Dear taxpayers,
The deadline has deemed and passed. I hope you didn't put up the frivolous argument that you weren't obligated to pay your taxes because you are a resident of the great nation of Texas and not of the United States. The tax-man wouldn't like that very much. There's a whole friggin section on the IRS website about arguments that won't fly, and I think I'd tango with Satan before I'd ever mess with the IRS.
Did you follow my money-making scheme about the IRA? Sure, millions of people could be wrong in using it, but then maybe you could be the wrong one in not using it (I'm sure this is a logical fallacy, but I can't quite put my finger on it). Don't worry--you can contribute for 2010 while the pretty graphs on morningstar point to the up and right, which is generally regarded as a good sign. Even though the money behind it is just a figment of our imagination, it's always nice to have pleasant dreams instead of nightmares.
--
Right about this time, my comrades have received their rotation schedules for their final year of pharmacy school (Woohoo!). The elation or pain of having received or not received their first picks have set in. So here's a couple of thoughts I have about the schedule, now that I've turned my vinyl over to the B-side:
Things change. Don't get too attached to your schedule if you're loving it. Don't start making babies with that piece of paper, because after all, it is still a piece of paper. And paper has a habit of changing on you (think about the varying value of the US dollar). Preceptors leave their jobs, they have babies (not with paper), they decide they don't want you*, etc. I think it might be safe to make living arrangements, but that's as far as that goes.
Things don't change except for good reason. Rotations can break up with you; you cannot break up with rotations. It's like the biblical days when the man could give his wife a certificate of divorce but not the other way around. Sorry--you're pretty much stuck with the cards you're dealt (excuse the cliche). Crying has helped in rare occasions, but it's generally regarded as a bad move.
The retail giants for the community rotation aren't automatically bad. Some of the best preceptors work in the busiest stores. And some of the worst preceptors work in the slowest stores. It depends more on your preceptor than the company you're stuck with.
Be careful when discussing your experiences. More for later once after you had a few rotations, but never ever speak ill of any preceptor even in confidence with a friend (saying a rotation is difficult is okay; saying a preceptor is difficult is frowned upon). Pharmacy is a very, very small world, and mouthings-off have a habit of being passed around like nosocomial infections, and like nosocomial infections, they're hard to get rid of.
You can be as clinical (or unclinical) at any rotation. You get what you put into it. Preceptors are disposed to teach you (preceptor certification is voluntary after all). I used a tacky Chinese proverb (don't you find that fortune cookie stuff horribly trite?) in a high school speech: Teachers open the door, but you must enter by yourself. It applies here even if the quote has the consistency of Cheez-Wiz.
Finally, it will all work out for the best. And if it doesn't, it's only six weeks of your life. To paraphrase another oft-quoted expression**: that which does not kill you only makes you stronger. If you don't learn anything, you will at least learn another method of patient assessment.
It will be okay. Trust me--I'm a doctor.
--
*that story is pretty sad. On a sidenote, the Washington Times has a surprising number of ads including distasteful pop-ups.
**Nietzsche
Showing posts with label the rotation files. Show all posts
Showing posts with label the rotation files. Show all posts
Friday, April 16
Wednesday, March 17
The Rotation Files, the Dreaded Eval Form
Dear Rising Seniors,
During the summer betwixt my junior and senior years in high school, I did this nerdy summer program at Rice University (the ‘Harvard of the South’, not a school for yellow-folk) where we attended some seminars and got to stay at the dorms. It sounded a lot better than it really was; I spent the majority of the day trying to stay awake while suffering from a horrible case of ennui (boredom). Having no TV at the dorms, I finished Ellison’s Invisible Man while attempting to keep warm since my dorm-mate insisted on keeping the place at a toasty 60 degrees (Fahrenheit).
It was at the beginning of this program that I first heard the phrase ‘rising senior’. And it sounded really cool, like if I was a piece of dough almost ready to be baked. So I’ll use that term to describe my buddies who will be incarcerated at various hospitals/pharmacies starting in May. If they do well and heed my advice, they’ll be let out at just under a year for good behavior.
So this is the long awaited continuation of the Rotation Files. Today’s introductory topic is the Evaluation Form.
Aim to improve in all attributes. There was some famous study that concluded that when things improved to a high point, people liked it better than when things started and stayed at the same high point. A quick simple example: When you start out at $13/hr and they give you a $1 raise at 6 months and 12 months, it feels better than if you start out at $15 and stay that way for a year. It seems like you made progress.
