Time flies, even when you have a lot of it!
This last 3 weeks have been a really nice "break". Yes, I am still in school/work (Toxicology- poisionings, overdoses, snake bites...totally awesome), but the hours are CUSHY (9-2), I don't have to write notes or even see patients on my own (which I feel I'm getting out of practice with as a result!), and it is a TON of teaching. This is super nice because I need to start getting ready to study for the next parts of my boards, which I take at the end of August. The faculty are so great and they are all Emergency Medicine trained before doing Tox, so it is a good source of information for me.
Currently I am home in a lot of pain from a tooth procedure that has had a little complication. Nothing catastrophic, but it hurts and there's nothing anyone can do about it. I've been eating nothing but liquids/soup/mashed potatoes for about a week and I am so sick of it...with no end in sight due to the little problem that happened yesterday. I'm hungry and cranky and I just want it to get better!
Still no word on the 2 tests I took a month ago. Hopefully in the next week or so I'll get my scores...I have gotten really good at waiting a looooong time for results! Still praying I passed, hoping I did well.
Not much else to say...livin is easy right now and I'm not being very productive but I need a break!
7.29.2010
7.12.2010
Phew!
Well, I did it. I am officially done with third year. Today was my first day as a 4th year (MSIV).
This is pretty incredible. This is the year that my medical education truly becomes MINE, and not what someone dictates for me. I have basically all electives this year, and I made my schedule in terms of when I do what. There have been some glitches in the system, but I think it is almost settled. It is crazy to think that now I will be learning some things that my classmates will not be learning and might possibly never know.
I started on Toxicology today- so drug overdoses, poison ingestions, insect/snake bites, etc. This is a great rotation for a future ER doc (like me!) because a lot of things that walk into the ER, particularly in Phoenix due to the snakes and scorpions, are tox problems. I hear this rotation has great teaching and is really interesting, so I am VERY excited for it. It is also very laid back, which doesn't hurt :)
Even though officially I am an MSIV, I am reluctant to actually call myself that because I don't yet know the results from my Surgery and OB shelves/rotations. I feel pretty confident that OB went just fine, but the Surgery test was BRUTAL and every one of my classmates felt like they failed, myself included. I'm sure we didn't all fail, and I'm just praying that I'm one of the ones that passed. Some people say that we find out 2 weeks after the test (which would be this coming Friday), but with other shelves it took 4-6 weeks. So I could be on my second rotation of 4th year before I finally feel like I have actually finished 3rd year. I'll just keep hoping and praying that I passed!!
This is pretty incredible. This is the year that my medical education truly becomes MINE, and not what someone dictates for me. I have basically all electives this year, and I made my schedule in terms of when I do what. There have been some glitches in the system, but I think it is almost settled. It is crazy to think that now I will be learning some things that my classmates will not be learning and might possibly never know.
I started on Toxicology today- so drug overdoses, poison ingestions, insect/snake bites, etc. This is a great rotation for a future ER doc (like me!) because a lot of things that walk into the ER, particularly in Phoenix due to the snakes and scorpions, are tox problems. I hear this rotation has great teaching and is really interesting, so I am VERY excited for it. It is also very laid back, which doesn't hurt :)
Even though officially I am an MSIV, I am reluctant to actually call myself that because I don't yet know the results from my Surgery and OB shelves/rotations. I feel pretty confident that OB went just fine, but the Surgery test was BRUTAL and every one of my classmates felt like they failed, myself included. I'm sure we didn't all fail, and I'm just praying that I'm one of the ones that passed. Some people say that we find out 2 weeks after the test (which would be this coming Friday), but with other shelves it took 4-6 weeks. So I could be on my second rotation of 4th year before I finally feel like I have actually finished 3rd year. I'll just keep hoping and praying that I passed!!
6.15.2010
Little Slip
Today, I am having a little bit of a breakdown. Just a little one. But I'm worried it could build into a monumental one. So I'm going to try to let it out before that happens...
