by Shannon | Sep 4, 2011
It’s amazing to me how quickly Ann Arbor transforms itself this time of year. Over the past couple of weeks, thousands and thousands of undergrads have returned to the campus, and it feels as though there has been a doubling in size of the town from its relatively sleepy summer state. I’ll admit that I have always been a sucker for the back-to-school season, and even though I technically no longer have a summer to come back from, I can’t help but get a bit swept up in (and more than a little nostalgic for) the start of the new college school year. I did, however, find myself not loving all the commotion quite as much last week when my 3-mile drive to a clinic at Briarwood took me over 30 minutes, nearly making me late for work.
For the most part, though, the Ann Arbor energy is contagious, which was exemplified yesterday morning as I made my way to the first football game of the season surrounded by hundreds of screaming, maize-and-blue-clad fans. We played Western Michigan in a game that turned out to be particularly memorable…more for the weather than the actual play. The temperature went from stifling (according to the Detroit Free Press, the temp on the field at the start of the game was 137 degrees!!!) to downright chilling as a massive storm came through drenching the two teams and the 109,000+ fans in the Big House. After two rain delays (the second of which was spurred by a lightning bolt that came dangerously close to the stadium) the game was called with a 34-10 Michigan victory in the first football game in the school’s history that was called short due to weather. I certainly hope the weather cooperates a little more next Saturday, when we play Notre Dame under the lights in the school’s first night game!
Alright, in fear of this post sounding more like a sports blog than a medical school one, I should probably write a little about school this past month since I last wrote. Internal medicine started off with a bang, as the short days and weekends off of psychiatry were quickly replaced with early mornings and Q3 call (on-call every third night) of inpatient cardiology. Despite the long hours at the hospital, I LOVED these four weeks and was sad to see this rotation end. This was the first time of M3 year that I have had a team with a set attending and residents with whom I worked every day. Even more so than with previous rotations, this structure gave a real sense of camaraderie as well as let me feel like, even as a third year medical student, I had a set (albeit very basic) role to play, which made the time even more rewarding. I also loved getting to learn more about the field of cardiology in general. As one would expect, many of the patients admitted to the service are quite ill, but it was rewarding to get to see some of the medications and procedures I had only read about make noticeable improvements in many of the patients.
I am now on my outpatient month, which consists of various general medicine and subspecialty clinics around Ann Arbor. So far, I am really enjoying the hands-on nature of these clinics and the variety of the patients I have gotten to see. It was a little challenging in week one to see patients in the subspecialty clinics (I have GI, liver, and pulmonary half-days), since at this point I have really only a basic understanding of these fields, and some of the patients present with very complex or advanced conditions. However, I think it’s one of those things where you best learn as you go—as I’m learning is the case with much of medicine—and it’s helpful to not get too bogged down in all the details.
I’m off to get a little studying in so that I can then enjoy the rest of this long weekend. Until next time…GO BLUE!
by Shannon | Jul 22, 2011
Hello again! I hope everyone’s summer is off to a good start and that this massive heat wave that seems to be hitting much of the country doesn’t last too much longer! Since the last time I wrote, I have completed 5 of the 6 weeks of the psychiatry clerkship at the Veterans Affairs hospital, which has been quite the change of gears from ob/gyn at the main hospital.
I started with two weeks of a program called HIOT, or High Intensity Outpatient Program (I’m not sure I’ve figured out the acronym yet!), which is a sort of intermediate between inpatient and outpatient therapy–the patients don’t sleep at the hospital, but they come in every day for several hours of individual and group therapy. Many of the patients in this program have substance abuse problems, and a good percentage also have post traumatic stress disorder, or PTSD, which I have come to realize is all too common in individuals who have seen combat. My favorite part of these two weeks was having the opportunity to observe some of the different support groups that are offered to the veterans, such as anger management, mindfulness, and AA-type meetings. It was eye-opening to see the way in which group members share incredibly personal stories, advice, and encouragement with their fellow members, and I came to appreciate the role that this form of therapy plays in the recovery process.
Another highlight of this rotation was my week of child psych at the U, which was an amazing, though emotionally-trying week. As difficult as it is to see adults suffer from depression or psychosis, I found it even more challenging to see pre-teens and teenagers who are afflicted by these debilitation illnesses at such a young age. However, that is not to say that there is not a lot to be optimistic about on the child psych unit. The doctors, social workers, and teachers trained in this field are wonderful with these children, and they have found an impressive balance between a structured hospital setting and an environment where the patients can just be kids. In my five short days on the unit, I got to see a few of the patients clearly making progress toward this transition of just being a kid again, and I can’t think of a more satisfying medical outcome than that.
