Aspiring Doctors

1. Make sure you spread the labia minora adequately. This is the key to not pinching them and perhaps the most important part. You can spread from above or below with your nondominant thumb and index finger, whatever is easiest for you.

2. Hold the bill of the speculum between your dominant index and middle fingers for the best control.

3. Insert the bill at a 45 degree or less angle. I personally insert it at a 0 degree angle. None of this 90 degree bullshit they teach you in med school. That just guarantees that you’ll hit the urethra and make them jump. The reason they teach that is so you don’t pinch the labia minora, but if you refer back to step 1, you’ll have a good spread so that won’t happen!

4. Once the bill is just at the entrance of the introitus, pause for a second and let her relax. Most people tense with anticipation at first, and if you keep pushing the bill in at that moment, they’ll just tense more. Give them a second to breathe.

5. Slowly push the bill in against the posterior wall of the vagina with slight downward pressure toward the rectum. Again, hitting the bladder and urethra is more uncomfortable in most people.

6. Angle the bill towards the sacrum, most people have a posterior cervix, so we’ll start here.

7. Insert the speculum ALL THE WAY! People are hesitant to do this and want to open sooner, but think about it for a second. Vaginas have more nerve endings at the entrance and most people don’t feel their posterior vaginas. You want the fulcrum of the speculum to be at the introitus because then when you open the bill, there’s no stretching at the sensitive part!

8. Open the speculum, and most of the time, a cervix will pop into view at this point. If not, she has a more anterior cervix. If this is the case, let the blades close, pull out a couple inches, angle the speculum more anterior than the sacrum (parallel to the floor is a good bet), and try again. Don’t forget to push it all the way in before opening again. If there still isn’t a cervix, she’s got a super anterior one! Repeat the adjustment steps and angle more towards the bladder, but don’t forget to pull down against the posterior vagina while doing it.

9. Once you’ve completed the exam, let the bill close while you’re pulling out so you don’t pinch the cervix or vaginal walls. Be aware of how much you’re stretching the introitus if it’s not closing automatically!

10. If the steps above failed, do a bimanual exam to find the cervix and repeat once you have that information to help.

Hello all!! This is going to be a master post where I (attempt to) keep track of what specialty all of us are going into. If you would like to add yourself to the list you can message me or reblog with the gif of your choice here. (PLEASE do not reblog this post!)

Anesthesiology

Dermatology

Emergency Medicine: @medschoolmanic @ermedicine

Family Medicine: @medschoolgrind @studentdrveebs @smoogleboog @frommetomd @honestlymd @dogemd

Internal Medicine: @texanmdtobe @wishbone-md @medicalgalaxy (en route to ID)

Internal Medicine/Pediatrics: @francescamichelle

Interventional Radiology

Neurology: @emii1496 

Neurosurgery

Obstetrics and Gynecology 

Orthopedic Surgery 

Otolaryngology: @ashleymd7

Pathology

Pediatrics: @rocker-doctor @mj-md @mindfullymedical @thedreamingdoctor 

Plastic Surgery

Psychiatry

Radiation Oncology 

Radiology 

General Surgery: @part-timemedstudent @snowandstarlight @nothingbutnetters

Thoracic Surgery

Urology

Vascular Surgery

You gotta get some gourds

HARK. Interview season is upon us!

And my old littles gave me the great idea to come up with a big ol’ list of questions the interviewing 4th year can use to find the answers they need about certain program OR give ideas that a 4th year may not have thought of at all.

I hope this helps anyone who has been dreading the “any questions for us?” moment. It’s not everything you can ask, it may not even highlight your program priorities, but hopefully you can get something out of it!

Is there any standard curriculum which the residents follow?

When do residents have to take step 3 by?

Is there any expectation to take step 3 before residency starts?

How are morning reports/grand rounds/resident lectures held?

Does the program support simulators and simulated learning?

Does the program have a sim center?

Is the in-training exam used by the program in any way?

When do the residents take the in-training exam at this program?

What is the percentage of specialty board pass rates?

What is the fellowship match rate/job placement rate?

What are you expected responsibilities on the floor?

What kind of call do you do as an intern vs as a senior?

What are you looking for a in a resident?

What do you value in a team?

