Since I have so much free time these days, I decided to go ahead and sign up for a "medical Spanish" elective. They typically offer the course at three different skill levels: advanced beginner, intermediate, and advanced. This year they were unable to offer the advanced level course, so only the first two are available. I just got home from taking a placement test to make sure that I am qualified to enroll in the course, and to find out which course is appropriate for my abilities. After a brief oral test (I also took a written test, but he hadn't even looked at it), the instructor told me that I am probably qualified for the advanced level, albeit "weakly" so, but definitely a solid candidate for the intermediate class. I was actually under the impression that I had performed pretty poorly, so I think with a little (or a lot) of practice, I should be able to do ok. I was pretty amazed at how much I had forgotten, though. Very basic words on the written test--like "green"--totally eluded me. I'm a little apprehensive about enrolling in the intermediate course; whereas the advanced beginner course offers a review of grammar and terminology, they skip over it entirely at the intermediate level. On the other hand, I think I will get a lot more out of the intermediate course, so I think I'll go for it. I may simply have to put in a little more work. The class meets weekly from 6-8pm on Wednesdays. Unfortunately, Wednesday is also the day that I have PCM from 1-5pm, as well as a lunchtime meeting from 12-1pm, so I will essentially be in class from 8am-8pm, excluding a 1 hour break for dinner. Eek!
There are also a few other electives I'm considering taking, all of which take place weekly from 12-1pm on various days. One of them is called Global Health Talks and is simply a series of lectures on various topics regarding global and public health, disaster response, etc. I've recently become very interested in medical opportunities abroad (since my trip to Costa Rica/Panama, really), so I think this would be a great elective for me to take. There's also another one called "Specialty Talks" where they highlight a different medical specialty each week and have a panel of doctors specialized in that field provide info on their career. This one is great for people who are totally clueless about what area of medicine they want to pursue, just like your friendly neighborhood blog writer, yours truly.
I think it's really important to be involved outside of simply taking classes, and there are already so many great opportunities to do so; it's too bad I don't have the time to explore them all.
Wednesday, September 22, 2010
Wednesday, September 15, 2010
Health Care Haiku #1
Please enjoy the following haiku that I wrote:
Anatomy lab:
where else could you hear things like,
"Hey, hand me that skin"
Tuesday, September 14, 2010
CHAPTER 2: Over The First Hurdle, Onto The Second Lap
Monday was my first med school exam. We have four exams in GIE (anatomy) over the 11-week course, one for each of the 4 blocks. Each exam consists of a written portion and a practical (lab) portion. The written is multiple choice. For the practical, the course instructors "tag" different structures on the cadavers and we have to identify specifically what they are. During the exam, we rotate through different stations, each one containing a single tagged structure (to tag a structure they simply loop some string around it or stick a pin in it). We had something like 100 seconds at each station, and then we had to switch. After everyone had been through all the stations, we had half an hour to revisit whichever stations we needed.
I'm a little disappointed in how the test went. I haven't gotten my grade yet, but I know I didn't do as well as I wanted (or, more importantly, as well as I know I should have done based on how much I studied and how well I know the material). The practical was a lot harder than I expected. I've heard several other students say that as well. Also, I made a mistake with my approach. I was too ambivalent/unsure with my answers. I ended up with way too many stations to revisit at the end. Half an hour seemed like it would be more than enough time; I thought I would even be able to go back through and look over all my answers. But I ended up not being able to check over many of the ones I wanted to revisit, and not giving myself enough time to think about the really tough ones. I'll definitely be adjusting my strategy the next time around.
As for the written portion, it was really straightforward, and actually really easy. I'm confident that I did well. In fact, it turns out I definitely over-studied for the test in general. I think everyone did. Most of the exam consisted of broad, big-picture type questions, where I had learned the material down to the specific details. So this begs the following question: do I scale back my studying and enjoy life a bit more, or do I keep going full force, trying to perform the absolute best that I can? I think I'll wait to see how I did on this exam before I decide. I had really hoped to score super well, but I know that didn't happen this time around. So if all that extra effort is just going to be wasted, I think I'd rather live a slightly less stressful life (while I still can--I'm told anatomy is the easiest course I will be taking).
Overall, the whole test experience was exciting but exhausting, lasting an insane 4.75 hours (with a 15 minute shovel-some-parfait-in-my-mouth-while-putting-on-my-pants-and-running-from-lab-to-the-lecture-hall "snack break" in the middle). And now, the day after a huge exam and an intense weekend of studying/preparing, we're getting right back into it with block 2. ...And so the marathon continues.
Oh yeah, so today in lab, I totally used a bone saw to cut through some ribs, peeled back the thoracic cage/wall, and took a look inside the chest cavity. ...No big deal.
Man, lungs feel freakin' WEIRD!
