Another rotation down, folks! I finished my EM rotation a week ago and then it was a frenzy of getting ready for my first residency interview: dusting off my suit and shoes, doing a mock interview, learning everything I could about the program, etc. More on that later. I'm off to California tomorrow for a week of relaxing and eating at my home away from home with my parents before I get back on the interview trail.
EM was a really great rotation. For probably many reasons, students have a lot more independence in the ED. In the past, I worked closely with a resident and though I did my own evaluation and assessment of our patients, it was still a team effort to make and execute the plan for their care. On my EM rotation, I was essentially an intern. As long as patients were stable, I could assess them independently, write up the note and put in all the orders I thought were appropriate before presenting to my attending and then they would sign off on my orders as long as they were within reason. It was a tough transition at first because the ED is a high-speed environment, and as a student you are not really responsible for efficiency of patient management. So it was a bit of a learning curve to figure out how to thoroughly evaluate a patient, write a complete note, make sure your orders were placed and signed off in a timely fashion, and finally present the patient to the attending (who may or may not be seeing one of their 10 other patients). Once I got the hang of it, though, it was a pretty fun rotation. I saw a really good code (aka resuscitation of a cardiac arrest patient) finally, and managed patients with a huge variety of problems.
Although, what post would be complete without getting on my primary care soapbox? I definitely reaffirmed (for the 10,000th time) my desire to enter the field of family medicine. You see a similar variety of patients in a primary care office (though, less critical in nature at times), but you actually have the time to do a complete workup and have the benefit of follow-up visits with patients. Sure, it's kind of a thrill to go into that code with guns blazing: popping in arterial and central venous lines, the AutoPulse squeezing away, intubations, vasoactive drugs, etc. But, I guess in the end I will feel better about my day's work if I can prevent someone from meeting that violent end.
Sunday, November 18, 2012
Wednesday, October 17, 2012
MRICU, etc.
It's hard to believe that my ICU month is over! I spent the last 4 weeks in my hospital's Medical Respiratory Intensive Care Unit, which handles patients with primarily medical or respiratory problems (as opposed to cardiac or neurosurgical problems, we have special ICU's for those people!). I felt feeble in the beginning with so many new things to learn: ventilators, pressors, sedation. And how easy it was during third year to think of vital signs as such a minor thing (a fever might point you in the direction of an infection, or a fast heart right might make you think dehydration). But in an ICU they can not only change rapidly and dramatically, but you also have to look at them in the context of how much fluid and pressors are required to keep the vital signs at an acceptable level. But those things quickly became routine, since so many people in the ICU require these types of life support.
I saw some really crazy things happen too. I saw a guy with a massive upper gastrointestinal bleed go through a massive [blood] transfusion protocol (he got upwards of 30 units of blood in the blink of an eye) and go on to have a Blakemore tube placed. I watched a young guy get placed on ECMO. I helped with countless central lines and even got to try my hand at placing one by the end of the month.
But the things I may never forget are much sadder, maybe too sad for these pages. So many people die in ICU's and to be honest, it's a terrible place to die. I wish more people had this kind of opportunity so that they could better understand what they might want at the end of life. The ICU should be there to resuscitate patients who have a good chance at life after the ICU, not to prolong the lives of those who have no prognosis, who are essentially dead or dying when they get wheeled to our floor. Then it becomes a gut wrenching process of keeping the patient alive long enough to guide the family from shock and denial to acceptance or to convince the family that palliative or hospice care would be in the patient's best interest. I don't think anyone goes into medicine wanting to do this kind of work, but it's the sad reality of our current system.
Anyway, on to brighter and cheerier things. The residency interview invites have flooded my inbox and I can't wait to go on all these adventures! I also started my Emergency Medicine rotation and we're three days in and I have yet to do any work...can't complain about that. My first shift in the ED is tomorrow. Hold onto your hats!
