Sunday, February 24, 2008

Grad vs Med: The Smackdown--UPDATE

First, a confession: I totally love tracking my blog visit stats. It is geeky and sad (yet not nearly the geekiest or saddest thing I have done in the past week) but there it is. My favorite is seeing what kind of Google searches bring readers to my blog.

One that keeps popping up is a phrase along the lines of "Which is harder, graduate school or medical school?". I find this very interesting. I mean, first of all, who are the people searching for this phrase? Are they trying to decide between going to medical school or going to graduate school? (By the way, if you happen to be one of these individuals, my feeling is PLEASE FOR THE LOVE OF GOD SAVE YOURSELF and GO TO MEDICAL SCHOOL.) Or are they MD/PhD students trying to see what the future holds? Maybe they're in some kind of smackdown themselves, where they are either med or grad students and the other type of student is trying to tell them that they have it easy.

Anyway, I re-read my original post, and it got me to thinking. I had said that grad school was more difficult by a hair. But now, with many of my psychological scars from grad school healing, and fresh ones from 3rd year springing up on an almost daily basis, I dunno. I guess I see them as more evenly matched now.

This tells me one thing: whichever you're doing is going to get extra points in the "ouch" column, because you're doing it right then. I think that the original analogies I wrote about there still hold pretty well, except I see now that, at least in 3rd year, there is less of a roadmap to success than in 1st or 2nd year med school. They tell you the things you can do to do well, but sometimes there are extra secret things you can do that no one tells you about. And sometimes, the things you can do to be great for one attending or team will really annoy the crap out of the next attending or team that you work with. True anecdotal example: One day, I got chastised for just starting to scrub in to a surgery without asking first. Two days later I got yelled at for asking if I should scrub in. I mean, at least in grad school they just don't tell you anything, which I guess is somewhat more helpful than telling you the wrong thing. Although I will note that it's really sad that those seem to be the two choices.

Also, 3rd year has really worn me down. It took longer for graduate school to wear me down; I think in the hitting a wall department it took 3rd year 8 months to accomplish what it took grad school 2.5 years to do. Now, I'm not sure if that would be the case if I hadn't been in school for six years before starting this one (and eight years older than many classmates); maybe those fresh-faced classmates of mine don't feel the same, never having tasted the triumph of making a plump salary in the real world for a few years (before becoming really, really poor), or the defeat of, well, most of graduate school.

So, I have to say that the Smackdown is now officially a tie in my book. In the interest of full disclosure I have to say that that opinion is in the minority among my MD/PhD friends, most of whom fully endorse the "Grad school is way worse" stance. I can see their viewpoint, and must also confess that there are some personal reasons why this year has been possibly more stressful for me (although everyone has their own cross to bear). I think that next year, when I have vast spans of time completely off, things may be different, but for now, I am still trying to wrap my head around the concept of a real vacation.

Holy cow. I'm on vacation. Wait a minute! I'm on vacation! I'm going to go do something vacation-y, relaxing, or fun, like...

Hm. I can't seem to remember what people do to relax or have fun. Maybe I can look it up on eMedicine. (Okay, I just looked "fun" up on eMedicine, and the first hit is "Substance Abuse". Who says doctors don't know how to party?!?)

Friday, February 22, 2008

Another One Bites the Dust

Well, I'm all done with my eighth month of 3rd year; my sixth rotation. Holy Awesome Awesomeness!
How was the exam? Flippin' hard. It was a written exam and they really pulled some tough ones on us. Ugh. But now I get a small vacation! Joy!
So. Medicine. It is tough. I am glad I had this outpatient medicine rotation before my inpatient medicine rotation; hopefully it will give me a boost and make me somewhat less spastic and retarded. I don't know. I'm not holding my breath. I did get to see some really interesting patients, and I love coming up with differentials. So in that sense, I actually kind of enjoyed it.
I have neurology next, and just spoke to a friend who told me that the national mean on the neuro shelf test has been around 35%. My feelings on this: !!!!!!!!!!!!!!!!!!!!!!
I may have to spend some of my rotation reviewing neuroanatomy, as I remember only two things about neuroanatomy: Jack and shit. And Jack left town.
NOT looking forward to it.
I guess it will be good to learn this stuff... maybe.
Anyway, I am going to go ahead and close off this basically pointless post. I may try to gather some of my thoughts and get some meaningful posts in over these couple of weeks. Later suckers! I hope you have something good going on, and hang in there!

Tuesday, February 12, 2008

It's About That Time

You have probably been asking yourself: "Self, I wonder how long it will be until Dr. VonB decides she has been in 3rd year long enough to begin giving out often obvious advice in her know-it-all way?" Well, the answer is: right about now.

So, first off, a brief run-down of outpatient medicine. As with any rotation, the quality and overall suckitude (or, if you're lucky, the lack thereof) depends entirely on your preceptor. I am at our University's outpatient clinic and it is definitely higher pressure than most of my classmates seem to be experiencing. On the other hand, I think I have learned a ton, which brings me to my first official piece of advice about 3rd year medical school (or maybe I'm deluding myself, and I've already given out a bunch of advice, but as with most things these days I don't remember it):

OFFICIAL PIECE OF 3RD YEAR ADVICE #1: You get out what you put in.

I mean this in a few ways.

SUBADVICE 1A. Read every day. This may sound 1) oblivious and/or 2) like a pain in the ass, but either way, it is key to success in 3rd year. Most rotations have a lot more reading than you expect, and if you put it off it creeps up on you and kicks your everloving butt. I was told to pick your review book, divide the number of pages by the number of days in the rotation minus about 5 days, and read that number of pages every single day. Your residents and, if you are lucky, your attending, will notice, and importantly you will get more out of what you see in the clinic. Also, do not underestimate the shelf exams. Those who underestimate the shelf exams end up curled up in a small ball, crying, in a corner. And no one wants that.

