by Angelica | Oct 13, 2016
Hello and happy fall! It’s actually starting to feel like fall now. The mornings are chilly, and the heat feels much less oppressive. I saw a few leaves changing colors, and there is apple cider everywhere. I love it so much. Fall also means that we’re halfway done with rotations. We had an intersession week three weeks ago that marked the halfway point. I can’t believe that the year is flying by so quickly, but I’m also very excited for what is to come next year.
On Saturdays, we wear maize.
I admit that it’s been an embarrassingly long time since I’ve posted an update. It turns out that being on the wards and studying for shelf exams is decently time consuming. However, I’ll try to bring things back up to speed.
Last time that I wrote, I was starting my surgery rotation. After the initial shock wore off, I really enjoyed surgery, despite the very long days. I learned how to sew and throw knots, and I touched a carotid artery. I learned anatomy much better than I learned it the first time around, and I saw the inside of a living, breathing person. These are amazing privileges, and I try to always remember that my training is also a privilege, especially on those 4am mornings.
Next up was family medicine. It was a rather short rotation at three weeks long, but I enjoyed every minute of it. I loved the variety throughout the day, as we saw everyone from children to senior citizens. The scope of family practice is astounding, and every day was different. I spent my time at the Chelsea clinic site, and it was a great experience. The public health part of me really enjoyed the focus on preventive medicine, and I just really enjoyed my time on family med.
After family med was another quick three-week rotation: neurology. We spent a week each on three different services, and I spent time on consults, inpatient, and pediatric neurology. The brain is an absolute black box, and it was great to learn a little piece of the mystery. I was a little scared of the rotation after our M2 neurology block, but it ended up being pretty great to see the things that we learned M2 year applied to patient care.
Now, I’m on obstetrics and gynecology, which we generally shorten to ob/gyn. In my three weeks on service, I’ve scrubbed into gyn surgeries, spent time in gyn onc clinic, spent time in ambulatory clinic helping with pre- and post-natal visits, and watched several births. Labor and delivery is the most emotional setting I’ve worked in so far. There is every kind of emotion, and I admit that watching parents cry joyful tears over seeing their babies for the first time made me a bit sniffly too. I have one more week on ob/gyn, and I am excited to see what it brings.
Quick break between surgeries… Bouffant caps are all the rage.
That was a whirlwind tour of the last couple months. I’ve been pushed and stretched in many ways, and I know there is only more of that to come. Despite the fact that there are good days and bad days, rotations that I like more and rotations that I like less, it is an incredible privilege to be able to learn in this setting. I want to take a moment to thank the patients who allow us to learn. I know that every patient I see has made a conscious choice to let a student see him or her, and I thank them for allowing me to speak to them, examine them, and learn. Hopefully one day, I’ll be able to make them proud.
There we have it. We’re halfway done with the core rotations of third year, and it’s October. For me, it seems like time is moving much too quickly. However, a lot has happened during the past few months. I’ve learned a lot (but definitely still have so much more to learn…), and I’ve started to figure out what I may be interested in doing as a specialty (and if nothing else, I have definitely crossed a thing or two off the list). It turns out that sometimes life is surprising, and sometimes the last thing you thought you’d ever do may be the one thing you can’t stop thinking about. I still have a few months to decide, but I’m definitely experiencing warm fuzzy feelings toward a certain specialty. We’ll see if it ends up being the one I choose.
However, I don’t have to make any decisions today, so for now, I’m going to enjoy the last bits of summer and the beginning of fall. I hope that you do the same. As always, thanks for reading, and until next time, spend some time outside and have some apple cider for me.
Angelica is a fourth-year medical student at the University of Michigan Medical School. When she’s not on the wards, you can find her on a run around Ann Arbor or passionately discussing medicine and public health over tea.
by Angelica | Jul 3, 2016
Hello again! It’s been a while since I last posted, so it seems like it’s about time for an update. We’re now 8 weeks into rotations, and life couldn’t be busier or better.
