Why oh why did I watch Grey's Anatomy tonight instead of studying. I mean, I still studied, but I could have finished what was on my study schedule if I hadn't watched grey's (maybe). Nothing like unrealistic study expectations to make you feel good about yourself. Oh, and finding out there were 14 weeks of lecture not 13 (my whole study schedule hinged on lucky 13).

Guh.

OSCE II

What a freakin' shit show.

You know when they put something on the OSCE that you learned in lecture this semester and haven't studied yet that you're in trouble. Yes, I'm the idiot who confused glaucoma and macular degeneration. Yes, I probably failed that station. Were we supposed to know those things for the OSCE? NO.

We were supposed to be tested in the skills and information learned in our clinical skills and our expanded clinical skills sessions. Macular degeneration was covered in neither. Fundoscopy, yes, strabismus, yes, nystagmus, yes, but macular degen, no. I didn't know we were supposed to have studied everything for our final exam that's in 2 weeks before our OSCE. It's fair game next semester, but not this one. I know I might sound like a whiny loser, but I really did think it was unfair, and so did others.

My lady for the sciatic nerve section didn't know her dermatomes so gave me a very confusing picture of which nerve roots were affected, thus I couldn't answer the question at that station. Fuck. This was awful and I feel like crying. I'm going to be an awful doctor.

OSCE

So, it's coming to the end of the semester and that means it's time for our OSCE. For those of you not in the know, it stands for Objective Structured Clinical Examination. Basically you go through a number of timed stations, each of which consists of a clinical scenario for which you must do a history or a physical exam.

For example: Ted is a 47 year old man who has come in with a complaint of melena. Do a focused physical exam. You will be asked a question at the 5 minute mark.

At this station you would be expected to do an abdominal exam and then a DRE. The examiner has things on a checklist that you get points for doing i.e. light palpation of the abdomen. It's great because every time you do something right you can hear them checking it off - it's a boost of confidence. Unless, of course, you do 5 things and don't head any check marks being made! It is totally artificial and isn't like being with a real patient at all, but it does test your ability to remember which tests to do for what scenario.

I have my OSCE for this semester tomorrow. I'm scared. Mostly because this semester we have had little time to practice our histories and physicals and have instead been focused more on findings, special skills etc. I have to go over my upper and lower back pain exams today and make sure I don't forget something important. I need to remember to FIFE the heck out of people on my history (function, ideas, feelings, expectations) and I need to go over my relevant review of systems because I keep forgetting which questions relate to which clinical scenarios i.e. seronegative arthropathy questions (SOAP BRAIN MD anyone?).

Then I have 2 weeks to study for exams. I started studying a while ago but have sort of lulled myself into a false sense of security and been going pretty slowly. I need to step it up now. 2 weeks to go through a week of notes a day for a total of 13 weeks. I've read the entire textbook but need to start filling in the blanks and reminding myself of what I do and don't know.

MCQ on the 13th, Short answer on the 14th and Practical on the 15th and then I'm FREE for Christmas. I'm excited.

You meet the nicest people in med school

Lately I've been a bit frustrated with a few people in my class (as you could probably tell from the last post). Sometimes, I forget how many nice people there are in medical school who I would have never met otherwise. After the latest frustrating incident with a few group members, one of the girls in my group came up to me and touched me on the arm. She said, "Don't worry, I felt the same way too. I like how you looked them in the eye when you were giving your criticisms, that was honorable." It was like it all ceased to matter. Someone had heard what I said and how I felt and she acknowledged that I was upset and needed support. If she wasn't going into pathology, I would want her as my doctor any day!

So, let this be a lesson to us all, great people go into medicine. The wanks are the exceptions, not the rule.

Bad Day

Some people you just can't get along with. You try to give them honest feedback in a group situation being as transparent and constructive as possible, and they take it the wrong way. You try to let them give you open and honest criticism, and they don't say anything and then make sarcastic comments afterwards. They tell everyone else how they love to give feedback and if they have a problem with someone they'll go up to them and arrange a time to tell them how they feel, and then when they clearly have a problem with you they just sit there and act all passive aggressively. I'm sick of it. Grow up.

Making Medicine Sound Good

Today some colleagues and I gave a talk at a conference to a bunch of engineers who might want to be doctors one day. We discussed all of the things you have to do to get into medical school, why it's great to be an engineer when applying, and how we went about getting in. It was all going well until someone asked what it was we didn't know about medicine when we got into medical school. When someone asks you this question, it's hard to make medical school sound good.

When I got into medical school I thought it was going to be awesome: I thought I would get to see patients and learn how to be a great doctor; I thought I would have fantastic classmates; I thought my professors would be great mentors; and, I thought I would fall in love with a specialty that I would do for the rest of my life. For the most part, all of these things are true.