I saw some really crazy things happen too. I saw a guy with a massive upper gastrointestinal bleed go through a massive [blood] transfusion protocol (he got upwards of 30 units of blood in the blink of an eye) and go on to have a Blakemore tube placed. I watched a young guy get placed on ECMO. I helped with countless central lines and even got to try my hand at placing one by the end of the month.
But the things I may never forget are much sadder, maybe too sad for these pages. So many people die in ICU's and to be honest, it's a terrible place to die. I wish more people had this kind of opportunity so that they could better understand what they might want at the end of life. The ICU should be there to resuscitate patients who have a good chance at life after the ICU, not to prolong the lives of those who have no prognosis, who are essentially dead or dying when they get wheeled to our floor. Then it becomes a gut wrenching process of keeping the patient alive long enough to guide the family from shock and denial to acceptance or to convince the family that palliative or hospice care would be in the patient's best interest. I don't think anyone goes into medicine wanting to do this kind of work, but it's the sad reality of our current system.
Anyway, on to brighter and cheerier things. The residency interview invites have flooded my inbox and I can't wait to go on all these adventures! I also started my Emergency Medicine rotation and we're three days in and I have yet to do any work...can't complain about that. My first shift in the ED is tomorrow. Hold onto your hats!
Monday, September 17, 2012
Family Medicine Elective
My first months of 4th year have already come and gone. I took the boards a month and a half ago and promptly went on vacation. I had a blast spending time with my family and catching up with a few friends.
On returning, I started my Family Medicine elective. I designed the month with the help of the lovely Family Med department at my school. The first two weeks were spent in a private practice in the 'burbs. I wanted to work with an energetic, young female so that I could try and imagine myself in their shoes. It worked! I had a blast and could almost imagine myself 5 years down the road in my shiny new practice. I spent the second two weeks at the local Family Medicine residency program. I worked with each of the attendings and several of the residents, attended lunch lectures, and even visited a couple of their other sites like the nursing home and OB clinic. I got a better feel for what residency will be like and really liked all the people I worked with. It was a great month in that it affirmed my decision to enter the field of Family Medicine.
Luckily this was a pretty laid back month, which allowed me to work on my residency applications! It wasn't all that hard really, but there are a lot of pieces to put together like getting a headshot, writing a personal statement, choosing which programs to apply to, making sure you have all your letters of recommendation from faculty members. And finally this past weekend I got to submit the thing. It felt like a lot of weight lifted off my shoulders.
Now I am back in the hospital working in the ICU. Today was my first day and I have to admit it was overwhelming seeing such incredibly sick people and not really understanding a lot of the interventions being used to treat them (ie, ventilators). Lots of learning to be had this month!
On returning, I started my Family Medicine elective. I designed the month with the help of the lovely Family Med department at my school. The first two weeks were spent in a private practice in the 'burbs. I wanted to work with an energetic, young female so that I could try and imagine myself in their shoes. It worked! I had a blast and could almost imagine myself 5 years down the road in my shiny new practice. I spent the second two weeks at the local Family Medicine residency program. I worked with each of the attendings and several of the residents, attended lunch lectures, and even visited a couple of their other sites like the nursing home and OB clinic. I got a better feel for what residency will be like and really liked all the people I worked with. It was a great month in that it affirmed my decision to enter the field of Family Medicine.
Luckily this was a pretty laid back month, which allowed me to work on my residency applications! It wasn't all that hard really, but there are a lot of pieces to put together like getting a headshot, writing a personal statement, choosing which programs to apply to, making sure you have all your letters of recommendation from faculty members. And finally this past weekend I got to submit the thing. It felt like a lot of weight lifted off my shoulders.
Now I am back in the hospital working in the ICU. Today was my first day and I have to admit it was overwhelming seeing such incredibly sick people and not really understanding a lot of the interventions being used to treat them (ie, ventilators). Lots of learning to be had this month!
Saturday, September 1, 2012
I'm a 4th year!