About two weeks ago, I finished pediatrics, which was my first rotation. I was definitely nervous to start seeing patients at the start of the rotation, but the interns, residents, and faculty I worked with quickly put me at ease. Kids are sometimes a difficult population to work with because they can’t always tell you what’s wrong, and it can take a fair amount of detective work to determine what is making them sick. However, peds can also be quite fun. I actually really liked the rotation. It made the public health part of me happy because there is such a huge focus on prevention and building healthy habits, and kiddos are just really fun to work with. I was able to be silly and playful, and there were a lot of stickers involved. One of the best moments of peds was when a kiddo told me that I was his favorite “doctor” ever (cue my heart absolutely melting). While the sad cases are incredibly heartbreaking, the majority of issues that bring kiddos to the hospital or clinic are fixable, and that means that peds is a happy rotation for the most part. The interns, residents, and faculty were also fantastic and made the rotation fun for everyone involved.
Truer words were never spoken.
From: http://gomerblog.com/2015/06/medical-specialty-part2/
Two weeks ago, I shifted gears and started surgery. Surgery is at the complete opposite end of the spectrum from peds, and the transition was a bit startling. However, once I got over that, I realized that surgery is also really interesting. The OR feels like an incredibly well-choreographed dance in which everyone involved moves around each other like a well-oiled machine. I can now say that I’ve seen the inside of a living person, and that is a pretty amazing thing. I often stand in awe as the surgeons and residents maneuver laparoscopic tools with ease or suture and throw knots faster than I could imagine. It’s clear that they have had years of practice, and that’s not at all difficult to respect. There is a certain rush to being in the OR, and I love that I am able to experience it.
How I felt the first day of surgery… From: http://whatshouldwecallmedschool.tumblr.com/post/72672166657/first-day-of-the-surgery-rotation
The start of rotations has been amazing, and I’m excited for what is to come. Each rotation brings new lessons, and every rotation teaches me something that I will one day incorporate into my practice regardless of what specialty I choose in the future. Most of all, I am enjoying my time with patients, and I would take a day on the wards over the first two years of med school any day. I realize that there is so much that I don’t know, and I look forward to learning something new every day. I found this hilarious video that explains M3 year in a nutshell. Enjoy!
As always, thanks for reading! Until the next time, happy summer!
Ice cream after a long day on the wards
Angelica is a fourth-year medical student at the University of Michigan Medical School. When she’s not on the wards, you can find her on a run around Ann Arbor or passionately discussing medicine and public health over tea.
by Angelica | May 8, 2016
Two posts from me in one week. Crazy, right? On this, the eve of my official entry onto the wards, I thought I would take a quick moment to reflect on the past year. I’ve experienced a lot and learned a lot, so I decided to share ten things that I learned this year. Once again, being succinct is not yet one of my specialties so hang in there during my rather long musings.
M2 year is worse than M1 year, but at the same time also so much better.
At first this statement doesn’t seem to make sense, but I promise it does. M2 year is worse than M1 year because the stakes are higher. Step 1 is at the end of the year, and some blocks only have an exam and no quizzes. I always felt like I had to be much more prepared pretty much all of the time this year. At the same time, the material was SO much more interesting than during M1 year. This year, we focused on abnormal systems, so we got to learn what happens when things in the body go very wrong. The material covered this year felt much more like what I imagined medical school would be like.
With a little help from technology, we made sure that no member of the Mottley Crew was left behind for our last day of M2 photo. I don’t know what I’d do without these lovely people.
Med student syndrome is a real thing.
I may or may not have self-diagnosed myself with a multitude of medical issues. I was mostly wrong, except for that one time I was right—that day, I was pretty proud of myself. In all seriousness, however, learning about tons of diseases with vague symptoms can get to you after a while, and more than one of my classmates has admitted to being more of a hypochondriac than when they entered med school. More often than not, our concerns are just us being neurotic, but if you’re really concerned about something, be sure to see your doctor.
Your study method is perfect until it isn’t.
