Social Media and (Pre) Medical Education

I joined Facebook back in 2004, only months after the site was launched. The internet, though I didn’t realize it at a time, was still a very disconnected place. Social media was fundamentally in its infancy, with Facebook joining only a few other social networking sites (MySpace and Friendster come to mind). Twitter and many other social media sites were just thoughts at that stage. Aside from Facebook, the only way I connected with other people was through AOL Instant Messenger, if even that.

Eight years and some 900 million Facebook users later, social media has exploded onto the scene. Rare are the websites that DON’T have a share button that allows users to share the site with users on many different social media outlets. Early on, I used Facebook exclusively to keep in touch with close friends. In contrast, I created this blog to disseminate information. Soon after I started blogging, I discovered Twitter and the medical community that was burgeoning there. I then began to explore using social media for learning more about healthcare and medicine.

People are slowly recognizing the vast potential of social media, especially in the context of healthcare. Not only is it poised to be an important tool in clinical practice, but also in training new generations of physicians. There is a hashtag #meded for a Twitter conversation that takes place weekly, where participants discuss medical education, any problems observed, and potential solutions. It, along with the #hcsm (Healthcare Social Media) Twitter conversation, represents a great forum to propose innovative ways to improve the field of medicine and medical education. I think for students, especially, it is an incredible asset. One can get a very broad perspective of medical education in general, and can reach out to others who are encountering similar problems and situations on their way to a career in medicine.

Speaking for myself, I am pre-med. When I will shed the “pre” part is unknown at this time, but that’s an entirely different topic. I am working, but I am still thinking about entering medical school down the road. I love Twitter, and I use it in part to connect with doctors and students, and to keep abreast of issues that are going on in both the education side and the clinical practice side. I tend to lurk in the background for both the #meded and #hcsm conversations, observing and learning, but not directly participating. I have learned a great deal, but this is information that will probably come in handy further down the road, when I officially start on the road to becoming a physician. What would be nice right now is a similar community for pre-meds.

There is a somewhat more cohesive community that exists on the Internet to provide a resource for pre-meds, as well as medical students and practicing physicians and other healthcare professionals to pose questions and get answers: Student Doctor Network. This is something that has been around for years, and many students have embraced. I have used this multiple times and I think it’s fantastic. However, it is somewhat static, compared to Twitter at least. Yes, people post answers, but it’s not quite the same. Twitter has the feel of a conversation among friends. The rapid-fire exchange of questions and answers feels more natural, and more human in some ways.

Now of course there is a community of sorts on Twitter. There are many pre-meds who have taken to Twitter for one reason or another, and who sometimes connect with other pre-meds along the way. Yes, we all come together to bond, complain, rage, and sometimes exult about classes, the MCAT, and medical school applications. Yet it would be nice to have a way to discuss issues that plague pre-meds from freshman year to the post-graduate years. Ideally the conversation could be fostered and archived under a hashtag. The resulting posts/tweets can be accessed readily later.

There are so many questions that arise for pre-meds even before they reach college. Which school should I apply to? Should I opt for a combined BA/MD program, or go the “traditional” route? In college, the questions can range from the general (What should my GPA be? What about my MCAT? Where should I do community service? Which doctor should I shadow?) to the painfully specific (What the heck is a racemic mixture? How much acid-base chemistry can one expect on the MCAT? What is the average GPA of students accepted to medical school X?). Pre-med is a label that encompasses a wide range of students from at least the age of 17 or 18 to those who are often in their mid to late 20s, if not older (as is the case for many non-traditional students). A social media community dedicated to pre-med issues would be a wonderful way to not only allow these questions to be answered and grievances aired, but it represents a great opportunity for mentoring of younger students by older ones who have had more experience. Having pre-medical advisers, medical school admissions staff, and medical school professors potentially join these conversations would add much needed perspective about what lies on the other side of that seemingly impervious wall called medical school admission.

I’ve been talking about Twitter quite a bit, because that’s what I tend to use most of the time, but other social media tools can be used as well. Facebook’s potential as a teaching tool is being explored in the context of medical education. However, there are some who have reservations with regard to its use in this context, especially if educators are involved, as outlined in this great blog post by Anne Marie Cunningham of Cardiff University in the UK. Blogging, though considered antediluvian by some nowadays, represents another opportunity to detail experiences and forge bonds with others who are in similar situations, and get answers from those who have walked down the same path.

