Senior Banquet Update June 4, 2009

As I noted in my post yesterday, I missed the big Senior Class Banquet due to my little brother’s graduation.  However, at the smaller affiliated school banquet today I got filled in on all of the details!

During the senior superlatives, the MC noted that the next particular winner had a blog.  He talked about reading the blog daily to keep up with my life.  I supposed at that point, the people in my class that knew I had a blog knew the award was for me… Most Likely to Become Department Chair!  I thought that was a good fit considering my love for orgnizations, leadership, research, and the fact that I’m going on to residency at an academic institution.  I guess we’ll see 20 years from now if that came true!

In addition to the superlatives, they distributed the yearbooks.  I can’t wait to see the yearbook since I worked on 6 of the pages.  Despite missing the drunken festivities at the senior banquet, I’m sure the yearbook will have captured the essence of many of my memories over the past 4 years.  Tomorrow I’ll be Dr. Med Obsession!  I guess I may have to adjust the header on my blog… no longer my life as a medical student; it’ll be my life as a doctor .

AOA Banquet June 2, 2009

Well I have now officially been inducted into Alpha Omega Alpha.  Earlier in 4th year I was selected and paid dues, but the ceremony had not yet been held.  It was different than other honor societies that I have been inducted into in college.  There was no oath we had to recite or true induction rights.  Anyhow, we did get a little bit of the history of AOA and our names were called as we were presented with a certificate.  We were also given a lapel pin with the University seal.

Before the ceremonial portion, we had cocktail hour.  Unlimited beer and wine plus hors d’oeurves.  I suppose since I hadn’t really eaten much all day, I really felt tipsy after just one glass of wine!  It was fun seeing several of my classmates that I hadn’t seen since Match Day.  They all were so surprised and excited for me that I had gotten engaged.  One of the great things about the night was that my mentor for Ob/Gyn was our Honorary Inductee for AOA.  It was great getting to see her one last time before going off to internship.  She was so supportive throughout the application process between selecting sub-I’s, writing me a letter of rec, reviewing my personal statement, and just general advice.  Tonight she had even more advice and well wishes for my internship and wedding planning.

After the cocktail hour and dinner, we were inducted as I described above.  It was nice to meet the 3 juniors that were selected as junior AOA as well.  The night ended with lots of pictures and smiles.  The first banquet was definitely a memorable one!

Transition to Internship May 21, 2009

As you may have gathered from my blog, the second half of 4th year is pretty relaxing.  Personally, I finished my all of my requirements for graduation on March 28.  Since then I have not even touched a book… well, except when I was packing them up for my move to my residency city!  So you can imagine, by the time I start internship, a full 3 months will have passed since I’ve been in a hospital treating a patient.  For those of you outside of medicine, that’s a long time.  There’s a reason that vacation time is limited as we started our clinical rotations.  You can get rusty pretty quick if you aren’t thinking about and practicing medicine on a daily basis.

My lovely medical school thought of a remedy for this gap in time, and for internship anxiety.  They offered a one-week “Transition to Internship” course in conjunction with our simulation center.  I am halfway through with the course and couldn’t be happier. Each day starts with 3 lectures, then a lunch break, and finally an afternoon of different simulations. So far we’ve had morning lectures on topics ranging from acute chest pain, dyspnea (shortness of breath), shock, and even a panel from current interns and cheif residents.  In the afternoon we went on to the simulator where each of us had to individually act as the patient’s doctor.  Thus far I’ve had to sort out diagnosing and treating a supraventricular tachycardia (heart beating very fast), a tension pneumothorax (lung collapse under pressure), and septic shock (inadequate blood flow to organs due to an infection).  We also had simulations where patients had problems with ventilator management, and how to place lines (arterial, central, and IV).

Talk about a crash course for internship!  Making some of these diagnoses seems simple enough, but when it’s on a patient simulator and you are watching the patient’s blood pressure tank and desat (oxygen levels drop) in front of you, you have to have a nice differential and begin treating quickly.  With the first few simulations I was pretty nervous and also frustrated on how long it takes to get a chest x-ray or labs back.  On any standardized exam, all of the info you need for a diagnosis presented in a question stem that can be read in 30 seconds or less!  The simulator forced you to use clinical judgement without all of these tests being ready instantly.  It was also funny because our attendings would act as the nurse and sometimes try to steer you wrong.  For example, for my septic shock patient my “nurse” was asking if I wanted to start dobutamine as a pressor for the blood pressure.  This is a case where you wouldn’t want to do that because the patient already has decreased vascular resistance and the drug would make it worse.  I had to tell him to start norepinephrine and the patient did alright!

