Bitcoin Proof of Stake: A Peer-to-Peer Electronic Cash System
Bitcoin mining is analogous to the mining of gold, but its digital form. The process involves specialized computers solving algorithmic equations or hash functions. These problems help miners to confirm blocks of transactions held within the network. Bitcoin mining provides a reward for miners by paying out in Bitcoin in turn the miners confirm transactions on the blockchain. Miners introduce new Bitcoin into the network and also secure the system with transaction confirmation.
We are an activist hivemind based on the principles of **equality, freedom and democracy**. Fighting for the [free flow of information](https://youtu.be/iY57ErBkFFE), we will operate as a free and open subreddit.
Vespucci is a system that evaluates cryptocurrencies using a large set of sources. Read more:https://volentix.io/documentation/vespucci-crypto-rating/ … #volentix #vdex #vespucci #verto #venue #bitcoin #eos #dex #crypto #decentralized #p2p
19 things you can do with Bitcoin: Get money in and out of China, Iran, and other restrictive countries; send money overseas cheaper than wire transfers; create a practical system for micropayments; sign electronic documents; create contracts that execute themselves; and more.
"Thanks for the interest in the double spend detection and instant transaction insurance work for #bitcoin #BSV it's very encouraging. I've documented the current intended design for these systems http://doublespenddetection.com/ Feedback welcome."
"Thanks for the interest in the double spend detection and instant transaction insurance work for #bitcoin #BSV it's very encouraging. I've documented the current intended design for these systems http://doublespenddetection.com/ Feedback welcome."
https://Peur.io marketplace ensures business continuity - ensure seamless knowledge transfer without documented systems and data recovery plans—even with changes in your company’s infrastructure. #peur #cryptocurrency #bitcoin #dash #litecoin #ethereum #ico #blockchain
Bitcoin mentioned around Reddit: Hackers released documents that indicated the U.S. National Security Agency had accessed the SWIFT interbank messaging system, allowing it to monitor Middle Eastern and Latin American banks. The relea /r/worldnews
I thought I'd write about the last four years, an eventful time for Bitcoin and me. For those who don't know me, I'm Hal Finney. I got my start in crypto working on an early version of PGP, working closely with Phil Zimmermann. When Phil decided to start PGP Corporation, I was one of the first hires. I would work on PGP until my retirement. At the same time, I got involved with the Cypherpunks. I ran the first cryptographically based anonymous remailer, among other activities. Fast forward to late 2008 and the announcement of Bitcoin. I've noticed that cryptographic graybeards (I was in my mid 50's) tend to get cynical. I was more idealistic; I have always loved crypto, the mystery and the paradox of it. When Satoshi announced Bitcoin on the cryptography mailing list, he got a skeptical reception at best. Cryptographers have seen too many grand schemes by clueless noobs. They tend to have a knee jerk reaction. I was more positive. I had long been interested in cryptographic payment schemes. Plus I was lucky enough to meet and extensively correspond with both Wei Dai and Nick Szabo, generally acknowledged to have created ideas that would be realized with Bitcoin. I had made an attempt to create my own proof of work based currency, called RPOW. So I found Bitcoin facinating. When Satoshi announced the first release of the software, I grabbed it right away. I think I was the first person besides Satoshi to run bitcoin. I mined block 70-something, and I was the recipient of the first bitcoin transaction, when Satoshi sent ten coins to me as a test. I carried on an email conversation with Satoshi over the next few days, mostly me reporting bugs and him fixing them. Today, Satoshi's true identity has become a mystery. But at the time, I thought I was dealing with a young man of Japanese ancestry who was very smart and sincere. I've had the good fortune to know many brilliant people over the course of my life, so I recognize the signs. After a few days, bitcoin was running pretty stably, so I left it running. Those were the days when difficulty was 1, and you could find blocks with a CPU, not even a GPU. I mined several blocks over the next days. But I turned it off because it made my computer run hot, and the fan noise bothered me. In retrospect, I wish I had kept it up longer, but on the other hand I was extraordinarily lucky to be there at the beginning. It's one of those glass half full half empty things. The next I heard of Bitcoin was late 2010, when I was surprised to find that it was not only still going, bitcoins actually had monetary value. I dusted off my old wallet, and was relieved to discover that my bitcoins were still there. As the price climbed up to real money, I transferred the coins into an offline wallet, where hopefully they'll be worth something to my heirs. Speaking of heirs, I got a surprise in 2009, when I was suddenly diagnosed with a fatal disease. I was in the best shape of my life at the start of that year, I'd lost a lot of weight and taken up distance running. I'd run several half marathons, and I was starting to train for a full marathon. I worked my way up to 20+ mile runs, and I thought I was all set. That's when everything went wrong. My body began to fail. I slurred my speech, lost strength in my hands, and my legs were slow to recover. In August, 2009, I was given the diagnosis of ALS, also called Lou Gehrig's disease, after the famous baseball player who got it. ALS is a disease that kills moter neurons, which carry signals from the brain to the muscles. It causes first weakness, then gradually increasing paralysis. It is usually fatal in 2 to 5 years. My symptoms were mild at first and I continued to work, but fatigue and voice problems forced me to retire in early 2011. Since then the disease has continued its inexorable progression. Today, I am essentially paralyzed. I am fed through a tube, and my breathing is assisted through another tube. I operate the computer using a commercial eyetracker system. It also has a speech synthesizer, so this is my voice now. I spend all day in my power wheelchair. I worked up an interface using an arduino so that I can adjust my wheelchair's position using my eyes. It has been an adjustment, but my life is not too bad. I can still read, listen to music, and watch TV and movies. I recently discovered that I can even write code. It's very slow, probably 50 times slower than I was before. But I still love programming and it gives me goals. Currently I'm working on something Mike Hearn suggested, using the security features of modern processors, designed to support "Trusted Computing", to harden Bitcoin wallets. It's almost ready to release. I just have to do the documentation. And of course the price gyrations of bitcoins are entertaining to me. I have skin in the game. But I came by my bitcoins through luck, with little credit to me. I lived through the crash of 2011. So I've seen it before. Easy come, easy go. That's my story. I'm pretty lucky overall. Even with the ALS, my life is very satisfying. But my life expectancy is limited. Those discussions about inheriting your bitcoins are of more than academic interest. My bitcoins are stored in our safe deposit box, and my son and daughter are tech savvy. I think they're safe enough. I'm comfortable with my legacy.