It's amazing to write that third year finally came to an end! It was a very long 12 months learning the ropes of the clinical world. Those first few rotations were rocky at best, my classmates and I learned the simplest things like writing daily progress notes and what "following" our patients means. Now with those concepts down pat, we have grown into baby doctors and can spend the majority of our time focusing on diagnosis and management of our patients' conditions. It's a great feeling!
4th year will be more of the same, but we'll see some new settings and have just a tiny bit more responsibility for our patients (of course, our senior team members will still have to oversee our actions) and become a more integral part of the decision making process. Here's a sneak peak of what's to come:
Block 1: Study for Step 2 Board exams
Block 2: Family Medicine advanced elective
Block 3: Medical-Respiratory ICU
Block 4: Emergency Medicine
Block 5: Interview month/Rosetta Stone-Spanish
Block 6: Geriatrics
Block 7: Endocrinology
Block 8: Reading month (aka, vacation!)
Block 9: Update course
Graduation!.....Residency!
I have a feeling it's going to go crazy fast. Hold on to your hats!
4th year will be more of the same, but we'll see some new settings and have just a tiny bit more responsibility for our patients (of course, our senior team members will still have to oversee our actions) and become a more integral part of the decision making process. Here's a sneak peak of what's to come:
Block 1: Study for Step 2 Board exams
Block 2: Family Medicine advanced elective
Block 3: Medical-Respiratory ICU
Block 4: Emergency Medicine
Block 5: Interview month/Rosetta Stone-Spanish
Block 6: Geriatrics
Block 7: Endocrinology
Block 8: Reading month (aka, vacation!)
Block 9: Update course
Graduation!.....Residency!
I have a feeling it's going to go crazy fast. Hold on to your hats!
Psychiatry
This is by far the hardest 3rd year clerkship to write about. I finished the rotation in mid-July, if that's any indication. But for completeness sake, I have to write it. I spent the entire 6 week Psychiatry rotation at an inpatient treatment center for children with acute psychiatric illness. This was not a site I wanted to be placed at. For one, my big buddy had to leave half-way through the rotation a year prior because she was so miserable. I'm also not too crazy about pediatrics. Third, it was the last rotation of the year and this site is rumored to be the most time-intensive of all our psychiatry sites, so no one was really interested in putting in long hours at this juncture in our academic careers. So it came down to drawing names out of a hat, naturally. And what do you know, lucky me got picked!
Team drama aside, I was placed at the treatment center with some very lovely classmates and it turned out the staff was very lovely too. Since it's an inpatient center, there is a lot of support for the kids including doctors, therapists, social workers, occupational therapists, teachers, nurses and even a therapy dog! The thing that was not so lovely were the stories. It was stuff out of television except when you watch TV it seems like it's not real and you can turn it off and go about your regular activities. I felt like I was trapped in the TV and I had to watch and learn about all the physical and psychological aftermath of the horrors these kids have been through. Within the first two weeks I began experiencing symptoms of vicarious traumatization, which can take on many forms, from anxiety/depression to actual PTSD-like symptoms that results from empathizing with victims of trauma. I was definitely not alone, I found after talking with my classmates on the team. And born out of our distress is a research project my classmate and I are taking on!
The rotation did get easier and I learned to take some comfort in knowing that the kids truly were receiving the care they needed. And I am also grateful for the experience. I learned how to work through my own emotions so that I can take better care of patients. I was pushed harder than I have ever been pushed before, and I know my interviewing skills improved by leaps and bounds. And I get to be a part of this great project. So, not so bad in the end.
Team drama aside, I was placed at the treatment center with some very lovely classmates and it turned out the staff was very lovely too. Since it's an inpatient center, there is a lot of support for the kids including doctors, therapists, social workers, occupational therapists, teachers, nurses and even a therapy dog! The thing that was not so lovely were the stories. It was stuff out of television except when you watch TV it seems like it's not real and you can turn it off and go about your regular activities. I felt like I was trapped in the TV and I had to watch and learn about all the physical and psychological aftermath of the horrors these kids have been through. Within the first two weeks I began experiencing symptoms of vicarious traumatization, which can take on many forms, from anxiety/depression to actual PTSD-like symptoms that results from empathizing with victims of trauma. I was definitely not alone, I found after talking with my classmates on the team. And born out of our distress is a research project my classmate and I are taking on!
