Archive for the ‘education’ Category

My lesson learned-based CV

november 20, 2012 8 kommentarer

The first time I came in contact with CV hunters was during a four week extracurricular clinical rotation in Prague. I went there for the fun of it and to improve my Czech and was surprised to see how other medical students were asking everyone for recommendation letters. It has not until now occurred to me that a rotation like that could be used on your CV when you are a recent graduate from medical school. I’m however not the only one who thinks like this. When discussing CVs with a Swedish friend of mine, he thought his brother was embarrassing for mentioning on his CV that he used to be a football coach.

From my international experience I have learned that CV hunting is a common thing in many countries. People will do things, or a least volunteer for positions, that look good on their CV. I see on Twitter how American educators recommend everyone to keep detailed portfolios of everything they ever do. Even though I think that might be valuable and interesting to yourself, I don’t see how anyone else can get anything out of a long list of lectures, seminars, courses, assignments or whatever it is that you put there. Trying to assess what you know and who you are based on a list, seems to me like getting to know people in your community by reading the phone book.

So, I wrote an alternative CV, focusing on what I have learned through the years, instead of what I have done. Please leave a comment and let me know what you think.

The lesson learned based CV of Katrin Hruska


Lessons from education
  • If you are supposed to do a presentation and don’t prepare, you might experience nausea, dizziness and mutism to such an extent that you have to return to your seat with mission unaccomplished.
  • However embarrassing and uncomfortable this experience might be, the sun will still rise the next day.

How: Religion class in grade 8.

  • People don’t only disagree with you because they don’t understand your arguments. They might actually understand all your arguments and come to a different conclusion.

How: Local leader of the youth wing of a political party.

  • You may win the debate but still lose the issue if you are not in power.

How: Political representative in a local council for one of the opposition parties.

  • Sometimes making irrational choices will change your life for the better.

How: When I quit half way through my last year of high school to go and live in Prague with my boyfriend for half a year. I doubt we would have been married today if I hadn’t and I am far from sure that I would have gone on to study medicine.

  • If you don’t go to the lecture, you have to read the book, otherwise you won’t learn anything and you won’t pass the exam.

How: First year of medical school. Attendance wasn’t compulsory and the books were so heavy I had to read them in bed and so boring that I feel asleep.

  • If you have been to a lecture that gave you nothing because the speaker was so bad, there is no use going to his second lecture even if it is called ”All you’ll ever need to know as a doctor”.

How: Medical school. Revised at conferences by dull professors with heavy accents.

  • Socializing in a foreign language will make you seem less smart and more shy.
  • If you are used to talking a lot, this can be a good experience.
  • Studying in a system that stresses memorizing details doesn’t make you smarter, but it does make you remember more details. At least for a short while.
  • If you stay up all night playing pool, you will be tired the next day.
  • If all shops close at noon on Saturday and are closed on Sundays, you will be very hungry if you don’t do your shopping on Fridays.

How: Exchange student in Germany for my second year of medical school.

Lessons from work experience
  • Taking responsibility for a patient is different from being a medical student.
  • Even if lab results improve, it doesn’t mean that the patient is doing any better.

How: Summer job as some sort of medical assistant in a geriatric clinic. While I was looking at the creatinine that just came back and finally started to decrease after a steady increase, the nurse came to tell me the patient died.

  • To feel better patients need to eat, pee and poop. Then they need to get on their feet and regain their balance so they don’t fall and hurt themselves.
  • Doctors can’t fix this, but a team of doctors, nurses and physiotherapists can help the patients fix it for themselves.
  • Patients are not only patients, they are people. Even old patients have been young and lived exciting lives. Some have even taken part in interesting happenings such as recovering the Wasa Ship, Sweden’s most popular tourist attraction which sank on its maiden voyage in 1628.

How: Junior officer in the above mentioned geriatric clinic.

  • If you do research you need to be in a group that understands your work and can discuss it with you. You need a supervisor who can teach you how to conduct studies and how to interpret results.

How: Research assistant, trying to write a paper on a study conducted by someone else for another purpose, but where a lot of blood tubes were saved and stored.