Part 1Part 2 I'm at $BigClient, which is taking a Citroen like approach to infrastructure and operations. "We recognize that the McPherson strut is simple, efficient, good enough for most use cases and accepted by everyone in the industry, but we shall do it with hydraulic fluid at high pressure. What could go wrong?" Except $BigClient's far away from a competent Citroen shop. $BigClient's Citroen has gone through a few years of 'just keep it running on the cheap' upkeep without access to factory parts. I've got an odd patching problem on a handful of servers. Systems are rolling back to insecure versions (2.0.2 ->1.4.6) and nobody knows why. Or at least, nobody's talking. I don't know what to do yet, so I decide to go and get lunch. I work out the possibilities.
There's something wrong with our validation procedure- they're actually patched and we're reading the wrong thing.
There's something or someone else downgrading these systems.
Number 1 requires more documentation, which $BC doesn't seem to want to show me. Number two might be hiding in logs, which are emailed to me on a regular basis. I walk back to my cubicle, grab my laptop and a notebook and find a quiet corner to figure things out. I find one in a tiny conference room. I read through my emails and search for any of the logs from the api servers. I spend about ten minutes on Stack Exchange for the appropriate sed, awk, tee and cat munging to pare them down to what I want. Eventually I dump them all to Excel, because I am a bad person. Some filtering and I can see what's going on. The system orchestration updates each server every other midnight. I see about three quarters of them download the 2.0.2 version as a part of the night's update. Every two nights a (seemingly) random selection of servers updates. I scribble the order on the conference room whiteboard and stare at them for a few minutes. Nothing in the orchestration system logs shows another process loading the older 1.4.6. version. But something is. Nothing in the logs emailed to me obviously points to another process. I take a walk to get a coffee and think. Nothing comes to me and I have to scour the kitchen for unflavored coffee. I walk back to my conference room to find an intern-like person. me:"Hey, I apologize. I didn't know the room was reserved. I'll take my stuff." Other person:"That's ok. Are you Rob?" me:"Nope, sorry" I take my stuff and make my way back to my cubicle. A few minutes searching leads me to a shared root password for the servers stored in the password vault. I login to one of the remaining servers running 2.0.2 and look at the running processes. Nothing obvious like "random updater". I'm stumped. I lean back and stare at nothing in particular trying to come up with some ideas. Unfortunately, it's fairly packed and I'm next to a bullpen. Voice 1:"So the Sky Caps put blotter in the vat without telling anyone" Voice 2:"Hilton Honors kicks' Marriott Bonvoy's ass any day." Voice 3:"No, I'll pick her up at 4" The voices wash over me in some clip reel workplace sitcom haze. I'm not going to get anything done. I take a walk around the offices to get the lay of the land. It's a Hanna-Barbera cartoon of grey cubefarms, tan breakrooms, free coffee but no snacks. The only attempts at color are people's cubicles. Family pictures, shirtless men with fish, desk toys and action figures. It's like a mall- everything's pleasant, non threatening and in identically-sized stalls, with colorful (but bounded) individuality, all for commerce. Then I find the Hot Topic meets Successories manifesting in a cubicle. There are two dorm-room sized posters of the gold Bitcoin-coin, along with framed inspirational quotes about success and perserverance set against pictures of Game Of Thrones characters and muscle-bound men in insignia-less camo. A new leather jacket with an embroidered skull is on the back of the chair. This person is either a hoot or insufferable. I keep walking. I have a breakthrough. Where are the API servers getting the older version to install? Maybe that'll lead me into the library. I'm not yet Adso, but perhaps I'm one of the other ,lesser scribes copying my book and scribbling fanciful drawings of the things I miss, like decent coffee and a cell-mate that doesn't snore. I walk back to my cubicle. A different intern-shaped person is in the conference room, all alone. I can't save them. Eventually they'll be standing in the corner of their cubicle looking away while the middle manager cleans out the rest of their team. I'm in my seat. Some searching results in a few possible repositories. Some more searching finds me the one repo that still has v1.4.6 of this application. Just to make sure, I compare a downloaded copy of v1.4.6 and the installed version of v 1.4.6 on one of the servers. I search all the folders and files for the URL of the repo server and find it. In the application itself. The server waits every two days and looks to the repo. If the installed version is not equal to v 1.4.6, it downloads v 1.4.6 from