Farewell Emelia

Anatomy is officially over and we've already moved on to Cell block. I can hardly believe that I have been in med school for over ten weeks already! While certain aspects of anatomy were fun and interesting, I was more than ready to move on. I'm excited to be in cell block now because I feel as though I have a pretty good base of knowledge about the cell that puts me at a bit of a head start. I took several related classes in college (Biochemistry, Molecular Biology, Genetics, etc) and those gave me a solid foundation in a lot of the topics we're starting to cover.

Here's a quick summary of my first ten weeks of med school: the anatomy block.

67 Lectures for 94 Hours
20 Dissections for 60 Hours Hanging Out with Emelia
24 Clinical Correlation Scenario Assignments
Over 1000 Pages of Reading to Memorize
5 Textbooks
[Ridiculous Number] Hours Studying
10 Hours Spent Volunteering/Shadowing
32 Meetings
24 Free Meals
3 Exams in 6 Parts (2 Parts Each) with 375 Total Questions

Seems even crazier typed out that way!

I definitely won't miss anatomy, but I learned a lot. I learned more about anatomy obviously, but I think my perspective also evolved in a positive way over these first weeks of med school. There's a lot more to becoming a good physician than just memorizing the facts.

Thanks Emelia for donating your body to science so that I could learn. I'll forever be grateful.

Med-Peds Shadowing

Yesterday, I shadowed a med-peds physician for most of the afternoon. Med-peds means they did a combined residency in internal medicine and pediatrics and are board certified in both. A lot of subspecialties are open to med-peds physicians, but about half of them stick with primary care. The physician I shadowed does primary care, which is what I would most likely do if I chose med-peds.

Most of the visits I saw were fairly routine primary care (colds, well child checks, etc). Because of the double certification, the patient population a med-peds physician sees is quite varied. While I was there, we saw some elderly patients as well as some infants. The physician did a routine physical, some check-ups, some diabetes mainenance, and some basic prescriptions.

The last patient we saw was the most complex and the most troubling. She was actually there because her two sons were sick with the flu and they needed checked out - but she had a big list of issues herself. There were so many things going on with this family, that I can't even begin to type them all out. It was borderline whether we should have called children's services or not. This woman had good intentions and wasn't actively putting any of her kids in danger, she was just extremely overwhelmed and had no support. If there were more support set up for her, it would make a world of difference for her kids. It was frustrating standing by while nothing could be done.

If I end up working in primary care and working in an office I really think I would want to have a social worker on staff. It's so important to me that the whole patient be addressed. This family needed support systems set up and needed to be educated on what kinds of services are available for help, but physicians just aren't trained to do that. It should be a team effort utilizing the strengths of different fields.

Perhaps this strong desire to address a wide range of issues in patients is naive and is driven by an unawareness of how being a physician will be. Maybe I'm just not jaded yet and have a naive optimism. I had a hard time going home last night knowing that we really didn't do anything to help that family. I hope I don't ever get to the point that I'm so jaded or just going through the motions that situations like that don't bother me. Seeing a family in that much distress should bother me. I hope that continues and I can figure out ways to provide more support than just acute medical care.

An Excellent Form of Stress Relief

Xenos Free Clinic

Last night I volunteered at Xenos Free Clinic, which is a free clinic that is funded by a local church in Columbus. The clinic is run entirely by volunteers and last night the clinic served about twenty patients with a nurse practitioner, a physician, and two nurses.

My goal any time I have one of these experiences is to learn something from it - whether that is something I hope to do, or something I hope I don't do. Last night was some of both, but mostly I learned what not to do from the physician I was shadowing.

The patient population of this clinic is very poor and the patients don't have any insurance. Most of them are uneducated and have never been taught how to live a healthy life style. They don't have money to get prescription meds or to see a specialist.

XFC helps with these patients by seeing them entirely free of charge. If a prescription is needed, they always try to prescribe from the free or $4 lists from grocery stores. If one is prescribed from the $4 list, they often also give the patient a $4 gift card for that store so that it is free for the patient. If a specialist is needed, there is another free clinic in town (Physicians' Free Clinic) that has different specialists available for referral.

