Making Up For Lost Time
You know that one thing on your to-do-list that you stare at everyday and tell yourself, "I'll get to that tomorrow"? It's important to you but somehow gets drowned in the sea of the day-to-day chores.
Today, tomorrow finally arrived, I have strapped myself down to this chair with every intention of starting and finishing this blog post today. Once logged in the first thing I did was read my last post, published during my third month in medical school.
The last line read, "the plan is to have more regular posts ... buuut its just a thought for now.. until next time!" Welll, now I'm a few months from graduating medical school and can only laugh at the good intentions I had!
A lot has transpired since those first three months of medical school. Part of me feels like it was a lifetime ago, yet when I look forward and realize that the end of this chapter is near I can hardly believe I will soon be trading in the title of "medical student" for that of "doctor."
Even as I sit here typing out this post, I'm silently kicking myself for waiting so long to get around to it. There's so much to say and it's hard to know where to begin. I think its best to start with the low hanging fruit; my most recent experiences and work my way BACKWARDS. One of the surgeons I used to work with used to say, "start with the easier stuff and with any luck that will make the harder stuff get a little easier".
Today is the last day of a 3 month journey. Three sub-internship rotations, each one month long. It began in Boston at Brigham and Women's Hospital. I spent a month there on the Thoracic surgery service. On my days off I would explore the city and soak up its temperate summer conditions. The next month was in LA, the city angels, working on the Cardiac surgery service at USC. I learned so much on that rotation... in addition, I had time to enjoy the city's gentle sea breeze and dependable sunshine. This month I have been in Atlanta, on the Cardiac surgery service at Emory. I've definitely been surprised by how much countryside there is here. On the trips to and from the hospital I get to bear witness to vibrant Fall colors and creative pumpkin carvings.
Being on the road poses many challenges inside and out of the hospital..Settling in to the new environment quickly makes it easier to get up to speed faster at the hospital.
For room and board I used Air bnb in Boston and LA and let me just say that definitely can be hit or miss. Transportation has been an even bigger challenge. I started off renting a car in Boston, however that was short-lived. I got a parking ticket the first night, ON A SUNDAY, even though I followed all the rules. I promptly returned the car the next day!! Since then I have been relying on my legs, uber, lyft and the kindness of fellow students to get around. Another challenge being on the road has been the inability to cook regular meals. I have become quite familiar with shakes and frozen dinner over the last few months.
Even though I have come to despise airports and the chaos that must be navigated to board a flight, traveling has allowed to reconnect with old friends now in new cities and explore more of the country... nevertheless Im excited to go home and drive my car and eat hot none frozen dinners
Before being allowed to graduate medical school in addition to taking a bunch of written test you have to pass a couple of significant Objective structured clinical examinations (OSCE's). These are
practical examinations that test clinical acumen, competence in basic physical exam maneuvers and history taking. Standardized patient actors are used to simulate real-world experiences and challenge the examinee to be innovative and decisive. Essentially these tests are another safety net to ensure doctors don't only have the knowledge but are able to relate to their patients and apply the book stuff to real life!
STEP CS is the a national OSCE that is a component of board certification. Unfortunately it is only available to be taken in a handful of cities across the country which means travel and hotel expenses for many examinees! Not surprisingly the test is also very expensive to register for...
The Integrated Curriculum Evaluation Exercise (ICEE) is a exit OSCE proctored by UTMB medical school, immediately following the end of 3rd year, specifically for its students. Again its basically another quality assurance measure to ensure graduating students meet acceptable skill standards... Rumor from a reliable source has it that 33% fail of the class is intended to fail the ICEE examination the first time around... brutal.
I took STEP 2 CS while I was on my third sub-internship in Atlanta.. I had to fly back to Houston to take the test as it was the only center that had a date that worked for my schedule! CS is a 10 hour long test day that includes 12 different patient encounters and post encounter notes that must be typed to document your findings and management plan for the patient. Immediately after the exam was over I headed to the airport to fly back to Atlanta so I could be at work the next day.
Before embarking on my sub-internships I sat for the written portion, STEP 2 CK, of the second part of the board certification process.
I took 3 weeks of dedicated study time to prepare for the exam. The memories of that study block are a blur of repetitive days consisting of food, study, exercise and sleep. The exam itself is marathon lasting 9hrs! It covers all material from the first three years of medical school but primarily focuses on clinical decision making, a skill honed during the third year of medschool.
Third year.. its widely considered the year boys become men, girls become women, liquids change to solid food... you get the point! Its the year students making the greatest advancement from "ugh the medical student" to "oh! there's the doctor".