the server and installs it, then forces a restart. This code is commented out (made non-executable) along with an actual comment: /REMOVE BEFORE PRODUCTION I quickly scan through the API servers to find one of the ones still running 2.0.2. I search for the term "REMOVE BEFORE PRODUCTION" And there it is, in the application code. Except it's not commented out. In a text editor, I write up my findings, conclusion and a recommended fix- delete the upgrade code snippet, increment to 2.0.3, push it out using the orchestration tool and call it a day. LC Chat won't let me attach my text file, so I breathlessly LC Chat my document, line by line at Vincent, the poor bastard tasked with closing audit finding 162, the mystery of the random rollback. Vincent:... Clearly, Vincent is choosing his congratulatory language carefully. Vincent:"Can't apply the fix. The application is owned by Development. They're behind on other things, so they won't update the software until next quarter." me:"It's about thirty lines of code we can comment out" Vincent:"Can we say it's fixed for the audit since we know what the problem is?" me:"No. We can patch it, or we could write up a remediation plan and get it on some schedule." me:"But that's more paperwork than the actual fix." Vincent:"But Ops isn't on good terms with Development." me:"So they're not going to touch it any time soon." Vincent:"Probably not" me:You guys own that repo server, too" Vincent:"I don't see how that's good for anything" me:"We cut out the update code in 2.0.2 and call it 2.0.3. We name the file 1.4.6 and replace the existing 1.4.6 on the repo server. Either the app gets updated via your orchestration server or it updates itself. We're fixed in two days either way. Vincent:"But policy requires that we get approval" me:"There's an exception, if you have a superior in Operations to sign off, you can call it an emergency fix. Ask Trevor. He just needs to not tell anyone else. You submit the ticket and eventually the devs will get to it and fix the problem for good. Until then, you pass that part of the audit." Vincent tells me he's going to talk to Trevor. I'm going to take a walk. Out of curiosity, I go back to the Hot Topic cubicle to get a look at its occupant. The jacket is gone and the monitors are off. Mystery person has left for the day, I assume. I look at the large jars of nutritional supplements with macho names- Gorilla Rage, LumberJacked, Psycho Focus". I notice the name-plate on the outside of the cubicle. Oh, no. Ian. To Be Continued... edit- made modifications to satisfy Internal Audit 8-)
/r/Monero Weekly Discussion – July 11, 2020 - Use this thread for general chatter, basic questions, and if you're new to Monero
Wallet: CLI & GUI
1. General questions
Where can I download the Monero wallet?
There are multiple Monero wallets for a wide range of devices at your disposal. Check the table below for details and download links. Attention: for extra security make sure to calculate and compare the checksum of your downloaded files when possible. Please note the following usage of the labels: ⚠️ - Relatively new and/or beta. Use wallet with caution. ☢️ - Closed source.
"Official" GUI / CLI
Windows, macOS, Linux
Default implementation maintained by the core team. Use this wallet to run a full node and obtain maximum privacy. Integrates with hardware wallets. Current version: 0.15.0.1 / 0.15.0.4.
Your balance is unlocked after 10 confirmations (which means 10 mined blocks). A block is mined approximately every two minutes on the Monero network, so that would be around 20 minutes.
How can I prove that I sent a payment?
The fastest and most direct way is by using the ExploreMonero blockchain explorer. You will need to recover the transaction key from your wallet (complete guide for GUI / CLI).
How do I buy Monero (XMR) with Bitcoin (BTC)?
There are dozens of exchanges that trade Monero against Bitcoin and other cryptocurrencies. Check out the list on CoinMarketCap and choose the option that suits you best.
How do I buy Monero (XMR) with fiat?
Kraken (USD and EUR): old-school, decent exchange. They might require your documents for verification and approval of your account.
LocalMonero: peer-to-peer exchange. They have pretty much everything as a payment method and they support hundreds of fiat options.
How can I quickly exchange my Monero (XMR) for Bitcoin (BTC)?
There are multiple ways to exchange your Monero for Bitcoin, but first of all, I'd like to remind you that if you really want to do your part for Monero, one of the simplest ways is to get in touch with your merchant/service provider and request for it to accept Monero directly as payment. Ask the service provider to visit the official website and our communication channels if he or she needs help with system integration. That being said, the community has been recommending two services in particular, XMR.TO and MorphToken. These services are only recommendations and are operated by entities outside the control of the Monero Project. Be diligent.