SUBADVICE 1B. Be enthusiastic. Sometimes you may have to pretend, but if you came to medical school for the right reasons, that won't be too often. Most days you get to see at least one really cool thing. And the best thing about being enthusiastic is that most supervisors will give you more cool stuff to do if you follow pieces of subadvice 1A and 1B, which makes both easier to follow.

SUBADVICE 1C. Do a good job. I know how dumb that sounds, and yet I am consistently amazed at how many of my fellow classmates fail to do this every single day. And here's the thing: doing a good job is something within the grasp of just about every even semi-normal person, because all I mean by doing a good job is stuff like: show up when they tell you; if they tell you to look something up, look it up; try not to make the same mistake a bunch of times in a row; etc. It is NOT THAT HARD. Just try. Even a little.

Basically what I am getting at here is the fabled Cycle of Awesomeness. How this works is that the more you read, and try, and are enthusiastic, the more people trust you and teach you and let you do stuff, which makes you read more and try harder and be even more enthusiastic, etc etc, until you feel like you are actually getting close to be a realio, trulio doctor. And it. Is. AWESOME.

Also, before I forget, one thing you MUST have in your white coat pocket: Sabatine's Pocket Medicine. I cannot begin to describe the awesomeness of this book. If you are a student buy it IMMEDIATELY. No real need for it on surgical rotations or possibly stuff like psych, but it is stunningly useful on any vaguely medicine related rotation.

Okay, I need to follow my own SUBADVICE 1A and get to reading. I am about halfway through this rotation, and ahead lies neurology, psychology, and inpatient medicine. Then I will be an honest-to-God 4TH YEAR MEDICAL STUDENT! HURRAH!

In the meantime, keep an eye out for the crazy patient who came back to clinic with a knife today because we wouldn't give him percocet. Good times!

Saturday, February 2, 2008

There's a first time for everything

Old MD Girl tagged me with this meme, and given that I have a ton of homework to do it only seemed natural to fill it out.

In 2008:

1. Will you be looking for a new job?

Job? What's a job? You mean people do things other than study? And they make more than $5/hr? Holy Cow, I gotta look into that...

2. Will you be looking for a new relationship?
I have to admit that I'm getting sick of my relationship with Blueprints. I'm thinking of having a torrid affair with Case Files.

3. New house?
God, I hope so. 1275 square feet is no way to live, especially with a husband who is morally opposed to throwing anything away, ever.

4. What will you do differently in 08?
Well, right now, I can't do much differently, but in the not-to-distant future my life will cease to revolve around evaluations and shelf scores. So, in short, I will become an actual human again, with feelings and interests outside of medicine, assuming there are such things.

5. New Years resolution?
Old MD Girl said: "Talk about things other than work." YES! Me too!! Any ideas on what else there is to talk about? I got nothin'.

6. What will you NOT be doing in 08?
I will not be seeing "Remember the Spartans". I promise. (Side note: remember when parody movies used to be awesome? Like Airplane? I miss those days.)

7. Any trips planned?
I trip all the time, but I rarely plan it. I blame my shoes.

8. Wedding?
An awesome family wedding coming up soon. Another good friend getting married later this year; frighteningly, most everyone else I know is married. When did this happen?!?

9. Major things on your calendar?
Husband graduates (GRADUATES!! From EVERYTHING!!) in May. Starts residency in June.

10. What can't you wait for?

To match into the residency of my choice (knock on wood) and to GRADUATE! Also, it may be time to start having tiny humans of our own...

11. What would you like to see happen differently?

In keeping with number 5 above, I would like to have things to talk about other than work.

12. What about yourself will you be changing?

Again, Old MD Girl and I are on the same page... I have gained some confidence in the last 7 months of clinical rotations, but I'm not quite where I need to be yet. Also I have to start working out before people confuse me with Jabba the Hutt.

13. What happened in 07 that you didn't think would ever happen?
I aced the surgery shelf test (I know! I couldn't believe it either!) and published my second dissertation paper... JOY!

14. Will you be nicer to the people you care about?
Mainly I plan on being nicer to people I don't give a shit about. It throws them off.

15. Will you dress differently this year than you did in 07?
Not unless I don't keep my plan as detailed in number 12 and I have to start buying Jabba the Hutt Wear.

16. Will you start or quit drinking?
A wise man once said: "I don't need to drink to have a good time. I need to drink to stop the voices in my head."

17. Will you better your relationship with your family?
I am basically happy with how things are now. The only thing which could improve would be if I had more time, which I won't, so I guess not.

18. Will you be nice to people you don't know?
No, as per my new policy, I have to figure out if I care about them or not before I can be nice to anyone.

19. Do you expect '08 to be a good year for you?
I am pretty sure it will be awesome.

20. How much did you change from this time last year till now?
A lot. I think I am more confident in most of what I do, even if I still have plenty of insecurity. I also learned an extraordinary amount, AND I'm a "Dr." now.

21. Do you plan on having a child?
I plan on having a child mow my lawn.

22. What are your plans for new year's eve?
We watched Aliens for the 293,393,595,391th time, and it was awesome.

23. Will you have someone to kiss at midnight?
We didn't realize when midnight happened, because Ridley was fighting the Queen Alien in the big robo-loader.

24. One wish for 08?
A big, fat raise. I want to know what it's like to live the life of the fat cats making minimum wage.

I tag Heidolicious and nosugrefneb. Now send me something else before I have to resort to doing my assignments.