Monday, November 28, 2011

Almost 1/2 way done

Hello there dear readers. I know, I know. It has been far too long since my last posting. I bet you thought that I forgot about this little blog of mine. Well, I did not. I have just been so tired that I have not had the chance to sit down to write. Of course, right now I am taking a break from writing my grant in order to write my blog. But alas, so it goes.

Since my last update, I have been done with my first time on the medical floors and now I am almost done with Cardiology. Both have been great to do. In addition, I have had clinic time each month. In fact, today I was told the best thing ever. I had a patient come in and say that she wanted me to be her Primary Care Physician!!! How about that. Although I am getting used to it, I still find it hard to believe that this is real. But now there are new challenges.

The biggest one is that of finances. Now that loans are starting to come off of their grace period, I have to get on the ball and call them back to get them onto deferment. No, I did not wait until the last minute but these things are very confusing. I mean I apply for it and first they tell me that I am in deferment until 2014 and then they tell me that I am not. Well that is not a nice thing to do to a guy who is very tired and works about 80 hours a week. Next there is trying to refinance a mortgage in this economy, good luck. And finally there is trying to get back on our feet financially. Well, I decided that we are obviously going to need help and so there is an appointment to be made with a financial planner.

The other challenge is trying to spend enough time with everyone. Yes, I did lapse a little in my Daddy/Daughter time and I am trying to get that back on the role. However, I also need time for the wife and myself. At least the time for myself should not be at the library writing a grant. But rather maybe reading a non medical magazine or going out with a friend (which I am planning). I did find out that our babysitter can come back from college with enough notice. Phew, now the wife and I can plan some outings. As long as I am not on call or post call. That is something I would advise those parents who want to go to medical school. Not only should you find a babysitter, but have several back up ones as well. They do come in handy. Sure you can find one or two or three amongst your classmates, but also have a local teen or two who are available as well.

Not much else to report. Other than the upcoming local NonTraditional Conference in March. I am going to try to get back into Paintball, I had so much fun with it and I have a cousin who is really into it. Always nice to have a hobby other than driver of kiddoes to birthday parties. Till next time.

Sunday, November 20, 2011

NonTraditional Conference has been announced

This is a quick one dear readers. The Annual Old Pre Meds Conference has been set for Orlando Florida in June. But, there is more good news..........

The Old Pre Meds NorthEast Regional Conference is set for March 18, 2012 at UMDNJ-School of Osteopathic Medicine in Stratford, NJ.

The school is in Southern NJ just outside of Philadelphia. So far there are 3 confirmed speakers and once I get everything fully confirmed I will post.


Saturday, October 15, 2011

on the floors

I know it has been some time since I last posted, but then again I have been very busy at work. well maybe not at work because I love what I am doing and therefor do not feel as if I am working.

Last month I was in the SICU, Surgical Intensive Care Unit, medically managing some of the post operative patients. The good thing about that rotation was that I was the only intern and resident so it was just the Intensivist and I which was great for 1:1 teaching time. But at the same time, if something was not done, the onus was 100% on me with no backup from a senior resident. And boy did I learn a lot.

There was one patient were I really learned how to manage shock and maintain blood pressure. I was in constant communication with the attending and it took about 5 hours to get the patient stable. By the end of the night, I really knew what to look for and how to manage things. Although I can use more practice my confidence went up. In addition, I really learned how to prioritize things in the ICU patient. And since my census was not very high I had to do several presentations to the other interns in the ICU so I learned a lot about topics including compartment syndrome, acute coronary events, delirium, etc.

Now I am on the general medical floors and I am doing well. These patients are much more stable and I am happy to be able to generate some form of relationship with them while they are in the hospital. And with my experience in the ICU, I do have confidence because before calling the resident, I think about the problem and come up with potential solutions. However, this is having a hard time at home because of my schedule.

I am on call every 4th night so I am at work from 7am until 9:30 pm and do not get home until about 10/10;30 so I can go a day or so without seeing the girls. This is why I do my best to spend quality time with them. Not always successful because I am so tired. I am learning to be much more patient with my girls, which is hard when you are sleep deprived. The other day I became angry and I took a drive to calm down, of course I went to get my clogs for work which are more comfortable for my feet but I was able to cool it and chit chat with my 10 year old the next day and smooth things over. Now I am going to close my eyes and count to 10 when I am starting to get frustrated because I forget that they are kids and are going to do kids things. Forgive me, I am human and therefor flawed.

With the wife, the issue is spending couple time. And the solution apparently has to be to schedule our time. While it may seem unromantic to say, "9pm thursdays is our night" it almost guarantees that it will happen because we wont schedule things at that time. However, while the schedule may not be romantic the time itself can be romantic. From putting a fire place on the computer from youtube, to going to the backyard and having some wine. It is a chance to be creative. Hopefully this will resolve one issue.

The other issue of course is finances, but that is for another discussion.

Saturday, September 10, 2011

in the ICU!!!!!!!!!! Love it.

So I am in what we call a "Golden Weekend". The first weekend in almost 2 months that I don't have to work either day. I was actually able to not only sleep in today, but I can look forward to doing it tomorrow.

Last month I was in the ICU and loved every minute of it. I was able to put in central lines, write orders, evaluate patients, but I also had the unfortunate responsibility to pronounce 3 patients, with family in the room.

I have been learning a TON in my program so far. I was also involved in several family meetings regarding the potential outcomes of the patients and having to tell the families that there is almost no chance of any meaningful recovery and that we would recommend comfort care and letting the patient die comfortably with no more invasive tests or procedures. While some families have agreed, others hold out hope beyond hope that things will change. I learned that with families who want everything done, the only way for them to come to the decision that they should let their loved one die peacefully is with time. But we never give them any false hopes.