The rotation did get easier and I learned to take some comfort in knowing that the kids truly were receiving the care they needed. And I am also grateful for the experience. I learned how to work through my own emotions so that I can take better care of patients. I was pushed harder than I have ever been pushed before, and I know my interviewing skills improved by leaps and bounds. And I get to be a part of this great project. So, not so bad in the end.
Wednesday, May 30, 2012
Obstetrics and Gynecology
Hard to believe I am back here posting so soon! My tour of OB/Gyn has nearly come and gone. I spent the past 6 weeks at a busy hospital in northern Virginia (NoVA to us Virginians) just outside of Washington DC. They sent a group of us up here because our home campus has a lower volume of obstetrics and I joined in thinking I would like to get good exposure to OB (Family docs, as it turns out, can still practice obstetrics if they choose, especially in the wild West!).
My first three weeks were spent on the busy Labor and Delivery service. A classmate and I alternated between L&D shifts and days watching C-sections. So. many. C-sections. But aside from that, I had a really good time on L&D. I would see new patients in triage; mostly ladies having contractions or leaking fluid who wanted to see if they were in labor. I became quite adept at doing quick sonograms, reading the fetal monitor tracings, and botching my way through a patient history in Spanish. The rest of the time was spent checking on the laboring patients, helping the residents, and most importantly pushing with the patients when it came time. I was surprised at how much I enjoyed coaching the ladies and monitoring their progress. I got to help with several deliveries where the resident would place their hands over mine while delivering the baby, but several times I got pushed out of the way due to complications like the baby's shoulder getting stuck or if they baby wasn't tolerating delivery. Med student gold on L&D is a multip (a lady who has had at least one prior vaginal delivery) since the delivery tends to go quicker and smoother. My opportunity finally came towards the end of my three weeks and I was allowed to deliver a baby all by myself. The resident was behind me the whole time making sure I knew what I was doing (or didn't do anything stupid for that matter), but she let me run the show and everything went perfectly. Such endorphin rushes have never been known!
The next two weeks I was on the urogynecology service, which involves pelvic organ prolapse repairs and pelvic slings for stress urinary incontinence. I was mortified by many of the procedures I saw and won't go into too much detail here. Suffice it to say, I no longer fancy a career involving surgery. I don't know why I was drawn to it early in the year!
There were certainly days on OB when I thought I could see myself enjoying this field as a career. I probably would. But I think the work-life balance would be much harder to attain and I would miss the variety of patients in primary care. If there is a future for me in OB, I guess the door is not completely closed with family medicine. We shall see!
My first three weeks were spent on the busy Labor and Delivery service. A classmate and I alternated between L&D shifts and days watching C-sections. So. many. C-sections. But aside from that, I had a really good time on L&D. I would see new patients in triage; mostly ladies having contractions or leaking fluid who wanted to see if they were in labor. I became quite adept at doing quick sonograms, reading the fetal monitor tracings, and botching my way through a patient history in Spanish. The rest of the time was spent checking on the laboring patients, helping the residents, and most importantly pushing with the patients when it came time. I was surprised at how much I enjoyed coaching the ladies and monitoring their progress. I got to help with several deliveries where the resident would place their hands over mine while delivering the baby, but several times I got pushed out of the way due to complications like the baby's shoulder getting stuck or if they baby wasn't tolerating delivery. Med student gold on L&D is a multip (a lady who has had at least one prior vaginal delivery) since the delivery tends to go quicker and smoother. My opportunity finally came towards the end of my three weeks and I was allowed to deliver a baby all by myself. The resident was behind me the whole time making sure I knew what I was doing (or didn't do anything stupid for that matter), but she let me run the show and everything went perfectly. Such endorphin rushes have never been known!