Similarly, when you first meet a person and you think s/he pretty much sucks as a human-being, but then find out later that s/he really doesn’t suck all that much, then you will probably like her/him better than if you didn’t think s/he sucked in the first place. This, as it turns out, is the plot of Pride and Prejudice. It, as it also turns out, is also the plot of Twilight. Bam! And that’s why teenage girls swoon over pasty Edward and his 4-inch bird’s nest hairdo! (I happen to like chick flicks, but Twilight was a bit much).
So with your self-evaluations, always mark yourself low initially, and aim to increase at the midpoint and final.
Humility is golden. Some Christian high-ranking official, possibly a pope, said that the three best virtues are humility, humility, and humility. Most likely you’re not going to know a lick about the rotation or the drugs. And even if you did, your preceptor is the ‘expert’ in the material because s/he has been working at it on a daily basis. Rotations will be a humbling experience.
Eventually (around the 4th rotation), you’ll get to a point where you feel comfortable to mark yourself a 3 or 4 on the initial evaluation. DON’T! Even on the 5th and 6th rotations, I never marked myself above a 3/5 for the knowledge and skills attributes.
Different types of attributes. There are some exceptions, as hinted in the previous paragraph. On most evaluation forms, there are attributes which I categorize as knowledge/skills, attitude, and integrity/character. These should all be handled differently.
Knowledge and skills – these are the attributes that pertain to the subject matter of the rotation. They are the ‘proficient in topic discussions,’ ‘able to assess patient information,’ ‘able to develop follow-up plans’, etc. This is what you should learn during the rotation, so it would make sense to mark yourself low initially and improve at the midway and final evaluations. I would say 1 or 2, depending on your comfort level with the rotation; 3 if you’re feeling ballsy.
Attitude – These are the ‘follows directions,’ 'is a team player,' ‘is willing to learn,’ ‘expresses intellectual curiosity’, etc. I would generally mark myself at least a 3 on these attributes, because these are independent of the rotation. You should come in with a positive attitude, so mark yourself decently. This signals that you’re open to learn.
Integrity/Character – These are the ‘displays strong moral character,’ ‘possesses high integrity,’ ‘is honest,’ etc. Again, these are independent of the rotation, but unlike attitude attributes, these are somewhat immutable characteristics. You either have it or you don’t. There’s not really much of an in-between. So rank yourself at least a 4, because some preceptors frown upon students giving themselves 5’s on anything at first.
Self-evaluation = what you think your preceptor will give you. Although you should aim to improve your evaluation scores, try to mark down what you think your preceptor will give you. It is a self-evaluation, but you can make a bad impression if your preceptor thinks you’ve over- or under-estimated yourself. But when in doubt, always guess under. At worst, it shows lack of confidence; at best, it shows humility, which is a good thing.
One neat thing you can do is underestimate yourself for the midpoint so that your preceptor evaluation will be higher than your self-evaluation. Then on the final self-evaluation, just copy your preceptor’s midpoint evaluation.
I know some people feel that the self-evaluation should be a SELF-evaluation, but some students are just too arrogant or too humble to be left to their own devices.
Get a pre-evaluation. To get a feel of what your preceptor will give you, ask how you are doing and how you can improve at the end of each week. Ask more often if you can get away with it. Usually if you’re casual about it, they will let you know. But try not to be annoying.
You know that guy/girl who repeatedly asks, ‘where is this relationship going’? Don’t be him/her.
Give your preceptor the form a week ahead and remind periodically. You are ultimately responsible for completing and turning in the evaluation forms. Preceptors are real people and have lives outside the pharmacy. Don’t give an evaluation form to them on Friday and expect them to complete it by the afternoon. Even if they do finish it, they will probably mark you lower because of your poor planning.
Sometimes preceptors forget to do your evaluation. Give them subtle reminders a few days beforehand like, ‘How’s the evaluation going?’ or ‘Did you get a chance to look at my evaluation?’ But avoid being confrontational.
Be prepared to explain yourself. A vast majority of preceptors will talk to you about the evaluation. If you’ve been getting informal pre-evaluations, then nothing should come as a surprise. They may ask you why you marked yourself the way you did, so be prepared; don’t use the reason that g-said-so.
