Kind of like duck, duck, goose, only with more mucous. That pretty much sums up Family Medicine.
Actually, I like it. I don't know that it is for me, for a lifetime, but for now it's good. There's a lot of variety, and good practice for general and focused H&Ps (history and physical). My preceptor is very very nice. I do have to admit that, unfortunately, I feel that the slope of my learning curve has really leveled out. That could be because I'm studying way less than I was on Surgery. Why? Well, first, the textbook we are supposed to use pretty much blows. Also, in contrast to Surgery, with Family, you don't have The Fear.
The Fear is very important, and it isn't just about the Socratic method, pimping, or angry, angry surgeons yelling at you. It's also about having a lot of patients who might just die on you if you don't figure out what is going on and how to fix it. It gives the whole thing a sense of urgency that frankly is lacking in Family Medicine, an urgency you can use very well to fuel your studying.
Don't get me wrong, there is a ton to learn--for example, I'm trying to remember at least three major medications and what they're used for (I try not to set my standards too high). There is a ton of breadth, but not a lot of depth, and I think that works against my disposition a little bit. Anyway, writing about this has made me feel that I should really go and get some studying done. So I will. That's a very, very important thing to remember in 3rd year: when you get the urge to study, for whatever reason, run with it. Just remember to put down the scissors.
Sunday, September 9, 2007
Friday, September 7, 2007
And we're back
Family medicine is a lot busier than I expected it to be.
First of all, I have to commute a little more than an hour each way (that's more than two hours of driving per day, for those of you who are math-challenged). Then, there's the homework.
Yes, that's right. All of a sudden you're like a frickin' 5th grader, with homework.
They try to dress it up; they're "presentations" and "research summaries", but honestly, that just makes it more insulting. In my opinion, it's time to stop this ridiculous crap. There's already a big exam at the end of the rotation (written and verbal). Plus--and I hope I'm not understating this here--I feel that if the motivation to NOT KILL PEOPLE isn't enough to make someone learn of their own volition, then I don't see how homework is going to do it.
Let me learn on my own. I am NOT a 5th grader. I don't need your damn homework. I can learn all by myself, just like I brush my teeth without being told and wear matching socks without you picking them out (well, most of the time).
My other gripe (Yes!! There's more!!) is that a big part of being a doctor (okay, a GOOD doctor) is to be what they like to call a "self-directed learner". This means--stick with me here, because this is a startling and complex idea--that if you don't know something, you look it up. Radical concept, huh? Well, they tell you that it's time that you become a "self-directed learner", and in some rotations (coughSURGERYcough) if you don't do that you are a dead doornail, while in others, I'm talking to you, FAMILY, they make you do stupid. Frickin. Homework.
The cherry on top: I won't be able to say for sure until after the exam, but my hunch is that these homework assignments are not going to be super helpful on the exam. I mean, I think that they are overall theoretically important things, but the kind of things that I could have learned on my own in about one third or less of the time it took me to put it together into homework.
There is another part to this that I have to confess. One of my biggest pet peeves--other than having homework at the age of 32 and the song "American Pie"--is a little something I like to call "forced audience participation". I bet you know exactly what I'm taking about. It can happen anywhere, from a "Hey, let's put those hands together!! I can't hear you!" to "Where is everyone from?" to what I am experiencing now: "What kinds of psychosocial issues do you think we should consider in this patient?". Ironically, I don't really mind the more Socratic surgery method, where they direct a question to one particular audience member (usually warmly and personally, as in "that guy back there in the blue shirt who isn't paying attention"). But when they ask this very subjective, open-ended question, and just sit there, silently, waiting for someone to speak up, which finally someone does, but inevitably doesn't give exactly the answer the person wants, so they say something inane like "Um, yes, okay, but what else?", I just want to punch their face in.
Wow, okay, I've really woven all over the blog road here. Let me wrap up and we'll come back to some of these hard-hitting issues--plus the things I LIKE about Family Medicine--after a brief commercial break. Seriously, I will try to post again this weekend. In the meantime, keep on keepin' on, people, and let me hear you put those hands together!!
First of all, I have to commute a little more than an hour each way (that's more than two hours of driving per day, for those of you who are math-challenged). Then, there's the homework.
Yes, that's right. All of a sudden you're like a frickin' 5th grader, with homework.