How often are you working with seniors vs other interns vs attendings?

What fellowship programs does this program offer?

What are the responsibilities of the fellows toward residents, if any?

How are mentors approached?

How does continuity clinic run through the program?

How many electives are offered per year?

What specialties does the hospital not have?

Which specialties are done at an outside hospital/system if any?

What are some hallmarks that make this program different from others?

How does this program participate in resident wellness?

Are their any resources if a resident feels they need help?

Is there support when there is a loss during patient care?

Does the hospital have any associated medical schools?

What are the 3rd and 4th year med student expectations?

What are the resident expectations to the medical students?

How many fourth years are around during audition season?

How is the schedule organized (how many floor, clinic, etc months)?

Are schedules flexible in any way?

If someone needs to miss a day or call, how is that rectified?

How are vacation requested, decided and divided?

Is there a holiday schedule?

How does the program approach QI projects?

What are some standout QI projects from the residents?

What are the research expectations for each year?

What resources does the program provide for research?

Are the residents provided food and drink (stipend/resident lounge supply)?

Are the residents provided scrubs?

Do you get white coat replacements or fleeces/jackets?

What is the expected attire on the floor, clinic, etc?

What is the parking situation?  

Are there any stipends for moving, study material, exams or conferences?

What is the average cost of living in that area?

Where do most of the residents live?

Do you need to be in close proximity to the hospital?

How do you think a program of this size facilitates the learning environment?

Do the residents hang out together?

I didn’t describe why someone would ask these so if you’re interested, don’t know what something means, or want elaboration feel free to send an ask.

Go forth! Be strong and confident!

Totallyalmostadoctor: pre- pre- med, 16, super excited about medicine. Is totally *not* almost a doctor (but it will happen! Don’t lose hope!) but keenly reblogs studyblr and medblr to be the best they can be.

Thesensiblehelpfulmedstudent: actual med student. Makes a point of being sensible and helpful. Lots of helpful medblr content.

Lifehurtsbutilovecheese: actual doctor, 90% of posts are queued up trashposts, interspersed with rants about residency.

like I’m among the minority of my friends in definitely for sure wanting kids someday

but each of my parenthood-eschewing friends has claimed a different role in my future offspring’s life and they seem very excited to play it

so we as a generation may have fewer children

Well, if you can’t do the job right yourself, the least you can do is help a friend raise THEIR child right, help take the burden off their shoulders, and give that kid all the love and attention they can stand.

So there’s that bit to it but there’s also quite a bit of intentionally unfriendly spaces in our culture that makes having children around difficult, and because there are so many places where children are not welcome and there is only community families where people are trying to have a community family, there’s this interesting set of adults who really want to be supportive but legit know nothing about kids. Like there’s grownups out there that don’t know how to rock a baby to sleep or change a diaper or have a conversation with a three year old about how their shoes are both black so that they definitely match even though they’re completely different shoes. And let me tell you, those are all learned skills.

The clinic space I have is designed to be child friendly for my adult folks. I have a baby carrier in the gyn room because adults with children still need paps and might not have childcare. All of my cabinets are magnet locked. I keep extra snacks, wipes, diapers, and sippy cups in the back. I have toys for a variety of ages of kid, because adults also chill and talk easier when they’re building legos.

All of these things I have because parents are my primary demographic and the best things I can do for my grownups is 1)allow them to access care when they need it. 2) act as part of the child raising community while their children are there. Yes, I wear children in the office and watch kids while a parent goes to the bathroom and chart with kids that aren’t patients on my lap.

You can’t just be neutral about “of course I would help” because every message parents get is that they are inconveniencing everyone by bringing their spawn to a place that is not specifically designated for children. Parents do not actually want to inflict other folks with their kids embarrassing shenanigans 99.9% of the time.

Everyone having kids needs help. I can hear echoes of “we all need help” but look y’all, I sleep 6 hours a night on a good night, am responsible for feeding, watering, bathing, clothing, and loving 3 other humans before I even have coffee in the morning, and I don’t know which one of them did it but someone exploded a stuffed animal that I’ve had since middle school all over the house. I have 20 charts to do, the kitchen to clean, breakfast to prep, and I’m going to be putting the kids to bed for at least 10 more minutes. I need help.