Match Day!

I am beyond ecstatic!!!!!!

I matched into one of my top programs in Family Medicine, and will be moving to St. Petersburg Florida!!!!

The journey has been crazy, and it's still not over, but I am over the moon with the results. Bayfront had my favorite fellow residents, lots of great community medicine opportunities, an alumni that runs a LGBTQ clinic, and, best of all, the BEACH ;)

The next few months are going to be crazy - I've got a research elective, preparations for graduation, trying to find an apartment, and (gulp) trying to figure out how to move all of my stuff far, far south.

Block III First semester Wrap Up

The road thus far:

Pediatrics:

I LOVED pediatrics. I was actually surprised by how much I loved pediatrics. At least some of it was due to just general excitement about being in the hospital working with REAL patients, but even 4 months out, I still really enjoyed it - to the point where I am seriously considering pediatrics as a career choice. 

Favorite moments: They all revolve around really getting to help a patient. We had a suicidal teenager that I was just really able to connect to, who felt comfortable enough talking to me to reveal the reason she tried to commit suicide. There was another baby with a pretty serious and rare genetic condition whose mom I was able to give a pamphlet explaining the condition (she was VERY young, and no one had really explained the "future" of her child's condition). I was able to bond with a lot of different kids, which was pretty damn amazing, considering I have never really been "into" kids before. 

Things I loved: pediatric ER shifts (I got to do a lot of diagnosing, and got to suture and set broken bones), nursery (seriously, can I just snuggle babies all day???), working in the outpatient clinics, and working with teenagers. I really felt like I was part of a community, and there were some GREAT mentors. 

Things I didn't love:  ICU was kind of hard for me - I learned a lot, and had some great mentors, but I definitely had a personality clash with one of the visiting residents, and didn't feel like I had as much to do there as I did on other services. 

Surgery

Surgery was a bit of a roller coaster for me. While my time at one hospital was very tiring, I learned a lot, and had great relationships with the residents. At the other hospital, I did not have a great experience - mostly related to some serious personality conflicts, and generally just feeling like medical students were unwanted. I enjoyed a lot of the patient care and definitely enjoyed the trauma side of things, but overall, I don't think the surgeon lifestyle is for me. 

Things I liked: getting to suture a lot in the trauma bay (lots of motorcycle accidents = lots of superficial wounds that need stitches), vascular surgery (they let me amputate toes!!!), follow up patient care during my vascular week, and getting to help admit patients from the ED. 

Things I didn't like: having to stand in one place for several hours, and the stereotypical surgeon ego (and the resulting conflicts) - I felt like you were really at the whim of how the head surgeon felt that day. If he was friendly, it was a good day. If he didn't like you or was in a bad mood, NO ONE had a good day. I felt like there really wasn't as much as a team aspect as I would have liked. I also had a patient ask me to "please don't let them kill me" right before going into emergency surgery, which was very tough emotionally. 

Internal Medicine

Overall, this was a great experience. The residents and physicians were AMAZING - great teachers, good team players, and very eager to work with  medical students. I got to see a lot of patients, and I did very well grade-wise in this rotation. However, I enjoyed admitting patients from the ED or seeing them in clinic a lot more than I did rounding - I don't think 10 minutes a patient when you round with the team is enough for what I want to do, at least if I am doing long-term care. 

Things I liked; working in the free clinic, being able to explain a lot of complicated medical jargon in a way that patients understood, getting really good at coming up with plans for patients coming in with chest pain, working with a team. 

Things I didn't like: Rounding. I know, I know....it's good, its a good way to see all the patients and still teach, but I just found it.....too much, and not enough? I liked rounding during peds and surgery, but for some reason it just seemed to draaagggggg on during internal med, and I felt like we really didn't see much of the patients during this time. 

So, overall, my favorite moments have been in the ER or in the clinic, and usually with pediatric patients or with patients that I get to explain things to. 

Right now, I am mostly torn between pediatrics or emergency medicine. I've been utilizing my break time to research different residency programs and find out which I am eligible to apply for. I have to start making a decision in....8 short months (HOLY COW), so I figure that more information now is better. 

