(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!
Friday, September 25, 2009
Thursday, September 24, 2009
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.
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.
Monday, September 14, 2009
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.
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.
Sunday, September 13, 2009
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.
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.
Wednesday, September 9, 2009
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:
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.
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.)
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.
Monday, September 7, 2009
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.
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.
Wednesday, September 2, 2009
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.
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.
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