Archive for April 2010
Interrupting my late night studying (neuroscience test on Thursday) to bring you two of my favorite mind tricks from class.
Big Spanish Castle Illusion
Instructions: “Stare at the dot for 30 seconds. Then, without moving your eyes, move the mouse over the image. The image will look like it’s in color until you move your eyes.”
There’s a lot of amazing visual tricks out there, but I think this one really is my favorite so far. Some of the others are incredible, but frustrating. This one’s just fun. :)
This next one’s kind of cheesy, but I hadn’t really heard of this effect before (which is weird; you’d think as a psych major it would’ve come up once or twice. Most other things had).
And now I should either go back to studying or get some sleep.
Free Lunches (and sometimes Dinners) are a fairly common occurrence during Medical School. Usually at least one a week (and during interviewing season, there’s free pizza every night before a school day). But free food is never completely free, and is generally tied to a talk of some sort (~1hr long). In the beginning of the year they’re mostly the introductory meetings of student groups, but as the year goes on, the balance shifts to Career Interest talks/panels and informational talks sponsored by student groups (none sponsored by Pharma companies).
I tend to go to most of these, for the food but often for the talks themselves. Especially the career interest talks*. I missed the Neurology panel, but so far I’ve made it to the Psychiatry and Pediatric panels, and the Internal Medicine one with fourth years who matched into IM. There’s also been two separate single speaker talks by the Anesthesiology Interest Group, and Student Support Services has talks that focus more on medical school itself (one was by our career counselor person, a sort of “You shouldn’t really need me yet, but just wanted to let you know I’m around” talk; the other was a panel of second years giving us a heads up for what to expect next year).
I’ve gathered a fairly random grab bag of advice from these talks so far. Some immediately valuable, some to be stored for later. Some of what I remember off the top of my head:
Know how you study. Don’t worry about what others are doing. Do what works for you.
Start studying for the boards early. Get First Aid. Go through it in parallel with whatever class you’re taking at the time.
Grades still don’t matter maybe sort of? Don’t kill yourself over not getting Honors/not being able to make junior AOA.
Hit the ground running at the beginning of Second Year; it starts off intense.
Picking a Specialty
Don’t pick based on who you like. Pick based on whose job you’d enjoy doing/life you’d enjoy living.
The interesting, rare stuff is always interesting, but which specialty’s daily boring stuff is interesting to you? Can you be happy with the “bread and butter” of the specialty being what you mostly see day in and day out? That’s the right specialty for you.
Also consider patient population. Who do you want to work with?
I really need to get better about writing these things right after they actually happen, because that’s when I have more interesting, concrete thoughts about them. There’s four lunch talks this week though! Maybe at least one of them will be worth writing about. :)
*The career interest talks that are the panels with Doctors actually don’t have any free food, just free (non-alcoholic) drinks.
Side Note: If someone could help me figure out why my mother can’t post comments to my blog on her iphone, that would be awesome. She’s tried several times but after she submits, they never go through. :(
So last week (Thursday, Friday and Saturday), several medical students and a few OT and PT (occupational and physical therapy) students put on a musical, Once Upon a Mattress. For the past few weeks I’d been helping put together the set (I meant to take a picture of it before we took it down but I forgot) and then on the Monday before the show I finally found out that I was, in fact, doing the lights, so from then till Saturday, my nights were spent in the theater first programming the lighting cues and then actually running the cues during the show. And Sunday was strike (taking down the set and getting our stuff out of the next door Pharmacy school’s theater. You heard me correctly. The Pharmacy school has a theater, and they were gracious enough to let us rent it out and use a lot of their equipment and props). So I’ve been busy, but as of tonight I’m mostly caught up with my classes again.
