Wednesday, July 28, 2010

Public Blog Redux

Hooray, the blog is public again, and hooray, I got to use the word redux in a title! (I'm slightly addicted to it after reading it all the time in the excellent Life In The Fast Lane.)

I have decided to make my blog public again, as I have kept to myself where I needed to over the past year.

Honestly, there is nothing on here that I wouldn't tell anybody anyway, so I'm not worried about somebody reading it and working out it is me. I may deny it when asked socially, depending on who does the asking.

Even when private, I don't say anything about patients or bitch about colleagues or particular hospitals or systems. I just consider this to be normal polite behaviour.

I have just come to miss the contact of being more open and public with the blogging community. I thought about (and briefly started) another blog under a different name, but it seemed better to just re-open this one and make the blog posts I wanted to make and post them here instead.

Thanks to those of you who stuck with me and logged in over this period. I appreciated your ongoing support and comments.

Now you get to read and comment without the rigmarole of logging in. ;)

Sunday, July 25, 2010

How To Survive Medical School Part 1: Friends

So, you have passed the MCAT/UMAT/GAMSAT/interview, and accepted the offer. Congratulations. Good luck.

You have quit your job, graduated from your university degree, finished high school and tied off the loose ends of your previous life.

You have perused forums, delved into the medical school's official website, grilled doctors in your circle of family or friends, and maybe bought some books.

But where do you go from here? How do you survive? There seems to be so much that you have to do. When you stand at the bottom of that hill, looking up at the mountain of information, expectations, exams and tasks, it can seem like too much for one person to take on.

That is because it is. There are bound to be some rare individuals who went through the whole process without asking for help or looking for handed-down notes or pointers left behind by previous students, but they would be hard to come by, particularly as they would be so stressed and busy that you would never see them.

If you have gotten into medical school, chances are you are now in a group of people who are (on average) extremely intelligent and motivated. As cynical as we can be sometimes about some of the people we work or study with, they could not be where they are if they weren't very smart.

It is worth remembering that very few of these people got over the hurdles and through the hoops by themselves. You need your friends, and you need the help of students who have been there before you.

Before I had gotten into medical school, I had no idea how much medical students rely on each other and are willing to help each other to get through. Each year of students has relied on the advice and help from previous years, so they help the coming years of students to get through to return the favour.

This can be in the form of tutorials, study notes and summaries, past exam papers or just encouragement. The directions from the medical school about how and what you need to study can be overwhelming and almost impossible. Student advice can keep you sane and quite literally help you pass. If you haven't heard of anything like this, make sure you ask around. There is bound to be something that can make your life easier.

Having a good group of friends (even one or two buddies) can also help keep everything in perspective. If you are feeling the pressure and feel like it is all too much, chances are that many people around you are feeling the exact same way, even if they stay calm on the outside.

It really helps to have other people there who you can be honest with about what you are going through, and when you learn how they are coping, it gets easier for all of you. I don't need to go into why having friends is important and how wonderful it is to have people around you who understand what you are going through, I'll just say that making time for friendships is vital.

Don't forget to try to maintain your friendships outside of medical school. Sometimes it is lovely to go out to dinner with a group of people and know that there is no chance of them describing their latest complicated laparoscopic surgery or FB retrieval. I have friends who apologise for talking about the latest adventures of their toddlers, but I love hearing about it. Normalcy is refreshing.

There are also avenues to ask for more substantial help, but I will talk about that in another post as I think it deserves its own space.

Another piece of advice I have to give is to remember that the people who are studying with will one day be your colleagues. You will refer patients to each other, call for advice and one day one of you may be the other's boss. They will know and work with people who you may desperately want to impress.

They may also be your treating doctor or the doctor of one of your friends or family. If you think they are hopeless, feel free to remember their names, but don't tell them so to their face.

Don't burn your bridges. Be civil, even if you find somebody really grates on you. You don't have to be their best buddy, but remember that one day you may have to work together as professionals, so it would be good to not get to the point where things get nasty.

Even if you are an important consultant and head of your department, having everybody you work with despise you is a very bad idea, and as a medical student it will be a long time until you will seriously consider being in that kind of position.

Hospitals are very small places, rife with gossip and intrigue, and so are medical schools. It is not the end of the world if you don't get along with another person, but if you can avoid being outright hostile, I would at least try to be neutral. Good luck. Ask for help.

Wednesday, July 21, 2010

Fools rush in

I keep running into doctors who used to want to do psychiatry for the same reasons I do, and didn't go into it in the end because it was too draining emotionally.

These same people keep trying to talk me into following radiology.

