not even go there.
Anyway, I suppose I ought to get used to questions like that. A lot of people still don't know what epidemiology is, and I guess I'll just have to teach them.
We need to talk about []
Spoken in THAT tone of voice, no words strike fear into my heart more than "We need to talk about [insert bad thing I've done here]."
And so it was that I walked by the office of the head of my PhD program this morning and he uttered those words. And my knees got all weak and I got all tremble-y like I had done something bad.
"Oh we were talking about you A LOT at XYZ meeting this weekend," he said in that tone of voice.
"Uh Oh," I said, "That doesn't sound good."
"Not at all," he said (now imagine me quaking in my boots even harder), "They LOVED your story, and want to make all these policy changes based on what happened to you."
"Uhhh... ok?" (Note, I'm still in the mindset that I'm about to get in trouble for something here.)
But! It turns out that this time, it wasn't a bad thing. He had been discussing my "case" at some national meeting of some sort. My "case" being a) the fact that I am the first Epi MD-PhD that my department has taken (except my mentor, which was 10 years ago), and b) that I didn't know exactly what I wanted to do my research in off the bat and that everyone FREAKED OUT about it (except me), and that c) I finally arrived on a project that is a perfect fit for my background and strengths AND interests in medicine.
And it all turned out ok in the end. Well, so far.
Anyway, I don't know what this will mean for me, or what he really wants to talk with me about. But fortunately, I am not in trouble. This time.
I will keep you posted as I find out more.
And so it was that I walked by the office of the head of my PhD program this morning and he uttered those words. And my knees got all weak and I got all tremble-y like I had done something bad.
"Oh we were talking about you A LOT at XYZ meeting this weekend," he said in that tone of voice.
"Uh Oh," I said, "That doesn't sound good."
"Not at all," he said (now imagine me quaking in my boots even harder), "They LOVED your story, and want to make all these policy changes based on what happened to you."
"Uhhh... ok?" (Note, I'm still in the mindset that I'm about to get in trouble for something here.)
But! It turns out that this time, it wasn't a bad thing. He had been discussing my "case" at some national meeting of some sort. My "case" being a) the fact that I am the first Epi MD-PhD that my department has taken (except my mentor, which was 10 years ago), and b) that I didn't know exactly what I wanted to do my research in off the bat and that everyone FREAKED OUT about it (except me), and that c) I finally arrived on a project that is a perfect fit for my background and strengths AND interests in medicine.
And it all turned out ok in the end. Well, so far.
Anyway, I don't know what this will mean for me, or what he really wants to talk with me about. But fortunately, I am not in trouble. This time.
I will keep you posted as I find out more.
Not psychiatry
I'm glad people seemed to like my post on why psychiatry is awesome (because it IS). I suppose now everyone thinks I'm going to be a psychiatrist. A guy in my program came up to me and started making comments about how great psychiatry was a few days after I wrote this, and I started thinking, "You are SO BUSTED, dude."
So now I guess I know who keeps checking my blog on the public computers in my department? Heh.
Anyway, the point of that post was to explain what I liked about psychiatry. But the problem is that I like several other fields as well, and many of them may be a better fit with my other life goals, like research.
And actually, at this point research is more important to me than seeing patients (and always has been a priority over seeing patients full time), so I may as well do what I can to maximize my potential there.
So this week, I will (hopefully) get around to writing, "What's not to like about Anesthesia." Or EM. Which ever tickles my fancy on a particular day.
And who knows, I may still end up going into Psychiatry after all.
So now I guess I know who keeps checking my blog on the public computers in my department? Heh.
Anyway, the point of that post was to explain what I liked about psychiatry. But the problem is that I like several other fields as well, and many of them may be a better fit with my other life goals, like research.
And actually, at this point research is more important to me than seeing patients (and always has been a priority over seeing patients full time), so I may as well do what I can to maximize my potential there.
So this week, I will (hopefully) get around to writing, "What's not to like about Anesthesia." Or EM. Which ever tickles my fancy on a particular day.
And who knows, I may still end up going into Psychiatry after all.
Sunday, March 21, 2010
Edward Scissorhands
Luca and I netflixed Edward Scissorhands this week. Luca has a minor obsession with Tim Burton movies, which I partially share.
Edward Scissorhands captures those feelings of ostracism and being an outsider to the mainstream blah suburban culture which permeates our land. It tells a story of a man who has scissors for hands, and the rather obvious problems that might cause. While for a time he is accepted into mainstream society even though he is different, quickly problems start to arise, and he ends up being expelled from the community.
I remembered that much of the movie from the first time I saw it back in 1991. Jesus, it came out 20 years ago.
Anyway. What struck me this time was the depiction of teen domestic abuse. I'd never noticed that angle before, but it is rather pronounced in retrospect. Anthony Michael Hall plays the spoiled angry boyfriend to Winona Ryder who pushes her around and attempts to kill Edward Scissorhands after Winona finally dumps him.
It's one of the few movies I remember that actually depict relationship violence among teens. Dear readers, can you recall any others?
Edward Scissorhands captures those feelings of ostracism and being an outsider to the mainstream blah suburban culture which permeates our land. It tells a story of a man who has scissors for hands, and the rather obvious problems that might cause. While for a time he is accepted into mainstream society even though he is different, quickly problems start to arise, and he ends up being expelled from the community.
I remembered that much of the movie from the first time I saw it back in 1991. Jesus, it came out 20 years ago.
Anyway. What struck me this time was the depiction of teen domestic abuse. I'd never noticed that angle before, but it is rather pronounced in retrospect. Anthony Michael Hall plays the spoiled angry boyfriend to Winona Ryder who pushes her around and attempts to kill Edward Scissorhands after Winona finally dumps him.
It's one of the few movies I remember that actually depict relationship violence among teens. Dear readers, can you recall any others?
Saturday, March 20, 2010
Investment
I recently found out that my neighbor has an investment company that he runs out of his basement, and THAT is why there are random men coming and going from his house at all times of the day and night.
I was a little disappointed actually.
It was so much more interesting when I had assumed they were all his lovers.
I was a little disappointed actually.
It was so much more interesting when I had assumed they were all his lovers.
Work hour restrictions
I was having a conversation with my neighbor yesterday discussing residency work hour restrictions, saying it *seemed* like the work hours were at least *somewhat* respected at my institution. I've seen residents who are Q3 be sent home at 8AM after signout rather than being forced to sit through rounds, and in *general* post call we usually got out by 12 or 1PM. Much better than the 36 hour shifts residents used to pull before the restrictions were passed.
"But I think it's different in surgery," I said.
No kidding. I guess there was a scandal where her husband worked some years ago where they were trying to crack down on abuses of the parking facility during off hours. It was in a prime location in the city, and it seems the hospital administration was CONVINCED that residents were using it to park downtown when they went out at night so that they wouldn't have to PAY for parking.
As it turned out a bunch of surgery residents got in trouble. Their cars were there 100+ hours per week. Were they living it up on the town?
Ha. What do you think. (Stupid hospital administrators.)
Anyhow, it was at that point that I said, "Well I think neurosurgery has an exemption. Their residents are allowed to work 90 hours per week."
My friend then said, "That's so dumb! That's EXACTLY WHO NEEDS the work hour restrictions! Do I really want some tired resident operating on my BRAIN????"