I'm a little disappointed in how the test went. I haven't gotten my grade yet, but I know I didn't do as well as I wanted (or, more importantly, as well as I know I should have done based on how much I studied and how well I know the material). The practical was a lot harder than I expected. I've heard several other students say that as well. Also, I made a mistake with my approach. I was too ambivalent/unsure with my answers. I ended up with way too many stations to revisit at the end. Half an hour seemed like it would be more than enough time; I thought I would even be able to go back through and look over all my answers. But I ended up not being able to check over many of the ones I wanted to revisit, and not giving myself enough time to think about the really tough ones. I'll definitely be adjusting my strategy the next time around.
As for the written portion, it was really straightforward, and actually really easy. I'm confident that I did well. In fact, it turns out I definitely over-studied for the test in general. I think everyone did. Most of the exam consisted of broad, big-picture type questions, where I had learned the material down to the specific details. So this begs the following question: do I scale back my studying and enjoy life a bit more, or do I keep going full force, trying to perform the absolute best that I can? I think I'll wait to see how I did on this exam before I decide. I had really hoped to score super well, but I know that didn't happen this time around. So if all that extra effort is just going to be wasted, I think I'd rather live a slightly less stressful life (while I still can--I'm told anatomy is the easiest course I will be taking).
Overall, the whole test experience was exciting but exhausting, lasting an insane 4.75 hours (with a 15 minute shovel-some-parfait-in-my-mouth-while-putting-on-my-pants-and-running-from-lab-to-the-lecture-hall "snack break" in the middle). And now, the day after a huge exam and an intense weekend of studying/preparing, we're getting right back into it with block 2. ...And so the marathon continues.
Oh yeah, so today in lab, I totally used a bone saw to cut through some ribs, peeled back the thoracic cage/wall, and took a look inside the chest cavity. ...No big deal.
Man, lungs feel freakin' WEIRD!
Saturday, September 11, 2010
Not THAT Kind of Catheter
As I mentioned in my last post, I was scheduled to start my preceptorship with the pediatric cardiologist this last week . Ideally, I am supposed to spend every Thursday working with her in the clinic. As it turns out, her schedule is somewhat variable from week to week, so there are going to be certain days where that just won't work. Last Thursday was one of those days--she wasn't working in clinic that afternoon, so I wasn't able to go in. To make up for it, she invited me in on Friday afternoon instead to observe her in the cath (catheterization) lab, which turned out to be a lot of fun. I'd seen some similar procedures in the past (while shadowing a cardiologist during college), but I felt like I learned/understood a lot more this time around. My preceptor seems very kind and easy to work with. She was also very willing to teach, and she tried to keep me informed about what she was doing.
The procedure was interesting: she was working with a really young patient who was born with a heart defect (called tetralogy of flow) that caused extreme hypoxia (not enough oxygen). The procedure was largely exploratory, making sure that the patient was ready for surgery, but the doctor did some intervention herself as well. I left after the procedure, which only took two and a half hours, so unfortunately I wasn't able to completely make up for missing Thursday.
For those wondering, cardiac catheterization (much different that the catheterization you're probably imagining) invovles the use of fluoroscopy, a technique that uses x-rays to get real-time images of internal structures (in this case, the heart and surrounding vessels). The doctors put tubes (catheters) up through arteries/veins and into the heart either for investigation or intervention (fixing defects). Radioactive dye can be injected for investigative purposes, yielding really cool looking images of the cardiac structures that show how well blood is flowing. On the other hand, I'm sure many of you, my avid readers, have heard of doctors placing a stent--this is an example of intervention. A stent is basically a metal tube used to expand a narrowed vessel. They can also use balloons to expand a narrowed vessel, which is what my preceptor did on Friday.
I was pretty disappointed when I first found out about my preceptor's schedule. It's rather unfortunate that I won't have a set schedule from week to week like I'm supposed to. On the other hand, it will allow me to observe the doctor in multiple avenues, such as in the clinic, on hospital rounds, during procedures, etc. So it isn't all bad, I suppose. Plus I really liked the doctor, so I'm very much looking forward to working with her.
It seems like this preceptorship is going to involve a lot more observing that actually contributing (although that is sort of the nature of the specialty preceptorship, as opposed to the primary care one). It will be interesting to see what working with her in clinic will be like. It's possible that I might get to contribute (actually see patients on my own, taking histories and vitals, etc.), which would be really exciting. At first I was pretty worried about seeing patients on my own so soon, but now I'm really looking forward to it. So now I'm a little disappointed that I didn't get assigned a primary care preceptorship for the first year. Then again, having it next year certainly has some advantages: I'll be much more knowledgeable and prepared as a second year. Hopefully I'll get to work with patients this year as well; that way I'd get the best of both worlds. I'll just have to wait until the 23rd (she's unavailable next week) to find out. And you'll be the first ones to hear!
