Update

They graded my surgery shelf and I passed (it wasn't even my worst shelf grade!)...I'm assuming I didn't fail the clinical portion of OB/Gyn or Surgery (I don't have those evaluations back yet), so as far as I'm concerned, I feel comfortable now saying I'M A FOURTH YEAR! This is an exhilarating feeling, which is nice 2 days before my boards. I am so relieved to have that out of the way, and I'll feel even better after I have the full official grades (shelf + clinical).

I have decided that my "last first day of school" will be Tuesday the 7th. Since these last few weeks were just studying, they were like my "summer", and since at that point I'll know I passed all of my third year, I can officially be a 4th year! I know, kind of a stretch, but I have REALLY been wanting a "last first day of school" picture since I mentioned it last time, and I am determined to have it. Since most people in my class took the first month of 4th year and studied, it was kind of like their summer, so now it's mine too (just a month later!). Now hopefully I'll remember to have D take my picture by the door!!

P.S. Still overwhelmed about my test and my application. Test part 1 on Monday, application due Wednesday, test part 2 on Friday...THEN a nice little vacation weekend with the fam. If I don't have an ulcer by the end of this week it'll be a miracle...what was I thinking?!?

Pause

Reading over my last post, most of those things still ring true. Except now I am even more overwhelmed. Right now just focusing on my multiple choice exam and my residency application. My sleep cycle is SO crazy (go to bed at 3am, wake up at noon). I am studying every day; it is getting to be a LOT of information. I'm not eating all that well. All I do is drive/study/drive/watch tv/sleep. And I have made zero progress on my application (sort of by choice...I can't think about that and try to study at the same time- it is too good of a distractor). I'm exhausted, cranky, hungry, and feeling inadequate. Oh, for it to be 2 weeks from now when it will all be over!!

Two things that are different:
1. The last thing on my list...not so let down. Too busy to really think about it right now, and maybe that has something to do with why I'm not let down, but whatever. Just takin it slow. Super slow. Maybe that's all I can handle right now.
2. Update about my surgery shelf grade: the NBME (National Board of Medical Examiners), who administers and grades the test, never graded mine. Last I hear, my answer sheet got left in my test booklet which was subsequently stored in a warehouse. They have sent for my test book and will grade my exam and notify my school by Tuesday. Slight panic attack. As long as they find it and grade it and it's actually mine, it'll be fine.

Totally different note: even though I am 6 weeks in, I just realized this is my last year of school. EVER. This is huge for someone who has been in school continuously for going on 22 years. I'm kind of sad that I didn't realize it at the time and take a "last first day of school" picture or something. Kind of forgot about it when I didn't get a summer break. Anyways, this makes me a little sad and scared...what will I do in the adult world? Because I am more and more convinced that a lot of what med school does is push back the real world (if you go straight from college). I'm excited for it, but I like school...I've always been good at school...school is my safe place (not so much since med school, but that's a different story...). Time to get on with the rest of the things I hope and dream for my life. So here's to a great last year...I know it'll go too quick. It's already almost September...sheesh.

Whoa.

Overwhelmed. That's all there is to it. Here's why.

1. My mouth still hurts. It is not healing as fast as I thought it would, and I'm crabby about it.

2. Studying for part 2 of my boards. Multiple choice test on August 30th, practical exam on September 3rd. I need to do well on the multiple choice, as Emergency Medicine residencies put a lot of stock in that exam. However, I have no motivation to study and find myself daydreaming...a LOT. This is stressing me out BIG time. And in true-to-myself fashion, I am ignoring it and pretending it will just go away. Typical.

3. My residency application is due September 1st. This is a big deal. Not only is it filling out the application (including a personal statement...ugh!), but it is getting letters of recommendation and, biggest problem of all, deciding what programs to apply to. If all I had to do was get the application ready and click "submit", I would not be that worried. But I need to narrow down the 120+ EM programs across the country to the 20-25 that I want to apply to. And I don't even know if 20-25 is the right number to apply to. This terrifies me, as all applications usually do. For college I didn't apply to enough programs, for med school I probably applied to too many...what the heck am I supposed to do now?? I know that I need to end up interviewing at and ranking 10+ programs, but how many do I need to apply to to ensure that I get at least 10 interviews? And how do I know what programs I am interested in? Clearly this is the biggest deal for me.

4. I still don't have my Surgery exam grade. I have my OB exam grade, and I did pretty well. Just waiting on the official overall grade (including my clinical grade) from OB. But Surgery...I am getting antsy.

5. I need to start getting things in order (flights, $$, paperwork, etc.) for my away rotation in October and my international rotation in February. I know those are farther away than the other things on my list, but unfortunately they still swirl around in my head.

6. Boys. Why do I have to get so excited every time only to end up feeling let down? That's all I have to say about that.

There's more...I'm sure of it. But that's enough for now. Back to studying and feeling slightly inadequate and in limbo. Blah.

Coasting

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!

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!!

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...

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!