The physician that I shadowed seemed like a good doctor and he was nice enough to volunteer his time at the clinic. However, I was intrigued by how he treated the patients. Often he would talk to them in medical terminology they clearly did not understand. The patients would stare at him blankly but he would continue using complex medical terms. He also would talk to me about the patient as though they weren't there while the patient was still sitting there. The physician was a decent teacher by explaining to me what was going on, but he was neglecting his patients. Even after prescribing something, he did little to talk to the patient about what it was for or how they needed to take it.

I recognize that the patients were extremely poor (maybe even homeless) and were at a free clinic, but I didn't think that warranted this physician talking over them. They were still patients who needed help and they deserved the same amount of humanity that would be shown to any other patient. I hope that I can always treat my patients with respect and talk to them on their level of understanding.

I enjoyed the time at XFC because it gave me a little bit more perspective on a population with which I have not had much contact. While the patients should not be treated with any less humanity, there are issues that warrant special considerations. If you refer them to another free clinic, will they have transportation to get there? Would educating them more about diet be a better solution than prescribing blood pressure meds? (He prescribed high blood pressure meds to a patient who admitted to eating fast food twice every day - but he didn't say anything about that.) Do they understand English enough to understand what is going on? (We had a patient that moved from Mexico only a year ago.)

All patients, regardless of background or financial situation, typically have complex issues going on that need to be considered in the delivery of health care. In a free clinic setting, these issues are even more evident and have to be considered. I hope to be aware of such issues and complex situations that some of my patients may be experiencing and help them do more than just get medication. My role may not be to solve their other issues, but my role is to help them connect with the resources that can help them.

Anatomy Division 2 Exam

The second anatomy exam is behind me now and I'm so excited for a relaxing weekend off! The format for this exam was exactly the same as the last exam. I did much better on this exam than the last one which is a big relief. I'm figuring out the system and how to study most effectively and it's rewarding to see that paying off.

I also picked up my white coat today which is now embroidered with my name on one side and the OSUMC emblem on the other side. It's exciting to get your white coat personalized and it definitely makes me look more professional. I'm looking forward to being able to use it with real patients.

These next few weeks should be exciting and busy! I'm shadowing several different physicians to start experiencing different medical fields a little bit. I'll also be starting my community project and hopefully meeting the child with whom I will be paired. In the next few weeks I'm going to be volunteering at a few free clinics around town as well. There are multiple free clinic opportunities here through OSUCOM and I'm trying to volunteer as much as possible to both gain the experience and help serve some of the underserved in Columbus. I'm really excited about all of these opportunities coming in the next few weeks. There are a few workshops that I signed up for as well: one will be on learning how to suture (put in stitches) and another is on phlebotomy (drawing blood). I'm pretty excited to learn some practical skills.

I'm Going to be a Big Sister!

(No, not that way. My mom is definitely done having babies.)

One of the requirements of the OSUCOM curriculum is at least twelve hours of community service. OSUCOM doesn't care with what agency we serve or if it's even medically related, as long as we are serving the community in some way. A few weeks ago, they brought in around fiftyagencies that were options for our community project. These options ranged from mentoring programs (such as Big Brothers/Big Sisters), to helping out at Ronald McDonald House, to working on a suicide prevention hotline, to filing charts in a free clinic.

I wanted to choose something that was not medically related so that it would be somewhat of a break. I also knew that it would likely need to involve kids, since my most enjoyable moments often involve hanging out with kids. I wanted my community project to be flexible as well, so that it wouldn't add any more stress to my busy schedule.

The project I chose is with Franklin County Children's Services. The program is similar in concept to Big Brothers/Big Sisters, but is for the kids within FCCS. These kids have usually been involved in some sort of abuse or neglect situation and are often desperate for some positive role models in their lives. I will get matched up with a child that has been involved with FCCS and will just get to hang out with them and mentor them. The agency is extremely flexible and I will be able to hang out with whoever I am paired with whenever it is convenient for me and them. I can take them anywhere I want, such as a movie, the park, the zoo or the mall. The agency often has discounted tickets available for different movies or events and will also reimburse for mileage.

