Healthy meals for clerkship – Part 2

Have no experience cooking? Want to learn to cook something that is healthy and tasty in a jiffy? This recipe has you covered!

This meal is something that can be prepared the evening before the work-week and stored for a quick and healthy lunch!

Baked Salmon with Veggies and Rice

Ingredients:

  1. Baking tray, aluminum foil and parchment paper.
  2. Veggies (I chose Green Beans and Brussel Sprouts).
  3. Olive oil.
  4. Lemons.
  5. Salt and Black Pepper.
  6. Salmon Filet.
  7. Brown rice

Directions:

Pre-heat oven to 250 degrees Celsius.

  1. Wash veggies. Cut the Brussel Sprouts into fourths.
  2. Cut Salmon Filet into 4-5 pieces and brush with olive oil.
  3. Line baking tray with aluminum foil and parchment paper for easy clean-up.
  4. Place green beans and cut Brussel Sprouts on the baking tray.
  5. Place salmon on the side of the veggies.
  6. Cut some lemon slices and place these on each of the salmon filets.
  7. Season with lemon juice, salt and black pepper.
  8. Cook for 25 minutes (cooking time will vary based on how thinly the salmon is sliced).
  9. Remove and check to see if the salmon is done (does it flake easily with a fork?). If not done, then return to the oven and reassess later.
  10. If done, then remove the salmon for plating.
  11. Place the veggies back in until they are cooked (the Brussel Sprouts are quite good when they are a bit charred).

Rice:

  1. I used a rice cooker to prepare the rice.
  2. Take 1 cup of brown rice and place into the rice cooker.
  3. Wash the rice 2X.
  4. Then place approximately 1.5 cups of water (1.5 times the volume of rice used).
  5. Turn on rice cooker and wait until ready.

Putting it all together:

  1. Plate and Eat!
  2. The leftovers are perfect microwavable lunches for the next week!

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A dialogue that recognizes imperfection, and encourages diversity…

It is so important to view our community of peers, colleagues and patients as individuals.  We are all human beings sharing the same world but holding very different experiences. Beyond the updates of everyday life, everyone has a story to tell. We hear from our friends, our peers, and our colleagues everyday, but it takes practice to aside differences, judgements and pre-conceived notions we may have and it’s often difficult to share without the fear of being judged.

After several conversations, I’m sharing of few unique stories, highlighting different reflections. By sharing our stories, we experience first-hand the strength and courage it takes to be vulnerable. Let’s celebrate unique stories and engage in a dialogue that recognizes imperfection, and encourages diversity.

“I spoke to a retired physician; for her “success” was getting up in the morning and baking muffins every day. Everybody has their own definition of success and it’s always changing. I don’t know if I’ve figured mine out yet. I had to redefine what success meant to me in terms of leading a balanced healthy life, and being happy rather than having my definition of success based on my academics. My previous idea of success helped me get to where I am, but I think my new idea of success will get me to where I want to be. “ EM, QMed 2019

“Me going to med school wasn’t all joy for my parents. Don’t get me wrong, my mum screamed like a little girl when she found out I got in. But they wanted me to be home, and this is me being gone. She loves me so much it hurts her. And it fills me with a lot of guilt, because she’s sick; I want to be taking care of her, but instead I’m far away learning how to take care of other people. I mean its all okay, but yeah. I’m very all or nothing, this was an all.” – QMed 2018

“Piano is my first true love. It is a way that I can express myself and bring the music to life in a way that I feel like it should be showcased. When I play Chopin, the music speaks to my soul, and with him, it only gets better with age. Whereas, when I play a prelude by Bach, I know I have to completely focused in order to appreciate the intricacies and perpetual motion of his pieces. I started playing piano when I was five years old and was able to work towards working at a diploma level. Through undergrad, I unfortunately wasn’t able to play as much as I was use to, but I still find solace in being able to sit in a room all by myself, and do something I love and am good at. It is the perfect way to recharge.” LS, QMed 2020

“Over the years, as I made my academic pursuits a priority, my hobbies of camping, painting, and music were put on hold. But now, I haven’t gone camping since high school, my comfort level with a paintbrush has diminished, and I am musically challenged. I think it was necessary for me to feel what it was like to have all of my eggs in one basket. Now, I realize the silliness of it and I feel as though I am trying to make up for lost time.” – SW, QMed 2019

Success. Guilt. Love. Priorities.  Everyone has a story to tell. By focusing on the individuality, the diversity and the various stories of the people in our surroundings, we quickly realize that we are not alone.