The reasons don’t have to be spectacular; just something to back it up. If you had followed my advice, most of the questions will be, ‘Why did you rank yourself low?’ Say something that accentuates humility.
Lastly, evaluations should not be scary. Think of them as a learning experience, not as a way for some horrible preceptor to crucify you for your lack of knowledge. But ultimately, there is no substitute for knowledge. These tips won’t save you if you epic fail in presentations and pimping* sessions.
But even if you end up with a poor evaluation, it shows great character and attitude if you respond well in the second half of the rotation.
I will end by repeating that there is no substitute for knowledge. Rotations are meant to be a learning experience, so don’t cheapen them by trying not to learn.
The rest of this week will be dedicated to rotation stuff, since I feel guilty for ignoring my blog.
--
*Pimping happens when preceptors rapid-fire questions at you until you mess up. It’s an utterly frightening experience for students and an utterly delightful experience for preceptors. Like the ‘now-defunct’ hazing in fraternities, the students who survive and become preceptors get to torture the next batch of pledges (interns).
During the summer betwixt my junior and senior years in high school, I did this nerdy summer program at Rice University (the ‘Harvard of the South’, not a school for yellow-folk) where we attended some seminars and got to stay at the dorms. It sounded a lot better than it really was; I spent the majority of the day trying to stay awake while suffering from a horrible case of ennui (boredom). Having no TV at the dorms, I finished Ellison’s Invisible Man while attempting to keep warm since my dorm-mate insisted on keeping the place at a toasty 60 degrees (Fahrenheit).
It was at the beginning of this program that I first heard the phrase ‘rising senior’. And it sounded really cool, like if I was a piece of dough almost ready to be baked. So I’ll use that term to describe my buddies who will be incarcerated at various hospitals/pharmacies starting in May. If they do well and heed my advice, they’ll be let out at just under a year for good behavior.
So this is the long awaited continuation of the Rotation Files. Today’s introductory topic is the Evaluation Form.
Aim to improve in all attributes. There was some famous study that concluded that when things improved to a high point, people liked it better than when things started and stayed at the same high point. A quick simple example: When you start out at $13/hr and they give you a $1 raise at 6 months and 12 months, it feels better than if you start out at $15 and stay that way for a year. It seems like you made progress.
Similarly, when you first meet a person and you think s/he pretty much sucks as a human-being, but then find out later that s/he really doesn’t suck all that much, then you will probably like her/him better than if you didn’t think s/he sucked in the first place. This, as it turns out, is the plot of Pride and Prejudice. It, as it also turns out, is also the plot of Twilight. Bam! And that’s why teenage girls swoon over pasty Edward and his 4-inch bird’s nest hairdo! (I happen to like chick flicks, but Twilight was a bit much).
So with your self-evaluations, always mark yourself low initially, and aim to increase at the midpoint and final.
Humility is golden. Some Christian high-ranking official, possibly a pope, said that the three best virtues are humility, humility, and humility. Most likely you’re not going to know a lick about the rotation or the drugs. And even if you did, your preceptor is the ‘expert’ in the material because s/he has been working at it on a daily basis. Rotations will be a humbling experience.
Eventually (around the 4th rotation), you’ll get to a point where you feel comfortable to mark yourself a 3 or 4 on the initial evaluation. DON’T! Even on the 5th and 6th rotations, I never marked myself above a 3/5 for the knowledge and skills attributes.
Different types of attributes. There are some exceptions, as hinted in the previous paragraph. On most evaluation forms, there are attributes which I categorize as knowledge/skills, attitude, and integrity/character. These should all be handled differently.
Knowledge and skills – these are the attributes that pertain to the subject matter of the rotation. They are the ‘proficient in topic discussions,’ ‘able to assess patient information,’ ‘able to develop follow-up plans’, etc. This is what you should learn during the rotation, so it would make sense to mark yourself low initially and improve at the midway and final evaluations. I would say 1 or 2, depending on your comfort level with the rotation; 3 if you’re feeling ballsy.
Attitude – These are the ‘follows directions,’ 'is a team player,' ‘is willing to learn,’ ‘expresses intellectual curiosity’, etc. I would generally mark myself at least a 3 on these attributes, because these are independent of the rotation. You should come in with a positive attitude, so mark yourself decently. This signals that you’re open to learn.
