The trick to medical school (the first two, class-room based, boring, pre-clinical years) is simple. It's not about being good at biochemistry, anatomy, or even histology. It's all about
RECALL.
If you can memorize X, Y, and the relationship between them, then spit it back out on test day, you're golden.
Now, just learn to deal with 10,000 Xs and Ys and you're really set. Again. Recall.
Monday, October 8, 2007
Thursday, October 4, 2007
Specialty
And so, you mature with age. You mature in many different ways - as a student, as an automobile driver, as a member of an intimate relationship, as an engineer/lawyer, anything.
I have realized that your perspective of medicine changes so rapidly from day to day, that it's a waste of energy to funnel yourself down into a given specialty any earlier on than mid-late 3rd year or even later.
It's great to read up on everything you can, shadow, ask questions, and learn. But keep an open mind! I realized that I cannot possibly know the first thing about any specialty until I've at least spent considerable time in the hospital during oh say...3rd year and 4th year. And even then, you're only seeing a small slice of the pie (academic setting, given hospital in given state, etc). It's fine to think you're "leaning towards" one thing or another as you move through the system...
But my advice, which I'm following, is to just freaking focus on getting through years 1-2 and doing your best on Step I. Do that first. Then worry about the next step. Don't even think about pigeon-holing yourself into anything right now.
A few kids in my class know with fair certainty what they want to do. One example is an older gentleman (mid-30s) who has spent considerable time as a paramedic. He wants to go Emergency Med. and will probably stick to it.
Anyway, I just tell myself "keep your mind open, don't think about it too much."
I have realized that your perspective of medicine changes so rapidly from day to day, that it's a waste of energy to funnel yourself down into a given specialty any earlier on than mid-late 3rd year or even later.
It's great to read up on everything you can, shadow, ask questions, and learn. But keep an open mind! I realized that I cannot possibly know the first thing about any specialty until I've at least spent considerable time in the hospital during oh say...3rd year and 4th year. And even then, you're only seeing a small slice of the pie (academic setting, given hospital in given state, etc). It's fine to think you're "leaning towards" one thing or another as you move through the system...
But my advice, which I'm following, is to just freaking focus on getting through years 1-2 and doing your best on Step I. Do that first. Then worry about the next step. Don't even think about pigeon-holing yourself into anything right now.
A few kids in my class know with fair certainty what they want to do. One example is an older gentleman (mid-30s) who has spent considerable time as a paramedic. He wants to go Emergency Med. and will probably stick to it.
Anyway, I just tell myself "keep your mind open, don't think about it too much."
Saturday, September 15, 2007
Mental Mas---- what?
I don't really let things get to me. As far as school's concerned, anyway.
Im about to jump head-first into my first battery (block) of exams this semester, and I'm ready to go. I've studied more for anatomy than probably 1/2 of all my undergraduate education put together; and I'd say it's not so bad. The material can be dry, but as long as you try to organize everything sensibly in your head, it comes together.
But back to my point. I think the reason that medical school/medical education doesn't really attack and stun me the way it does to a lot of my peers is because I'm a ...well, a reductionist.
I'm not special or different or above anyone else in my class in terms of who I am, I just take things for what they are and don't expect anything more. Not that I'm a pessimist or fatalist, no, not at all. But what I see a lot of kids doing is, again what dear Uncle Panda calls "Mental Masturbation."
So much of what we do and what we expect is lofty, heaped-on happy stuff. And yeah, we need it; we as a society and culture need all of this showy stuff like student-council, activities, study groups, class president. But on the fringes of my class, I just take what comes. I go to class, come home, learn the material, then go take the tests. If I expected to have some sort of huge, life-changing experience, than I'd either construct one out of nothing and live a lie, or be sorely disappointed.
You see, a great deal of group-think is involved whenever you have a tight group of people in one place at one time. Psychologists and sociologists would have a ball with medical school classes. Everyone is understandably under a ton of stress. We all share the same locker-room, facilities, anatomy lab, lecture halls, etc. We are all funneled into the same classes, tests, finals and we're all under the same administration. It's so easy to get lost and caught up in this new reality that I see kids losing themselves already and it's only been a month.
It's just school - I don't intend on being at the top of my class. Or even in the top 15%. The amount of work it takes to do that is extreme and is reserved for the inevitable 15% that actually want to live this stuff. As I've heard a lot, someone who is all study completely lacks breadth. What does 100s on anatomy exams and a class rank of 1 mean? To them it might mean a lot...but I can't imagine that lasting forever. They might get a coveted dermatology residency position and practice in a cush suburban town earning 400k/yr doing botox injections.
But it is what you make of it...what you expect. The tendency here at this point is to put life off and say "it will get better later." Sure, to a degree, it will. Second year is supposed to be a bit more interesting and the clinical years are supposed to be pretty enjoyable (overall...the key is overall). But you can't put everything on hold. Life is going by right now - you're in your early-mid 20s and at your prime. Live now. I will keep going out (not as often as before) and playing video games and doing all my geeky things because that is who I am. You don't have to put in 100 hours a week to master this stuff.
I can't speak from experience yet...but I know that you can log your 4-5 hours a day on the material and veg-out for the rest of the day. This should leave at the least an hour or two every single day to chill, on top of getting a good 7-8 hours of sleep! If you have the discipline, log 9a-5p on Saturday and perhaps another 8-hour "shift" on Sunday, and you can go out Friday and Saturday nights without a hitch! Even before a Monday exam I know people who survived and kept up a semblance of a normal life.
I can't wait until I actually have the credibility to talk about study-habits, but I can say that studying for hours and hours every day hasn't been all that awful. Yeah, it's a marathon. One semester feels like hell and forever and there are 4 vicious pre-clinical semesters to endure. After that lies 3rd year, surgery rotation, intern year, etc etc etc.
I think that ... there's just too much hardship to get scared about. Yeah, it sucks and its hard. Everyone who applies (should) know this. It's a path to choose and to walk. But I believe it's all in attitude and what you make of it. You can go into this and just rip yourself to shreds to get into a neuro-surgery residency at Harvard. That same person would probably be #1 at whatever they chose to do in life because they're a hard-worker, period.
But happiness is relative. What is happiness to you? To me? I can't imagine someone needing so much academic achievement to be happy. Is their appetite that big that they need to immerse themselves in uninterrupted study 24/7 to become a respected doctor? I guess so. But for me, happiness is a balance of a fulfilling career and lots of friends and family. That's what everyone tells you...but don't create realities for yourself in here, you just can't afford more stress than what's already going to come.
I think my bottom line is that person A and person B can take radically different approaches, experience radically different amounts of stress, yet still achieve the exact same thing. It's all in personal preference and approach. I can commit the brachial plexus to memory while sitting at home in my PJs and listening to Tool. You can do the same thing at the medical library at 11pm in your cubicle in dead silence. That's great. Come test day we'll both have the same thing in our head. I'm happy doing my work at home and you want to stay at school to do yours; that's fine.
Just do what's best for you, I think. And, while not being a pessimist, don't expect anything more than what you see. There doesn't have to be sugar-coating on everything. People get sick, people die, kids get cancer, good people have bad things happen to them. Lots of things in this world just suck and I think all one can do is look for the glimmer of light and live according to their own principles. I'm happy - I love medicine but I will not let it enslave me. There are so many other things that I love to the point of fanaticism (rock bands/music, Japanese animation, video games, computers, my closest friends, my girl-friend). These things, for me, make the world great despite all the bull-shit, and make things worth living through.
This post has no real point. I just dumped a bunch of mental masturbation on here myself, I think. But if you haven't caught it before, mental masturbation is simply when a group of people stand around and talk BS/blow hot-air about nothing. Happens a ton in medical school...especially by first-years who want to sound cool.
By the way; remember that essay (...personal statement) you had to write to get into medical school? That's pretty much mental masturbation in purified form. I can't believe how imperfect the admissions process is, but it is the only way of screening the masses of eager pre-meds out. It's unfortunate, because once you're in, your essay is just a pile of too-good-to-be-true words written for a perfect world that won't exist. But so it goes....I can tell you now that over 75% of those happy essays mention how they want to altruistically journey abroad and work for the betterment of humanity. Lump 8 years of debt and academic/personal/emotional abuse on them and that 75% turns to the true 5% or less.
I'm out - good night.
Im about to jump head-first into my first battery (block) of exams this semester, and I'm ready to go. I've studied more for anatomy than probably 1/2 of all my undergraduate education put together; and I'd say it's not so bad. The material can be dry, but as long as you try to organize everything sensibly in your head, it comes together.
But back to my point. I think the reason that medical school/medical education doesn't really attack and stun me the way it does to a lot of my peers is because I'm a ...well, a reductionist.
I'm not special or different or above anyone else in my class in terms of who I am, I just take things for what they are and don't expect anything more. Not that I'm a pessimist or fatalist, no, not at all. But what I see a lot of kids doing is, again what dear Uncle Panda calls "Mental Masturbation."
So much of what we do and what we expect is lofty, heaped-on happy stuff. And yeah, we need it; we as a society and culture need all of this showy stuff like student-council, activities, study groups, class president. But on the fringes of my class, I just take what comes. I go to class, come home, learn the material, then go take the tests. If I expected to have some sort of huge, life-changing experience, than I'd either construct one out of nothing and live a lie, or be sorely disappointed.
You see, a great deal of group-think is involved whenever you have a tight group of people in one place at one time. Psychologists and sociologists would have a ball with medical school classes. Everyone is understandably under a ton of stress. We all share the same locker-room, facilities, anatomy lab, lecture halls, etc. We are all funneled into the same classes, tests, finals and we're all under the same administration. It's so easy to get lost and caught up in this new reality that I see kids losing themselves already and it's only been a month.
It's just school - I don't intend on being at the top of my class. Or even in the top 15%. The amount of work it takes to do that is extreme and is reserved for the inevitable 15% that actually want to live this stuff. As I've heard a lot, someone who is all study completely lacks breadth. What does 100s on anatomy exams and a class rank of 1 mean? To them it might mean a lot...but I can't imagine that lasting forever. They might get a coveted dermatology residency position and practice in a cush suburban town earning 400k/yr doing botox injections.
But it is what you make of it...what you expect. The tendency here at this point is to put life off and say "it will get better later." Sure, to a degree, it will. Second year is supposed to be a bit more interesting and the clinical years are supposed to be pretty enjoyable (overall...the key is overall). But you can't put everything on hold. Life is going by right now - you're in your early-mid 20s and at your prime. Live now. I will keep going out (not as often as before) and playing video games and doing all my geeky things because that is who I am. You don't have to put in 100 hours a week to master this stuff.
I can't speak from experience yet...but I know that you can log your 4-5 hours a day on the material and veg-out for the rest of the day. This should leave at the least an hour or two every single day to chill, on top of getting a good 7-8 hours of sleep! If you have the discipline, log 9a-5p on Saturday and perhaps another 8-hour "shift" on Sunday, and you can go out Friday and Saturday nights without a hitch! Even before a Monday exam I know people who survived and kept up a semblance of a normal life.
I can't wait until I actually have the credibility to talk about study-habits, but I can say that studying for hours and hours every day hasn't been all that awful. Yeah, it's a marathon. One semester feels like hell and forever and there are 4 vicious pre-clinical semesters to endure. After that lies 3rd year, surgery rotation, intern year, etc etc etc.
I think that ... there's just too much hardship to get scared about. Yeah, it sucks and its hard. Everyone who applies (should) know this. It's a path to choose and to walk. But I believe it's all in attitude and what you make of it. You can go into this and just rip yourself to shreds to get into a neuro-surgery residency at Harvard. That same person would probably be #1 at whatever they chose to do in life because they're a hard-worker, period.
But happiness is relative. What is happiness to you? To me? I can't imagine someone needing so much academic achievement to be happy. Is their appetite that big that they need to immerse themselves in uninterrupted study 24/7 to become a respected doctor? I guess so. But for me, happiness is a balance of a fulfilling career and lots of friends and family. That's what everyone tells you...but don't create realities for yourself in here, you just can't afford more stress than what's already going to come.
I think my bottom line is that person A and person B can take radically different approaches, experience radically different amounts of stress, yet still achieve the exact same thing. It's all in personal preference and approach. I can commit the brachial plexus to memory while sitting at home in my PJs and listening to Tool. You can do the same thing at the medical library at 11pm in your cubicle in dead silence. That's great. Come test day we'll both have the same thing in our head. I'm happy doing my work at home and you want to stay at school to do yours; that's fine.
Just do what's best for you, I think. And, while not being a pessimist, don't expect anything more than what you see. There doesn't have to be sugar-coating on everything. People get sick, people die, kids get cancer, good people have bad things happen to them. Lots of things in this world just suck and I think all one can do is look for the glimmer of light and live according to their own principles. I'm happy - I love medicine but I will not let it enslave me. There are so many other things that I love to the point of fanaticism (rock bands/music, Japanese animation, video games, computers, my closest friends, my girl-friend). These things, for me, make the world great despite all the bull-shit, and make things worth living through.
This post has no real point. I just dumped a bunch of mental masturbation on here myself, I think. But if you haven't caught it before, mental masturbation is simply when a group of people stand around and talk BS/blow hot-air about nothing. Happens a ton in medical school...especially by first-years who want to sound cool.
By the way; remember that essay (...personal statement) you had to write to get into medical school? That's pretty much mental masturbation in purified form. I can't believe how imperfect the admissions process is, but it is the only way of screening the masses of eager pre-meds out. It's unfortunate, because once you're in, your essay is just a pile of too-good-to-be-true words written for a perfect world that won't exist. But so it goes....I can tell you now that over 75% of those happy essays mention how they want to altruistically journey abroad and work for the betterment of humanity. Lump 8 years of debt and academic/personal/emotional abuse on them and that 75% turns to the true 5% or less.
I'm out - good night.
Sunday, September 9, 2007
Medical School Sucks
I'm thankful to be in, and for the vast myriad of opportunities that await me and my hard-working colleagues.
That said, medical school really does suck no matter how you spin it. It's a prestigious profession with pretty much the longest training time-scale of anything a person could choose to go into. It's expected that the training will take sacrifice, sacrifices I was willing to make when I interviewed and that I'm still willing to make now that I'm in and starting to really make them.
That said again, (bitch, moan) it sucks. My class-mates are so competitive. We're all going into different specialties for the most part - who cares who gets the highest grades? Oh no...if you're not in the top 10% of the class you might....not get into medical school or something! Truth be told, the higher your marks, the more chances you will have for residencies and specialties that you want. If I wanted dermatology, I'd be studying this instant instead of typing a blog-post...that is just how bad dermatology is to match into, for instance. Luckily, I don't want the ultra-competitive specialties. The things I think are cool are the mid-level ones, so I gotta still work as hard as possible.
Agh, it's all driving me nuts. Just nuts. The first exam block is beginning and I'm losing it.
That said, medical school really does suck no matter how you spin it. It's a prestigious profession with pretty much the longest training time-scale of anything a person could choose to go into. It's expected that the training will take sacrifice, sacrifices I was willing to make when I interviewed and that I'm still willing to make now that I'm in and starting to really make them.
That said again, (bitch, moan) it sucks. My class-mates are so competitive. We're all going into different specialties for the most part - who cares who gets the highest grades? Oh no...if you're not in the top 10% of the class you might....not get into medical school or something! Truth be told, the higher your marks, the more chances you will have for residencies and specialties that you want. If I wanted dermatology, I'd be studying this instant instead of typing a blog-post...that is just how bad dermatology is to match into, for instance. Luckily, I don't want the ultra-competitive specialties. The things I think are cool are the mid-level ones, so I gotta still work as hard as possible.
Agh, it's all driving me nuts. Just nuts. The first exam block is beginning and I'm losing it.
Tuesday, August 21, 2007
Pretty Laid Back
I'm a pretty laid back guy...
I've always prided myself on being able to distill things down to their essence and then accomplishing them with speed and efficiency. This applies to school, as I got through pre-med college work accomplishing the same as others while putting in 50%-75% of the energy.