This was my medical school’s fifth student musical, and I hope it stays a tradition. We don’t get much funding, unfortunately, and rely heavily on the ticket sales to fund future performances. Still, a great time was had by all the cast and crew, and we even had many faculty cameos during each show (one involved a doctor dressing in drag, and it was amazing). I think the majority of the medical students involved were first and second years, but one of the main actors was a third year (replacing the original actor who dropped out maybe a month ago) and another was a fourth year.
I didn’t get involved until fairly late in the process (by which I mean, we started working on the sets pretty late), but hopefully next year we’ll start earlier, and I’d like a bigger management type role. I can’t stand being on stage, but I’m still very drawn to theater and the theatrical world. Working on the sets and the lights, being stage manager, those give me ways to be involved and to be important without having to act. I enjoy paving the way for the actors to shine. I like support roles in general.
I did a lot of technical theater in high school and during my first two years of college (I also very nearly majored in Theater), but I stopped after my sophomore year when I decided I was going to be a doctor. I’ve missed it, and this was a nice way of affirming that you know, theater really was a happy part of my life, but I’m okay for having stopped. The five years of my life where it was fairly all consuming, those were good years, and I can live contentedly with my happy memories and minor regret and nostalgia for what I gave up. To some extent, I think theater left a hole in my life, but I’m still optimistic that someday I’ll find my niche in my career and that hole will finally be filled again.
I am not an adventurous person. I do adapt quickly to new situations, but I don’t crave them. Instead, I crave stability.
So it is interesting for me living in a day and age where it is so easy to live in one city for a few years, then another far, far away, and then yet another. Developing networks of friends only to have to create a new one in a few years. I know people who’ve had it worse growing up, moving year after year after year. My life’s only been broken up into 4+9+4+5+Now. After Residency it will have been 4+9+4+5+4+(4 to 7).
Technology makes it easier. I can keep an eye on people from my past, and on people who are still a big part of my life but no longer live near me. It’s easier to handle, with skype and gchat and email and everyone having cellphones, not having lived in the same city as my brothers since I was 11, or my parents since I was 13 going on 14. Even my best friend and my boyfriend no longer live nearby. People still tend to shy away from long distance relationships, but I think they’re becoming more commonplace and viable.
I dream of planting my roots somewhere, but at the same time I’ve wandered enough that I don’t know if I’ll ever be able to choose a location (ah, the paradox of choice). I wish sometimes I came from a small town in the US, that I schooled there from kindergarten to high school, then went to my state college and then state medical school. That my life long dream was to be a doctor back home, where all my friends and family have always been and still are. There is no such place for me, and maybe this idea is only alluring because it is so far from the reality of my life.
I’ve grown quite fond of my medical school class, and especially of my friends within it. It’s weird realizing that when we graduate, the match is probably going to split us up and it’s fairly unlikely we’ll ever end up in the same city again. But the solution is not to withdraw. It’s to make the most of what I’ve got and to try to enjoy the adventure of relocating and building new networks every few years, even if it’s not my nature.
Still, I’m really looking forward to staying in the same room for four years (at least, that was the plan; my friends are looking for a house we can rent together). I’ve had to pack up and move every year for the past nine years (dorms for 8 years, apartment for 1 year). Maybe it’ll get old, but I think no change could be a nice change.
I’ve mentioned our Practice of Medicine course a few times before. It’s a bit misleading to refer to it as one big course, because while it is in theory, it covers a very wide range of class types. It is basically the “everything else that isn’t basic sciences” course. Ethics, Clinical Skills, and… misc? It is in this class where we have the most small group discussions, and where we get a lot of hands on, practical experience. It is very much a mixed bag varying from “Here’s how you do an eye exam” to “How do you think it feels to be an asthma patient?”.
One component of this class was to pair each student up with a Primary Care provider, and have us shadow the doctor four times this year (each visit ranged from 2 to 3 hours). We had our last visit yesterday. Overall, I enjoyed the experience. I enjoyed yesterday a lot more because I actually brought my phone with me and had something to do during the 10-15 minute waits in his office between patients. I realized that I wasn’t enjoying the visits as much because of the down time, but once I could keep myself occupied, I had a much better positive opinion of the whole thing. I half wish I’d signed up to do a summer primary care preceptorship instead of applying for research (yeah… I caved).