Find yourself a Failure Friend

The article « Failing Up and Failing Better » by Sara Gray published on CanadiEM on Nov 22, 2017 outlined 5 Steps « to fail up ». The premise of the article is that failure is inevitable, so let’s accept failure and learn to fail.  The author outlined 5 principles of failure which included: 1) accepting failure, 2) breaking the silence, 3) excellent self-care, 4) learn and teach about it and 5) taking care of each other.

These principles are incredibly important as we progress further into our medical training. Take a look at this article for more information: https://canadiem.org/failing-failing-better/

It is so important to know how to support one another and debrief.

A few key pointers on learning how to debrief:

  1. Ask for permission: friends and peers may be going through a similar learning process. Debrief is most effective when friends/peers have the time to listen. Friends want to be able to listen and be present but it’s difficult to do so if they’ve had a challenging day themselves.
  2. Just the facts: Outline the story in it’s entirety to provide context to your listener. Provide your listener with context and an understanding of the situation. This allows a   “set-stage” for your emotions, and your thoughts.
  3. Express emotion: There is strength in vulnerability, and finding someone that can be your “failure friend” is key. Take the time to be honest with yourself and to find someone you can truly be 100% honest with.
  4. Learning, not finger pointing: Once you’ve processed all the facts, the emotions, reflecting on your triggers, your stressors and learning from the experience will facilitate the learning.
  5. Be present: We should aim to support, and be present, as we would expect to be supported from our own friends and colleagues; let’s be present and open-minded.

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Healthy & Quick Breakfast Meals

Picture1Healthy & Quick Breakfast Meals

It can seem time consuming to make breakfast in the morning, and it can get pretty boring eating the same cereal or bagel every day. My go to whenever I’m in need of new interesting recipes is Pinterest, and I found these two recipes to be quick and healthy, and provide me with enough energy to get me through the morning!

1) Chia Seed Pudding with Fruit
This is a quick snack you can make the night before so you can grab it before class or heading to the hospital!

Ingredients:

1/2 cup lite coconut milk

1/2 cup unsweetened almond milk

3/4 cup of fresh fruit (pineapple, mango, strawberries)

3 tbsp chia seeds

1 tbsp sweetened shredded coconut (optional)

*Honey to taste

Instructions:

1) Mix all the ingredients together into a small mason jar (you can blend the ingredients together if you’d like one consistency)
2) Put the jar into the fridge over night for at least 5-6 hours
3) Enjoy in the morning!

Link to original recipe: https://www.skinnytaste.com/mango-coconut-chia-pudding/

Burnout isn’t a dirty word

Note: You can see our blog post defining burnout and its symptoms here, and a post on one strategy to cope with it here

In pre-clerkship, I would have told you that I would be able to recognize burnout in myself and my colleagues when it happened. Because, of course, based on the statistics, it would happen to some of us someday! I would have told you that there are many things that can be done to mitigate burnout, and that I, of course, would do them. Get a good night’s sleep, go home when you’re told to go home, make sure you’re eating right, take time for yourself. The thing is, clerkship came, and it just wasn’t that simple. With CaRMS hanging over our heads, we didn’t say no when we didn’t have the energy. We said it’s okay, I don’t mind staying when our preceptors suggested we go home after ten hours at the hospital. We didn’t get eight hours of sleep, we missed meals, we missed workouts, and either missed or were half present during time with friends and family. We filled our “free time” with studying, research projects, and other extracurriculars. We sometimes did, but definitely didn’t always, take the time to unpack complex emotions or debrief after the first time we were part of a code, or a patient died, or we observed a medical error with awful consequences.

We did talk about it. We discussed how difficult it was. We knew, and we tried to take better care of ourselves. We continued to remind each other why we are doing what we are doing. For the record, I don’t think burnout dominated our experience of clerkship. I think most of us would agree that clerkship was an incredibly rich, unique, amazing experience that we feel privileged to have undergone. I do think though that many (most?) of us experienced symptoms of burnout at some point or another during clerkship.

I didn’t notice my own symptoms at first, because they didn’t come out in the clinical setting. Maybe my patients were affected to some degree, but I actively worked to prevent that. I carefully monitored my thoughts and feelings towards patients to ensure that I wasn’t feeling compassion fatigue. What I didn’t realize, however, was that compassion fatigue can manifest in your personal life too. For me, it shone clearly through in the way I treated my family, friends, and partner. After a long day of seeing suicidal or psychotic patients in the emergency department, or listening to and empathizing with oncology patients, or even just seeing coughs and colds on an urgent care shift, I had nothing left. When my partner, parent, sibling, or friend needed someone to just empathize, something that had always been one of my best qualities, I didn’t have the energy to listen. I found myself annoyed with the people I loved for burdening me with more problems, when all I’d done all day was listen to other people’s.