Right now I am in the Surgical ICU, which in my program is my surgery rotation. Makes more sense than my doing surgical consults or being in the OR since I do not want to do that. Rather I take care of the patients Post operatively with the intensivist. So not only am I still doing ICU but I get 1:1 time with the attending and therefor get teaching.

This was great because it solidified my decision to go into critical care medicine. One day I am up to my neck in new admissions, 2 code blues, 3 lines, the next day I discharge 4 patients and pronounce 2. The next day, the unit is sparse and the hospital is quiet. Only to be broken by a rapid response.

But the hours are a killer. I have put in, on average, 75 hours a week. The one week I was actually over the limit with 85 hours. But I am so happy that it does not bother me. It really is true, I am not working. I am enjoying my new career.

But it really is weird, when someone calls me who does not know and I hear, "Dr., would you like some saline for this patient?". and all I can think is, holy crap, they are talking to me.

Friday, August 12, 2011


I know that it has been quite some time since I posted but a lot has been going on. First of all, I am done with the ER, and thank god for that as I can now really work and not just feel like a student. I have been in the ICU for 2 weeks now and I am not only loving every minute of it but I am exhausted.

I have to be in the hospital by 6am which means I have to get up at 4:30 and leave by 5. Then we sign out to the overnight crew at around 6pm and it takes about 30 minutes to go through each patient and give the night team an idea of who the patient is, if the patient is new to the unit, what happened during the day, and what needs to be followed up or what needs to be done. Sometimes it even takes an hour if we get paged. I  have a 6 day work week. Last week I worked 89 hours and this week I will be pushing 75.

We get an incredible number of sick people. From heart attacks to strokes, to terminal conditions. I have had to speak to patients about their illnesses, talking to families about their loved ones and communicating with other doctors. Everything I have been experiencing has substantiated my decision to go into medical school late in life. And because I am older and have been in the workforce, I know the politics of work and I have the emotional intelligence to react or not react to things that are said.

In about a month, I start clinic hours and I get my own census of patients that I will be following for the next 3 years. This is just getting better and better.

Till next time.


Friday, July 22, 2011

Month almost over

So my first month as an intern is almost over and I finally have access to patient charts in the ER. But I cannot write anything or order anything. Fine. But I did get to spend some time in the ICU, which is where I will be tomorrow night, next saturday night and then for the entire month of August.

While I was there, it was great. But nothing was really going on at night so it was still no different from being a medical student. Until the nurse paged me. She told me that the patient's blood pressure was still high even after getting medication and wanted to know what I wanted to give him. Well, my heart DROPPED!!!!! Now I really have to make a decision. If I do not give the right medication then the patient can be in bigger problems. But if I give too much they could be in problems also. The nurse hinted that it may be a good idea to give the patient hydralazine. So I looked up the labs and called my resident, which he told me the same thing. And I wrote the order.

The nurses know that we are all brand new doctors and so they are there to have our backs. As long as you are not nasty or rude to them. Which I am not (something that gives non trads an advantage over our traditional counterparts due to our emotional intelligence). Since then, I have decided that I am going to be reviewing the treatment of each emergency for each organ system. So far, so good. The only issue is that I have not been able to put the information to good use, yet.

Since starting, I have seen common medical problems enter the ER. Things that I eventually will take care of either on the floors or in the ICU. I have been able to perform several pelvic exams (with a chaperone of course), put in a couple of nasalgastric tubes, and IVs. But I am looking forward to putting in central lines, intubation, and other stuff life that.

I am looking forward to my time in the ICU. I plan on reviewing my notes on the information I have been reading about. And wondering how I am going to feel when I put in 72 hours a week.

Friday, July 8, 2011

It has been 1 week

So I have been an Intern for a whole week, as stated in the title of today's episode. The cool thing is that when I walk into see patients, I say I am Dr. Lerman, no longer saying Student Doctor Lerman and it is awesome. This whole month I am in the emergency room, which is kind of like an extension of medical school because I cannot chart anything, order anything, and I have to report everything to attending and have to try to follow my patients.

But, I am learning some. And that is the main point of course. I have taken the time that I am not seeing people and using it to read articles and get myself ready to take on the role of a good intern and eventually a good resident and practitioner. Not to mention, I have to get ready to take step 3 of the boards. I plan on taking them in 6 months. So to get ready, I am reading Kaplan's Mastering the Boards and will be signing up for the Q-banks. The more questions I do, the better I will be. I plan on getting a fellowship so I would like to score very well. While I did about 2500 questions to prepare for Step 2, I plan to do at least this many for Step 3. The big difference is that this test is 2 days long. That's right dear readers, you heard me; 2 DAYS!!!! Lord Help Me.

Our last loan check came in, so we no longer have to eat Ramen Noodles and I am going to start getting paid, which is a nice return to the way things ought to be.

   Uptodate: Clinical Reference

Next time, I will talk about my first on call in the ICU!!

Thursday, June 30, 2011

Last Day of Vacation

So today is it. The last day of my vacation and the last day that I am among the ranks of the unemployed (hopefully for good). I am putting finishing touches on my vacation, am going to try to get some fishing in later today when the sun goes down a little and get some me time. The last time I had me time was in Las Vegas.

This week is also tough because we are still waiting for our last residency loan check to come in but expenses do not wait for that. The cash reserves are starting to really scratch the bottom of the barrel and I may have to suck it up and take a few late fees just to wait. But at least in 2 weeks I get paid and then a steady stream of income will come our way.