I have 2.5 weeks left of surgery. So 2.5 weeks down. It is going just fine I think...not stellar but I don't hate it and I'm not getting yelled at every day, which is nice. However, at this point it is time for my mid-point evaluation. I asked my resident for an informal eval, and he said "Yea, you're doing fine. You show up, you see your patients, you seem interested". Now, this sounds fine, but for someone who has Honored the clinical part of every rotation, he said pretty bland things without a lot of enthusiasm, which translates (to me) to mean nothing too great. So I pressed him a little further, "Is there anything I can improve on? I do really well with negative feedback, I'm not going to go cry about it or anything". And his response? "No. I can't really think of anything you need to improve on". Again, unenthusiastic and completely unhelpful. I'm worried he's thinking terrible things he's not saying. But I tried to ask, right? I did my best to try to do better, and he has nothing concrete to give me. So I guess just keep doing what I'm doing? Since I asked, I had better not fail for not meeting expectations. I'm worried about it, but not too much because I don't know what else to do about it.
This also means that I have 2.5 weeks until my "double shelf" day...2 "Shelf" exams in one day (OB and surgery). This was a dumb idea from the beginning (I fully blame the administration for this one), and people are legitimately failing these exams due to them being on the same day. 2.5 weeks sounds like a long time to study, but when I'm working and/or exhausted most of the time, it's hard to study. And it is SOOOO much information! I don't want to fail these tests because I just don't want to have to take them again. I just want to pass! I think I will, but I don't want to be overconfident.
Lastly, I'm a little down and lost lately. Just feeling a little lonely and "stuck" and tired of being so focused on school. I need a little break and I'm not really going to get one. This is my first summer EVER without a break, and I think maybe I'm feeling it. I can relax more after Surgery is over, but (like I've said before), I'm kinda ready to get along with the rest of my life and be done with school. Less than 1 year left until graduation (333 days to be exact...and yes I just calculated that). I guess just keep pushing through. One step at a time...just get through these next 2.5 weeks, and then worry about the rest later.
Just keep swimming, just keep swimming...
I have 2.5 weeks left of surgery. So 2.5 weeks down. It is going just fine I think...not stellar but I don't hate it and I'm not getting yelled at every day, which is nice. However, at this point it is time for my mid-point evaluation. I asked my resident for an informal eval, and he said "Yea, you're doing fine. You show up, you see your patients, you seem interested". Now, this sounds fine, but for someone who has Honored the clinical part of every rotation, he said pretty bland things without a lot of enthusiasm, which translates (to me) to mean nothing too great. So I pressed him a little further, "Is there anything I can improve on? I do really well with negative feedback, I'm not going to go cry about it or anything". And his response? "No. I can't really think of anything you need to improve on". Again, unenthusiastic and completely unhelpful. I'm worried he's thinking terrible things he's not saying. But I tried to ask, right? I did my best to try to do better, and he has nothing concrete to give me. So I guess just keep doing what I'm doing? Since I asked, I had better not fail for not meeting expectations. I'm worried about it, but not too much because I don't know what else to do about it.
This also means that I have 2.5 weeks until my "double shelf" day...2 "Shelf" exams in one day (OB and surgery). This was a dumb idea from the beginning (I fully blame the administration for this one), and people are legitimately failing these exams due to them being on the same day. 2.5 weeks sounds like a long time to study, but when I'm working and/or exhausted most of the time, it's hard to study. And it is SOOOO much information! I don't want to fail these tests because I just don't want to have to take them again. I just want to pass! I think I will, but I don't want to be overconfident.
Lastly, I'm a little down and lost lately. Just feeling a little lonely and "stuck" and tired of being so focused on school. I need a little break and I'm not really going to get one. This is my first summer EVER without a break, and I think maybe I'm feeling it. I can relax more after Surgery is over, but (like I've said before), I'm kinda ready to get along with the rest of my life and be done with school. Less than 1 year left until graduation (333 days to be exact...and yes I just calculated that). I guess just keep pushing through. One step at a time...just get through these next 2.5 weeks, and then worry about the rest later.
Just keep swimming, just keep swimming...
