By:  Jessica R


Jessica:  Hi, welcome back. My name is Jessica and I'm the content editor for @daily.absite.fact. Please look for us on Facebook as @AbsiteSmackdown and on Insta as @Daily.Absite.Fact. We are here with the creator of the only ABSITE review book with a video lecture included:  Absite Smackdown!, Dr. David Kashmer.

David Kashmer, MD: Jessica, thanks for having me back on the program.

Jessica:  Hi David. Thanks for coming back. let's touch on current events. Before we get into today's topic, here's what's going on in the news. In the news...the president has officially extended the social distancing guidelines for the remainder of this month, most likely until Easter. If you want to explore the specifics on those guidelines, you can find the link here as part of the transcript of this podcast on our website This affects all of us as a country.  Doctor, what are your thoughts on this situation?

David Kashmer, MD:  Jessica just as you said, the situation is constantly evolving, and what's so tough about this particular virus is its long sort of latency period. The time when people are able to transmit the disease to others but have no real symptoms.  That makes this tough. Now, I'm not a virologist, or immunologist. I'm not an infectious disease sub-specialist. But just having the background as a physician, I can tell you this is a tough one.

It does, preferentially, kill older people. That's not necessarily just because it infects them any more often. It's just that its consequences tend to be more devastating.

You know, influenza has killed about 30,000 plus people in the US since last October. The coronavirus is much less than that as of when we are taping this podcast.  Only about 3000 to 4,000 in these months since we've identified and focused on it as of the time we are taping here.  But its rate seems to be faster. it's a difficulty. Again, it seems to be in part that transmissibility.  So bottom line, however, we want to put the healthcare terms on it or not. This one's tough. It's been tough on us economically. Like we said, it looks like it's going to continue to be so in the United States as the president, as you said, sort of extended, the social distancing guidelines, which again, you'll have the link for on the website.

Jessica:  So with the social distancing, many of us have the privilege of doing our 40 hour work week from the comfort of our own homes. Kind of that's the only upside to this whole thing. But for healthcare workers and people in that industry like yourself that does not apply.  You guys are in the trenches, especially the residents. Even with their newly accepted offsite clinical hours, I was researching for my blog and I read that in 2003, the ACGME dictated residents cannot put in more than 80 hours in the clinical or hospital setting.  80 hours. That is a lot.

David Kashmer, MD:  Well, it is.  When you think of a typical work week or the expectations about 40 hours hearing the idea that the resident work week was limited to 80 hours sort of seems funny.  But it was, and we abide by that. It's changed a lot of what we have to do on the training side since then. There used to be a focus really on a brute force training.  Doing a lot of cases, you know, swinging the bat, the club or whatever.

A lot of times that focus is on doing it again and again. Now they still sure do plenty of cases. However there's more of a focus on deliberate practice and proper practice, making sure the educational components fleshed out, teaching differently.

Since this work hours change came down after something called the Bell commission, findings from a sort of an index case that came out in New York, the bottom line is things are very different. But that is the current situation. Residents sure do work long hours and the limitation is approximately 80 hours,


Jessica:  But that is 80 hours in the hospital & the clinic. That's not counting their commute. That's not counting their study time. That's not counting the stuff that they're doing. That's still really over 80 hours. It's just not in that operating room.

David Kashmer, MD:  Well, I think you make a great point. they do have to live life study and do all these other things beyond just that very formal training time. You know, the term resident came from the fact that originally these trainees were residents in the hospital. They lived in there, they got their laundry done there, they got their food there. much of that spirit continued since the concept of residency was sort of invented.

Nowadays, the world has shifted around us. We have to do a better job as educators. We have to work and train them differently. We've really focused on that in our residency and there's a huge component of what you said, the resident staff, even though they're now limited to 80 hours of this more formalized training that we provide, they have to do what they have to do. Otherwise, whether that be commute, get food, live life, it's still a very challenging to be a resident.


Jessica:  Even with that limitation that you talked about speaking of the challenge because that time that they have to live their life and do things outside the hospital is so limited, how do you think they can maximize that time to get the most out of it Because that's the time that they have to use, not just for lives, but to study. They have boards, they have the ABSITE tests, they have everything. What, what makes it easier for them to just maximize that limited amount?


David Kashmer, MD:  Well, you've hit on one of the reasons why we did what we did creating the Absite Smackdown. And here's why. Absite Smackdown! includes this video lecture series that you can listen to and watch on different devices, all sorts of different devices, along with a review book that follows it pretty much spot on. And the reason we did that is exactly what you said. How can you maximize your scarce time? You know, it's really a question for everybody, but it's especially important for resident staff because things are so limited. So what can be done?

Well, resident staff listen to podcasts. There are other surgical podcasts out there already. They watch videos, they do all these things as they go about living their life. Now of course you can't watch a video or at least you probably shouldn't while you're driving a vehicle.

But you can listen to the audio portion of it. You can, when you get to where you're going review the lecture notes in the book. And I think the way to really think about the Absite SmackDown is it's a great complete ABSITE lecture series that you don't have to travel or fly for. You can cut out all that nonessential stuff like travel. It's less expensive than traveling for an ABSITE review. Of course, we can't travel nowadays anyway, but what you can do is purchase this course with a book together that follows as if it's lecture notes and doing that is one of the ways.  The residents can maximize their scarce time and try to get this content processed.