The wife and I were talking yesterday about all of the great FREE things that are going around that, if we can, we should take advantage of. For example, free concerts sponsored by the recreation department, going to parks with a picnic, etc. This is certainly the lowest point in our financial life. It is ironic that I am going to be 37 years old and I still cannot hold my head above water financially. It will be great that I can start feeling that my family can hold its own. Yet, I know in my mind that this will be the case once I am done with training either in 3 or 6 years if I get into my fellowship (which I intend to).

So many things that we would like to do. And yet we still have to wait. But if we waiting this long, what is another few years right? We are young and fairly healthy.

OK. till next time.

Sunday, June 26, 2011

Orientation almost over

Hello there dear readers. I hope that everything is going well. I am speaking to you from the other side of orientation. Well, not quite. I have 2 more days to go. Tomorrow I take the ACLS exam and then on tuesday I learn the electronic medical record. Then I have 2 days off and the I officially start with my first day as an intern.

So, according to my schedule I am spending my first month in the Emergency Department. Kind of ironic in that this is what I was originally trying for. However, I get to be on call in the ICU and THAT is what I AM going for. Then I do 1 month in the Intensive Care Unit. I will be happier than a pig in shit.....Then I get a month of elective, which I may either stay in the ICU, or do pulmonary. Although I am leaning towards ICU. My hours are probably 7a-5p unless I am on call, then my hours increase until 10:30pm. But I am psyched.

This whole week in orientation, I was anxious and excited and scared at the same time. I am anxious and excited to start, but I am also scared that I do not know much....this is normal for all new interns. But I started reading. I read the NEJM every day and I am going to be adding 1-2 hours per day of a pertinent subject. I will take 1 or 2 cases and read all about them.

In the meantime, have been reading "The Jungle" by Upton Sinclair. It is about the meatpacking industry at the turn of the century. Since the Kindle is a free app for android, the book is available for free as well. So when there is a break, or lunch, or I am in line I break out the phone and read the book. It is a nice diversion from everything else.

Until Next time.

Thursday, June 16, 2011

Calm before the storm

So I am relaxing right now. I have until next week, exactly, to be able to sit at the dining room table with a cup of coffee and be able to drink it properly and not have to wait for a red light to prevent spillage. In the meantime, I have house-husband stuff to do. For instance, put away the laundry, clean the house, pick up the girls from the babysitter, pick them up from the bus stop. But that is all in the afternoon.

I plan on going fishing at least once this next week and even hitting the driving range before I start. The good news is that I was able to secure a residency loan to keep the family afloat until I start earning a regular paycheck. This, in addition to more cost cutting items will certainly help. Some of the cutting is to shift money from a low interest rate CC to a higher one in order to pay that off more quickly. I found out that the local supermarket offers free family movies once a month. Free tv shows and movies on the internet such as hulu and comcast. But also I discovered Groupon, where you can get things at a cheaper price. Let's see how that works out.

Also this week, rather than going to the movies at night, the wife and I will take in a matinee. Since the girls are in school or at the babysitter, no need to pay extra. And matinees are usually 1/2 the price.

During this time, I am also starting to work on a new concept for Old Pre Meds, and that is a Northeast Regional Conference. One that is only for day and will provide a good amount of information but will also introduce people to the larger, annual conference. I do not know where or when it will be held but stay tuned. And if you are in the area, please check it out.

I really should start ramping up the reading, considering I have been decompressing. See you later.


Monday, June 13, 2011

10 days to go

So in 10 days, I will have orientation for residency. During these next few days I will have the time to fix things around the house, probably hit a Matinee with my wife (date day) and just enjoy and relax.

A recent issue had come up that I wanted to share with you all. I miscalculated how much we would need between medical school ending and getting a paycheck. So I applied to get a residency loan and I was turned down because of an issue with my credit report. It turns out that said issue was an error by the creditor which needed to be taken care of right away. Had I looked at my credit report before I applied for the loan, I would have seen the error, fixed it, and then applied. Since I fixed the problem, I am debating whether or not to apply for the loan again. The question is, should we grin and bear it or should we give ourselves some breathing room.

Last week, I had the utmost pleasure to go and speak at the Old Pre Meds conference in Las Vegas ( For those of you have not gone to a conference of this kind yet, I urge you, nay, I STRONGLY urge you to go next year. Word on the street is that it will return to the east coast but nothing formal has been announced.  The conference is 100% non traditional. There is nothing in the conference that does not aim at the non trads. Not to mention there was a good showing of schools and programs to speak to.

I had the pleasure of speaking to several people who are just starting out and they have families. Specific questions included how to assuage your spouse from fearing that once you are done with medical school that you will  not leave them. This is one of the most feared situations a support person has. The best advice that I can give is to constantly remind them how much you appreciate them, how much you love them, and how much you cannot do this without their support. Recognize them whenever you can. Whenever I am asked how I was able to accomplish medical school with a family, the first words out of my mouth are that "I could not have done it without my wife. She deserves the praise". In addition, during graduation, I had the family gather around and I presented her with my own gift to her. Which is seen below. The wording took me about 3 weeks to figure out.