What this week has showed me is several fold.  Of course, I still have so much to learn.  However, I really have come a long way from my first simulation as a 1st year where I would be afraid to speak up.  Here I was coming up with differential, ordering labs and imaging, and starting appropriate treatment on my own.  I learned when to call for help as well.  If you get to a point where you don’t know the dose… call Pharmacy.  If you are just in over your head, call your senior resident, shoot you may even have to call an attending.  And of course, get other specialties like cardiology or general surgery involved if need be.  I found this course to be invaluable and can’t wait for these next 2 days of class.  I feel a bit more ready to start internship now that my mind has been jogged.  I have to remain confident in my abilities (although not overly so) and be ready to hit the ground running in a month!

No More Short White Coat! March 27, 2009

Today I finally get to retire the short white coat.  It’s a bittersweet moment.  I mean, seriously.  I remember starting medical school like it was yesterday.  The culminating event of our first year orientation was the White Coat Ceremony.  Everyone had their family and friends there.  We were in an auditorium and our name and undergrad was called as we took the stage to put on the white coat.  I was so happy!  No longer the premed… the white coat was like a status symbol.  I was now a professional student.  Instead of merely shadowing, perhaps I would be able to interview a patient or do a physical exam.  Every time I would visit my preceptor during first and second year, I would be excited to pull out my crisp, piercing-white coat!

Then came third year.  The coat became less starchy… perhaps a little less white.  Instead of it being a status symbol, it was a way for the asute patients and nurses to quickly identify that you were at the bottom of the totem pole!  Everyone knows that the medical student coat (at least at the majority of US medical schools) is short.  It also became a source of neck and upper back pain since I had it loaded up with every resource you could imagine: stethoscope, pens (several since residents never give them back), pen light, PDA (10lb right there!), Maxwell, folding clipboard, front pocket notebook for personal notes, larger notebook for patient intake notes,  pocket medicine (or Ob/Gyn for Clinicians AKA the red book, when on those rotations), reflex hammer & tuning forks (for Neuro), trauma shears, etc.  Man, that’s alot of stuff!

Fourth year came along and by that time I was smart enough to have a second white coat in the laundry rotation.  The pockets were still full, but I removed quite a few of the extra items that weren’t applicable to that rotation.  I even carried fewer pens, and just had the guts to ask for my pen back immediately after use by any resident or attending.  I did 7 weeks of Ob/Gyn sub-internships, 6 weeks of research and 2 weeks of anesthesiology that didn’t even require me to wear the coat!

That brings me to today… my final day of rotations as a 4th year medical student.  I cannot believe that it is over.  I will forever be Dr. Med Obsession, instead of “Med the 4th year student” or “my medical student.”  I am having a hard time realizing that I will not have a purpose to wear the short white coat.  Perhaps when internship gets rough and I want to reminisce about the great medical student memories.  I have the next 3 months to enjoy life before internship starts.  I suppose in that same 3 months, I may need to get some reading in so that I actually deserve for my coat to be a few feet longer!

Match Day! March 20, 2009

First of all, I want to say sorry for not posting yesterday (Match Day)… it was truly a busy day and I wanted to give you all the quality posts that you are used to .  Hopefully you at least saw my Twitter status with the great news!

So I show up to my match celebration 15 min before the refreshments were to begin being served, which was an hour and 15 min before we got to open our envelopes.  I was so nervous that I literally ate only 3 grapes and 2 orange slices!  I was running around talking to everyone, wishing them luck, etc.  The one day that I chose to actually be early to an event and it was driving me crazy.  About five min before it was time to open the envelopes my Dean took the stage to share some stats.  Apparently 78% of the class would be staying on the same coast – with 40% staying at hospitals affiliated with my home institution, and 24% at my home institution specifically.  As far as specialties go, 32% went into primary care, followed by 21% in surgery/surgical subspecialties, and 9% in radiology.  “All others” made up the remaining 38% (with 8% being Ob/Gyn).  Clearly I was distracting myself from the anticipation by taking notes!

Then the clock strikes and my Dean has all of our family and friends go outside to the terrace.  I had no idea what was going on.  I thought they were going to make us open the envelopes in solitude or something crazy!  Then we are told to go outside.  All of our envelopes are taped to the window in alphabetical order.  I find my envelope and grab my boyfriend.  We walk all the way to the back corner of the terrace.  I really only wanted he and I to be a part of this moment.  I flip my envelope over to open it and there’s a photographer standing right there!  So much for privacy.  I tear into the envelope (and the letter) and unfold it frantically.  There it was… the name of my #1 PROGRAM!!!  I started jumping, and laughing, and smiling.  I hugged and kissed my boyfriend so many times.  He did such a great job of capturing it all with my camera.  I was in total disbelief at what I was reading.  I must’ve read #1 program’s name over and over and over.  I actually took a picture of it to be sure!