I think the project will be a lot of fun and will be a nice break from studying. I will end up investing more than twelve hours I'm sure, but I wanted to pick a cause about which I was passionate. I'm so excited to get started and meet the child with whom I will be paired!

Who Thinks Medicine is Glamorous? Read on.

We've been doing some really fascinating dissections lately since we're currently in the thorax/abdomen region. It's been awesome exploring the heart, lungs, major blood vessels, and upper digestive tract. Today was NOT one of those interesting dissections. (To give you fair warning, if you have a weak stomach or are easily grossed out, you may want to skip reading this post.)

While we have explored the structures of the abdominal cavity for a few days now, nothing quite compared to today. Part of our dissection today was opening and exploring a few parts of the digestive tract.
Before we explored the structures today, we were to completely disconnect them from the body. We removed the stomach, spleen, pancreas (under the stomach in the above picture), liver, intestines, and associated vessels and nerves and literally lifted up the entire mass and set it on a cafeteria tray (Emelia doesn't have a gall bladder or appendix and has the surgical scarring to prove it!). Yes, the exact same trays you often eat from. To disconnect the GI tract, we tied off and cut through the esophagus and the rectum. I certainly did not wake up this morning hoping to cut through a rectum.

Once on the tray, we started exploring a bit. Exploring and opening the stomach was not too bad. There was some partially undigested food, but it was pretty interesting. It was after the stomach that things started getting a little messy. We were asked to cut into the different parts of the intestines to see the internal structures. This is where it gets especially gross (this is your second warning...so it's not my fault!). Some groups, upon cutting into the intestines, literally had fecal geysers. Not a little bit of leakage, but a full spewing geyser. Keep in mind that this is a group full of med students who are used to seeing disgusting things - and this was too much for some of them to handle. In my opinion, there is nothing interesting enough in the inside of the intestines to make it worth dealing with the fecal matter...not even close.

(And did I mention that we had lunch immediately following lab? And being med students, we were of course discussing the most disgusting parts as we ate.)

So, I'm sorry colorectal surgery, but I just do not see a future with you.

Another Cool Dissection

Emelia no longer has connected lungs. In lab today, we took off the entire front of her rib cage to expose her thoracic cavity. Then we were supposed to remove and explore the lungs. Emelia's heart was at least twice the size it normally should be (most likely from her hypertension) and was almost crushing her left lung. In the picture below, you can see what the normal relationship of heart and lungs should be:
Emelia's heart was almost all the way against her ribs on the left side it had grown so much from being overworked. Since her heart had more than doubled in size, her left lung didn't have much room to expand and I can imagine that Emelia had some trouble breathing. Because of the position of Emelia's heart over her left lung, we couldn't remove over half of her left lung until we take the heart out.

It was interesting walking around and seeing the different lungs in lab today. Some tables had cadavers who had smoked and some had cadavers who had died from lung cancer. One table found an undiagnosed tumor in the lung of their cadaver - possibly the beginning stages of cancer.

Unfortunately, I don't get to remove the heart. The other lab group is doing that part tomorrow, but my group will still get to see it after they've dissected the heart.

Exam 1

I forgot to mention in the last post about the exam that the written part is multiple choice. This is a huge plus for me and I think it's easier than a fill-in-the-blank kind of an exam. The other thing I forgot to mention is that for the practical, spelling counts. Some of the Latin muscle names are not easy, and if we have even one letter wrong, the answer is wrong.

The written portion of the exam was at 8am and we had to be there by 7:30am to get set up and signed in. It took me about an hour to complete the exam but we had up to two hours maximum. My practical part of the exam wasn't until 3:45, so I had quite a bit of time between the two portions of the exam. My group was the last shift to take the practical, and I'm hoping they rotate it so I don't have so much dead time in between for the next exam. The practical also took about an hour.

For the written portion of the exam, the score pops up as soon as you submit the exam, but I won't know my practical score for a few days. They average the two scores together for the final grade.

I'm definitely relieved to have the first exam behind me and having a weekend off was really nice! Now I'll have to get back into the routine and start preparing for the next exam, which is 10/2.