Jessica:  That is the feeling I get from it. I know it is a book, but it's more like the video is the main component and that's what you're there for. And then the book follows along with it. Was that your intent?

David Kashmer, MD:  It was, and I think you guys on the publishing side really followed up on that.  That's how we initially designed it. We made the video course with the particular facts that you need for the ABSITE. You know, a lot of the review book materials, with respect to the factoids, they're the same.

The difference here is having a course and then a work that follows along with it, of course.  Again, you don't need to travel for anything like that. It keeps it easy. And that's really what it's about for residents to maximize their scarce time. It's gotta be easy. It's gotta be the bulk of the content they need. It's gotta be really helpful to them, really easy to get, and really accessible on different devices. That's the key. And so that's what we tried to set up with this excellent review course with a book that follows along almost as lecture notes.

Jessica:  So, speaking of the devices, can you just real quick maybe give our listeners a rundown of some of the platforms and devices they're able to use with this?

David Kashmer, MD:  Yeah. You guys set it up really well. it's hosted on a site that allows a lot of this. I'm not the tech guy for it, so I don't know them all. But last time I checked, iOS. So the Apple devices, all the Macs, iMacs, et cetera.  Android, all the different Google operating systems, the PC, and Linux, all the different platforms that you can use, via web browser, et cetera, all the different web browsers that I'm familiar with, the common ones work with it. So the staff who set it up did a great job putting it across all the different platforms in a way that was accessible.

Jessica R:  I want to give a little bit more props to the publishing company and the people that set that up because by doing it this unique way where you have the lecture series and the book that follows, we have the opportunity to cut down on a big problem in publishing, which is piracy. And because the fact that when you purchase this, you get the links to the videos and without the videos, it's not that the book isn't useful, but you know, you want those lecture videos and you have to purchase the book to have those.

And so anyone could take your book and converted and put it online, but then you're lacking all that matters. So the way they did at this time with all the steps they took to protect the book and make it better and keep it safe from piracy, it's definitely different than anything I've seen before. How did you feel as the author with the way they handled

David Kashmer, MD:  I thought it was a great way to protect the content. it was a great idea to set it up that way really. Again, like you said earlier, this is a lecture review course that has a book along with it for notes. It's sold as a book that let it be sell so easily on Amazon that let it be sold easily on other platforms. But it's packaged together. And I'll tell you as the author, it's been a really interesting experience, Jessica, because within a week of it coming out, the book was bought in countries across the world and in several of those countries, people took the book and made it into a PDF and put it online. Now I don't know whether big publishers who do that as a way to eliminate competition or why else somebody would do that, but there's just no way you're going to figure out who pirated the book and get to the bottom of that trail if that even is what happens.

And it's costly to do. I can imagine, I guess as a publisher because a lot of money to figure out how that happened. So it's an interesting technique and I think you guys were very smart and saying, we're just going to only sell these together. And in doing that you can take the book, the lecture notes and you can put it online. And this is also interesting. A lot of the content, like the high res photos and different things are in the lecture series, but not as much focused on in the book at all. And the reason why is sure you can pirate the text from the book, but it doesn't give you the experience that you need. It doesn't represent the content completely. And so when people do that or another, I dunno, publishing company or somebody tries to pirate it, it's just not as effective.

It's just sort of the lecture notes and it doesn't mean the same thing. And I'll add even one more thing on a personal note. I watched the reviews and as you know, you know you all strategy along with me is to learn from their reviews, improve the book for the next edition and it's a really good strategy.  Listening to what people want and the changes to tweak it. I can't wait to see what comes next. The reviews that were negative, some are fine, it's gotten very few overall negative reviews, but some of them were outright not real.

You would try to get to the bottom of who said, I think one or two reviews would say, "Oh the, the videos are not really sold along with the book" and well that's not correct at all.  The come with the book of course.  So some reviews were outright untrue.

But it is challenging to get the fake reviews removed.

And it's really been interesting to see how piracy and scam online reviews that are intentionally negative and misrepresent the work get on there. And it's just been really interesting for me to learn how you guys have kind of dealt with all that and the good choices you made up front with how you went to publish it. So as an author, I really appreciate that working with you guys.

Jessica:  Yeah, I think it was just great. I think anyone that reads this and knows the way the system works and how we have it set up, they can look back at those reviews now and be like, Oh that's a pirate. You know, cause if you actually purchased the program, you know exactly how it works and why it's set up that way and how beneficial it is. So I mean I think there's a lot the team here did right in that capacity as well as much more that they did correctly. Obviously, I feel like from the positive feedback from our readers, it really attests to that. And I'm excited to continue to not only work on this book, but growing and hopefully expanding into the new stages. I really enjoy having you on the show doctor, and I'm wondering if maybe we could do this weekly.

David Kashmer, MD:  Yeah, I appreciate it. I like that the you all asked me to do some content focused ones, like things about jaundice and different clinical scenarios with the resident staff. I've appreciated being able to make those, but I gotta say I do like it when I'm not just kind of on the host side and in the host role. So, yeah, I appreciate it. I would come back and talk with you again and we'll see where it goes. I do appreciate it.

Jessica:  Well, we're looking forward to it. And as always, this is Jessica, the content editor for @daily.absite.fact.  Look for us on Facebook and Insta.  #AbsiteSmackdown!

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