During third year you get to sample each major specialty. The line-up includes OB/GYN, Psych, Internal Medicine, Family Medicine, Surgery and Pediatrics.
The hardest part about third year is finding your niche. The sad truth is that the hospital would continue to function (probably even more efficiently) if med students weren't there. Closed mouths don't get fed, similarly as a third year student finding ways to be helpful increases the chances of a meaningful learning experience and that someone will like you enough to take time to impart some wisdom onto you.
STEP 1 is the first examination in the series of tests needed for board certification and is the most daunting. Most students take the exam at the end of 2nd year and as arduous and exhausting as that period of studying is, I think it provides the perfect launching pad that allows for a smooth transition from the classroom to the hospital. It tests mainly basic sciences learned during the first two years but rumor has it there has been more and more clinical decision making questions creeping into the exam in recent years! When I published my last post I was in the midst of learning the foundational stuff, gross anatomy, radiology, biochemistry, pathology, histology etc. During second year those concepts are used to understand organ systems. From the heart and lungs, to the kidneys, the intenstines, skin and blood disorders everything builds off the foundation created during first year!
The life of a medical school student is busy...no surprises there. Looking closer, the responsibilities shift from being a bookworm in your first two years to being a patient advocate and healthcare provider in your last two. However, the learning never ends! After graduation the expectations change and responsibilities are increased. After graduation we all choose different specialties to focus our energies on but the foundational stuff remains the same.
Over the next few months I'll be traveling all over the country to different cities for interviews. Admittedly I definitely underestimated the costs. Statistics published by the NRMP (http://www.nrmp.org/wp-content/uploads/2017/06/Main-Match-Results-and-Data-2017.pdf)
show most people match (get a job) to residency program if they have somewhere between 10-12 interviews. 12 interviews, that means potentially 12 flights, 12 hotels, endless ubering/lyft... it adds up.. To console us as our already fragile bank accounts are drained of what remaining life remains in them, we are told not to think of our current expenses and that our future earning potential will take care of todays debts.... easier said than done.
I would like to think that I will blog while I'm on the interview trail but my track record isnt encouraging! Nevertheless looking ahead the next big day on the calender is March 16! That's the date an envelope will arrive containing the details that state where I will be living and training for the next few years...that seems normal, right?..
Posted below is a link that kinda explains the residency "match" process explained far better than I probably could
http://www.nrmp.org/matching-algorithm/
The last line read, "the plan is to have more regular posts ... buuut its just a thought for now.. until next time!" Welll, now I'm a few months from graduating medical school and can only laugh at the good intentions I had!
A lot has transpired since those first three months of medical school. Part of me feels like it was a lifetime ago, yet when I look forward and realize that the end of this chapter is near I can hardly believe I will soon be trading in the title of "medical student" for that of "doctor."
Even as I sit here typing out this post, I'm silently kicking myself for waiting so long to get around to it. There's so much to say and it's hard to know where to begin. I think its best to start with the low hanging fruit; my most recent experiences and work my way BACKWARDS. One of the surgeons I used to work with used to say, "start with the easier stuff and with any luck that will make the harder stuff get a little easier".
Today is the last day of a 3 month journey. Three sub-internship rotations, each one month long. It began in Boston at Brigham and Women's Hospital. I spent a month there on the Thoracic surgery service. On my days off I would explore the city and soak up its temperate summer conditions. The next month was in LA, the city angels, working on the Cardiac surgery service at USC. I learned so much on that rotation... in addition, I had time to enjoy the city's gentle sea breeze and dependable sunshine. This month I have been in Atlanta, on the Cardiac surgery service at Emory. I've definitely been surprised by how much countryside there is here. On the trips to and from the hospital I get to bear witness to vibrant Fall colors and creative pumpkin carvings.
Being on the road poses many challenges inside and out of the hospital..Settling in to the new environment quickly makes it easier to get up to speed faster at the hospital.
For room and board I used Air bnb in Boston and LA and let me just say that definitely can be hit or miss. Transportation has been an even bigger challenge. I started off renting a car in Boston, however that was short-lived. I got a parking ticket the first night, ON A SUNDAY, even though I followed all the rules. I promptly returned the car the next day!! Since then I have been relying on my legs, uber, lyft and the kindness of fellow students to get around. Another challenge being on the road has been the inability to cook regular meals. I have become quite familiar with shakes and frozen dinner over the last few months.