"Three weeks!!!! Why did it take you so long to figure out what to say. Why not say 'I Love You' and be done with it?" And the answer is, because she KNOWS I love her. She does not need a plaque for it. What she wants to know is how much I appreciated her SACRIFICE  she sacrificed everything for me. And I needed to not only let her know how much I appreciated it, but that I publicly acknowledged it. The wording, I felt, needed to reflect not only how much I appreciated her love, but how much I appreciated her doing a lot more of her fair share so that I can study, go to conferences, build my resume, and participate in school functions.  But the sacrifice was not isolated to medical school but also to the preparation for it. For the time I took to go to graduate school and prepare for it. Write and defend my thesis, study and take the MCAT (not once; but twice).  But most importantly, for keeping the family together during this stressful time. And while a gift or a plaque will not fully assuage the fear that I would leave her after I am done, telling her that I will not and showing her that I will not (by being open and honest) will do that.  But the most important thing you can do, is to acknowledge the fear and keep telling them that all will be ok. 

And so with that, fellow non trads I leave you for now. Stay tuned for more as I enter Residency. 


Wednesday, June 1, 2011

Transition Period is hard

Well here I am, a fresh Doctor of 1 week, and we are in a bind. Because I am not in school anymore, I am unable to get anymore student loans and since I have so many loans because of school, my credit report is affected. As a result, time to scrounge up some cash!!!!

There are things that we have been doing to reduce payments but still. It is very anxiety ridden to not be able to tap into funds. I feel like I have to go out and find a part time job, but then I remember that I already have a job and I just have to wait for it to start. Once I start the residency then I know that I will be earning a paycheck again and things will start to get better. But still, it can make some one go nuts.

So now the question is, what can I do? Rather, what can my family and I do? Well, we still have our reserves (which will only last for so much longer). I will learn to love Spaghetti but not meatballs, and will look for free things to do with the kids. The park is a great place. One thing that I did do, was get a bike rack from Craigslist for a much lower price than I would have if it were new. And because of that, I can take the kids to the park and they can bring their bike while I bring the cooler with food from home, as well as water from home. That way, there is nothing to buy.

And while I know that this period is only so long, it reminds me that I was able to weather the economic downturn at school only for so long. And with the reports coming in that the economy is still not doing well, it is time to think about the long term again. Keep reducing the balance on the credit cards, think about refinancing the mortgage, etc. This brings me a very important point: No matter how much you want to, no matter how much you think it is the right thing to do: DO NOT USE YOUR CREDIT CARDS WHILE YOU ARE IN SCHOOL UNLESS ABSOLUTELY NECESSARY!!!

Remember, you will have to pay that back plus interest. And unless you feel that you have no other choice, the best thing is that Cash is King and a debit card it preferred. Even though you fell the pinch right away, you will not have to worry about paying it off later. I mean it is not like the cash was yours anyway because you already gave it to the credit card company once you signed the agreement and you have the interest to pay as well. So even though it is hard, do not use the cards.

Tuesday, May 31, 2011

1 week until the Old Pre Med Conference: The line up

Rebecca J. Patchin, MD, (keynote address) Immediate Past Chair, Board of Trustees, AMA
Past Chair, Council on Medical Education, AMA
Past Co-Chair, Council on Graduate Medical Education, AMA Faculty, Loma Linda University School of Medicine
Kenneth Geller, MD, MEd, FACS (featured speaker) Director, Academic and Advising Program for
USC College-Keck School of Medicine
Vice Chair, Department of Surgery and
Head of the Division of Otolaryngology
Childrens Hospital Los Angeles 
Miriam Bar-on, MD (featured speaker) Professor of Pediatrics and Associate Dean for Graduate Medical Education, University of Nevada School of Medicine
Terri Richardson, MD, MS Consultant Special Projects University Corporation & California State University Chancellor's Office, Health Professions Advisor, California State University, Northridge
Judy Colwell, MA Former Assistant Director of Admissions
Stanford University School of Medicine
presenting "The Nuts and Bolts of Applying"
Jacqueline DuBose, MD 
Department of Family Practice
Medical College of Georgia
presenting "I’m Not Old, I Have Short Telomeres"
Tara Cook, MD 
Department of Neurology, Malcolm Grow Medical Center, USAF, presenting "Choosing a Residency (and other things I wish I had known"
Gina Moses, M Ed Associate Director of Application Services, American Association of Colleges of Osteopathic Medicine 
Trena Gologan, MBA Admissions Coordinator/Recruiter
Philadelphia College of Osteopathic Medicine
(Georgia campus) presenting "Professionalism and
Admissions: a viewpoint from the other side"
Gabriel Lerman, DO, MS 
Internal Medicine Resident, Mercy Fitzgerald Medical Center presenting "You've Been Accepted! Congratulations. Now What?"
Richard Levy, MA 
Executive Director, National Society for Nontraditional Premedical & Medical Students presenting "Lexicon for the New OldPreMed"

This year's raffle grand prize is an Amazon Kindle New E Ink Pearl Technology Free 3G + Wi-Fi, 3G Works Globally and Marware Eco-Vue Leather Folio Black. Also on the raffle are a pair of consulting hours with our own Judy Colwell, former Ass't Director of Admissions at Standford University School of Medicine, a Kaplan MCAT course scholarship, and some OldPreMeds goodie bags

This year's exhibitors feature our major sponsors
Physician Assisted Student Success (PASS) Program
Georgia Campus of the Philadelphia College of Osteopathic Medicine (GA-PCOM)

Additional Sponsors
University of Guadalajara School of Medicine (UAG-SOM)
Lincoln Memorial University - DeBusk College of Osteopathic Medicine (LMU-DCOM).