I realized that a lot of energy is wasted on things as simple as gossip, freaking-out, and over-studying. The group of super-gunners at my school will study in the medical center for 12 hours straight with no breaks and burn out. I stick to a solid schedule of daily study, leaving time for relaxation, keeping my head fresh for the next day. All the while, I feel relatively comfortable with the material, though this will change as time goes on and things become more unfamiliar and nasty.
We had some "soft" classes today; I think I'll enjoy them because they provide the training for the other half of being a physician: clinical work. Actually, being a good clinician is probably 90% of being a doctor, while the hard-science background is still just as important.
Concepts of Health and Disease: This one is pretty cool. Think of the scenes in House M.D. when the team stands around a white-board and writes down what the diagnoses could be. Only in real life (on previously written-out cases). Seven of us sit in a little conference room with a faculty facilitator. In our case, it's a tough, mid-40s guy from Brooklyn with a thick New York accent. Seriously, the guy sounds like a mobster and you think he's picking a fight with you when he talks, but it's just how he talks! He's a Ph.D. in immunology and microbiology so he's going to be schooling your ass, too. And he does!
His job is to steer us in the right direction and keep us from going too deep into blind alleys. So we started with a case that seemed simple enough; a 45 year-old guy comes into the Emergency Dept. complaining of crushing chest-pain, shortness of breath, all that. Turns out, things get real tough real fast. We're all first-years, so we're all newbies when it comes to real medicine like this. We'd get stumped all the time and the facilitator would have to be like,
"...maybe....do a physical exam?"
"...try asking for a blood test? But be specific!"
"Hold on! Is a cholesterol level of 250 mg/dl really unremarkable?"
"You're missing an important detail!"
It got tough. We'd get to a part where we collectively said, "we need data from a physical exam" or "we need to do a urine test", at which point the facilitator would hand out the results of those tests. With the new data, we'd develop our hypotheses and think of more things to try to narrow things down. Along the way, we run into countless terms, procedures, tests that we know nothing about and have to go home and look them up. He had chest pain, but how can you rule out pulmonary edema? His WBC count was a little high, but that tells you nothing about a possible myocardial infarction. His serum albumin level was this but you thought it should be that...or his creatinine phosphokinase level said this.
It was all over and by the end of the session we only had a vague idea of what might be wrong with lots of data pointing nowhere (because we're all very new). Humbling, exciting!
Evidence Based Medicine: Decent. Not too exciting but kind of fun. Run by the emergency medicine department, so you get to see lots of Emerg. docs and read a lot of emerg. cases. I like that aspect of it. This course is about accessing data and articles and scientific/clinical studies within the scope of practice. It's about using patient data to help your own practice and how to know when a study has valid/invalid, relevant/irrelevant results. Cool.
Well...tonight I'm going to hit some more thoracic-region anatomy. Biochem and molecular cell started off really fast, but mostly college review. *deep breath* Let's do this...
I've always prided myself on being able to distill things down to their essence and then accomplishing them with speed and efficiency. This applies to school, as I got through pre-med college work accomplishing the same as others while putting in 50%-75% of the energy.
I realized that a lot of energy is wasted on things as simple as gossip, freaking-out, and over-studying. The group of super-gunners at my school will study in the medical center for 12 hours straight with no breaks and burn out. I stick to a solid schedule of daily study, leaving time for relaxation, keeping my head fresh for the next day. All the while, I feel relatively comfortable with the material, though this will change as time goes on and things become more unfamiliar and nasty.
We had some "soft" classes today; I think I'll enjoy them because they provide the training for the other half of being a physician: clinical work. Actually, being a good clinician is probably 90% of being a doctor, while the hard-science background is still just as important.
Concepts of Health and Disease: This one is pretty cool. Think of the scenes in House M.D. when the team stands around a white-board and writes down what the diagnoses could be. Only in real life (on previously written-out cases). Seven of us sit in a little conference room with a faculty facilitator. In our case, it's a tough, mid-40s guy from Brooklyn with a thick New York accent. Seriously, the guy sounds like a mobster and you think he's picking a fight with you when he talks, but it's just how he talks! He's a Ph.D. in immunology and microbiology so he's going to be schooling your ass, too. And he does!
His job is to steer us in the right direction and keep us from going too deep into blind alleys. So we started with a case that seemed simple enough; a 45 year-old guy comes into the Emergency Dept. complaining of crushing chest-pain, shortness of breath, all that. Turns out, things get real tough real fast. We're all first-years, so we're all newbies when it comes to real medicine like this. We'd get stumped all the time and the facilitator would have to be like,
"...maybe....do a physical exam?"
"...try asking for a blood test? But be specific!"
"Hold on! Is a cholesterol level of 250 mg/dl really unremarkable?"
"You're missing an important detail!"
It got tough. We'd get to a part where we collectively said, "we need data from a physical exam" or "we need to do a urine test", at which point the facilitator would hand out the results of those tests. With the new data, we'd develop our hypotheses and think of more things to try to narrow things down. Along the way, we run into countless terms, procedures, tests that we know nothing about and have to go home and look them up. He had chest pain, but how can you rule out pulmonary edema? His WBC count was a little high, but that tells you nothing about a possible myocardial infarction. His serum albumin level was this but you thought it should be that...or his creatinine phosphokinase level said this.
It was all over and by the end of the session we only had a vague idea of what might be wrong with lots of data pointing nowhere (because we're all very new). Humbling, exciting!
Evidence Based Medicine: Decent. Not too exciting but kind of fun. Run by the emergency medicine department, so you get to see lots of Emerg. docs and read a lot of emerg. cases. I like that aspect of it. This course is about accessing data and articles and scientific/clinical studies within the scope of practice. It's about using patient data to help your own practice and how to know when a study has valid/invalid, relevant/irrelevant results. Cool.
Well...tonight I'm going to hit some more thoracic-region anatomy. Biochem and molecular cell started off really fast, but mostly college review. *deep breath* Let's do this...
Friday, August 17, 2007
MS1-WK1...over
So week one of MS one is over...meaning now things about only about to begin. All the little orientation activities drove me insane by the end. Lectures are one thing. But sitting through 2-hour session after 2-hour session back to back to back of boring presentations gets really old really fast. One more and I think I'd have just started skipping. I've already found a super-gunner...for those uninitiated:
Gunner = medical student hell-bent on achieving the most possible at all costs. Has no social life, does not go out on weekends, studies every waking moment, and will talk down to fellow class-mates. Extremely competitive. Usually going for surgery, plastics, dermatology, ophthalmology, and in some cases radiology. Always annoying.
This girl wears her scrubs...during morning lecture. There's no need for this, as you're given plenty of time to change around 3 PM before anatomy lab starts. I see her walking around at 9 AM in scrubs, her name-tag proudly and deliberately displayed on the front pocket. Nobody else does this, because there's just no need to. Plus, those are supposedly scrubs from lab...they're likely pretty nasty, unless (heaven forbid) she has a clean pair just to wear for the hell of it during the day. She goes to eat at one of the on-campus hospitals and makes sure everyone sees her, sits in the very front row at lecture, and doesn't talk to anyone. To her, I say: Have fun with that!
Anyway, I really enjoyed the intro. lecture to Molecular Cell Biology this morning. I like the room it is in, and the professors seem very excited, friendly, helpful, and even fun! It's probably my favorite topic of all the classes I'm in right now, so I see it as quickly becoming my favorite class of the semester. Speaking of which, this is my proposed schedule for next week, Monday through Thursday...I think this is a decent start. It's going to be madness, I tell you.
8:00a - Wake up (pissed, no doubt)
9:00a - Arrive at lectures at school
12:00p - Lunch
1:00p - Anatomy lecture (MWF), other classes (TR)
3:00p - Anatomy lab (MWF), other classes (TR)
4:00p - I'm outta here! (TR)
5:00p - Anatomy lab should end (MWF)
6:00p - Get home, grab dinner, shower anatomy-smell off, regroup my thoughts...
7:00p - Off to Barnes-and-Noble/Starbucks/Apartment for focused study
11:00p - Dedicated AIM/phone time for friends/additional study/thoughts of bed?
12:00a - Watch anime episode to cool-down before bed/go to bed
1:00a - Passed out
So, 7-11pm, if I can pull it off, is the most valuable time of my days. If I can make good use of that time and get in the habit of focusing daily, I can keep up (and still, jussst barely). Weekends are a wild-card. I can plan on Friday-night off, but towards exams, weekends will be crunched. Sundays are generally going to be full-on study days as well. You learn fast here that time is precious.
First semester is the big hump, the proving grounds, the do-or-die, the sink-or-swim. If I can get past this huge monster, no more labs await me, ever. Histology and Microbiology lab are nothing compared to the involvement of anatomy lab. Some gems lie ahead, such as Christmas break and next summer, but I'll get to those when they come. Right now? Day by day...
Gunner = medical student hell-bent on achieving the most possible at all costs. Has no social life, does not go out on weekends, studies every waking moment, and will talk down to fellow class-mates. Extremely competitive. Usually going for surgery, plastics, dermatology, ophthalmology, and in some cases radiology. Always annoying.
This girl wears her scrubs...during morning lecture. There's no need for this, as you're given plenty of time to change around 3 PM before anatomy lab starts. I see her walking around at 9 AM in scrubs, her name-tag proudly and deliberately displayed on the front pocket. Nobody else does this, because there's just no need to. Plus, those are supposedly scrubs from lab...they're likely pretty nasty, unless (heaven forbid) she has a clean pair just to wear for the hell of it during the day. She goes to eat at one of the on-campus hospitals and makes sure everyone sees her, sits in the very front row at lecture, and doesn't talk to anyone. To her, I say: Have fun with that!
Anyway, I really enjoyed the intro. lecture to Molecular Cell Biology this morning. I like the room it is in, and the professors seem very excited, friendly, helpful, and even fun! It's probably my favorite topic of all the classes I'm in right now, so I see it as quickly becoming my favorite class of the semester. Speaking of which, this is my proposed schedule for next week, Monday through Thursday...I think this is a decent start. It's going to be madness, I tell you.
8:00a - Wake up (pissed, no doubt)
9:00a - Arrive at lectures at school
12:00p - Lunch
1:00p - Anatomy lecture (MWF), other classes (TR)
3:00p - Anatomy lab (MWF), other classes (TR)
4:00p - I'm outta here! (TR)
5:00p - Anatomy lab should end (MWF)
6:00p - Get home, grab dinner, shower anatomy-smell off, regroup my thoughts...
7:00p - Off to Barnes-and-Noble/Starbucks/Apartment for focused study
11:00p - Dedicated AIM/phone time for friends/additional study/thoughts of bed?
12:00a - Watch anime episode to cool-down before bed/go to bed
1:00a - Passed out
So, 7-11pm, if I can pull it off, is the most valuable time of my days. If I can make good use of that time and get in the habit of focusing daily, I can keep up (and still, jussst barely). Weekends are a wild-card. I can plan on Friday-night off, but towards exams, weekends will be crunched. Sundays are generally going to be full-on study days as well. You learn fast here that time is precious.
First semester is the big hump, the proving grounds, the do-or-die, the sink-or-swim. If I can get past this huge monster, no more labs await me, ever. Histology and Microbiology lab are nothing compared to the involvement of anatomy lab. Some gems lie ahead, such as Christmas break and next summer, but I'll get to those when they come. Right now? Day by day...
Tuesday, August 14, 2007
Calm.
Ok, so I've calmed down a little.
Found an alternate route to school that saves 5-7 minutes and bypasses about 8 (count 'em!) traffic lights, giving my car an easier time and increasing overall gas-mileage. Interstates can be crowded in the mornings, but they keep things moving nonetheless.
This first week is pretty light...I like to think of it as a transitional week. The only class I have is gross anatomy (and lab), plus a molecular cell biology (MCB) lecture Friday morning. The rest of the time is (unfortunately) spent doing what I call really soft stuff. Part of my school's curriculum is hard-science; the meat-and-potatoes of medical school. But, of course, they have a soft side that deals with ethics, moral reasoning, understanding patient's social contexts and all that. Good stuff, but I say its best left to specific classes like Intro to Clinical Medicine, which I'm taking.
So anyway, as part of this week, we spend time in ... workshops or modules, talking in little groups and "exploring" these other aspects of being a physician. Reasonable enough rationale, but in practice, it's really boring and annoying. I dread going in tomorrow morning to another four-hour block (8a-noon) of this crap. I'd rather wait and have an extra week of summer, then jump head-first into all my classes.
Whatever. It's just been funny, because here I am, officially started medical school, and I've spent my days playing games and watching anime. That'll all change soon enough, but I can't help but cling desperately to that last shred of freedom.
Ok, this is for real. This path is tough! You work your ass off to get in in the first place, then an up-hill battle awaits you. Talk about needing dedication! I'm already feeling like I'm drinking from a fire-hose and nothing has really started yet. But here are the good points, if there are any:
Textbooks Are History
That's right; virtually no textbooks. I know a 4th year who used none and did awesome. You can easily get by on notes alone. I personally have two and only two text-books. One is the anatomy dissection guide so I can study the cadaver better ($51.00). The other is a hand-me-down from my older sister; an anatomy atlas. That's it. I spent about 1/6 the money I usually do for a semester of college. But here's where it gets nasty. The notes, which you have to know cold, are pretty much entire reams of paper for each class.
I got my gross anatomy note packet (all shrink-wrapped and all) and was delighted! Oh, look at all these notes! It's 1 1/2" thick, thicker than a bible, and has to have around 400 pages! I realized only later that this is just the packet for exam 1, of which there will be 3 exams. Multiply that stack of paper by 3 and you have a stack of paper as high as about 3 Holy Bibles stacked on top of each other. Each page containing loads of information you are responsible for. And that's just anatomy...
Throw in Molecular Cell Biology, Immunology, Biochemistry, and two "soft" classes and you have a sick amount of information to learn, even if only by notes. And that's just first semester of first year.
Overwhelmed doesn't even start to describe what I am.
The fact that I haven't ran to the Dean's office crying "I quit" is testament to my desire to actually do this, so I think I'm going to make it.
Medicine really does threaten to consume you, but I've met enough Emergency Medicine doctors who have big-time lives outside of medicine to be convinced that you don't have to die for it. Plus, my friend from Livejournal graduated from my school and is a 1st year resident. A huge gamer like me, his advice to me was helpful.
I'm overwhelmed. As long as I retain important contacts/relationships and have fun now and then, I'm up for anything...
You'll Spend Less and Less Time at School
Yeah, my schedule is kind of crappy. 8a-5p most days for now. Later in the semester, it cuts back some and I get to come in a bit later, but typically, first semester is by far the worst when it comes to time spent at school. The reason is gross anatomy lab, which consumes hours and hours of time at school. I spend Mon/Wed/Fri in lecture for that class, 1p-2:30p, then hit the lab from 2:30p-5:00p and more if they had their way.
Spending 9 hours a day at school then going home with only studying to do is quite, quite demoralizing and dehumanizing. But there is hope...
All lectures are recorded and posted online. Most are even video-taped and posted online. All recordings are typed out verbatim and posted online. Get this? This means you don't have to come to lecture at all. And many don't. After the drudgery of first-year anatomy lab, the focus shifts to predominantly lectures, most of which I plan to skip. I retrieve the information at home and get a heck of a lot more done. Get this:
A) Spend the hour driving through rush-hour traffic to and from school, walking to and from your car, dealing with in-between class nonsense, lunch, etc to get home at 6:00pm exhausted
B) Get up, study, retrieve lectures, study them, finish a full day of focused work by dinner-time (at home) and spend the evening chilling out/going out.
Yeah, I choose choice B. You'll get just as much (or more) done during a full day at home from 9a-5p then you will from 9a-midnight going to school. Energy is important. Trying to get your best studying done when you're exhausted from a day at school is counter-productive. I'm all for efficient, convenient at-home learning which saves time for better things later.
Now, I can't practice this wonderful philosophy just yet; first year has far too many at-school engagements. But mark my words, I'm going to milk this system for all its worth and get the most out of it. That's how I like doing things and I plan on having fun!
