Author: Jacob Brown (Page 7 of 7)

Anxious Thoughts

May 20, 2020 / Jacob Brown

From being immersed in the medical student culture for almost 2 years now I have noticed a huge amount of anxiety among the students. Most of them seem to be fairly anxious about everyday tasks, but they really seem to get anxious when they are approaching a big test date or a large event. I think everyone gets anxious at times, and it’s good to now how to handle that anxiety.

My wife is a planner. She enjoys figuring out the logistics of every day, and trying to stick to it. Planning out when and how she will accomplish tasks helps her to keep her day and mind organized. On the downside, when there are changes that don’t follow this plan she has a hard time coping. There are not a lot of things that we can control in life, which makes it harder for people that are planners. So when small things change in a daily schedule, it tends to add stress to her day.

Lately she has been studying for Step 1 amid the COVID-19 pandemic. Her studying was put to a halt by the fact that her exam has now moved to October. She has had a lot of stress relief knowing that there is a set date again. Before it was changed to October the date moved 3 times. All of the students had been studying more than 10+ weeks for a test that was only intended to have 5-6 weeks of study time. Some students were able to take their exam in Mid-May, but the seats available were limited.

With speaking with my wife I have found that there are a couple things that make medical students more anxious. This is not an all inclusive list, but it is some of the high points that I have found are common.

An unknown future. Being out of control never fun. There is a certain amount of unknown that comes with not being at the helm to steer the ship. This is a very prevalent in medical school in general, but most of the unknowns seem to occur in the last 2 years of medical school. The first big unknown for my wife has been trying to take her Step 1 exam. The Step 1 exam in general is a big unknown. The whole future of what field of medicine the student can go into is determined by this one exam. Students spend weeks studying and in the end, can achieve a score that is too low for the specialty they want to partake in. Another big unknown, that we have not reached yet, is matching with a residency program.

Important dates changing. All of the COVID-19 madness in the United States has created a lot of uncertainty for my wife. One major change has been the date for her Step 1 exam keeps getting pushed back. She was originally scheduled to take it in May of 2020, but she is now schedule to take it in October of 2020. Hopefully the date will not change again. Another major change has been the class scheduling. The medical school has been forced the shorten their rotations in order to fit all of it in the school year. The end of the school year has to be the same as they can not delay this year and just keep delaying.

Important test dates approaching. Finishing classes and starting new ones seems to put people on edge. After all, each student has a lot riding on this short 4 year journey through medical school. Tests stress people out partly because of the unknown. The student doesn’t know what the questions will be, how it will be graded, or whether or not they did a good job. It can be hard to relax and do the best job possible.

Long sessions of study. Long sessions is referring to days, not necessarily hours in a day. For example, studying for 5 days in a row without getting to have a break. This is very common for medical students as they have a lot of big exams. Having long periods of time without a break or relaxation period accumulates stress that lead sit anxiety.

Tips for the reader.

Don’t try to sleep with your mind running. Something good is to try to prevent all of the stress and worry in life from becoming anxiety. Something important for me is to resolve issues as quickly as possible, and try not to let them carry over into the next day. I find that this helps me sleep well, and not stress over work. If I can resolve these issues, I won’t be thinking about them, and in turn will allow myself to relax.

Plan for the best and expect the worst. It can be hard to have plans change, but when they do, you need to be agile enough to take another approach. Sometimes the many changes in life require us to have a backup plan. For everything with your education (and most of life) have a backup plan. It can take a lot of pressure off when things change.

Talk to others. If you are having a hard time with stress or a situation, you are not alone. There are many others who are going through the same situation as you, and they might be able to help. Never think you are alone in what is going on, because you’re not.

Find ways to take short breaks often. My wife has had success with taking short breaks to relieve some stress when possible. Working for a few hours and scheduling lunch or a 15-30 minute activity session is a good start.

Learn Basic Car Maintenance

April 26, 2020 / Jacob Brown

I enjoy finding ways to save money and learn new skills. Having enough money to pay for certain things while a spouse is in medical school can be difficult. After all, the easiest way to have more money, is not to spend it. I will outline some things that make a positive impact for me in our budget.