Think of how great it might have been for you to have a community right at your fingertips, where most (if not all) of your pre-med questions can be answered, and readily at that? It’s something that I definitely wished I had early on. While SDN has its benefits, at least on Twitter, there is a greater sense of openness and trust that enhances the learning experience in that context. I have communicated with students and doctors, and they have been wonderful sources of insight. I consider many of them to be friends and invaluable sources of information. It would be wonderful to see universities embrace social media as a powerful source of information and a teaching tool not only for pre-meds, but for all students. Social media participation should be encouraged, but it would be nice to see classes being offered to students that taught them about using social media wisely and managing their online reputation. Perhaps professors can get in on the act and provide information to their students on the social media groups, sites, and hashtags where conversations about topics that are being covered in their class. The possibilities are endless.

Thoughts? Comments?

Unsolicited and Unwarranted Emails: Privacy in the Internet Age

I am not the most tech-savvy individual in the world (most of my close friends know this all too well) but I know enough to know how to handle the Internet, especially when it comes to privacy. Rarely do I sign up for anything, and if I am forced to, I use one of several “junk” email addresses. I generally never use my personal email address or school email addresses. This is pretty standard practice nowadays.

Back in December, I woke up to a deluge of emails. A deluge of emails is not exactly unusual for many of us, and generally is never a problem for me. The problem was that these emails all had one thing in common: they were all from online education sites in response to supposed requests I made regarding a variety of academic programs and degrees. All the emails were directed to one of my school email addresses.

For those of you who don’t know, I have a bachelors and two masters degrees. Given the amount of student loan debt I have been tackling, if I was going to further my education, it would not be now but sometime in the future. It seems inconceivable that, if I were to consider going the online education route, I would use my school email address to request information. I also have anti-virus/anti-spyware/anti-malware software installed.

Not only did I receive probably no less than 100 emails over the next month, but received calls on my cell phone from many, if not all of the institutions from whom I had received an email. Rather than passively mark them as spam, I decided to contact them. Only after responding to each and every call, and requesting each caller to take me off of their calling list, did I see a decrease in the communication I was receiving. Now I receive maybe one or two every few days, and all get automatically relegated to my spam folder.

I thought that was the end of it.

Boy was I wrong.

This morning, I woke up to another deluge of emails. No, these weren’t from online universities, but insurance companies. Each was emailing me in response to an auto insurance quote request that I supposedly made…again using my school email address. Apparently I am not alone. After Googling the issue, I found that many people have been similarly inundated with unsolicited emails from insurance companies. After a local agent contacted me in response to my supposed quote request, I sent him an email and got the following:

I went to NetQuote’s website. It’s a company that apparently sells insurance leads. Thanks to a nifty little extension called Web of Trust (WOT), got this warning as soon as I landed on their homepage:

Frankly, given their reputation, I was hesitant about emailing them, didn’t want that information somehow stored and used by their system. However, I called the 800 number and a very helpful representative did look into my situation. I wasn’t listed as a consumer, but the quote request ID did show up in their system. Someone did make a request using my information. The rep thought that it would have been because I filled out a survey or requested a gift card online, something that would require my email and other contact information (I’ve never done anything of the sort). They assured me that emails would be sent to the insurance agents to not contact me. While I’m glad that they did help me, something is still clearly not adding up. So I’m telling my story here, the only way I know to try to publicize the issue.

I feel violated and worried. As careful as I am, these things are still happening to me. Sure, insurance and online universities are not exactly dangerous entities in their own right. Yet if someone can use my private email and make my cell phone number readily available to entities with whom I have no connection, what else can they potentially do? I have checked all of the more important things (bank account, credit report, etc.) and there doesn’t seem to be anything amiss. Nonetheless, I want something to be done. This is a blatant invasion of privacy for personal gain, and they are really picking on the wrong person.