Next I proceed to call my parents who were both excited.  I also called my best friend who got her #1 program as well!!  I spent the next hour running around to all of my classmates to see where they were going.  It was such an intense experience.  There were tears of joy and tears of disappointment filling the room.  There were hugs and kisses, screams and laughs.  Such an intense amount of emotion it was a bit overwhelming.  The hardest part was seeing the faces of the classmates that I knew didn’t get their first choice.  I suppose that’s the downside of the 3 week waiting period.  By the end, people were alot more open to sharing where they were going to end up.  So when I asked where they ended up, we both would know that they didn’t get their number 1.  Even more shocking was a classmate that was a stellar student, had stellar interviews, great personality, and got their 4th choice.  This classmate was just in shock… it’s still an amazing program, but since we’ve talked about it extensively, I knew how heartbreaking it was.  In the end though… at least we matched!

I spent the rest of the day eating and drinking.  First with my boyfriend.  Then with a few of my close classmates.  Then with my best friend and her classmates at a neighboring school.  The night concluded with me putting the final touches on my poster and heading off to the club and dancing the night away.  I suppose my school was smart for making us have to be at school the next morning for poster presentation set-up at 8am!  I definitely drank less and came home earlier because of that obligation.  That won’t stop me from partying tonight!

My last point, for those readers that have not yet applied, I will update my “Numbers” posts under the USMLE Books & Advice page if it may help to give you insight.  If I could match my #1, so can you!!

MedObsession on Twitter March 7, 2009

During the election I was pretty hooked to CNN for the political commentary.  The broadcasters used to always talk about Twitter.  They would post questions and then read the comments live on air.  I had forgotten about it until recently.  My intern has a crackberry like me and was on “TwitterBerry” one day.  He instructed me on the ins and outs of Twitter.  Basically, it’s like constant facebook status updates.  People can become “followers” of your page to stay up to date with your posts.  You can also reply to other posters’ updates as well.

My first reaction was that this seems way too invasive!  I heard that there was a celebrity “twittering” during the delivery of her baby.  So I immediately deactivated my personal twitter.  I decided that only my close friends and family need to know what I’m doing moment-to-moment, and they can get all the updates they need by calling and texting me.

However, I thought about my readers.  My blog has had increasing numbers of readers, with 4800 views alone last month!  I know that my time during Ob/Gyn residency will be limited, and thought this could be a good way to still stay in touch with my readers.  I created a Twitter page for my blog: http://twitter.com/MedObsession, this link is also post on my blog roll.  I’ve also subscribed to my own RSS Feed and displayed it in the right-hand panel under “twitter updates.”  For those of you that don’t have twitter you can read the updates on my own blog.  For those that do, you can click on each of the status updates and it’ll take you to the page to favorite it or to reply!

We’ll see how long I keep this up…

Only 1 More Rotation! March 6, 2009

Today was my last day on the Endocrine Consult service.  It was pretty interesting since I saw quite a few pituitary tumors (non-functioning adenomas with resulting hypopituitarism, acromegaly, craniopharyngioma), on top of the several thyroid disorder workups (factitious hyperthyroidism, myxedema coma).  The last day ended on a note of interest to me as a future Ob/Gyn.  The attendings switched and my new attending wanted to talk about oral contraceptives!  It was great because nobody has ever gone over OCPs with me in that much detail.  She prepared several articles for us to review and really got into the nitty-gritty about the difference between the progesterones in the pills and how that could lead to differing amounts of acne and hirsutism.  We reviewed the effects of these hormones on the hypothalamus, pituitary, uterus, and of course the ovaries.  Lastly, we went over this article about the benefits of OCPs in decreasing the incidence and mortality from ovarian cancer.  It was a great learning experience and chance to review concepts before actually starting internship.

Anyhow, I only have one more 3-week rotation and I will officially be done with medical school!  In the meantime, I have to present a poster at my school’s annual poster fair for senior students, and submit a paper ready for publication.  It may be alot to do in 3 weeks, but I’m so ready to be done that I’ll do anything.  After that, nothing but mini-vacations until I graduate .

