Update: Life on internal medicine

My internal medicine rotation is off to a pretty good start! I’m 2 weeks in now. I’m working at our VA hospital taking care of patients with complicated past medical histories. All of the patients that our team has taken on since I’ve been here are older men–many with poor lifestyle choices that have led them to where they are now. I’m slowly learning some of the many algorithms for treating COPD, heart failure, and kidney injuries. Since I’ve started, I have definitely grown more confident in my management plans for my patients, and become more comfortable being wrong. No medical student likes to be wrong, but I think it’s way better to still offer something and to learn why it’s incorrect, than to not offer anything at all–especially when it’s concerning your patient. I want to make sure I’m seen as an active participant in their care.

The residents and attending physicians I’ve worked with for the past two weeks have been instrumental in helping me along the learning curve. Every teaching opportunity is taken advantage of, and my questions are answered fully. At the same time, they push me to read and learn more on my own so they aren’t just handing me everything. During my evaluation with my attending, he was saying that my curiosity was one of my better assets. But he said it like three times, so in the back of my mind I wonder if he thinks I ask too many questions haha. I’m sure he meant well. But I definitely don’t hesitate to ask for quick explanations. I like to give a possible answer as I ask the question, so at least it seems like I put thought into it before just asking. Ex. “Is the reason why the creatinine levels spiked today because the patient is dehydrated? (even though that might be a complete guess)” vs. “Why is the patient’s creatinine up today?”

For our schedule, everyday starts at 7 and we’re on call from 7a-7p every 4 days which is when we get all of our admissions (new patients), whether from the Intensive Care Unit or the Emergency Department. On the other days we’re there until 4 latest, but I’m usually let out earlier. No one likes being in the hospital all day long, but call days are the best for me as a student. I get to go to the ED and see the patient first, work them up, and come up with my problem list and plan for the patient. After the resident sees them I’m able to report to them and we solidify the plan together. They teach me how to prioritize the different problems, the right wording for what I’m trying to say, and the right work up for the patient. I learn SO MUCH from just one patient (because they usually have a million things going on).



In other news, yesterday, I was inducted into the Gold Humanism Honor Society! They induct 15% of the medical school class based on nominations from our classmates and review of our CVs. I was so humbled that enough of my classmates felt so highly of me! And it’s amazing that there’s such a high honor given to students for simply being good people, no matter what your GPA is.


SN: Today was my first day off in a while. So refreshing, even if most of it was spent studying. I look at the residents and just wonder how I’m going to be able to handle the workload they have. Hats off to all the residents out there!
– Today was also the first time one of my patients died, ironic and sad that I wasn’t in the hospital to be with the family 😦

SSN: Congratulations in advance to all the 4th years matching this week!!! May God’s plan for your lives manifest in entirety.

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Ushering in the new year!

Including a prayer for 2018

Just like that another year is over! To everyone, Happy New Year! Getting through this year was such an accomplishment for me as a third year medical student. This was the year that I battled to the top of the mountain of my medical school career and then started my descent. Going into 2018 means going into FOURTH YEAR–otherwise known as the promise land. I’m beyond excited for all this year will bring. This time next year I’ll be finalizing my rank list for residency. I’m so amazed and grateful at the way God works in my life. I have come SO FAR. Like 2017, 2018 will bring it’s share of joy and hardship. But I will continue to keep God at the center of everything I do and every decision I make, and His favor will give me the confidence I need to prosper. I still need to write down and cement my 2018 goals, and I encourage all of you to do the same.

This is my prayer for 2018:

Lord I pray that you will carry me and my family through 2018 in good health.
I pray that you will continue to increase me as I walk in my purpose this year.
I pray that no thoughts of self-doubt are produced in my mind this year, and if they are, may they be driven out by the power of the Holy Spirit.
Give me strength and motivation in the moments where I can’t find it.

May this year be filled with only your will being done my life and those of my loved ones.
I pray for wisdom and the spirit of discernment to know who and what is from You and deserves my time and energy.
Lord please watch over me as I continue on this path to become a healer of your people.
All these things I ask in the mighty name of Jesus, Amen.

I’m ready to prosper in 2018! Are you??? And I’m excited to continue sharing my journey through this blog! Have a safe and Happy New Year, see you in 2018!

How you can make a difference as a medical student on rotations

We play a small but mighty role in the lives of our patients!