I have another full week of break, and then I start back up with Neurology, followed by Psych, Family Med, and OB/GYN. My schedule is *theoretically* a little less hectic, at least for the next 4 months, so I will hopefully have more time to document things as I go along. 

Step 1 Score and my first week of Block III!

First of all, I'm writing this from the first floor of my 3 story rental house in Flint - that's right, I am all moved in and (mostly) settled into my clinical setting. My student ID card doesn't even work in GR anymore!

I got my Step 1 score this past Wednesday. I passed!!!! My score is much lower than I wanted it to be, and lower even than my practice exam, but I passed. It's a relief to have it over with, and to know that I can just beef up my medical CV with clinical skills, honors grades, research, volunteering, and a better Step 2 score, which I was planning on anyway :)

I have already survived 2 weeks of Block III, although one week was orientation so I'm not sure that counts. My first rotation is pediatrics, and the rest of my schedule is as follows:

Pediatrics

Jr. Surgery

Internal Medicine

Elective (Neurology)

Psychology

Family Medicine

Ob/Gyn

I'm pretty excited. My year is definitely front loaded, which I'm a little nervous about in terms of burnout, but so far it's going well, and that means I will have a pretty easy spring semester. 

So far, pediatrics is amazing. I'm liking it a lot more than I thought that I would. I mean, I like kids, but after my stint as a camp counselor I haven't always been 100% comfortable around small screaming people. However, I have been having a blast and learning a TON. I've mostly worked with the two extreme of pediatrics - small, small babies, and older adolescents. I love working with babies and their parents - the parents are very tired, and definitely appreciate my ability to reduce what the attending/residents are saying into non-medical jargon. And babies: OMG tiny fat babies with their little grasping hands and their kicking legs and their sucking reflex - LOVE. I also like working with teens: they are definitely challenging patients, but I like being able to talk to them about depression and sexual activity, and being able to treat them like adults, especially when they are sensitive to their parents helicoptering a bit. 

It's not all perfection - I got to admit a not quite so fun case today. The kid will be absolutely fine, but they were in quite a bit of pain, so getting a physical exam was rough on everyone involved. There's just no explaining to an under-5-year-old that you HAVE to poke and prod at the things that hurt, and a crying child tugs on everyone's heartstrings. 

I also have great residents and a great attending to work with this week. Dr R is a fantastic teacher, asking questions that are appropriate for my level of training and never making anyone feel dumb for not knowing something - just encouraging them to look it up in an article, and then share with the group. I also really like my residents. The 1st years are just starting too, so it helps to not feel as out of place. 

My favorite things so far (in list form):

1. BAABBIES

2. Listening to heartbeats

3. Feeling a sucking reflex

4. Getting to work as a true team with a resident - them teaching me, and me even sometimes teaching and helping them

My goals for this rotation:

1. Never lose my compassion for my patients - this includes staying behind to explain things a bit more, being an advocate for the more challenging patients and parents, and always introducing myself by name before I perform a physical on a patient. 

2. Honors the non-exam portion of this domain. I would like to honors the entire thing, but I am trying to be realistic, since I am not sure about the extent of the shelf exam. 

3. Get extremely comfortable doing full physical exams on all age groups. 

Pelvic exam

Today was one of my final clinical skills experiences - learning how to do a pelvic exam!

Being a woman, I can tell you there is not much worse in this world than a poorly done pelvic exam, so I was anxious to learn how to do this exam FAST and WELL - I didn't want to inflict any more discomfort on our practice patients than I had to!

There's 2 parts to the pelvic exam - the first part involves the speculum, which sort of spread the vaginal canal so the doctor can look at and/or get a cell sample of the cervix. I was able to locate the cervix on the 2nd try on my first patient, and on the first try on my 2nd patient - I felt super accomplished!

The second part of the exam is called "the bimanual exam", and essentially involves inserting your fingers into the patient's vagina, and then using your other hand to press down on the patient's abdomen and sort of "smush" all the soft tissue together, so you can feel the outline of the uterus and the ovaries. This is much trickier, although I was able to at least palpate one ovary. It feels sort of like a little marble!