I guess what I’m trying to say is, they’re not kidding when they call burnout insidious. The early symptoms probably happen to all of us, at some point, in some way or another. And it’s TOTALLY OKAY to admit it. Burnout isn’t a dirty word. I’d like to say I’ve figured it all out, and that I can impart some sort of wisdom upon you all to prevent it and/or fix it. But I can’t. I don’t know the answer to this problem our profession wrestles with. My friends and I have all changed, in mostly good ways and a few not-so-good ways, from our first year in the clinical setting. It’s been an incredible experience. Now, I’m actively trying to recognize when I’m feeling symptoms of burnout and create a better balance in my life to help me cope with them. I’ll let you know if I come up with something revolutionary. In the meantime, I’ll direct you to www.thehappymd.com , a site I’ve used to learn about burnout and educate my family and friends on what I’m feeling.

 

OMSA Wellness Retreat 2018: Wellness of Mind, Body, Spirit, Emotion

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Click on the follow link to view the Retreat Brochure:

Wellness Retreat Brochure

There is an exciting lineup of speakers and workshops at this year’s retreat.  See the attached brochure for details, where you’ll find options on everything from Yoga and Urban Poll Walking to Mindfulness-based Stress Reduction and Self-Care.  This retreat is open to medical students across Ontario! Mark the registration date on your calendar (March 5 at 5 pm) – it’s first come first serve with limited spots for each Ontario medical school.

Event Date:                  March 23-25, 2018

Cost:                              $90 per student for the entire weekend (incl. hotel & meals)

For more info and to register, check out the OMSA Wellness Retreat page: https://omsa.ca/en/wellness-retreat

 

BEDTIME ROUTINE – not just for kids?

Starting off medical school, I felt very overwhelmed – a combination of excitement, imposter syndrome, and anxiety as everything felt different from undergrad.

This anxiety and worry actually started translating into sleepless nights – I was consumed with these thoughts during the night, and had trouble falling asleep. I realized that I had started using television as a medium to help me fall asleep, watching Netflix to avoid my anxious thoughts.

After a few weeks, I realized how this had become my routine, and how this dependency was unhealthy. So I booked an appointment with my school’s counselling session, and made the conscious effort of having a positive sleep schedule.  

I had never consciously paid attention to my sleep routine before – I would simply sleep whenever I was tired, or had completed the day’s tasks. In fact, I had the perception that bedtime routines are only for kids. But I learned from this journey how important it is to have a routine, training your mind and body for sleep.

Below are a list of things I tried to adopt for a healthy sleep routine, and my experiences related to them.

  1. Setting a specific time

Having a set time to sleep – 12am for me – really made me aware that it was time for bed, and allowed me to prioritize sleep. It was difficult at first to remember to wind up work at 11:45 in preparation for bed, but after a few days, my body was naturally tired around 12am, and I was ready to sleep.  I found that I had less trouble convincing myself to sleep, because my body was naturally inclined to rest at the time. Also, having a set time for bed really pushed me to complete all my day’s tasks before the time, making me more efficient in terms of my daily schedule.

2. Reading a book before going to bed.

04-man-reading-book-in-bedI found this to be extremely relaxing – even reading for 10 minutes before bed had a significant impact on my mindset. I was able to forget about my daily life stressors and immerse myself into the story, which consequently made it easier to sleep. Also, by reading a book instead of watching TV, I was able to avoid being on my laptop, which felt like a break from the daily work. It gave me the sense that work-time was now over, and got me into the mindset for sleep. Also, I was able to avoid the bright light from my laptop right before bed, which may have helped attain a proper sleep as well.

3. Taking deep breaths

I had heard of the benefits that breathing techniques/meditation provides, but only recently experienced it. I decided to breathe in and out for about 3-4 minutes every night before bed, as suggested by the counsellor. I found that this was very relaxing – I was able to concentrate on breathing correctly instead of my anxious thoughts. Also taking deep breaths also triggers a change in the nervous system from ‘sympathetic’ mode – which is what we associate with fight or flight – to ‘parasympathetic’ – or ‘rest and digest’ mode, indicating that I was ready to sleep.
I have stuck to these three activities that I do on the daily – they take only about 15-20 minutes of my time before bed, and have really helped establish consistent, peaceful nights. This inevitably then also helps me start off my day well-rested.  I urge you to try these activities and adopt your own sleep schedule, and notice the dramatic improvement in sleep and mood these simple changes can make.