My Second First Patient

I know I called Emelia my first patient, but I had another first patient today. And this one wasn't my patient in the traditional sense either. (Meaning that, yes, there will be a third first patient!)

Today was my first interaction with a standardized patient (which was recorded!). I interviewed Mr. Welkins (I'm only using his name because it's a made up name anyway) who was presenting with a chief complaint of frequent headaches. We were supposed to do a HOPI interview using the BATHE technique. HOPI stands for "History of present illness" and is basically just gathering details about what brought the patient to see you and what the chief complaint is, how long it has lasted, etc. At this point, we are not doing any physical exam. The BATHE technique is one strategy or approach to patient interviewing and is certainly not the only way to interview.

BATHE stands for:

• Background (When did the symptoms start? How long do they last?)
• Affect (How is it affecting the patient's daily activities? How is the patient feeling about it?)
• Troubling (What troubles the patient most about what's going on? What makes the symptoms worse?)
• Handling (What is the patient doing about it? What makes it better?)
• Empathy (Displaying empathy towards what the patient is going through.)

BATHE is not meant to be sequential (don't have to get the background, then do affect, then troubling, etc), but just helps keep track of different aspects of the interview that should be covered. Typically, the patient tends to take the lead in where the conversation goes.

We've been taught to do patient-centered interviewing as opposed to physician-centered interviewing. This basically means that we should let the patient guide the interview. This involves using mostly open-ended questions and letting the patient tell the story without the physician immediately asking only about what he/she deems relevant. Some yes/no questions are necessary when needing certain symptoms/issues clarified, but should only come after the patient has had time to express what they feel they need to.

At this point in our training, we don't have a clue about diagnoses or treatment. Mostly we're just starting to practice interacting with patients and asking questions that will elicit information. This standardized patient interview isn't going to be graded but is just for practice/critique. Our CAPS instructors will review our videos and give us feedback on how we did and how we can improve.

I wasn't nervous at all for this interview. I'm sure part of that was that I knew it wouldn't be graded, but mostly I was just excited to actually interview a patient - even if it wasn't real. While I do see the importance of all of this anatomy we're learning, actually interacting with patients reminds me why I'm memorizing all of these seemingly trivial details. Despite the fact that it wasn't a real patient and I could offer no help with diagnoses or treatment, it felt very much like a real encounter. Standardized patients are (typically) really good actors and could easily be mistaken as real patients. We dress professionally (complete with white coat and ID badge) and do exactly what we would do if it a real patient in an office.

The feeling of interviewing patients and trying to help them with what is going on reminds me of what prompted me to sign up for these four years of constant studying and paying massive amounts of money. It won't be long before I am responsible for actual patients and their well-being. For my future patients, I am learning every muscle I can, paying attention during lectures (most of the time!), and trying to see the bigger picture - because if all of this is not for them, it is not at all worth it.

First Exam

My first exam (other than my drug test - which I passed!) will be this Friday. The exam consists of two parts: a written exam and a practical exam.

The written portion of the exam is computer based and is taken using software that we had installed on our own laptops. All of the M1s will take this portion of the exam at 8am on Friday. The written part of the exam is seventy-five questions. Twenty of these questions are from embryology. Considering we only had four lectures on embryology, this is a heavily skewed distribution. The reasoning given to us for this skewed distribution toward embryology is that they didn't want us to blow it off because it was such a small portion of what we've covered. Blowing off embryology was exactly what I was planning on doing since anatomy is so much more of a focus - but obviously I can't do that now! The remaining fifty-five questions come from the anatomy that we have covered (and will cover this week). This includes the back, the upper limb, and the lower limb. For those parts of the body, we need to know all of the muscles, nerves, blood vessels, bones, ligaments, etc. For every muscle, we need to know all of the attachments, what nerve innervates it, what artery supplies it, what vein drains it, and where it is in relation to other muscles. The amount of information that we are expected to master adds up so quickly. There are sixteen muscles just in the hand to give you some idea of how much we have covered just for this first exam. The hand and forearm were covered in a one hour lecture!