They try to dress it up; they're "presentations" and "research summaries", but honestly, that just makes it more insulting. In my opinion, it's time to stop this ridiculous crap. There's already a big exam at the end of the rotation (written and verbal). Plus--and I hope I'm not understating this here--I feel that if the motivation to NOT KILL PEOPLE isn't enough to make someone learn of their own volition, then I don't see how homework is going to do it.
Let me learn on my own. I am NOT a 5th grader. I don't need your damn homework. I can learn all by myself, just like I brush my teeth without being told and wear matching socks without you picking them out (well, most of the time).
My other gripe (Yes!! There's more!!) is that a big part of being a doctor (okay, a GOOD doctor) is to be what they like to call a "self-directed learner". This means--stick with me here, because this is a startling and complex idea--that if you don't know something, you look it up. Radical concept, huh? Well, they tell you that it's time that you become a "self-directed learner", and in some rotations (coughSURGERYcough) if you don't do that you are a dead doornail, while in others, I'm talking to you, FAMILY, they make you do stupid. Frickin. Homework.
The cherry on top: I won't be able to say for sure until after the exam, but my hunch is that these homework assignments are not going to be super helpful on the exam. I mean, I think that they are overall theoretically important things, but the kind of things that I could have learned on my own in about one third or less of the time it took me to put it together into homework.
There is another part to this that I have to confess. One of my biggest pet peeves--other than having homework at the age of 32 and the song "American Pie"--is a little something I like to call "forced audience participation". I bet you know exactly what I'm taking about. It can happen anywhere, from a "Hey, let's put those hands together!! I can't hear you!" to "Where is everyone from?" to what I am experiencing now: "What kinds of psychosocial issues do you think we should consider in this patient?". Ironically, I don't really mind the more Socratic surgery method, where they direct a question to one particular audience member (usually warmly and personally, as in "that guy back there in the blue shirt who isn't paying attention"). But when they ask this very subjective, open-ended question, and just sit there, silently, waiting for someone to speak up, which finally someone does, but inevitably doesn't give exactly the answer the person wants, so they say something inane like "Um, yes, okay, but what else?", I just want to punch their face in.
Wow, okay, I've really woven all over the blog road here. Let me wrap up and we'll come back to some of these hard-hitting issues--plus the things I LIKE about Family Medicine--after a brief commercial break. Seriously, I will try to post again this weekend. In the meantime, keep on keepin' on, people, and let me hear you put those hands together!!
Thursday, August 23, 2007
To sleep, perchance to, well, sleep
Today was my last clinical day of surgery; tomorrow is the surgery shelf exam. My feelings can be summarized by combining the traditional "zzzzzzzzzzz", indicating sleep or sleepiness, and the "ARRRGGGGGGGGGGGHHHHHHHHH" of fear/frustration, thusly forming the new compound expression:
zzzzzzzARRRGGGGGHHHHHHzzzzzzzzzz,
which is the rallying cry of 3rd year surgery clerkship students everywhere.
I was on call last night, and after two solid weeks of madness it really took a toll. I was able to leave the hospital early today but have found that I'm not doing very well with the last-minute studying. But I'm looking on the bright side: I'm too exhausted to panic.
I'm pretty sure I will be able to pass the shelf and therefore the rotation (knock on a forest full of wood). Unfortunately, though it is uncool to acknowledge that you are "gunning" for honors, these things do matter, especially if you are strongly considering a very competitive subspeciality, which I am. So, passing is not really enough. I'm trying to give myself a break since this is my first rotation back and I have, by careful calculation, ZERO knowledge of minor things such as, I dunno, ANY DRUGS AT ALL, but I can't allow myself to be complacent about being behind my classmates. I'm trying hard, but right now I'm not sure it is enough.
Also, much to my chagrin, I've found that osmosis learning does NOT occur after falling asleep on your book, which I have done more in the past few weeks than in the entirety of my life up until now. In addition, I have found that I've become stupider as the rotation wears on. I'm not sure if this is due to the previous "topping off" phenomenon I wrote about before, or the exhaustion, or hearing slightly different versions of "the next appropriate step of management" from three different books and ten different people, but it is definitely true.