It can be pretty hard sometimes to find your place as a member of the “team” while you’re on your rotations. Speaking from experience, it’s hard to feel like I’m making much of a difference. After feeling good about the patient encounter and presenting everything to the attending (including the correct diagnosis for the patient), they come in and ask all the same questions and do all the same physical exam! Of course I understand why, but I can’t help but feel a little undermined at times. If you’re in a big hospital on a team with interns and residents then you might feel even more useless, because the students in training do all of the real work. I remember feeling lost in the shadows my time on a hospitalist team. Technically I was following my own patients and would present on them, but after rounds I was pretty out of the loop, unless I forced myself into it (and I didn’t want to be that girl). So it can be pretty frustrating. But rest assured, there are ways that you can impact your patients unlike any other person, as well as make a huge difference for your care team.

We’re eager and fresh in this new environment. We haven’t been jaded by the system and we only want to do the best by our patients. Our hearts tug when we hear bad news; we give people the benefit of the doubt; we believe it when they say they’re taking their medicine. This is such a meaningful thing that patients actually notice! There’s a difference in the way a medical student talks to them versus an attending. We show them the compassion, care, and empathy that they truly need and sometimes don’t get. There are times we can do more for them than all of the medications and tests that the residents are ordering. We have the time to sit with them and get to know them more personally. This especially goes if you don’t have to write notes after your patient encounter. More practically, there are many things you can do to be a rockstar team member: print rounding reports, gather new data on patients, do extra research on topics you or the residents may be pimped on, etc.

I’ll always remember on my OB/GYN rotation, there was a patient whose child had to be transported to another hospital while she had to stay to recover. It was so hard for her to be separated from her child. I came in during pre-rounds and was a soundboard for her to express her feelings. I told her that she was going to be a wonderful mom and that the time would soon come for her to be reunited with her child. I stopped in again later in the day, and as she was being discharged, she thanked me so much for being her rock as she waited for the go-ahead to leave the hospital. And she gave me the biggest hug. She said people just came in and out of her room all day and no one cared what she was going through. In that moment I felt like I did more for her than any of the nurses or even my attending–who really just signed her discharge papers.

So just remember that even though you might not have access to the computer record to look up patient info, or you might be the third person to take the same patient history, you really can make all the difference in a patient’s life. Our worth as medical students is unfortunately defined by how good our oral presentations and differential diagnoses are. But our worth as physicians is really in the connections we make with patients and in the rapport we build with them. That’s what makes all the difference. While learning to be good clinicians, we are also learning to be good doctors.

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Have a wonderful week! Subscribe on your way out if you haven’t already!

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Life and Death

A week of palliative care has shown me a lot

I’ve spent a week on my palliative care rotation and boy has it been heavy. Palliative care is focused on quality of life and relief of symptoms, especially towards the end of life. I’m assigned to a nursing home, so not only am I exposed to end of life issues, but I’ve been able to learn about geriatric/elder patient care in general. I did a puzzle with a 94 year-old in occupational therapy and I saw a patient around the same age in her last days of life. It’s been quite the ride.

Earlier in the week I was part of a very delicate conversation concerning one of our patients nearing the end of life. It was a team meeting with the patient’s son and grandson. Our medical director asked questions like “how do you envision a good death for the patient?” and “what are your goals for the end of life?” They were trying to think about what the patient would want, as he could no longer speak for himself. Such a delicate time for the family.

Dealing so much with death and end of life has actually made me reflect a lot on life and how we all want to life full lives. And even at old age, after living a full life, death can still come suddenly to a family. There’s never really any way to prepare for that conversation. But it’s a reminder to live each day to the fullest and take advantage of all the ways you can make a difference in people’s lives. To pursue your passions and not put a hold on your goals for life. Because at the end, we aren’t all going to be blessed with the opportunity to plan out how we or our loved ones will leave the world.

As a future physician it’s nerve-racking to think that I’ll have to have these kind of conversations with patients and their families as soon as my first year out of school. So I’m happy to be getting the small exposure I am now so that maybe when I’m more important I’ll be able to guide a family through such a vulnerable time as this.

One more week of palliative care, then Family Medicine. Stay tuned. I’m excited for the week ahead!

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How to keep fighting the good fight

What do you do when you’re ready to throw in the towel?

It doesn’t take much time after starting school that all the excitement gets sucked out of everything and you’re just fighting to stay afloat. That’s not a very optimistic statement to make, but there’s some truth in it, especially in medical school. There are random moments when you’re reminded of why you’re putting yourself through such suffering, but they seem few and far in between, until you get to the clinical years. For the first two years of med school, lots of people use the swimming analogy: everyone is just trying to stay afloat. There’s times when you’ve got your stride and you’re cruising, and at some points (most points) you’re barely making it, swamped by the waves that keep coming and coming…and coming. It takes so much effort to stay afloat, eventually your body gets tired, and you want to say screw it. But you can’t. Because you’re supposed to get a couple letters behind your name soon, and you really want those letters.