The other half of our exam is the practical exam. This portion of the exam is in the cadaver lab and uses our cadavers. The class will have different assigned times for this portion of the exam since it would be chaos to have all 225+ of us in the lab at the same time. The instructors will tag structures that we need to identify. For example, they can wrap a string around a specific muscle and ask us to name the muscle. They can also wrap a muscle and ask us what innervates it or what artery supplies it. Arteries, nerves, and ligaments can also be tagged. There are fifty questions on the practical. Also included in the practical could be recognizing structures on x-rays, ultrasounds, MRIs or CT scans.

Of the 125 total questions (75 written, 50 practical), we have to get a 70% to pass. The computer program gives us a score for the written portion instantly when we submit the exam, but this isn't our final grade. The practical has to be added to our score and the score on the written exam can change. Inevitably, med students argue that certain questions were worded unfairly or contained conflicting answers and we are able to convince the instructors that certain questions should be thrown out - which tends to raise everyone's score. These instances where med students temporarily think they are law students arguing in court usually get a few questions thrown out or graded differently.

I'm a little nervous about the exam since it's hard to know what exactly to expect. The instructors have been really good about helping us know what to expect on the written portion through posting practice quizzes, but I'm not sure how representative those are to the actual exam. Some of the M2s put together a practice practical as well so that we can see how we are doing with our studying. Mostly, I'm just ready to be done with this first exam and have it behind me. After this exam I will be over 1/3 done with anatomy and will finally have a weekend off! The greatest part about the structure of the curriculum is that after an exam we have the weekend free. The next unit hasn't started and only the ridiculously motivated (and crazy) students that want to get way ahead start studying before the unit starts. I certainly will NOT be studying that weekend.

Time flies.

Today is the first day for interviews at OSU. It was strange walking out of lecture to see the lobby packed with nervous interviewees in new suits. They all looked as though they felt awkward and uncomfortable and were just ready to get the day over with. Some were making idle conversation, but most were just sitting, probably silently rehearsing their answers to some of the most popular interview questions: Why medicine? Why OSU? What would you do if you couldn't go to medical school? A group of interviewees just passed by on their tour of campus. If they are anything like I was, not a single step of the tour will be remembered. The places you see will blend with the other schools The conversations you have with M1s and M2s will be forgotten. The interviews coming after the tour are much more so the object of focus.

I can hardly believe that it was just a year ago that I was sitting in those same seats, just as nervous and uncomfortable as they were. (My interview at OSU wasn't quite this early, but I had other interviews that began in September.) It seems like ages ago that I was interviewing and didn't have any idea where I would be attending medical school. Now, only two and a half weeks into classes, I already feel as though I've been here for months.

It won't be long before I'm walking out of lecture at this time next year noticing how stressed all of the M1s are about their upcoming first anatomy exam. Soon after that, I'll be making my rounds in the hospital looking back fondly on the days when I could "sleep in" until 7:00am.

Time flies. Even if you're not having fun. I hope I can embrace where I am now, and find ways to make M1 fun. A few more percentage points on an exam won't make a difference nearly as much as an evening with friends. One more memorized muscle isn't comparable to a genuine conversation with a patient. No one will ever know what my exam scores were unless I tell them. If I could tell the interviewees anything, it would be to relax. And when I'm an M2, I'll be telling the M1s to relax...and so the pattern continues.

And with that thought, I'm off to memorize that one more muscle in hopes of boosting my exam score a few more percentage points.

Hands and Exams

Yesterday in lab, we dissected Emelia's hand. There is something different about the hand than much of the rest of the dissections. Emelia's fingernails were still neatly manicured with a few chips that likely happened after her death. Her knuckles were worn, slightly crooked and likely arthritic as could be expected from an 83 year old. There is something uniquely human about the hand, which may be part of why it is harder to dissect.

The hand is amazingly complex. After dissecting for a few hours I realized why hand surgeons have such a long training. There are so many tendons, nerves, blood vessels, and muscles that allow us to do all of the small motions with our hands. I was fascinated by the complexity inside the hand. If the training weren't so long and ridiculous, I think being a hand surgeon would be rewarding and challenging and something I would enjoy. The training and the lifestyle that come with that specialty choice rule it out for me though.