Other Exhibitors scheduled include:

American Assoc of the Colleges of Osteopathic Medicine (AACOM)
American Medical Student Association (AMSA)
American University of the Caribbean School of Medicine (AUC)
Apprentice Doctor
A.T. Still University (ATSU)
...Kirksville School of Osteopathic Medicine (ATSU-KCOM)
...School of Osteopathic Medicine in Arizona (ATSU-SOMA)
Des Moines University including:
...College of Osteopathic Medicine
...College of Podiatric Medicine and Surgery
Kaplan Test Prep and Admissions (KAPTEST) 
Lake Erie College of Osteopathic Medicine (
Mid-Western University (MWU) including: 
...Arizona College of Osteopathic Medicine (AZCOM)
...Chicago College of Osteopathic Medicine (CCOM)
...Arizona Podiatric Medicine Program (AZPOD)
Oceania University School of Medicine (OMU-Samoa)
The Princeton Review (TPR) 
Touro University Nevada College of Osteopathic Medicine (TUNCOM-NV)
University of Chicago, Pritzker School of Medicine
Western University Of Health Sciences including:
...Osteopathic College of Medicine of the Pacific (COMP)
...Lebanon Oregon/Northwest Campus (COMP-NW)
...College of Podiatric Medicine (CPM)
MedEdPath - Univ. Queensland Australia & Ochsner Health Systems
University of Medicine and Dentistry of New Jersey – School of Osteopathic Medicine (UMDNJ-SOM)

Thursday, May 26, 2011

Tuesday, May 24, 2011

It is Done!!!!!!!!

Yesterday, I ended my very long career as a student and started my dream of being a Doctor. I graduated yesterday and would like to thank many people for their support.

1) My wife. Who without her love, her dedication, and her support I would never have been able to do this.
2) My daughters. Who without their love and their support I would have forgotten to live
3) To my Brother, who without his support and love things would have been very difficult
4) To my parents for their guidance, love, support, and unwaivering faith in me.
5) My in-laws, who not only helped me, but more importantly supported my wife and emotional support during these very hard time.
6) To my friends who always supported my dreams.

Thank you all and now, a rest followed by residency.

Sunday, May 15, 2011

1 week to go

So here I am, one week before convocation where I officially become a doctor. It has been something. These last 2 weeks, unlike many of my fellow students, I have had to make up my radiology rotation. And since they are very laid back about it, I have been going in the mornings and getting my fill of CT images, MRIs, and flat plates. Once I have seen a bunch I usually go. The radiologists prefer that since they have a lot of work to do, and I ask questions and go over the chest images with them. But I am learning. Also, I am taking it easy since there are no exams or other requirements for this rotation. It gives me something to do in the morning.

This past weekend, I went with my father to get a new car. It was great, not only spending some quality time with my father but also it is a sign that I am finally getting on with my life where it should go. Up until recently, I had a 2000 Chevy tracker that I needed to get a couple of years ago because my car at the time was always going back to the mechanic for breaks. Well, this car just kept leaking like a sieve and it was not very reliable. I was throwing good money after bad in order to get it to stay on the road. Finally I decided to drive it into the ground until I can get a more reliable car. And this happened late last week.

I was able to get a 2009 PT Cruiser with very, very low mileage on it. And with the help of my parents, I was able to finance it. And when I finish fellowship, it will be all mine!!!! It is a sleek black color, which is what I was looking for. It kind of feels like a graduation present, but one that I bought myself and that I have to pay the bank to eventually own outright. Heck, when you are $250,000 in debt when is another few thousand right?

Now that the car headache has been taken care of, I can focus on the loan repayment headache. But, that is nothing that I have not dealt with before.

Well dear readers, till next time.

Tuesday, April 26, 2011

Almost there

Whew!!!!! I just looked and there is LESS THAN A MONTH TO GO!!!!! In 29 days I will officially be a Doctor and I cannot wait.

I am in the middle of my next to last rotation. It is a combined 4 week rotation of Pain and Palliative care medicine. So I finished my 2 weeks of Palliative medicine and it was quite depressing and quite impressive at the same time. I was having some weird dreams about death and dying while I was doing my Hospice time. However, I did get to go on home visits like doctors used to back in the day. It got me thinking that I would like to incorporate house calls into my practice one day, maybe. Of course, I would need my own practice first. But I digress.

Right now, I am in the Pain Medicine portion of the rotation. And I really want to learn about pain management, which is what I want to get out of this rotation. After that, 2 weeks of Radiology that I have to make up from last year and then I am done!!

Last week, I was able to get out to the driving range for the first time in 4 years and I intend to do that a bit more often. Eventually I want to get my swing back and go for 18 holes. Then, as long as I can go, I would like to the do the Alumni Golf Outing and then do more fund raising golf games in addition to just going for fun. Now if I can only get my brother out onto the links I can have my golf buddy. I already have a fishing buddy in my oldest daughter and a friend from medical school.

Exciting times, exciting times. 

Tuesday, April 12, 2011

selected "Dr" for Title

So this afternoon I booked my flight to the Old Pre Meds conference in Las Vegas ( And when asked about my title, I was super excited to select "Dr."  for the very first time!!!!!!!!!!!!!!!!!!!!!

So Psyched about it.

If you can, go to the conference. you wont forget it.

Any hoot, started my last full rotation yesterday; Pain and Palliative Care. Did Hospice today, will do it again tomorrow and next week. Hard not to be depressed about it, especially when it is raining outside. Did I say raining, I meant a monsoon. All of this reading about hospice and death is really depressing. I am going to have to watch some up lifting Television for the next 2 weeks jut to get through it. Not to mention all of the busy work I am required to do. After that, I have to make up 2 weeks of radiology. Hopefully I will get good news tomorrow that I can already consider the rotation set up and waiting.

Till Next time...positive thoughts, positive thoughts, positive thoughts.