Well...back to studying. GIE exam 1 on Monday. Eek!
The procedure was interesting: she was working with a really young patient who was born with a heart defect (called tetralogy of flow) that caused extreme hypoxia (not enough oxygen). The procedure was largely exploratory, making sure that the patient was ready for surgery, but the doctor did some intervention herself as well. I left after the procedure, which only took two and a half hours, so unfortunately I wasn't able to completely make up for missing Thursday.
For those wondering, cardiac catheterization (much different that the catheterization you're probably imagining) invovles the use of fluoroscopy, a technique that uses x-rays to get real-time images of internal structures (in this case, the heart and surrounding vessels). The doctors put tubes (catheters) up through arteries/veins and into the heart either for investigation or intervention (fixing defects). Radioactive dye can be injected for investigative purposes, yielding really cool looking images of the cardiac structures that show how well blood is flowing. On the other hand, I'm sure many of you, my avid readers, have heard of doctors placing a stent--this is an example of intervention. A stent is basically a metal tube used to expand a narrowed vessel. They can also use balloons to expand a narrowed vessel, which is what my preceptor did on Friday.
I was pretty disappointed when I first found out about my preceptor's schedule. It's rather unfortunate that I won't have a set schedule from week to week like I'm supposed to. On the other hand, it will allow me to observe the doctor in multiple avenues, such as in the clinic, on hospital rounds, during procedures, etc. So it isn't all bad, I suppose. Plus I really liked the doctor, so I'm very much looking forward to working with her.
It seems like this preceptorship is going to involve a lot more observing that actually contributing (although that is sort of the nature of the specialty preceptorship, as opposed to the primary care one). It will be interesting to see what working with her in clinic will be like. It's possible that I might get to contribute (actually see patients on my own, taking histories and vitals, etc.), which would be really exciting. At first I was pretty worried about seeing patients on my own so soon, but now I'm really looking forward to it. So now I'm a little disappointed that I didn't get assigned a primary care preceptorship for the first year. Then again, having it next year certainly has some advantages: I'll be much more knowledgeable and prepared as a second year. Hopefully I'll get to work with patients this year as well; that way I'd get the best of both worlds. I'll just have to wait until the 23rd (she's unavailable next week) to find out. And you'll be the first ones to hear!
Well...back to studying. GIE exam 1 on Monday. Eek!
Tuesday, September 7, 2010
Medical Musings, Part 1: A Lunchtime Lament
Since my schedule these days necessitates eating breakfast so early, I always end up starving during cadaver lab. I'm starting to worry that my brain is going to permanently associate being around dead bodies with being hungry.
Saturday, September 4, 2010
Clinical Experience: The Heart of Medical School
Ok. So I have some news to report. But before I do, I should probably bring everybody up to speed on my current class schedule. For the first two years of medical school, my course schedule is pretty much predetermined. I do have the option of throwing in an elective now and again, but for the most part I will just be taking the core (basic science) courses.
You all know that I'm currently taking anatomy; I've made this very clear in my previous posts. Well, to be more specific, I'm class I'm in right now is called GIE, or Gross Anatomy, Imaging and Embryology. This is a daily course that lasts for the first 11 weeks. It focuses primarily on anatomy, but also includes includes lectures on the other topics mentioned in the title as well. It consists of both a lecture component, as well as lab (you know, that smelly place I mentioned previously). After GIE comes Cell Structure and Function (9 weeks), then Systems Processes and Homeostasis (9 weeks), and finally Biological Basis of Disease (9 weeks). And that's my core schedule for the year. Pretty simple, eh?
In addition to my basic science courses, I also have a class called PCM, or Principles of Clinical Medicine. PCM is a weekly course that lasts for the first two years of medical school. The purpose is to give us an early introduction to the true clinical aspect of medicine--a sort of practical application of the things we are learning in our science courses--as well as to teach us about ethics, finance, health organization, biostatistics, etc. There are two parts to this course: the didactic portion (a 4 hour weekly lecture) and the preceptorship. In addition to large and small group discussions surrounding the topics I listed above, the didactic portion of the course also serves to prepare us to see patients, teaching how to take histories, perform physical exams, take vitals, etc. The preceptorship, on the other hand, is what I really came here to tell you about.
A preceptorship is sort of like a shadowing experience on steroids. I've shadowed doctors in the past, and it essentially consists of a lot of watching. Preceptorships are all about doing. Whereas the PCM lectures teach us the practical knowledge, the preceptorship provides hands on experience. Though the experience will vary from student to student, I will likely have the opportunity to see patients (either with the doctor or prior to the doctor seeing them) and do all the doctor-y stuff I mentioned above (histories, vitals, exams, etc.) So basically, it's going to be an incredible experience. In fact, I've been told that the reason many students ultimately choose OHSU is for the early clinical experience they offer. I'm a little scared to dive in head first so soon, but it will certainly be well worth it.