Study Habits
Haven't figured this out yet. In college, I did my most heavy-duty work at the computer-lab, which was a 5-minute walk from my dorm. I can't just walk to places anymore. Studying in my room is looking to be more and more something I don't want to do, but it takes so much energy to go anywhere that I don't want to leave it. My 1st choice is Barnes and Noble; I can get my latte/chai/french-vanilla or what have you, and work efficiently. Then I can browse/buy manga when I'm done! There's a Starbucks really close to where I live, but I like the book-store aspect of things.
I'm not someone who likes studying at school (at all), so studying at the medical library or in a lounge on campus is out of the question. It's a decent campus, but to me it is strictly a tool for using and getting out when possible. I study best at my own places where I'm comfortable.
So I might try studying at home at first when things get tough. Then I'll see how that goes and try at the bookstore and compare the two. Who knows what will transpire. I'm just overwhelmed right now so excuse me.
Found an alternate route to school that saves 5-7 minutes and bypasses about 8 (count 'em!) traffic lights, giving my car an easier time and increasing overall gas-mileage. Interstates can be crowded in the mornings, but they keep things moving nonetheless.
This first week is pretty light...I like to think of it as a transitional week. The only class I have is gross anatomy (and lab), plus a molecular cell biology (MCB) lecture Friday morning. The rest of the time is (unfortunately) spent doing what I call really soft stuff. Part of my school's curriculum is hard-science; the meat-and-potatoes of medical school. But, of course, they have a soft side that deals with ethics, moral reasoning, understanding patient's social contexts and all that. Good stuff, but I say its best left to specific classes like Intro to Clinical Medicine, which I'm taking.
So anyway, as part of this week, we spend time in ... workshops or modules, talking in little groups and "exploring" these other aspects of being a physician. Reasonable enough rationale, but in practice, it's really boring and annoying. I dread going in tomorrow morning to another four-hour block (8a-noon) of this crap. I'd rather wait and have an extra week of summer, then jump head-first into all my classes.
Whatever. It's just been funny, because here I am, officially started medical school, and I've spent my days playing games and watching anime. That'll all change soon enough, but I can't help but cling desperately to that last shred of freedom.
Ok, this is for real. This path is tough! You work your ass off to get in in the first place, then an up-hill battle awaits you. Talk about needing dedication! I'm already feeling like I'm drinking from a fire-hose and nothing has really started yet. But here are the good points, if there are any:
Textbooks Are History
That's right; virtually no textbooks. I know a 4th year who used none and did awesome. You can easily get by on notes alone. I personally have two and only two text-books. One is the anatomy dissection guide so I can study the cadaver better ($51.00). The other is a hand-me-down from my older sister; an anatomy atlas. That's it. I spent about 1/6 the money I usually do for a semester of college. But here's where it gets nasty. The notes, which you have to know cold, are pretty much entire reams of paper for each class.
I got my gross anatomy note packet (all shrink-wrapped and all) and was delighted! Oh, look at all these notes! It's 1 1/2" thick, thicker than a bible, and has to have around 400 pages! I realized only later that this is just the packet for exam 1, of which there will be 3 exams. Multiply that stack of paper by 3 and you have a stack of paper as high as about 3 Holy Bibles stacked on top of each other. Each page containing loads of information you are responsible for. And that's just anatomy...
Throw in Molecular Cell Biology, Immunology, Biochemistry, and two "soft" classes and you have a sick amount of information to learn, even if only by notes. And that's just first semester of first year.
Overwhelmed doesn't even start to describe what I am.
The fact that I haven't ran to the Dean's office crying "I quit" is testament to my desire to actually do this, so I think I'm going to make it.
Medicine really does threaten to consume you, but I've met enough Emergency Medicine doctors who have big-time lives outside of medicine to be convinced that you don't have to die for it. Plus, my friend from Livejournal graduated from my school and is a 1st year resident. A huge gamer like me, his advice to me was helpful.
I'm overwhelmed. As long as I retain important contacts/relationships and have fun now and then, I'm up for anything...
You'll Spend Less and Less Time at School
Yeah, my schedule is kind of crappy. 8a-5p most days for now. Later in the semester, it cuts back some and I get to come in a bit later, but typically, first semester is by far the worst when it comes to time spent at school. The reason is gross anatomy lab, which consumes hours and hours of time at school. I spend Mon/Wed/Fri in lecture for that class, 1p-2:30p, then hit the lab from 2:30p-5:00p and more if they had their way.
Spending 9 hours a day at school then going home with only studying to do is quite, quite demoralizing and dehumanizing. But there is hope...
All lectures are recorded and posted online. Most are even video-taped and posted online. All recordings are typed out verbatim and posted online. Get this? This means you don't have to come to lecture at all. And many don't. After the drudgery of first-year anatomy lab, the focus shifts to predominantly lectures, most of which I plan to skip. I retrieve the information at home and get a heck of a lot more done. Get this:
A) Spend the hour driving through rush-hour traffic to and from school, walking to and from your car, dealing with in-between class nonsense, lunch, etc to get home at 6:00pm exhausted
B) Get up, study, retrieve lectures, study them, finish a full day of focused work by dinner-time (at home) and spend the evening chilling out/going out.
Yeah, I choose choice B. You'll get just as much (or more) done during a full day at home from 9a-5p then you will from 9a-midnight going to school. Energy is important. Trying to get your best studying done when you're exhausted from a day at school is counter-productive. I'm all for efficient, convenient at-home learning which saves time for better things later.
Now, I can't practice this wonderful philosophy just yet; first year has far too many at-school engagements. But mark my words, I'm going to milk this system for all its worth and get the most out of it. That's how I like doing things and I plan on having fun!
Study Habits
Haven't figured this out yet. In college, I did my most heavy-duty work at the computer-lab, which was a 5-minute walk from my dorm. I can't just walk to places anymore. Studying in my room is looking to be more and more something I don't want to do, but it takes so much energy to go anywhere that I don't want to leave it. My 1st choice is Barnes and Noble; I can get my latte/chai/french-vanilla or what have you, and work efficiently. Then I can browse/buy manga when I'm done! There's a Starbucks really close to where I live, but I like the book-store aspect of things.
I'm not someone who likes studying at school (at all), so studying at the medical library or in a lounge on campus is out of the question. It's a decent campus, but to me it is strictly a tool for using and getting out when possible. I study best at my own places where I'm comfortable.
So I might try studying at home at first when things get tough. Then I'll see how that goes and try at the bookstore and compare the two. Who knows what will transpire. I'm just overwhelmed right now so excuse me.
Monday, August 13, 2007
You Get Used to It
It's not something that many people do, sinking a fresh scalpel blade into human flesh. I wasn't sure if I was putting enough pressure into the incision, but when I saw the layers of sub-cutaneous fascia peel back, I knew I had gone deep enough. Just above that lay the dermis and above that, the epidermis (skin). The epidermis is so thin; such a thin layer of cells to keep your body from catching the endless diseases and infections waiting just outside of it. The skin gave way so easily; a disturbing reminder of just how thin our security blanket is, like the skin on an apple.
The doors of the dissection table opened like a clam-shell, swinging 180-degrees down where we latched them back to each other at the bottom. Underneath lay a shrouded figure, a white-cloth covering a vague human form. I could see toes peeking out from underneath the bottom of the cloth...then, as about 25 other tables were opened, my nostrils flared and I coughed, the pungent smell of formaldehyde overcoming my senses.
We lifted the veil off and discovered an elderly lady underneath, lying sadly but intentionally on her stomach. Her arms and head covered in another white cloth, she didn't seem to mind the attention or the smell; she'd been dead for months after-all. Therefore, she didn't complain when we sunk our scalpel into her head, just inferior to her external occipital protuberance. It was an intense few hours. It took a little bit at first to overcome the psychological/emotional barrier of what we were doing. It's morbid, visceral, fascinating. I thought I'd know just what it would be like, but when you're there doing it...it is totally different. Within 15 minutes me and my lab partners were digging right in (literally). Clamp, forceps, scalpel...it all began to come together...if only it weren't for that strong smell in the air.
A network of large, flat plasma screens litter the lab. From the front, the professor or assistants display examples for all 125 or so students to see. We work fast. Dead bodies everywhere and after a few minutes, it all becomes normal, everyday business.
The doors of the dissection table opened like a clam-shell, swinging 180-degrees down where we latched them back to each other at the bottom. Underneath lay a shrouded figure, a white-cloth covering a vague human form. I could see toes peeking out from underneath the bottom of the cloth...then, as about 25 other tables were opened, my nostrils flared and I coughed, the pungent smell of formaldehyde overcoming my senses.
We lifted the veil off and discovered an elderly lady underneath, lying sadly but intentionally on her stomach. Her arms and head covered in another white cloth, she didn't seem to mind the attention or the smell; she'd been dead for months after-all. Therefore, she didn't complain when we sunk our scalpel into her head, just inferior to her external occipital protuberance. It was an intense few hours. It took a little bit at first to overcome the psychological/emotional barrier of what we were doing. It's morbid, visceral, fascinating. I thought I'd know just what it would be like, but when you're there doing it...it is totally different. Within 15 minutes me and my lab partners were digging right in (literally). Clamp, forceps, scalpel...it all began to come together...if only it weren't for that strong smell in the air.
A network of large, flat plasma screens litter the lab. From the front, the professor or assistants display examples for all 125 or so students to see. We work fast. Dead bodies everywhere and after a few minutes, it all becomes normal, everyday business.
Sunday, August 12, 2007
Anxious
Whenever I go through a huge change or my mind is reeling 10x faster than normal, I tend to have to write to keep things from getting out of control. It is partially therapeutic and it helps other people know what is going on with me. Case-in-point, I began my LJ when I began college back in fall of 2003. Wow...forever ago!
And here I am on the eve of my very first true day of medical school, writing again. I had two days of orientation, yes, but tomorrow is the official, actual first day when the material starts hitting me from all sides! I plan on starting on the right foot, on hitting the ground running so I don't fall behind from the get-go. Daily discipline is how I plan on attacking things; forming solid study-habits early on and keeping up as best I can.
I feel strangely ready and confident, having had practically a year of almost no academic commitments. I have no excuse not to be ready after the huge break I've had. Yet, you slip all too easily into routines, and it will take effort to get my brain churning again. Tomorrow I have some things to do for the school, like some CPR-training (who knows why...), fit-testing (for these M95 masks...), and first anatomy lecture/lab. Eh, it'll go, I'm sure.
I'll let you know how it goes.
And here I am on the eve of my very first true day of medical school, writing again. I had two days of orientation, yes, but tomorrow is the official, actual first day when the material starts hitting me from all sides! I plan on starting on the right foot, on hitting the ground running so I don't fall behind from the get-go. Daily discipline is how I plan on attacking things; forming solid study-habits early on and keeping up as best I can.
I feel strangely ready and confident, having had practically a year of almost no academic commitments. I have no excuse not to be ready after the huge break I've had. Yet, you slip all too easily into routines, and it will take effort to get my brain churning again. Tomorrow I have some things to do for the school, like some CPR-training (who knows why...), fit-testing (for these M95 masks...), and first anatomy lecture/lab. Eh, it'll go, I'm sure.
I'll let you know how it goes.
Friday, August 10, 2007
First Day? Kind of?
All right, so I had orientation today. A long, boring day of buying materials, meetings, and more meetings.
Imagine sitting in a room with 290 other kids while department head after department head are thrown at you, presenting information on financial aid, student council, and various student services.
I arrived around 9:00AM and ended up being parked right across from the one other kid at this medical school that comes from my undergraduate college. He and I walked together to the main building (Medical Sciences) and got lost in the frenzy of kids and tables. I went to the first table and got my name-tag and folder full of orientation-type goodies. It was an hour and a half of scurrying about, getting money from the union building, getting my (anatomy) locker key, buying packets of notes, getting pictures taken, and other odds and ends. Boring.
We shuffled into the lecture hall for a few presentations from the faculty. A nice Dermatologist lady introduced us to the class she will teach: Introduction to Clinical Medicine: Patient-Doctor Relationship. That class seems like it will be really good. Then the anatomy professor came up...that class looks like it will be a real trip! The guy is really nice and seems cool, though. He told us all about cadavers and how those people died hoping that their bodies would educate doctors who would, in turn, heal many sick people.
Can you imagine the impact then, that these dead people have on ultimately 1,000s of patients? Accomplishing that much after you're dead is pretty cool!
We saw that we would end up having to learn over 10,000 terms over the course of anatomy, and that's just the terms. Agh! What a trip!
A word on the fellow students: boring! I'm sure that as the year begins, I will meet some neat people, but on the whole, typical medical crowd. Sports, boring stuff, sports all over. How did a geek like me get attracted to medicine when nobody else in medicine is like me? I'll never figure out how I share that one common point of interests with all those people.
Anyway, I met Johnny for lunch and he told me the stresses of Dental School. The afternoon was just a bunch of boring presentations from various people, and we took a Meyers-Briggs personality-type indicator. It tells you what kind of personality you have or something like that...last time I took it I got INTJ. But whatever, ya know?
We got it driven into our heads a lot that we will "undergo a transformation from civilian life to professional life", and even the financial guy was telling us about how huge income comes with huge responsibility. Yeah, yeah, I just wish I were in college again where things are actually fun. I'm here to learn a profession, not deal with all this paper-work!
Hmm, so it seems like a really good faculty and school. I have plenty of escapes around my state so I know I can stay sane. I look forward to getting the most out of my school, and then moving on to a really enjoyable career in perhaps Emergency Medicine or Anesthesia!
I'm sleepy. I have more "activities" tomorrow, including the white-coat ceremony.
Imagine sitting in a room with 290 other kids while department head after department head are thrown at you, presenting information on financial aid, student council, and various student services.
I arrived around 9:00AM and ended up being parked right across from the one other kid at this medical school that comes from my undergraduate college. He and I walked together to the main building (Medical Sciences) and got lost in the frenzy of kids and tables. I went to the first table and got my name-tag and folder full of orientation-type goodies. It was an hour and a half of scurrying about, getting money from the union building, getting my (anatomy) locker key, buying packets of notes, getting pictures taken, and other odds and ends. Boring.
We shuffled into the lecture hall for a few presentations from the faculty. A nice Dermatologist lady introduced us to the class she will teach: Introduction to Clinical Medicine: Patient-Doctor Relationship. That class seems like it will be really good. Then the anatomy professor came up...that class looks like it will be a real trip! The guy is really nice and seems cool, though. He told us all about cadavers and how those people died hoping that their bodies would educate doctors who would, in turn, heal many sick people.
Can you imagine the impact then, that these dead people have on ultimately 1,000s of patients? Accomplishing that much after you're dead is pretty cool!
We saw that we would end up having to learn over 10,000 terms over the course of anatomy, and that's just the terms. Agh! What a trip!
A word on the fellow students: boring! I'm sure that as the year begins, I will meet some neat people, but on the whole, typical medical crowd. Sports, boring stuff, sports all over. How did a geek like me get attracted to medicine when nobody else in medicine is like me? I'll never figure out how I share that one common point of interests with all those people.
Anyway, I met Johnny for lunch and he told me the stresses of Dental School. The afternoon was just a bunch of boring presentations from various people, and we took a Meyers-Briggs personality-type indicator. It tells you what kind of personality you have or something like that...last time I took it I got INTJ. But whatever, ya know?
We got it driven into our heads a lot that we will "undergo a transformation from civilian life to professional life", and even the financial guy was telling us about how huge income comes with huge responsibility. Yeah, yeah, I just wish I were in college again where things are actually fun. I'm here to learn a profession, not deal with all this paper-work!
Hmm, so it seems like a really good faculty and school. I have plenty of escapes around my state so I know I can stay sane. I look forward to getting the most out of my school, and then moving on to a really enjoyable career in perhaps Emergency Medicine or Anesthesia!
I'm sleepy. I have more "activities" tomorrow, including the white-coat ceremony.
Thursday, August 9, 2007
Confucius
A journey of a thousand miles begins with...a single step. Well, no doubt about that; no way to get around the fact that everyone has to start somewhere, even the most arrogant, high-up guy or gal out there.
