No essay today. A picture is worth 1,000 words.
Tuesday, January 28, 2014
Saturday, January 25, 2014
a surprise maybe-not-so-surprising announcement
There are some people who come into medical school set on an idea (most typically it's a jock-looking guy interested in orthopedic surgery) and are shocked when they love pediatrics and completely change their career path. There's actually a statistic that 75% of medical students end up going into a different specialty than what they planned when starting medical school.
Then there are others, like me, who insist they are open minded. I insisted on my awareness of this statistic and how I would change my mind anyway, so I didn't even want to tell people my favorite specialty. But while I remained purposefully vague, the people around me seemed all too certain. When I look back, I think about my weird obsession as a preteen with watching "The Baby Story" on TLC (which literally just consists of interviewing couples and then watching the birth in a 30 minute episode). I think about how of all my high school science classes, AP Biology and Anatomy were my favorites. I think about how I took Women and Gender studies classes in college just because I was interested - when they didn't count towards either of my two majors. I think about how my college roommates and I would have too many discussions about how "it's your uterus and not your vagina shedding during a period" or how does surrogacy really work? I think about how first year of med school I got really mad when a professor said that sperm penetrate the egg - which, by the way, is a lie which you can read about in this fascinating article - and then a med school friend said "if you don't become an OB/GYN I will eat my shoe."
Then came third year when everything I loved pointed to the same thing. On surgery, I liked the breast cancer patients the best. I loved being in the OR and doing surgery much more than I expected, and one of the things people forget about OB/GYNs is that they don't just look at vaginas and deliver babies, they also perform various surgeries. On radiology, I liked ultrasound the best.
So I went into my OB/GYN rotation hopeful that I would just have this feeling. That everything about it would be perfect. Truthfully, not everything about it is perfect. I am not ignorant of the negatives. I'm not terribly thrilled about going into a specialty that has 90% female residents. I have already experienced how terrible it is when a baby is born and can't breathe on its own. But there is a lot of happy to counter the sad. And dealing with the tragic parts of life is a burden anyone going into medicine is choosing to carry.
But there were two things about OB/GYN that made me sure it was the right fit - 1) I just liked the people better. When I look back at my blog post about surgery, that was a major thing that made me feel unsure about choosing it as a career - I just didn't like the people. I didn't think "I want to be the kind of doctor you are" - but on OB/GYN, I thought this so many times. Not only did I want the attendings to be my friends, I also wanted to be as good with patients and as interested in what I do as they are. 2) I loved delivering babies. I know this is cheesy, and there are certain things that all medical students love to do - and delivering babies is definitely one of them. But delivering babies made me emotional in this deep and wonderful sense. And even though I said there were only two reasons, if you reference above, clearly 3) is destiny. Ha I love how freaking cheesy that is.
I am going into Obstetrics and Gynecology! (surprise!)
I am so excited. Not just because I love the relief of finally having decided and getting to focus on the next steps, but because I feel like I've found something that really fits me. The first time I delivered a baby, afterwards the attending said "I've never had to help a medical student so little! You just knew what to do!"
I am also so happy to be choosing a specialty that is so varied in what I can do with my life - I can be a generalist and do surgery, see people in the office, and deliver babies; I can be a cancer surgeon and operate and follow women during chemotherapy; I can specialize in endocrine and infertility and work on medical problems as well as do procedures to help people get pregnant; or I could specialize in high risk OB and deal with sick pregnant women and the interesting and intense complications surrounding high risk pregnancy. So many choices! I can't imagine I will ever be bored for too long. I get to combine surgery and procedures with primary care and advocacy.
I am really excited and I just want to thank my family and friends for supporting me along the way! Can't wait to see what adventures the future holds.
So I went into my OB/GYN rotation hopeful that I would just have this feeling. That everything about it would be perfect. Truthfully, not everything about it is perfect. I am not ignorant of the negatives. I'm not terribly thrilled about going into a specialty that has 90% female residents. I have already experienced how terrible it is when a baby is born and can't breathe on its own. But there is a lot of happy to counter the sad. And dealing with the tragic parts of life is a burden anyone going into medicine is choosing to carry.
But there were two things about OB/GYN that made me sure it was the right fit - 1) I just liked the people better. When I look back at my blog post about surgery, that was a major thing that made me feel unsure about choosing it as a career - I just didn't like the people. I didn't think "I want to be the kind of doctor you are" - but on OB/GYN, I thought this so many times. Not only did I want the attendings to be my friends, I also wanted to be as good with patients and as interested in what I do as they are. 2) I loved delivering babies. I know this is cheesy, and there are certain things that all medical students love to do - and delivering babies is definitely one of them. But delivering babies made me emotional in this deep and wonderful sense. And even though I said there were only two reasons, if you reference above, clearly 3) is destiny. Ha I love how freaking cheesy that is.