Touche.
Maybe if I stay in this PhD program long enough, they'll have made a 5 hour nap when you're on call a legal requirement by the time I get to residency..... One can always hope! Too bad things probably won't ever change in surgery.
"But I think it's different in surgery," I said.
No kidding. I guess there was a scandal where her husband worked some years ago where they were trying to crack down on abuses of the parking facility during off hours. It was in a prime location in the city, and it seems the hospital administration was CONVINCED that residents were using it to park downtown when they went out at night so that they wouldn't have to PAY for parking.
As it turned out a bunch of surgery residents got in trouble. Their cars were there 100+ hours per week. Were they living it up on the town?
Ha. What do you think. (Stupid hospital administrators.)
Anyhow, it was at that point that I said, "Well I think neurosurgery has an exemption. Their residents are allowed to work 90 hours per week."
My friend then said, "That's so dumb! That's EXACTLY WHO NEEDS the work hour restrictions! Do I really want some tired resident operating on my BRAIN????"
Touche.
Maybe if I stay in this PhD program long enough, they'll have made a 5 hour nap when you're on call a legal requirement by the time I get to residency..... One can always hope! Too bad things probably won't ever change in surgery.
Friday, March 19, 2010
Holy Cow!!
My grant is due three weeks from yesterday! Which means it basically has to be done by TWO weeks from yesterday.
AHHHHHHHHHHHHH!!!!!!!!!!!!!!
I did get a rough draft sent out last Sunday, and comments back on Wednesday. Unfortunately, what with the projectile vomiting disease and all, not much has happened since then.*
:-P
On the plus side, I've gotten a number of my supplemental documents done. And oh Nelly! There are a LOT of them.
On the minus side, I just found out that some of them actually have to include 2-3x the information I had already included.
Oh joy. Oh rapture.
It's going to be a crazy couple of weeks.
Don't worry dear readers. I won't be going anywhere. You know how much more I tend to blog during times of stress.
*I'm feeling much better now thank you. And! I lost 3 pounds! I wish I could say that made me happy, but with the acheyness associated with the disease, I suspect it was mostly muscle. Damn you, gluconeogenesis!
AHHHHHHHHHHHHH!!!!!!!!!!!!!!
I did get a rough draft sent out last Sunday, and comments back on Wednesday. Unfortunately, what with the projectile vomiting disease and all, not much has happened since then.*
:-P
On the plus side, I've gotten a number of my supplemental documents done. And oh Nelly! There are a LOT of them.
On the minus side, I just found out that some of them actually have to include 2-3x the information I had already included.
Oh joy. Oh rapture.
It's going to be a crazy couple of weeks.
Don't worry dear readers. I won't be going anywhere. You know how much more I tend to blog during times of stress.
*I'm feeling much better now thank you. And! I lost 3 pounds! I wish I could say that made me happy, but with the acheyness associated with the disease, I suspect it was mostly muscle. Damn you, gluconeogenesis!
Thursday, March 18, 2010
Worthless
We seem to have a mouse. I saw the thing scurry across the floor, and attempted to sic the dog on it, but she didn't even notice it as it scurried RIGHT UNDER HER NOSE, because she was more interested in playing.
I guess she thought my jumping up and down and yelling (which I was doing to get the mouse to scurry) looked like a fun game?
Worthless, I'm telling you.
I guess she thought my jumping up and down and yelling (which I was doing to get the mouse to scurry) looked like a fun game?
Worthless, I'm telling you.
Acceptance
It turns out that my grad group is still accepting MD-PhD students. Maybe I'm not thought of as a complete screw up afterall? Hee hee.
I actually met one of the people who they accepted. She was not only smart, but very personable, and comfortable in her own skin. We really liked her.
Apropos of nothing, I was reflecting on the fact that when I was applying to MD-PhD programs, there was this weird expectation that I already knew what area I was going to do research in, and who I wanted to study with. The easy route was to just let them assume that I would continue doing diabetes health policy research because that was what I had been doing before.
But in retrospect, how freaking wacked is that? I was actually supposed to know what topic I was going to want to research three? No, FOUR YEARS before I started in my PhD program. Before I'd even done a smidge of med school?
Now the interesting thing is that I am doing something related to what I did before, but in critical care medicine as opposed to outpatient medicine. Oh, and there's nothing related to diabetes either. And how was I supposed to be able to identify my future mentors when neither of them were even on faculty when I applied?
I suppose the powers that be know that we will change our minds once we get in. Still, it's weird to me that we have to put on this show where we pretend that -- YES!! I've known I've wanted to do XYZ research my whole life!! It's not like it makes us any better researchers than if we were honest and said -- I like lots of topics, my track record is excellent, and I will decide what I want to do once I've had some clinical exposure and seen what's out there. XY and Z are all interesting to me because of [insert why here] but I don't want to commit until I've seen what my options are.
Anyone have any thoughts on this? I guess it's just how the game is played, but it does seem weird to me. Disingenuous even.
I actually met one of the people who they accepted. She was not only smart, but very personable, and comfortable in her own skin. We really liked her.
Apropos of nothing, I was reflecting on the fact that when I was applying to MD-PhD programs, there was this weird expectation that I already knew what area I was going to do research in, and who I wanted to study with. The easy route was to just let them assume that I would continue doing diabetes health policy research because that was what I had been doing before.
But in retrospect, how freaking wacked is that? I was actually supposed to know what topic I was going to want to research three? No, FOUR YEARS before I started in my PhD program. Before I'd even done a smidge of med school?
Now the interesting thing is that I am doing something related to what I did before, but in critical care medicine as opposed to outpatient medicine. Oh, and there's nothing related to diabetes either. And how was I supposed to be able to identify my future mentors when neither of them were even on faculty when I applied?
I suppose the powers that be know that we will change our minds once we get in. Still, it's weird to me that we have to put on this show where we pretend that -- YES!! I've known I've wanted to do XYZ research my whole life!! It's not like it makes us any better researchers than if we were honest and said -- I like lots of topics, my track record is excellent, and I will decide what I want to do once I've had some clinical exposure and seen what's out there. XY and Z are all interesting to me because of [insert why here] but I don't want to commit until I've seen what my options are.
Anyone have any thoughts on this? I guess it's just how the game is played, but it does seem weird to me. Disingenuous even.
Wednesday, March 17, 2010
Man cold
Luca had the projectile vomiting disease a few days ago, and now I seem to have caught it. I do feel much better post-vomiting session, however. I feel completely up for class in fact, but I'm not sure that my classmates would be thrilled about me bringing my likely norovirus infected self to class 30 minutes after puking my guts out. :-P
I hate missing class.
Ladies, please tell me, is this your man when he gets a cold?
I hate missing class.
Ladies, please tell me, is this your man when he gets a cold?
Tuesday, March 16, 2010
Blow dry meeting*
This morning I had a meeting with a mentor of mine. An Important Person.
It's funny how for this meeting, I put on slacks and a nice shirt and blew my hair dry before walking over there. I even put on earrings. Everyone else gets jeans and sneakers. They're lucky if I'm wearing a nice shirt rather than a t-shirt.
Ah, grad school.
I wonder if I know I have finally made it when my future mentees dress up for a meeting with moi. I wonder if I will even notice.
