Dirty Skipper

I just couldn't make myself go to school this morning. Having a guy who specializes in stem cell research teaching us cardiac physiology is just too painful. And then a 2 hour "lab" that involves looking at plastinated specimens that I won't remember anyways. I'm planning on spending some time reading cardiac arrhythmias this morning and trying to get a handle on heart block and then I have to go to PBL (problem based learning).

My school does PBL every semester that we have lectures. For the most part, I kind of like it because it's a good time to review and solidify my knowledge about the subjects taught in class and to get an idea of the literature available on a variety of subjects. Some of the people in my class HATE PBL passionately. They see it as a waste of time and full of "stupid" sociological concerns and questions. I have to say though, one or two people who hate it can bring the group down hugely. It's too bad it's manditory to show up because sometimes I'd rather that some people didn't.

My group this semester is really good, but our facilitator really isn't very good. He doesn't understand that the point of a PBL facilitator is not to offer all of his own knowledge but for him to keep the group moving and allow us to explore our own questions and steer us to the questions mentioned in the outline he is given. He spends half of each session talking and we run over time every week. I like PBL but I want it to be efficient. I like to get things done and keep them moving and I often feel like I don't have all of the time in the world. Each case comes with a tutor guide telling the tutor which subjects we should address and what the diagnosis is. My tutor doesn't read the guide, therefore, two weeks ago we missed 4 topics we were supposed to discuss and missed the correct diagnosis. Although one of my group members suggested it, our tutor brushed it off because he had never heard of it. I hope this improves in the future. It would be a shame to diminish the learning experience by missing topics and hearing our tutor drone on about the same thing week after week that I'm sure he forgot he talked about the week before.

Oh Marks

So, I got my marks today. I did a lot better than I'd thought. I got honours again, BIG releif. I'm not sure if there are any other schools, especially those not in Canada, that work on this strange system. Under 60 is a fail, 60-80 is a pass and over 80 is honours. We never actually get our numerical marks, we just get a F, P, or H on our transcript. Sometimes it's frustrating and sometimes it's great knowing that a few percentage points don't make a huge difference unless you're on the cusp of the boarders between the marks. I always tell myself that I don't care as long as I pass, but secretly I do and I'm proud of myself for being a straight honours student. Only two more semesters with these stupid exams to go and then clerkship! I'm really looking forward to it although it's a scary thing.

Teen Pap Smears and my new profile pic

For Med school we have to do a community project. My group is making posters and a pamphlet giving teens information about pelvic exams for nurses who run a health clinic at a local highschool and for the local health unit. I just finished two of the posters, let me know what you think!



And, for those of you who are confused by new profile pic, I've been thinking a lot about the uterus lately. Seemed appropriate. GO to : http://iheartguts.com/

Family Medicine - Yours To Discover

Wow. I just came back from the GREATEST family medicine talk. We had a couple who are married and both family docs come in to talk to our family medicine interest group about their lives. It was so enlightening. Did you know that with a Canadian family medicine certification you can be licensed to work almost anywhere in the world without taking a test? You can go do locums is many interesting places. They've been to New Zealand, St. Lucia, Bosnia, Serbia and lots of places in Canada including Iqaluit and Sioux Lookout. They both have extra qualifications in anesthesia, the husband does lots of obstetrics including sections and they both do ER in small towns they visit including medevac. I can't explain how much this makes me want to do my family medicine residency RIGHT NOW and just get out there and practice. The opportunities seem endless. This is what makes medicine the best profession in the world.

I think I've pretty much decided that I want to do family medicine. The lifestyle and the flexibility are so appealing to me. Maybe I'll do a PGY3 in obstetrics to fulfill my desire to be involved in pregnancies and deliveries - but then again, you can do that just having your 2 year cert too. Man, I'm so high on family med right now! My new difficulty - urban or rural program for residency???

A Poll

Ok, a friend of mine asked me to post this on my blog after her boyfriend did something incredibly stupid. Here's the burning question/scenario:

Scenario:
A guy kisses a girl in the summer (August) and then he goes back to where he's from (a far awayish city) and carries on emailing her 3 times a week from August until January. Girl plans a trip on an airplane to visit guy in January. Guy does not indicate that he is dating another person as of November.

Quesion:
In your opinion, is it reasonable for the girl to expect that the guy is interested in having some sort of romantic encounter when she arrives for her visit?