How do I mine Monero? And other mining questions.
The correct place to ask questions and discuss the Monero mining scene is in the dedicated subreddit MoneroMining. That being said, you can find a list of pools and available mining software in the GetMonero.org website.
2. Wallet: CLI & GUI
Why I can't see my balance? Where is my XMR?
Before any action there are two things to check:
Are you using the latest available version of the wallet? A new version is released roughly every 6 months, so make sure you're using the current release (compare the release on GetMonero.org with your wallet's version on Settings, under Debug info).
Is your wallet fully synchronized? If it isn't, wait the sync to complete.
Because Monero is different from Bitcoin, wallet synchronization is not instant. The software needs to synchronize the blockchain and use your private keys to identify your transactions. Check in the lower left corner (GUI) if the wallet is synchronized. You can't send transactions and your balance might be wrong or unavailable if the wallet is not synced with the network. So please wait. If this is not a sufficient answer for your case and you're looking for more information, please see this answer on StackExchange.
Why does it take so long to sync the wallet [for the first time]?
You have decided to use Monero's wallet and run a local node. Congratulations! You have chosen the safest and most secure option for your privacy, but unfortunately this has an initial cost. The first reason for the slowness is that you will need to download the entire blockchain, which is considerably heavy (+70 GB) and constantly growing. There are technologies being implemented in Monero to slow this growth, however it is inevitable to make this initial download to run a full node. Consider syncing to a device that has an SSD instead of an HDD, as this greatly impacts the speed of synchronization. Now that the blockchain is on your computer, the next time you run the wallet you only need to download new blocks, which should take seconds or minutes (depending on how often you use the wallet).
I don't want to download the blockchain, how can I skip that?
The way to skip downloading the blockchain is connecting your wallet to a public remote node. You can follow this guide on how to set it up. You can find a list of public remote nodes on MoneroWorld. Be advised that when using a public remote node you lose some of your privacy. A public remote node is able to identify your IP and opens up a range for certain attacks that further diminish your privacy.A remote node can't see your balance and it can't spend your XMR.
How do I restore my wallet from the mnemonic seed or from the keys?
To restore your wallet with the 25 word mnemonic seed, please see this guide. To restore your wallet with your keys, please see this guide.
3. Wallet: Ledger
How do I generate a Ledger Monero Wallet with the GUI or CLI?
This question is beautifully answered on StackExchange. Check this page for the GUI instructions, and this page for the CLI instructions.
How can my local node become a public remote node?
Decentr ($DEC) - foundational cross-chain and cross-platform DeFi protocol
Decentr is a protocol designed to make blockchain/DLT mainstream by allowing DeFi applications built on various blockchains to “talk to each other”. Decentr is a 100% secure and decentralised Web 3.0 protocol where users can apply PDV (personal data value) to increase APR on $DEC that users loan out as part of of our DeFi dLoan features, as well as it being applied at PoS when paying for stuff online. Decentr is also building a BAT competitor browser and Chrome/Firefox extension that acts as a gateway to 100% decentralised Web 3.0
Allows DeFi Dapps to access all Decentr’s dFintech features, including dLoan, dPay. Key innovation is that the protocols is based on a user’s ability to leverage the value of their data as exchangeable “currency”.
Decentr is building foundational chain-agnostic protocols that will support “true” 100% DeFi Dapps, a 100% secure and decentralised, user-centric alt economy. DeFi dApps inter-connected by Decentr can talk to each other and share PDV (personal data value) of their users. PDV is best described as a personalized “exchange rate” (in a sense social reputation where more effort leads to more rewards and NOT more capital to more rewards. ) between currencies that users apply at point-of-sale to make the cost of goods and services cheaper online. PDV is applied to the APR users earn on $DEC (native token) that they hold that they loan out as part of the investing pool. PDV will also allow uncollateralized loans on their dLoan platform, and also on platforms like Aave and Compound.
Decentr will implement ZKsync to get super cheap and super fast transactions across the ETH network. It is also working with HoloChain and Tomochain to allow connect their DeFi ecosystem to the Ethereum DeFi ecosystem. Decentr has DEEP TIES and a PARTNERSHIP with Holochain: https://medium.com/@DecentrNet/decentr-holochain-ama-29d662caed03
Decentr is also building a browser and Chrome/Firefox extension - a gateway that “transitions” Web 2.0 into a 100% decentralised Web 3.0 via their suite of decentralised dFintech and dCommunications features. The browser adds a 100% decentralised “user layer” to current blockchain protocols so that applications built on blockchain can actually “talk to each other”. The browser uses encryption all the time and the power of blockchain to keep private keys safe. Browser will offer a more robust and innovative type of blockchain storage and caching that is much faster than VPN or TOR. It will allow surfing .onion addresses as well as the regular ones. >>BAT browser 400m marketcap, DEC marketcap 4m<<
Decentr is researching a hardware application, powered by Decentr software, that would greatly enhance current IoT networks. It’s called a “Smart Chip Node” (SCN) and will adhere to 4G LTE standards (with in-built 5G capability), which means connectivity between devices will match or exceed current speed and connectivity, dramatically improving stability and coverage of standalone devices, such as a laptop or tablet, as well as IoT devices, such as home routers and modems.