I have my orientation tomorrow - the day I consider to be the first day of actual medical school and the end of summer as I know it. We get ID cards, meet professors, meet each other (choke me now), and go through all the cute little motions you have to go through. Saturday is a few more activities (breakfast, tours) and then the initiation ceremony (white-coat). Then I have Sunday off before starting Monday. I'm petrified!
It all begins soon. It's all-or-nothing now. I plan to work very, very hard, but do not plan to be a gunner. I will balance myself and still enjoy life. Here goes...I'll keep you updated.
I have my orientation tomorrow - the day I consider to be the first day of actual medical school and the end of summer as I know it. We get ID cards, meet professors, meet each other (choke me now), and go through all the cute little motions you have to go through. Saturday is a few more activities (breakfast, tours) and then the initiation ceremony (white-coat). Then I have Sunday off before starting Monday. I'm petrified!
It all begins soon. It's all-or-nothing now. I plan to work very, very hard, but do not plan to be a gunner. I will balance myself and still enjoy life. Here goes...I'll keep you updated.
Tuesday, June 26, 2007
The International Aspect
International education: what gives?
Though I'm hopelessly poor in international experiences, I do hold the belief that they can be vital to a person's resume, no matter what career they go into. I went to a college that stressed international education. In fact, its study-abroad program was basically its selling point, as it is one of the nation's better-known schools for having a large proportion of its student body study abroad (about 50%). That said, I was in the 50% that did not study abroad, and do I regret it? Not really.
My Mother came to the United States in the 70s from Indonesia along with her immediate family. Some other 1st-generation immigrants from her family are here in the States as well. I grew up around both my father's "American" culture and my mother's "South-East Asian" culture, being exposed to the practices, customs, and languages of both. However, I've been largely assimilated into U.S. culture, as I hardly know more than 3 words of my Mom's native language, and can only barely point the country itself out on a map (yeah, it's the one that shares an Island with Papua/New Guinea).
Anyway, other than being a hybrid of Chinese and White by blood, I'm a very American guy. I've had many friends/acquaintances go abroad for 3 months during college to...Dominican Republic, Ethiopia, China, Germany, even Peru. Their experiences have changed them and have been very valuable. I envy the clinical experiences they've had and the languages they've learned. But strangely, I feel right at home with the path I've taken. I've spent my summers doing research and my semesters loading up on the science courses I've needed.
Ultimately, I used my extensive research experience as my pitch to the admissions committee. Not every single person needs to boast working an AIDS clinic in Sub-Saharan Africa, right? It's a plus, but (at least not yet) it isn't an un-written rule like hospital volunteering is.
But just how important is the international experience? While shadowing the ophthalmologist last Thursday (who graduated from my college as well, albeit awhile ago), he asked me the dreaded question, mid-operation mind you: "So where did you go for your Study Service Term?"
"...Actually, I didn't do it. I took the alternatives instead."
"[Just about jabbed the sedated patient's eye with his scalpel] Are you kidding me? Yuki, Yuki, Yuki!"
The usual question, usual response, usual shocked answer. He wasn't actually upset, I mean it's my life, but he made his speech about how his time in Central America was so pivotal to his identity as a doctor.
"Down there...you practice real medicine. No bureaucratic systems or endless paperwork to get in your way; you do medicine on needy people and get to the heart of what it is all about. Only there are you a real doctor."
Yes, yes, I know. Things are different out there, outside the high-gates of this magical country stained with power-politics and malpractice suits. He kept telling the other docs that I was going to become a "missionary doctor", as if to poke fun at the fact that I've done nothing outside of the U.S. I didn't take offense then, and don't now, but he was just another person laying into me for not going abroad during college.
Is it that important? I don't doubt for a second that the experience is valuable...to understand another place, another culture, another people. Places where 911 doesn't get you to the nearest ER within 10 minutes, places where insurance is a foreign concept and places where germ-theory hasn't yet permeated common knowledge. I'm aware of this, and while brute knowledge/awareness is no substitute for experience, I'd say I'm more culturally sensitive than a lot of other pre-MDs I know. Unless driving the 2007 BMW your Dad bought you to school, and complaining about how "hard" life is at your $850/month 1 bedroom apartment on the Canal constitutes cultural sensitivity. Not every medical student is like this, but they do tend to come from higher tiers of society and these attitudes have been seen again and again.
But again, being an American citizen going to an American medical school to practice medicine in America for your entire life, will having visited or not visited a foreign country prior to medical training affect your skill at practicing medicine? America does have a great amount of immigrants living in it from every conceivable location; no matter what kind of doc you are, you are going to work directly with patients and patients come from everywhere. Just as with many other careers, inter-cultural awareness/sensitivity is important ("Diversity Training" on that show, The Office). Yes. I know this. Perhaps it is even more important in medicine because of the relationship you establish with your patients and the diversity of beliefs as they pertain to medicine found around the world.
I'm not sure what the general consensus is out there, but in the bubble that I've grown up in, people seem to think that your ability to practice medicine is directly proportional to how much international service you have done. I'm sure there are many great docs out there who have never left their state! I'm sure there are radiologists and pathologists out there who do impeccable work, never having spent a second serving in a foreign country. I'm also sure there are docs from this same pool who have spent time abroad and feel that it has helped them become who they are.
I think it is just a personal choice and that everyone has a different path. Sure, if I had spent time in Peru volunteering at a Peruvian hospital, I'm sure that my perspective on the human condition and patient care would be more broad today. But, won't I get the same training as the guy next to me who spends every other week in Haiti? I'll do schooling and residency and develop the skills needed to become an excellent physician. It all comes from within. Anyone reasonable enough to get into medical school has to have enough reason to acquire cultural sensitivity throughout their training and practice.
Bottom line? I agree that international experience can really help a physician have a wider perspective. But not having that experience can't hurt you if you work hard and do your part to become a great doctor. There's enough work to do in American health-care. This is where I ultimately want to practice. Can't I just focus here and not be hassled?
Though I'm hopelessly poor in international experiences, I do hold the belief that they can be vital to a person's resume, no matter what career they go into. I went to a college that stressed international education. In fact, its study-abroad program was basically its selling point, as it is one of the nation's better-known schools for having a large proportion of its student body study abroad (about 50%). That said, I was in the 50% that did not study abroad, and do I regret it? Not really.
My Mother came to the United States in the 70s from Indonesia along with her immediate family. Some other 1st-generation immigrants from her family are here in the States as well. I grew up around both my father's "American" culture and my mother's "South-East Asian" culture, being exposed to the practices, customs, and languages of both. However, I've been largely assimilated into U.S. culture, as I hardly know more than 3 words of my Mom's native language, and can only barely point the country itself out on a map (yeah, it's the one that shares an Island with Papua/New Guinea).
Anyway, other than being a hybrid of Chinese and White by blood, I'm a very American guy. I've had many friends/acquaintances go abroad for 3 months during college to...Dominican Republic, Ethiopia, China, Germany, even Peru. Their experiences have changed them and have been very valuable. I envy the clinical experiences they've had and the languages they've learned. But strangely, I feel right at home with the path I've taken. I've spent my summers doing research and my semesters loading up on the science courses I've needed.
Ultimately, I used my extensive research experience as my pitch to the admissions committee. Not every single person needs to boast working an AIDS clinic in Sub-Saharan Africa, right? It's a plus, but (at least not yet) it isn't an un-written rule like hospital volunteering is.
But just how important is the international experience? While shadowing the ophthalmologist last Thursday (who graduated from my college as well, albeit awhile ago), he asked me the dreaded question, mid-operation mind you: "So where did you go for your Study Service Term?"
"...Actually, I didn't do it. I took the alternatives instead."
"[Just about jabbed the sedated patient's eye with his scalpel] Are you kidding me? Yuki, Yuki, Yuki!"
The usual question, usual response, usual shocked answer. He wasn't actually upset, I mean it's my life, but he made his speech about how his time in Central America was so pivotal to his identity as a doctor.
"Down there...you practice real medicine. No bureaucratic systems or endless paperwork to get in your way; you do medicine on needy people and get to the heart of what it is all about. Only there are you a real doctor."
Yes, yes, I know. Things are different out there, outside the high-gates of this magical country stained with power-politics and malpractice suits. He kept telling the other docs that I was going to become a "missionary doctor", as if to poke fun at the fact that I've done nothing outside of the U.S. I didn't take offense then, and don't now, but he was just another person laying into me for not going abroad during college.
Is it that important? I don't doubt for a second that the experience is valuable...to understand another place, another culture, another people. Places where 911 doesn't get you to the nearest ER within 10 minutes, places where insurance is a foreign concept and places where germ-theory hasn't yet permeated common knowledge. I'm aware of this, and while brute knowledge/awareness is no substitute for experience, I'd say I'm more culturally sensitive than a lot of other pre-MDs I know. Unless driving the 2007 BMW your Dad bought you to school, and complaining about how "hard" life is at your $850/month 1 bedroom apartment on the Canal constitutes cultural sensitivity. Not every medical student is like this, but they do tend to come from higher tiers of society and these attitudes have been seen again and again.
But again, being an American citizen going to an American medical school to practice medicine in America for your entire life, will having visited or not visited a foreign country prior to medical training affect your skill at practicing medicine? America does have a great amount of immigrants living in it from every conceivable location; no matter what kind of doc you are, you are going to work directly with patients and patients come from everywhere. Just as with many other careers, inter-cultural awareness/sensitivity is important ("Diversity Training" on that show, The Office). Yes. I know this. Perhaps it is even more important in medicine because of the relationship you establish with your patients and the diversity of beliefs as they pertain to medicine found around the world.
I'm not sure what the general consensus is out there, but in the bubble that I've grown up in, people seem to think that your ability to practice medicine is directly proportional to how much international service you have done. I'm sure there are many great docs out there who have never left their state! I'm sure there are radiologists and pathologists out there who do impeccable work, never having spent a second serving in a foreign country. I'm also sure there are docs from this same pool who have spent time abroad and feel that it has helped them become who they are.
I think it is just a personal choice and that everyone has a different path. Sure, if I had spent time in Peru volunteering at a Peruvian hospital, I'm sure that my perspective on the human condition and patient care would be more broad today. But, won't I get the same training as the guy next to me who spends every other week in Haiti? I'll do schooling and residency and develop the skills needed to become an excellent physician. It all comes from within. Anyone reasonable enough to get into medical school has to have enough reason to acquire cultural sensitivity throughout their training and practice.
Bottom line? I agree that international experience can really help a physician have a wider perspective. But not having that experience can't hurt you if you work hard and do your part to become a great doctor. There's enough work to do in American health-care. This is where I ultimately want to practice. Can't I just focus here and not be hassled?
Saturday, June 23, 2007
Light Shed
Well, since my post on Anesthesiology, I have had some light shed on the subject!
First, through an unexpected (but greatly appreciated) comment from an actual anesthesiologist, I got feedback on my post and then read her extremely informative post. The post is the result of her frustrations with the general misconception (even by other physicians) about her profession/specialty. Really informative and insightful stuff; just what I was looking for! Read it here.
The other aspect of this is when I shadowed an oculo-plastics ophthalmologist the other day. He is a friend of my friend, so I guess I'm connected to him by two points. Anyway, there was an anesthesiologist present during some of his cases, so I had the chance to talk to the gas man himself! It wasn't a very long interaction, but it was useful in any case. I also got to talk with a pathologist, who seemed quite happy tucked away in his nice office, far from the buzzing, meat-moving flow of the rest of the hospital. A few histology slides later, and I was on my way back to the O.R. to watch more eye-lids get slashed open.
Anyway, it goes to show. You must mature a lot during medical school; the exposure you receive, the blood and sweat you suffer, the time you spend, and the experiences you have probably all act to guide you into your own little niche. And as I've discovered elsewhere in life, things always change, and if you're up to it, they'll change for the better. I think the best I can do now is focus on the two years ahead...or perhaps just the month or two ahead.
Overwhelmed, but excited.
Countdown until day 1 of school: ~51 days
First, through an unexpected (but greatly appreciated) comment from an actual anesthesiologist, I got feedback on my post and then read her extremely informative post. The post is the result of her frustrations with the general misconception (even by other physicians) about her profession/specialty. Really informative and insightful stuff; just what I was looking for! Read it here.
The other aspect of this is when I shadowed an oculo-plastics ophthalmologist the other day. He is a friend of my friend, so I guess I'm connected to him by two points. Anyway, there was an anesthesiologist present during some of his cases, so I had the chance to talk to the gas man himself! It wasn't a very long interaction, but it was useful in any case. I also got to talk with a pathologist, who seemed quite happy tucked away in his nice office, far from the buzzing, meat-moving flow of the rest of the hospital. A few histology slides later, and I was on my way back to the O.R. to watch more eye-lids get slashed open.
Anyway, it goes to show. You must mature a lot during medical school; the exposure you receive, the blood and sweat you suffer, the time you spend, and the experiences you have probably all act to guide you into your own little niche. And as I've discovered elsewhere in life, things always change, and if you're up to it, they'll change for the better. I think the best I can do now is focus on the two years ahead...or perhaps just the month or two ahead.
Overwhelmed, but excited.
Countdown until day 1 of school: ~51 days
Sunday, June 10, 2007
Skeptic
I'd have to side with Uncle Panda on the Chiropractic issue: Its junk science at best, and most likely just a quack/hoax to get gullible "patients" to cough up money for perceived symptom relief.
The very (shaky) foundation upon which this (undeserved and isolated) "branch" of medicine rests is itself laughable. Daniel D Palmer, back in 1895, created some theory that states that there is an innate life force which flows through all of your organs/tissues/cells via the spinal column. He said that 95% of ailments are the result of mis-aligned vertebrae, because the vertebrae "pinch" nerves. By performing physical manipulations on these vertebrae (vertebral subluxations), one can (supposedly) correct the nerve-pinching culprit and restore "flow" to the affected organ(s), relieving symptoms.
With over 60,000 licensed chiropractors "practicing" in the U.S., I'm sorry to see so much money being thrown at quacks. But aren't palm-reading, fortune-telling, and herbal-medicine shops still in business? Yeah, and that's the category that I toss Chiropractic in as well. The very nebulous nature of their catch-phrases (no two Chiropractors could agree on or tell you the exact pathology of subluxations and their supposed corrections) and reliance on high-frequency-return visits proves their illegitimacy as health-care providers. Food for thought:
Baloney, baloney, baloney. You might get immediate relief, but that whole theory makes me annoyed.
And so, I'm quite a skeptic. Not to say that I refuse to believe in things that are not directly observable, but things like Chiropractic, acupuncture, ghosts, chi-manipulation...how can the masses fall under the opium so easily?
The very (shaky) foundation upon which this (undeserved and isolated) "branch" of medicine rests is itself laughable. Daniel D Palmer, back in 1895, created some theory that states that there is an innate life force which flows through all of your organs/tissues/cells via the spinal column. He said that 95% of ailments are the result of mis-aligned vertebrae, because the vertebrae "pinch" nerves. By performing physical manipulations on these vertebrae (vertebral subluxations), one can (supposedly) correct the nerve-pinching culprit and restore "flow" to the affected organ(s), relieving symptoms.
With over 60,000 licensed chiropractors "practicing" in the U.S., I'm sorry to see so much money being thrown at quacks. But aren't palm-reading, fortune-telling, and herbal-medicine shops still in business? Yeah, and that's the category that I toss Chiropractic in as well. The very nebulous nature of their catch-phrases (no two Chiropractors could agree on or tell you the exact pathology of subluxations and their supposed corrections) and reliance on high-frequency-return visits proves their illegitimacy as health-care providers. Food for thought:
There is plenty of room for the passage of spinal nerves and blood vessels through the fat-padded foraminal openings between the vertebrae. It cannot be imagined that slight displacement of a normal vertebra will place pressure on a spinal nerve. This was proven conclusively 25 years ago by experiments performed by Edmund S. Crelin, PhD, a prominent anatomist at Yale University. Using dissected spines with ligaments attached and the spinal nerves exposed, he used a drill press to bend and twist the spine. Using an ohm meter to record any contact between wired spinal nerves and the foraminal openings, he found that vertebrae could not be displaced enough to stretch or impinge a spinal nerve unless the force was great enough to break the spine [1].Not only that, but time after time, investigators go to multiple Chiropractors and receive different results/treatments each and every time. One time I'm told my left leg is longer, another time vice-versa, and another time I'm told my bladder is going to be distended because my x, y, z nerve is pinched. You get the idea.