Let me know what you think, oh public!

Yoohoo, Douglas Coupland ... your book sucks!

Dear Douglas Coupland,
What were you thinking when you wrote this book? Did you think that if you wrote another Microserfs, nobody would notice? Are you John Grisham? Maybe it's all a money making scheme, put out a new book assuming all those who liked 'serfs will buy it, who cares if they like it once you get your cheque.

What's up with putting yourself in this book as an asshole. I loved Microserfs but this book is driving me nuts. Too much computer code, too many pages wasted to junk and 100 000 digits of pi. At least the side story in Microserfs was about Jed and Daniel's subconscious world. Did you run out of ideas for novels? The characters are likeable and interesting but all the other crap takes away from the ability to develop them fully.

I'm going to read the last 50 pages but I don't think they can possibly make up for the load of suck so far. I'm going to have to go back and read Microserfs again to make up for this travesty.

Snow!

Ok, so the snow finally came this weekend. But, so did freezing rain, and rain. All in all, it added up to hard slogging to get to school on Monday. I'm a cyclist and I bike all winter. Usually it's ok because the roads here are mostly plowed. On Monday, however, nothing was plowed. Riding a bike in fresh snow is like riding a bucking bronco. You slip and slide and it takes a lot of balance to keep on the bike. I did live to tell the tale though.

I've been snowboarding so far 4 times this season all of which were teaching expeditions. Ben is getting a lot better and soon he's going to start going by himself to practice during the week. Hopefully soon I'll get to do some serious boarding on my own so I can try out my new board. It's really fun to board with Ben and watch him improve, but sometimes I feel I'm starting to lose my own skill!

Well, I'm off to do laundry, it's been a busy week so I'll update more about that tomorrow when I don't feel so exhausted!

Swamped

It's only week 3 and I feel pretty swamped with work. This semester is the big 3: nephro, resp and cardio. It's nice to finally get an understanding of how the vital organs work to a certain extent but putting all 3 together was someone's idea of a funny joke. In some ways it's good though because it's forcing me to keep up with things as they happen. I actually did some work last week which is a new thing for me at the beginning of the semester.

In good news, I won an award of merit for my contributions to the medical school community. I'm guessing this is due to my efforts in starting and maintaining the family medicine interest group at my university. I was nominated by one of my peers and I get a free dinner this week because of it. It really makes me feel good that someone noticed how much work I put into this group and it makes me want to keep doing it!

Drugs like Candy

I don't usually spend my food money on magazines, thus I usually only pick up a "women's" magazine once a year when Santa brings me one in my stocking. This year's mag was "Jane", a publication that I usually find harmless and sometimes humorous. This year's January issue, however, had something very disturbing in it. There was an article called "Herbal tea is for weenies" in which a "journalist" compares herbal remedies with pharmacotherapy for "stress".

I was flabbergasted to know that this person managed to get prescriptions for xanax, klonopin and a beta blocker for the sole purpose of writing a magazine article. Furthermore, the "stressful" situations this author was put in were all things that were part of their job, i.e. interviewing celebrities or part of every day life i.e. visiting a friend in prison. I have an idea, if you're SO stressed out by being a journalist; why not just quit your freaking job? Not only did this person consume all of these drugs but they also gave a few of their beta blockers to a friend... it's always a good idea to share your prescription drugs... not.

Even the premise for the article is stupid. People who take herbal supplements by in large are not taking them because they think they're going to work the same way as a valium does. Lots of people take herbals because they don't want to consume or don't think their stress is bad enough to need drugs. Who in their right mind needs a comparison between an aromatherapy arm patch and klonopin done by a journalist to know that the klonopin might give you a stronger effect?

And yes, lets remember, these are drugs. Controlled substances, for which you need a prescription. They're not something to be taken lightly. The article makes light of popping pills for every normal daily stressful event and encourages people to borrow drugs from friends. I found the whole thing disgusting.

Interlude

Medical school lecturers are funny (more in a funny frustrating that a funny Ha Ha way). No matter how much time they're given for a lecture, they always want more so they try to cram in twice as much stuff as they can teach well into the lecture slot. Thus, everything gets taught badly. We've just started nephrology and I can tell you, after half a week of whirlwind lectures I'm already starting to feel lost. At least our physiology lectures made sense to me, but we got a lecture today on fluid balance and IV fluids and the woman talked so fast that nobody understood what was going on. Reading over my notes, some contradict what we were previously taught. i.e. her notes say: if you want to give someone salt and water give half-strength saline. I would interpret this as saying that for someone who is hyponatremic give half-strength saline. This is wrong. One should only give hypotonic solutions when someone is hypernatremic because they lower the serum sodium and increase intracellular and extracellular water. If I'm wrong, please, someone correct me.