In any case this will be over, for better or for worse, tomorrow before noon. I move on to family medicine next which will be AWESOME in terms of hours (closer to 9 to 5 than the 5 to 9 of surgery) but is a continuation of the brain-stuffing I've been attempting with mixed results. I am going to try to get caught up on my drugs (learning, not taking) and general medical knowledge, but also on remembing what my husband looks like. I miss him, a lot. Also I miss fun, and sleeping. And my dogs. And sleeping.
I am going to sign out before this becomes any more rambling... not surprising given that I wrote it more to have something to do other than study and not so much because I have something specific or interesting to say. My positive thought for the post is easy: tomorrow I'm done with surgery, considered by most to be the most difficult rotation of 3rd year. What have I learned?
1. Waking up any time after 5am is "sleeping in".
2. Caffeine can be your best friend, but use her wisely; she is a bitch-goddess who does not take either abandonment or abuse lightly.
3. Surgeons are crazy.
4. Papillary is the most common type of thyroid cancer.
5. I can't remember the fifth thing, 'cause my brain is full.
Okay, that's all for now. In closing, always rememzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz
zzzzzzzARRRGGGGGHHHHHHzzzzzzzzzz,
which is the rallying cry of 3rd year surgery clerkship students everywhere.
I was on call last night, and after two solid weeks of madness it really took a toll. I was able to leave the hospital early today but have found that I'm not doing very well with the last-minute studying. But I'm looking on the bright side: I'm too exhausted to panic.
I'm pretty sure I will be able to pass the shelf and therefore the rotation (knock on a forest full of wood). Unfortunately, though it is uncool to acknowledge that you are "gunning" for honors, these things do matter, especially if you are strongly considering a very competitive subspeciality, which I am. So, passing is not really enough. I'm trying to give myself a break since this is my first rotation back and I have, by careful calculation, ZERO knowledge of minor things such as, I dunno, ANY DRUGS AT ALL, but I can't allow myself to be complacent about being behind my classmates. I'm trying hard, but right now I'm not sure it is enough.
Also, much to my chagrin, I've found that osmosis learning does NOT occur after falling asleep on your book, which I have done more in the past few weeks than in the entirety of my life up until now. In addition, I have found that I've become stupider as the rotation wears on. I'm not sure if this is due to the previous "topping off" phenomenon I wrote about before, or the exhaustion, or hearing slightly different versions of "the next appropriate step of management" from three different books and ten different people, but it is definitely true.
In any case this will be over, for better or for worse, tomorrow before noon. I move on to family medicine next which will be AWESOME in terms of hours (closer to 9 to 5 than the 5 to 9 of surgery) but is a continuation of the brain-stuffing I've been attempting with mixed results. I am going to try to get caught up on my drugs (learning, not taking) and general medical knowledge, but also on remembing what my husband looks like. I miss him, a lot. Also I miss fun, and sleeping. And my dogs. And sleeping.
I am going to sign out before this becomes any more rambling... not surprising given that I wrote it more to have something to do other than study and not so much because I have something specific or interesting to say. My positive thought for the post is easy: tomorrow I'm done with surgery, considered by most to be the most difficult rotation of 3rd year. What have I learned?
1. Waking up any time after 5am is "sleeping in".
2. Caffeine can be your best friend, but use her wisely; she is a bitch-goddess who does not take either abandonment or abuse lightly.
3. Surgeons are crazy.
4. Papillary is the most common type of thyroid cancer.
5. I can't remember the fifth thing, 'cause my brain is full.
Okay, that's all for now. In closing, always rememzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz
Tuesday, August 14, 2007
On second thought, no post today.
I was about to write a quick but scathing post about my horrific day and my generally abysmal outlook on the entirety of my medical education when I noticed my previous post. Let's just say that given my current state of mind I don't think anything I could write today would be in keeping with my new resolution, so I am going to take tonight to cool off and hopefully have a more reasonable outlook tomorrow.
Positive thought for the day: Today, despite persistent thoughts to the contrary, I did not harm myself or others. At least not physically.
To the best of my knowledge.
So far.
Positive thought for the day: Today, despite persistent thoughts to the contrary, I did not harm myself or others. At least not physically.
To the best of my knowledge.
So far.
Sunday, August 12, 2007
Super happy shiny fun time!
In flipping back through my previous posts, a subtle, yet persistent, theme emerged: bitching.