Baloney, baloney, baloney. You might get immediate relief, but that whole theory makes me annoyed.
And so, I'm quite a skeptic. Not to say that I refuse to believe in things that are not directly observable, but things like Chiropractic, acupuncture, ghosts, chi-manipulation...how can the masses fall under the opium so easily?
Friday, May 25, 2007
Anesthesiology: It Doesn't Fit!
I'd like to think that the universe is fundamentally based on order. The physicists have already tackled this question, from Einstein's relativity ("God does not play dice") to more modern quantum mechanics and its uncertainty.
Still, things tend to fit into a sensible world-view, right? Those who work hard get rewarded and those who are lazy end up on the bottom.
We all know that life isn't by any stretch of the imagination fair, and that the world often works in chaos-mode. Kids starve in Africa, bad things happen to good people, the hard-working go unrewarded and the hero goes unsung.
In medical specialties, I came to the realization that things do have an internal order. The specialties with a better lifestyle/income are predictably harder to match into because of competition resulting from too many students vying for few coveted spots.
"Better/Lifestyle" specialties equal harder to get while "Not-so-fun/lower-income" specialties *cough* Family Medicine *cough* are easy to match into because "nobody" wants them. It makes sense...work hard to match into dermatology, get the 9-5, Monday-Friday hours, no call, and (extremely) high pay. Screw around, mess up your USMLE Step I score, and get matched into FM with long hours, call, and lower pay.
But someone has messed up my lofty world-view!
Anesthesiology! You dastardly creature! I do not get you...
From what I hear, you are (relatively) easy to match into, pay well, have super hours, are definitely a "lifestyle" specialty, and don't even have many litigation issues. Wait...easy to match into? How does that work? One of my EM-bloggers, EM Physician, puts it so eloquently:
So that's what I hear...the 90% boredom, 10% super-crazy life of the anesthesiologist. And medical students don't know anything about the specialty unless they do a rotation on it during medical school. Is it a closely-guarded secret? Is it a conspiracy? Is there a hidden evil in the specialty that nobody knows about?
*shakes head* I just can't accept this. A lifestyle specialty like that, so easy to match into. What ails it? An uncertain future (all of medicine faces this, though)? Encroachment from mid-levels?
Anesthesiology, you puzzle me with your defiance of logic. At the least, you make me very curious. I do not know what I want to specialize in, but I hope to unlock your secrets one day. That's for sure.
Still, things tend to fit into a sensible world-view, right? Those who work hard get rewarded and those who are lazy end up on the bottom.
We all know that life isn't by any stretch of the imagination fair, and that the world often works in chaos-mode. Kids starve in Africa, bad things happen to good people, the hard-working go unrewarded and the hero goes unsung.
In medical specialties, I came to the realization that things do have an internal order. The specialties with a better lifestyle/income are predictably harder to match into because of competition resulting from too many students vying for few coveted spots.
"Better/Lifestyle" specialties equal harder to get while "Not-so-fun/lower-income" specialties *cough* Family Medicine *cough* are easy to match into because "nobody" wants them. It makes sense...work hard to match into dermatology, get the 9-5, Monday-Friday hours, no call, and (extremely) high pay. Screw around, mess up your USMLE Step I score, and get matched into FM with long hours, call, and lower pay.
But someone has messed up my lofty world-view!
Anesthesiology! You dastardly creature! I do not get you...
From what I hear, you are (relatively) easy to match into, pay well, have super hours, are definitely a "lifestyle" specialty, and don't even have many litigation issues. Wait...easy to match into? How does that work? One of my EM-bloggers, EM Physician, puts it so eloquently:
For one, [anesthesiology] was a very easy specialty to get into. Not a whole lot of butt kissing involved. The salary was great. The job market, wide-open. It was known as a ‘life-style’ specialty, which allowed time to enjoy life outside of medicine, and that appealed to me. Anesthesiologists only deal with one patient at a time, and they sit all day (and read magazines) behind the curtain. What a life!!
So that's what I hear...the 90% boredom, 10% super-crazy life of the anesthesiologist. And medical students don't know anything about the specialty unless they do a rotation on it during medical school. Is it a closely-guarded secret? Is it a conspiracy? Is there a hidden evil in the specialty that nobody knows about?
*shakes head* I just can't accept this. A lifestyle specialty like that, so easy to match into. What ails it? An uncertain future (all of medicine faces this, though)? Encroachment from mid-levels?
Anesthesiology, you puzzle me with your defiance of logic. At the least, you make me very curious. I do not know what I want to specialize in, but I hope to unlock your secrets one day. That's for sure.
Wednesday, May 16, 2007
Waiting
So I've been around the "blogosphere" lately, reading blogs from medical student to attending. I even ran across the blog of a girl who is a pre-med, detailing her daily life as a health-sciences student shooting for a spot at Medical School. For now, I am the only "MS0" blogger that I know of (that's MS-Zero; Medical Student, year zero, a denomination for those accepted but not yet started). There aren't too many MS0 bloggers, simply because it is a very temporary status that kids only ever have for perhaps 3-9 months.
I am finishing up my very last class for college, and I have to say it is a nice, refreshing break from everything else. One week from this moment, Wednesday, May 16th, 2007, I'll be officially in summer vacation at last! I plan on working only part-time at my research lab, then shadowing a few docs in (hopefully) some different specialties. Kids on Student-Doctor Network give the advice of shadowing while you can because, unlike rotations, you get a unique glimpse into physician life at a private/community hospital as opposed to a gigantic teaching hospital. Even as such, they make the important point that you can never truly step into someone else's job even for a moment. Think about watching a grandmaster play chess; you see him/her move pieces every once in awhile...easy job, right? The mental aspect of being a physician is probably far more than half of the job and its stresses. Watching an anesthesiologist sit in the OR might lead me to believe, "what an easy and boring specialty!" but I must remember that the anesthesiologist is (hopefully) running through 100s of scenarios in his/her head, utilizing the years of training they've received.
Nonetheless, I look forward to sitting around the local ED overnight or on a busy Sunday, seeing once again all the crap that Dr. Emergency has to deal with. I hope to see some oncology-related docs, as we have a very good cancer center in my town.
But you know what? At this point, you kind of sit down and breathe slowly, relieved, having passed the toughest part: getting in. I believe that those of you out there who really understand what you are getting into will be happy from that point on. Medicine's future is uncertain, bureaucratic systems and legalities creep in on all sides, but those of us with the fortitude to take the beatings and belief that this is what we are meant to do no matter what, will keep marching. Just read Hoover's article posted on medschoolhell.com to get an idea of how much you trudge through just to get in (and that's just the beginning of the floggings you'll take).
I think the best thing you can do as an MS0 is to mentally prepare yourself. And I do not mean studying Grey's Anatomy all summer. I mean:
-look into the field of medicine in general
-ask questions
-read through medschoolhell to learn about all the bad stuff in medicine
-search yourself
-meditate
-vacation
-see friends and family
-read the blog of the depressed ER doc who suffers multiple law-suits and burn-out
-search yourself again and ask, "am I ready?"
The idea is to realize that medicine is exactly what you want to do, and all you want to do. This is how I have arrived at the point where I am. I am, on some level, the doe-eyed, idealistic, hopelessly optimistic pre-med that everyone starts out as. At the same time, I am doing my best to keep informed, get different perspectives, and make sure that there is nothing else I want to do. Is there? Not a thing (besides "Lead Game Programmer" and "Rock Star"). These soul-searching questions are certainly things to ask yourself before you even apply; I did those things then. But just as much after acceptance and through the training process, these are things to always be aware of. If you can take it, warts and all, then you're one of the few who will lovingly shoulder the burden of medicine and commit yourself to a lifetime of its practice.
I got my class schedule...I start a week and a half earlier than I anticipated. I'm game, are you?
I am finishing up my very last class for college, and I have to say it is a nice, refreshing break from everything else. One week from this moment, Wednesday, May 16th, 2007, I'll be officially in summer vacation at last! I plan on working only part-time at my research lab, then shadowing a few docs in (hopefully) some different specialties. Kids on Student-Doctor Network give the advice of shadowing while you can because, unlike rotations, you get a unique glimpse into physician life at a private/community hospital as opposed to a gigantic teaching hospital. Even as such, they make the important point that you can never truly step into someone else's job even for a moment. Think about watching a grandmaster play chess; you see him/her move pieces every once in awhile...easy job, right? The mental aspect of being a physician is probably far more than half of the job and its stresses. Watching an anesthesiologist sit in the OR might lead me to believe, "what an easy and boring specialty!" but I must remember that the anesthesiologist is (hopefully) running through 100s of scenarios in his/her head, utilizing the years of training they've received.
Nonetheless, I look forward to sitting around the local ED overnight or on a busy Sunday, seeing once again all the crap that Dr. Emergency has to deal with. I hope to see some oncology-related docs, as we have a very good cancer center in my town.
But you know what? At this point, you kind of sit down and breathe slowly, relieved, having passed the toughest part: getting in. I believe that those of you out there who really understand what you are getting into will be happy from that point on. Medicine's future is uncertain, bureaucratic systems and legalities creep in on all sides, but those of us with the fortitude to take the beatings and belief that this is what we are meant to do no matter what, will keep marching. Just read Hoover's article posted on medschoolhell.com to get an idea of how much you trudge through just to get in (and that's just the beginning of the floggings you'll take).
I think the best thing you can do as an MS0 is to mentally prepare yourself. And I do not mean studying Grey's Anatomy all summer. I mean:
-look into the field of medicine in general
-ask questions
-read through medschoolhell to learn about all the bad stuff in medicine
-search yourself
-meditate
-vacation
-see friends and family
-read the blog of the depressed ER doc who suffers multiple law-suits and burn-out
-search yourself again and ask, "am I ready?"
The idea is to realize that medicine is exactly what you want to do, and all you want to do. This is how I have arrived at the point where I am. I am, on some level, the doe-eyed, idealistic, hopelessly optimistic pre-med that everyone starts out as. At the same time, I am doing my best to keep informed, get different perspectives, and make sure that there is nothing else I want to do. Is there? Not a thing (besides "Lead Game Programmer" and "Rock Star"). These soul-searching questions are certainly things to ask yourself before you even apply; I did those things then. But just as much after acceptance and through the training process, these are things to always be aware of. If you can take it, warts and all, then you're one of the few who will lovingly shoulder the burden of medicine and commit yourself to a lifetime of its practice.
I got my class schedule...I start a week and a half earlier than I anticipated. I'm game, are you?
Monday, April 30, 2007
Con "grad" ulations
Graduation: I graduated from college yesterday (April 29th, 2007). A time for celebration, reflective thoughts, family, friends, and accomplishment! Yeah, OK. It was all that, but now it is over and I'm relieved because I can go back to sitting around and not doing anything while I await August. The count-down to when I move is at exactly 3 months now, putting the 2007-2008 school year well under 4 months. Scary to think about, seeing as I was a freshman here just yesterday.I graduated from High School in the class of 2003, college in the class of 2007, and here I am entering the graduating medical class of 2011. I should really aim for a four-year residency so I can graduate from that in 2015 and call it good. Life comes in segments until you get to your career, at which point you have (assuming a stable one) an approximately 35-50 year block of time before retirement. Whatever, I'm going to totally do everything I can before mid-August. There's lots to see and do! And so, I am off. And no, that picture is not of me, and has nothing to do with my college.
Wednesday, April 11, 2007
Ignorant
I am ignorant and naive.
I do not have any first-hand experience in medical education yet, and therefore my blog is not even a real blog because I have no experiences to share.
Part of being prepared is to be unprepared and aware of this: thinking that you know what is coming is realizing that you know nothing.
I preach on and on about how "certain" I am that I'll go into Emergency Medicine. After thinking and meditating at length on the whole issue, I digress. I clear my plate. I still have a marked interest in that specialty, but I could not possibly have the knowledge to truly sway one way or another.
I am open again to anything and everything, to changing times, changing minds, and new experiences. I can safely say that certain things are ruled out, such as:
General Surgery
Psychiatry
OB/GYN
Ophthalmology
Dermatology
That's a start, right? But I'm going to go into this fresh, focusing on the pre-clinical years with USMLE Step I in mind and no further. I do not know myself just yet.
I do not have any first-hand experience in medical education yet, and therefore my blog is not even a real blog because I have no experiences to share.
Part of being prepared is to be unprepared and aware of this: thinking that you know what is coming is realizing that you know nothing.
I preach on and on about how "certain" I am that I'll go into Emergency Medicine. After thinking and meditating at length on the whole issue, I digress. I clear my plate. I still have a marked interest in that specialty, but I could not possibly have the knowledge to truly sway one way or another.
I am open again to anything and everything, to changing times, changing minds, and new experiences. I can safely say that certain things are ruled out, such as:
General Surgery
Psychiatry
OB/GYN
Ophthalmology
Dermatology
That's a start, right? But I'm going to go into this fresh, focusing on the pre-clinical years with USMLE Step I in mind and no further. I do not know myself just yet.
Monday, April 9, 2007
Hoops
Hoops? Think I like sports? Wrong!
I'm talking about the magical hoops, like the ones you see on dog shows on Animal Planet. The ones that every medical blogger I've read talks about. It seems they have to jump through 100s of them to keep going places. I don't know how I ended up on this road, but I'm here and this is my intended path and I'm going to follow it!
Before I begin in just a few months, I get to enjoy the last few months of naive freedom here in the sad ending of my undergraduate years. To graduate, I have to finish up some general education (read: useless) courses. These classes are typically formalities. Classes that the institution makes everyone take because they give you "well-roundedness". This is the last time that I will ever be able to rant about a non-medical class (I'm positive that said medical rants will happen, and in great force, later on).
So I'm in this awful class called Communication Across Cultures. It is a class that serves as an alternative to the :cough: mandatory :cough: study-abroad program that my college so graciouslyenforces offers. Basically, 50% of all students that go through here end up spending 3 months in a third-world country (Dominican Republic, Cambodia, Ethiopia...) studying and doing service. As much as I'm sure it would have looked great on my medical school application, I opted to avoid this experience, as my school tends to taint such things with its religious splendor. In retrospect, I'm glad I did not go; I hear largely negative reviews of kid's experiences, and honestly, I do not feel the need to do this in order to become a great doctor.
So this class serves as one of four classes that are "alternates" to this study-abroad program. Read: punishment for not going. They haven't been too bad, and one of them that I am currently taking is even decent :gasp:! But this communications class is abysmal. Rock-bottom. First, it is taught by a stand-in professor with no teaching skills at all. This prof, we'll call her prof B, is standing in for the usual prof, prof A, who actually makes the class bearable. Prof B sucks at handling the class, and all 45 of us are painfully aware of it. We are treated like 6th graders. We meet every Monday evening, and let me tell you, every single time we meet, the thought actually crosses my mind at some point during the ~3-hour drudgery: "Whoa. I haven't done something like this since 6th grade!"
You know, she'll say things like, "Now...what is the definition of culture, again?" and wait for someone towake up pipe up and say the answer. We'll split off into groups of four and "discuss" things like "when have you felt advantaged/disadvantaged because of your ethnicity/class/gender?" We'll play little "games" to reinforce class "material" like dividing the class in two and playing the part of two different cultures meeting up. Her "lectures" involve her throwing up shoddy Powerpoint presentations and then elaborating on "terms" as if they were actual unfamiliar vocabulary (I think we know what "stereotype" and "prejudice" mean by now, lady).
The culmination of our semester involves doing an "Ethnographic Research Project" in which we identify some on-campus sub-culture and write an 8+ page paper on it. We have to interview and observe members of the culture and also do research on the topic so that we have viable sources. Then we turn it in and give a 3-5 minute presentation on it. She treats this like its a doctoral dissertation. She spends some time each week "addressing" the projects and making sure we know how to look up information and write a basic paper.