I am going into Obstetrics and Gynecology! (surprise!)
 |
| Chosen for its complete creepiness |
I am also so happy to be choosing a specialty that is so varied in what I can do with my life - I can be a generalist and do surgery, see people in the office, and deliver babies; I can be a cancer surgeon and operate and follow women during chemotherapy; I can specialize in endocrine and infertility and work on medical problems as well as do procedures to help people get pregnant; or I could specialize in high risk OB and deal with sick pregnant women and the interesting and intense complications surrounding high risk pregnancy. So many choices! I can't imagine I will ever be bored for too long. I get to combine surgery and procedures with primary care and advocacy.
I am really excited and I just want to thank my family and friends for supporting me along the way! Can't wait to see what adventures the future holds.
Monday, January 6, 2014
snow day: a contemplation of expectations and evaluations
What does a medical student need to arrange in order to get the day off work? Just a foot of snow and a wind chill of -30 degrees. No big deal.
I would apologize for my lack of posting, but when I realized my last post was about burnout, so I thought - how appropriate for me to illustrate my own point!
As I sit curled up on my couch with snow drifts on my windowsills and an espresso in my hand, I'm thinking, what do I have to say about being a medical student lately? I want to talk about expectations and evaluations. Because I am sick of both of those things.
Expectations. Here are some things I am expected to know how to do, magically without ever learning. Granted, some resident will show me how to do these things, however they will make it clear how very nice and patient they are being because the idiot med student can't figure it out:
1. How to use a fax machine. This, ladies and gentlemen, is a complicated task. I thought the pathophysiology of glycolysis and gluconeogenesis was complicated, but figuring out how to send a fax to a long distance number is more complicated. Speaking of long distance numbers...
2. The long distance code. Sounds simple, right? A long distance code. I didn't even know these existed. That's what cell phones are for, right? Ok, so the hospital has a system, right? Every single rotation I have been told a different story about this magical code. On the psych floor, the social worker has it. On the neuro floor, every resident has their own code. On ob/gyn, it's on the board (duh! how could I not know that). I've been told on medicine everyone uses the same code, so you just have to memorize it. I've also been told by every secretary I've ever asked that I should have my own code. I don't. On surgery, I never called a long distance number. Ha.
3. Where the stapler is. Probably a common office problem, just never thought it would be a problem I'm often working on solving. Where is the stapler???
4. How to write notes in the fashion of each specialty:
a. Copy it out on this lined paper.
b. Print out this form and "skeletonize" it for us.
c. Print out this form, fill it out, sign it, then copy it with four pages per sheet and put the real one in the chart.
d. Don't write a note, just have it memorized.
e. None of the above, SNOW DAY!
The point is, no matter the environment, and perhaps especially in the uptight medical environment, it is difficult to figure out how the seemingly simple things work. It takes time. I don't magically know how to be the best secretary ever and a brilliant budding doctor. And that leads us to...
Evaluations. Here is the range:
5 = Honors (greatly exceeds expectations)
3 = the average 3rd year medical student (is this strange to you too? shouldn't we all be 3s?)
1 = probably never selected because they would have already pulled you aside and failed you
You are judged weekly, if not daily, on your performance. And whatever small amount of time you spend with a physician, halfway through you should ask for "mid-rotation" feedback. This week I'm going to ask a doctor for mid-rotation feedback after spending two afternoons with her. It's really insane. I think the point of it is supposed to be that we receive feedback "in time" for us to use that feedback to improve our performance and hopefully get the grade we want, but the feedback is usually either "you're doing fine" or "I haven't spent very much time with you." Very formative.
I guess I'm just getting tired of being evaluated constantly. Imagine for this whole year if every day were an interview and you received feedback at the end of each week on your performance. That's kind of what being a third year medical student feels like.
But here's the thing. If you're not somehow already magically performing like a fourth year or intern after one week, you're probably not going to get higher than a High Pass (the equivalent of a B). Now I say this with the caveat that everyone has a different view of how many students deserve Honors (the equivalent of an A) and what constitutes honors-level work. So naturally your grade not only depends on your performance, but on your grader's opinion of what grades mean and how they should work.
So basically Honors is the enigma of the third year medical student. What does it mean, really? What is the formula to achieve it? It seems that the usual medical student recipe - hard work, studying all the time, knowing everything - doesn't really work. It also seems that my method - hard work, being really helpful, people skills :), and trying to convince myself to study sometimes - also doesn't really work. It's not that I really need Honors in everything. It's just kind of hard to work 60 hours a week, to try your hardest at something that kind of scares you, and then to be told that you "seemed like a genuinely nice person" (literal direct quote) but you get HIGH PASS. Buzz. Next.
Needless to say the excitement of third year has worn off a little bit, in addition to the fact that I'm still tested around once a month (the results of which are always discouraging), thus I am already close to ready for third year to be over with.