Coming into M2 year, I thought that I had perfected my study method until I came to Neuro, when I quickly realized that my study method wasn’t cutting it. Instead of self-destructing like I would have last year, I changed what I was doing. It seems like a small and relatively obvious step, but if nothing else, medical students are creatures of habit. We study in the same places in the same way day after day. The simple fact that I had learned to adjust at some point over the past two years is an amazing step, and one that will be very helpful on the wards.
Step 1 is still scary, but what’s on the other side matters so much more.
Let’s be real: Step 1 is incredibly scary because it always feels like so much is riding on that 3-digit score. I think that it’s sometimes easy to forget that we haven’t spent the last two years exclusively preparing for Step. Instead, we have spent the last two years learning the basic science foundations of the diseases that our patients will have so that we can one day learn how to take care of them. Step 1 is merely the gateway that we must pass through in order to do so. When we forget that everything we do is actually about the patients, trouble arises. Some of my worst days during study period were those in which I forgot that everything I do and all of the sacrifices that I make are for my future patients. On my absolute worst Step 1 study day when I was in an awful mood and the absolute worst version of myself, I walked up to school and saw a patient going into the cancer center for chemo. It hit me hard and fast that there are real people suffering from real diseases out there, and in the grand scheme of everything, one exam didn’t mean that much. Here I was griping about this one-day exam that I had to take when there are people out there fighting for their lives. That encounter quickly put things into perspective and snapped me out of my awful mood. Patients are what we are here for and what this whole journey is all about.
Things still won’t always go as planned, and it’s still okay.
Sometimes life comes at you hard. People that we love pass away, relationships end, friendships hit rocky points, and sicknesses occur. Life doesn’t just stop because you’re in medical school. Sometimes, it’s important to take a step away from medicine to take care of life. Yes, this puts you behind on your study schedule, but sometimes, it’s more important to be present in your own life. I’m the absolute worst at this, but even I definitely had to take a couple deferrals this year due to illness. The most important thing at that point was that I was back to functioning and ready to go, even if it meant taking my exam 2 days late and being behind on the next block. We are still people, even if we want to be invincible, and it’s okay if something affects us now and then.
Some days are really hard.
Just as there were many good days this year, there were also days that seriously made me reconsider my decision to go into medicine. For example, in my clinical reasoning elective, I had a really troubling encounter with a patient. The health care system failed this patient in a big way, and I found this incredibly distressing. I always knew that the health care system isn’t perfect, and I had dealt with its over-arching fallout in public health. However, this was the first time that I truly realized that by entering the health care system, I was now a part of the problem and would be fighting this for the rest of my life. I am now part of a system that tries to do right by patients but can actually hurt them significantly in the process. It’s easy to talk about failures of the health care system, but it’s an entirely different situation to see how patients’ lives are impacted. It’s an encounter that has stuck with me, and I get the feeling that it will be one of those that I will never forget.
The ones who get me through the hard days
Find your role model.
One of the best parts of being at an amazing academic medical center is that there are role models everywhere. Every now and then, there is a physician who shows me exactly what I don’t want to be when I’m practicing (which is also useful), but for the most part, I’m surrounded by truly amazing physicians who genuinely care about their patients and are all-around fantastic humans. One such amazing physician was my clinical reasoning elective preceptor. She taught me so much about how the social determinants of health can impact patients’ lives in big ways, and her actions made it more than obvious that she cared about her patients and went above and beyond expectations for them. I want to be her when I grow up. The physicians who are our role models teach us about the art of medicine, which is something that can’t be taught in a classroom but is just as important as medical knowledge. In short, we all need people to look up to, and there is no better time to find a role model than when you’re surrounded by so many of them.
Take time for yourself.
Disclaimer: I am horrible at this. I have this really bad habit of hitting the gas pedal and neglecting the brakes until illness forces me to slow down. However, this year, I tried to do nice things for myself now and then. I tried to go for runs or to yoga, I made an effort to spend time with friends and family, and I bought myself some fancy loose-leaf tea to enjoy. Those seem like small things, but when life is otherwise ridiculously busy, the small things make all the difference. It’s important to find a couple things that keep you sane and make sure that they find their way into your schedule. The time away from studying doesn’t seem worth it sometimes, but I promise that it is.