I wonder if that will ever actually happen.
*No, not blow j** meeting. Get your mind out of the gutter!
It's funny how for this meeting, I put on slacks and a nice shirt and blew my hair dry before walking over there. I even put on earrings. Everyone else gets jeans and sneakers. They're lucky if I'm wearing a nice shirt rather than a t-shirt.
Ah, grad school.
I wonder if I know I have finally made it when my future mentees dress up for a meeting with moi. I wonder if I will even notice.
I wonder if that will ever actually happen.
*No, not blow j** meeting. Get your mind out of the gutter!
Monday, March 15, 2010
Crate mat
I finally caved and bought Boo a mat for her crate. She's been sleeping on some folded up fleece blankets, and they work just fine, but she's kind of destroyed them.
It was time for a new bed.
So, I received the mat today. And it was lovely, and stuffed. And I thought to myself, "Uh oh, she's going to think this is a plush toy to destroy."
I then put it in her crate and tried to distract her with an *actual* plush toy to destroy. Squeaker removed in 3 minutes flat.
10 minutes later, she was stalking her mat and play bowing to it outside her crate. Then she started barking at it. I turned back to the computer, and a split second later she had ripped it out of her crate and was galloping around the living room proudly waving it in her mouth. Then she'd throw it on the ground and pounce on it repeatedly.
*Sigh*
It was really cute.
I would tell her no, but it's futile, really. She finds the darn thing irresistible. I'd just prefer if she waited to chew on it until I've left her lying on it in her crate....
Maybe we should get a second dog?
Heh heh.
It was time for a new bed.
So, I received the mat today. And it was lovely, and stuffed. And I thought to myself, "Uh oh, she's going to think this is a plush toy to destroy."
I then put it in her crate and tried to distract her with an *actual* plush toy to destroy. Squeaker removed in 3 minutes flat.
10 minutes later, she was stalking her mat and play bowing to it outside her crate. Then she started barking at it. I turned back to the computer, and a split second later she had ripped it out of her crate and was galloping around the living room proudly waving it in her mouth. Then she'd throw it on the ground and pounce on it repeatedly.
*Sigh*
It was really cute.
I would tell her no, but it's futile, really. She finds the darn thing irresistible. I'd just prefer if she waited to chew on it until I've left her lying on it in her crate....
Maybe we should get a second dog?
Heh heh.
Sunday, March 14, 2010
Why do an MD AND a PhD?
It seems like overkill, doesn't it? The fact is though, an MD prepares you to be a clinician. It in NO WAY prepares you to do research. And while I wouldn't recommend the dual degree pathway for someone who either a) has no interest whatsoever in patient care, or b) is not interested in doing research as a career, for someone who likes both and knows this in advance, it is the only way to go.
So, here are my reasons:
1. If you get a PhD, and can't get a job doing research, it's harder to find a back up career. The other angle is that it's pretty nice to have "doctor" as your back up career.
2. MD-onlies can still do research, but doing so requires a multi-year fellowship, a Master's degree (at least) and a period during which they apply for a K-award.* This can take 3-5 years POST RESIDENCY to accomplish. And while most (but not all) MD-PhDs will still need to do a fellowship in order to get a tenure track faculty position, they can use that fellowship time to actually write their K-award and do more substantive research than their colleagues who still have to get their Master's degree. This can only help when they enter the job market.
3. You do actual substantive research on a project that YOU HAVE TO THINK THROUGH YOURSELF before you even get to residency. This is very different than what you do as an MD-only. Most research done by medical students during medical school is someone else's research. Someone else conceived of the idea, thought of how to do it. The Student is just carrying out the process. Not to knock the experience -- it IS important to learn -- but it's just not the same as coming up with your own idea and figuring out how to test it yourself. Even some Master's level students wind up doing this if they can't think of their own project, and suffice to say most of these people do not ever become independent investigators.
4. Getting a PhD gives you excellent experience doing research. However, most PhD students I've met don't have a great grasp of a) how doctors think, b) how things work in a hospital, or c) medical pathophysiology. Case in point, a PhD colleague of mine did not know what varicella was. Another thought an adenocarcinoma was a cancer of the adenoids. Sure, you can use UpToDate to fill yourself in on the details of whatever disease you are studying, but it's no substitute for medical school, or actually working in a hospital environment. I would never have been able to think of my project on doctor-patient communication had I never seen it go horribly wrong during my rotations.
5. A lot of MDs get Master's degrees and do research that way. However, a Master's degree only begins to scratch the surface of how to do solid research. You would not believe how much bad and plain wrong research gets published. In addition, there are a lot of administrative details that you need to learn by messing them up a few times. Not saying that a PhD solves this problem completely. However it does help to have a few more years of experience under your belt before you dive into being an independent investigator.
6. I feel really bad for the PhD-onlies in my department. They have to fund 95% of their salary via grants, and in this economy, that must be very stressful. While clinical work will detract from research time, at least I know that I'll always be able to pay for myself.
7. MD-PhDs more often than not (rightly or wrongly) default into the "boss" position. If you have a single degree, you can get there too, it's just not as common. I've heard it's easier to get grants as a dual degree person, however that may not be true.
8. I have a friend who has a PhD in sociology. She is working as a statistician in my department UNDER MDs. Who knows if she will ever advance or get a job as a professor. She may not want to. Still, I would be pretty upset if the end target of all my training was a $40,000 job still doing other people's research. That is a real risk of getting a PhD only.
9. MD-PhDs get paid more for the same jobs filled by PhDs. Sorry, it's just true.
10. No debt. My tuition is paid, and I get a stipend. This is really the worst reason to do an MD-PhD, because as say..... an anesthesiologist I could make the whole bundle back in about 2 years, but it's a nice carrot anyway.
11. You meet potential collaborators during your PhD. The benefits of this should not be underestimated.
12. You get to be a Dr.Dr. Also, you get to be in school FOREVER!
Now for how much time these things take: (times are approximate)
1. PhD only -- 6 years PhD + 3 years post-doc = 9 years
2. MD only -- 4 years med school + 3 years residency* + 3 years fellowship + 1-2 year K-award application = 11-12 years
3. MD-PhD -- 8 years MD-PhD + 2 years residency** + 3-4 years fellowship*** = 13-14 years
So, you do spend a bit more time doing the two degrees. I think the argument for doing both degrees is even more compelling in the basic sciences because you just need to spend time in the lab to get good at what you do in those fields. It has to be hard to catch up if you only have a fellowship after residency to build up a publication record off which to apply for grants. Many of the young investigators I see doing this have had a really difficult time, and are often under prepared. This is not universal, but it does happen to a lot of people.
*Some residencies take longer, but then fellowship may be shorter.
**Assuming you fast-track residency to fellowship, then fellowship is 4 years instead of 3.
***I know a few people who don't end up having to do a fellowship.
K-award = NIH grant for junior investigators
Questions?
So, here are my reasons:
1. If you get a PhD, and can't get a job doing research, it's harder to find a back up career. The other angle is that it's pretty nice to have "doctor" as your back up career.