Oh, the headache, the headache. Make this useless class stop. Every time I see one of the other 44 kids in there around campus, our eyes meet and we exchange a "I know how you feel about this class too, it sucks" glance. Half the time we actually would stop and discuss how bad the class sucks, and I see other members of the class doing it around campus as well. It's like a secret "we all belong to this awful class" society. As with most other general education courses, I learn next to nothing and just go through the motions to get the grade and leave. This class is far worse than the others, though. This one, I actually learned nothing, and typing up this awful paper is something I could do any day, even back as a 6th grader.
Take-home message: I love all my free-time, and even the luxury of complaining about an easy-but-useless class. It will break my heart to leave this campus and the great people on it that I care so much about. But a much larger city, and bigger, better things await. Medical School countdown: approximately 130 days.
I'm talking about the magical hoops, like the ones you see on dog shows on Animal Planet. The ones that every medical blogger I've read talks about. It seems they have to jump through 100s of them to keep going places. I don't know how I ended up on this road, but I'm here and this is my intended path and I'm going to follow it!
Before I begin in just a few months, I get to enjoy the last few months of naive freedom here in the sad ending of my undergraduate years. To graduate, I have to finish up some general education (read: useless) courses. These classes are typically formalities. Classes that the institution makes everyone take because they give you "well-roundedness". This is the last time that I will ever be able to rant about a non-medical class (I'm positive that said medical rants will happen, and in great force, later on).
So I'm in this awful class called Communication Across Cultures. It is a class that serves as an alternative to the :cough: mandatory :cough: study-abroad program that my college so graciously
So this class serves as one of four classes that are "alternates" to this study-abroad program. Read: punishment for not going. They haven't been too bad, and one of them that I am currently taking is even decent :gasp:! But this communications class is abysmal. Rock-bottom. First, it is taught by a stand-in professor with no teaching skills at all. This prof, we'll call her prof B, is standing in for the usual prof, prof A, who actually makes the class bearable. Prof B sucks at handling the class, and all 45 of us are painfully aware of it. We are treated like 6th graders. We meet every Monday evening, and let me tell you, every single time we meet, the thought actually crosses my mind at some point during the ~3-hour drudgery: "Whoa. I haven't done something like this since 6th grade!"
You know, she'll say things like, "Now...what is the definition of culture, again?" and wait for someone to
The culmination of our semester involves doing an "Ethnographic Research Project" in which we identify some on-campus sub-culture and write an 8+ page paper on it. We have to interview and observe members of the culture and also do research on the topic so that we have viable sources. Then we turn it in and give a 3-5 minute presentation on it. She treats this like its a doctoral dissertation. She spends some time each week "addressing" the projects and making sure we know how to look up information and write a basic paper.
Oh, the headache, the headache. Make this useless class stop. Every time I see one of the other 44 kids in there around campus, our eyes meet and we exchange a "I know how you feel about this class too, it sucks" glance. Half the time we actually would stop and discuss how bad the class sucks, and I see other members of the class doing it around campus as well. It's like a secret "we all belong to this awful class" society. As with most other general education courses, I learn next to nothing and just go through the motions to get the grade and leave. This class is far worse than the others, though. This one, I actually learned nothing, and typing up this awful paper is something I could do any day, even back as a 6th grader.
Take-home message: I love all my free-time, and even the luxury of complaining about an easy-but-useless class. It will break my heart to leave this campus and the great people on it that I care so much about. But a much larger city, and bigger, better things await. Medical School countdown: approximately 130 days.
Monday, March 26, 2007
Residency = Crack!
So I found out some shocking information from a program that I heard on NPR's "Talk of the Nation" about Physician sleep deprivation in residency. Ever wonder just why you guys are working 80-hour weeks with no sleep? Just where did that fun "tradition" come from? I transcribed part of the program...
Spoken by Dr. Charles Seizer, director of the division of sleep medicine at Harvard Medical School.
So there you have it! According to Dr. Seizer on NPR and his citation of the New England Journal of Medicine, all that intense residency training owes its roots to cocaine addiction! Your wife nagging at you for working such long hours in residency? "Oh honey, don't worry. I'm trying to emulate a crack-head lifestyle, that's all!" Sure, that'll work.
And so, I'm gearing up. After I finish medical school, I get to live like a bona fide crack-head, and I bet after 30 hours and no sleep, you'd probably write prescriptions like a crack-head, too. You might as well bond with that frequent-flyer in the ED and tell him to just stay up for 30 hours straight in the hospital! He'll never snort the white stuff again, and you'll have one less guy to watch over in the ED. He'll probably even go for medical school himself so one day, he too can get his fix in the hospital, just like all the medical residents partaking in the wonderful cocaine-catalyzed "tradition."
Bottom line: A tradition as crazy as medical residency could only be explained by something like a guy on crack. The funny thing? It's true. I guess it's probably not all it's cracked up to be, eh?
Spoken by Dr. Charles Seizer, director of the division of sleep medicine at Harvard Medical School.
...the Tradition dates back to 1890, and was started by a pioneer in American medicine: professor William Halstet, from Johns Hopkins, who established the first program in residency training in surgery. He really set the standard for the nation by establishing these marathon 30-hour shifts. It was only revealed this past year in an article in the New England Journal (of Medicine) just how he was able to stay awake for so long.
It turns out he was a cocaine addict.
He had just been discharged from the Butler hospital in Rhode Island where he had been an inpatient for about a year and a half trying to get rid of his cocaine addiction. They were using morphine to treat him so he ended up with a morphine and a cocaine addiction as he took over his role starting up the program.
So we're left with the same traditional schedule in which interns and residents are expected to do 24 or 30-hour shifts and are expected to perform at their best...
So there you have it! According to Dr. Seizer on NPR and his citation of the New England Journal of Medicine, all that intense residency training owes its roots to cocaine addiction! Your wife nagging at you for working such long hours in residency? "Oh honey, don't worry. I'm trying to emulate a crack-head lifestyle, that's all!" Sure, that'll work.
And so, I'm gearing up. After I finish medical school, I get to live like a bona fide crack-head, and I bet after 30 hours and no sleep, you'd probably write prescriptions like a crack-head, too. You might as well bond with that frequent-flyer in the ED and tell him to just stay up for 30 hours straight in the hospital! He'll never snort the white stuff again, and you'll have one less guy to watch over in the ED. He'll probably even go for medical school himself so one day, he too can get his fix in the hospital, just like all the medical residents partaking in the wonderful cocaine-catalyzed "tradition."
Bottom line: A tradition as crazy as medical residency could only be explained by something like a guy on crack. The funny thing? It's true. I guess it's probably not all it's cracked up to be, eh?
Thursday, March 22, 2007
No Smoking
And so, there I was. My grand performance, my most challenging summer of all. The times that tried my soul. The best of times. The worst of times.
So I stood there at the Emergency entrance in mybig, sore thumb uniform red-coat. Doing what I did best, I was standing out there, idle in the summer heat, MCAT flash-cards in my front pocket but not being glanced at. There was a nice elderly gentleman who drove a parking-lot shuttle (read: long-ass gas-powered golf cart). He did his job religiously, every weekday from 6AM to 3PM, meaning that I always saw him when he'd stop in front of the ED to relax. He was a great guy; handed out stuffed animals to children and stopped people to make light conversation.
Turns out he's an ex-CEO, and he was quite a successful one at that. He owned a huge RV factory in a lucrative area, drove one himself, and payed $600/month to use a Satellite phone (this was back in the 80s when they were OMG expensive). Somewhere along the line, business went bad or was bought out (he did not say) and he basically lost his fortune, becoming a relatively normal guy again. He loved telling me about his time in the Korean War. He loved griping about the reckless young teenagers he'd see walking into the ED. Just don't get him started on politics. He's opinionated and haughty - he'll talk your ear off...which I could afford, being a busy volunteer and all.
So, I forgot his name but we'll call him Earl for now. Earl had left to do his driving and I stood out there thinking about how long four hours is when you do nothing the whole time. As if from nowhere, a woman was standing but 6 feet to my left. Standing directly in front of the NO SMOKING sign, she stood there puffing away; a thin, shaky hand holding a smoldering cigarette. She had dirty-blond hair and dark, leathery, worn skin that made her look older than she probably was (she looked 50 but was probably 35).
I blinked and raised an eyebrow, slightly less-bored than usual, but still abysmally aware of each passing second.
Her other hand rested on her IV pole, which she had so kindly brought outside with her. She raised her cigarette-holding hand up to her lips, a long, wrinkly index finger pressing to her sun-burnt lips.
"Shhhhhhh!" She peered at me cheerfully through glazed eyes.
"You didn't see me out here! A girl needs her simple pleasures and nobody saw me, so I decided to take a little walk!" She huffed out another breath of smoke and took a few steps up the sidewalk, the IV pole obediently rolling along just in front of her.
I was highly amused, but also blank. Smoking while in the hospital seems crazy enough, but escaping with your IV pole and doing it in front of the NO SMOKING sign was just too much. I wish I had a camera. Oh, I've heard worse. I know there have been hospitalized methamphetamine addicts who escape to the parking lot so their "friends" can give them a quick fix. People can be desperate.
Being merely a not-employed-at-the-hospital volunteer, I smiled at her and nodded. I figured I had no responsibility to "stop" her. If someone was doing something blatantly horrendous, like stealing supplies or doing something illegal, I would contact the proper contacts. But this lady was doing her own thing and as far as I could consider, I didn't exist at the hospital, so she may as well have never been seen by me for real. And besides, when she strolled back through her unit, the nurses probably just smiled and waved at her, turned to each other and said, "there she goes...again."
Volunteering...a huge formality.
So I stood there at the Emergency entrance in my
Turns out he's an ex-CEO, and he was quite a successful one at that. He owned a huge RV factory in a lucrative area, drove one himself, and payed $600/month to use a Satellite phone (this was back in the 80s when they were OMG expensive). Somewhere along the line, business went bad or was bought out (he did not say) and he basically lost his fortune, becoming a relatively normal guy again. He loved telling me about his time in the Korean War. He loved griping about the reckless young teenagers he'd see walking into the ED. Just don't get him started on politics. He's opinionated and haughty - he'll talk your ear off...which I could afford, being a busy volunteer and all.
So, I forgot his name but we'll call him Earl for now. Earl had left to do his driving and I stood out there thinking about how long four hours is when you do nothing the whole time. As if from nowhere, a woman was standing but 6 feet to my left. Standing directly in front of the NO SMOKING sign, she stood there puffing away; a thin, shaky hand holding a smoldering cigarette. She had dirty-blond hair and dark, leathery, worn skin that made her look older than she probably was (she looked 50 but was probably 35).
I blinked and raised an eyebrow, slightly less-bored than usual, but still abysmally aware of each passing second.
Her other hand rested on her IV pole, which she had so kindly brought outside with her. She raised her cigarette-holding hand up to her lips, a long, wrinkly index finger pressing to her sun-burnt lips.
"Shhhhhhh!" She peered at me cheerfully through glazed eyes.
"You didn't see me out here! A girl needs her simple pleasures and nobody saw me, so I decided to take a little walk!" She huffed out another breath of smoke and took a few steps up the sidewalk, the IV pole obediently rolling along just in front of her.
I was highly amused, but also blank. Smoking while in the hospital seems crazy enough, but escaping with your IV pole and doing it in front of the NO SMOKING sign was just too much. I wish I had a camera. Oh, I've heard worse. I know there have been hospitalized methamphetamine addicts who escape to the parking lot so their "friends" can give them a quick fix. People can be desperate.
Being merely a not-employed-at-the-hospital volunteer, I smiled at her and nodded. I figured I had no responsibility to "stop" her. If someone was doing something blatantly horrendous, like stealing supplies or doing something illegal, I would contact the proper contacts. But this lady was doing her own thing and as far as I could consider, I didn't exist at the hospital, so she may as well have never been seen by me for real. And besides, when she strolled back through her unit, the nurses probably just smiled and waved at her, turned to each other and said, "there she goes...again."
Volunteering...a huge formality.
Wednesday, March 14, 2007
Five Months and I'm Petrified
Savor the Days
I remember when I got my acceptance letter. After running around my older sister's basement in an ecstatic fit of glee, I calmed down and relished the stress-free months that laid ahead. It's hard to believe that I've already burned 4 of those months down, with only 5 left (less than that before I move to the city where my school is).
I've been so settled into my newfound state of "post-accepted senior" that I've forgotten what it is like to put in a hard day of studying. I live in an on-campus apartment with 2 other fine gentlemen (intended to be a six-person apartment; we have 3 now, had 4 last semester). One of them is a post-accepted Pre-Dental senior and the other is a non-traditional Pre-Med junior studying his butt off for the MCAT in May.
There is something liberating about having time left before the storm. My last months as a truly lay person. Go do what you want to do; travel, see friends and family, live, rave, visit Greece, heck I don't care. But live while you still can! I'm petrified about starting in a measly 5 months. I'm not sure how quickly I'll be able to adjust. In the meantime, I plan on shadowing a few Emergency Physicians, finishing up my undergraduate research involvement (finally), having as much fun as possible, and getting everything ready for the big move.
I remember when I got my acceptance letter. After running around my older sister's basement in an ecstatic fit of glee, I calmed down and relished the stress-free months that laid ahead. It's hard to believe that I've already burned 4 of those months down, with only 5 left (less than that before I move to the city where my school is).
I've been so settled into my newfound state of "post-accepted senior" that I've forgotten what it is like to put in a hard day of studying. I live in an on-campus apartment with 2 other fine gentlemen (intended to be a six-person apartment; we have 3 now, had 4 last semester). One of them is a post-accepted Pre-Dental senior and the other is a non-traditional Pre-Med junior studying his butt off for the MCAT in May.
There is something liberating about having time left before the storm. My last months as a truly lay person. Go do what you want to do; travel, see friends and family, live, rave, visit Greece, heck I don't care. But live while you still can! I'm petrified about starting in a measly 5 months. I'm not sure how quickly I'll be able to adjust. In the meantime, I plan on shadowing a few Emergency Physicians, finishing up my undergraduate research involvement (finally), having as much fun as possible, and getting everything ready for the big move.
Tuesday, March 6, 2007
The Calling
The Calling
Pressure mounts on all medical students to decide on a specialty earlier and earlier these days (the last decade or two). Medicine as a career-choice is not to be taken lightly. You absolutely must be someone willing to sacrifice lots of time and energy for your goals. Not only that, but for many physicians, their family, friends, and social life suffer as well.
I truly believe that medicine has always been a deeply-rooted calling for me. My decision to enter it has been affirmed time and time again every day that I wake up. Sure, medical school will be tough; rotations will screw me over and residency will grind me to the bone. But I've accepted this. 80-hour work weeks in General Surgery rotation with call? I'm aware of this. "You think you know, but you have no idea." I'm aware of this and ready to accept what comes.
But beyond all this, I feel especially called to Emergency Medicine. I know that online medical blogs are no place from which to base real-life experiences or future plans. But they do offer an unedited, unscripted view into a lot of physician/resident/student's lives that you would never know about from medical school itself. Third and Fourth year medical school clinical rotations, as many say, do not give you a complete or accurate picture of life in those particular specialties. Sure, you get exposure and a good idea of what each of those specialties offers, but what about community vs. academic hospitals? What about doing that for 3 decades instead of 3 weeks? What about politics, hospitals, burn-out? The bottom line is that you should not limit your choice of a medical specialty based solely on your clinical rotations in medical school. They are very valuable, yes, but they are to be taken with a grain of salt. This is what I gather from reading many blogs and sites, at least.
I believe that your medical specialty should truly be a personal calling; a deep passion. If it is something you could not imagine doing for 30+ years and waking up every day to, do not do it! A specialty should also be one that appeals to you personally. If you find that patient-interaction is not important to you, you will want to avoid Family Medicine and Internal Medicine. With Emergency Medicine, I find myself rabidly fascinated; I read and keep up with every EM blog I can find online (just look at my links list). I read about EM on the Student Doctor Forums down to the last post and enjoy every bit of information I can read.