5.29.2010
Another End
I am finished with my OB rotation...W-O-W it went fast! The most frustrating/annoying/difficult thing about 3rd year is that just as soon as you start to feel comfortable on a rotation (you know where everything is, you get along with your residents, the attendings remember your name, you know what is expected of you and can stop worrying about doing something wrong and start actually thinking critically about the patients and their problems) you switch to a new one. And the cycle starts all over again. Naturally, that is what has just happened with OB.
I had a hard time on this rotation in the beginning, but it had gotten much better by the end. I still didn't feel as comfortable on the rotation and with the patients and the diagnoses that I was seeing as I had on some other rotations, but I was getting the hang of it. I am sad to leave this rotation as there were things about it I had come to really like. I actually liked the clinic part of this rotation; there were a couple of patients that I saw in the clinic multiple times and that was pretty cool.
I did not get my wish of doing things in the OR this past week...we had a really huge team (an attending, an intern, a 3rd year and a 4th year resident) and since they all take preference over me for doing procedures I didn't get to do ANYTHING. I literally only scrubbed in for 1 case all week. The others were all laparoscopic or robotic cases, and so there is really only room for 2 people to be scrubbed in and around the patient. It was disappointing. It was also a little annoying to be there from 5:30am-10pm some days where I literally did not do a single thing. On the other hand, the attending was SO fun to be in the OR with, and was really apologetic about me not getting to do anything, so I guess I'm not that upset.
Three day weekend (YAY!!) and then surgery on Tuesday. I didn't get a whole lot of practice on OB for my surgery tasks, but hopefully I'm ready!
I had a hard time on this rotation in the beginning, but it had gotten much better by the end. I still didn't feel as comfortable on the rotation and with the patients and the diagnoses that I was seeing as I had on some other rotations, but I was getting the hang of it. I am sad to leave this rotation as there were things about it I had come to really like. I actually liked the clinic part of this rotation; there were a couple of patients that I saw in the clinic multiple times and that was pretty cool.
I did not get my wish of doing things in the OR this past week...we had a really huge team (an attending, an intern, a 3rd year and a 4th year resident) and since they all take preference over me for doing procedures I didn't get to do ANYTHING. I literally only scrubbed in for 1 case all week. The others were all laparoscopic or robotic cases, and so there is really only room for 2 people to be scrubbed in and around the patient. It was disappointing. It was also a little annoying to be there from 5:30am-10pm some days where I literally did not do a single thing. On the other hand, the attending was SO fun to be in the OR with, and was really apologetic about me not getting to do anything, so I guess I'm not that upset.
Three day weekend (YAY!!) and then surgery on Tuesday. I didn't get a whole lot of practice on OB for my surgery tasks, but hopefully I'm ready!
5.22.2010
Home Stretch
I have one week left on OB and then onto 5 weeks of surgery...after that and 1 week of b-o-r-i-n-g lectures I will be a 4th year!!
My last week of OB is on Gyn Surgery, so hysterectomies, ectopic removals, cancer resection, etc. Basically I have 6 weeks of surgery. I am alright with this, as long as I get to do SOMETHING in the OR. Even if it is just holding the suction thing and sucking away the smoke that the bovy makes (bovy= metal wand thing that burns/cauterizes vessels and burns through fat). If I am not doing anything I am SO bored and get really tired of standing there with noone saying anything and me not doing anything. Some of these gyn surgeries can go 6, 7, 8 hours or more if they are big cancer resections. That is a long time to stand, not touch anything (because I'm scrubbed in and sterile), not eat or pee or drink anything and not talk. So I am going to be aggressive about doing something, anything. Hopefully I can help stitch someone up at the end of the surgery. The surgeons have to like you and trust your skills for that to happen, so I need to really bust my butt and show off.
I can't believe 3rd year is almost over. This is probably the hardest year (as a whole) in med school. It was difficult, but I have had a GREAT time. The next hardest year will be my intern year after graduation. Interview season will be difficult, but as a whole 4th year should be really fun...easier schedules, no tests, way less pressure. It is hard to wrap my head around the fact that all these years of working hard at school are almost over. I am almost to the point where I will have a job that requires no additional work outside of work hours.