  • Primary care is the most difficult specialty and not something inexperienced doctors should be doing without proper supervision.
  • Doing something you think is right doesn’t mean it is.
  • If you don’t ask and admit you were wrong, it is possible that no one will find out. It is also highly likely that you won’t learn anything from it.

How: Junior officer at a primary care clinic.

  • Doctors from different specialties have different priorities. Anesthesiologists see a need for more fluids, where cardiologists see a need for diuretics. Chest pain in a psychiatric patient can be cardiogenic. Chest pain in a cardiology patient can be anxiety related.

How: 21 months of internship, rotating through internal medicine, surgery, anesthesia, primary care and psychiatry.

  • Anyone can start a fight. Anyone can also take the first step towards ending it.
  • Try to dislike people’s actions instead of disliking them personally.

How: Bringing up three children with strong wills.

  • If you don’t delegate well and clearly, you will either end up doing everything yourself, or frustrate people who want to help out.
  • Starting up a new business is a lot of work.
  • Even the best employees will not perform well, if the group doesn’t work well together.
  • The best result you can get as a founder, is something that will work just as well without you.

How: Starting up a cooperative daycare together with two friends but no money. The school is celebrating its tenth anniversary next year.

  • Taking care of three small kids is a hand full, even if you are two to share it. Allowing yourselves five months leave in a foreign country will make it more interesting and give you the chance to learn a new language.

How: Spending five months in Argentina with no other agenda than being with my family.

  • The emergency department is the most interesting place in the hospital. It is also where you will have to work most intensely.
  • If no one really knows what emergency physicians do, if there are no specialists and not even a recognized specialty, you cannot specialize in emergency medicine.

How: Started to work at Sodersjukhuset, one of the first hospitals in Sweden to employ doctors for full-time work in the ED, instead of doing occasional shifts.

  • Primary care can be a lonely specialty.
  • If you try to solve all you patients’ problems, your ToDo-list will continue to grow.
  • If you don’t have a supervisor who is a roll model for the kind of doctor you want to be, learning to tackle these issues is very hard.
  • If you start going into the restroom to bang your head against the wall in tears, it is time to move on to another workplace.

How: Resident in family medicine.

  • Being an expert in one field of medicine, says nothing about your ability to treat patients with diagnoses outside of that field.
  • A resident who takes a good history and does a literature search, can provide better care that a specialist who cares more about his research than about his patients.
  • Patients need care even if no specialist thinks that it should be provided in their department.
  • If the head of your department doesn’t address important issues, someone has to bring those issues up. If he fails to do what he has promised to do, someone has to hold him responsible.
  • If that person is your friend and you agree, you have to stand by her, even if it decreases your chances to get promoted.
  • If the conflicts can’t be solved constructively, one of you might have to leave.

How: Resident in Internal medicine. Specialist training concluded.

  • Replacing ”I don’t have time to…” with ”I don’t prioritize to…” makes it harder to trick yourself.
  • Introducing a new medical specialty is difficult and requires perseverance.
  • A well working group of people will come up with better solutions than any single person.
  • Even if that group decides on something after a long discussion, the work still has to be done in order for things to change.

How: Secretary of the Swedish Society for Emergency Medicine.

  • Medical evidence only applies to settings that are similar to where the data was collected.
  • Well’s score for pulmonary embolism is useless if it takes a whole day to get a d-dimer and the hospital doesn’t have a CT scanner.
  • Patient safety is a concept that needs to be taught, understood and become part of your culture.
  • For sick patients you need a team of doctors and nurses who work well together.
  • Excellent care in the emergency department, followed by inadequate care in the wards, can be life prolonging, but probably not for very long.

How: Clinical rotation in the emergency department of the university hospital in Botswana.

  • Transferring a concept like lean production will not solve the problem if the hospital hasn’t decided whether or not emergency physicians should run the emergency department.
  • You have to choose your battles and avoid unnecessary conflicts.
  • If everyone is wrong and your are the only one who is right, there is nothing to be gained by insisting.
  • Every person has a good side. If you can’t see it, you have to try harder.
  • If you want to learn well in a non-ideal environment, you have to take great responsibility for your own learning.
  • The best way to learn is to teach. It will even make you realize how much your learned in medical school but never understood.
  • When you have fully understood something, you don’t have to revise it to remember it.