Even though I have come to despise airports and the chaos that must be navigated to board a flight, traveling has allowed to reconnect with old friends now in new cities and explore more of the country... nevertheless Im excited to go home and drive my car and eat hot none frozen dinners
Before being allowed to graduate medical school in addition to taking a bunch of written test you have to pass a couple of significant Objective structured clinical examinations (OSCE's). These are
practical examinations that test clinical acumen, competence in basic physical exam maneuvers and history taking. Standardized patient actors are used to simulate real-world experiences and challenge the examinee to be innovative and decisive. Essentially these tests are another safety net to ensure doctors don't only have the knowledge but are able to relate to their patients and apply the book stuff to real life!
STEP CS is the a national OSCE that is a component of board certification. Unfortunately it is only available to be taken in a handful of cities across the country which means travel and hotel expenses for many examinees! Not surprisingly the test is also very expensive to register for...
The Integrated Curriculum Evaluation Exercise (ICEE) is a exit OSCE proctored by UTMB medical school, immediately following the end of 3rd year, specifically for its students. Again its basically another quality assurance measure to ensure graduating students meet acceptable skill standards... Rumor from a reliable source has it that 33% fail of the class is intended to fail the ICEE examination the first time around... brutal.
I took STEP 2 CS while I was on my third sub-internship in Atlanta.. I had to fly back to Houston to take the test as it was the only center that had a date that worked for my schedule! CS is a 10 hour long test day that includes 12 different patient encounters and post encounter notes that must be typed to document your findings and management plan for the patient. Immediately after the exam was over I headed to the airport to fly back to Atlanta so I could be at work the next day.
Before embarking on my sub-internships I sat for the written portion, STEP 2 CK, of the second part of the board certification process.
I took 3 weeks of dedicated study time to prepare for the exam. The memories of that study block are a blur of repetitive days consisting of food, study, exercise and sleep. The exam itself is marathon lasting 9hrs! It covers all material from the first three years of medical school but primarily focuses on clinical decision making, a skill honed during the third year of medschool.
Third year.. its widely considered the year boys become men, girls become women, liquids change to solid food... you get the point! Its the year students making the greatest advancement from "ugh the medical student" to "oh! there's the doctor".
During third year you get to sample each major specialty. The line-up includes OB/GYN, Psych, Internal Medicine, Family Medicine, Surgery and Pediatrics.
The hardest part about third year is finding your niche. The sad truth is that the hospital would continue to function (probably even more efficiently) if med students weren't there. Closed mouths don't get fed, similarly as a third year student finding ways to be helpful increases the chances of a meaningful learning experience and that someone will like you enough to take time to impart some wisdom onto you.
STEP 1 is the first examination in the series of tests needed for board certification and is the most daunting. Most students take the exam at the end of 2nd year and as arduous and exhausting as that period of studying is, I think it provides the perfect launching pad that allows for a smooth transition from the classroom to the hospital. It tests mainly basic sciences learned during the first two years but rumor has it there has been more and more clinical decision making questions creeping into the exam in recent years! When I published my last post I was in the midst of learning the foundational stuff, gross anatomy, radiology, biochemistry, pathology, histology etc. During second year those concepts are used to understand organ systems. From the heart and lungs, to the kidneys, the intenstines, skin and blood disorders everything builds off the foundation created during first year!
The life of a medical school student is busy...no surprises there. Looking closer, the responsibilities shift from being a bookworm in your first two years to being a patient advocate and healthcare provider in your last two. However, the learning never ends! After graduation the expectations change and responsibilities are increased. After graduation we all choose different specialties to focus our energies on but the foundational stuff remains the same.
Over the next few months I'll be traveling all over the country to different cities for interviews. Admittedly I definitely underestimated the costs. Statistics published by the NRMP (http://www.nrmp.org/wp-content/uploads/2017/06/Main-Match-Results-and-Data-2017.pdf)
show most people match (get a job) to residency program if they have somewhere between 10-12 interviews. 12 interviews, that means potentially 12 flights, 12 hotels, endless ubering/lyft... it adds up.. To console us as our already fragile bank accounts are drained of what remaining life remains in them, we are told not to think of our current expenses and that our future earning potential will take care of todays debts.... easier said than done.
I would like to think that I will blog while I'm on the interview trail but my track record isnt encouraging! Nevertheless looking ahead the next big day on the calender is March 16! That's the date an envelope will arrive containing the details that state where I will be living and training for the next few years...that seems normal, right?..
Posted below is a link that kinda explains the residency "match" process explained far better than I probably could
http://www.nrmp.org/matching-algorithm/
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