Yes, if I had to rename this blog, it would have to be called: "The Incessant and Unrelenting Bitchfest: A Tale of Two Degrees."
I'm sorry about that, for two main reasons. First--and you are never going to believe me about this one--I am basically a positive person. (I know! After reading my previous posts, it surprised me too!!) I'm not depressive, am only mildly moody (I like to think I experience the least possible amount of moodiness possible for a girl). I tend to be an optimistic, glass-half-full kind of person. And second, overall, I didn't hate graduate school, and third year medical school is basically awesome. Painful and terrifying and sad and really, really hard, but awesome.
So why so much bitching?
Honestly, I'm not 100% sure. I think a lot of it is that there are a whole lot of things about this career path that are extremely stressful, frustrating, challenging, etc. etc., and at some point my husband, family and friends get really sick of hearing about it, and tell me to knock it off, already! and I still have some venting to do, and, hey!, blog. Another part of it is that--and this is especially true of the grad school stuff--once you crawl out of a pit of despair, you want to put orange cones and CAUTION! tape and stuff around it, so other people don't fall into it, too. (Unless you are a certain person I am having to interact with a lot lately, in which case if you happen to fall into a pit with tigers and spikes and poisonous snakes I would laugh and laugh, and maybe throw rocks).
In any case I have resolved to try and always include something positive in every single one of my posts. Even if all I can manage is "Today I continue to successfully turn oxygen into carbon dioxide", my God, it'll be in there.
Currently, I am working on a list of "Everything you ever wanted to know about the surgical rotation, asked about, and were yelled at by a nurse." Expect it after I shake off my 30 hour shift. Until then, remember: fluffy bunnies are happy and cute!! Yay!
Yes, if I had to rename this blog, it would have to be called: "The Incessant and Unrelenting Bitchfest: A Tale of Two Degrees."
I'm sorry about that, for two main reasons. First--and you are never going to believe me about this one--I am basically a positive person. (I know! After reading my previous posts, it surprised me too!!) I'm not depressive, am only mildly moody (I like to think I experience the least possible amount of moodiness possible for a girl). I tend to be an optimistic, glass-half-full kind of person. And second, overall, I didn't hate graduate school, and third year medical school is basically awesome. Painful and terrifying and sad and really, really hard, but awesome.
So why so much bitching?
Honestly, I'm not 100% sure. I think a lot of it is that there are a whole lot of things about this career path that are extremely stressful, frustrating, challenging, etc. etc., and at some point my husband, family and friends get really sick of hearing about it, and tell me to knock it off, already! and I still have some venting to do, and, hey!, blog. Another part of it is that--and this is especially true of the grad school stuff--once you crawl out of a pit of despair, you want to put orange cones and CAUTION! tape and stuff around it, so other people don't fall into it, too. (Unless you are a certain person I am having to interact with a lot lately, in which case if you happen to fall into a pit with tigers and spikes and poisonous snakes I would laugh and laugh, and maybe throw rocks).
In any case I have resolved to try and always include something positive in every single one of my posts. Even if all I can manage is "Today I continue to successfully turn oxygen into carbon dioxide", my God, it'll be in there.
Currently, I am working on a list of "Everything you ever wanted to know about the surgical rotation, asked about, and were yelled at by a nurse." Expect it after I shake off my 30 hour shift. Until then, remember: fluffy bunnies are happy and cute!! Yay!
Thursday, August 9, 2007
Ow... my brain
You know how there are signs at the gas station that tell you not to "top off" your tank? Well, I think I've topped off my brain.
It seems that no matter how much reading or studying I do there is actually MORE that I don't know. It's like when you are packing up your house and you spend two days putting stuff in boxes but somehow now there is still the same amount of stuff unpacked, so you pack more frantically, and now there is EVEN MORE STUFF UNPACKED THAN WHEN YOU STARTED PACKING AHHHHHHHHHHH.
Lately I don't know if I have any more boxes upstairs, if you know what I mean.
I have to admit, it's all pretty interesting. With as much studying as I've been doing, none of it has been nearly as painful as other stages of this process. Basically everything I'm trying to learn now is clinical, it's about taking care of people, and I really like that. Also, it's amazing actually seeing diseases and syndromes that somewhere along the line you convinced yourself existed only in books. It's amazing seeing how the new innovations in care over the last few years are actually being used to save people's lives, and seeing what new things are on the horizon.