I look up information on specialties and read about every one, checking out lifestyle, compensation, nature of the work, residency, etc. I keep an open mind, and time and time again I find myself gravitating towards EM. I find the idea of the field exciting and wonderful for many reasons. I must organize this whirling mess in my head:
Pros
+Personality Match - The kind of guys I got to know through Panda Bear MD, M.D.O.D, Doc Shazam, and Scalpel or Sword (see my links) are a good personality match with me. They're realistic, laid-back, blunt, and seriously great doctors when they need to be. I've never quite fit in with the other pre-meds here; I'm not all 100% serious and anal all the time. These EPs seem to possess that same air of being free and alive that so many medical students lose. I've shadowed EPs (Emergency Physicians) and volunteered in the ED; the docs are really awesome people.
+Lifestyle - Shift-work. EPs are known in medicine for being people who have a true passion for life. They are able to separate their professional responsibilities from their personal life. Now, I'm not trying to shirk the Hippocratic Oath, but personal time is critical to one's happiness as well as their success as a doctor. From the doctorjob.com website:
As you can see, EM is consistently considered one of the "lifestyle" specialties, meaning that it allows a physician to have control over his/her hours and actually have a real life outside of the hospital (for general surgeons, internists, and OB/GYNs, this is a foreign concept). I have always been a firm believer in "work hard. play hard." I also like to leave work at work.
Q: You like to leave work at work? You want to have a life outside of medicine? Then why did you go into medicine!
A: My friend. This is precisely why EM has found me.
EPs are always the kind of people with lots of interests outside of medicine. I know an accomplished older EP who also runs his own audio business. He helps do live audio mixing for a very large and well-known Jazz festival near my home every summer. He loves RVs and outdoor living. He has had great success in the software/hardware business. I did not even know he was an EP until long after I heard about his other accomplishments in life. This is what I want - the ability to work hard and be a great physician while returning to my home/family and pursuing other passions!
+No Call - Apparently, call sucks. I've heard it from physicians, friends with physician-parents, and probably worst of all on every med blog I've ever been to. It seems that call is this old-school tradition in medicine where you come into work at 6AM Monday morning and do not leave until Noon on Tuesday (basically a 36-hour shift). I hear that it is not really "just" call, but indeed extended work ( at least for residents). For example, a Family Practice physician will be on call 24/7 and will be interrupted at 3AM, during dinner, during a wedding etc. to act as a consult for one of his/her patients.
Imagine going home from the hospital after a long shift and being able to relax with nothing on your mind. Your mind suddenly shifts to your patients - how are they doing? What kind of medications might they need when you round on them tomorrow morning at 5:30 AM? Yeah right. An EP stays far from this reality!
+No Rounding - Apparently, rounding sucks. Rounding is when you rotate through your roster of patients on the wards. You ask them how they're feeling, check their progress, discuss possible further treatments, and have 2-hour discussions on K+ levels and electrolytes. Again, I have had zero experience rounding, but from what I know and what I know about myself, I'm likely to agree with many that rounding is not the high-point of many specialties. Sure, some specialties do not admit patients too often, but still, why mess with it?
+Short Residency - 3 Years (in some cases, 4) is relatively short for a residency. Compare to 4 for neurology and 5+ for general surgery and its subspecialties. Do you know what a shorter residency means? You'll be out working and paying off those pesky 6-figure loans while your colleagues in cardiology keep training for another 2-3 years after you're out! Get to the point, that's what I say.
+Lots of Procedures - Now, I've developed a taste for working with my hands. I have not been able to suture up real wounds or anything, but I dissect frogs a lot. I enjoy working with tweezers, scissors, scalpels, retractors, surgical silk, etc. I like tying those little knots and poking at soft tissues. I do not want to be a surgeon, but I do enjoy working hands-on. ER offers an insane myriad of procedures from suturing lacerations to splinting broken bones and injecting dental nerve blocks. Did I mention traumas?
+When you're off, you're off - This is something certain people want, others don't. Me personally, I never liked homework much. The ability to leave work at work with a clear conscious (even if it is at 1AM when you get off) is its own beautiful thing.
+Variety - Newborn babies to the elderly, indigent and wealthy, kings and peasants, come one, come all. You get them all in the ED. Drunk or sober, pregnant, raped, stabbed, shot, stomachache. Everything. Not to mention, where else will you read an EKG, and X-ray, and pump someone's stomach on the same day?
+Compensation - It's not everything, but in the face of very high debts, medical students have been seeking higher-paying specialties. Again, while salary is not everything, EM has particularly good compensation.
Cons
-Lack of Continuity - OK. So I suppose I won't be tracking Mrs. Nesbitt's progressive loss of feeling in her extremities over the years. And I won't see Billy grow up into a big man. But it's ok! I really don't mind the idea of no continuity. Some people like the relationships and ongoing stories, but I really just want to practice medicine.
-Working Nights/Holidays/Weekends - All right, well you kind of got me there. Yeah, I love my weekends. But you know what? Loving what you do take precedence over hours. Yeah, staggered shifts from night to day and back are tough. But guess what; EPs tend to work far less hours per week than docs in other specialties (35-40 hours a week are not unheard of). Compare to 55-60 hours a week in other specialties with similar or even lower pay. When the month is said and done, you worked an average of around 40, perhaps 45 hours a week. Big deal. The point is that those hours are self-contained. That is, you worked them and when you went home to your family/recording studio/pets/friends you really went home to them. You didn't go home and spend your remaining hours on call or worrying about what you would come to work and find the next day. Every specialty has a downside; if you have overwhelming positives and love it - do it!
-Indigent/Drunk/Disrespectful Patients - Yeah. You're on the front-lines of medicine, down in the trenches. You get the drunks taking swings at you and the psychotics begging for drugs. You have the guy who got stabbed in the gut screaming the F-word at the top of his lungs while you try to anesthetize his abdomen. It's part of the job and it's reality. Just remember, not everyone is going to be like that.
-Disrespect from other doctors - "He's the whipping boy! He just stabilizes patients and then sends them to us!" Ok, sorry I didn't spend 6 years in residency studying the cardiovascular system like you did. At least I got Mr. Doe stabilized and worked up properly for you, Mr. Cardio. I hear this situation is getting better, as the specialty gains more support and recognition.
Bottom Line: I cannot and do not claim to truly know the ins and outs of this, or any other specialty. Not even close. I understand that I am only a pre-MS1 kid with an idealistic smile and and a lofty head. But you know what? It's never too early to start thinking. You have a personality and you know yourself. You can read up on specialties, talk to docs, think, discuss, ponder. You have every right to say "Hey, this is how I am...this is how these specialties are. I think that, based on what I observe, I would most likely enjoy this specialty the most." And along the way, the additional data keeps reaffirming my EM hypothesis. I am open to whatever comes my way, but I have a hunch, a gut-feeling that I'll end up in this insane place.
Pressure mounts on all medical students to decide on a specialty earlier and earlier these days (the last decade or two). Medicine as a career-choice is not to be taken lightly. You absolutely must be someone willing to sacrifice lots of time and energy for your goals. Not only that, but for many physicians, their family, friends, and social life suffer as well.
I truly believe that medicine has always been a deeply-rooted calling for me. My decision to enter it has been affirmed time and time again every day that I wake up. Sure, medical school will be tough; rotations will screw me over and residency will grind me to the bone. But I've accepted this. 80-hour work weeks in General Surgery rotation with call? I'm aware of this. "You think you know, but you have no idea." I'm aware of this and ready to accept what comes.
But beyond all this, I feel especially called to Emergency Medicine. I know that online medical blogs are no place from which to base real-life experiences or future plans. But they do offer an unedited, unscripted view into a lot of physician/resident/student's lives that you would never know about from medical school itself. Third and Fourth year medical school clinical rotations, as many say, do not give you a complete or accurate picture of life in those particular specialties. Sure, you get exposure and a good idea of what each of those specialties offers, but what about community vs. academic hospitals? What about doing that for 3 decades instead of 3 weeks? What about politics, hospitals, burn-out? The bottom line is that you should not limit your choice of a medical specialty based solely on your clinical rotations in medical school. They are very valuable, yes, but they are to be taken with a grain of salt. This is what I gather from reading many blogs and sites, at least.
I believe that your medical specialty should truly be a personal calling; a deep passion. If it is something you could not imagine doing for 30+ years and waking up every day to, do not do it! A specialty should also be one that appeals to you personally. If you find that patient-interaction is not important to you, you will want to avoid Family Medicine and Internal Medicine. With Emergency Medicine, I find myself rabidly fascinated; I read and keep up with every EM blog I can find online (just look at my links list). I read about EM on the Student Doctor Forums down to the last post and enjoy every bit of information I can read.
I look up information on specialties and read about every one, checking out lifestyle, compensation, nature of the work, residency, etc. I keep an open mind, and time and time again I find myself gravitating towards EM. I find the idea of the field exciting and wonderful for many reasons. I must organize this whirling mess in my head:
Pros
+Personality Match - The kind of guys I got to know through Panda Bear MD, M.D.O.D, Doc Shazam, and Scalpel or Sword (see my links) are a good personality match with me. They're realistic, laid-back, blunt, and seriously great doctors when they need to be. I've never quite fit in with the other pre-meds here; I'm not all 100% serious and anal all the time. These EPs seem to possess that same air of being free and alive that so many medical students lose. I've shadowed EPs (Emergency Physicians) and volunteered in the ED; the docs are really awesome people.
+Lifestyle - Shift-work. EPs are known in medicine for being people who have a true passion for life. They are able to separate their professional responsibilities from their personal life. Now, I'm not trying to shirk the Hippocratic Oath, but personal time is critical to one's happiness as well as their success as a doctor. From the doctorjob.com website:
When most people think of a physician's career, they associate it with long hours, little or no personal or family time, and tireless effort. Many newer physicians entering the workforce are not as willing to sacrifice themselves at the expense of spending time with their loved ones. And rightly so – having a more enriching family life and social life will make you happier and more successful in your professional life as well.
Currently, many physicians are focusing on specialties that have more flexible lifestyles instead of focusing purely on income level and prestige. Some fields of practice that can be considered “lifestyle friendly” are areas such as anesthesiology, dermatology, emergency medicine, ophthalmology, neurology, radiology, and pathology. These specialty areas offer you more control over your hours, and the income can be commensurate with the workload and level of responsibility.
As you can see, EM is consistently considered one of the "lifestyle" specialties, meaning that it allows a physician to have control over his/her hours and actually have a real life outside of the hospital (for general surgeons, internists, and OB/GYNs, this is a foreign concept). I have always been a firm believer in "work hard. play hard." I also like to leave work at work.
Q: You like to leave work at work? You want to have a life outside of medicine? Then why did you go into medicine!
A: My friend. This is precisely why EM has found me.
EPs are always the kind of people with lots of interests outside of medicine. I know an accomplished older EP who also runs his own audio business. He helps do live audio mixing for a very large and well-known Jazz festival near my home every summer. He loves RVs and outdoor living. He has had great success in the software/hardware business. I did not even know he was an EP until long after I heard about his other accomplishments in life. This is what I want - the ability to work hard and be a great physician while returning to my home/family and pursuing other passions!
+No Call - Apparently, call sucks. I've heard it from physicians, friends with physician-parents, and probably worst of all on every med blog I've ever been to. It seems that call is this old-school tradition in medicine where you come into work at 6AM Monday morning and do not leave until Noon on Tuesday (basically a 36-hour shift). I hear that it is not really "just" call, but indeed extended work ( at least for residents). For example, a Family Practice physician will be on call 24/7 and will be interrupted at 3AM, during dinner, during a wedding etc. to act as a consult for one of his/her patients.
Imagine going home from the hospital after a long shift and being able to relax with nothing on your mind. Your mind suddenly shifts to your patients - how are they doing? What kind of medications might they need when you round on them tomorrow morning at 5:30 AM? Yeah right. An EP stays far from this reality!
+No Rounding - Apparently, rounding sucks. Rounding is when you rotate through your roster of patients on the wards. You ask them how they're feeling, check their progress, discuss possible further treatments, and have 2-hour discussions on K+ levels and electrolytes. Again, I have had zero experience rounding, but from what I know and what I know about myself, I'm likely to agree with many that rounding is not the high-point of many specialties. Sure, some specialties do not admit patients too often, but still, why mess with it?
+Short Residency - 3 Years (in some cases, 4) is relatively short for a residency. Compare to 4 for neurology and 5+ for general surgery and its subspecialties. Do you know what a shorter residency means? You'll be out working and paying off those pesky 6-figure loans while your colleagues in cardiology keep training for another 2-3 years after you're out! Get to the point, that's what I say.
+Lots of Procedures - Now, I've developed a taste for working with my hands. I have not been able to suture up real wounds or anything, but I dissect frogs a lot. I enjoy working with tweezers, scissors, scalpels, retractors, surgical silk, etc. I like tying those little knots and poking at soft tissues. I do not want to be a surgeon, but I do enjoy working hands-on. ER offers an insane myriad of procedures from suturing lacerations to splinting broken bones and injecting dental nerve blocks. Did I mention traumas?
+When you're off, you're off - This is something certain people want, others don't. Me personally, I never liked homework much. The ability to leave work at work with a clear conscious (even if it is at 1AM when you get off) is its own beautiful thing.
+Variety - Newborn babies to the elderly, indigent and wealthy, kings and peasants, come one, come all. You get them all in the ED. Drunk or sober, pregnant, raped, stabbed, shot, stomachache. Everything. Not to mention, where else will you read an EKG, and X-ray, and pump someone's stomach on the same day?
+Compensation - It's not everything, but in the face of very high debts, medical students have been seeking higher-paying specialties. Again, while salary is not everything, EM has particularly good compensation.
Cons
-Lack of Continuity - OK. So I suppose I won't be tracking Mrs. Nesbitt's progressive loss of feeling in her extremities over the years. And I won't see Billy grow up into a big man. But it's ok! I really don't mind the idea of no continuity. Some people like the relationships and ongoing stories, but I really just want to practice medicine.
-Working Nights/Holidays/Weekends - All right, well you kind of got me there. Yeah, I love my weekends. But you know what? Loving what you do take precedence over hours. Yeah, staggered shifts from night to day and back are tough. But guess what; EPs tend to work far less hours per week than docs in other specialties (35-40 hours a week are not unheard of). Compare to 55-60 hours a week in other specialties with similar or even lower pay. When the month is said and done, you worked an average of around 40, perhaps 45 hours a week. Big deal. The point is that those hours are self-contained. That is, you worked them and when you went home to your family/recording studio/pets/friends you really went home to them. You didn't go home and spend your remaining hours on call or worrying about what you would come to work and find the next day. Every specialty has a downside; if you have overwhelming positives and love it - do it!
-Indigent/Drunk/Disrespectful Patients - Yeah. You're on the front-lines of medicine, down in the trenches. You get the drunks taking swings at you and the psychotics begging for drugs. You have the guy who got stabbed in the gut screaming the F-word at the top of his lungs while you try to anesthetize his abdomen. It's part of the job and it's reality. Just remember, not everyone is going to be like that.
-Disrespect from other doctors - "He's the whipping boy! He just stabilizes patients and then sends them to us!" Ok, sorry I didn't spend 6 years in residency studying the cardiovascular system like you did. At least I got Mr. Doe stabilized and worked up properly for you, Mr. Cardio. I hear this situation is getting better, as the specialty gains more support and recognition.
Bottom Line: I cannot and do not claim to truly know the ins and outs of this, or any other specialty. Not even close. I understand that I am only a pre-MS1 kid with an idealistic smile and and a lofty head. But you know what? It's never too early to start thinking. You have a personality and you know yourself. You can read up on specialties, talk to docs, think, discuss, ponder. You have every right to say "Hey, this is how I am...this is how these specialties are. I think that, based on what I observe, I would most likely enjoy this specialty the most." And along the way, the additional data keeps reaffirming my EM hypothesis. I am open to whatever comes my way, but I have a hunch, a gut-feeling that I'll end up in this insane place.
Wednesday, February 28, 2007
Pre-Med Culture
Pre-Med: The Stigma! Oh, the Stigma!