2. MD-onlies can still do research, but doing so requires a multi-year fellowship, a Master's degree (at least) and a period during which they apply for a K-award.* This can take 3-5 years POST RESIDENCY to accomplish. And while most (but not all) MD-PhDs will still need to do a fellowship in order to get a tenure track faculty position, they can use that fellowship time to actually write their K-award and do more substantive research than their colleagues who still have to get their Master's degree. This can only help when they enter the job market.
3. You do actual substantive research on a project that YOU HAVE TO THINK THROUGH YOURSELF before you even get to residency. This is very different than what you do as an MD-only. Most research done by medical students during medical school is someone else's research. Someone else conceived of the idea, thought of how to do it. The Student is just carrying out the process. Not to knock the experience -- it IS important to learn -- but it's just not the same as coming up with your own idea and figuring out how to test it yourself. Even some Master's level students wind up doing this if they can't think of their own project, and suffice to say most of these people do not ever become independent investigators.
4. Getting a PhD gives you excellent experience doing research. However, most PhD students I've met don't have a great grasp of a) how doctors think, b) how things work in a hospital, or c) medical pathophysiology. Case in point, a PhD colleague of mine did not know what varicella was. Another thought an adenocarcinoma was a cancer of the adenoids. Sure, you can use UpToDate to fill yourself in on the details of whatever disease you are studying, but it's no substitute for medical school, or actually working in a hospital environment. I would never have been able to think of my project on doctor-patient communication had I never seen it go horribly wrong during my rotations.
5. A lot of MDs get Master's degrees and do research that way. However, a Master's degree only begins to scratch the surface of how to do solid research. You would not believe how much bad and plain wrong research gets published. In addition, there are a lot of administrative details that you need to learn by messing them up a few times. Not saying that a PhD solves this problem completely. However it does help to have a few more years of experience under your belt before you dive into being an independent investigator.
6. I feel really bad for the PhD-onlies in my department. They have to fund 95% of their salary via grants, and in this economy, that must be very stressful. While clinical work will detract from research time, at least I know that I'll always be able to pay for myself.
7. MD-PhDs more often than not (rightly or wrongly) default into the "boss" position. If you have a single degree, you can get there too, it's just not as common. I've heard it's easier to get grants as a dual degree person, however that may not be true.
8. I have a friend who has a PhD in sociology. She is working as a statistician in my department UNDER MDs. Who knows if she will ever advance or get a job as a professor. She may not want to. Still, I would be pretty upset if the end target of all my training was a $40,000 job still doing other people's research. That is a real risk of getting a PhD only.
9. MD-PhDs get paid more for the same jobs filled by PhDs. Sorry, it's just true.
10. No debt. My tuition is paid, and I get a stipend. This is really the worst reason to do an MD-PhD, because as say..... an anesthesiologist I could make the whole bundle back in about 2 years, but it's a nice carrot anyway.
11. You meet potential collaborators during your PhD. The benefits of this should not be underestimated.
12. You get to be a Dr.Dr. Also, you get to be in school FOREVER!
Now for how much time these things take: (times are approximate)
1. PhD only -- 6 years PhD + 3 years post-doc = 9 years
2. MD only -- 4 years med school + 3 years residency* + 3 years fellowship + 1-2 year K-award application = 11-12 years
3. MD-PhD -- 8 years MD-PhD + 2 years residency** + 3-4 years fellowship*** = 13-14 years
So, you do spend a bit more time doing the two degrees. I think the argument for doing both degrees is even more compelling in the basic sciences because you just need to spend time in the lab to get good at what you do in those fields. It has to be hard to catch up if you only have a fellowship after residency to build up a publication record off which to apply for grants. Many of the young investigators I see doing this have had a really difficult time, and are often under prepared. This is not universal, but it does happen to a lot of people.
*Some residencies take longer, but then fellowship may be shorter.
**Assuming you fast-track residency to fellowship, then fellowship is 4 years instead of 3.
***I know a few people who don't end up having to do a fellowship.
K-award = NIH grant for junior investigators
Questions?
Friday, March 12, 2010
Italian for the dog
My in-laws are coming to visit for THE ENTIRE MONTH OF MAY. As a result, we have been slowly but surely preparing for their arrival.
This morning we finally got a new mattress. Now when they arrive, they will have something to sleep on. Hurray!
We might also get a tv for their room, and possibly a chair and a dresser (but we'll have to see).
In addition, I have been teaching Boo basic obedience in Italian as well as in English. Now she will sit in response to:
a) the hand signal
b) sit
c) seet ("sit" said with an Italian accent)
and
d) siediti
We've also been working on wait (aspetta) and come (vieni qui).
So now that Boo will be able to understand my in-laws, my only hope now is that they aren't too appalled by the dog toys scattered all over the living room floor and the extent to which she has become the focus of our lives.
Oh well. Gotta start somewhere, I guess.
This morning we finally got a new mattress. Now when they arrive, they will have something to sleep on. Hurray!
We might also get a tv for their room, and possibly a chair and a dresser (but we'll have to see).
In addition, I have been teaching Boo basic obedience in Italian as well as in English. Now she will sit in response to:
a) the hand signal
b) sit
c) seet ("sit" said with an Italian accent)
and
d) siediti
We've also been working on wait (aspetta) and come (vieni qui).
So now that Boo will be able to understand my in-laws, my only hope now is that they aren't too appalled by the dog toys scattered all over the living room floor and the extent to which she has become the focus of our lives.
Oh well. Gotta start somewhere, I guess.
Thursday, March 11, 2010
What's not to like about Psychiatry?
One of my readers inquired what I found appealing about Psychiatry. So here goes.
First, the pros:
1. You can actually make your patients feel better and be more functional in society.
2. Many people with severe psychiatric illness are completely unable to advocate for themselves. As a psychiatrist, you are in the unique position to truly help those who cannot help themselves.
3. Talking to people about their emotional problems / psychiatric illness requires attention to minute details of conversations, the understanding of nuance and tone, the ability to read the subtext of a conversation. You really have to think in order to be a good psychiatrist.
4. Counter-transference. You use how the patient makes YOU feel in order to aid in your diagnosis and treatment decisions. In other specialties this often gets reduced to, "That patient is Borderline," with a wave of the hand, a practice which makes me INSANE.
5. Psychiatric medications work in tangible ways. After marinating in fluphenazine for a few weeks, your floridly psychotic schizophrenic patient may not only stop spitting at you, they may even try to talk with you. The progress can be incredibly rewarding to observe.
6. You start thinking about why people are the way they are. Why they do what they do. I feel it enhances my understanding of humanity.
7. A lot of medicine people have no clue whatsoever when it comes to psychiatric illness. It's like they missed that entire block during med school. In consult liason psychiatry, you get to be the knight in shining armor that rescues your patient from the incompetent medicine person who thought that the patient's dysarthria was due to her schizophrenia (and not a stroke).
8. Addiction is fascinating. For me, anyway.
9. The field is wide open for research. Epidemiology? What is that? Also, most of the top residencies have a large amount of protected time for research, which is a big plus for me.
10. Did I mention the hours are nice. The pay is bad, but since I'm planning to be an academic, I'm not looking at enormous salaries anyway.
11. Cognitive Behavioral Therapy is the secret to happiness. You should try it some time.
12. The people who go into psychiatry are awesome. Weird sometimes, but awesome. And they tend to have interests outside medicine, which I find really nice.