Tuesday, April 5, 2011

some good ideas to save money

5 ways to negotiate for a lower price

getting free stuff

spring clean for $$

Jut a few ways to save money. Remember, always ask. The worst that the person can say is NO and you are no worst off than you were before. But what if they say yes? Maybe carry your student ID with you in your wallet just in case there is a student discount.

Also, do your best to not use credit cards or just pay them off as quickly as you can.

Till next time.

Tuesday, March 29, 2011

Training License.

So the other day I received a great letter. It was from the Pennsylvania License people telling me that they received my application for my medical license while I am in training.  I could not believe that I am getting information about my medical license. Then I get the email telling me about orientation. I cannot wait.

Only 56 more days to go, but no one is counting. Ah, who am I kidding; I AM COUNTING. This is the greatest feeling in the world. To know that in less than 2 months I will be a doctor. The cool thing is that when I book my trip to Las Vegas for the Old Pre Meds conference ( I plan to reserve it under Dr. Lerman. Something that I have wanted to do for a very long time.

Right now I am on my Endocrinology rotation. It is still a lot of general medicine, however I am really learning how to manage the diabetic issues in people, which is the reason I took the class anyway.

This week I am going to be going to the Exit Interview, which pretty much drills into your brain that you have to pay your loans back. I have to look into programs that help with loan repayment if you work in an underserved hospital. But I will be earning a paycheck again. I have to kick out the senioritis out of my. I have stuff to read and I even purchased my Step 3 review book. In the meantime, I have been reading non medically related books.

The first book is Mad Money by Jim Cramer. I am reading this because I will be getting back into the stock market after a several year hiatus in order to make some more money. It is a nice diversion from medicine. The other book that I am reading at the same time is Sun Tzu's The Art of War. This book is purported to be read by heads of state as well as corporations. Since I am gunning for that fellowship position, I need to have all of the tools possible for my success. I will let you all know how it turns out. There is something to be said about a book that has been around for 2400 years and is still being published (bible not included).

I am also looking forward to my time off between graduation and start of residency. Getting back to the golf course and fishing.

Till next time.

Sunday, March 13, 2011

Relaxing and Motivation

Hello there fellow Non Trads,

Well, since we last spoke I received, signed, and returned my contract for residency. I am so glad that I do not have to worry about that anymore. It is for real and I will soon be getting my orientation schedule and on July 1, I will begin my new career as a doctor. However, until then I still have to be a student.

Recently, I finished my Cardiology rotation and I noticed that I have absolutely no motivation to do anything. I mean, I do not want to read or want to listen to anything. I just cannot seem to get myself to read for more than 5 minutes. When I get to the computer, I play games until it is time to go to sleep. I realize that this can be a problem. Especially since I need to start getting motivated again and prepare for residency.

I downloaded this program back in January to test it out. It is called Life Manager Pro. It is for Mac but I am sure that there is a version out there for PC. Well, it has allowed me to set some goals and organize projects and activities into these goals. Since I am a type A personality (and what medical student is not) and I am OCD, this is perfect. I noticed that with those goals and this program trying to put things into perspective I have been able to accomplish many things. For instance, I have been able to once again organize my family's financial books by getting a program for the computer that is made for Mac and I was able to sync all of the accounts that I need to keep track of. I am able to look at where the money is going and how I can better work things out financially. It will also allow me to ensure that the credit cards are taken care of. In addition, future plans include rolling over 401Ks into IRAs and once I start working again, rolling over my 401K so I can start contributing again. These are the things that sets us non trads apart from the trads.

In addition, I am going to be using the Kelly Howell meditation files to get motivated again and I would like to start meditating in order to clear my mind and remain more calm. Especially with my girls, since I have noticed that I have been a little short lately. 

On the other side, I am sooo ready to be done. We have planned a trip to the Shore for a few days after graduation and then once we get back, my wife and I are flying to Las Vegas where I am going to be presenting a talk at the Old Pre Meds annual conference: 

Then when we get back, I have a few weeks of R and R before starting my new life as a physician. During that time, I plan to go to the pool in the morning, when no one is around. Get in a few shots around the links, and get to the ol' fishing hole. In addition, read, read, read, oh and did I mention read.

Tomorrow, I start a new rotation in Endocrinology and have to be at the hospital at 7am. Until next time dear non trads.

Monday, February 14, 2011


So today was the day, the day that I found out not only what type of doctor I am going to be, but where I am going to be for the next several years.

And the winner is.......Mercy Fitzgerald Hospital in Darby Pennsylvania for Internal Medicine!!!! The goal is to do a fellowship in Pulmonary/Critical Care medicine after that and finally be an Intensivist/Critical Care physician in the ICU.

As promised, I will go through what I did and why I did it.

Let's start at the beginning. When I was making my list of residency choices, I was gung ho about going into Emergency Medicine. I was, after all, a 20 year veteran as an EMT. And it only seemed natural. While was rotating through the emergency department is always felt right. However there were several things that were going against me. First and foremost, Emergency Medicine is very competitive and there are a lot less spots than there are applicants. So, I needed to be realistic. That being said, while looking into the Osteopathic programs that were available, there were only 3 that I could realistically apply to. I forgot to preface that the decision was made not to move from the area, but that I would apply to programs that were within a 1-1.5 hour driving radius of my house.

The other Emergency Medicine programs were all Allopathic and from looking at the residency classes over the years, many had not had a respectful number of Osteopathic physicians within their programs. So that already told me that there would be very little to no chance of getting an interview there let alone match into their program.  So I had to decide what to do about a backup plan and decided on Internal Medicine. I liked seeing patients, especially in the hospital but I was not crazy about taking care of little kids. Then came my fateful rotation in November in the ICU.