The inevitable question that comes up to any college student: "...and what are you majoring in [little boy/girl]?" I feel like smiling and saying, "I'm...I'm going to become a big doctor when I grow up!" and then getting patted on the head three times while the relative smiles at everyone else and replies, "Aww, well isn't that just adorable?"
Yeah, and I forgot to mention that I want to be a fire-fighter and an astronaut, too. Thanks, Aunt Sally.
Seriously, I cannot stand the word Pre-Med. It stands proudly with its annoying, pretentious sisters: Pre-Vet, Pre-Pharm, Pre-Dental and Pre-Law to name some. Pre-professional programs have their purpose: they are intended to provide a framework from which to schedule classes and plan for the future. They give one's undergraduate career a greater sense of direction and meaning, not to mention a cutesy label to tack onto one's soul. That's great, but does Pre-Med culture have to be so annoying!?
They Do Not Even Have to Tell You
The pale, blond girl sitting at the front-right of the room. The skinny, curly-haired guy trudging up 4 flights of stairs at 7:52 AM with his chemistry goggles hanging around his neck. The Kenyan boy who furiously scribbles notes down in 4 different colors. The brunette holed up at the back of the school's cafe, dark-rimmed glasses, hair tied tightly back in a bun, MCAT books sprawled out confusedly over the table.
We are the few, the proud, the Pre-Med! (What, were you expecting the Marines?) At larger schools, we (sneak into the lab after-hours and) sabotage each other's organic chemistry experiments. We get old exams from last year and hide it from our peers to get an edge over them on the next test. We'll cut you off in the hallway to get to class faster. We feverishly ingest every science fact and store it for both the upcoming exam and the looming MCAT. Don't even sit with us in the dining hall, your basic, non Pre-Med major cannot possibly hold up against our biochemistry!
And so it has been, at a small, Liberal Arts (Population: 1,000) college for nearly four years, living in a unique (and oh-how-colorful) sub-culture hell-bent on one goal: acceptance. They are a very driven and hard-working bunch, but also an edgy bunch.
Just For Show
Pre-Med has become a national catch-phrase. By tacking that flattering label on yourself, you are set up for great expectations. If you make it past the "weed-out" courses during college (read: organic chemistry), you will be applying for a (very sought-after) position at a medical college. The national acceptance rates have been hanging around 46% to 49% since the turn of the century. I'd say that "a little less than half" of all applicants are able to get a spot nationally. Often, the local statistics are far worse. At the medical school in my state, upwards of 2,000 applicants apply each year for a fixed ~200 spots. Thus, in this particular case, the acceptance rate is around 10% (ouch!).
Important: Most (75%) of the applicants to this school are out of state. Of the out of state applicants, the odds are around 10%. This is because schools are pressured by state legislature to accept mostly in state applicants. The 25% of total applicants that are in state have a much better chance (around 60-70% are accepted). So you have to consider that. Bottom line: A state school will typically interview tons of out of state kids and only accept a small fraction of them, while accepting a much higher proportion of in state applicants.
Culture
I chose to avoid the culture as much as possible. I had everything I needed right in front of me; the courses to take, the MCAT (and study guides), and the AMCAS site to apply. My college is small; gossip/rumors/news travels fast. Everyone knows everyone else's status. Nonetheless, my policy was always to slip underneath the other's inquiring noses and mind my own business with my admittedly computer-science major friends.
I haven't much to say or reflect on the kids here, because there is not much to say. Pre-Med kids live with their path, work hard in classes, often sneer and act snobby, and tend to think they're big stuff. Maybe it is the pressure of being successful? One thing is that most of them (me included) have absolutely no clue about what this profession really means. Even once you weed out all the freshman who came into college all starry-eyed, 75% of the remaining kids would turn tail and run if they tried an 80-hour week on an OB/GYN rotation, waking up at 4:00 AM and being on call.
Well, that concludes my exhaustive (sure...) thoughts on Pre-Med culture. It's full of pressure, expectation, constant check-ins from nosy parents and relatives, and competition with kids you'd rather chuck off of a schooner than spend a lab period with. It's bright and full of dreams, hopes, and ambitions! It's for all the academic superstars to shine and show how many hours they can spend in the ER pushing gurneys! Unspoiled and uninitiated, we form ranks and march towards certain destruction. So God help us.
Tuesday, February 20, 2007
To Take or Not to Take?
The $50,000 question: Prep-Courses for Medical School?
"The guy smokes!" I thought to myself as I watched my physical sciences section teacher sitting in his car, puffing away during a break. I would not have been surprised if the guy had been blowing trees; he was a sharp fellow, well-versed in his subjects, a (presumably successful) biochemistry major at a prestigious private school, and had done well enough on the MCAT to teach at this center.
Yet,
he was a total bad-ass. The guy taught us with a confident yet smug attitude, but he laid it down thick and heavy. The first time I saw him he was in a dingy white T-shirt, baseball cap covering his eyes and a goatee on his chin as he raised his muscular arm to the board to write out physics equations. But I respect him; an educated individual with a diverse lifestyle (though I certainly disapprove of smoking) is something I have not had enough of in the Mennonite culture I was brought up in.
That's great, but should I take courses or not?
You're (most likely) 19-21 years old and medicine is where it is at for you. You rocked grades at your undergraduate institution, volunteered, worked at your Aunt's clinic, and became president of the student body. Super. Excellent. Great! But medical school admissions needs to have a standardized measuring stick for you as well - one that is constant across the nation! You face the hurdle in its most ugly form: the MCAT (Medical College Admissions Test). The format has been changed from pencil-and-paper to electronic-only for 2007, but the core remains the same: Biological and Physical Sciences, General and Organic Chemistry, Verbal Reasoning, and a Writing Sample.
Run out to the nearest bookstore and get an MCAT guide if you want the scoop. I'm going to tell you what did and did not work for me.
Thinking...
My forehead hit the table and my head jerked up. Another Saturday afternoon wasted in the test center, taking (full-length, 5.5 hours + breaks mind you) practice test #4 out of 5. How far would you go to get the high-score? I admit; I am not Mr. Standardized test. Anyone can take basic science courses and spit concepts and facts back at their professor, but this thing makes your gears turn.
I took my first MCAT in April of 2006 and got a decent but not stellar score. I decided to take a prep-course over the summer to see if I could smash the test that August. That August was also the very last administration of paper-and-pencil MCAT, so I figured I'd be a part of history. Cute. Not.
You never know until you try, and things are always different in retrospect. I have no regrets about taking the course, but in the end it made no appreciable difference in my overall application process. In short, a waste of $1,000, lots of gas (45-minute commute each way), lots of evenings, and lots of Saturdays I could have spent playing video games and hanging out with friends.
Again, I could not have possibly known during the course that my performance after all that work would not jump into the realm of super pre-med. My personal experience may be discouraging to one considering prep-courses, but take it with a grain of salt, please!
Course Anatomy
The course was simple. You get a pile of books to compliment lectures (twice a week, 3 hours each). The lectures went on (6 hours a week) for about 10 weeks (most of the summer). In the second-half of the summer, you had to come in every Saturday to take full-length practice exams (this gets you in the mode for the real thing, apparently). You have extensive homework assignments and practice test booklets to work on, plus a huge "question-bank". All in all, you could easily spend 8 hours a day all summer with the material they gave you.
The best course, the perfect tutor, the most expensive study aids: they are all useless unless you yourself put your head to it.
If I can take away anything from this whole charade, it is that studying for tests like this comes from within, not from the outside. I made progress when I worked through my own books and did my own practice. By getting caught up in the rigors of the classroom setting, I found myself sliding into a false sense of security that I think a lot of kids in there got:
"I'm going to classes, so I must be improving my mad skills!"
Verdict...
Taking these multiple-choice, standardized tests is an art and a science. Anyone can bust their butt preparing for them (MCAT, USMLE, etc). For me, the trick is knowing the core material cold, then doing practice questions like there's no tomorrow. Time put in correlates positively with performance (up to a reasonable point). Put in a lot of time and still did not do well? Most likely, "a lot of time" wasn't really a lot of time. For MCAT? Some people are inherently better than others at test-taking - welcome to life.
Ultimately, the MCAT is a surmountable hurdle for anyone serious enough about medicine to pursue it. As for prep-courses, they're potentially useful, but it greatly depends on your style of learning. Prep-courses could also feed your ego if you want to be surrounded by pre-med gunners and bigots. I would recommend saving the money and spending perhaps a fifth of it to get some good study materials. You'll likely spend your time more efficiently, get more bang for your buck, and not have to deal with other stinky pre-meds.
I salute you who have yet to jump over the MCAT. Good luck and see you on the other side!
"The guy smokes!" I thought to myself as I watched my physical sciences section teacher sitting in his car, puffing away during a break. I would not have been surprised if the guy had been blowing trees; he was a sharp fellow, well-versed in his subjects, a (presumably successful) biochemistry major at a prestigious private school, and had done well enough on the MCAT to teach at this center.
Yet,
he was a total bad-ass. The guy taught us with a confident yet smug attitude, but he laid it down thick and heavy. The first time I saw him he was in a dingy white T-shirt, baseball cap covering his eyes and a goatee on his chin as he raised his muscular arm to the board to write out physics equations. But I respect him; an educated individual with a diverse lifestyle (though I certainly disapprove of smoking) is something I have not had enough of in the Mennonite culture I was brought up in.
That's great, but should I take courses or not?
You're (most likely) 19-21 years old and medicine is where it is at for you. You rocked grades at your undergraduate institution, volunteered, worked at your Aunt's clinic, and became president of the student body. Super. Excellent. Great! But medical school admissions needs to have a standardized measuring stick for you as well - one that is constant across the nation! You face the hurdle in its most ugly form: the MCAT (Medical College Admissions Test). The format has been changed from pencil-and-paper to electronic-only for 2007, but the core remains the same: Biological and Physical Sciences, General and Organic Chemistry, Verbal Reasoning, and a Writing Sample.
Run out to the nearest bookstore and get an MCAT guide if you want the scoop. I'm going to tell you what did and did not work for me.
Thinking...
My forehead hit the table and my head jerked up. Another Saturday afternoon wasted in the test center, taking (full-length, 5.5 hours + breaks mind you) practice test #4 out of 5. How far would you go to get the high-score? I admit; I am not Mr. Standardized test. Anyone can take basic science courses and spit concepts and facts back at their professor, but this thing makes your gears turn.
I took my first MCAT in April of 2006 and got a decent but not stellar score. I decided to take a prep-course over the summer to see if I could smash the test that August. That August was also the very last administration of paper-and-pencil MCAT, so I figured I'd be a part of history. Cute. Not.
You never know until you try, and things are always different in retrospect. I have no regrets about taking the course, but in the end it made no appreciable difference in my overall application process. In short, a waste of $1,000, lots of gas (45-minute commute each way), lots of evenings, and lots of Saturdays I could have spent playing video games and hanging out with friends.
Again, I could not have possibly known during the course that my performance after all that work would not jump into the realm of super pre-med. My personal experience may be discouraging to one considering prep-courses, but take it with a grain of salt, please!
Course Anatomy
The course was simple. You get a pile of books to compliment lectures (twice a week, 3 hours each). The lectures went on (6 hours a week) for about 10 weeks (most of the summer). In the second-half of the summer, you had to come in every Saturday to take full-length practice exams (this gets you in the mode for the real thing, apparently). You have extensive homework assignments and practice test booklets to work on, plus a huge "question-bank". All in all, you could easily spend 8 hours a day all summer with the material they gave you.
The best course, the perfect tutor, the most expensive study aids: they are all useless unless you yourself put your head to it.
If I can take away anything from this whole charade, it is that studying for tests like this comes from within, not from the outside. I made progress when I worked through my own books and did my own practice. By getting caught up in the rigors of the classroom setting, I found myself sliding into a false sense of security that I think a lot of kids in there got:
"I'm going to classes, so I must be improving my mad skills!"
Verdict...
Taking these multiple-choice, standardized tests is an art and a science. Anyone can bust their butt preparing for them (MCAT, USMLE, etc). For me, the trick is knowing the core material cold, then doing practice questions like there's no tomorrow. Time put in correlates positively with performance (up to a reasonable point). Put in a lot of time and still did not do well? Most likely, "a lot of time" wasn't really a lot of time. For MCAT? Some people are inherently better than others at test-taking - welcome to life.
Ultimately, the MCAT is a surmountable hurdle for anyone serious enough about medicine to pursue it. As for prep-courses, they're potentially useful, but it greatly depends on your style of learning. Prep-courses could also feed your ego if you want to be surrounded by pre-med gunners and bigots. I would recommend saving the money and spending perhaps a fifth of it to get some good study materials. You'll likely spend your time more efficiently, get more bang for your buck, and not have to deal with other stinky pre-meds.
I salute you who have yet to jump over the MCAT. Good luck and see you on the other side!
Volunteering
Why did I wear the Red Coat?
It was not until the second-to-last day of volunteering that I ran into an acquaintance from my college. He was an ER tech and, upon asking him, he politely informed me that the red coat need not be worn in the ED (Emergency Department). Nobody ever complained, and I never even got any weird looks (beyond the looks I usually get). But in the end, I could only smack my forehead as I realized that wearing that big, bulky coat made me look like a total tool. In the pristine, white halls of the then-under-construction ED, I probably looked like a crimson avenger
My Purpose
"Valuable clinical experience", as it was proudly written on my AMCAS statement. Perhaps it was valuable ... for the nurses to look at me and laugh at me.
"Here comes big red again, guys!"
Yeah. Thanks. As I learned in my undergraduate days, the wards of the hospital, as well as the hospital itself, are not a place to joke around in. There is a hierarchy in place (perhaps more apparent in academically-affiliated teaching hospitals as opposed to community hospitals like the one I was in). Everyone has a specific job to do that they were very thoroughly trained for and ideally, every aspect of the hospital (and thus, health-care) should run like a machine.
I was useless. It would have sufficed to have been an actual ghost, floating around and watching the events of the ED. At least then I would a) be able to actually see doctor-patient interactions and b) not be a big, red eyesore taking valuable bed-changing time away from the techs. I am not sure if it was my particular ED, the guy that "trained" me, or my lack of initiative, but my job description was pretty bleak. The ED is the place, if nowhere else in the hospital, where teamwork and efficiency is vital to saving lives. Skills and roles were important, and I had neither of them.
I mostly hung around the nurse's station, chatting with them on slow days. I begged to take urine samples (still warm and toasty) to the lab, and I fought the techs to change patient's beds after discharge (making a one-minute job take even less). I sat outside the ED and directed people to various wings of the hospital, and once I even wheeled a teenage mother in labor up to the maternity ward. But in the end, I was a big, red eyesore.
Better Dead than Red
I was the only volunteer under the age of 65 in the entire hospital. "You're a young red coat!" they would always say with a gleeful smile as I scampered by on my way to the mail-room to fetch mail for the ED. Like a 3rd year medical student on their rotation, my coat was packed with MCAT flashcards, keys, a cellphone, and my wallet. The big difference? My coat was red, not white, and I did not have even 2 years of medical school curriculum under my belt. Why did I wear the coat? Oh, that's right. Dan, my trainer, had worn the coat as well.
There were a few other "kids" in the ED. "Patient liaison", it said on their name-tag. They were getting paid. They did more than me! They had a purpose, and they dressed up in normal dress clothes plus their name-tag. Yet, they did not tell me I looked like a gigantic, sore thumb against the cool, white background of the ED. I'm sure red is the last color to comfort a nervous patient; scrubs are green and blue for a psychological reason.
Finished
I had one day left. It was early-August. I should have just stuck my name tag onto a dress-shirt, but I put that glaring red coat back on for the last time. It was also my second day in the newly-renovated ED; I stuck out even more. Patients probably wondered what a completely unskilled kid with no purpose was doing wandering the halls. At least I was going over MCAT equations in my head (the life of the pre-med...).
6 Months have passed since that balmy August, and 6 more months will pass before I set my foot into medical school for my first day of class. I'm sure the ED staff still looks around from time to time and wonders where that red blob went.
Subscribe to:
Posts (Atom)