The Cons
1. No respect. I can't tell you the number of residents and attendings I have spoken to who have openly mocked a psychiatrist colleague for their lack of knowledge about how to manage something like..... diabetes. Psychiatrists aren't thought of as "real doctors" by many many people.
2. The hand wavy nature of psychiatric diagnosis. Sure, the DSM has really detailed definitions that they make you memorize for your shelf. Unfortunately, psychiatry has yet to catch up with the rest of science. For instance, while we have our medications, and must memorize the receptors they act on, the truth is, we really have no clue why they work. Really.
3. A lot of psychiatrists really have forgotten pretty much everything they learned in med school. It would be hard for me to give all that up, since I love medicine.
4. Outpatient psych.... I don't know. In the clinics I saw, appointments were kept short. There was no couch and no 50 minute hour. I don't think I could really do psychoanalysis.
5. The worst of the worst of the malingerers fake psychiatric illness. What kind of person *wants* to be locked up in the psych hospital.
6. The annoying as crap capacity consult. Please guys, this is not hard to do.
7. Some psychiatric patients are truly scary, evil individuals. I guess that could be said for all patients, but they do seem to cluster into this field. Or at least you're made aware of those issues in a way you sometimes wish you weren't.
8. Did I mention the lack of respect?
9. Did I mention the absence of the rest of medicine?
10. Also, despite the fact that there is little epidemiology in psychiatry right now outside the RCTs for new drugs, that does not mean that they are looking for people who do what I do. Alas, their lack of knowledge means the exact opposite: that they are actively NOT looking for people like me, and I face an uphill battle doing what I do in that field.
****
I know someone is going to tell me that I can do a joint residency in medicine and psychiatry. I already know this. The problem is that those programs are primarily meant for people who intend to be full time clinicians. I am planning on doing research, and I'm not sure they'd be a good fit as a result.
First, the pros:
1. You can actually make your patients feel better and be more functional in society.
2. Many people with severe psychiatric illness are completely unable to advocate for themselves. As a psychiatrist, you are in the unique position to truly help those who cannot help themselves.
3. Talking to people about their emotional problems / psychiatric illness requires attention to minute details of conversations, the understanding of nuance and tone, the ability to read the subtext of a conversation. You really have to think in order to be a good psychiatrist.
4. Counter-transference. You use how the patient makes YOU feel in order to aid in your diagnosis and treatment decisions. In other specialties this often gets reduced to, "That patient is Borderline," with a wave of the hand, a practice which makes me INSANE.
5. Psychiatric medications work in tangible ways. After marinating in fluphenazine for a few weeks, your floridly psychotic schizophrenic patient may not only stop spitting at you, they may even try to talk with you. The progress can be incredibly rewarding to observe.
6. You start thinking about why people are the way they are. Why they do what they do. I feel it enhances my understanding of humanity.
7. A lot of medicine people have no clue whatsoever when it comes to psychiatric illness. It's like they missed that entire block during med school. In consult liason psychiatry, you get to be the knight in shining armor that rescues your patient from the incompetent medicine person who thought that the patient's dysarthria was due to her schizophrenia (and not a stroke).
8. Addiction is fascinating. For me, anyway.
9. The field is wide open for research. Epidemiology? What is that? Also, most of the top residencies have a large amount of protected time for research, which is a big plus for me.
10. Did I mention the hours are nice. The pay is bad, but since I'm planning to be an academic, I'm not looking at enormous salaries anyway.
11. Cognitive Behavioral Therapy is the secret to happiness. You should try it some time.
12. The people who go into psychiatry are awesome. Weird sometimes, but awesome. And they tend to have interests outside medicine, which I find really nice.
The Cons
1. No respect. I can't tell you the number of residents and attendings I have spoken to who have openly mocked a psychiatrist colleague for their lack of knowledge about how to manage something like..... diabetes. Psychiatrists aren't thought of as "real doctors" by many many people.
2. The hand wavy nature of psychiatric diagnosis. Sure, the DSM has really detailed definitions that they make you memorize for your shelf. Unfortunately, psychiatry has yet to catch up with the rest of science. For instance, while we have our medications, and must memorize the receptors they act on, the truth is, we really have no clue why they work. Really.
3. A lot of psychiatrists really have forgotten pretty much everything they learned in med school. It would be hard for me to give all that up, since I love medicine.
4. Outpatient psych.... I don't know. In the clinics I saw, appointments were kept short. There was no couch and no 50 minute hour. I don't think I could really do psychoanalysis.
5. The worst of the worst of the malingerers fake psychiatric illness. What kind of person *wants* to be locked up in the psych hospital.
6. The annoying as crap capacity consult. Please guys, this is not hard to do.
7. Some psychiatric patients are truly scary, evil individuals. I guess that could be said for all patients, but they do seem to cluster into this field. Or at least you're made aware of those issues in a way you sometimes wish you weren't.
8. Did I mention the lack of respect?
9. Did I mention the absence of the rest of medicine?
10. Also, despite the fact that there is little epidemiology in psychiatry right now outside the RCTs for new drugs, that does not mean that they are looking for people who do what I do. Alas, their lack of knowledge means the exact opposite: that they are actively NOT looking for people like me, and I face an uphill battle doing what I do in that field.
****
I know someone is going to tell me that I can do a joint residency in medicine and psychiatry. I already know this. The problem is that those programs are primarily meant for people who intend to be full time clinicians. I am planning on doing research, and I'm not sure they'd be a good fit as a result.
Wednesday, March 10, 2010
Opting out
I was talking to a friend who I swim with the other day about how difficult is must be to be a junior investigator these days. How there's so much pressure to get grants and so little money available. How I don't see how anyone stays sane through the process. How hard it must be to have a life too.
I ask myself regularly if this is something I really want. I think it is, but we'll have to see where I am in 10 years from now and I'm in (hopefully) my first tenure track position as a junior faculty member. If "tenure track" even exists anymore.
Cynical "ha" over here.
I wonder how people do it. I wonder how *women* do it. And the truth is? They don't. They opt out a lot/most of the time. I think a lot of women physician scientists simply decide that it's just not worth all the suffering and pain in the end. The endless competition. And they decide to get off the hamster wheel and they go back to their $200,000 jobs as doctors. I don't even consider that a "failure" really. It's a choice, and probably a smart one for a lot of women. It's just a choice that more women make than men, it seems.
My friend suggested I talk to a woman who is doing it. Find a woman who is living the academic physician scientist dream. And you know what? I can name only ONE woman MD-PhD at my institution who is a junior faculty member in a tenure track job. There is one more who does basic science, but I don't know her.
Do you have any idea how dispiriting that is?
ONE.
Pathetic.
I wanted to ask the MiM if they had any thoughts on this, but I don't think any of them are research track. Maybe there are a few who are clinician educator track, but that is not the same thing (not that there's anything wrong with that). Maybe I'm wrong. Please tell me I'm wrong!
I honestly don't think I even partially fathomed how barren (so to speak) my field is in terms of women until maybe a year ago. It never even occurred to me that this would be the case given how many woman doctors there are.
Anyway, please tell me I'm not crazy to want a job that allows me to be intellectually stimulated (research) and also allows me to see patients (doctor). Sometimes it just seems like such a long and difficult path that I wonder if it will be worth it in the end. Especially since there are practically no women who do it.