Decentr uses Coinbase API to optimise integrated implementation of the user layer and Blockchain as a Service (BaaS) to allow users to leverage cloud-based solutions to build, host and use their own blockchain apps. Tierion’s technological infrastructure, the Chainpoint Proof protocol, will come into play whenever a user adds something in Tierion’s data store. Hyperledger Fabric and R3 Corda private blockchains are used as an immutable transaction database for data transfers, including the following tech: R3 Corda, Hyperledger Fabric, Ansible, Bitbucket Pipelines, AWS, Node.JS, GoLang, Kotlin and CouchDB.
Implements a system of layered security protocols based on a radically-new software architecture that combines Elliptic Curve Cryptography (ECC)4 and Sobol sequencing with a n-dimensional chain as part of AI-enhanced, platform-wide community consensus mechanism — a mechanism that assigns mutually agreed value to data and user security protocol upgrades (further encouraging enhanced data integrity) by deploying a Delegated Proof of Stake (DPoS) protocol.
Bank of England has reached out to Decenr to discuss the potential of a UK CBDC upon hearing about the potential of their tech. Decentr is consistent with their own R&D into a "dGBP" and they requested a top-level document for review >> Decentr created this proposal: https://decentr.net/files/Decentr_Consultancy_Doc_UK_CBDC.pdf
A fee is charged for every transaction using dPay whereby an exchange takes place between money (fiat and digital) and data, and vice versa, either as part of DeFi features or via a dApp built on Decentr. They are launching pilot programmes in the following industries:
Banking/PSP Industry: On Product launch, due to Decentr’s powerful PSP connections (including the worlds #2 PSP by volume), a medium-scale pilot program will be launched, which will seed the network with 150,000 PSP customers in primarily the Spanish/LAC markets, generating revenue from day one.
“Bricks and Mortar” Supermarket/Grocery Industry: Decentr aims to ensure the long-term competitiveness of “bricks and mortar” supermarkets against online-only grocery retailers, such as Amazon, by a) building secure tech that allows supermarkets to digitise every aspect of their supply chains and operational functions, while b) allowing supermarkets to leverage this incredibly valuable data as a liquid asset class. Expected revenue by Year 5: $114Mn per year.
Online Advertising Industry: Decentr’s 100% decentralised platform credits users secure data with payable value, in the form of PDV, for engaging with ads. The Brave browser was launched in 2012 and in 8 years has reached over 12 million monthly active users, accented by as many as 4.3 million daily active users.
TOKEN $DEC AND SALE
Decentr recently complete their token sale on a purchase portal powered by Dolomite where they raised $974,000 in 10 minutes for a total sale hardcap of 1.25M. The $DEC token is actively trading on multiple exchanges including Uniswap and IDEX. Listed for free on IDEX, Hotbit, Hoo, Coinw, Tidex, BKex. Listed on CoinGecko and Coinmarketcap. Listed on Delta and Blockfolio apps. ➡️ Circulating supply: 61m $DEC. ➡️ Release schedule and token distribution LINK -> NO RELEASE UNTIL 2021.
A tradeable unit of value that is both internal and external to the Decentr platform.A unit of conversion between fiat entering and exiting the Decentr ecosystem.A way to capture the value of user data and combines the activity of every participant of the platform performing payment (dPay), or lending and borrowing (dLend), i.e a way to peg PDV to tangible/actionable value.Method of payment in the Decentr ecosystem.A method to internally underwrite the “Deconomy.
Attention incoming interns! Here's a list of TIPS I WISH I KNEW starting my intern year, some things you can start working on now and some less commonly discussed but very important parts of your job
It’s that time of year and yet again I’ve seen plenty of incoming interns asking what they can do to prepare. I wrote this post to share some tips for all of the not-exactly-medical stuff I wish I knew before I started intern year and to share a few things that interns can do before they start to feel like they’re well prepared for the long white coat. As a quick background, I was a surgery intern in the first half of the 2010s and much of this is informed by my notes and memories from that time in addition to everything I’ve learned since, particularly about professionalism both in medicine and in the business world with work I’ve done in the healthcare startup arena. I’m also not perfect and very much a work in progress myself and, outside the intern-specific items here, I try to do most of these things myself—sometimes more successfully than others. So take what you think are good ideas here, leave what you don’t think would be useful, and if anyone else has anything to add, please feel free to chime in. TL;DR: Intern year is hard. Here are some not-so-commonly-disucussed tips that may help.