The next two weeks I was on the urogynecology service, which involves pelvic organ prolapse repairs and pelvic slings for stress urinary incontinence. I was mortified by many of the procedures I saw and won't go into too much detail here. Suffice it to say, I no longer fancy a career involving surgery. I don't know why I was drawn to it early in the year!
There were certainly days on OB when I thought I could see myself enjoying this field as a career. I probably would. But I think the work-life balance would be much harder to attain and I would miss the variety of patients in primary care. If there is a future for me in OB, I guess the door is not completely closed with family medicine. We shall see!
Saturday, May 5, 2012
Internal Medicine: Parts 2 and 3
Oh, hi. Remember me? Time has completely slipped away from me these past few months. Case in point, my desktop calendar still reads March.
I spent 2 months on the medicine wards (I believe this term refers back to the olden days when all the patients resided on the same floor, but nowadays our patients are spread throughout several buildings) at MCV and the VA hospital. It was, how shall I say, enlightening. Six days a week, 11-15 hour days, many of those hours spent in a drab team room typing notes and calling consults with less than enthusiastic residents. There was complaining, a few tears, anger and resentment on my part. I did not like myself in this environ. And more importantly, there was no one inspiring me enough to turn my frown around. The attendings were great physicians, don't get me wrong. I learned so much these past few months. But I always love coming to work knowing there will be someone invigorating and excited to teach me something. That rarely happened these past few months.
The patients were never a problem. I got quite close to a few. I helped one gentleman work through end of life decisions. He literally begged for us to let him die as he had developed a colitis that left him sitting in a pool of his own bloody diarrhea for weeks. Another young man I related to all too well, was fighting a brainstem tumor. That kid was mentally and physically tough and easily became one of my favorites. I even got to see him a week out from his discharge and all the progress he had made. Then there were the GI patients, a meek lady with Crohn's disease and a motherly figure with cirrhosis. And the devastatingly sad nursing home patients, many suffering from neglect and malnourishment. What. the. heck. The flirtatious old men at the VA hospital. So, so many of them. They all taught me something.
Towards the middle of the two months, I started to think about an internal medicine residency: nearly 3 years of wards and ICUs and scattered clinics that none of the residents seem to enjoy, even those that claim they are pursuing primary care careers. It got me down. I don't like the hospital much or the confines of the team room or the depressed attitudes. Residency seemed like such a forlorn experience and I lost hope for myself and my happiness over the next few years. But then I started to talk to friends and mentors about it and began to realize I may have been so mentally committed to internal medicine that I was suppressing my inner family physician! And since making that realization I have been so much happier. I admitted to myself that I don't hate pediatrics as much as I have said (I definitely enjoyed my peds rotation). And I love outpatient medicine, that much I knew already. I love that family docs to be get to train in a variety of settings, including a little bit of surgery and ob/gyn. And as my mentor put it, when he goes on a medical mission trip they press the internal medicine and pediatrics folks to see what ages of patients they are willing/capable of seeing, whereas with him they simply show him to his chair. He can see anyone and be of great service in many settings. Since I am pretty sure I want to work in a rural or underserved area, this just makes the most sense to me.
I spent 2 months on the medicine wards (I believe this term refers back to the olden days when all the patients resided on the same floor, but nowadays our patients are spread throughout several buildings) at MCV and the VA hospital. It was, how shall I say, enlightening. Six days a week, 11-15 hour days, many of those hours spent in a drab team room typing notes and calling consults with less than enthusiastic residents. There was complaining, a few tears, anger and resentment on my part. I did not like myself in this environ. And more importantly, there was no one inspiring me enough to turn my frown around. The attendings were great physicians, don't get me wrong. I learned so much these past few months. But I always love coming to work knowing there will be someone invigorating and excited to teach me something. That rarely happened these past few months.
