Wednesday, January 30, 2008

Sunday, January 27, 2008

Big Deal, I'm Very Professional

As you probably know, a huge portion of your grades in 3rd year medical school are based on evaluations. Everyone evaluates you; the interns, the residents, the fellows, the attendings--I've even had a rotation where a nurse coordinator evaluated me. Sometimes, it's nice to get evaluated, because it gives you an ego boost, plus some constructive things to work on. Sometimes it's crappy to get evaluated, because they give you a mediocre review for no apparent reason with nothing constructive (or even non-constructive) to work on.

For example, a friend of mine, who is brilliant plus a super great and hard-working guy with good social skills, got a very average evaluation from one of his attendings; you know, a "meets expectations" kind of thing. The attending told him, "You've been great, but I expect you to be great." So, my friend asked the attending, "What else could I have done to get an excellent evaluation?" And he said, "Nothing, really. Like I said, I expect you to be great, so you met my expectations." Awesome motivator, no?

The other kind of evaluation you can get is super lame because you are forced to get it from someone who basically works with you for five minutes. This happens often, because as a 3rd year medical student, you typically work almost exclusively with interns and residents, but you are required to get a certain number of evaluations from attendings, so you are forced to feel like a total wonk asking a bigwig to evaluate you when they couldn't say for sure that you don't work for food services.

Alright, I've gotten off topic here. What I wanted to write about were another type of evaluation that we have to do at our school: "Professionalism Evaluations". Believe me, they are as stupid as they sound.

Essentially, they are to try and make sure that you aren't some kind of a deranged weirdo with bad personal hygiene who is liable to get everyone on the team sued. The biggest reason that I think these are stupid is that they clearly don't work, as evidenced by a student I worked with a few rotations ago who was so wildly inappropriate that his "unprofessional behavior" actually crossed the line into felony (sadly, I am not kidding) and yet he is, as far as I know, still a student here.

However, they are terribly amusing to read. Whereas most evaluations are set up so that the boxes for "Best Ever Student Whom I Would Be Proud To Call Son/Daughter" are on the far right, and the boxes for "Should Consider Alternative Life Choice, Like Prison" are on the far left. However, on the Professionalism Evaluations, the good boxes--the only ones you want checked--are in the middle, and to either side there is badness to opposite extremes.

For example, one middle box is something like "Personal Appearance is Professional", and to the far left is "Looks like Pigpen From The Peanuts, with the Dirt Swirls and Everything" and to the far right is "Looks Like a Ho". Another is something like "Displays Appropriate Empathy", with "Spit on No Fewer than Three Patients" to the left and "Often Attempts to Hump Patients" to the right.

This setup has led to some hilarious, although unfortunate, evals where the attending, not having the time to read the ten zillionth eval form thrust at them by a 3rd year, tries to do the nice thing and check all the way down the right hand side--normally the side of honors, now the side of Axis II Personality Disorders.

In any case, it is clear that at some point some big, important committee told my school that professionalism is a Big Deal and they needed a Formal System in Place to Evaluate the Living *#$& out of us. Well, hats off to you, there, University. I could only be happier if you started evaluating how well I endure being evaluated.

Oh, wait... you already do that.

Friday, January 25, 2008

We Only Come Out at Night

So, I finished my week of night shifts and in five hours I have my OB/Gyn shelf exam. My take on nights: I hate nights. I'm too old for that crap. I'm exhausted, and cranky, and I've had a headache for three days. I realize that some nights are inevitable pretty much no matter what you do these days, but ugh. Most other fields, at least around here, have a night float system where you only have to do a week or so of nights at a time, and for surprisingly few weeks per year. On OB you spend months on nights. Months. And speaking of OB, I have one word for you about "NSVDs" (normal spontaneous vaginal deliveries--OB/Gyns flippin' LOVE their acronyms). Here is that word.

Ok, so, OB/Gyn. I have to say that it was my least favorite rotation so far. Now, I do also want to say that around here, OB/Gyns sort of had a reputation for being awful to work with as a medical student, but I have to say I found the opposite. Everyone (okay, with a few scary exceptions) was fantastic and really interested in teaching. It's just that I don't like the rotation. The hours are awful, and just through luck of the draw I was on during one of the more depressing months in history, patient-wise. You know, pregnant moms being diagnosed with metastatic cancer and being given 2-6 months to live, moms miscarrying a second trimester multiple gestation after trying for 10 years to conceive, stuff like that. Wrist-slitting.

Also, at least half of the patients speak Spanish, and I do not speak Spanish. Well, I sort of do, but kind of like Tonto if he were drunk. (Me student. Me no talk large in Spanish. Tall pain is having you where? You have water from your (indecipherable)? Big water or little water?)

Okay, it is time for me to go study for the shelf exam even though I am getting hives just thinking about it. But I will post again soon and I already know exactly what I would like to rant a little about: a little something our school likes to call "Professionalism Evaluations". In the immortal words of Ron Burgundy, "Big deal! I'm very professional!"

Saturday, January 12, 2008

Operation: Vajayjay

Just a few quick things:

1. My head is spinning. I am reading at a pace which is exceeding my ability to retain information. Sadly I do not have the option of slowing down if I wish to get through the reading before the shelf test.

2. I do not like the OR. I especially do not like the OR when I don't scrub in but instead stand on two stacked stools for hours and hours so I can catch an occasional glimpse of sheets/piles of random tissue and 34,234 clamps over the shoulders of three doctors crammed in between some poor woman's legs. Plus it's freezing.

3. If I never see another hoohoo, it will be much too soon, and I haven't even done labor & delivery yet. That goes for cervixes (cervi?) too.

4. As it turns out I got really lucky in that not only was Doc Mamma right and they can't make me work Thurs night before the shelf, but we also have a required holiday (I'm not kidding, it's required--we aren't techically allowed to be in the hospital) that Monday, so I will only have to do three nights instead of five. This almost makes up for me having my night shift week last.

Okay, as per usual, time to get back to reading. The great thing about this rotation is that you never know what fantastic thing you get to learn about next. Incontinence? Prolapse? Disgusting STDs? All of the horrible things that can happen to you before, during, and after childbirth? I'm so happy to be a woman! With complex parts that apparently fail all the time! Haha!!! By the way, I just learned that leakage which occurs while laughing is a sign of stress incontinence. Not that I have that problem.


Wednesday, January 2, 2008

OB/Gyn, Thy Name is Terror


Okay, I feel much better now. Today I started my OB/Gyn rotation, and although everyone I've met has been very to excessively nice, I am petrified. You see, our rotation is already only four weeks long, but we started two days late due to the holiday so it is even shorter. And my God, have you looked at OB/Gyn Blueprints lately? It's a kagillion pages long!!!

(PS: You might wonder why I didn't go ahead and start studying over break. This is an excellent question, and I would love to answer it, but calls to the decision-making regions of my brain were not immediately returned.)

There's more: the way the rotation is set up here, we don't have call for three of the weeks, but one of the weeks is all OB night shift (5pm-7am). And my nights week, as luck would have it, is the week of the shelf test. What this means is that I have two and a half weeks to learn enough OB/Gyn to pass the shelf test. Then I have to find a way to keep it in my brain as it (my brain) is scrambled due to a completely jacked up sleep pattern in the days leading up to the exam. Mix this in with the long hours of this rotation, and you have one trembling, sweating Dr. VonB.

Anyway, I have to get back to reading, for super duper serious. I will write more if I can stop my screaming, which, honestly, is really making it hard to read.