I next moved onto a week of consult psychiatry, and then this past week completed half of my inpatient psych block. As I approach the end of psychiatry, I realize that I had a somewhat skewed perception of this clerkship prior to its starting. Among many med students, psychiatry is known as one of the “easy” clerkships, and I am now not sure that I entirely agree with this description. I certainly won’t deny that the hours are nice, and not having to work weekends—especially during these summer months—has been amazing. However, some of the patient encounters I’ve had in these five short weeks have been frustrating, upsetting, and even downright chilling. The elderly patient with severe dementia and depression who wanted nothing more than to go home made my heart break for his loss of memory and—worse—independence. And sitting across from the ghost white faces of two parents as they described finding their son after his failed suicide attempt was unlike anything I’ve ever experienced. I’ve found myself thinking about some of these encounters well after I’ve gone home for the day, and I wonder if any other clerkship will have quite this effect on me.
Outside of the hospital, I’ve been finding plenty of time to enjoy the summer and sunshine, which has been a nice surprise. I have also been making sure to stock up on sleep these past couple of weeks, as I start internal medicine next Monday and anticipate having a little less free time on my hands!
by Shannon | Jun 9, 2011
After what seems like a mere few days on my ob-gyn clerkship, I can’t believe that in less than a week I will be taking my first shelf exam. The past few weeks since I last wrote have been a blur of many, many new experiences. In fact, a common sentence that has been running through my head throughout this clerkship has been, “I have never felt this new at anything!” I quickly came to realize that no matter how much I had heard about third year, or how many standardized patients I had worked with during M1 and M2 years, nothing had quite prepared me for that first time I knocked on a real patient’s door and entered her room to hear about her entirely real, unscripted problem.
I think I floundered a bit through that first interview—and the next several following it—coming to the off-putting, yet in retrospect obvious conclusion that actual patients don’t know the standard format of a patient interview that we are taught (chief complaint, history of present illness, past medical history, family history, etc), and the actual parsing out of these details can take quite a bit of work. I know I’m still incredibly far away from being what one would called “skilled” at these interviews, and yet I am amazed at how much more comfortable I already feel. It seems as though with each new patient, I learn a new little trick or morsel of advice that helps me with future patient encounters, from little ways to make nervous patients feel more at ease (and I’ve found that many moms-to-be are understandably quite nervous) to making sure to include family members in the room in the conversation, especially if they happen to be the fathers-to-be (often even more nervous).
One unique aspect of the ob-gyn clerkship is that each week I am on a new service, bouncing between inpatient and outpatient. I started with a week of Labor & Delivery, where as hoped in my last blog entry, I did in fact get to help deliver several babies! I then had a week of Reproductive Endocrinology and Infertility, a surgical week of Benign Gynecology, and then just finished a week of Maternal Fetal Medicine, which deals with high-risk pregnancies, such as diabetics and women struggling with addiction. Although the nature of this schedule hasn’t allowed me to ever feel quite comfortable with a given service, I have really enjoyed getting to experience such a gamut of subdivisions within the field of obstetrics and gynecology, and the combination of medicine and surgery inherent to this clerkship has been a great way to start off the year.
I finish next week with three days of Gynecologic Oncology, another predominantly surgical week—and one that I’ve heard to be the most time demanding—before taking the shelf exam and then enjoying my first, study-free switch weekend. After that, I’m onto psychiatry at the VA hospital, which I anticipate being an entirely different experience than these first six weeks of third year. I have heard that a common theme of M3 year is that just when you start to feel comfortable with one service, it’s time to switch to a new one and feel lost all over again. It is with this prediction that I anticipate with both anxiety and excitement, feeling new all over again…
by Shannon | May 8, 2011
Greetings from M3 year (almost)! I write this during a break of our M3 orientation, which has consisted of three days filled with various activities geared toward preparing us for our entry into the clinical phase of our education, including life support training, seminars on how to place an IV and NG tube, and even a session entitled, “M3 Survival Workshop.” Our rotations officially start Monday morning, so we have one final, free weekend before it all begins…
The nearly two months since I last wrote certainly were an experience. I finished up my second year of medical school on a Friday in mid-March, enjoyed one blissful day off, and then began studying for Boards bright and early that Sunday morning. I look back on the five week study period with mixed emotions. The ten to twelve hour study days were certainly grueling and at times very frustrating, and it was hard to be so isolated from friends, family…and human beings in general. However, looking back, the sheer volume of material that I relearned and synthesized over this period—an amount that seemed simply impossible at first—feels like an accomplishment on par with actually taking the eight-hour exam.
