Just got done listening to a lecture about the FDA process of drug approval. This comic was included in the lecture. This rat lived, but I wonder how many had to die to develop the miracle drug. Moral of the story is that drug development takes a long time and is very expensive. The FDA approval process has been speed up recently but now more drugs are having to undergo further phase IV evaluation.

I think I found this on the Student Doctor Network forums awhile back. Maybe I’m strange, but I found this quite funny.

tripod -
I’m pretty hardcore but this is the best way to practice. Sit down on a chair and take some 1% lidocaine and inject it into your thigh. Then take a #15 blade (or a #10…11 goes too deep) and make a 6cm incision longitudinally, preferrably more to the lateral aspect (avoids the vessels if you get too overzealous and start stitching too deep), then take some vicryls and practice your deep dermals and close it up with a nice subcuticular with 4-0s. It works great. It’s the closest thing to a real patient’s skin you can get. Plus you’re really motivated to try your best because chicks don’t dig nasty looking scars. you gotta make em look cool

nbjmd -
Hey there,
I tried this on my last night of call in the SICU. It sure kept me awake and the nurses were intrigued. :D Oh, make sure that you keep the sharp edge of the #15 pointed away from you and cut away from yourself.

This summer I had the opportunity to participate in a research project at the Medical College of Wisconsin. The project that I worked on was called the Hypertonic Saline Study (HSS). It is part of the Resuscitation Outcomes Consortium. (NIH News: New Federally Funded Research Program Aims to Improve Survival from Cardiac Arrest and Severe Trauma) The Medical College of Wisconsin and Froedtert is one of many sites throughout the United States and Canada that is participating.

The HSS looks at how pre-hospital interventions improve outcome and quality of life for trauma victims. The most common trauma that I saw were gunshots or motor vehicle crashes. (FYI, “crashes” is preferred over accidents because accidents imply that there in no fault.) Paramedics would give study solution to trauma victims with either a systolic BP < = 70 and/or a GCS <= 8. I won't go into the other exclusion criteria. The study solutions could be either normal saline, hypertonic saline, or hypertonic saline plus dextran. Hypertonic just means that the saline had a higher concentration of salt. The paramedics gave this fluid (250cc) intravenously in order to try and restore blood pressure and prevent shock. The general idea behind the added salt is that it helps the body hold onto water and maintain blood pressure. We were blinded to the type of IV fluid administered.

The experimental treatment side of the study ended after the 250cc fluid was given. My job as a student researcher was to follow up on these patients as they entered the various ICUs and the step down floors. This involved data collection from patients' charts and interaction with the patients to see how they were doing. Probably the most important thing that I did was to inform patients and families of the experiment that they had been enrolled in. Due to the emergency nature of this study, the FDA allows us to administer the study solution without informed consent (or under exception to informed consent). (IV saline is a standard of procedure that is necessary to restore blood pressure in order to help these trauma victims survive. Previous research has showed that the study solutions that might be given in leu of normal saline are believed to be better than normal saline. So, regardless of the type of saline that the patient was given, he received at least the current standard of care.) Most patients were very happy to continue participating (meaning that we are then able to continue to collect their hospital stay data) and glad to know that information that they provide may one day be used to create a new standard of care with one of the experimental fluids.

All in all, this was a great experience. Unlike some students whose research involved a lot of chart review, my day involved rounding on patients. Since I would rather be walking around and interacting with people, this suited me just fine. I also gained an appreciation for the emergency medicine system, the doctors/nurses/staff that work on it, and the layout of the hospital. I know I won’t feel lost the first time I’m on 3rd year rotations trying to find the SICU.

I’ve been wanting to start a cycling club for the Medical College of Wisconsin since the summer. Wisconsin has some terrific road biking, but, I’m afraid, not too many people know this. They think of Wisconsin as just a flat state. And in comparison to some of the western states it is. However, during the last ice age, glaciers came through what is now Wisconsin and gave us the rolling hills that are perfect for road and mountain biking. It isn’t official yet, but I’ve spent quite some time on the site after the last set of exams and put together a basic cycling club site. I’m hoping to talk to some administrative people at school as soon as possible to make this club official. Eventually I’m hoping to hold short clinics on bike maintenance and repair, but for now I’d just like prospective students to know that such a club exists. Medical schools are always looking for ways to distinguish themselves from the other schools out there. Letting students know that an active cycling club exists would probably help attract many great students. If I was debating between two otherwise similar schools, knowing that a cycling club exists would have helped me choose one over the other.

The MCoW Cycling Club is a work in progress that will be continually updated as we discover new routes. There’s a cycling club forum that I’m hoping will be an informal meeting place to announce and organize rides. And, if you are interested in seeing the quality of the rides please check out the photo gallery.

Orientation at the Medical College of Wisconsin is a week long “process.” It starts bright and early on Monday morning and ends with the white coat ceremony on Friday.

I officially moved to Wauwatosa on August 5, 2006. My roommate, Joe, and I set about 3 alarms each for Monday morning. Monday is the one day that you absolutely cannot miss. The admissions committee has been known to give away your spot in the class if you are more than a few hours late.

We made it to the school plenty early and grabbed some of the provided breakfast. This was our first opportunity to meet our new classmates. Orientation officially began at 8:30am. This was when we picked up our name tags and a bag full of goodies (coffee mug and a bunch of important papers). Though I had been continually receiving emails from MCW reminding me about orientation, I was very relieved to see that was not just imagining all this, that I had a name tag.

If you want to learn more in detail about what happens at orientation, just leave a message. But, we generally got to hear from a variety of people in the school. We were welcomed many times and instructed about professionalism a few more times. Dress was business casual the first and second days. Mid week we alternated taking a professional CPR certification course and attending one of the excursions. This year we had the choice of the Milwaukee County Zoo or the Milwaukee Art Museum. (In the past I think options have also included a Brewers game.) I chose the art museum because I had already been to the zoo numerous times.

Orientation week was a chance for us to meet and interact with our peers. Having orientation over the entire week allowed us to spend more time socializing before classes started. Other events that I went to were Jazz in the Park, which Milwaukee has ever Thursday night during the summer. And, on Friday evening we went to a piano bar where some incredibly talented pianists/singers played. And let’s not forget about Hart Park and the 12 tennis courts that are only a few minute walk from our apartment. We played quite a bit of tennis during orientation week and were happy to find quite a few people to play with.

Orientation week culminates with the white coat ceremony. This event symbolically marks our entrance into medical school. It was a nicely run event for us and our parents/friends. Unfortunately, I didn’t have a video camera along, but I do have a few pictures.

I’m the guy in the back.
I’m on the far left.
I’m the one who apparently didn’t get the memo to wear dark pants.

I can’t wait to begin classes on Monday!

I hope that this blog about my medical school experiences will eventually be interesting and a fun read for current and prospective students. However, my intent is also a little selfish. I want to look back four years from now and see how much I have learned and matured. Material that I’m just being introduced to now will hopefully be second nature upon graduation in 2010. (Wow, that seems like a long time!)

So, I’m going to try and update this blog weekly or as interesting clinical experiences present themselves. I will also be starting a podcast for the same intentions. Feel free to read and listen to my ramblings…