For a woman who harped on and on about IV fluids being the most important thing to learn from the lecture, she sure didn't treat it like it was. Also, if the information is complete on the slides for many topics, maybe it's more worth spending time on difficult/unclear subjects rather than reading off your 15 pages of slides (6 slides per page).

We also had a lecturer who gave us a sheet of problems to work through in renal physiology and he couldn't do one of his own problems... which makes it doubly difficult for the rest of them to do them!

A tip to medical lecturers: if everyone looks lost, they probably are!

Revelations

These are things I thought about or learned today:
1) Do not drop your phone in curry - it gets into every little crevace
2) when other people cry, it makes me cry - why?
3) I can't stop eating before I feel full but when I feel full it's like I instantly feel like I'm going to puke - there's no such thing as a little bit full to me
4) When is Grey's anatomy to going start again with new episodes? I had a great Grey's dream the other day...
5) How come the guys downstairs shut off our heat when they went on vacation - did they not think that someone else might be in the house before they got back?

I'm freezing!!!!!

Engineering and Medicine

I recently read a post over at that mirror belongs to frank in which the author puzzled about students from engineering wanting to go into medicine. I'm an engineer with both an undergraduate and a masters degree in bioengineering and yes, I always knew I wanted to be a doctor. Quite frankly though, I thought normal biomedical degrees were A) boring and B) less likely to get me into medical school because I would look like every other joe shmoe applicant.

I took the usual courses in biology, microbiology, physiology, chemistry, physics, biochemistry plus lots of other interesting things that run of the mill premed students are never taught: biosystems design, bioreactor and bioprocess design, differential equations (well, ok, that one wasn't very interesting), biomechanics, mechanics, heat and mass transfer, design, and the list goes on. And you know what? The courses that taught me the most stuff that has helped me in medical school were my engineering courses.

How can that be? Well, most of the mindlessly memorized information from my undergrad I forgot. What stayed with me was the ability to problem solve, find information in books and from other resources, talk to people and work with people, and think about things in non-conventional way. These are skills taught in engineering. As an honours medical student I can honestly say that not taking a biomedical science degree has not hurt me and it has helped me in ways I could have never imagined.

Yes, maybe medicine would be better if we decided in high school what degree we wanted to do and we went through a 6 year medical degree, but then we would miss out on a whole pool of applicants from unique backgrounds who will make great doctors. In my opinion, most of the learning in medical school occurs in clerkship. I think this is a profession that would benefit from more apprenticeship style learning. Clerkship is great because it takes what you've learned in the classroom in whirlwind style and solidifies it in your mind. Maybe med school should be 5 years with one additional year in clerkship. Maybe we should just attend school during the summers so more time can be allotted for clerking. I don't know.

All I know is that you can be an engineer who loved engineering but wanted to be a doctor.

I think that orthopedic surgeons are really mechanical engineers in disguise. I think that nephrologists are chemical engineers who work in the realm of medicine. I think physiatrists are biomechanists hiding out in white coats. Maybe you just have to be an engineer to understand where I'm coming from.

Note: for those of you who don't know what the ring at the top of the post represents you can read about it here.

I'm Baaaaaaaaaaaack

So,
I'm back from my vacay. I snowboarded for 3 days, ate and drank way too much for 3 weeks and slept many nights in a bed with my lovely lovely man.

We nearly didn't make it to 12:00 on new year's night because... we were sleepy. Mom and Dad and Ben and I spent between Christmas and New Years at the cottage. The only slope with snow in this whole province with more than 1 run open happened to be just down the road. I spent most of the three days teaching Ben how to snowboard (he'd been once before and now owns all the kit so I thought he should know how to do it :) and took a few runs on my new board (ooooo do I ever love it). Meet my new lover:I'll say more about my vacation later but first I wanted to say, if you're thinking of making cupcakes you should make the fairy cakes with butter icing from Nigella Lawson's How to be a domestic goddess. You can make them entirely in a food processor (icing and all) and they taste DIVINE. MMmmmm.