I know I am not alone, so I’m requesting anyone who has had similar problems or know anyone who has to share and retweet this post as much as possible. The Internet has ballooned into a vast and complicated entity. While that has provided innumerable benefits, the expansion has also driven the rise of people whose sole goal is to take advantage of others for the sake of making money or other purposes, many of them illicit.

If you have received similar emails, rather than ignore them or mark them as “spam”, dig deeper. Find out who gave out this information and contact them. If they don’t help, look up their profile on the Better Business Bureau or other similar regulatory agency’s database. File a complaint, describe your story, make sure your voice is heard. That is the only way they will learn that we will not stand by quietly and allow them to invade our lives and our privacy.

Why Neuroscience is Awesome

For those of you who know me know that I am, simply put, neuro-obsessed. Here’s where I try to justify that.

Think about the human body and how incredibly complex it is. Think of all the chemicals that course through your bloodstream to regulate this organ or that, that allow you to grow and mature. Think of the electrical and structural precision that is needed to keep your heartbeat normal. Think of the myriad events that go on to maintain normal digestion even when you are unaware that it is going on.

Now think of the brain and think of the fact that it regulates all of it. A three-pound (give or take a few ounces), gelatinous and convoluted mass of neural tissue sitting comfortably in your cranium regulates all of it. I think that’s pretty cool, right?

Consider this a kind of (grossly simplified) neuroscience primer from someone who has neither an M.D. nor Ph.D (so take it for what it’s worth).

The Death of Cursive Writing

This article in Newsweek made me incredibly depressed:

http://www.newsweek.com/id/184751

I was probably one of the few kids that enjoyed (and still do enjoy) writing in cursive. I loved how cursive writing was flowing and graceful. I even joined the calligraphy club in my middle school to further my penmanship, learning a few forms of calligraphy before graduating. Regular letters are all lines and edges, there is nothing beautiful about them, and frankly when I can, I avoid writing in print to this day. Yes, I am one of this people that wrote in script on the SAT.

Just for that, I’m writing the rest of this post in cursive. Let me know if you can’t read some or all of it.

No Welcoming Open Arms For Us

I spent most of my formative years in the nurturing cocoon of the Clinton administration. I was vaguely aware of Bush 41, but the first president I chose (in my head) was Clinton, so he was really my president. I didn’t really know what war was. I had heard of the first Gulf War, but it seemed less a war, more a way to keep a madman at bay. I knew something of Bosnia and Serbia, but these were minor engagements (especially compared to what we’re involved in now). All I was aware of was economic excess and of prosperity. I assumed that everything always came easily, not necessarily without work, but without worry. I realize now that I was wrong to assume. This is not to say Bush 43 is entirely at fault, or that Clinton is blameless. There were mistakes being made everywhere, on Capitol Hill, on Wall Street, in banks, and in our own living rooms. Now the fruits have been borne from our mindless sins of ignorance.

I was talking to a sixth grader I tutor yesterday and we ended up discussing various things. At one point, she asked me about medicine and how long it takes to become a doctor. I laughed and went through the whole spiel. I told her that if she doesn’t take any breaks in between, she’ll probably be in her late twenties by the time she starts working. It was the truth; the road to becoming a doctor is a long, winding, pothole-ridden road. She sighed before declaring the world was probably going to end before then. I was taken a little aback by her pointedly frank pessimism, especially given her age. Pessimism wasn’t supposed to kick in until at least the angst-ridden teen years. Yet as I thought about it more, I realized she was right to assume, and right to worry. We have become conditioned to fear.

I’m not saying the world is going to end. Obviously that’s not what I’m saying. What I’m saying is that the smooth sailing we have had for the last decade or so has come to an end in the most unceremonious and clumsy fashion possible. Gone are the times when wide-eyed, college graduates can expect a job waiting for them within months after their graduation, followed by buying their first home, setting up their children’s trust fund, and letting their 401(k)s bloat with money. Employers no longer are waiting at the end of the college road with open arms and a fat paycheck. Instead we are seeing college grads moving back with their parents, as they wait and wait for employers to come calling. Over 2.6 million jobs were lost in 2008, and the number continues to grow. As the economy shrinks, states are now cutting spending in places that could have drastic consequences (like Paterson cutting hospital spending in New York State in a time where healthcare is suffering). Again I used to assume that doctors were at least a little immune to economic crises; after all, there’s always a need for doctors right? Yet when hospitals can’t afford to take on new doctors, and when people can’t afford to get healthcare, even doctors are finding it difficult to find work. There is no real certainty in the current economic climate, and the possible ramifications are frightening.

