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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Trauma Surgery: Expectations vs. Reality

When I signed up for 2 weeks of Trauma surgery in my third year, I just knew it was going to be action packed. I wanted to get out of my comfort zone and be pushed to work under pressure. I even figured doing it at my institution would be the best place because we’re the Level 1 trauma center in our area. I really imagined it being a highlight of my clinical rotations. ABCs, ex laps, chest tubes, gun shots, all of that! I was ready. So just imagine the look on my face (well, the thoughts in my mind since I’ve learned how to save face) when my classmate and I meet our resident on the first day and he says “you guys don’t go to the OR on this rotation.” All my dreams were crushed.

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We work with the resident who manages the patients on the floor. It’s our job to read up on the patients hospital course and answer the question What’s keeping them in the hospital? So I just get to read about all the crazy stuff that happens as opposed to being let in on all of the action. Basically feels like any other inpatient medicine service. We get to the hospital early to pre-round, then round with the trauma team, then follow up on what we need to do for the patients based on rounds. At this point, we (medical students) are sent home and the resident stays behind to man for floor. We don’t have access to put orders in so it’s really hard to be useful.

So am I learning stuff? Absolutely. Management of the complex injuries in patients with gun shots, stabs, falls, electrocutions, etc with different hospital teams coordinating their care is super educational. Right now, I have 5 patients that I’m following, and each of them are teaching me something different. However, it’s definitely not the experience I was hoping for. I guess it’s still a part of trauma surgery. But when you don’t plan on going into surgery, you really want to see as much surgery as you can. So that was disappointing. I did get to go to the OR once and that was for my patient who needed debridement of his foot wound (exit wound from a 14000 volt electrocution). I got a really good lesson/review about burns from my attending that day. (In case you didn’t know, there’s no such thing as 1st, 2nd, 3rd degree burns anymore–they’re changing the terminology to superficial/deep partial thickness and full thickness burns).

With my shelf exam coming up on Friday, I’m actually really not pressed to be in the OR very much anyway since I use every free moment to study, and each day is basically a half day. If I had this rotation toward the beginning of my 8 week surgery stent, I’d be pretty unenthused about it. I’ve just never heard of a surgery rotation where you don’t…go to surgery! But anyway, please keep me in your prayers for my shelf exam this week! I’ll write another post about my study resources/schedule for my preparation, but for now it’s back to work!

Thank you for reading! Enjoy your week! Subscribe on your way out if you haven’t already!

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How to be the most efficient with your study time

In third year, you lose control of your schedule and are left at the mercy of your dead fuck my life GIFattending and residents. With the early mornings and early evenings, by the time I get home, I only have a few hours to study. Especially if I go to the gym, things are even more constrained. And I’m not the type to stay awake late, I’m surely in bed by 11. So, when I sit down to study, I have to be efficient. Here are some tips to help you maximize your time.

First and most important is to make a SCHEDULE. Before you sit down to study, you should already know what you’re about to accomplish. This way you keep yourself on track and can sense if you’re getting behind. You can do this day-to-day with to do lists, but to be most successful, you want to make this schedule at least on a weekly basis. On Sunday, you can generally map out what you plan to accomplish that week. Then each day, before sitting down, review that plan and make amends based on the amount of time you have to study that night. Particularly during third year, when you already know what resources you want to get through, you can actually plan out your study schedule entirely before the rotation starts, then make changes to it as you go along (this is what I do).

phone call GIFWhen you sit down you need to minimize distractions. Turn your computer notifications off and put your phone on do not disturb. I usually keep my phone in another room or on the floor out of my sight. You can check up on messages/DMs/snaps during a break, but never mix your studies with your social life if you’re trying to be efficient. If you aren’t in an ideal location, plug your ears or listen to your favorite background noise with headphones.

Take advantage of your time during the day to decrease the amount of other random things you need to do at night when it’s study-time. Respond to emails, online shop, do busy work for school, work on the application, etc. Do these more mindless things before trying to squeeze in studying during the day–which actually requires brain power. So when it’s time to focus on studying, you won’t have so many little tasks to complete beforehand and waste time.

Lastly, you need to intentionally prioritize your studying. Seems intuitive, but if you don’t believe that your readings/questions/review/etc. are top priority in that time period, you will easily find distractions and reasons to do other things. You might find yourself cleaning something, constantly getting stuck on instagram, fiddling with another hobby of yours, or caught up on the phone with friends/family. So when you say the next 2 hours you are going to finish X, Y, and Z, you need you be firm and really mean that!

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Hope these tips help you next time you prep for a study session! Have a wonderful week, and Happy Valentines Day in advance!

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Life in the fast lane

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Me trying to catch up with life

We’re 3 weeks in to 2018 and I already feel like my life is propelling way too fast. During first and second year it was just one day at a time, one block at a time. Last semester for the most part was just one rotation at a time. But now all of that has changed! A week into January, we had to declare our specialties to our school and got advisors in our fields to help us moving forward. I proudly declared Family Medicine, which I’ll probably go into my reasons in another post. Then 2 weeks later they opened up the portal for us to plan out our entire 4th year! We have to determine when we want to do electives, away rotations, and our core rotations for the year. It’s a tad overwhelming for someone who barely even has a list of residency programs she’s interested in. I thought that would be my first step, but nope!

In the midst of all that, I submitted my application for STEP2, which cost me $1895 (should be illegal the way people make money off of us). I’m still traumatized by STEP1 and I’m already planning for the next test, which really shouldn’t be as bad from what “they” say. Meanwhile I’m only 3/8 weeks into my surgery rotation (which I have surprisingly been loving!) and I’m just trying to get through my UWorld sets and pages of Pestana’s each night!

Ish is getting REAL y’all! Everything is snowballing. Today I’m thinking about my surgery shelf exam, tomorrow I’ll be checking my email for the notification that I matched (in Jesus name). I’m excited to keep moving forward, but a piece of me kind of wants things to slow down again so I can wrap my head around it all and feel a little more control. I just feel this sense of unpreparedness, but everyone just says that everything is going to work out so not to worry. Easier said than done if we’re being honest. I’m a medical student, it’s kind of my nature to worry.

But these are problems that I’m grateful to have. Honestly, I couldn’t ask for better problems. I’m confident that in the end, everything will indeed be just fine, even if the path from A to B doesn’t look very clear at all at the moment. In the meantime, I’m still forcing myself to take things one day at a time, because I don’t have the energy to spend on stressing myself out, especially when I serve an awesome God. *kicks feet up*


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