Dammit.

I'm so sick of the bull-shit. And asshole personalities. I'm aware that there are rude, inconsiderate people in any field. And that medicine is also full of very kind and great people. I know all this and take it into consideration. But I'm done being Mr. Nice-Blog. I'm going to speak my fucking mind and I don't really care because this is here for me and if anyone wants to read it, it's their time lost. Things that annoy the hell out of me:

-One of my team-mates, a fellow medical student, really proved himself to be a rat today. We were doing walking-rounds. He started bitching about the fact that someone had erroneously placed my name on his patient's chart as the responsible medical student. "Who's in charge of putting our names on the patient's charts?", he asked. I just replied, "I'm not sure, maybe our interns?" Then he said it. I thought he was a nice kid, I really did, but he pulled a bombshell of assholery out of nowhere and it floored me and changed my opinion of him in an instant.

"I'll get in trouble."
"What?"
"I'll get in trouble, they need to change it back to my name. I don't want them mixing us up. You're going to get a bad evaluation." [the implication being that since he thinks I will, he doesn't want that on himself]

Excuse me? Since when do you have the right to judge me? You're not my resident or attending. You are entitled to your own opinions, but please don't push them on me, especially when you've been sitting there all month regarding me as an incompetent fool.

He had no grounds on which to base that accusation. I've received positive feedback from my "superiors" all month. Sure, points have been brought up of things to work on, but they're no different from what I've heard anyone else go through. No glaring deficits, not by any stretch. And how could my classmate know, anyway? He had no right to think that, no right to tell me that, and his smug attitude just served as a last straw in shattering my hope of there being reasonable people around this place. Damn. Ya know? Ridiculous.

-Bitch interns. Had one for the first half of the 4-week rotation. She wanted to get her work done and didn't care about our education one bit. She would repeat to me every time I went to go interview a new admit patient..."Oh sorry, I tend to not let the med-students do the interview. I kind of like to get it done myself and then they can go do what they need to after." She never smiled one the whole time I saw her, I don't think.

-Time ambiguity. It's about a daily occurrence. I'll be sitting in the team room in the late-afternoon. The other students are often in there, too. We don't know where our higher-ups are, and it'd be a rude idea to page them for no reason. We're not sure if we can leave yet, even though we could have easily left hours earlier, with no loss to patients or our own learning. Yet, the way it works, you just sit there. You hate being there because you've done your errands for the day. Yet you can't just leave, for there are constant fear of repercussions. The slightest misstep no matter how late into the game can tarnish your otherwise decent record in the eyes of a disgruntled resident.

-Brown-nosing. Our aforementioned male team-mate hero does this. He'll do anything to look good for the higher-ups. Anyone who will have a say in his grade will get the special treatment from him. He's even taken initiative on my patients at a few points, so he can interject his efforts during rounds. I don't know if its just him being a hard-working fellow, trying to undercut me, or a mixture of both (I'm going to go with the mixture idea).

The point of this point? In the pre-clinical years, the gunners simply fade into the background and study to get their high-scores. But now, when actions count, they become painfully obvious as they play the game of sucking-up, over-achieving, and trying to look good. Yes, there is a component of doing well that everyone should achieve. I'm not saying you shouldn't work hard and respect your higher-ups. But don't undercut your class-mates, don't insult them, and don't look down on them and pass smug judgments. That just makes you a tool in life.

You know what. In the end, I'm not the guy who's going to go 100 miles out of his way to get that top score, publish that paper, and rub the boss' balls. I'm proud of who I am and I'm in this to get through it and become the best doc I can be. I probably won't land a coveted plastic surgery or urology residency, but I don't care. If I wanted to be super-competitive and sacrifice my vital 20s for that, I would have. But then I wouldn't be who I am.

Medicine

I'm in the last week (week 8 out of 8) of my internal medicine rotation. The first month was out-patient which was really helpful and nice. This month has been inpatient, which has been really educational as well...very, very important, but also it has sucked on a lifestyle perspective.

Most medical schools will have 3 months of medicine rotation. We have just as much, but spread out. The difference with us is that we take a "sub-internship" in medicine during 4th year. Meaning I'll get to do this month again next year, only with more responsibility. For now, I'm really glad to have been through it, but I'm really glad to get it done with in a few days. Goodness.

Hierarchy

I had my first day of out-patient (ambulatory) Internal Medicine today. Before I divulge into that, I wanted to relay to you my new status...at the bottom of the medical teaching hierarchy. Like a private in the army, I get to be the MS3 (Medical Student 3rd Year). The chain of command goes as such, in descending order.

Attending
Resident
Intern (1st year resident)
Sub-Intern (4th year)
MS4
MS3

Woo! The climb begins! The basic philosophy of training at this early stage is exposure, exposure, exposure, and do, do, do. Then do some more. We've taken our pre-clinical basic science courses and consolidated our "knowledge" in USMLE step 1. Now its time to see it all literally come to life. I'll just say for now that this is a very exciting time in training, and it is where you make leaps and bounds towards becoming an actual physician.

Oriented

Now I'm ready to begin. I guess.

Got my pager...my PDA is on the way in the mail. I have several "pocket guides" ready to stuff in my short white coat.

Today I heard that the nurses know full and well what our short, white coats mean. They mean that we're doctors in training. We are clinically very incompetent. I hope the nurses are respectful and kind to us...because I know we are to them. In a matter of a number of years, I look forward to the day when I really know what I am doing. Until then, it is in the bowels of medical education that I shall dwell, where I will, like every other physician, slowly and steadily climb my way up, day after day.

It begins!

I feel a lot of similarities between now and (almost) 2 years ago. I'm starting 3rd year now...I was starting 1st year then. I'd much rather be where I am now, mind you.

We got the emails just a day or two ago that we are now officially considered MS3s. We, the class of 2011. It is a seemingly small matter, but to me it means a whole lot.

Later today (it is 1AM), I have a sort of survival skills workshop at school for getting transitioned into 3rd year. Skills like writing "SOAP" notes, presenting patients, and integrating into the teaching-hospital hierarchy. It shall be awesome.

In other news. I'm upgrading my computer tomorrow...by tomorrow at this time, I should have 1.5 TB more hard-drive space, and a vastly superior video card! For now...more cleaning as I just moved back to my place.

I Return! ...as an MS3

Wow.

Well that was fun. I kind of fell out of blogging for awhile there as I realized the the first two years (plus boards) were a real bear to tackle.

So I did.

And now I'm finally, finally here, staring 3rd year in the face.

I absolutely love writing, regardless of how my writing is perceived. I was going to start a brand new blog, but I logged in here and noticed that this thing had been sitting here for years with all my old posts and writings in it. So I took the easy route and decided to simply pick up where I had left off. I will post about the glorious pre-clinical years and boards, as I must express my thoughts on them!

The Trick.

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.