So what do you do? Here’s some tips from my experience on how to keep fighting the good fight.

  1. Keep good friends around you–I don’t use the term friend here loosely. When Isay friend, I mean someone you can confide in, who knows your weaknesses, who you don’t have to explain yourself to, who only wants to uplift you. When we share our joys they are doubled, and when we share our burdens, they are halved. Medical school isn’t meant to go through alone. It’s important to have friends around you that can encourage you and tell you that you can do it when you don’t believe in yourself. Watch the people you surround yourself with, because negative, toxic friendships can easily add to hardship. happy dog sad hug adorable GIF
  2. Don’t rely on your own strength–We are all strong people, especially to be in this field. We know how to fight to stay up late or wake up early, study harder to get the results we want. But sometimes the fight just isn’t in us. Human strength isn’t always enough and we need to call on God to give us the supernatural strength and power we need to persevere. Surrender it to Him and let him take control. Staying faithful in the Word and strengthening your spirit can help you tap into that power on demand.
  3. Have an outlet/escape–It feels like my life is consumed by medicine, especially so back in first and second year. I found that it was actually harder for me to stay afloat when I convinced myself that I didn’t have time to refresh and do things I enjoyed. I would envy people who had time to keep up with TV series until I realized that they were making time for things to let their brains escape while I had mine on lock down. I learned that taking breaks can actually make your time studying more efficient. So when you feel like you’re ready to throw in the towel, do it. Refresh. But only for a little while.
  4. Give yourself positive affirmations–write them on your bathroom mirror, put  write you are beautiful writen GIF hem on your screensaver, leave sticky notes around your room, recite them to yourself every morning. Positive affirmations help increase your mental toughness, so when doubt, weakness, or negative energy comes your way you can easily block it out because you’re full or positivity. Examples include your favorite uplifting quotes, bible verses, or simple phrases such as: “you are smarter then you think,” “I am powerful,” “I’m going to be a doctor one day,” “You make the world a better place,” “you are important.” You get the idea.
  5. Trust the process–The road isn’t easy and it’s not supposed to be. This profession isn’t for the weak hearted. The process is meant to test you, sharpen you, grow you. We all struggle. When someone on the other side tells me that everything is going to be OK, it’s hard to swallow in the moment. But then I cross that hurdle and realize that they were right. When the going gets tough, instead of getting worn out, we have to trust that we will be better professionals because of this, and let our future selves motivate and pull us through.

Thanks for reading. If you liked this post, check out this one on Embracing the Journey! Subscribe below for more updates from The Balancing Act.

The medical tag

15 questions to learn more about me and my blog

Check out my answers to the 15-Q medical tag to learn more about me and my blog! 