1. Being an effective intern is, at its core, about being responsible, effective and reliable.
Your day to day responsibilities are nearly always dominated by the need to get things done and to do so in a manner that lets your other team members focus on their own roles and responsibilities. What about learning clinical medicine? You'll learn plenty and fast. Don't worry. When reading through these tips below, view them from an angle of “would this help me develop an effective system for making sure everything gets done and nothing falls through the cracks?”
2. For your in-the-hospital life as well as your outside-the-hospital life, remember this one thing: you will forget.
You will be busy and have responsibilities in a way you likely have never experienced before. This will naturally make the day-to-day things in life more difficult than you’re used to so developing ways to outsmart your forgetful brain will pay off.
3. You are a professional now. This is your career. You’re in it.
It’s easy to view your life as a trainee as a sort of advanced student or something in between a student and a “real doctor”. But that’s not true. View yourself as a professional building your career. Your intern year is just the first step of that career. You’re a real doctor as much as any other now.
4. One of the hardest things about being an intern or resident is dealing with feelings of isolation. It will take work to actively manage and overcome those feelings.
Imposter syndrome, feeling like you don’t know what you’re doing or that you don’t belong, feeling like you’re not the person you used to be, that you don’t have time to do all the “normal” things that other people do, thinking your co-residents or attendings think you’re dumb, feeling that you don’t have time for friends/family/hobbies, ruminating on “what if I screw this up and hurt a patient?”, or “this doesn’t matter -- the patient is going to XX or YY anyway” etc are all common feelings and they all share the same undercurrent of feeling isolated in one way or another. You need to actively work to find ways to confront and overcome these feelings or else they will control you. When they control you, you’re burned out. It may not seem like it at first, but nearly every single tip below is geared towards avoiding feelings of isolation. Feeling like you’re not in control of your finances will make you feel isolated. Feeling like you’re losing a handle on your relationships will make you feel isolated. Feeling like you’re behind on your email and haven’t done all the little things in life you need to do will make you feel isolated. Read these tips through that lens.
What you can do before you start
1. Organize and update your contacts. Seriously.
Here are some ways it can help you maintain and grow your relationships.
Use the ‘Notes’ feature in your contacts for everyone important in your life and all the new people meet.
You will forget your friends’ kids names and ages. Every time you get a birth announcement or see a post on social media, go to your friend’s contact, edit the notes and put in the info. Then, when you reach out to your friends, ask about their kids...by name.
You will forget your friends’ boyfriend/girlfriend/wife/husband/partner’s name, especially if you’ve never met them or haven’t seen them for a long time. Put their name in your friends’ card with a note like “Started seeing Sam in June 2020, he/she’s a software engineer”. Someone you know gets married? Add their wedding date to their card.
You will forget how you knew people in your contacts. Met at a conference? Was a medical student on your heme onc service? Friend-of-a-friend you met at a wedding? Someone shares an interest you have? Make a note in their contact card. Tip: these notes are for you, not them. So if someone reminds you of an actor, or didn’t stop talking about bitcoin, make a note. It will help because you will forget.
Tag your contacts or add them to lists and use those tags/lists to your advantage.
Make lists or tags for your family, your medical school friends, your undergrad friends, your coresidents, your attendings, your medical students, the hospitals you’ll be working at, etc. Put those lists or tags to use like this:
You will forget to stay in touch with people important to you. Set reminders in your phone for every week / two weeks / month, etc to pull up a list (family, medical school friends, etc), pick someone on that list you haven’t chatted with in a while and text them and ask them how they’re doing. Aim to start a conversation, ask about what’s happening in their life. Texts are more personal and meaningful than liking a post on social media or sharing a meme. Initiating conversations with your friends and family will help you feel connected and will increase the likelihood they reach out to you.
Don’t label your medical students like “MS3 Laura” or “Sub-I Juan”, etc. Label them with their full name and treat them like the colleagues they are. Put them on a list, clear it out next year if you want, but don’t treat them as “MS3 XXX“ or “MS4 YYY”. I’m sure you remember feeling like a nameless/faceless medical student at times in school and I’m sure you didn’t love it. So don’t repeat that behavior. Add a note or two about them while you’re at it. Take enough interest in your medical students to treat them well. You never know when or how you’ll cross paths with them again.
If you rotate through different hospitals, you will forget which “ED” or “PACU” or “nursing station 3rd floor” numbers are which. Tag them or put them on a list. It’ll make finding them when you need them much easier.
2. Use a good note taking app and a good task manager app to help with both your in-hospital life and your outside-of-the-hospital life.
Here are some ways to use a notes app.
Make a note for each rotation you’re on. Add in any unstructured tips as they come up, like “Send all of Dr. X’s patients home with Y”, “Use the call room in the basement outside of the locker room, passcode 1234”, “Park in the X lot on the weekends”, “Dr. A likes to manage Z with Y”, “The case manager, NAME, usually sits at the computer behind the 2nd floor nurses station”, etc. Don't overthink them, just write them down when they come up. Review those notes the next time you rotate through because you will forget all those little things and they will help you in the future.