There are many aspects of Primary Care that I do like, and while sometimes I was not very excited about having to go, it was overall a worthwhile learning experience. My Preceptor brought up an interesting point today, which was that in medical school teaching hospitals, you see a lot of sick patients. You don’t get to see a lot of the well patient visits, or quick chronic care check ups, that come through a private primary care practice. He apparently has about 4000 patients, which while surprising, I realized makes sense, as he sees most of his patients only once or twice a year, some once every three months. His practice is in the midst of switching over to Electronic Medical Records, and it was fun seeing how happy he was with learning the system and getting to play around with his new tablet pc that he takes his notes on. Apparently, among the doctors in his practice he’s the furthest along in learning the system.
It’s interesting how the doctor you were assigned to shadow colors your opinions. I talked to a friend yesterday and he said that the experience made him not want to do primary care, because his preceptor was so angry. He never yelled at the patients, but after seeing them, he would yell over the phone and one time even threw a pen across his office. Imagine what he must be like when he doesn’t have a student following him around! My doctor, however, never seemed to get particularly riled up. Disappointed, yes, a bit frustrated, yes, busy and overworked, yes, but he maintained an okay though not cheery mood throughout it all.
My medical school has not always been very good about teaching us anything clinical during the first two years, but they’ve been ramping it up the past year or two. I think my year is different even from last years. We’ve definitely had a lot more than the current third or fourth years had at this point. We’ve been learning physical exam components by practicing on each other first, and then we get a chance to practice interviews and physicals on both Standardized Patients (4 opportunities so far; I think 2 more to go this year) and on real patients in the hospital (Seven times so far; for sure 1 more, maybe 2). I really enjoy working with both the SPs and the real patients. I can be shy and/or quiet during social situations, but I actually do have decent people skills, so interviewing (especially when I get feedback after) is often a wonderful ego boost and I always feel really good after. I’m a listener by nature (or by growing up with three loud older brothers? Honestly, I think by nature), which also helps.
Some people say there’s little value in clinical exposure during the first two years of medical school, which in a way, is true. I will probably learn more during the first few weeks of third year than I will these two years preceding it. However, for someone like me who’s straining at the bit to be “done” (you’re never really done) with classroom learning, these are a nice way to refresh my motivations for learning this material. Why am I learning this biochemical pathway again? Oh right! So I can legally and safely talk to and treat patients!
Both my mother and my boyfriend have raised concerns about my mentioning skipping class on my blog, so I think it’s worth a quick post explaining what I mean when I say I “skipped class.” Through elementary school, high school, and college, I was never the sort to skip class. This is a new thing for me. I like it now, but it wouldn’t have worked in the past for a variety of reasons.
First, I always mean that I skipped lecture. I do not skip small groups or labs unless they are explicitly mentioned as being purely optional and I’m not interested in the material. Second, the lectures I skip are recorded and available online as videos and mp3s. Third, and most important, I actually watch the videos.
I would say that a solid 1/3, if not half, of my class does not regularly attend lecture. Lecture is not an interactive experience and I’ve found that I get more out of them when I watch them at home on my own time. But medical school is far from all lecture, so there are plenty of hands on/interactive learning experiences that I can and do go to.
My Mother (Hi Mommy!) would like me to post more on what I’m learning and some of the littler, daily details of medical school, so I’m going to try to post more often because these sorts of details slip out of my mind very quickly once the day has passed.
My school has an interesting system of extracurricular classes, during out first year, which are semi-mandatory. We’re all required to take 4 of them, 2 of which have to be from the ones that are classified as basic sciences, and 1 from the humanities selection. I’m a little baffled by this, because I don’t think that really controls well for these to be valuable experiences.