The patients were never a problem. I got quite close to a few. I helped one gentleman work through end of life decisions. He literally begged for us to let him die as he had developed a colitis that left him sitting in a pool of his own bloody diarrhea for weeks. Another young man I related to all too well, was fighting a brainstem tumor. That kid was mentally and physically tough and easily became one of my favorites. I even got to see him a week out from his discharge and all the progress he had made. Then there were the GI patients, a meek lady with Crohn's disease and a motherly figure with cirrhosis. And the devastatingly sad nursing home patients, many suffering from neglect and malnourishment. What. the. heck. The flirtatious old men at the VA hospital. So, so many of them. They all taught me something.
Towards the middle of the two months, I started to think about an internal medicine residency: nearly 3 years of wards and ICUs and scattered clinics that none of the residents seem to enjoy, even those that claim they are pursuing primary care careers. It got me down. I don't like the hospital much or the confines of the team room or the depressed attitudes. Residency seemed like such a forlorn experience and I lost hope for myself and my happiness over the next few years. But then I started to talk to friends and mentors about it and began to realize I may have been so mentally committed to internal medicine that I was suppressing my inner family physician! And since making that realization I have been so much happier. I admitted to myself that I don't hate pediatrics as much as I have said (I definitely enjoyed my peds rotation). And I love outpatient medicine, that much I knew already. I love that family docs to be get to train in a variety of settings, including a little bit of surgery and ob/gyn. And as my mentor put it, when he goes on a medical mission trip they press the internal medicine and pediatrics folks to see what ages of patients they are willing/capable of seeing, whereas with him they simply show him to his chair. He can see anyone and be of great service in many settings. Since I am pretty sure I want to work in a rural or underserved area, this just makes the most sense to me.
Tuesday, February 21, 2012
Internal Medicine: Outpatient month
And just like that my outpatient medicine month is almost over! I spent the first two weeks in a primary care clinic and now I am finishing my two weeks in the ER at the Veteran's hospital.
The primary care clinic was stressful. The way I see it, the 3rd year of medical school is all about refining our history and physical skills and improving our differential diagnoses. In this block, I was thrown into the deep end of the swimming pool and I was forced to learn how to swim. My attending treated me like an intern: I saw the patients, wrote their visit note, ordered their prescriptions and any tests or consults they might need, and scheduled the follow-up visit. All the while being hammered with questions and criticism by the attending. Needless to say, I grew some thicker skin on this rotation. But in the end, I appreciate the experience because this is how things are going to be: am I going to sink or swim...the answer is definitely swim!
Next I moved over the world of emergency medicine. And I LOVE it! The thing I was missing in the primary care clinics was being able to DO things for my patients. If they have a pre-cancerous skin lesion, I want to freeze it off. If they come in with a laceration, I want to sew it. If someone has a possible AAA (abdominal aortic aneurysm) or ascites (fluid in the abdomen due to a failing liver), I can wheel the ultrasound into the room and look for myself! And I have been getting more and more freedom in the ER. The attendings and residents have gotten more confident in my abilities (or maybe it's just that I am more confident) and I find I am getting to drive more. It's like having that learner's permit all over again. I am in the driver's seat but thank goodness the instructor has his own set of breaks just in case I muck things up. I finally feel like an almost-doc!
Next up: inpatient wards!!
Thursday, February 2, 2012
Pediatrics: Part 3
So it seems that I have failed to update in quite a while! Since my last peds post, I completed the final outpatient week on newborn nursery and an entire month of inpatient pediatrics (including night float, hematology/oncology and general inpatient pediatrics). I am going to briefly summarize each experience.
1. Newborn nursery: A great week indeed. My team consisted of an attending physician, one intern and three medical students. By mid-week the nursery was booming and that meant we med students actually got to do useful work, filling out new charts for the babies and scanning their mother's charts for pertinent prenatal information, examining our tiny patients, and giving parent talks (anticipatory guidance for new parents, signs of dangerous infections in an infant, and newborn safety information). This was actually a great experience: carrying up to 6 patients, using translator phones to speak to patients, and gaining some confidence in my physical exam skills.