Do basic auto maintenance yourself or find a friend that can. I perform nearly all of my own maintenance on my cars, and for any of my medical school friends. From my experience, a normal shop fee is anywhere from $85-$125 per hour. At this rate, most simple tasks are worth the small amount of time learning how to do them. The tool investment is also small, and pays for itself quickly due to the cost of a professional shop. Some simple tasks are changing your battery, changing oil, checking all of your fluids, replacing brakes, and replacing spark plugs. Oil changes usually include an oil check, coolant, power steering, and washer fluid. Having brakes replaced, spark plugs, or any work not included in an oil change will be put on an hourly rate. Instead of paying a shop to replace your battery, take it upon yourself to go to a store that sells auto parts and make the battery purchase yourself. The shop will be buying a similar (or the same) battery and marking it up. In addition to that, most of the large chain stores will replace your battery for you at no charge. This is dependent on your make and model, but most vehicles are simple to replace.

How I justify doing the work myself. If you’ve ever taken a car to a shop you will know that it is extremely expensive. The billing is based on the “book” time for completion of the task. So if the job will take 2 hrs of shop time, the bill could be anywhere from $170-$250 for the work (excluding parts). I look at this number and see that if this is work I can manage, I could save this money. Not only could I save money, but with the approximate cost between $170-$250, I could purchase the tools for the job. This sets me up for future work or if I know somebody that needs help with similar maintenance. As an example, most vehicles with gasoline engines have spark plugs that are relatively easy to replace. A shop will charge about 1 hr for most vehicles, resulting in a cost of $85-$125 without parts. So, a car owner could spend $85-$125 on the tools (and their time) to complete the job themselves and it would cost the same.

Why I use full synthetic engine oil. Saving money on small maintenance tasks adds up. I drive about 22,000 miles/year. I use full synthetic oil and run it for about 12,000 miles between oil changes. Running full synthetic costs about 25% of conventional oil, and I have had a lot of success with it. An oil change usually costs me about $36 for 12,000 miles, while conventional would cost me about $32 for 3,000 miles. From information, I show that for 12,000 miles of conventional, it would cost about $128. This is almost 4 times the cost of full synthetic oil for the same distance. I understand that full synthetic engine oil is not the beat choice for every vehicle (especially brand new vehicles) but it works well for me. Having a shop change your oil for you can still save a lot of money. If you’re car is not made to handle full synthetic oil, don’t use it. Look in the manual or contact the manufacturer to find out if it’s okay to use.

My recent work. I was getting some odd feelings in the steering when driving and when I checked out my car I had quite a few components that needed to be replaced. I prices out parts from some aftermarket vendors and ordered them to my house. I had to replace a lot of the steering, bearings, and suspension components, which cost me about $500 in parts. The approximate labor cost for a shop to replace these parts would have been about $750-$1,250. So, looking at that kind of price, I chose to purchase a few tools for myself and completed the work at my house. This kind of work is not within everyone’s abilities, but it is within mine.

“Renting” Tools. If you don’t want to purchase any tools, there are auto parts stores that sell parts, and rent tools. One of the greatest things about their tool rental is that it is “free.” When renting tools the store will charge you the cost of the tool, which means that you have purchased it. After you are done with the work, they allow you to return the tool in good working condition and refund you all of the money. As long as you don’t want to keep the tools for yourself, just return them for a full refund.

Tips for the reader.

Do what you feel comfortable doing. If you don’t feel comfortable doing work on your car, don’t. It’s better to have someone help you, or pay someone if you feel uncomfortable. I do not condone performing work outside your abilities or comfort zone, it can be dangerous.

Learn how to tell when you have a problem. If you don’t want to do your own work, try to get good at finding upcoming problems before they become big problems.

Learn online. I find it best to look up how other people are doing the work. This can make it a lot easier and get an idea on how long it will take and how much it will cost.

Purchase parts for the shop. If you are not going to do the work yourself, buy the parts and take them to the shop. This makes it so that you get the parts you want, and there are less overhead costs. The shop will still charge the same on an hourly basis, and you will have more money in your pocket. Make sure to do research on exactly which parts you need and they will fit before ordering.

Eat Steak, Not Fast Food

April 26, 2020 / Jacob Brown

Would you think I’m crazy if I told you that you could eat steak 2 times per day, and it would be cheaper than fast food? Well I guess I am a little crazy, but it’s true. When compared to a meal from fast food chains, you CAN eat cheaper and better at your own home. It just takes a little time and planning.

Fast Food. I know for me when I stop in at a fast food chain I prefer to order a meal and not off the dollar menu. The quality of the food is much better, but the meals end up costing upwards of $8. I would say that $10 is a good estimate on how much a meal would cost for myself. Now, let’s compare that to cooking at home.

If we estimate that an average person eating out everyday for 3 meals would spend between $10 per meal, that’s about $10,950 per year ($210.50/week)! A huge chunk of change.

