Archive for May, 2013

Hypotension 2

Discussion of treatment of varying degrees of hypotension and some management strategies. The song “Butterfat” by David Sanborn played by myself and Brian Hughley at a gig at my house in 2006. Thanks for listening. JY

Presenting Patients…

The ability to present patients succinctly and effectively is one of your most important skills. I go over some of my thoughts on the subject, and give a variety of sample presentations to demonstrate how I think it should be done. Thanks for listening. JY

(original podcast screwed up at end, please re-download)


Basic discussion of some burn principles. A little music from a CD I recorded with Tom Jolly in 1994. Thanks for listening. JY

Correcting some myths about med school, and medical experience in college

Just saw something fairly stupid on a pre-med site as I was looking up some stuff with my son. Someone was asking whether it was worthwhile to pursue ALS training after EMT, and whether that would improve their chance of getting into med school. The incredibly experienced pre-med who posted a response said “every pre-med is an EMT so its meaningless”.

While this college student undoubtedly has tremendous experience with med school admissions (remember I’m a med school professor and was on the admissions committee of my med school), lets put a few things in perspective. First, not every pre-med is an EMT, probably fewer than 10-15%, but there’s no real data to go by. Second, when looking at an application, we look for these things: good grades, good MCAT’s, familiarity with medical care, and research. To have all four, you need not worry about getting in. If you’re not going to have one of the four, skip research, since it is only in rare instances that a college student is really going to contribute to a research project. So we know you’re following orders, maybe doing some preps, and learning about scientific investigation, which is great.

I would not skip clinical experience. I would personally be very suspicious of a candidate who had never touched a patient or interacted with one. Many undergraduate experiences can check that box, including hospital volunteering (should be low on your list, that’s a high school thing), scribing in an ED, and EMS.

So you can do anything clinical and check that box, and many admissions committee members don’t know an EMT-B from and EMT-I from and EMT-P. Some do, but you can’t guarantee that person will see your app. So you shouldn’t me a medic to get into med school. You should be a medic to be a better clinical medical student and a better physician.

While I understand many are worried about just getting into med school, you should also consider what will put you ahead of other students, get you better recommendations from med school faculty, and get you a residency in the specialty you want at the hospital you want. EMS experience, especially ALS, where you will be in command of a clinical situation, have to think on your feet, weigh options, and commit to a treatment plan, and carry it out, will provide invaluable experience that many of your fellow med students will not have. I can tell you that my wife’s and my experience as medics helped us immeasurably in our clinical years. We knew how to approach patients, how to talk to them, how to do procedures on them, how to deal with the pain and fear, etc., etc. While your colleagues will be dumbfounded, you will be helping the team put in IV’s, taking vitals, and doing a ton of other things that will make you an accepted member of the team and not the “med student” who stands in the back watching.

So if you like running EMS, and you want to be a doctor, advance to ALS. Finally, I can also tell you I am pretty suspicious of college students that stay EMT-Bs for 3-4 years. Were they not interested in more training? Were they running EMS just to check the box? If you like medicine, you will want to do more clinical stuff. ALS is the only opportunity you will have as an undergrad to do that.

Safety and Risk Assessment

I discuss the challenge of safety, and how to rationally assess risk in the environments we work in. JY.