AOA Part 2 December 11, 2008

A few months ago, I talked about being selected for membership into AOA: Alpha Omega Alpha. Since then I’ve officially become a paid member. I ordered the certificate in the mail which is framed with green matting, perfect for medicine, along with an extra copy for my parents. I even ordered the key, which is something that I did for my undergrad honor societies. This key is nice because it has my name, the chapter, and year of induction on the back. Check out the picture of the certificate (well the part without my name) and the gold key overlaying where the symbol is on the certificate:

I paid only for one year because applying for residency is expensive!! Once I get my first pay check, I intend to pay lifetime dues, since this is a distinction that I want to follow me for a lifetime.

2 Year Blog Anniversary December 3, 2008

I can’t believe that another year of blogging has passed!  My blog has definitely grown over the year, as have I.  This post will be full of links to posts with the most hits over the past year, and to some of the ones that were important to me.  I first saw my monthly readership triple when I became syndicated in March 2008: I’m syndicated!.  My main topics included the transition from being a nervous third year medical student: Hmm…Excellent?, to a confident third year medical student earning honors in several rotations (Ambu Med, Psych, Medicine) and my proud moment of being selected for the medical honor society: Alpha Omega Alpha.  I also talked about my personal life and experiences with relationships: Long Distance Coming to an End, Valentine’s Day, Cooking for His Parents, and A Surprise Concert.  In addition, I polled the readers for opinions about things I don’t understand: Diamonds Are Forever, Right?, Insight into the Cheating Mind.  I even went on a game show, Deal or No Deal Part 1, Part 2, Part 3, Part 4, Part 5, which I now realize I never did a “Part 6″ post for.  I guess I owe you one.  My monthly readership then more than doubled again in July 2008 when I became a 4th year (MSIV, Finally) and started talking about applying for residency: Advice for Applying to Residency, ERAS Submission, MyERAS, taking boards: Step 2 Preparation, The Numbers, Step 2 and interviewing: Ob/Gyn Interviews.

Over my 2nd year here are some of the stats for those of you that are curious.  Check out the post from my 1st year: 1 Year of Blogging.  I put the total for each category with the amount from each year alone in parentheses to compare the years:

256 Posts (Year 2: 143, Year 1: 113)

470 Comments (Year 2: 325, Year 1: 145)

3144 Spam Comments (Year 2: 1983, Year 1: 1161)

21084 Visits/Page Views (Year 2: 17439, Year 1: 3645)

—-Best day ever: Year 2 – 376 (November 19, 2008); Year 1 – 85 (July 1, 2007)

—-Best month ever: Year 2 – 3316 (November 2008); Year 1 – 479 (June 2007)

To date, the top three pages are: “Ob/Gyn Interviews“, “About Me“, and “Step 1 Books & Advice“.

The top three posts are: “MyERAS“, “BRS vs Goljan Pathology“, and “Done with USMLE Step 2“.

As you can see I have quadrupled my annual readership, and my best month this year has 7 times more readers than my best month the prior year!  It is very exciting to have new readers and new people commenting on the posts as well.  I hope that you keep coming back to read!  Please pass on the link to your friends: www.medobsession.com.  That’s right, for those of you that may not have noticed, I bought my own domain!

Alpha Omega Alpha (AOA) September 24, 2008

About 2 weeks ago we were told to submit our CV to be considered for election into the medical honor society.  Now, I have to admit, I would not consider myself a gunner by any means, but I am definitely very focused on doing well in school.  I was the first year that was asking people about the boards after only 2 months of school.  When my friend was elected into AOA during my second year (her 4th year), I emailed her immediately to find out her secret.  Yeah, kinda crazy… but my school is only pass/fail so there’s only but so many ways to differentiate yourself.

 

So today was the day that they had elections.  I have now learned that people got personalized phone calls letting them know that they were selected.  However, my old house phone number is listed in the student directory, not my cell phone.  So instead I get an email from one of the AOA presidents asking me to call (not telling me why), because my phone number was not updated online (and our CV’s were blinded).  Of course, that already excited me, since this isn’t really a person that emails me normally.  So I call back… no response… I start getting a little antsy because I want a confirmation about why he emailed!  Then I resort to my third method of communication: my pager… and it’s dead!  I’ve been just using my cell as my pager on my away rotation. Luckily, our text paging system archives messages online.  So I log in and this is the last page:

“Congratulations! You have been selected for AOA. You do not have a current number in the system. Please give me a call so that I can confirm that you got this page.”

 

Finally, the written confirmation of selection into this medical honor society!!  I’m so excited right now.  It makes all of those long nights studying, working long hours, and just working to juggle community service and leadership all worth it.  I have no idea what the criteria was for election into AOA, but hey, I guess I did something right! I’m so excited !

 

I guess the lesson here… make sure to update your information!