As I was buying my ticket to Penn Station from my home station, I saw a man who asked me for a buck or two towards a train ticket. This wasn’t your typical bum though, and this wasn’t the city. This was Long Island. He looked like any other Joe Schmo who lived on Long Island. Maybe I’m naive to have even entertained the idea that Long Island was somehow, immune, from the economic downturn. I can’t help but think that the number of people booted onto the streets will increase as the economy continues to sink.

Many of you must be reading this and thinking, “She is such a pessimist” and “This is so depressing.” It’s the truth. No one wants to envision a world where we have to be fearful for our livelihood as well as for our lives. Certainly we don’t want that for ourselves, and we definitely don’t want that for our children. We want our children to know that they can do anything they want, with little worry, assuming they put in the effort. Yet it’s something to keep in the back of your mind. To continue assuming that everything is perfectly peachy is a sign of sure insanity.

Yet to those that say, “Why bother doing anything if we’re just destined for a rough road to employment in the end?” the point is not to give up, the point is to work harder. Employers (presumably) will favor the more qualified candidates over the guy or girl who just scraped through with a bachelors degree. Go for the unpaid internships to get your foot in the door. Network as much as you can, a resume and transcript can only tell so much about a person. Do whatever you can, short of stepping on another guy’s toes.

We’ll have to make some changes to the way we conduct our lives now. We can’t continue the same wasteful practices that landed us here in the first place. We can’t allow the market to operate of its own volition. We need strict regulations to rein everything back to some sort of stable state. It’s important to note that all situations are temporary, good times, and bad. I’m just hoping that, for the time being, the stimulus plan passed by Congress will have its intended effect sooner rather than later.

Until then, we have to work hard and stay positive. This, too, shall pass.

Another New Year

I can’t say 2008 was a bad year. It could have been better, but that goes for any year I suppose. Graduated from Cornell (ok fine that was 2007 technically, but it’s January 2008 for all intents and purposes), started my masters (make that two masters), and met new people. Things seem to be heading in the right direction, in terms of school, family, friends, and other areas. So far so good.

So New Year’s Eve is around the corner. You know what that means? That’s right, more New Year’s resolutions. The end of the year means self-reflection and planning the upcoming year to be the best it can be. Whether this means losing weight or ending a bad habit, everyone has their own set of goals.

The person with the hardest set of resolutions is probably Barack Obama. Here’s my theoretical list of resolutions:
1. Save the world, or at least make strides in that direction.
2. Quit smoking
3. Keep sane despite existing in the bubble that is the Presidency, Secret Service and all.

Mine are pretty average, the get into shape, find (and maybe end up with) a great guy, do well in classes-sort of resolutions. There are a few that may be a little more out of the ordinary:

1. Get a book deal.
2. Get into medical school.

Will one or any of those things happen? I don’t know. Wishful thinking perhaps, but hopefully a few of those will work out.

I’m curious what the most popular New Year’s resolution is among people. What is your top resolution for 2009?

To all of you, friends I have known all along, friends I have gotten to know through blogging, and the readers who may have just stumbled here today, I want to wish you a happy, peaceful, and prosperous New Year. Here’s to another year of new beginnings and new possibilities.

Welcome and Hello…Again!

Dear Readers,

I figure after 3500+ views in a little over a month, I should probably welcome all of you who read my blog. Welcome, bienvenidos, bienvenue, welkom, swaagat, swaagatham, and (insert welcome of choice here).

I’m so glad to see this blog has started to blossom and attract numerous viewers. I hope you are finding the posts informative and maybe even entertaining. I will try to keep the topics varied and interesting, so that everyone can find something to read and enjoy on this site.

Thank you so much for your support, kind words, and even criticisms. Here’s to hoping this blog continues to thrive!