Create a master grocery list of all things you typically get at the grocery store. Share it with a roommate/partner so they can keep it updated too. That way if you ever stop to pick something up, you can review the list to make sure there’s nothing you’ll forget.
Make master lists for other things in your life too like “packing for a conference”, “packing for a family trip”, “Target/Wal-Mart household master list” so you can quickly review anytime something comes up so you minimize the chance of forgetting something
Make notes for all of the other stuff you have to manage in your life like your car, your apartment/house, your loans, etc and update them every time you work on that thing. Change your loan repayment? Add it to the note. Have to get your brakes fixed? Add to the note where you got it done, how much it cost, etc. Talk to your landlord about fixing the shower? Add it to the note. Have to call the medical board to sort something out with a license? Add it to the note.
I like two note apps on iOS: Bear for personal notes since it’s fast and has great tagging and Apple’s Notes app for shared notes
Pick a good task manager app and use it for all the things in your life that aren’t your day-to-day work
Cousin getting married and you can go to the wedding? Make tasks to ensure your time off, book your travel, buy a gift, rent a hotel room, etc. Then put all the relevant info into your note because...you will forget.
Pandemic is over and you get to present a poster at a conference? Make tasks to review your draft with your coauthors, print your poster, book your travel, submit your reimbursement, etc. Then put all the relevant info into a note. Otherwise, you’ll forget.
I like Things and have also liked OmniFocus. There is a ton of content on how to set one of these things up for productivity so review it and use it YouTube search
3. Take charge of your finances
When I was an intern, I figured all I had to do was pay my loans and not go into more debt. I wish I had done the following instead:
Read these two books: The White Coat Investor and I Will Teach You To Be Rich. Both are very good and have different strengths. The WCI is directly applicable to you and will help educate you in ways medical school didn’t about your financial future. IWTYTBR is much more of a “millennial” book but it’s very good for explaining big concepts and for providing a system to set yourself up for success. They’re both easy and relatively quick reads and don’t require any financial background. WCI is fine as an e-book but IWTY has a bunch of dialog boxes that make the e-book a poor experience, get a physical new or used copy.
Set up a budget. I use and swear by You Need A Budget. It’s the best money I spend every year. Their system is easy and straightforward and it doesn’t take long to get the hang of it. I can’t recommend it highly enough.
4. Update your CV now and keep it updated regularly
You will no doubt have to share your CV with someone at some point whether it’s for fellowship or a research project or any number of things. The time to work on it is not when someone says “can you share your CV?” -- that’s a recipe for omissions, typos and mistakes. The only thing you should be doing every time you share your CV is giving it a quick once-over to make sure you don’t spot any mistakes and to make sure it’s up to date There are plenty of templates online and your training institution may even have a preferred format somewhere on their website. Your ERAS application will give you a good head start but most of your medical school CV lines will either be condensed or removed all together unless something was particularly notable. You can almost always find example CVs online from senior people in your department or institution with a quick web search -- use a few as a guide Set a reminder / task to update your CV at regular intervals. Quarterly is good, yearly at least. Save new versions of it each time so you can refer to the old ones if you need to and name them in a way to let you know you’re always sharing the most recent version, e.g., LASTNAME_FIRST NAME_CV_2020-06. You will forget if the one marked “CV” only is the right one you want to share.
5. Subscribe to a couple of newsletters to stay up to date with the world outside of your hospital
For general news, your preferred newspaper probably has a daily email briefing. Otherwise, Axios AM/PM and Politico’s Playbook are both very good quick reads to stay up to date with current events.
Keep up with healthcare news so you know what’s going on in the healthcare system broadly
Politico’s Pulse and Morning eHealth are both very good and have quick facts at the beginning if you just want to skim
Rock Health’s Rock Weekly is a decent summary of each week in the healthcare startup and technology world
Pick a few of these and aim to get through them each day. If you can’t get through them, unsubscribe to the ones you think are least relevant to you so you never feel “behind” in staying up with the news. You can breeze through the few you pick in a few minutes here and there throughout the day -- don’t make it any harder than that to feel like you’re “up to date” on the news.
General tips for maintaining relationships
For any romantic relationship, do these things if you don’t already:
1. Make a rule: no phones at the table. * Don’t put your phone on the table face-up. Don’t put your phone on the table face-down. Keep your phone off the table and set to silent. * Focus on the person in front of you and show them you care about them by paying attention to them. We all know what it feels like to be with someone more interested in their screen than in interacting with you. If you’re on call, say “sorry, I’m on call, I may have to check something here and there”, apologize if you do check it and then put your phone away. 2. Make another rule: no phones in bed * Same principle as at the table. Want to feel like two strangers just passing through life who just so happen to share the same bed? Wake up, reach for your phone and scroll through your feeds like a zombie before getting out of bed. Same idea before bed. Your phone can wait. 3. If you’re at the point where you share finances, set a regular meeting to review how you’re doing. * Ideally, this is a “red, yellow or green” meeting and should only take a few minutes. Money can be a big conflict issue for relationships and avoiding talking about money is a surefire way to eventually turn to conflict. If you have a budget and shared goals, this should be quick. * A monthly check-in is good. Create a recurring calendar event, attach the shared notes or spreadsheet document you use, add your goals for the meeting and honor the meeting when it comes around.