From the first time that I started that rotation, I felt like it was right. That was especially true after one of the Intensivists started teaching us and while waiting for a patient to come up we had a very interesting conversation about critical care. The more I spent time in the ICU, the more I realized that I loved it there and so I became very torn. What to do? EM or IM to pulm critical care.

I added a couple of combined EM/IM and EM/FM programs and interviewed at a few. Then came the time to rank my list. I started receiving bad news that I would not be ranked at one location for Emergency Medicine and slowly I was coming to see that EM was probably not going to happen. I then received a phone call from Mercy Fitzgerald telling me that I am going to be ranked very high and they feel that the program and I were a good fit. Three days before submitting my list, I received a phone call from a combined program telling me that they were ranking me high. So there was a chance that I can do both EM and IM and eventually do critical care medicine.

Why did I set my rank list the way that I did (no, I will not post my rank order or the other places that I ranked). There were several things that I looked at:

First, what type of doctor do I see myself. Then I looked at the didactics. How were their teaching? Did the residents like the teaching style? Did I like the teaching style? From one of the places that I rotated at, I knew that I did not like their teaching style so, while I ranked them, I did not rank them high.

Then I looked to see what benefits the program offered. And most of them had very similar benefits so this was not a big deal.

I looked at a time frame. how long until I can finally be done with training. IM=3 years, Fellowship=3 years, EM/IM=5 years fellowship =1 year. So there was no difference there.

Finally I looked at salary. And there were big, big differences. While one program had very high salary compared to the others, I did not like the didactics. If I am not going to be happy, no amount of money will compensate for it. So that did not change. In the end I was torn between my #1 and my #2 but as you know, there can be only 1 and therefor I had to make the decision.

In the end, I matched in a location where it was close to home, had a good salary and benefits, had good didactics, and in the end would train me to be the doctor that I want to be.

Now, my focus will be to graduate from medical school, and enter into residency with my eye on getting that fellowship in 3 years. No holds barred.

Wednesday, February 9, 2011

Almost there but have Senioritis

So we are less than a week before I find out my fate. Before I get news of whether I matched to my #1, matched at all, or have to scramble. In the meantime, I having a bad case of senioritis. I mean I just do not want to sit and read anymore. After 3 or so years of hard core reading my brain just wants to shut down.

But I need to pucker up and get it done. I am almost done with my infectious diseases rotation and I am glad that I did this rotation. I am really understanding how to give antibiotics but more importantly, which antibiotics I should give. Next I am on Cardiology. Another very important rotation. Then 3 more rotations and I am done!!!!

Now comes the hard part. Since I am on the cusp of the end of my medical school career I am no longer eligible for scholarships or financial aid. Now I have to start earning a paycheck again, which while it will feel great will require tweeking of the budget. I decided that I am going to need a bridge from here until I start getting paid on a regular basis to ensure that the bank accounts do not go dry. There appears to be a limited number of these residency loans. One thing you need to remember is that the more loans you take out the more that you have to pay back, this on top of the mortgage that you already took out for the house. One thing that I did when I moved was that I did not trade up in my house.

We actually stayed the same, or some people may even say that we traded down. The house we bought was cheaper than one that we sold. Albeit we moved from Northern NJ to Southern NJ and the father from NYC you go, the more normal the prices get. When I sat down with the finance guy I pretty much laid it out in front of him: 30 year fixed or I am walking out. But some people may say that a 5 year ARM is better since you will be in school for 4 of those years, when you are paying very little and you may then move depending on where you do residency or you can then refinance to a fixed rate.  To that I say, you are correct but that is also how this housing debacle started too. People buying houses they could not afford with a 5 year ARM and then when the rate readjusted they could not pay. These are things you should think about and do it carefully. Not just how far you should be from school. Another thing to think about would be the chores of the house. Will you have enough time in your day to cut the grass, rake the leaves? We moved to a townhouse complex and I do not have to do those things. They are part of the association fee. So my weekends are free for the family.

You should also think of ways to reduce how much you spend. Before you leave work, it would be beneficial to you to invest in a coffee maker (if you are one person, get those single cut coffee makers and buy the filter so that you can buy coffee in bulk and use the ground coffee), buy a lunch box to make your own lunch, invest in a wholesale club membership. Be a coupon clipper, shop around for textbooks on line and when you are done with a class, sell them back on line. I just sold a bunch of books that were just sitting on my shelf for almost $200.

Well, I am done reading probably for tonight. See you later dear readers

Tuesday, February 1, 2011

Time to Wait

Hello there dear Readers, 

It has been a few weeks since my last update. Since that time, I not only ranked my match list, but I can no longer make any changes as it has already been submitted. What does this mean? Well basically I have to wring my hands until February 14th to find out where I am going for the next 3-5 years. I took the time to make my list and there is rhyme to my reason of why I ranked my list the way that I did. I do not want to say anything yet as the match process is still going on, but once I match then I will spill everything. 

In the meantime things on the studying end have been hard. I mean I really do not want to sit and read anymore. After spending 3 years reading hours on end, the last thing I want to do is read. But alas, I still have to. In fact during this current rotation, Infectious Diseases, I plan on doing more reading. I am in the library now taking a break from doing such. This rotation is nice because it is not very intensive and at times there are 1/2 days where I can catch up to reading or relaxing. Although it has been the later lately. 