Ok. Just a few more explanations, then I promise I'll tell you the news. Like I said, the preceptorship occurs weekly and lasts for the first two years. One year is the "primary care year" (either family practice or internal medicine), and the other year is the "specialty year". For primary care, you spend the whole year with the same doc. For specialty, you rotate between 3 difference specialists, one each term.
And finally, we have come to the purpose of this overly wordy, sleep inducing post: my announcement. My fate. My preceptorship. This year will be my specialty year. For the first term (starting next Thursday), I will be working with a pediatric cardiologist. Cardiology was one of the specialties I listed as an interest. Pediatrics was not, but I think it will add a very interesting perspective. Furthermore, I also discovered that the doctor specializes in transplants, which could potentially be really exciting. So, my friends--my most faithful of readers, those who have endured this lengthy post to the bitter end--please continue to feverishly check my blog for updates, for I will definitely be reporting all preceptorship-related developments as they arise. And arise they shall.
Now, before I click that long overdue Publish Post button at the bottom of my screen, here is my current class schedule, for anyone interested in seeing the thrilling occurrences of my day-to-day life in a neat, chart format. Enjoy!
You all know that I'm currently taking anatomy; I've made this very clear in my previous posts. Well, to be more specific, I'm class I'm in right now is called GIE, or Gross Anatomy, Imaging and Embryology. This is a daily course that lasts for the first 11 weeks. It focuses primarily on anatomy, but also includes includes lectures on the other topics mentioned in the title as well. It consists of both a lecture component, as well as lab (you know, that smelly place I mentioned previously). After GIE comes Cell Structure and Function (9 weeks), then Systems Processes and Homeostasis (9 weeks), and finally Biological Basis of Disease (9 weeks). And that's my core schedule for the year. Pretty simple, eh?
In addition to my basic science courses, I also have a class called PCM, or Principles of Clinical Medicine. PCM is a weekly course that lasts for the first two years of medical school. The purpose is to give us an early introduction to the true clinical aspect of medicine--a sort of practical application of the things we are learning in our science courses--as well as to teach us about ethics, finance, health organization, biostatistics, etc. There are two parts to this course: the didactic portion (a 4 hour weekly lecture) and the preceptorship. In addition to large and small group discussions surrounding the topics I listed above, the didactic portion of the course also serves to prepare us to see patients, teaching how to take histories, perform physical exams, take vitals, etc. The preceptorship, on the other hand, is what I really came here to tell you about.
A preceptorship is sort of like a shadowing experience on steroids. I've shadowed doctors in the past, and it essentially consists of a lot of watching. Preceptorships are all about doing. Whereas the PCM lectures teach us the practical knowledge, the preceptorship provides hands on experience. Though the experience will vary from student to student, I will likely have the opportunity to see patients (either with the doctor or prior to the doctor seeing them) and do all the doctor-y stuff I mentioned above (histories, vitals, exams, etc.) So basically, it's going to be an incredible experience. In fact, I've been told that the reason many students ultimately choose OHSU is for the early clinical experience they offer. I'm a little scared to dive in head first so soon, but it will certainly be well worth it.
Ok. Just a few more explanations, then I promise I'll tell you the news. Like I said, the preceptorship occurs weekly and lasts for the first two years. One year is the "primary care year" (either family practice or internal medicine), and the other year is the "specialty year". For primary care, you spend the whole year with the same doc. For specialty, you rotate between 3 difference specialists, one each term.
And finally, we have come to the purpose of this overly wordy, sleep inducing post: my announcement. My fate. My preceptorship. This year will be my specialty year. For the first term (starting next Thursday), I will be working with a pediatric cardiologist. Cardiology was one of the specialties I listed as an interest. Pediatrics was not, but I think it will add a very interesting perspective. Furthermore, I also discovered that the doctor specializes in transplants, which could potentially be really exciting. So, my friends--my most faithful of readers, those who have endured this lengthy post to the bitter end--please continue to feverishly check my blog for updates, for I will definitely be reporting all preceptorship-related developments as they arise. And arise they shall.
Now, before I click that long overdue Publish Post button at the bottom of my screen, here is my current class schedule, for anyone interested in seeing the thrilling occurrences of my day-to-day life in a neat, chart format. Enjoy!
Monday | Tuesday | Wednesday | Thursday | Friday | |
8:00am | GIE Lecture | GIE Lecture | GIE Lecture | GIE Lecture | GIE Lecture |
9:00am | |||||
10:00am | GIE Lab | GIE Lab | GIE Lab | GIE Lab | GIE Lab |
11:00am | |||||
12:00pm | |||||
1:00pm | PCM Lecture | Preceptorship | |||
2:00pm | |||||
3:00pm | |||||
4:00pm |
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