Sometimes you just have to get away.
Lean on your people.
My support system is still the reason why I have made it this far. I don’t know what I’d do without my family, friends, and mentors. They’re the reason that I keep going on my worst days, and they’re always behind me in my best moments. I can’t imagine making this journey without them, and I am so grateful to have them in my life. I can’t thank them enough for all of the encouragement in the past year and for putting up with me on the days when I was at my absolute worst (I’m looking at you Step 1 study period).
M2 BMA ladies celebrating the last day of classes
There is still truly nothing that I want to do more than medicine and public health.
This year, someone asked me if I would take the same pathway if I were given the choice again. I can stand here confidently and say yes. There are still days when I question the decision, but in all seriousness, I would absolutely do this again. The intersection of public health and medicine is where I am in my happy place, it’s my calling, it’s where I belong. I was talking with one of my friends who is about to start residency, and he mentioned how he can’t imagine having a job that was just a job. He’s right. Medicine isn’t for those who want a job where they can clock in and out at whatever time and leave everything behind. Medical school is a sacrifice, and the sacrifice certainly doesn’t end when you have M.D. behind your name. However, it is so worth it when you realize that lives can be absolutely changed because of the work you do. It’s a gift that comes with huge responsibility, but I really can’t imagine doing anything else, and I would do this a thousand times over.
Tomorrow, I will wake up, don my white coat, and head to my first day of clinic. While I’m glad to put M2 year behind me, I am also glad that I had the experiences I did. Hopefully, some of the lessons I’ve learned will help me on the wards, but I know that these lessons have also shaped the person I’ve become since starting medical school. Now, however, it’s time to begin a whole new set of experiences. I can’t wait to see what the next year brings.
As always, thanks for reading. Until next time, here’s to lessons learned and new beginnings.
Angelica is a fourth-year medical student at the University of Michigan Medical School. When she’s not on the wards, you can find her on a run around Ann Arbor or passionately discussing medicine and public health over tea.
by Angelica | May 3, 2016
I think that to say it’s been a while would be an understatement at this point. It seems like I fell off the face of the earth, and it actually kind of feels like I did too. Since February, I completed the last 3 blocks of M2 year, studied for and took Step 1, and began M3 orientation. To say it’s been a whirlwind would be putting it lightly.
The last three blocks of the year, Gastrointestinal, Endocrine, and Reproduction, flew by. Hanging over all of them was the notion that Step 1 was on the horizon. At this time, I found it more important than ever to stay focused because I wanted to make sure that I was in a good place once the dedicated study period for Step began. Before I knew what happened, I took my last exam of M2 year and had approximately 6 hours to celebrate before Monday came and study period began (Sunday quizzer life).
Quick ice skating break during the last few weeks of school. In case med school doesn’t work out…
I’m not sure that there are words that can adequately describe study period. There are so many emotions that occur during that 5-6 week period (which doesn’t feel like nearly enough time to relearn/review everything you need to know). I went through moments of elation and moments of complete and utter doubt. There are few times in my life that I’ve felt quite so humbled as when a question set absolutely destroyed my confidence. Yet at other times, the work that I put into studying over the past two years shined through. Studying for Step 1 is a process.
Getting ready for a day of Step studying
Before I started studying for step 1, people kept telling me it was a rite of passage. I didn’t understand how a test could be a rite of passage, but now I definitely get it. Step 1 is all about discipline and learning how you learn best. It’s about finding just how much information you can cram into your head without driving yourself crazy in the process. It’s about experiencing every emotion in the human spectrum because it’s impossible to know absolutely everything going into test day. Step is a mind-bending experience. When I walked out of the test center that day, all of the emotions hit again: the confusion, the anxiety, the trepidation, but most of all, the relief that it was over. I won’t know how I performed on the exam for several weeks, and while I’m trying not to think about it until then, I realize that the simple act of taking Step 1 is an accomplishment in itself.