Lately I have been really looking forward to having a life outside of school. I really feel like I have been missing that for the last few years. Outside of school I have nothing; no house to really spruce up, no vacations to plan, no one to take care of, no real consistent hobbies. I think it is really sad that by the time this is all over, my 20's will be almost entirely over and all I will have to show for it is a career. Now don't get me wrong, that is a huge deal, and it will give me so many opportunities for the rest of my life. But I want more than a career. As soon as surgery is over (I know, another delay, but seriously it is NOT possible until after that 5 weeks is over) I am going to start doing things to round out my life. When I was in high school I was so proud of the fact that I was so well rounded. I have totally lost that and I need to get it back. More specific plans to come later.
My last week of OB is on Gyn Surgery, so hysterectomies, ectopic removals, cancer resection, etc. Basically I have 6 weeks of surgery. I am alright with this, as long as I get to do SOMETHING in the OR. Even if it is just holding the suction thing and sucking away the smoke that the bovy makes (bovy= metal wand thing that burns/cauterizes vessels and burns through fat). If I am not doing anything I am SO bored and get really tired of standing there with noone saying anything and me not doing anything. Some of these gyn surgeries can go 6, 7, 8 hours or more if they are big cancer resections. That is a long time to stand, not touch anything (because I'm scrubbed in and sterile), not eat or pee or drink anything and not talk. So I am going to be aggressive about doing something, anything. Hopefully I can help stitch someone up at the end of the surgery. The surgeons have to like you and trust your skills for that to happen, so I need to really bust my butt and show off.
I can't believe 3rd year is almost over. This is probably the hardest year (as a whole) in med school. It was difficult, but I have had a GREAT time. The next hardest year will be my intern year after graduation. Interview season will be difficult, but as a whole 4th year should be really fun...easier schedules, no tests, way less pressure. It is hard to wrap my head around the fact that all these years of working hard at school are almost over. I am almost to the point where I will have a job that requires no additional work outside of work hours.
Lately I have been really looking forward to having a life outside of school. I really feel like I have been missing that for the last few years. Outside of school I have nothing; no house to really spruce up, no vacations to plan, no one to take care of, no real consistent hobbies. I think it is really sad that by the time this is all over, my 20's will be almost entirely over and all I will have to show for it is a career. Now don't get me wrong, that is a huge deal, and it will give me so many opportunities for the rest of my life. But I want more than a career. As soon as surgery is over (I know, another delay, but seriously it is NOT possible until after that 5 weeks is over) I am going to start doing things to round out my life. When I was in high school I was so proud of the fact that I was so well rounded. I have totally lost that and I need to get it back. More specific plans to come later.
5.06.2010
In Brief
Um, it's been a while! Here's a summary:
Finished Neuro. Had a GREAT experience. Don't think I can do it as a career because neuro diseases are so devastating and usually there is no cure and in a lot of cases no great treatment. But that is hard for me to say. I really liked it.
Spring Break. Such a nice break.
Emergency Department (ED) rotation. Rocked. My. World. I loved every second of it from day one. The traumas, the routine people coming in (women miscarrying, asthma exacerbations, chest pain, cellulitis), my interactions with the residents, how much everyone really cared about the patients, how BUSY everything was, how quick decisions were made and how quick results were obtained, getting to DO things (stitches, pelvic exams, ultrasound, re-locating joints), etc. I could rave on and on about it.
Anesthesia rotation. It was alright. I learned a lot about physiology that I forgot, saw some cool surgeries, but talk about a lot of down time. Wow.
Started my OB rotation. Not stellar. I don't hate it, but I definitely don't love it. I have not really been getting that overwhelming feeling of awe when a baby is born that I was expecting to. And the rotation is hard...the residents and attendings are very critical and judging everything you do it feels like. Haven't had that in a while, so glad that is almost over. Very long hours...13 hour days at work at least, 30 hour calls once a week. Literally I get up at 4am, work 5am-6pm, get home at 6:30pm, go to bed at 8pm. Since I'm supposed to be studying everyday when I'm not at work, that really cuts down on the other things I can do (laundry, grocery shop, cook)!