Eat with people who are important to you, if you can.
There’s something about sharing a meal that’s special in human nature. Friends who are important to you? Partners? Mentors you’re looking to get to know better after you’ve had a few chats? Try to eat with them when you can. And keep your phone off the table.
The same idea works with your coresidents and teams in the hospital. Eat with them if you can. Eating with others builds, strengthens and maintains relationships. Keep your phone off the table if you can.
Think about it this way: who would you consider a better mentor, the person you’ve met with a few times in their office where they sit behind their desk and you in front of them while they glance at their computer screen every time it pings or the person who’s invited you to get coffee or food and they kept their phone away the whole time? Now turn that around and realize the power of the message you can send to people you care about by trying to eat with them and show them they have your full attention.
1. Learn to think about tasks as a continuum from start to finish instead of as a binary 'done/not done'.
Let’s say you have to order a CT for a patient of yours.
Instead of marking the task as complete the second you place the order for the CT, recognize that the whole task is not just placing the order, but also knowing when your patient is going down to the scanner, when they’re back, when the CT is up in the system, when the report is up and also that you’ve looked at the CT yourself and have read the report.
When your senior or attending asks you, “Did patient X get their CT?”, a not-so-great answer is “Yes” or “No”. A better answer is “they’re down at the scanner now” or “the scan’s done but it hasn’t been read yet. Want to look at it?” or “Yes, it’s negative for XXX but did show YYY”.
Whatever system you eventually adopt for your day-to-day task management in the hospital, whether it’s a list or index cards or a printed signout sheet, make sure you’re tracking both when orders go in, when they’re complete, when they’re cancelled, etc. Just marking things as complete once you place the order isn’t enough.
2. Signout is taken, not given.
What I mean by this is that when you take signout, that means you’re accepting responsibility for those patients. They might be your patients, you might be cross-covering, it doesn’t matter. What matters is that when those patients are your responsibility, it’s your responsibility to get what you need to know to take care of them. Is someone signing out to you in a hurry and not giving you what you need? Ask them for that relevant past medical history, those exam findings, and so on. It’s not enough for the person handing off to say “we’re worried about x or y”, you’ve got to follow that up with “in case of x or y, is there a plan for what the team wants me to do?”. Get the answers you need. A lot of covering patients on call is playing defense whereas the primary team generally plays offense. But that doesn’t mean you can play defense in isolation. The last thing you want is for the primary team to feel surprised by your choices.
* Here’s two ways for the above example to go when turning the patients you were covering back over the next day or whatever: 1. You: “For patient so-and-so, you said you were worried about x or y. Y happened.” Them: “What did you do?”. You: “Z”. Them: “Shit, my attending’s not gonna like that”. 2. You “Y happened so I did A like you said, it went fine and here’s the current status”. Them: “Great, thanks” * See the difference?
Along the lines of taking responsibility for those patients, that means that if you couldn’t get the information you needed at signout then you have to go and see those patients and get the information you need yourself.
You’ll hear this idea said a bunch of different ways like “trust but verify”, “trust no one” and your comfort level will change over the year as you become more confident and comfortable. But always error on the side of going to see the patient and getting your own information at the start.
3. If you will be miserable without something when you’re in the hospital, bring it with you. You won’t reliably be able to find it at the hospital every time you need it.
Need coffee otherwise you turn into a demon? Bring it with you. You never know when you’ll get caught doing something and won’t be able to run to the cafeteria for your fix.
On call overnight and know you need food so you don’t go insane? Bring it with you. Here’s a hospital food rule: never rely on the hospital's ability to feed you. The hospital will let you down sooner or later, I guarantee it.
Know you always get cold on call? The day you forget your jacket/sweatshirt is the day you won’t be able to find a spare blanket in the hospital to save your life. Put a backup in your locker (if your hospital respects you enough to give you one).
Miscellaneous productivity, professionalism and lifestyle tips
1. Aim to “touch” everything only once
Example: your physical mail. You know, the stuff made of dead trees that accumulates in that box you check every once in a while. For every piece of mail you get, you should either trash it, file it, or act on it. Don’t touch it until you’re ready to do one of those things.
Example: your email. Either delete it, archive it, reply to it or do the thing it’s telling you to do right away. Don’t fall into the trap of using your inbox as a to-do list -- that’s a recipe to get burned. Use a task manager for your to-do list and aim to keep your inbox at zero. Realize that email’s true power is communication and use it as a communication tool and nothing else.
I’ll use the example of going to a wedding again as something to “touch once”. Aim to accomplish all the tasks at once or at least create tasks and reminders to complete those tasks all in one go. Respond to the RSVP, create the calendar invite with all the information from the invitation, share the calendar event with your date, book your travel, book your hotel, book your rental