  • Who are you?
    I’m Ijeoma Okoye, a 23 yo first generation American, and third year medical student at the Medical College of Georgia. I like sunsets, long walks on the beach, and the occasional ratchet turn up.
  • When did you start studying medicine or premed courses?
    I began premed studies in 2011 at the University of Georgia and matriculated into med school in 2015 directly from undergrad.
  • What made you choose the medical field?
    Both my parents work in healthcare, but really it wasn’t until high school when I decided to pursue medicine. The only subjects I liked were math and science–I was your typical nerd. I only liked math because I was really good at it, but with the sciences I actually enjoyed the study. I contemplated pharmacy because of all of the chemistry but then considered my personality–how much I like talking to patients, how I wanted to be challenged, and the level of autonomy I wanted in my career–and I landed in medicine.
  • How did you come up with your blog name/username?
    My life has been a balancing act since college as a pre-med, and I don’t think it will ever stop. I think it’s something all pre-health and health professional students can relate to–this constant juggling between our identities as students, leaders, siblings, friends, regular people, etc. It just resonates. My content is also reflective of this balance and I feature people who can speak to the same.
  • How would you describe your blog?
    I’d describe my blog as the perfect blend between encouragement and entertainment for the health/pre-health professional student. I write very casually and lightheartedly but I cover things that are important to touch on in this journey into the healthcare field. I’m honest and transparent with my followers. As a minority blogger, it’s especially important to me that I put myself out there so that other minorities on the ride with me stay encouraged by seeing my journey.
  • What’s your favorite quote?
    – In life, you get out of it what you put into it
    – In all things, we are more than conquerers through Him who loved us
  • Best memory in medical school?
    My roommate and I hosted Christmas parties for our class during our first and second years of med school and they were always so much fun! Med students party way harder than I expected. Must be something about the stress….
  • What’s one course you struggled with?
    I struggled with GI a lot. Whether it was the anatomy with the blood supply or the physiology with all of the different hormones, or the drugs, it was just so hard for me to wrap my head around. I ruled that specialty out very quickly. Even while studying for STEP1, it was always my lowest section and unfortunately I don’t think I ever really conquered it. No success story this time around lol
  • What’s your favorite book?
    I’ve read very many great books, even just in my time in medical school. I think my favorite would be The Alchemist. It’s timeless.
  • What do you do in your free time?
    What free time? HA. No, I’m kidding I do try to make free time and these days when I get some time I will read, blog, exercise, clean, cook, watch a TV show/YouTube videos, call my parents, bother my roommate, call my boyfriend, look up new hairstyles, or hand out with friends if they’re also free.
  • What do you want to major or specialize in?
    I want to do primary care, and leaning towards Family Medicine right now. But I also want to own a gym and do personal training on the side.
  • Who do you look up to?
    My sister, my mother and father. I’m so blessed to not have to look far for role models.
  • How do you study (productively)?
    First step-put my phone on do not disturb and turn my notifications off on my laptop. Second step-establish my game plan for that chunk of time, always keeping it realistic. Then I just jump in. First and second year it was one lecture at a time, one slide at a time (our school does a lot of powerpoint) taking notes on paper or electronically as needed. Now that I’m in third year, it’s watching videos/taking notes, supplemental readings, and boat loads of practice questions
  • How do you stay motivated in medical school?
    I’m self motivated for the most part. But when that eventually fails, I’m motivated by those around me, so I will study with someone and feed off of their energy. If that fails or I don’t want to be around anyone, I think about my future patients and how I need to learn this stuff for them. When that fails, I pray for strength. Sometimes I feel like even that fails and at that point I just need to take a step back, breathe, maybe go for a walk, and come back to it (maybe even the next day).
  • What are your best tips for future medical students?
    First of all, don’t compare yourself to anyone else, because we are all meant to follow different paths to our end destinations. If medicine is truly the path for you, you will get there as long as you keep working hard, surround yourself with the right people, and cancel out any negativity or doubt that tries to come your way. When you get to medical school, buckle up! This is not for the weak hearted. That phrase that the hardest part of medical school is getting in is a lie! But you will learn so much about medicine and about yourself; all of your labors will not be in vain and you’ll find that it is indeed so, so rewarding.

I hope you enjoyed the read! Please subscribe on your way out if you haven’t!

Hello from the other side!

Post STEP: How the day went, some test details, and how I feel now!

I’m officially on the other side! Who knew this day would ever come. I am so elated to be done with this beast that’s been riding me all summer. And before I even get on with this post, I really want to sincerely thank everyone who reached out to me through all mediums leading up to my test, and even during my test. It helped SO much to go into the exam knowing that I had so much support and so many people rooting for me!

Like I said in my last post, I had let go of all the negative energy the night before my exam, so I was feeling pretty calm as I got in bed and even when woke up the next morning. I had everything packed to the tee and just as I was saying goodnight and ready to get in bed, my mom offers to pray for me. If you’ve ever heard any African pray then you know that took an extra 15 mins away, but I wasn’t complaining! I went to bed feeling very anointed. It took me a while to fall asleep–not because of anxiety, but because my body just wasn’t used to being in bed so early. But regardless, I slept fine, and woke up well rested before my alarm went off (also thanks to my mom who thought I was oversleeping).

From there, the day went smoothly just as I had rehearsed (yes, I had practiced this day a few times in the past with various practice tests). Everyone’s messages and prayers kept me calm and there were some residents at my center taking STEP3 who gave me some encouragement too. I locked all my stuff away (including my sweater which was “too thick” to bring into the room SMH), and led me to my seat and then I was alone. I was like oh boy Ije this is it, it’s happening, this is the moment you’ve been waiting for. Then I prayed, then I started, and then I finished–literally in the blink of an eye 8 hours went by. I was in a vortex. Quite anti-climactic I must say. When it was over I was thinking so this is what all the hype is all about huh.

And I don’t say that because I slayed the test and I’m walking out like it was nothing (absolutely not!!), it’s just that it wasn’t the big scary monster everyone makes it out to be. The test itself wasn’t any different caliber of questions from the thousands I’d seen from Q-banks and NBME exams (some of them were just out there though; I think they made up some diseases that don’t exist lol). I used the same skills, knowledge, and brain power that I had been acquiring. Only difference was that this was the real thing. I couldn’t just finish and check my answers afterwards and learn from my mistakes. This was it. Period. So that obviously added a different air to everything, but I tried not to get caught up in that so it wasn’t as nerve-wracking.