I ask myself regularly if this is something I really want. I think it is, but we'll have to see where I am in 10 years from now and I'm in (hopefully) my first tenure track position as a junior faculty member. If "tenure track" even exists anymore.
Cynical "ha" over here.
I wonder how people do it. I wonder how *women* do it. And the truth is? They don't. They opt out a lot/most of the time. I think a lot of women physician scientists simply decide that it's just not worth all the suffering and pain in the end. The endless competition. And they decide to get off the hamster wheel and they go back to their $200,000 jobs as doctors. I don't even consider that a "failure" really. It's a choice, and probably a smart one for a lot of women. It's just a choice that more women make than men, it seems.
My friend suggested I talk to a woman who is doing it. Find a woman who is living the academic physician scientist dream. And you know what? I can name only ONE woman MD-PhD at my institution who is a junior faculty member in a tenure track job. There is one more who does basic science, but I don't know her.
Do you have any idea how dispiriting that is?
ONE.
Pathetic.
I wanted to ask the MiM if they had any thoughts on this, but I don't think any of them are research track. Maybe there are a few who are clinician educator track, but that is not the same thing (not that there's anything wrong with that). Maybe I'm wrong. Please tell me I'm wrong!
I honestly don't think I even partially fathomed how barren (so to speak) my field is in terms of women until maybe a year ago. It never even occurred to me that this would be the case given how many woman doctors there are.
Anyway, please tell me I'm not crazy to want a job that allows me to be intellectually stimulated (research) and also allows me to see patients (doctor). Sometimes it just seems like such a long and difficult path that I wonder if it will be worth it in the end. Especially since there are practically no women who do it.
4 years from now
The department of medicine at UMASS twittered my "No love for IM" post and linked me. It was on the FRONT PAGE of their website, so I decided to take the post down.
So, I guess I have an audience, eh? People actually read this thing? No kidding.
Though I am not applying for residency likely for another 4 years, I really can't run the risk of having random people say, "Hey, weren't you that A-hole who said medicine residents were all jerks?" 4 years from now.
Even though that is NOT what I said.
Let me make something clear. The point of that post was to say that everything in my career has been pulling me down the medicine path. That is, everything besides a few unpleasant people I worked with during my 200 level rotation. I am not the only person to feel this way about this rotation at my med school.
Sorry dear Medicine course director. It's just a fact.
However I really really greatly enjoyed my medicine sub-i. I was shocked by this. I had just come off of Neurology externship (which to date had been the most awesome rotation I had done), and I didn't think it could get any better. That rotation made me seriously happy. I loved it.
The sub-i didn't beat out Neurology, but it tied it.
Aren't people supposed to hate their sub-is? This is what I thought. Suddenly, medicine was back on my list. And given the experiences I'd had in the ICUs (albeit limited -- they don't allow you near a MICU until you're done with your sub-i), and my relative ambivalence towards outpatient medicine, I decided to do a General Internal Medicine-y PhD project.
Well, there were those reasons. There was also the fact that almost everyone in my PhD department does Medicine. There are practically no Neurology people. Plus, my research interests aligned almost perfectly with two Intensivists, both of whom I greatly respect.
Anyway, what I'm saying to you, UMASS IM department, don't hate on ME. Perhaps there are valid reasons that I am hesitant to say, "Oh yes TOTALLY going into IM, AND doing a Critical Care fellowship!!" Even though I think the patient care parts of it are fascinating. Even though I love the thought process in Medicine. Even though on paper it seems like a near perfect fit.
Like I said, I just don't feel like I'm in the in crowd. Mostly. That's started to change a little, but it is what it is. You're a tough nut to crack, IMers.
So, for the list o Specialties I'm still considering:
Neurology
Medicine (Critical Care)
Psychiatry
Anesthesia
Emergency Medicine
If you hang out and read some future posts, you will see that I have some pretty major reservations about all of them.
Thank goodness I have another 4 years to think about this.
So, I guess I have an audience, eh? People actually read this thing? No kidding.
Though I am not applying for residency likely for another 4 years, I really can't run the risk of having random people say, "Hey, weren't you that A-hole who said medicine residents were all jerks?" 4 years from now.
Even though that is NOT what I said.
Let me make something clear. The point of that post was to say that everything in my career has been pulling me down the medicine path. That is, everything besides a few unpleasant people I worked with during my 200 level rotation. I am not the only person to feel this way about this rotation at my med school.
Sorry dear Medicine course director. It's just a fact.
However I really really greatly enjoyed my medicine sub-i. I was shocked by this. I had just come off of Neurology externship (which to date had been the most awesome rotation I had done), and I didn't think it could get any better. That rotation made me seriously happy. I loved it.
The sub-i didn't beat out Neurology, but it tied it.
Aren't people supposed to hate their sub-is? This is what I thought. Suddenly, medicine was back on my list. And given the experiences I'd had in the ICUs (albeit limited -- they don't allow you near a MICU until you're done with your sub-i), and my relative ambivalence towards outpatient medicine, I decided to do a General Internal Medicine-y PhD project.
Well, there were those reasons. There was also the fact that almost everyone in my PhD department does Medicine. There are practically no Neurology people. Plus, my research interests aligned almost perfectly with two Intensivists, both of whom I greatly respect.
Anyway, what I'm saying to you, UMASS IM department, don't hate on ME. Perhaps there are valid reasons that I am hesitant to say, "Oh yes TOTALLY going into IM, AND doing a Critical Care fellowship!!" Even though I think the patient care parts of it are fascinating. Even though I love the thought process in Medicine. Even though on paper it seems like a near perfect fit.
Like I said, I just don't feel like I'm in the in crowd. Mostly. That's started to change a little, but it is what it is. You're a tough nut to crack, IMers.
So, for the list o Specialties I'm still considering:
Neurology
Medicine (Critical Care)
Psychiatry
Anesthesia
Emergency Medicine
If you hang out and read some future posts, you will see that I have some pretty major reservations about all of them.
Thank goodness I have another 4 years to think about this.
Monday, March 08, 2010
That's my excuse and I'm sticking with it
I decided to try doing some push-ups and sit-ups this morning after taking Boo for a run.
Alas, Boo had other ideas about this.
It's very difficult to sit-ups when doggie is play-bowing/ pouncing on you with every sit-up.
So, I guess sit-ups are out?
Darn.
Well, that's my excuse anyway. And I'm sticking to it!
Alas, Boo had other ideas about this.
It's very difficult to sit-ups when doggie is play-bowing/ pouncing on you with every sit-up.
So, I guess sit-ups are out?
Darn.
Well, that's my excuse anyway. And I'm sticking to it!
Sunday, March 07, 2010
As a side note
Even though I grouse because I am working on my power calculation for a grant as we speak, I am really very happy today. Why? It's 60 degrees out! And sunny!
Holy cow!
Luca and I took Boo for a 2 hour walk yesterday around the neighborhood, and it was soooooo relaxing. My tulips are coming up in full force (though I had to look up my order to remember what I had planted....), and you can see the buds on the cherry tree in front of my neighbor's house forming.
Spring in Philadelphia is truly a wonderful season.