Still, I’ve enjoyed most of the ones I’ve taken (I didn’t enjoy one of my basic sciences ones, and the other one I don’t think really deserved to be labeled as a basic science, but I’m really thankful it was), and I’ve taken quite a few more than I needed to. My favorites, I think, have been my Emergency Medicine classes. I took one in the Fall, and I’m taking another now. They’re small classes, 5 lessons of 1hr 45mins each, covering a variety of medical emergencies and how they typically present and how you treat them. I enjoy the format: power point lectures peppered with mini-case studies, by a very engaging EM doctor (I adore Emergency Medicine doctors, by the way; my interactions with them as teachers have all been amazing), and the material is genuinely interesting and someday will be useful. Today we learned about obstetric emergencies, from ectopic pregnancies (which I’ve heard quite a bit about by now; these are when the fertilized egg implants anywhere outside of the uterus. These are, I think, never viable, and are very dangerous as left untreated, they will rupture and cause the mother to internally bleed to death) to molar pregnancies (which I only vaguely maybe knew existed; they’re very weird. It’s essentially the placenta becoming cancerous and taking over the womb, and is incompatible with the growth of a fetus).
So yeah, Emergency Medicine II is fun so far. In EM I we learned about things like trauma, wilderness, cardiovascular, toxic, and pediatric emergencies. This time we’ll also be covering abdominal, endocrine, ophthalmic, and some more environmental emergencies.
After my class I idled around for a bit and then went to a free dinner talk sponsored by a student group that endorses a more muted Pharmaceutical advertising presence. Delicious Thai Food, and an actually interesting lecture on conflicts of interests. It’s kind of ridiculous the lengths Pharma reps can and do go through in orders win doctors over. Advertising in general is something that bewilders me a bit. Such a huge industry and so much money involved, but I guess it works, it’s here to stay, and it’s very profitable. I mean, look at Google.
Today is my first day of classes back from Spring Break. My school divides the first year into 3 main blocks:
Practice of Medicine, Physiology, Histology, Anatomy, Biochemistry
Winter Break (2 weeks)
Practice of Medicine, Physiology, Histology, Genetics, Immunology, Microbes and Pathogenesis
Spring Break (1 week)
Practice of Medicine, Neuro
Summer! (11 weeks)
So right now we have just started Neuro Block, and I’m feeling at home. It is incredibly comforting to be learning material that I might not remember, but that I’ve at least seen before, and it’s wonderful finally understanding this material that bewildered me as an undergraduate Psychology/Behavioral Neuroscience major.
There is a lab component to Neuro Block, and we’re dissecting the brains that we saved from our Anatomy Cadavers. After years of seeing the brain as a 2D structure through drawings, pictures, and imaging scans, it is refreshing to look at the real thing, to hold it in my gloved hands and trace out the structures. For the first time, I looked down on a real brain, parted the two halves, and stared down at a whole, attached corpus collosum, the structure through which the halves communicate with each other. It was a lightbulb moment for me. Much of the lab was. We didn’t do much but identify the cranial nerves and the major arteries, then cut off the brain stem and cerebellum and slice the brain through the corpus collosum, separating the left and right half from each other and observed a few other obvious, major structures. And yet this was the first time that I’ve taken a neuro class and really felt like I was actively absorbing and retaining the information. There really is value in being exposed and then re-exposed to material. At some point it’s bound to sink in.
And another great thing about the lab is I’m lucky enough to be reunited with my Anatomy Lab group. =) We’re in groups of 6 instead of 4 now, so some groups have been broken up. We got to stick together, and have stolen two people from two other groups. Hopefully the inside jokes won’t make them feel uncomfortable. Not all anatomy groups bond well, but it’s an experience that lends itself to that happening.
And so starts a new block, and one that I think I’m really going to enjoy. I’ve improved my studying technique a lot since I started medical school, and I think this block is going to go pretty smoothly. I think I’m finally getting a hang of things.