Now, if that same person were to go out for 2 meals per day (instead of 3) and cooked their 3rd meal at home every day for $5, they would spend about $9,125 per year ($175.50/week).

If a person were to eat breakfast at home, go out for lunch, and eat dinner at home every day ($5/meal), they would spend about $7,300/year ($140.50/week). Still an astonishing amount of money.

If the same person were to make all of their meals at home ($5/meal) and go out 1 time per week, they would spend about $5,735/year ($110.50/week).

Something interesting is my wife and I BOTH eat for under $110 per week with going out together 1 time.

Eating at home. Another way to look at this is if a person were to spend an average of $10 per meal eating at home, they could be eating shrimp and steak at nearly every meal. Shrimp usually runs between $5-$10/lb, and a steak like NY Strip is around $8/lb. Even a high quality fillet minion is around $20/lb and can be divided into four 4oz steaks, making each steak about $5 before cooking. The experience is dependent on learning how to cook properly, but most of the basics of cooking are not hard. It just takes practice.

Now, I understand that a person may not have very much time for making meals everyday, so I suggest making meals for the next day or two. If a person has time at lunch on a Monday, make food for Tuesday and Wednesday. Depending on what food item is being made, it will still be good on Tuesday or Wednesday. There are some other meals that can be prepared in a slow cooker, but I enjoy the freshness of food being baked or cooked off the stove. Proper warming of food that has been cooked earlier in the week is also crucial for the experience. If I am warming something like steak, or another food that wouldn’t fair well in a microwave, I will warm it in the oven. The oven doesn’t boil the fat and water out of food cooking it more, and it’s easier to control when it’s warm enough.

I get that eating steak only would probably not be the healthiest for your body. It might be a little bit rough on your digestive tract as well if there is nothing but fat and protein. What I am trying to show is that we can buy ingredients and spend a little bit of time cooking, and save quite a bit of money. My wife and I try to buy items like vegetables, fruit, cereal, and dairy products on our weekly budget in addition to different meats. Keeping our budget fairly low it’s down on the purchase of nonessential items, and makes it possible for us to be spontaneous at times. We have room in our budget to go out with friends if we want without going over budget. We can buy new clothes, tools, or swing through somewhere for dessert without having to worry about our budget.

Tips for the reader.

Set up a budget. Figure out how much you would like to be able to spend on nonessential items and savings, and work your food budget around it.

Practice patience. With how American culture is based on “GO, GO, GO“ it can be difficult to take the time to cook your own meals. Be patient and make time to cook. This is also great time to spend with your spouse.

Keep it as cheap as possible. We like to travel and as you may know, it’s expensive. If you can keep your variable costs down, you will have more room in your budget for traveling and fun activities.

Do what you can afford. You may be able to eat out at every meal (I don’t know your budget), but I find it best to keep it reasonable and make sure that I can meet my other life goals.

Buy in bulk. Bulk pricing will get you a better deal most of the time. Purchase in larger quantities and store (freeze what can be) and use it later.

Finding Hobbies

April 7, 2020 / Jacob Brown

Medical students spend a lot time completing classwork. My wife typically studies for 8-16 hours per day. This is dependent on what class she is taking, but the heavier class loads are more toward the 16 hour mark.

When I get home from work, she is studying.

When I get ready for bed, she is studying.

While she is studying, I have a lot of time for myself. I work a full time job from 6:30 am – 5:00 pm, Monday through Friday, but have every other Friday and weekends off. I usually get home around 5:30 pm, which is about 3-4 hours before she is done studying for the day. I try to fill this time that I have by myself with hobbies.

Why are hobbies so crucial to my life? If I didn’t have hobbies, what would I do? Probably just sit on the couch and stare at my phone, which is not the greatest use of my time. Hobbies are important to me because I don’t get to spend as much time with my wife since she is in school, and I am working. I am not upset with her or disappointed in her about not having as much time together, but it is different for me spending less time with her. So, hobbies are a way for me to get out of my head and into a job or task. Instead of lounging or relaxing (which is also important), I have chosen to make more use of my time.

For me, there are a couple different kinds of hobbies that I enjoy, some by myself and some with others. I tend to do a lot more hobbies by myself, but I enjoy the occasional hangout with friends.

One of the categories encompasses activities like riding bikes, running, and general exercise. There is no tangible return on the investment, but it is fun and healthy. I think that these are useful to everyone and tend to have short amounts of dedication (for short periods of time) to complete. Tasks do not usually carry over from one day to the next, but if they get interrupted, it can set certain goals back. One key feature of these types of hobbies is there are few tangible products from the effort. Most of the resulting achievements are times, physique, distances, or reps. These hobbies tend to be cheap. Some common items to purchase might be shoes, a subscription, a membership, or a bike. My wife and I try to enjoy this type of activity together when the weather is good. We spend nearly every evening during the summer riding bikes together or going for walks for 30-60 minutes.