Boo likes it too. She is stretched out on on the floor snoozing in a little piece of sun as we speak.
Holy cow!
Luca and I took Boo for a 2 hour walk yesterday around the neighborhood, and it was soooooo relaxing. My tulips are coming up in full force (though I had to look up my order to remember what I had planted....), and you can see the buds on the cherry tree in front of my neighbor's house forming.
Spring in Philadelphia is truly a wonderful season.
Boo likes it too. She is stretched out on on the floor snoozing in a little piece of sun as we speak.
Power
Me: I need to get the distribution of X variable in our data set so I can do the power calculation.
Mentor: Why don't you just guess? It's just a power calculation. People do this all the time.
Me: Well, I HAVE the data. I can figure out what the ACTUAL value is. I don't HAVE to guess. Wouldn't that be better?
Mentor (sarcastic tone): You may as well just do the analysis then. Why even DO a power analysis or apply for a grant? That's the dumbest thing I've ever heard.
Me: Ummmmmm........
Mentor: Why don't you just guess? It's just a power calculation. People do this all the time.
Me: Well, I HAVE the data. I can figure out what the ACTUAL value is. I don't HAVE to guess. Wouldn't that be better?
Mentor (sarcastic tone): You may as well just do the analysis then. Why even DO a power analysis or apply for a grant? That's the dumbest thing I've ever heard.
Me: Ummmmmm........
Saturday, March 06, 2010
Spring Break
Next week is Spring Break at my grad school. Since I'm working on my grant, clearly there will be no spring break for me. I was a little surprised actually, to hear that a number of the people in my program *were* actually going on some sort of vacation.
Slackers.
Apparently spas are very popular? Who knew! I've never been to a spa myself, and as someone whose never even gotten her nails done, it seems like an odd way to spend a vacation. When I'm on vacation, I like to:
a) exercise, preferably multiple times a day in different (and sometimes novel) sports
b) eat a huge amount of food
c) drink wine
d) read a book or two (or three!) for fun
e) play with my dog
f) hand out with mu husband and not feel like we have to do chores
g) sleep
h) watch movies
i) take walks, preferably to beautiful places
j) hang out with people I like
Note: Absent from this list are anything to do with grooming or shopping. I guess maybe I'm not really a girl, after all?
I'd also like to point out that I have succeeded in filling up my weekend with must dos. For instance, we MUST buy a bed so that my in-laws have something to sleep on when they arrive in a few weeks. We MUST remove the nasty garbage and leaves from my garden that was buried under 4ft of snow until this week. We MUST walk the dog extensively.
I also MUST work on my power calculations for my grant. You know what? Just not as much fun as walking the dog, or even bed shopping, I gotta say.
I did just order a bunch of plants for my garden. I can't wait until they arrive. I am so excited!
Slackers.
Apparently spas are very popular? Who knew! I've never been to a spa myself, and as someone whose never even gotten her nails done, it seems like an odd way to spend a vacation. When I'm on vacation, I like to:
a) exercise, preferably multiple times a day in different (and sometimes novel) sports
b) eat a huge amount of food
c) drink wine
d) read a book or two (or three!) for fun
e) play with my dog
f) hand out with mu husband and not feel like we have to do chores
g) sleep
h) watch movies
i) take walks, preferably to beautiful places
j) hang out with people I like
Note: Absent from this list are anything to do with grooming or shopping. I guess maybe I'm not really a girl, after all?
I'd also like to point out that I have succeeded in filling up my weekend with must dos. For instance, we MUST buy a bed so that my in-laws have something to sleep on when they arrive in a few weeks. We MUST remove the nasty garbage and leaves from my garden that was buried under 4ft of snow until this week. We MUST walk the dog extensively.
I also MUST work on my power calculations for my grant. You know what? Just not as much fun as walking the dog, or even bed shopping, I gotta say.
I did just order a bunch of plants for my garden. I can't wait until they arrive. I am so excited!
Thursday, March 04, 2010
Treadmill
Two years ago on a rotation, I was chatting with a classmate (let's call him Douchebagissimo), about running.
It turns out, Douchebagissimo only ran on the treadmill. He did this so that he could "make sure" that he was constantly improving. I then asked whether he ran on an incline, since running on a treadmill is easier than the real thing, and this is something people do to better approximate the "outdoors" experience -- account for things like wind resistance and the like.
I shouldn't have done that.
He got really defensive, and demanded that I produce literature on the subject PROVING that the treadmill was not the same as outdoor running. He accused me of being competitive, and generally went berserk. Then when we were seeing a patient together, he wouldn't let me see the patient's chart.*
Yes, I am serious.
Well, today the NYT has an article that supports my position. That the treadmill is just not as effective as the running path. And while it is the NYT, and thus probably not entirely accurate, there are several authors who do this sort of research cited in the article. And that, friends, is enough proof for me. Not that I ever doubted myself.
Eat THAT Douchebagissimo.
*Yes, folks. Someday this fine young lad may be YOUR doctor.
It turns out, Douchebagissimo only ran on the treadmill. He did this so that he could "make sure" that he was constantly improving. I then asked whether he ran on an incline, since running on a treadmill is easier than the real thing, and this is something people do to better approximate the "outdoors" experience -- account for things like wind resistance and the like.
I shouldn't have done that.
He got really defensive, and demanded that I produce literature on the subject PROVING that the treadmill was not the same as outdoor running. He accused me of being competitive, and generally went berserk. Then when we were seeing a patient together, he wouldn't let me see the patient's chart.*
Yes, I am serious.
Well, today the NYT has an article that supports my position. That the treadmill is just not as effective as the running path. And while it is the NYT, and thus probably not entirely accurate, there are several authors who do this sort of research cited in the article. And that, friends, is enough proof for me. Not that I ever doubted myself.
Eat THAT Douchebagissimo.
*Yes, folks. Someday this fine young lad may be YOUR doctor.
Her Royal Highness, Princess Boo
Before Luca and I got Boo, we weren't too sure about the whole crate thing. We (like many people, I am guessing) felt it would be evil and cruel for us to keep her in it for hours at a time. Probably it would be better if she didn't have to stay in it all day (with a break from the dog walker) three days a week. But we have jobs and that's the way it is.
Now we LOVE the crate. And I think Boo does too.
When we first told our dog walker that she was good about the crate, I don't think he believed us. He told us that he has to practically shoehorn his other client's dogs into the crate at the end of walk time.
Not so with our animal. In fact, her affinity for the crate has grown to disturbing levels over the past few weeks.
The other night we were sitting on the sofa, and I said something like, "I need to get a new blanket for her crate," and Boo picked her head up, looked at us, and then trotted across the living room, into the dining room, and then INTO THE CRATE. Where she waited for us expectantly to give her a treat.
Most nights I don't even have to use the word, "crate," or walk with her to the dining room where the crate is. Instead I say, "Time for bed," or "Do you know what time it is?" while I'm sitting watching tv in the living room, and she will get up off the couch next to me, and trot over to the crate and wait inside.
Similarly, when I leave in the morning, she takes cues from things like me packing my bag, or putting on my shoes and coat, and she will (without being asked) trot happily into the crate and wait there. She's even gotten to the point where I will be straightening her crate blankets, and she can barely contain herself to let me get out of her way, in her enthusiasm to go into her crate and receive a treat.