My mentor for this session was an ER doc I've worked with before, and this time I especially appreciated her style, both as a doctor and as a teacher. She was efficient but not cold, and got the job done quickly - something both myself and the patient appreciated. I asked her how many pelvic exams she does as an ER doc, and she said that if she wanted to, she could do 10 or more a day - lots of pregnant patients and people coming in for STD checks at the ER.

To me, that's really cool. I wasn't interested in OB/GYN because I don't think I would want to do this sort of thing all the time, but its definitely an interesting procedure, and one that I could feel comfortable doing as an ER doc.

Just 2 more clinical skills experiences this year - phlebotomy, and our Gateway exam!!!!

60 days left!!!!

Holy cow. I have 60 days until my Step 1 exam. 2 months, people. TWO MONTHS.

I am 76% done with my first run of QBANK - if I do at least 20 per day for the next 25/30 days, I will have completed all 2200+ questions before my final domain exam, and can start anew on my first day of ISP. Piece of cake, right?

I am excited and nervous and just READY.

Counting Down....

Wrapped up Cardiology, finally. Spring break in the middle was nice (actually, really nice. The best, even. Myrtle Beach with mom was exactly what I needed), but 4 week domains are kind of a beast to begin with, and the extra week just meant that I am SICK about learning about the heart!!!

Thankfully, I MASTERED the exam, and can move on to my next domain, Metabolism/Endocrinology/Reproductive.

We started today off with a bang, and had a HILARIOUS German professor. Okay, so she wasn't actually that funny, but her accent just made the entire lecture hilarious (***she was really a great lecturer...just hearing about testosterone in a foreign accent makes it a *little* hard to pay attention early in the morning!)

By they way, did I mention I have 6 weeks exactly until I am done with preclinical exams? I had my Flint campus meeting yesterday, and while I am SUPER excited to move on to the next part of my medical life, I cannot believe how fast this semester is going.

6 weeks. 40 days. 2 domain exams. 3 clinical skill sessions. That's all the separates me from my Intensive Study Period.

And, oh, by today's count, I have 70 days until I take my Step 1 exam. And that means like, 75 days until I move to Flint.

AHHH!!!!!!!!*****





*****(this is a scream of excitement. Can't you tell???)

2015 Updates

Gosh this year has been going by fast. Fall semester was here and gone in a blink of an eye, and even though my winter break was an extra week longer than usual, it still wasn't long enough. I've already been back in school for a month and it feels like it might as well have been just a week!

The renal domain was a bit tough. I got my lowest score on any exam in the past year, but considering that a friend attempted suicide and I was sick with the flu for about a week during this domain, I was happy just to pass. It was still frustrating because I don't think the exam really reflected the knowledge that I gained and because my goal is to master every exam, but at least it is over.

Pulmonary seems to be going well so far, but I admit it's been a bit tough to find my groove this semester. I know part of it is due to the aforementioned events of my friend's hospitalization and my illness, but my depression seems to be rearing its ugly head and throwing things out of balance.

I tried reducing my medication dose over winter break (with permission/supervision from my therapist) -- BIG MISTAKE. I did fine at first, but after about 3 weeks of the reduced medication I kept wondering why I was feeling more anxious and panicky and lashing out at people and then it hit me - duh, I should probably go back on the dose I know that works. Since then, things have been *better*, but I still feel out of sorts. My sun lamp helps when I am studying, but I just overall have been feeling lower than I would like. Hopefully this changes soon.

I added a countdown clock to my first licensing exam - 121 days as of today. I am about 30% through my first run of my question bank. I was hoping to be at around 50% by now, but the way the domain schedule works there are a lot more questions related to school stuff in the spring semester, so hopefully I will be more on track soon. I am remembering a decent amount of things from last semester, or at least remembering enough to at least be familiar with what the test is asking, so I'm feeling pretty good about having a good intensive study period in May.

I also can't believe that beside my test being in 4 months, I also move to Flint in 4 months. I've got my apartment search narrowed down to two places, possibly plus or minus a few (there are a few condos/lofts downtown that don't really advertise online that I'm going to check out in the next few weeks). K and I were going to try to live in one apartment together, but due to some family stuff, that probably isn't happening. However, we are going to try to live in the same complex, just to have someone nearby.