Now that Step 1 is over, a new kind of excitement has taken over: M3 orientation. Orientation began on Monday and will continue for the rest of the week. It’s the last thing that stands between the newly minted M3 class and the wards. I have to say that I’m really excited about what is to come. When I picked up my pager yesterday, things finally started to seem real. I can’t even believe that in a few days, I’ll see my first patient as an M3. I’m nervous and excited, and I just can’t wait.
As always, thanks for reading. Until next time, it’s back to training modules and preparations for the wards!
Angelica is a fourth-year medical student at the University of Michigan Medical School. When she’s not on the wards, you can find her on a run around Ann Arbor or passionately discussing medicine and public health over tea.
by Angelica | Feb 3, 2016
It’s the beginning of February, but it feels like spring. The mid-40s weather is a welcome change from the sub-freezing series of days we’ve had recently. It’s been nice to thaw out a bit, and I have especially appreciated it since I’ve had the last few days off.
My last post left us at the beginning of our hematology/oncology sequence, conveniently shortened to heme/onc colloquially. Heme/onc was very involved, with many different concepts coming together at the end of the two-week block, but it was an interesting block nonetheless. In my pre-med life, I did cancer research, so it was great to revisit the newest advances in cancer treatment, especially since so many of us know someone undergoing chemo or radiation therapy.
To complicate things, I managed to be ill throughout the sequence, and it certainly made for a rough start to the year. I was sick enough to have to go to the doctor, which reminded me that (future) doctors make the absolute worst patients. Advice such as “take care of yourself,” “you need to rest,” and “you need to slow down” does not bode well with medical students. However, that really is the only way to get better. I was even sick on my birthday and didn’t feel much like celebrating. However, I have the best friends who surprised me with cake a couple days later when I was feeling a bit better, and my family came to visit the next weekend. Family and friends are so instrumental to making it through med school.
Seriously the best friends anyone could ask for...
After finishing heme/onc, we began our last ever Clinical Foundations of Medicine week. I used to call them our “how to doctor” weeks, and I still can’t think of a better name. We spend these weeks working on our physical exam and history taking skills, as well as participating in lectures and small groups about topics that we don’t often cover, including interpersonal violence, rural health, and palliative care. In addition to having the chance to feel like doctors in training, the weekends are another great part of CFM weeks, mostly because we have them off with no quizzes or exams.
Naturally, that means that we usually take a trip, and this round was no exception. Several classmates and I headed to Chicago, where we spent the weekend eating excellent food, laughing our heads off at a comedy show, salsa dancing, meeting up with friends from other med schools, and just generally enjoying a free weekend. It was wonderful.
Requisite Starbucks, ice floes for days, a beautiful skyline, and lovely people
We headed back for the last week of CFM, at the end of which was the dreaded M2 CCA. While I jest, the CCA, or Comprehensive Clinical Assessment, is a test of our ability to take patient histories and perform physicals to make sure that we are adequately prepared to use these skills on the wards (in a few short months!). My friends and I had prepared for this exam extensively in the prior weeks, and we went into the final week with our game faces on. I took the CCA relatively early, on Saturday, so I had to be prepared. The experience was actually a pleasant one, and now I’m more excited than ever to head to the wards in May.
Since I took the CCA on Saturday, and students were able to schedule their exams from Friday to Wednesday, I’ve had the last couple days off. I spent the time visiting my family. Tomorrow, we start our Gastrointestinal (GI) sequence, so for now, I’m enjoying the time off and trying to catch up on things that I’ve neglected in the past couple weeks. With Step 1 study period less than 7 weeks away, I know that come tomorrow, I will hit the ground running with few breaks until I take Step 1. It’s daunting and always the elephant in the room, but I’m trying to focus on the tasks ahead of me right now. I try to stay positive and remember that on the other side of Step 1 is my introduction to the wards, and I couldn’t be more excited. So for now, it’s all about taking things one step at a time.
As always, thanks for reading. Until next time, take a moment to enjoy life even when it’s crazy busy.
Angelica is a fourth-year medical student at the University of Michigan Medical School. When she’s not on the wards, you can find her on a run around Ann Arbor or passionately discussing medicine and public health over tea.