The exam is 7 blocks of 40 questions, and each block had its own feel to it. Some were heavier in things I was unsure about and some went by more smoothly. I only had to use the calculator once, and it was baby math. I had prepared to go ham on some statistics questions! But again, not complaining. The pharm was straight forward, the anatomy was all over the body, and it had more embryology than I expected. There were very few, if any, first order questions–knowing the diagnosis only gets you so far. Overall I don’t know how to feel in terms of whether or not I met my goal score, especially after looking up answers to questions I remembered that stumped me (which I was warned not to do but still did anyways). What I do know is that I did my absolute best and now its out of my hands. I was locked in focus throughout the entire thing. I hated the times when I was torn between answers and changed them, because I know that’s a dangerous game for me to play. But as each block ended, I put it behind me and moved on, because that was all I could do.

So now that it’s over, I feel very accomplished. This was a big step (no pun intended) for me and I made it through! I’m proud of myself for having the discipline to sit my butt down for 15 hours a day to study, because that work ethic is what brought me through to this point. On the flip side, I feel like I’ve sort of lost myself a little. I came home from my exam and just sat down in the living room in silence because I didn’t know what else to do. And I couldn’t even remember what the pre-STEP me would have done with her free time. It was weird. But with time I’ll ease my way back into being normal again. I got a month to not think about it until our scores come back! I’m just going to enjoy the free time that I have until third year starts in 2 weeks. Good bye classroom, hello hospital!


My Take on Black History Month

Reflections on the month past, from my perspective

black-power.jpgAt this point in my life, Black History Month isn’t about the focused history lessons and bulletin boards around school anymore. We don’t get assigned famous African Americans to do projects on or do an obligatory reading of the I Have A Dream speech. When I think back over the month, no one was really required to think about the time as special, especially those outside of the minority group with little routine exposure to black culture. For me, it feels like as I get older it’s up to me and fellow minorities to keep it relevant for those around us–rightfully so. I’m thankful to be part of organizations like SNMA that celebrate and promote black history nationally, and to be friends with so many others that used their social media platforms to do the same on a smaller scale.

With Dr. David Satcher, former US Surgeon General and keynote speaker for the 50th anniversary celebration.

A couple of weeks ago, my medical school celebrated 50 years since its desegregation in 1967. So Black History Month had a much deeper resonance for me, as I shook the hands of Dr. Frank Rumph, a man who made it possible for me to sit where I’m sitting now. Fifty years ago, he and Dr. John Harper (who passed away in 2016) decided to accept the invitation for admission and get their medical training from MCG. I’m not sure if the weight behind that sentence really comes across. For context: MCG accepted black people because they were going to lose federal funding if they didn’t, not necessarily with wide open arms. These men knew their journey wouldn’t be easy and yet they had the courage to take that step and persevere as pepper flakes in a sea of salt. Both would later go on to work with admissions to ensure the door stayed open for more students of color.


With Dr. Frank Rumph, member of the first desegregated class at MCG

I attend a predominately white med school and I’ll admit that sometimes it’s just exhausting feeling like you have to choose your battles, watching everything you say and how you react. And sometimes you feel like you’re belaboring a point when you want to br16995949_10212733505594990_332141279675699729_n.jpging up topics that are close to home. It makes you naturally turn towards those who look like you because you know that they will understand, and you don’t have to use filters when you talk to them. I couldn’t imagine being in school during a much more racially tense time and not having someone to turn to outside of one other classmate. The stress of constantly having to hold my tongue and watch my back would wear me out. Dr. Rumph and Dr. Harper stood strong, pushed through, and were successful despite the odds against them. I’m inspired to do the same.

Black History Month was a wonderful time to celebrate and pay homage to those who came before me–in medicine and just life in general. With all that’s going on in the world, I’m reminded that it’ll be a while before I feel fully accepted in this country. But being able to remember those heroic individuals who made life as I know it possible gives me hope and resilience as I continue along on my journey. I’m so grateful to God for placing trailblazers on this Earth and equipping them with the tools needed to weather their storms. The past 28 days were dedicated to them. Unfortunately most will tuck these notions away until this time next year, but I implore students to use their leverage to make sure that doesn’t happen–especially those in leadership of ethnically based organizations. Minorities are here to stay, and our issues and emotions are just as relevant and valid as the majority. 

“You can’t be hesitant about who you are.” – Viola Davis

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