This weekend is my school's annual Medicine Ball. Basically it is a dinner/dance and people get dressed up for it. My wife and I are not going this year for a couple of reasons. For one, we do not have a babysitter available. And for the other, being older to just about everyone we do not really feel like we fit in. We mainly sit around the table talking to ourselves. Why should we pay $100 when we can do that at home for free. But I am glad that we did go the previous 3 years. We are just not in that scene anymore. We have other friends that we have more in common with anyway. Besides, we can use the money for our trip after graduation. 

A question came up in the comments about studying with children in the house and not being guilty about spending time with my wife. This is a question that has come up to me many, many times. And it is one that I will address here and at the Old Pre Meds conference in June (hint hint). In answering the question I need to preface it by saying that until this past June there were only 3 kiddoes. 

While I was a 1st and 2nd year I needed to be very anal with my schedule. I stuck to it like glue and it worked out well. I treated my medical school time as if I were at work. I would not be home during those hours anyway so nothing was lost. When school was done for the day, I would go home where we would have dinner as a family. This would be around 5:30pm. Yeah, I know very early. During dinner, the TV would be off and the radio would play jazz that was barely audible. My wife and I would sit and our girls would each tell us about their day. At about 7pm, after dinner was done and I was settled, I went to the public library that was across the street and studied there until it closed at 9pm. I then went home and studied some more. This wold happen Monday through Friday afternoon. On Friday evening through Sunday afternoon, I would not study as this was our Sabbath and it was family time. On Saturday night, I would go out with my wife if we had a sitter and on Sunday mornings I would make breakfast as the short order cook and the girls would be the waitresses. 

If there was an event at my kids' school then I would study when classes end and then meet everyone at the school to see the event. I made sure that I was at the parent teacher conferences and on Sundays if there was something going on, I would see if I can make it. Or I would go to campus in the morning and get a couple of hours done before going to the event. So to answer the question about guilt, no I never felt guilty because my kids and my wife understood and I made time for them as well. 

During my 3rd year and now my 4th year I had less studying and thus more down time. So I would spend time with each girl on their own. We would either go to the mall or go to the diner for a drink but we would only talk about what they wanted to. Sometimes they did not want to talk at all, just draw with me around.  They know what I am about to become and they are glad that I am doing it. They are also looking forward to when it is done and it soon will be. 

I can tell you that being an older student does have its advantages. For one, many patients feel more comfortable with you because you are older and have a tendency to act more mature. We have a way of the world and since we have been in the workplace, are aware of office politics and how to play the game. We also know how to network with other people. We also have priorities that do not include drinking and partying every week. And we know how to make our money last longer. For example, I found a way to get some new cologne every few months and not have to shell out the high cost for it. Ask the counter people at the stores if they have any samples. Sometimes these samples come in a spray bottle that can last a couple of months depending on how much you use or it comes in a packet that is single use, but you can get a couple of them. In addition, ask for discounts. What is the worse that can be said, no? Then you are no worse than you were before. 

When I saw that my cable bill went up, I called them up and explained the situation. They brought it down to the introductory rate for another 2 years. When I went to buy a suit for interviews, I spoke to the manager and they knocked off 10% of each item. The library is a great resource for magazines and books that you do not need to buy. In addition to borrowing CDs and listening to them. 

Finally, we have restraint. Dear readers, I really want a brand new 40+" TV that is top of the line and has all the bells and whistles on it. But I cannot afford it now. I will be able to in the future. My car is rusting out and I brew my coffee at home. All of these things add up to less in loans. 

I hope that you keep on enjoying to read this and I will update more often as time permits, and baby too. 

Thursday, January 13, 2011

Match day is almost here

Well fellow readers what can I say? I received a notice from the match that it is time to put together my list and to rank them in order of preference. In about 1 month I will know where I will be going for my residency, hopefully. For those who do not understand, let me explain.

Back in August, I submitted my application to the Electronic Residency Application Service, or ERAS. It is an application packet that includes your transcript, resume, and personal statement. Then you need to select which programs you are going to apply to. Then you wait for interview invitations. If this is sounding a lot like applying to medical school, it is.

When you get interviews, they usually last about 20 minutes and you then take a tour of the facility. From About September until January it is interview season. Then both you and the programs submit lists of rankings. You submit your list of most to least preference and so do the programs. On match day, the computer compares the lists and the first time there is an agreement between the lists, you match. If there is no agreement, then the next day you scramble. Where you send out applications to who ever has any openings left.

The important thing to remember is that you need to be realistic. If you always wanted to be a neurosurgeon and your grades are below average and your board scores are below average, you will never match into a program. Simply because there are too few programs and too many applicants and they programs only want the best. This is why you should always have a backup plan. I did just that.

However, I am a believer that things happen for a reason. I have been an Emergency Medical Technician for 20 years. I have been involved in emergency medicine this whole time. And when I went into medical school I was sure that I wanted to go into emergency medicine. I also thought that I would be able to make up for not getting honors in any classes by showing my work ethic to programs. Unfortunately, my board scores were not in the competitive range for emergency medicine. But I still applied. However, I also liked Internal Medicine and I applied to those programs as well. Back in November, I did a month in the Intensive Care Unit. Wouldn't you know it, I fell in love with the ICU. And for the first time in my medical school career I felt torn between the ER and the ICU. This past month I was doing a sub-internship in medicine and I just happened to be a part of the pulmonary service. And let me tell you, it solidified my decision. I want to go into Pulmonology/Critical Care.

I was able to see 2 patients from admission to discharge this week and the best part was that as a sub-intern I wrote orders and the resident cosigned them. It was just like being a real physician, but without all the responsibility. I can now see myself running an ICU. Like I said, funny how life works out.

I pretty much made my match list. This I will have to keep to myself until after I match.  Next time, I will  talk about some tricks to living on a very very tight budget.