Another category includes activities like home remodeling, knife making, automotive repair, woodworking, cooking, and construction projects. There is a task at hand, and I can gain a tangible reward for my efforts. These tasks have less impact when interrupted and can be completed in small steps. This also tends to be the best way to do them. A downside to these types of hobbies is they tend to be more expensive than the other category. Buying items like tools and supplies can cost quite a bit, but the reward is greater for me. There are ways that these types of hobbies can save money as well. I have made a few different items around my house instead of buying them, which has been cheaper and more fun than just purchasing at a store.

There are activities that merge both of these types. A good example for me is fishing from a kayak. I enjoy fishing, and being in a kayak makes the event exercise. I am able to have the leisure of being out on a river or lake and catch fish (which has a material reward). This activity requires a 1 time payment, then it does not cost hardly anything (usually just fuel to get to the water). My wife usually just paddles around while I am fishing out in the summer sun, reading her book every now and then.

I know that these sound pretty simple to accomplish, but a key component is self motivation. I regularly have to motivate myself (with the help from my wife) to get up and work on projects. As humans, we tend to take the easiest route, and it’s easy to be lazy and watch tv or play on my phone. It’s hard to get up and go, but being active is important. Set goals in your hobbies and chase them.

Useful tips for the reader.

Put together a list of interests. I like to find about how much it will cost as well. That way I can weigh the cost against my interest. Some things could be long running hobbies, but cost a lot.
Rank the hobbies. Find what interests you and something that has a return that you seek. If you don’t find something that you are really interested in, it will be hard to continue over the long run.
Find activities you can do together, and alone. I like to have a few hobbies for myself, and a few that I can do with my wife. This way, we can spend time together.

Step 1 Preparation

March 25, 2020 / Jacob Brown

Dedicated is the study period the is “dedicated” for Step 1. It’s a larger window of time where there is no class, but required practice exams for Step 1. Dedicated and Step 1 are some of the largest challenges of my wife’s Medical School journey, and is the most challenging to date.

Before dedicated started, my wife began laying out how she was going to study during this time. She has online study guides and tools, and she planned to use them accordingly. She planned to go through practice questions in excess of 150 per day, and watch videos to help her remember key terminology. She laid out the study session for 6 weeks, and is currently approaching the end of her fourth week of study.

She began studying at home, but soon found it to be boring. It was hard for her to sit in the same place everyday and try to study. So, she started going out after lunch and studying in a new location. This mixed up the scenery a little bit, and it seemed to help her keep focused. Her favorite locations to study are the alcoves of the simulation building and coffee shops. She loves to have lots of windows for sunshine and scenery.

She hasn’t tried studying with other students, but I think this is mainly because the students work at their own pace and can go through whatever material they want.

In the evening I usually make dinner when I get home from work. She enjoys when I make dinner because it allows her to study up to dinner time, then we can eat together and her study time isn’t used on meal preparation. I enjoy making dinner as well. I tend to make roasts, chicken dishes, or pasta. It just depends on how much time we have and what we are interested in eating.

Unfortunately for her, we are in the midst of the Coronavirus outbreak in the US. This has closed a lot of the places where she was studying, and has made the future seem a little bit unpredictable. The state of Ohio has put restrictions on schools, which has put the status of taking the Step 1 exam in jeopardy. If all goes well, she will be able to take the Step 1 exam early this year and will not have to wait longer.

“Let me see if I have time.”

March 15, 2020 / Jacob Brown

This is one of the most common phrases that I have heard from med students. Talking with my wife’s classmates, I hear this in nearly every conversation. The main focus for medical students is studying, and time is the biggest constraint. School is their full time job, and they are expected (by the school) to not only succeed, but excel. Medical school is extremely fast paced and time consuming, which makes breaks very precious.

A lot of my wife’s classmates take breaks very seriously. By seriously I mean when they get any opportunity, they travel. They tend to take large trips, depending on the allotted time. These can be fairly expensive trips, especially when they travel to Europe, South America, and Florida on student loans. In my opinion, it is more important to find a hobby and do small trips regularly. Taking large extravagant trips is fun, but the relaxation and enjoyment needs to be distributed. It is good to be able to spread out the relaxation, and not be looking forward to trips just once every 8-10 weeks.

