Tag: Travel

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What To Do Before Starting Med School & Residency

What to do before starting medical school is one of the most commonly asked questions I hear from students about to begin their first semester of medical school. It’s the same question that I wrangled with after graduating medical school before starting my internal medicine residency. Here are my top three things to do with your last remaining days of freedom before starting medical school or residency.

 

 

Travel

Before starting residency I explored Thailand for two weeks and my only regret is that I didn’t stay longer. Traveling is a source of sustenance for the soul that can never truly be satiated. Traveling pushes you out of your comfort zone and forces you to grow as a person. You learn a lot about yourself when you remove your familiarities and submerge yourself in another culture and society. Who knows what a few weeks in another country will do for you. Go get lost so you can find yourself.

 

 

Nothing

As a resident we average one day off per week each month. That means we get, at minimum, four days off per month and sometimes that’s exactly what you get. So during residency, when you finally have free time on your hands you are often forced to be productive despite your zeal to just stay in bed and sleep all day. You have groceries to buy, laundry to fold, and an apartment to clean. Not to mention that research project you’re working on because you want to go into a competitive specialty. The work never stops. And after medical school you think your days of studying are over but  step 3 and your specialty specific board exams always loom in the background. So if you want to sit and do nothing before you start medical school or residency then go sit and do nothing. You earned it and you don’t have to explain yourself to anyone.

 

 

Work

Med school is expensive and residency doesn’t pay too well so it certainly won’t hurt if you can muster up some extra cash while you can. I worked as the most overqualified AP bio tutor prior to starting residency. A friend of mine worked at our medical school as a standardized patient. A colleague of mine worked as a scribe in the emergency department. There are opportunities out there if you seek them out. Ultimately everyone’s financial and social situations are unique and you may not have the luxury to choose to work or not, let alone go on a vacation. For instance, the extra money I earned prior to residency helped me pay for my vacation while my friend who was a standardized patient used his money that he earned to pay for step 3 while my colleague used his extra money to pay for his kid’s braces. So work if you can but don’t overdo it. You don’t want to squander these last few weeks of sanity and freedom if you can afford to.

 

 

Take USMLE Step 3

Okay this is residency specific and should only be performed if you have so much extra time on your hands that you can do the aforementioned (1) Travel, (2) Nothing, and (3) Work and then still have more free time before starting residency. I would not advise anyone to take step 3 in lieu of traveling or doing absolutely nothing. Step 3 isn’t a particularly difficult test in my opinion. However, it is difficult to find the time and energy to study for it during residency. So do yourself a favor and if you have the time and money to take step 3 then register for the test, finish UWorld, and take it already (more detailed post on how to prepare for step 3 and when to take it is in the works).

 

 

What did you do the summer before medical school or residency?

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How To Avoid Spending Vacation on the Toilet- and other useful tidbits

Before starting residency I traveled to Southeast Asia for two weeks with my best friend. Somehow neither of us managed to get sick…or robbed. Here are my best travel tips to stay healthy while traveling through Thailand, Cambodia, and the rest of Southeast Asia.

 

 

Only drink bottled water

Although I work in a hospital I prefer to avoid unnecessary trips to my place of work. Especially to hospitals in Southeast Asia. Drinking tap water in Thailand is like drinking tap water in Mexico, except in Thailand they don’t have a cute name for chronic diarrhea like Mexico’s Montezuma’s revenge. This isn’t ‘a bad burrito from Chipotle’ kind of diarrhea. I’m talking about 2-5 days of debilitating bowel movements that can leave you dangerously dehydrated necessitating a trip to the hospital for intravenous fluid replacement (probably not on your list of ‘must see’ places in Thailand). So how do you prevent yourself from getting sick?

  • Do not drink tap water. Period. To be extra safe use bottled water to brush your teeth.
  • Don’t consume anything cleaned with tap water. Avoid raw or undercooked fruit or vegetables. Seriously. You’re not being paranoid, you’re being vigilant.
  • When in doubt avoid the ice. I never got sick while in Thailand or Cambodia. This may be anecdotal but most hotels, hostels, and bars I went to used clean water to make their ice or bought ice from a manufacturer (although I have no idea where the ice came from for the buckets in Koh Phangan…). Better to be safe than sorry. So get whiskey straight and skip the rocks.

 

 

Pepto-Bismol as an appetizer

Two really interesting studies that I’m surprised more people don’t know about looked at using Pepto-Bismol prophylactically to prevent traveler’s diarrhea. The two studies showed a decreased risk of developing traveler’s diarrhea with the prophylactic use of Pepto-Bismol. Specifically, the second study ‘reported that two tablets [of Pepto-Bismol] chewed four times a day reduced the risk of developing diarrhea by 65 percent’. 1,2 So it isn’t a cure-all but it certainly seems to decrease the chance of developing traveler’s diarrhea. I took two Pepto-Bismol before each meal and it worked for me. Or maybe it did nothing and I wouldn’t have gotten sick regardless. I met many backpackers who had been traveling for months and had never gotten sick but I wasn’t about to risk it on the two short weeks I had to explore the other side of the world.

 

 

Immunizations before you go

Check out what the CDC recommends depending on where you are traveling and be sure to discuss what you find with your physician. Some medications aren’t routine for your pharmacy to have on the shelves so be sure to give yourself a minimum of one week to procure your meds. For instance, my malaria prophylactics meds had to be special ordered and were luckily able to be delivered the next day. Also be sure to note if your medications need to be refrigerated. For instance, the oral thypoid vaccine (one pill, once a day, every other day, completing the regimen prior to travel) would be rendered useless if I left it out.

 

 

Mosquito borne illnesses

As I reviewed in my post about Zika Virus, the best way to prevent mosquito borne illnesses is to prevent mosquito bites in the first place. Insect repellent sprays that contain DEET have been proven to be the most effective but still aren’t 100%3. You can decrease your risk of mosquito bites by wearing long sleeved shirts and pants when traveling through jungle terrain and other areas where mosquitoes thrive. Also avoid scented deodorants. If you do get bitten up, Tiger Balm is the only stuff that I’ve ever found to decrease the itch.

 

 

Did I miss anything? What guidelines do you have for yourself to stay healthy while traveling abroad?

 

 

Works Cited

1-DuPont HL, et al. “Prevention Of Traveler’s Diarrhea (Emporiatric Enteritis). Prophylactic Administration Of Subsalicylate Bismuth). – Pubmed – NCBI”. Ncbi.nlm.nih.gov. N.p., 2016. Web. 4 Apr. 2016.

2- DuPont HL, et al. “Prevention Of Travelers’ Diarrhea By The Tablet Formulation Of Bismuth Subsalicylate. – Pubmed – NCBI”. Ncbi.nlm.nih.gov. N.p., 2016. Web. 4 Apr. 2016.

3- “What’s The Best Way To Keep Mosquitoes From Biting?”. NPR.org. N.p., 2016. Web. 4 Apr. 2016.