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.
Wednesday, October 28, 2009
Wednesday, October 14, 2009
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.
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.
Sunday, October 11, 2009
Wednesday, October 7, 2009
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.
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.
Friday, October 2, 2009
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 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.
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