My wife tries to do something fun or relaxing every day, and I think it makes a difference in her mental health. I can usually tell when she needs to take a break. During summer we try to ride bikes daily for 30-60 minutes. It’s not quite as fun when its 95 degrees outside, but it serves its purpose as exercise and time together. This is time where she can talk to me about school or we can talk about anything outside of school. Usually we ride in Metro Parks because we like the nature scenery. We are from rural Indiana, so it makes us feel a little bit closer to home.

Something else that we do that would be considered a “break” is going to the store together. She takes a little time out of her schedule so that we can go to the store and buy groceries. This is also very helpful to me because she gets what she wants to eat, and I don’t have to guess. I try to keep the fridge stocked with food that is easy for her to prepare because she doesn’t have a lot of downtime while she is studying.

My wife has made the goal to be done with school work at about 9 pm every night. Occasionally she is working at 10 pm, but that is uncommon. Having a set end time allows her to spend about 1 hour of her night doing whatever she wants. Her time is a lot tighter now than it was earlier in medical school. She is currently in Dedicated, the window of time set aside specifically for medical students to study for Step 1. This is a very important exam that causes a lot of stress as it is the exam that dictates their entire career (I will talk more on this in another post).

Some final thoughts for the reader:

Find something that you can do daily. If you can find a hobby or relaxing activity you can do daily, you will feel better than trying to hold the stress waiting until your next big break.

Set a schedule, and stick to it. This will make a huge difference in how much time you have to spend with others. Make time for things you love outside of medicine.

Take day trips when possible. Try not to just take trips or do something fun when you have a long break. Breaks between classes or weekends offer a good opportunity for relaxation. This makes it possible to do it more often, and can keep your stress level lower.

Finding a Job

March 4, 2020 / Jacob Brown

It’s been almost two years now that my wife and I transitioned from undergrad to medical school. For us, this meant a new city and new opportunities. Moving to Ohio distanced us from our family, and we had not really lived apart from them until now. Moving away was not easy, but it had to be done for this next adventure in our lives.

I began looking for a job in February of 2018 during college. I started applying for jobs solely in my major. Without any offers, I began to widen my search. From my perspective, the biggest challenge was making myself more appealing than the other engineers in this city. This city is home to a large Engineering University, which creates a lot of engineers and not a lot of open jobs. This also means that the businesses in the area are more familiar with their engineering program than mine. The main goal of my search was to accept any job that would give me an offer. After all, the only necessity at the time was cash flow. I applied for jobs at stores, engineering firms, manufacturing plants and more. We realized that if I didn’t get a job soon, we would be forced to take loans for cost of living (this isn’t the end of the world, but it could significantly add to school debt). This would have been a very costly financial decision, seeing as we would have to pay it back as such a high interest rate.

In the end of July of 2018 I started my first job. This is where having connections came in handy. I interned with this company between my first two years of undergrad, and they were excited to have me back in the company. They were expanding their reach and developing a new facility 23 miles from my house, and I would be able to work there until I found another job. The job entailed documenting construction progress and troubleshooting machinery installation. Not really an engineering based job, but I would gain a lot of experience working on such a large project.

I was able to make an agreement with my employer that I would work for them, while continuing my job search. There were a couple times I left work early or came in late because I was at a job interview. Without this kind of arrangement, I would not have been permitted to miss as much work as I did. I wasn’t as stressed about finding another job because we had income. I could look as long as I wanted for a job in the engineering field, and we would be financially stable.

We accepted my first job for many reasons, but one had a higher priority. We could become Ohio residents. By becoming residents, we were able to knock the tuition cost nearly in half for my wife’s first year of medical school. This was a great financial decision (who wouldn’t want to save $30,000), and if anyone else is in this situation, I recommend taking this approach.

I left my first job in the end of September in 2019 after I accepted a position as a Supply Chain Engineer for a fabrication company. Leaving was hard, but I think that it was the right decision. I now work in a better field and am learning more information that will benefit me in any future job. Over the course of 18 months I applied for nearly 175 jobs at about 150 different companies.

Final thoughts from my application process.

If you need money, don’t be picky. If you can get a job that pays your bills, you will make it. Land a paying job, then worry about finding one you enjoy.

Keep applying. Applying in numbers is one of the biggest contributors to success. Apply for more than you think is necessary and for jobs that you are not 100% qualified for (not the VP of a company, but something just outside your reach that you know you can do). Employers list their wants and needs, and don’t always stick to the requirements listed in the ad.

Be confident in yourself. When you get an interview, do your best. Don’t let the pressure of needing a job distract you.