I enjoy imaging, don't get me wrong. There is something really nice about looking at a picture and understanding what is in front of you, and being able to label the anatomy with certainty, understand the physics and the likelihood of the pathology.

I'm just confused. Fortunately I have an elective scheduled where I do four weeks of each, one after the other. This will help me make up my mind.

God knows, maybe I'll end up in a completely different field. This would also be okay. :)

I'm starting to think that I really should take my time getting into something and pay attention to the old proverb of "Fools rush in".

Monday, July 19, 2010

And the good news?

I got my first preference for internship!

I'm so relieved. And a little scared.

I think it will all become more real when the paperwork starts to arrive.

Friday, July 16, 2010


I finished the last of our exams for this rotation today!

They went okay and I think I passed all of them. I know I did well on the last OSCE, as the examiner told me so (the patient ovarian torsion due to a dermoid), and I looked over the first case and worked out that I covered what I needed to cover (discovering a twin pregnancy that then goes into early labour).

For those of you who haven't done a medical school OSCE, it goes like this:

You walk into the room and meet the examiner. They are a consultant (i.e. attending doctor if you are in the USA) and they are sitting in the room looking at notes that you can't see. They say hello, introduce themselves and you exchange pleasantries until the bell/buzzer/knock on the door tells you that it is time to start.

They introduce the case with a simple statement (e.g. Jane Doe comes into your GP office complaining of X) and you have to take a history from them, say what you want to examine, organise texts and talk to the patient as if it were a real situation, except you are being examined and drilled at the same time and have nothing to refer to in front of you.

There are generally multiple patient encounters, so after you are finished with the first encounter (and the examiner has finished prompting you, mostly to help or sometimes the occasional examiner will mess with you a little), they lead into the next encounter which follows on in time from the first. This might continue on in a different location, at a different time, for example, "Jane Doe comes into the emergency department and you are a resident there, her results from her GP read as follows" and you then have to continue care of the patient. And so on and so forth.

It is challenging because it is a foreign situation, sitting in a room talking with an examiner rather than being in a hospital/office with a patient in front of you. It is harder to remember to do the basic things that you would do out of habit, such as get a drip running or call for help from the registrars of the other disciplines if it isn't immediately apparent that they are needed.

If you get a helpful examiner, they can help you along by describing the situation in more detail for you, and leading you to answer things rather than forget them, because if they describe the situation more and you know the answer then you are familiar with what you have to do but have just been put off by the format.

You should still be able to pass without that help, but I won't ever knock back a couple of extra marks for things that I actually know but would have otherwise forgotten to mention due to nerves and the strangeness of the situation. ;)

It is actually kind of fun if you can relax enough to enjoy it. That said, I'm glad I'm done with this lot. Now I only have two big exams, both of them multiple-station exams, and I'm done with medical school. It is very exciting.

Monday, July 12, 2010

Exams, again

We have our exams this week for O&G. They consist of a long T/F paper, and two OSCEs where we are given a fake patient (who can be male and is also the examiner and an O&G physician to boot!) in a structured assessment situation.

I'm mildly nervous, but much less than I would have been a year ago. We have been through so many exams in the past few years that it seems so mundane and normal.

The thing that is starting to weigh on my mind is internship. I have two lots of rotation exams (including this one), one elective rotation, one MSAT at the end of it all, and then I am technically a (junior) doctor.

In studying for these exams, I keep seeing myself actually being in these situations in a year or so. This is helpful for study, as it really makes it stick, but on the flip-side it is also scary.

Quite a lot of girls I went to highschool with are now experienced nurses in the system, with over ten years on the job. I have lost contact with them over time, but it would be very strange to interact with them in a work situation, particularly as a junior doctor. I actually think that most of them would be good to work with, and if things get uncivil, we can threaten to show the rest of the staff pictures of each other in dreadful 90's garb and fluffy hair. ;)

I'm also possibly going to be doing internship at the hospital where I have worked for years in my previous profession, which will also be odd. On the bright side, I have a good reputation there in my other role, so hopefully that will make the transition a bit smoother.

I have worked and studied in the same corner of the world for my whole uni and working life. As Mr TGWTBS has said, it will be a bit of an adventure if and when we get to go elsewhere, in the not-too-distant future.

Sunday, July 11, 2010

One week and one day to go

In one week and one day we get our first offers for internship. It is a very exciting time.

It has been very interesting that I have made it this far, mainly because I have been focusing so much on taking things one day at a time.

I'm trying to work out where the following years may take me, but it isn't easy, particularly as some information is hard to come by. I don't feel like I can call people and ask just yet, as I'm still only a medical student, and email responses are either slow or don't happen. That said, I have received a couple of very helpful responses.

Fun times are ahead.