Planning my 4th year is still an issue. Now that I've 98% decided on Emergency Medicine my schedule needs some tweaking. A work in progress.
So that's it in a nutshell. My life is consumed by school. This will continue until at least July 4th because after OB I go onto Surgery, where the hours are even worse and the attendings even harsher (or so I hear). Wish me luck!
Finished Neuro. Had a GREAT experience. Don't think I can do it as a career because neuro diseases are so devastating and usually there is no cure and in a lot of cases no great treatment. But that is hard for me to say. I really liked it.
Spring Break. Such a nice break.
Emergency Department (ED) rotation. Rocked. My. World. I loved every second of it from day one. The traumas, the routine people coming in (women miscarrying, asthma exacerbations, chest pain, cellulitis), my interactions with the residents, how much everyone really cared about the patients, how BUSY everything was, how quick decisions were made and how quick results were obtained, getting to DO things (stitches, pelvic exams, ultrasound, re-locating joints), etc. I could rave on and on about it.
Anesthesia rotation. It was alright. I learned a lot about physiology that I forgot, saw some cool surgeries, but talk about a lot of down time. Wow.
Started my OB rotation. Not stellar. I don't hate it, but I definitely don't love it. I have not really been getting that overwhelming feeling of awe when a baby is born that I was expecting to. And the rotation is hard...the residents and attendings are very critical and judging everything you do it feels like. Haven't had that in a while, so glad that is almost over. Very long hours...13 hour days at work at least, 30 hour calls once a week. Literally I get up at 4am, work 5am-6pm, get home at 6:30pm, go to bed at 8pm. Since I'm supposed to be studying everyday when I'm not at work, that really cuts down on the other things I can do (laundry, grocery shop, cook)!
Planning my 4th year is still an issue. Now that I've 98% decided on Emergency Medicine my schedule needs some tweaking. A work in progress.
So that's it in a nutshell. My life is consumed by school. This will continue until at least July 4th because after OB I go onto Surgery, where the hours are even worse and the attendings even harsher (or so I hear). Wish me luck!
2.27.2010
Decisions, Decisions
I took a quiz online (from a university's med school website) to tell me what specialty I should pick for my career. It assigned a point value to each specialty based on my answers; I had the same score for a number of specialties so they are a tie. These are the results (with some comments by me):
1. (46 points) ophthalmology (I do not have the grades for this)
dermatology (ditto)
2. (45 points) endocrinology (I would have to do internal medicine first, #7 on this list. yuck)
pathology (um, I said I LIKE talking to people...)
plastic surgery (see #1)
3. (44 points) urology (see #1)
neurosurgery (see #1)
emergency medicine (actually one I was considering!!)
allergy and immunology (I also would have to do internal medicine first)
4. (43 points) anesthesiology (I like TALKING too much for this)
gastroenterology (internal medicine first)
physical medicine and rehabilitation
occupational medicine (I have no idea what this even is)
5. (42 points) radiology (again, I LIKE people...)
rheumatology (internal medicine first)
neurology (I am on this right now and I do like it)
infectious diseases (internal medicine first)
6. (41 points) hematology (internal medicine first)
nephrology (internal medicine first)
radiation oncology (I am not a physicist)
nuclear medicine (again, I am not a physicist)
otolaryngology/ENT (don't have the grades)
pediatrics (another thing I thought I REALLY wanted...hmm, so low on the list!)
7. (40 points) thoracic surgery (general surgery first...um, no)
orthopedic surgery (don't have the grades)
pulmonology (internal medicine first)
colorectal surgery (general surgery first)
internal medicine (hurl)
8. (39 points) medical oncology (internal medicine first)
general surgery (seriously, shoot me now with those hours and those attitudes)
aerospace medicine (no idea what this is)
9. (38 points) psychiatry (something I thought I would like but is just ok)
preventive medicine (don't know what this is)
obstetrics and gynecology (wow, this is lower than I thought it would be)
10. (37 points) cardiology (internal medicine first)
11. (35 points) family medicine (really liked my rotation, could never do it as a career)
While this list is interesting, if you look at the point spread, it is only a one point difference between each ranking and there are multiple specialties that tied at each rank. So basically, I am just as indecisive as I thought I was. There are a lot I can cross off the list, but of note is that all the ones that I said I would have to do medicine first (ex. endocrine, hematology, nephrology, etc.), I could also do pediatrics first. Now we might have something here. Even though peds is lower on the list, I always said that I would probably not do general peds, I would subspecialize. The highest subspecialty on the list is endocrinology. So I guess according to this list I should do endocrinology over emergency medicine. But again, only by one point.