I could go on and on, but I can feel details about primary hyperparathyroidism leaking out of my ears as I type, and I need that for tomorrow, when I'm on overnight call. Overnight call is often a prime time for pimping, because it is even funnier when medical students not only don't know the answer, but we cry. If you come up with any new innovations in brain drain plugs, definitely let me know, if I can remember why I needed it.
It seems that no matter how much reading or studying I do there is actually MORE that I don't know. It's like when you are packing up your house and you spend two days putting stuff in boxes but somehow now there is still the same amount of stuff unpacked, so you pack more frantically, and now there is EVEN MORE STUFF UNPACKED THAN WHEN YOU STARTED PACKING AHHHHHHHHHHH.
Lately I don't know if I have any more boxes upstairs, if you know what I mean.
I have to admit, it's all pretty interesting. With as much studying as I've been doing, none of it has been nearly as painful as other stages of this process. Basically everything I'm trying to learn now is clinical, it's about taking care of people, and I really like that. Also, it's amazing actually seeing diseases and syndromes that somewhere along the line you convinced yourself existed only in books. It's amazing seeing how the new innovations in care over the last few years are actually being used to save people's lives, and seeing what new things are on the horizon.
I could go on and on, but I can feel details about primary hyperparathyroidism leaking out of my ears as I type, and I need that for tomorrow, when I'm on overnight call. Overnight call is often a prime time for pimping, because it is even funnier when medical students not only don't know the answer, but we cry. If you come up with any new innovations in brain drain plugs, definitely let me know, if I can remember why I needed it.
Monday, August 6, 2007
I don't know where time is, but it ain't on my side
Okay, this is going to be short. Why? Check out the title.
How in God's name to surgeons do this?!? It is NUTS. I mean, I haven't even had hours that were that bad and I feel like I'm barely scraping by. To be fair, I do have to do a whole truckload of reading and studying and other random busywork stuff when I'm not in the hospital, but still. Interns have it a lot worse, hour-wise. To give you a more specific idea of the hours I'm talking about, I have been spending 12-16 hours a day, an average of 6 days a week in the hospital. Then I need another 1-3 hours of studying time each day. My schedule has me working the next 13 days straight; then I get one day off, then work six more days. Then the exam. Included within those spans are two nights of all-night call where I could get five hours of sleep or zero sleep.
Also, I have to take the shelf test in less than three weeks, and that is freaking me out. The shelf test is a big, really hard, national exam you take at the end of each clinical clerkship--so, two weeks from Friday, I'll be taking the surgery shelf. Lots of people say it's the hardest one, but I don't listen to them. I listen to my brain, which is shrieking: AHHHHHHHH, we will never pass this exam!!!!!!!!!!!!!!!!!!
Okay, in any case, I have to go get some work done so I can get more than six hours of sleep tonight. Your final random thought: don't you think that Daniel Radcliffe always wears WAY too much blush in interviews?
How in God's name to surgeons do this?!? It is NUTS. I mean, I haven't even had hours that were that bad and I feel like I'm barely scraping by. To be fair, I do have to do a whole truckload of reading and studying and other random busywork stuff when I'm not in the hospital, but still. Interns have it a lot worse, hour-wise. To give you a more specific idea of the hours I'm talking about, I have been spending 12-16 hours a day, an average of 6 days a week in the hospital. Then I need another 1-3 hours of studying time each day. My schedule has me working the next 13 days straight; then I get one day off, then work six more days. Then the exam. Included within those spans are two nights of all-night call where I could get five hours of sleep or zero sleep.
Also, I have to take the shelf test in less than three weeks, and that is freaking me out. The shelf test is a big, really hard, national exam you take at the end of each clinical clerkship--so, two weeks from Friday, I'll be taking the surgery shelf. Lots of people say it's the hardest one, but I don't listen to them. I listen to my brain, which is shrieking: AHHHHHHHH, we will never pass this exam!!!!!!!!!!!!!!!!!!
Okay, in any case, I have to go get some work done so I can get more than six hours of sleep tonight. Your final random thought: don't you think that Daniel Radcliffe always wears WAY too much blush in interviews?
Subscribe to:
Posts (Atom)