What I didn't know is that I wouldn't get to see many patients until 3rd year, I would have to sit through hours of lecture that were pitched way above my level of understanding and mumbled through by professors who would rather be operating/medicating/sleeping/etc., and that my life would revolve much more around medical school than I ever thought it would. I love medical school, but there definitely are some drawbacks that I never imagined before hand.

I fell in love with rural family medicine and think I would like to do that for the rest of my life, but I'm not always sure. I have some great mentors who are also my professors, but some of them don't really care who I am or what I do. I love many of the people in my class, but sometimes it's a bit claustrophobic to be with them every minute of the day. Alas, medical school like life isn't perfect. And I don't expect it to be.

Professionalism

There has been a bit of a hubub this week at my med school. Last week we had a scheduled session on "career counseling" which not many people attended. I was personally at the family medicine forum in Quebec City representing my school and learning about family medicine promotion initiatives for the coming year. Other classmates were studying, sleeping, doing observerships, cramming in a little bit of exercise, or generally doing anything but going to this lecture. We then got an email later that week from the doctor who was giving the lecture complaining that nobody showed up and telling us that it was unprofessional of us all to miss it.

I wrote him a message saying that I was sorry I had missed it but the lecture only went onto our schedule 2 weeks earlier and I'd already booked my train tickets to attend this conference. Other individuals sent him emails explaining that they preferred to be doing the things they were actually doing at the time and didn't think the lecture was that helpful in the curriculum (those who were concerned about their future career probably went). Then Dr. Career counselor proceeded to flip out and send an email to the entire medical school explaining how our class is full of unprofessional assholes and taking people's private emails to him and cutting bits out of them to demonstrate that we're assholes. He didn't name any names within our class, but it left me scratching my head... Isn't that a bit unprofessional? Isn't it unprofessional to add a lecture to our schedule on short notice and then take it personally when people have scheduled other things for that time slot?

I think all in all this is a very bad situation. If I was giving the lecture, yes, I'd be pissed if nobody showed up. But, I wouldn't send an email to the whole medical school berating the individuals who didn't come and complaining about "unprofessional behavior". Counseling should be optional and on an as per need basis. Lectures on career counseling don't seem very effective to me. But, alas, I didn't go so I have no idea what he said.

We're grown-ups. Everyone in my class already has an undergraduate degree (or at least 3 years of one) and we should be responsible for our own education. The taking attendance malarky that has happened at this medical school lately is stupid. If people learn better at their desk at their house, so be it. If they can pass the exams and interact clinically with patients at an acceptable standard, what's to say that they aren't going to be as good a physician as any of the rest of us? What use is it wasting one's time in a lecture if that is not the way that one learns? Ultimately, one will not pass unless they learn the material, so let us learn it as we see fit.

Why Med Students are Human

Lately I've been having trouble with three things:
1) Wine
2) Cupcakes/Candy
3) Going to the gym

Wine for me is greatly connected to time spent with friends/family having fun and being care-free. My family loves wine and loves to discuss wine and go on wine tasting/buying trips. I don't drink very often (maybe 2/3 times a month) and if I go out to a restaurant I only ever have one glass. The problem for me is when there's a whole bottle just sitting there. I drink wine like it's water - I tell myself that I should alternate between wine and water because I'm just drinking wine because I'm thirsty, but I never do. Wine also exacerbates my stomach problems. Alcohol is also not great for weight loss/maintenance (see items 2 and 3) so part of my new commitment to personal health and fitness is cutting down. Wish me luck.

Recently I was at a baby shower where there was far too much wine and far too many cupcakes. I managed to limit myself to one cupcake while there, but dammit, my Mum sent me home with 6 leftover ones! If something is there, I will eat it (or drink it). I tell myself that once they're gone, they're gone, but somthing else always seems to come along i.e. leftover halloween candy. I need to develop more willpower. No more cupcakes. Dammit.

Last but not least, the gym. I always have grand plans to make it to the gym 3 times a week. I usually make it twice. Although I ride my bike to and from school every day it's not enough exercise and I'm not liking what's happenening to my body. With exams coming up I have a hard time seeing myself keeping up with my work-out routine. I need to find something else to do that doesn't involve travelling. The upside is that my gym is in the grocery store so I can't very well go buy groceries without commiting to a workout. Unfortunately, sometimes I just choose to go for a week eating frozen food and everything in cans from my pantry and stealing my roommate's milk instead of going shopping. I guess overall laziness might be more my problem.

So, I guess it all comes down to me needing to get off my growing ass and take care of myself. How come it's always easier to sit here and worry about failing neurology?

Magic

Hand in hand we come
Christopher Robin and I
To lay this book in your lap.
Say you're suprised?
Say you like it?
Say it's just what you wanted?
Because it's yours ---
Because we love you.

Welcome to the world Ari Campbell Good