Today marks the halfway point to our first exam. Two weeks from today I will have my first anatomy exam which will cover the back, the upper limb and the lower limb. The limbs also include where they attach (shoulders and hips). There are a lot of muscles to learn in those sections. We have to know where all of the muscle attachments are on the bones, all of the different parts of the bones, what nerve innervates the muscles, and what arteries supply the muscles with blood. We also have to know where everything is in relation to the other parts. Which parts are superficial, which parts are deep, etc. We are also expected to be able to put everything together. If they tell us that the median nerve is damaged, we should be able to say every structure that would be affected and how it would be affected. Also included on this exam is the first four weeks of development of an embryo. I'm looking forward to that first exam being over. I want to see what the exam structure is and how I can more effectively study. I'm also definitely looking forward to having a weekend off!

I also just bought the medical equipment that we need for patient exams. I bought a stethoscope, and oto/ophthalmoscope (eyes and ears), and a few smaller, less expensive pieces of equipment. These costs add up so quickly! We start practicing physical exam techniques on each other starting next week and have a taped standardized patient interview (basic history of present illness) in just two weeks!

A New Mindset

I've found that I have a whole new way of looking at the human body now that I've been studying human anatomy pretty intensely. I took anatomy in undergrad, but it wasn't this intense and it didn't include cadaver dissection.

I can no longer just move my arm, leg, hand, head, etc. Every movement is accompanied by the thought of all the actions that have to work together for every seemingly simple movement. What muscles are involved? What nerves make those muscles move? What blood vessels supply the area? What blood vessels drain the area? What parts of the brain coordinate everything? I look at my wrist as it moves and think about what Emelia's wrist looks like and wonder if my muscles look the same as hers (though hopefully fully alive). I see the veins in my arm and think about their names, what areas they drain, and what arteries are nearby. I raise my arm and think about the entire grouping of muscles that were necessary to make that motion.

I can't help but think about the whole system and wonder how it ever works without things going wrong.

I'm sure this sense of wonderment will gradually decline I get further from anatomy in these next few months and get lost in the more microscopic processes but I hope I never lose my awe of the workings and design of the human body.

OSU Football!

Far more exciting than anything that happened in class today: I picked up my football tickets!

I think these games will be a fantastic form of stress relief! Most of the M1s (first year med students) sit together for these games which will make it even more fun!

Emelia Didn't Drink Enough Milk

Today in lab, I learned a few more things about Emelia. She was 83 years old when she passed away and her cause of death was a heart attack. She also had coronary artery disease (accumulation of plaque in the arteries around her heart), hypertension (high blood pressure), and osteoporosis. Personally, I'm impressed that she lived to 83 with the heart problems and the fact that she was fairly obese.

For the purposes of our dissection, it was nice that Emelia didn't drink enough milk (it's not quite that simple) and had osteoporosis, because part of our task today was to crack open her spinal column. We literally broke her vertebrae with a chisel and hammer and removed the back half of the spinal column. There is something very strange about intentionally cracking someone's bones and ripping them out.


In this picture, the arrows are pointing to approximately where we put the chisel in, except we were a little more towards the outside (left and right) of the vertebrae to expose more of the cavity. The view of this image is as though someone is lying on a table and you are standing by their head (or feet) looking down their spinal column. The part of the picture that is pointing straight down is called the spinous process, and is the ridge that you feel when you run your fingers down someone's spine. Each of our vertebrae have one of these "spines" that together make up what we think of as the spine. That white triangle in the middle of this picture is the space that actually contains your spinal cord. Our entire purpose in cracking Emelia's vertebrae open was to expose the spinal cord and see it all the way from Emelia's neck to her hips. Seeing and touching a spinal cord and all of the nerves that attach to it was very interesting.

I'm not going to post about every dissection we do, but I will mention particularly interesting ones - such as exposing the spinal cord, removing the heart, removing the brain, etc.

Meet Emelia: My Cadaver and My First Patient

Today was the first day of dissecting. My group named our cadaver Emelia. There isn't really reasoning behind the name, it just seemed to fit.