Also of note, lately I have been saying that if I had 2 lifetimes to live I would spend one of them as a neurosurgeon (and that was as high as emergency on the list). I am exposed to a lot of neurosurgery on my current rotation (neurology), and I am completely in awe of the neurosurgeons and what they do...it is so amazing. However, you literally don't have any other aspect of your life if you have that as your career, and I'm not willing to devote the one lifetime I do have to my career, no matter how awesome it is. (And I also currently don't have the grades.)
Basically this was not that helpful! I just don't know myself well enough I guess, or exactly what I feared would happen is happening...I love something about everything. What to do now?
1. (46 points) ophthalmology (I do not have the grades for this)
dermatology (ditto)
2. (45 points) endocrinology (I would have to do internal medicine first, #7 on this list. yuck)
pathology (um, I said I LIKE talking to people...)
plastic surgery (see #1)
3. (44 points) urology (see #1)
neurosurgery (see #1)
emergency medicine (actually one I was considering!!)
allergy and immunology (I also would have to do internal medicine first)
4. (43 points) anesthesiology (I like TALKING too much for this)
gastroenterology (internal medicine first)
physical medicine and rehabilitation
occupational medicine (I have no idea what this even is)
5. (42 points) radiology (again, I LIKE people...)
rheumatology (internal medicine first)
neurology (I am on this right now and I do like it)
infectious diseases (internal medicine first)
6. (41 points) hematology (internal medicine first)
nephrology (internal medicine first)
radiation oncology (I am not a physicist)
nuclear medicine (again, I am not a physicist)
otolaryngology/ENT (don't have the grades)
pediatrics (another thing I thought I REALLY wanted...hmm, so low on the list!)
7. (40 points) thoracic surgery (general surgery first...um, no)
orthopedic surgery (don't have the grades)
pulmonology (internal medicine first)
colorectal surgery (general surgery first)
internal medicine (hurl)
8. (39 points) medical oncology (internal medicine first)
general surgery (seriously, shoot me now with those hours and those attitudes)
aerospace medicine (no idea what this is)
9. (38 points) psychiatry (something I thought I would like but is just ok)
preventive medicine (don't know what this is)
obstetrics and gynecology (wow, this is lower than I thought it would be)
10. (37 points) cardiology (internal medicine first)
11. (35 points) family medicine (really liked my rotation, could never do it as a career)
While this list is interesting, if you look at the point spread, it is only a one point difference between each ranking and there are multiple specialties that tied at each rank. So basically, I am just as indecisive as I thought I was. There are a lot I can cross off the list, but of note is that all the ones that I said I would have to do medicine first (ex. endocrine, hematology, nephrology, etc.), I could also do pediatrics first. Now we might have something here. Even though peds is lower on the list, I always said that I would probably not do general peds, I would subspecialize. The highest subspecialty on the list is endocrinology. So I guess according to this list I should do endocrinology over emergency medicine. But again, only by one point.
Also of note, lately I have been saying that if I had 2 lifetimes to live I would spend one of them as a neurosurgeon (and that was as high as emergency on the list). I am exposed to a lot of neurosurgery on my current rotation (neurology), and I am completely in awe of the neurosurgeons and what they do...it is so amazing. However, you literally don't have any other aspect of your life if you have that as your career, and I'm not willing to devote the one lifetime I do have to my career, no matter how awesome it is. (And I also currently don't have the grades.)
Basically this was not that helpful! I just don't know myself well enough I guess, or exactly what I feared would happen is happening...I love something about everything. What to do now?
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