Integrity/Character – These are the ‘displays strong moral character,’ ‘possesses high integrity,’ ‘is honest,’ etc. Again, these are independent of the rotation, but unlike attitude attributes, these are somewhat immutable characteristics. You either have it or you don’t. There’s not really much of an in-between. So rank yourself at least a 4, because some preceptors frown upon students giving themselves 5’s on anything at first.
Self-evaluation = what you think your preceptor will give you. Although you should aim to improve your evaluation scores, try to mark down what you think your preceptor will give you. It is a self-evaluation, but you can make a bad impression if your preceptor thinks you’ve over- or under-estimated yourself. But when in doubt, always guess under. At worst, it shows lack of confidence; at best, it shows humility, which is a good thing.
One neat thing you can do is underestimate yourself for the midpoint so that your preceptor evaluation will be higher than your self-evaluation. Then on the final self-evaluation, just copy your preceptor’s midpoint evaluation.
I know some people feel that the self-evaluation should be a SELF-evaluation, but some students are just too arrogant or too humble to be left to their own devices.
Get a pre-evaluation. To get a feel of what your preceptor will give you, ask how you are doing and how you can improve at the end of each week. Ask more often if you can get away with it. Usually if you’re casual about it, they will let you know. But try not to be annoying.
You know that guy/girl who repeatedly asks, ‘where is this relationship going’? Don’t be him/her.
Give your preceptor the form a week ahead and remind periodically. You are ultimately responsible for completing and turning in the evaluation forms. Preceptors are real people and have lives outside the pharmacy. Don’t give an evaluation form to them on Friday and expect them to complete it by the afternoon. Even if they do finish it, they will probably mark you lower because of your poor planning.
Sometimes preceptors forget to do your evaluation. Give them subtle reminders a few days beforehand like, ‘How’s the evaluation going?’ or ‘Did you get a chance to look at my evaluation?’ But avoid being confrontational.
Be prepared to explain yourself. A vast majority of preceptors will talk to you about the evaluation. If you’ve been getting informal pre-evaluations, then nothing should come as a surprise. They may ask you why you marked yourself the way you did, so be prepared; don’t use the reason that g-said-so.
The reasons don’t have to be spectacular; just something to back it up. If you had followed my advice, most of the questions will be, ‘Why did you rank yourself low?’ Say something that accentuates humility.
Lastly, evaluations should not be scary. Think of them as a learning experience, not as a way for some horrible preceptor to crucify you for your lack of knowledge. But ultimately, there is no substitute for knowledge. These tips won’t save you if you epic fail in presentations and pimping* sessions.
But even if you end up with a poor evaluation, it shows great character and attitude if you respond well in the second half of the rotation.
I will end by repeating that there is no substitute for knowledge. Rotations are meant to be a learning experience, so don’t cheapen them by trying not to learn.
The rest of this week will be dedicated to rotation stuff, since I feel guilty for ignoring my blog.
--
*Pimping happens when preceptors rapid-fire questions at you until you mess up. It’s an utterly frightening experience for students and an utterly delightful experience for preceptors. Like the ‘now-defunct’ hazing in fraternities, the students who survive and become preceptors get to torture the next batch of pledges (interns).
Thursday, February 11
The Rotation Files, Pt 1
Dear rising 4th year pharmacy students around the country,
You don't have to resort to feel-good posts written by idealistic fourth-years who are going to do a pharmacy residency and are afraid for their scholarly lives of ruining a reputation they have yet to make. You get the low-down g-style that you're used to and love.
Unfortunately, like Mystery and Mystery's Lounge, you'll only be privy to the deepest secrets if you're in the inner circle of friends, who are basically people I trust not to reveal my secrets to the unworthy. Most of my tips will be hum-drum stuff, but I will attempt to point out stuff that other people may not have noticed (but are within tasteful reason and don't seem manipulative).
Let me first start off by saying that, 'Impressing preceptors is a lot like picking up chicks, except it's much easier.'*
The reason why I'm drawing the parallel between how to impress preceptors and how to pick up girls is that the concepts are fairly similar (as I am figuring out reading all these PUA material). Though I'm not a natural pickup artist, I was decent on rotations and my preceptors all liked me (so I hope!). I think pickup artists would rock rotations given some pharmacy knowledge.