I am currently in the middle of my Obstetrics and Gynecology rotation, which I really am enjoying (despite the difficulties inherent in third year mentioned above). My goal is mainly to study really hard so I hopefully get a better grade on this test than any of the others, then I basically feel like I can stop worrying and just settle on getting High Passes for my remaining rotations. Hopefully then I will have Honors in the two things I am thinking of going into, and that seems good enough to me! I am hopeful that I'll write another post summarizing OB/GYN in the next three weeks.
 |
| This is actually from the snow Sunday before my snow day, when I should have been doing work, but instead I was doing arabesques in the snow! |
As I sit curled up on my couch with snow drifts on my windowsills and an espresso in my hand, I'm thinking, what do I have to say about being a medical student lately? I want to talk about expectations and evaluations. Because I am sick of both of those things.
Expectations. Here are some things I am expected to know how to do, magically without ever learning. Granted, some resident will show me how to do these things, however they will make it clear how very nice and patient they are being because the idiot med student can't figure it out:
1. How to use a fax machine. This, ladies and gentlemen, is a complicated task. I thought the pathophysiology of glycolysis and gluconeogenesis was complicated, but figuring out how to send a fax to a long distance number is more complicated. Speaking of long distance numbers...
2. The long distance code. Sounds simple, right? A long distance code. I didn't even know these existed. That's what cell phones are for, right? Ok, so the hospital has a system, right? Every single rotation I have been told a different story about this magical code. On the psych floor, the social worker has it. On the neuro floor, every resident has their own code. On ob/gyn, it's on the board (duh! how could I not know that). I've been told on medicine everyone uses the same code, so you just have to memorize it. I've also been told by every secretary I've ever asked that I should have my own code. I don't. On surgery, I never called a long distance number. Ha.
3. Where the stapler is. Probably a common office problem, just never thought it would be a problem I'm often working on solving. Where is the stapler???
4. How to write notes in the fashion of each specialty:
a. Copy it out on this lined paper.
b. Print out this form and "skeletonize" it for us.
c. Print out this form, fill it out, sign it, then copy it with four pages per sheet and put the real one in the chart.
d. Don't write a note, just have it memorized.
e. None of the above, SNOW DAY!
The point is, no matter the environment, and perhaps especially in the uptight medical environment, it is difficult to figure out how the seemingly simple things work. It takes time. I don't magically know how to be the best secretary ever and a brilliant budding doctor. And that leads us to...
Evaluations. Here is the range:
5 = Honors (greatly exceeds expectations)
3 = the average 3rd year medical student (is this strange to you too? shouldn't we all be 3s?)
1 = probably never selected because they would have already pulled you aside and failed you
You are judged weekly, if not daily, on your performance. And whatever small amount of time you spend with a physician, halfway through you should ask for "mid-rotation" feedback. This week I'm going to ask a doctor for mid-rotation feedback after spending two afternoons with her. It's really insane. I think the point of it is supposed to be that we receive feedback "in time" for us to use that feedback to improve our performance and hopefully get the grade we want, but the feedback is usually either "you're doing fine" or "I haven't spent very much time with you." Very formative.
I guess I'm just getting tired of being evaluated constantly. Imagine for this whole year if every day were an interview and you received feedback at the end of each week on your performance. That's kind of what being a third year medical student feels like.
But here's the thing. If you're not somehow already magically performing like a fourth year or intern after one week, you're probably not going to get higher than a High Pass (the equivalent of a B). Now I say this with the caveat that everyone has a different view of how many students deserve Honors (the equivalent of an A) and what constitutes honors-level work. So naturally your grade not only depends on your performance, but on your grader's opinion of what grades mean and how they should work.
So basically Honors is the enigma of the third year medical student. What does it mean, really? What is the formula to achieve it? It seems that the usual medical student recipe - hard work, studying all the time, knowing everything - doesn't really work. It also seems that my method - hard work, being really helpful, people skills :), and trying to convince myself to study sometimes - also doesn't really work. It's not that I really need Honors in everything. It's just kind of hard to work 60 hours a week, to try your hardest at something that kind of scares you, and then to be told that you "seemed like a genuinely nice person" (literal direct quote) but you get HIGH PASS. Buzz. Next.
Needless to say the excitement of third year has worn off a little bit, in addition to the fact that I'm still tested around once a month (the results of which are always discouraging), thus I am already close to ready for third year to be over with.
I am currently in the middle of my Obstetrics and Gynecology rotation, which I really am enjoying (despite the difficulties inherent in third year mentioned above). My goal is mainly to study really hard so I hopefully get a better grade on this test than any of the others, then I basically feel like I can stop worrying and just settle on getting High Passes for my remaining rotations. Hopefully then I will have Honors in the two things I am thinking of going into, and that seems good enough to me! I am hopeful that I'll write another post summarizing OB/GYN in the next three weeks.
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