Nothing really can prepare you for that first day of dissection. You walk into a room full of cadavers with classmates who know just as little as you do and are expected to act as though you are not cutting human flesh. There is some degree of dissociation necessary to be able to complete the tasks we are asked to do. Conversely, you can't dissociate entirely because you have to learn everything in the context of a living human body and you also can't dissociate because you have to treat the cadaver with a lot of respect, just as you would a living human. Before we ever see the cadavers, their heads and eyebrows are shaved to dehumanize them to some extent to make it a little easier for us to handle initially.

Today we removed all of the skin from the back, back of the neck and the back of her arms to expose the muscles. We also had to remove the layer of fat between the skin and the muscles. Emelia probably enjoyed good cooking and relaxing because she is much larger than most of the other cadavers - which makes dissection difficult, but my group readily embraced the challenge.

I found that I handled the dissection well as long as I was actively doing something. The moments when I was standing by and others in my group were taking a turn, it was much harder to not react. Having a task to distract me from the idea of what I was doing was extremely helpful. A few times I did get a little light-headed (probably partially from the overwhelming smell), but a short break to sit or take a walk down the hall helped. I'm sure, like most things in life, dissection will get easier as the exposure increases. Despite more time in the lab increasing comfort level, I've heard from many med students that the hardest dissections to handle are the face and hands - since those areas are what we generally associate with "being human".

I hope to learn a lot from Emelia. I hope to learn a lot from all of my patients, but I think my first, Emilia, will teach me the most.

I won't be in the lab dissecting every day. There are eight of us assigned to the table, but divided into two teams of four. We rotate which day we are dissecting so I don't dissect again until Thursday.

First Day of Class!

Med school classes officially started for me today! There were four one-hour lectures this morning from 8am-noon. Each lecture was on a different topic and was taught by a different doctor. Being done at noon is really nice. I came back to my apartment and had a nice afternoon break to eat lunch and relax by the pool before studying.

The first lecture was just a general intro to anatomy and to the course. We were told about supplies and procedures for the anatomy lab among other general information.

Our second lecture was about a specific case study with a patient suffering from a herniated disk which was intended to help us see the purpose for what we will be learning. Understanding basic anatomy is crucial for a lot of diagnosing and problem solving.

The third lecture covered some embryology and went through the first two weeks of development after fertilization. It's amazing how much happens in those two weeks. (It's also amazing how many terms there are to memorize from those two weeks!)

The last lecture for today was an overview of the different imaging options available in medicine. We went through the basics of x-ray, CT scans, MRI, PET scans and some other options. The technology available to doctors is incredible and always developing.

Dissecting in the anatomy lab starts tomorrow. We only have one lecture tomorrow morning followed by three hours in the anatomy lab.

I don't want to bore everyone with summarizing every lecture that I have this year, but I thought a run through of the first day would be helpful for knowing what med school is like (at OSU at least). I'll probably do more general updates about how things are going after today (instead of summarizing everything that happens) and include updates on any significant events or memorable experiences that happen.

Moving and Orientation

I apologize for the delay in posting an update, but lately things have been a little more chaotic than I anticipated. (That will likely be the trend for the next few years!)

I moved to Columbus on Aug 1 and moved in to my 2 bed/2 bath apartment with one roommate. I took my time unpacking and finally got everything unpacked and organized just in time for orientation to start the next week. (Once orientation started though, the organization and cleanliness of my room quickly deteriorated!) I wanted to have a bit of a relaxing week as well since I know it will be one of my last weeks for a long time where I will have lots of time to relax! My apartment complex is really nice and has a pool, a 26-acre lake, tennis courts, a sand volleyball court, a work-out room, and a nice community rec room. While I've been in Columbus, I've also gotten my OSU ID card (BuckID) and my OSUMC (OSU Medical Center) ID card.