Love,

Saroj

Breaking Down the Major Obama Appointments to Date

So far so good, I’d say, with some exceptions:

Rahm Emanuel: I cannot think of a better person for the position of chief of staff, given his reputation as someone who “takes no prisoners.”  He has been involved in politics for some twenty three years, from political staffer to Congressional Representative from the state of Illinois.  Besides his experience, his no-nonsense attitude is much needed to keep President Obama’s staff on task, with regard to seeing his agenda through.

Bill Richardson: This one I’m not terribly sure about.  Bill Richardson has had ample experience in federal office, as a representative, and as a member of Bill Clinton’s Cabinet as Secretary of Energy.  However, I’m not certain much in his years of political experience has set him up to serve as Commerce Secretary.  I could be wrong, the man did serve as U.S. Ambassador to the U.N., so that in itself may have given him some understanding of the state of foreign commerce.  His tenure as Governor of New Mexico, too, lends itself to some understanding of domestic commerce.  Who knows.

Janet Napolitano: I feel like she would have been better for Secretary of Education than Homeland Security, given her accomplishments as Governor of Arizona.  Her nickname was the “Education Governor,” so I’m curious why Obama tapped her for Homeland Security, of all things.  I would rather have someone like, I dunno, Wesley Clark or someone with at least some experience in that realm.  Nonetheless, she could surprise me.

Tim Geithner: This one was a solid pick, I have no complaints.  He served as 9th President of the Federal Reserve Bank of New York.  I think that speaks for itself.

Larry Summers: Good pick, but I think many of the women in the country may have simultaneously shuddered at the announcement that he was going to be head of the National Economic Council.  Gaffes aside, he was Clinton’s Treasury Secretary, and I think he’ll be fine in this position.

And then of course, best for last:

Hillary Clinton: I’m wonderfully conflicted about this one, which I know is not “confirmed” yet, but looks highly likely.  On one hand, she has solid foreign policy experience (minus that little thing called the Iraq War).  For better or worse, by appointing this Clinton, you get the other Clinton as part of the package and he is still an active (not to mention mostly beloved) presence in most of the world, so that in itself could be a benefit to the Obama administration.  On the other hand, I would have rather seen her in another role, like head of the Department of Health and Human Services, given her strong support for universal healthcare.

More analysis to come as the appointments roll in. 

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There is Something Fundamentally Wrong Here…

I have no health insurance.  I have to worry about getting a cold, getting a flu, getting food poisoning, or some other unfortunate ill.  Heaven forbid I do, I have no way to go and see a doctor for any sort of treatment.  In the back of my head, I worry every time I step out off the curb into the crosswalk, worry that some crazed taxi driver will gun his engine and inadvertently take me out.  In that case, I hope I go quickly and painlessly, and not have to end up in a hospital and drive my family into bankruptcy.  That is my prayer, in the supposed land of freedom and opportunity.

I, along with many of my peers, went to college and are pursuing further grad work.  I, along with many of my peers, are in debt up to our eyeballs.  Cornell Arts and Sciences costs something in the order of $40K, though I was in Cornell’s College of Human Ecology, a measly $20K as a New York State resident.  Meanwhile, I just Googled the tuition cost to attend the University of Cambridge in England and here is what it said:

“In 2009, the University of Cambridge will charge tuition fees of £3,145 (plus a small inflationary rise to be determined by the DIUS) per year for all courses, as outlined in our Access Agreement, which has been approved by the Office for Fair Access (OFFA).” (http://www.cam.ac.uk/admissions/undergraduate/finance/tuition.html).  That’s $4654.  Per year.  At one of the world’s premier universities.  In order to succeed in the land of freedom and opportunity [the United States] you must be willing to fork over an arm and a leg, in addition to your firstborn.  This is the mantra that the country continues to chant.

So getting back to my story.  I have no health insurance, and I’m signing loan after loan to pay my way through school.  Theoretically, I have only another…5 more years of school to go before I get a steady paycheck.  After that, maybe another thirty years before I pay off my loans.  Even if I didn’t take my double-masters detour from medical school, I would still be paying off loans well into my child’s teen years.