How: Resident in Emergency medicine (Still pending). Responsible for the education of junior doctors who had not yet started residency.

  • Global health is extremely complicated.
  • Political organizations develop cultures that are hard to change, but that change people who come to work there.
  • If you want big impact, you have to work through powerful channels.

How: Volunteer at WHO Headquarters in Geneva.

  • If you make your blog posts too long, people won’t read them. (Maybe not yet fully learned)

How: Tweet from the Swedish minister of health saying he started to read my blog post but put it aside when he realized how long it was.

Note to potential employer:

I am not very interested in money. Just give me the average salary for that particular position.
If you show your trust in my capability to do a good job, I will probably exceed your expectations. I won’t hesitate to tell you my opinion in the most friendly and honest way I can. NB! If your department is a mess and you don’t intend to do anything about it and won’t let me try either, please don’t offer me a job. I will make both of us miserable.


I assume most of my previous employers will give me excellent references. The only one who probably won’t, and hence would be the most interesting for you to contact, is the former head of the department where I did my internal medicine residency. He is also, by far, the one with the most impressive looking CV.


Kategorier:education, English

Playing the game of emergency medicine

september 17, 2012 2 kommentarer

The best way to learn a subject is to teach it. This has become obvious to me during the last few months, when I have been responsible for the teaching of the new doctors in our emergency department. Since they are not enrolled in any residency program, it has been all up to me to decide how and what to teach.

Not only have I had to revise all the subjects we have been discussing, I have also tried to learn how to become a better teacher. Therefor we have concluded every four-hour session with an evaluation. In general no one has anything negative to say. I don’t think they like to be critical when they can see how much effort I put into this, but something that does come up frequently is the request for more interactivity. Saying interesting things is just not enough to keep people awake and receptive. So I decided to try a concept I had come up with before: Brainstorm for meducation.

Brainstorm is a quiz-style board game, that I play with my friends. The question takes the form of a topic, and the playing team has to rapidly mention as many things fitting under that topic as possible. When the time is up, the players’ answers are checked against a checklist on the question card. Every answer found on the checklist is worth one point, or two points for more difficult ones. The original game has topics like ”Things you eat at a birthday party”. My version has topics that we have covered during earlier sessions, such as ”Signs and symptoms of hypocalcemia” or ”Possible causes of lower back pain”.

So, this is how it works. A team should have three or four members and I think it is hard to handle more than four teams. To involve as many people as possible in every question I let someone from the opposite teams read the question and mark the correct answers on the card. Every card has a topic with five to ten correct answers. I choose relevant answers from Medscape, so that it is easy to go back to the source if there is any controversy. To avoid unnecessary frustration and endless debates, I thoroughly inform the participants that if an answer is correct, but not on the card, they won’t get any points. Another person writes all the answers on the white board. I have tried both two and three minutes per question and I think two minutes are usually enough.
So for two minutes the whole team is brainstorming around the subject, creating an atmosphere where saying the right thing is less important than coming up with many suggestions. Often wrong answers are corrected by other team members, but it is somehow less intimidating and embarrassing to say stupid things when you are playing a game. And misconceptions are always important to bring out, so they can be replaced by a deeper and more correct understanding.

When time is up, the answers on the board are compared to the ones on the card. Now the group’s collective knowledge has been brought out, and this is when the actual teaching takes place. I highlight and elaborate on some of the answers and also address the wrong ones. It is brief and intense, and nobody dozes off.

The first time we tried this everyone was extremely positive and when it wasn’t included in the next session, they were disappointed. So now I have decided to make it a part of every session. With three teams they can do two questions each in one hour. Normally, a board game gets boring when you use old questions, because you already know the answers, but here that is exactly the point. The old cards can be used over and over, and new ones can be included. My plan is to add at least two new cards after every session, to repeat what has been taught that day. I am also considering adding bonus cards with more specific questions like ”How to calculate the osmolar gap” or ”Branches of the celiac trunk”, for teams that score a certain point.

Unfortunately, I won’t be able to develop this any further, since I am leaving my position. I will keep the cards, though, and maybe challenge some of the other EM nerds over a beer sometime.