This morning when we woke up, we opened her crate door and she just sat inside looking at us expectantly. Luca and I were like, "Hello your royal highness. Would you like a special invitation to go for your morning walk?" No, the dog was not feeling ill. She (I am guessing) was waiting for a treat as she waited patiently for us to release her (verbally) from the crate.
It's a little weird, but we're getting used to it. And it does make us feel less guilty about crating her for so many hours each day. We know it's just because she wants a treat, but still. Thank goodness she's still a skinny-mini, otherwise we'd be in big trouble!
Now we LOVE the crate. And I think Boo does too.
When we first told our dog walker that she was good about the crate, I don't think he believed us. He told us that he has to practically shoehorn his other client's dogs into the crate at the end of walk time.
Not so with our animal. In fact, her affinity for the crate has grown to disturbing levels over the past few weeks.
The other night we were sitting on the sofa, and I said something like, "I need to get a new blanket for her crate," and Boo picked her head up, looked at us, and then trotted across the living room, into the dining room, and then INTO THE CRATE. Where she waited for us expectantly to give her a treat.
Most nights I don't even have to use the word, "crate," or walk with her to the dining room where the crate is. Instead I say, "Time for bed," or "Do you know what time it is?" while I'm sitting watching tv in the living room, and she will get up off the couch next to me, and trot over to the crate and wait inside.
Similarly, when I leave in the morning, she takes cues from things like me packing my bag, or putting on my shoes and coat, and she will (without being asked) trot happily into the crate and wait there. She's even gotten to the point where I will be straightening her crate blankets, and she can barely contain herself to let me get out of her way, in her enthusiasm to go into her crate and receive a treat.
This morning when we woke up, we opened her crate door and she just sat inside looking at us expectantly. Luca and I were like, "Hello your royal highness. Would you like a special invitation to go for your morning walk?" No, the dog was not feeling ill. She (I am guessing) was waiting for a treat as she waited patiently for us to release her (verbally) from the crate.
It's a little weird, but we're getting used to it. And it does make us feel less guilty about crating her for so many hours each day. We know it's just because she wants a treat, but still. Thank goodness she's still a skinny-mini, otherwise we'd be in big trouble!
Wednesday, March 03, 2010
On professionalism
A few weeks ago, an attending who teaches one of my classes was openly complaining about a medical student.
Apparently, said attending has a habit of calling his lab repeatedly throughout the day to keep tabs on things while he is on service. The student had the AUDACITY to write in an evaluation of him saying that he found this unprofessional.
Now, I wasn't there. I don't know what went down. But what I DO know is that it is highly unprofessional to complain about these sorts of things in front of other medical students.
I felt myself siding with the student on that basis alone. What a petulant little boy this attending was! Take your evaluations like a man, dammit! We have to! What makes you special?
Apparently, said attending has a habit of calling his lab repeatedly throughout the day to keep tabs on things while he is on service. The student had the AUDACITY to write in an evaluation of him saying that he found this unprofessional.
Now, I wasn't there. I don't know what went down. But what I DO know is that it is highly unprofessional to complain about these sorts of things in front of other medical students.
I felt myself siding with the student on that basis alone. What a petulant little boy this attending was! Take your evaluations like a man, dammit! We have to! What makes you special?
Tuesday, March 02, 2010
List
A few years back, I came up with a list of things I'd like to accomplish before I die. Some might call it a bucket list, but ever since that movie came out, I've become disenchanted with the term. Plus, my list doesn't include things like bungee jumping, or seeing the Great Wall, so I don't really think of it in the same way.
On that list included:
- Take Physics with calculus (done!)
- Become fluent in a foreign language (not fluent, but I'm still working on it -- Thanks Luca!)
- Get doctorate (working on it)
- Own house (done!)
- Find something I love to do that people will pay me for (done!)
- Have and raise baby
- Learn how to grow things (done!)
- Become part of a community (working on it)
- Own dog (done!)
So I was talking about my list with a friend, and she thought the fact that "have baby" was on the same list as "take physics with calculus" was a bit weird. I don't think it's weird at all. Taking physics is something I felt I needed to do to prove something to myself. Having a baby is something I'd like to do so I can see what it's like. It's an experience I want to have at some point in my life.
So, why is a person *supposed* to want kids, then, if having it on the list of things to do in life is thought to be..... I don't know, cynical? Crass? Am I supposed to say, "I want children because they are a gift from heaven and I wish to devote my life to them?" I hope not. Fundamentally, I believe we all have children for ourselves. Then you do your best to do right by them once they're here.
My parents still refer to me as "their little experiment," which while mildly annoying, is understandable to me on a certain level. Perhaps this explains my perspective on the matter. Thoughts?
What are the items on some of your lists, dear readers?
On that list included:
- Take Physics with calculus (done!)
- Become fluent in a foreign language (not fluent, but I'm still working on it -- Thanks Luca!)
- Get doctorate (working on it)
- Own house (done!)
- Find something I love to do that people will pay me for (done!)
- Have and raise baby
- Learn how to grow things (done!)
- Become part of a community (working on it)
- Own dog (done!)
So I was talking about my list with a friend, and she thought the fact that "have baby" was on the same list as "take physics with calculus" was a bit weird. I don't think it's weird at all. Taking physics is something I felt I needed to do to prove something to myself. Having a baby is something I'd like to do so I can see what it's like. It's an experience I want to have at some point in my life.
So, why is a person *supposed* to want kids, then, if having it on the list of things to do in life is thought to be..... I don't know, cynical? Crass? Am I supposed to say, "I want children because they are a gift from heaven and I wish to devote my life to them?" I hope not. Fundamentally, I believe we all have children for ourselves. Then you do your best to do right by them once they're here.
My parents still refer to me as "their little experiment," which while mildly annoying, is understandable to me on a certain level. Perhaps this explains my perspective on the matter. Thoughts?
What are the items on some of your lists, dear readers?
Monday, March 01, 2010
This biostats exam needs to end NOW
This biostats exam WILL NOT DIE.
This is day #3, hour #15. And it is still my first pass over the problems.
I was all excited because I thought problem 3 was half done this morning. All the previous problems had had parts a-e.
Problem 3? A-g motherf***er.
WAHHHHHHH!!!!!!
Don't they know I have a grant to work on???
***
On the plus side, the snow has finally melted off my garden, and I saw that my bulbs have begun to sprout. It's March 1st! What's up with that?
Hopefully they'll be pretty when they bloom. If they don't die first if the ground freezes again.....
***
Also on the plus side, once this biostats exam is over, I will have no more biostats this semester. Hence more free time to work on the grant.
Yay.
This is day #3, hour #15. And it is still my first pass over the problems.
I was all excited because I thought problem 3 was half done this morning. All the previous problems had had parts a-e.
Problem 3? A-g motherf***er.
WAHHHHHHH!!!!!!
Don't they know I have a grant to work on???
***
On the plus side, the snow has finally melted off my garden, and I saw that my bulbs have begun to sprout. It's March 1st! What's up with that?
Hopefully they'll be pretty when they bloom. If they don't die first if the ground freezes again.....
***
Also on the plus side, once this biostats exam is over, I will have no more biostats this semester. Hence more free time to work on the grant.
Yay.
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