I'll also frame the teachings by progressing from beginnner to intermediate to advanced lessons. Let me make the disclaimer that these posts will be about how to interact with preceptors, not about what you should read for such and such rotation. Evidence and literature change every day, and I don't keep up with that stuff.
In a way, if I had done the residency route and became a preceptor myself, this is how I'd like my interns to act.
Part 1 - Newbie Lessons: Mostly common sense, but needs to be said.
Teachers and professors like me because I'm intelligent. I slept in Org Chem every time at 6PM (5:30-7PM, TTh classes), but Dr. X never called me out on it because I made 100s on his tests. Same thing happened in pharmacy school with my sleeping. Intelligence is like money and power; it is intrinsically attractive to most teachers as the dollar bill is intrinsically attractive to a majority of women**. But if you weren't a studious worker bee, no matter. Rotations are about interpersonal communication. Note that you will not get away with sleeping on rotations, no matter how good you are.
Lesson 1: Show up on time and properly dressed. This is how you make a good first impression. When you contact them ahead of time (email is fine but make sure your email address it's not something like vietballa27@gmail.com) to learn of the time and place to meet up on the first day, be very professional. Err on the side of being uptight. One of my mantras is you can always dress down when you're too professional (by taking off the coat, removing tie, etc).
A friend of mine got slammed for asking the, 'So what is the dress?' question. Here's how to phrase it: 'So, just to confirm, the dress is professional, is that correct?' It makes you sound somewhat intelligent while confirming the required apparel. If they say you can wear scrubs, then great. But don't buy scrubs beforehand, because some places restrict the colors.
For the gents, always wear a tie (and not of Playboy bunnies, go to Ross/Marshalls and get some conservative ones for $10) on the first day. After a week with a tie, you can calibrate your look to the rest of the men on the ward. Stick to solid blue or solid white button-downs. For the ladies, wear comfortable shoes and know that this is not the club; even if you want to attract the cute resident physicians, this is not the place nor time.
Lesson 2: Be enthusiastic and open to learn. And smile; that's important. Attitude matters a lot. You will undoubtedly suck during your first couple of weeks on rotations. Most preceptors know that, and they're usually okay with your not knowing much to start. But they're not okay if you seem uncooperative or unreceptive to their teaching (which you may feel is more criticism than lessons). If you need a confidence boost, think about the weakest student in your class (hopefully you're not that guy) and know that even he will make it through rotations.
Lesson 3: Write down everything and review it daily. Preceptors are a little like women in that they expect you to remember everything they said even if they didn't emphasize that it's important. Whereas a 'you should have known that fuchsia is my favorite color!' from a girl may mean a few minutes of tongue-lashing, a preceptor saying, 'I had told you to follow RG's potassium counts, and you didn't do it?' may mean a lower grade. Note: It's a bad sign when people use rhetorical questions.
On the flip-side, if you did something that they had mentioned, be sure to bring it up. To a girl, 'I know your favorite flower is a tulip***, so I got you some for no reason except to put them next to you and show you that you're vastly more beautiful than nature's best attempt at perfection.'**** To a preceptor, 'You had mentioned that when patients have DKA, I should monitor potassium when try try to correct it, since K + Glu go together. SY's potassium level is 4.0, which is normal.' Major brownie points!
Lesson 4: You will be overwhelmed. There is no doubt in my mind to this truism. When you feel lost, ask your preceptor nicely something like, 'I know this is all important, but what do you feel is most critical that I look up and follow?' If you don't put the first disclaimer, they will usually retort with, 'It's all important!' But when you take someone's argument away from them (by acknowledging it), they won't have it to use against you.
Whatever they say next is extremely important (because they themselves probably follow it), write it down and make sure you follow those on a daily basis. You can't ask, 'So Dr. XYZ, what's going to be on the test?' when you're in an auditorium, but you can certainly ask it when on rotations. Ask the 'what's really important' question during your first week.
So that's 4 quick lessons for today. I'll try to do these posts on a weekly basis, but just remember that preceptors are real people and you can get away with a lot of things while on rotations than you couldn't in a classroom.
--
*my response back to my friend who asked me on tips for rotations
**excuse the generalization, but I've never met a girl who said some guy she's dating made too much money.
***I think tulips are beautiful, especially the deep purple ones, so close to noir, that are full of foreboding wonderment and mystery
****Feel free to use this line, but don't be this cheesy
Subscribe to:
Posts (Atom)