The beautiful beach in Punta Cana, Dominican Republic
During this study time, I also took a wonderful long weekend off to fly down to New Orleans, where I presented a poster on my summer research at the American College of Cardiology conference. Not only was this trip a perfect halfway break in my studying, but it was also my first time attending a large conference, which was an exciting experience in itself. And, New Orleans is an amazingly fun city!
After finishing Step One last Monday, twenty of my classmates and I headed to the Dominican Republic, for a much needed week-long vacation in Punta Cana. We stayed at a beautiful resort located right on the beach and soaked in as much sun (well, under my near-constant coat of SPF 50, that is!) and relaxation as we could.
It wasn’t easy leaving beautiful Punta Cana (see picture above) for the less-than-tropical weather of Ann Arbor, but I think we all shared a sense of excitement—and yes, some anxiety too—at the year we are about to begin. After two long years in the lecture halls, we are at last going to be working with patients and physicians, and in some senses, it feels as though medical school is just truly beginning. I will be spending my first six weeks of third year on obstetrics and gynecology, so by the next time I write, I hopefully will have been part of my first labor and delivery!
by Shannon | Mar 13, 2011
Hi everyone! I promised myself that I was not going to fall into the habit of having to start each blog entry with something akin to “Sorry it’s been so long since my last post!” and yet after a month and a half of bloglessness, I feel obligated to once again convey such sentiments. These past two months have been quite busy, though—for a nice change—it seems to be extracurricular activities rather than merely school work that have been driving the craziness of my days.
First and foremost, the Galen’s Smoker was this past weekend. As already discussed in a couple of my fellow bloggers’ posts, this is an annual medical student production that lampoons the faculty with “clever, high-brow humor,” or so it has been said. Even with my less-than-lead role (I had nine words, to be exact, which is just the right sized part for me!), I spent over forty hours in the theater during the week leading up to the play, the week during which the show really came together. That time commitment is nothing compared that of the Czars (four 4th year med students in charge of the entire production), the band, crew, singers, and many others who absolutely amaze me by their ability to do all this during medical school classes and rotations. This year’s play, Spleen Girls, was a great success and an absolutely wonderful, hilarious activity to be a part of.
In addition to the Smoker, there seems to be a lot of tying up of loose ends as I prepare for the six week study period for USMLE Step 1 that is rapidly approaching. From finishing up my summer research project, to transitioning positions I hold in various organizations to the M1s who will take over these roles, I can’t help but feel a bit of sadness that this chapter of medical school is coming to a close. One activity in particular that I have found incredibly rewarding is my weekly shadowing of a pediatric cardiologist. I was paired up with this physician through a mentoring program offered by the medical school, and have since met with him for a few hours once a week.
During these meetings, I have gotten to sit in on electrophysiology studies and arrhythmia ablations, heart catherizations, and echocardiograms. More than just getting to see these various procedures, I have gotten to watch my mentor interact with patients in both the out-patient and intensive care unit settings, and to see the knowledge that I have learned in the classroom truly put to use with actual patients. I have also learned little tricks he uses to put both younger and adolescent patients more at ease, and have recognized and admired his willingness to spend as much time with each patient to ensure that all of his or her questions (and often those of the patient’s worried parents) are answered. I think that shadowing experiences for preclinical students are incredibly valuable, as they allow us to learn and ask questions and begin to learn how to work with patients in a low-stress, grade-free environment. Therefore, although I am particularly sad to see this weekly activity come to a close, I feel that it has provided a nice groundwork for what is to come in just a few short months, as well as provided me with a wonderful role model whom I will aspire to keep at the forefront of my mind with each patient encounter.
Since we are down to five days of classes (!), this will probably be my last blog as an M2, but I will definitely check back in during the Step 1 study period. With the many, many hours of science studying that are to come, I think a nice writing break will serve me well. Until then, and in honor our bid in the NCAA tournament announced today, Go Blue!