2. Night float: This was an easy rotation to start the new year on since I trained myself to stay up late the week prior. I had a great time working with a small team of residents and would follow them to see any interesting cases that came in overnight. I was assigned to one of the general medicine teams so I also interviewed and examined patients we admitted to my team and I presented them to the day-team on rounds the next morning. The best part was chasing around the intern assigned to the newborn nursery. One night an infant was crashing because his blood sugar was less than 10 (normally we keep our blood sugar level between 80-100) and I got to participate in his resuscitation! Saving lives, people!
3. Heme/onc: My teammate and I started heme/onc on an unusually slow week for that service, so we initially spent our time following patients who were just chilling, for lack of a more appropriate medical term. Later in the week things picked up and we took part in a new diagnosis of leukemia including the bone marrow biopsy and enrolling the patient in a clinical trial. The moment that stuck with me was when my patient and her mom told me her hair had started to fall out one day so they decided to braid a section of hair and cut it off so they would remember what it looked like. Through the course of their treatments, these kids go through hell, but typically they do quite well.
4. Inpatient pediatrics: I lucked out during these weeks and got to follow two very interesting patients. One was in a traumatic accident and had suffered every possible complication thereafter. The other was being evaluated for a rare cancer syndrome. Though I can't say I developed a great relationship with the patients themselves (who can blame them, I was part of the team of strangers who was inflicting a great deal of their pain), I did enjoy working with their parents more than I thought I would. For the first time I understood what everyone has been saying all along, that we med students have more time than the rest of the team and we can really make a difference in patient care. I spent hours walking the halls with one patient who suffered a terrible drug reaction that caused widespread edema (fluid in her tissues) and I was able to participate in a great deal of the other patient's care including a family meeting to discuss his diagnosis and helping to create a family tree for genetic analysis.
Overall, I found I ended up enjoying pediatrics. Though I still don't think it will make my list of considered specialties, I learned a great deal and I feel more prepared for the coming months of internal medicine.
Speaking of, this was my first week on internal medicine (which means adult medicine). I am starting on outpatient medicine with 2 weeks in a primary care clinic and 2 weeks in the Veteran's hospital emergency department. More on that to come.
Monday, January 2, 2012
2012!
And here we are, just one calendar year away from graduation! This year will bring residency field selection, more Boards, and actually applying and interviewing for chosen residency. But that's OK, because we're not going to panic.
I've actually been pleasantly surprised with my lack of panic of late. Early in the year when I was liking my surgery rotation, I felt a tiny panic. Opening more doors meant decisions would be harder to make and there were still so many doors to peep through this year! But then Family Medicine came along and showed me the way (oddly enough, it showed me the way to adult primary care). The deal was more or less sealed when I started my pediatrics rotation last month. It was rough at first in my 2 weeks of community practice, and then things got better in specialties and newborn nursery (a very busy, fun week of mostly healthy infants). But even though I found myself liking Pediatrics and the practitioners thereof, it just doesn't feel right (again I said it!). And Family Medicine is out because it seems like a waste of time, time that would be better spent learning more in depth about the population I do want to see, training for a population I'd really rather not see in my practice (sorry, kiddos). So, even though I haven't actually-officially done my internal medicine rotation, it is pretty much decided--sigh of relief--.
Now I just have to get Boards Part II under my belt, a solid team of advisers, a few good letters of recommendation, and I think I'll be on my way: ready to apply for residency, that is.
Those things aside, I'm not much into resolving to do things this year. I could improve/fine-tune some personality traits like projecting confidence and remembering to be a "yes" woman. I would love to find more time for exercise and healthy eating. But you know how those types of resolutions go...
Anyway, I wanted to wish you all (how ever few of you there are) a Happy, Healthy New Year!
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