Orientation started on Aug 10 and was Monday through Thursday of this week from about 8am to 4pm. The first day of orientation kicked off with some professionalism talks and other lectures but in the afternoon we had what is known as the "White Coat Ceremony". This ceremony is when we are given our first white coats that doctors are known for wearing. Because we are students, our coats are shorter than physicians' coats. We also gave our medical oath at the ceremony (an updated version of the Hippocratic Oath). The rest of orientation consisted of various talks on what to expect in med school, how to take care of ourselves, and how we should behave.

Classes start on Monday (Aug 17). Classes for the first two years of med school are divided into two main parts. We have our "core" class - which is the class that takes about 90% of our time. This core class is separated into blocks. Our first block is Anatomy (with a little bit of Embryology mixed in) , which lasts ten weeks. After Anatomy, we have Cell block, then Host Defense block, then Neural Science block for our first year. Each block lasts about ten weeks and will have three exams within that time. The second year's blocks are a little different in structure than the first year and are typically divided by body system (urology, cardiology, etc) and are shorter blocks (4 weeks).

In addition to our core class, we have a course called CAPS (Clinical Analysis and Problem Solving) which runs all four years of med school. In our first two years, our CAPS small group meets once a week to cover the things important to becoming a physician that aren't covered in basic science classes: Things such as how to interview patients, how to do physical exams, and how to integrate what we're learning into a clinical setting.

There have been a lot of social events going on constantly since I've moved to Columbus. Some are officially hosted by the med school and some are unofficial gatherings hosted by various students. Since our class has 220 people, there are tons of people to meet and get to know!

I'm not sure how frequently I'll be posting updates on here because it depends on what's going on at that time. If you're curious about something with med school, post it as a comment on here and I'd love to answer it.

Financial Aid

I received my financial aid letter today from OSU saying that I did not receive any scholarships, which means I will need to entirely fund my med school education with loans. I was hoping for some scholarships, but was not expecting any. I still consider OSU to be the right place for me despite the lack of financial aid. I think that the debt will be well worth the excellent education I will receieve at OSU.

Apartment Search

My apartment search in Columbus last weekend was successful. I found a great place to live next year. The complex has a pool, a nice lake, tennis courts, a workout room, and lots of other nice perks. I will only be a ten minute drive from OSUCOM.

I also found an awesome roommate. We had been talking some before meeting last weekend and we seem to have a lot in common. We're both pretty excited to move into the two bedroom apartment in August and start med school!

Having the roommate and apartment situation figured out is a huge relief! The next step is finding out what, if any, financial aid I will receive. The financial aid office will be sending out letters at the end of this week or the beginning of next week. I have no idea what to expect.

Case & Northwestern Decision and Update

I officially withdrew from Case Western's waiting list. I also received an email saying I was no longer being considered for Northwestern's class.

I plan on using this blog once I'm in med school as a way of keeping people informed about how med school is going and what it's like. Even though my search for a med school is over, I definitely will keep updating this blog. There just isn't a whole lot going on at the moment.

I'll be heading down to Columbus this weekend to start looking for apartments in the area. I've been busily trying to arrange appointments to see different apartments and I am hoping to find somewhere nice (but affordable) while I'm down there this weekend.

I'll be back in Columbus in two weekends (4/18) for what OSU calls "2nd Look Day". It's basically just a chance to see the campus and school again and talk with students. I'll be meeting future classmates as well as current OSUCOM students and learning a little bit more about the school. I may also be looking at apartments more that weekend if I need more time after this weekend.

UVa Decision

University of Virginia officially rejected me today. I was anticipating this since I had not heard from them yet. However, since I've already decided on OSU, decisions from other schools don't really matter.

I'm going to be a buckeye!

OSU is definitely where I want to go. All of the pieces seem to fit together really well at OSU. The program is phenomenal, in-state tuition is nice, and the location is perfect. OSU just seems to be a great fit for me.

The next step in this process is trying to work through the financial aspect of medical school. Med school is expensive and requires a lot of financial planning.

Cinci Interview Invite

Cincinnati finally invited me for an interview, but by the time they invited me I had pretty much decided on OSU. I withdrew my application from Cinci. Because I really want to go to OSU, interviewing at Cincinnati would have been wasting my time and theirs. Cinci has a great program, but by this point I'm just really excited about OSU.