 

A light reminder

winter-63801_960_720It was day five of my first surgical rotation in clerkship. A Friday in November – another day on the wards and in the OR. Waking up at 5am and getting home after 5pm; arriving to and leaving from the hospitalin darkness. I adjusted to my new schedule well. I was going to bed early, meal prepping and coming to the hospital each morning with a positive attitude. I had a gym membership and was going regularly. It seemed as though my self-care was optimal. I thought that I had finally figured it out – the way to prepare myself physically and mentally for the responsibilities of clerkship.

This Friday, however, I had a slight change in my schedule. I was invited by a couple friends to eat my meal-prepped lunch in the hospital cafeteria. As soon as I walked into the cafeteria, my mood improved significantly. At first I wondered, why was this the case?  Things were going well and I felt great. What drastic of a change could have improved my mood to such a degree? Then I realized, it was the first time that I’d seen the sun all week!

It’s that time of year where the days are getting shorter, and sunlight is scarce. Making time to see the sun significantly improved my mood and made me feel energized for my last day of the week.

It is well known that sunlight is important for vitamin D production, ultimately lowering your risk for breast and prostate cancer as well as promoting bone strength. More recently, preliminary research has linked sunlight exposure to improved mood and a reduction in depressive symptoms.

Therefore – I challenge all those reading this post to make sure they make time to take a look outside at least twice a week; either through a window or by exiting the hospital or clinic for a few minutes on a break. It is a small change that can give you the extra boost you need to get through a long day or week!

 

The Language of Medicine

I’d like to open with an experience from last week during my Family Medicine clerkship rotation.  A patient (let’s call him John) was next on the list, and my preceptor warned me about a severe language barrier, and that he expected me to take about twice as long as normal for that reason.  So it was with some trepidation that I walked into the room, mentally rehearsing the hand signals and charades that I would have to use.  What a surprise when I walked in and realized the patient spoke my mother tongue: Cantonese.

The look of relief that crossed his face (probably mine as well) was unmistakeable when we both realized this would go a lot better than expected.  What we didn’t realize, however, was that although I was fluent in Cantonese, I was not at all medically literate in Chinese.  Google Translate made more than one appearance as I searched for terms like “sciatica” and “post-nasal drip”.  Although we both laughed about it during the visit, it was bizarre to be both fluent, yet not, in a second language.

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Canada’s medical student population is culturally diverse, and students speak a large variety of languages.  This is, of course, invaluable given the diverse patient population.  However, I encourage medical students to brush up on medical terminology in other languages lest you run into the same experience as I did.  If nothing else, it will win you extra points with your preceptor and with the ward nurses!

There is a hidden bonus to practicing a second (or third) language on the side of medicine: you continue to exercise your mind in different ways yet within medicine, refreshing it from the mundanity of reading Bates’ Clinical Exam yet another time.  Research has shown that speaking more languages puts off the incidence of aging disorders such as Alzheimer’s.  Finally, for the pragmatic and career-oriented students out there, remember that if you speak “medicine” in another language, you make yourself more marketable in competitive fields.  Just a side bonus!

Just Do It

UnknownWhen I sat down with a friend to work on what would become the first provincial suicide intervention workshop for medical students, there were a ton of doubts.  Who would go?  Who would pay for it?  Where would this happen?  The questions kept going.  It was discouraging.

But meeting after meeting, plans slowly fell into place.  We got funding, we got special rates, we got institutional support from the Ontario Medical Association.  Through work and perseverance, we happily launched a successful Applied Suicide Intervention Skills Training workshop that is still making waves now.

Where am I going with this anecdote, you ask?  Well, my message is a simple one: Just Do It.

At few points in your life do you have as much free time as during medical school (sounds weird, but it’s true).  Classes are pass/fail, your clinical work is overseen by a preceptor, and most of us don’t have families to take care of.  Contrast this with our medical future, when work and family begin taking a greater percentage of our lives.  Talking to my peers, many med students fall into the trap of thinking medical school is about work, studying, and then de-stressing.  Rinse and repeat.  As we all know, this is no way to live your life!

Enrich yours and others lives.  If you have an idea for something that could work, be it a quality improvement project, community advocacy, or even putting on an art gala, follow it down that rabbit hole!  We hear stories of students doing amazing things every month, as OMSA posts its Student of the Month blog post.  Bear in mind that there’s nothing inherently separating you from them, save for the audacity of going just one step further than their peers, and another, and another.

I’m not going to belabour the importance of living a balanced life, but I will emphasize the importance of diversifying one’s life.  Like Jack Nicholsen in The Shining would say, “All work and no play makes Jack a dull boy.”