I have tried to find a job, but finding a job in itself is a hassle.  I finally got one, after 6 to 7 months of searching (not including the tutoring position I currently have).  Other friends, though, are still in the job-hunting game, with little to no success.  Most, if not all, are from top-tier universities around the country.  Even if they’re not, they are certainly smart and capable, yet they are all being denied.  Welcome to the United States, the land of freedom and opportunity.

Why have we failed our own people?

Part of the problem is we are still operating in an exclusively capitalistic mindset.  Privatize this and that so that the brunt of the cost falls on the individual and the group is spared.  Leave it to market forces, because the market will cure all.  We have no concern for the group, just the individual, whose health and future is put in the hands of the market.  This is the equivalent of leaving them in the hands of a temperamental child, easily swayed, and never entirely stable.  Inflation is only driving costs up.  While, in the case of healthcare, Medicaid and Medicare do exist and for education, there is state and federal financial aid, they are imperfect solutions.

Medicaid remains a often-abused and neglected system.  Millions, if not billions of dollars, are being spent because clinicians are billing the system fraudulently, exploiting loopholes in the system that have yet to be resolved.  If they aren’t inappropriately billing the system, they are less likely to treat patients on Medicaid, and those hospitals and clinics that do accept Medicaid are notorious for being sub-par in comparison to their private counterparts.  While Medicaid targets those who are often well-below the poverty line, and private insurance takes care of people in the upper brackets, there is still a whole set of people who are neither poor but are neither capable of shelling out money for private insurance that are left without health insurance.  There are no resources for these people.

“Give me your poor, your tired, your huddled masses…” unless they’re above this income bracket and below another.  In that case, you’re on your own.

Yet even if you can pay for private health insurance, you are probably out of luck if you were to end up with a major medical condition.  While routine checkups and most lab tests are covered by most health insurance plans, the more complex procedures are oftentimes not covered.  So regardless of your status, in terms of health insurance coverage, there are problems just waiting to happen from which no one can effectively bail you out.  Russian Roulette, if you will.

Welcome to the United State, the land of freedom and opportunity.

If someone wants to have enough money, not just to pay off health insurance, but to have a decent quality of life, they need an education.  Education, especially in recent years, has become prohibitively expensive.  People who would otherwise be capable of getting into an Ivy League are stopped short by the costs, and have to go somewhere else (which may not necessarily be a bad thing, refer to my earlier post).  Inflation is driving up university costs at astronomical rates, and greater pressures are being put on colleges to construct new buildings and upgrade what they already have, adding to the cost.  Why do we have to be restricted from attending some of the nation’s finest universities by something like cost?  We have become a society of debtors, in part due to this phenomenon.  Don’t even get me started on the fact that, despite the fact that we pay through our (insert orefice of choice here) for a halfway decent education, we lag behind most of the world, especially in science and mathematics.  That’s for another post.

The irony is that I want to be a doctor with a few grad degrees aside from my MD, and currently I neither have health insurance nor a sound way of even paying for one grad degree, let alone medical school.

Welcome to the United States, land of freedom and opportunity.

Dear President-elect Obama: Do you hear the the death moans of a nation once at the pinnacle of greatness, now reduced to a society of forgotten people, languishing in their own physical and financial sickness?  You spoke of healthcare for everyone, where even the poorest person can have the same healthcare as a United States Senator.  Coming from a distinguished background, you know the pain students go through to get a decent education, just to enjoy some of the benefits that you have.  I will bite my tongue and pay my loans off as best as I can, dutifully carry around my bottle of Purrell in an effort to stave off illnesses for the time being, and look both ways before I cross the street (in a very anti-New Yorker fashion) but at some point this needs to stop.  I need to stop worrying about how I’m going to pay for my education and I need to stop worrying about whether my next step could land me in a hospital.  More importantly, though, my younger brother shouldn’t have to worry about which college he can afford to go to, or how he’ll be able to get healthcare once he’s older.  My parents shelled out a lot just to see me enjoy opportunities that in some cases, they had to forgo.  Now that the second one is lining up for his turn, I don’t want to see them struggle anymore.

Can you bring meaning back to the phrase “Welcome to the United States, the land of freedom and opportunity,” and not leave it sounding sarcastic and empty?  Can you fix it?