Dr. Katie goes to Med School

Official Blog Move!

2011-06-17T16:18:00.002-04:00

You can now find me here: http://www.drkatiegoestoresidency.blogspot.com.

Thanks to everyone who has read the blog over the past few years. You're the best.

Dr. Katie Graduates from Med School!

2011-05-26T12:26:00.000-04:00

That's right folks, it's official... I am now an M.D.

Wow, that's scary even to me.

Sorry I've been so sparse in updates lately, I've had so many ideas and just never got around to blogging... I've been traveling and enjoying my last few months of school (or lack thereof). That being said, here's an update in 5 parts (I'll try and post pictures later, as I'm currently stealing my mother's computer).

1. The Last Official Day of Rotations

Let me preface this by saying that Wayne State has a program called Co-Curricular, it is an program during first and second year that is comprised of a total of 150 hours of volunteering and 50 hours of additional lectures (related to medicine, but not in the medical curriculum). This program, if completed, grants a fourth year student a free elective. That along with the fact that Wayne State has only 8 months of electives out of the possible 11 months of fourth year, means that I had 4 months off this year. I didn't take time off for Step 2 CK, but I took 2 months for interviews (December and January). All that means is that my last day of medical school rotations was March 25th... and I was doing radiology that month.

The day itself was really low key. I can't even remember what I was rotating through that day, although I'm almost positive I was the only student who actually came in that day. I went to the mandatory lunch lecture and then was released.

I went and returned my pager and my badge and walked out of the hospital, for the last time as a student. It was all very surreal... no pomp, no circumstance. Just me walking away on a beautiful spring day, by myself.

And I hate to admit it, but I did cry in my car on the way home, excited to be done, but so sad that it was over. No more, "I'm just a student." It's kind of like taking your last test of high school or college, but at least then you're with all your friends... It does not feel right to just walk away and be done, but that's how it is apparently.

2. San Francisco

A few days after walking away, I got to start a 2 week vacation seeing friends. I started my vacation by visiting one of my best friends from college while he was on business in San Francisco. I spent the days walking around and exploring, while he worked. I walked around Fisherman's Wharf, walked down Lombard Street, and went to the Museum of Modern Art. It was awesome.

On Friday we both headed down to the Golden Gate Bridge and then headed to Napa for the weekend, where we had a great time catching up on old times, drinking fabulous wines, and exploring amazing vineyards.

I was so great to catch up with him, since I hadn't really spent much time with him since college.

3. Austin

From San Fran, I hopped on a plane and went straight to Austin to visit another wonderful friend, Lindsay. I met Lindsay through my mother, as Lindsay, before moving to Tejas, was active in the theatre community in Lansing.

I spent that week learning and exploring Austin. I went to the LBJ library and we went to San Antonio and the Cathedral of Junk together. But most importantly, we spent the week celebrating her birthday and just having fun!

4. Memphis

A couple weeks ago I headed down to Memphis with my mom to find a place to live. And, as fate would have it, the Mississippi was cresting the day I arrived. That being said, let's get the following outta the way: Memphis is on a bluff. While there was really bad flooding in Tunica and Dyersburg, there was little flooding in Memphis - a small section of Riverside Drive and a few homes on Mud Island (which is an island in the middle of the Mississippi). Yes, no flooding is good... but it wasn't the apocalypse everyone seems to think happened.

Anyways, I found an apartment within the first few days (it's great and I cannot wait to live there) and spent the rest of the week playing tourist with my mom. It was so much fun! I also got a lot of the business stuff out of the way -- fitted for my white coats, ID picture taken, paperwork turned in, and bank account set up. It's weird to actually be starting a life in a new state... I've been so tied to Michigan my whole life.

5. Graduation

For the past few weeks I've not really been doing much, besides hanging out at my local coffee shop with my mom and seeing some theatre. And then Sunday arrived... which meant Baccalaureate.

Baccalaureate at Wayne is when we get our doctoral hoods placed. It's a ceremony where we are introduced by specialty ad where we are going and two people of our choosing place our hoods over our heads; I chose my mom and dad. It was great.

Tuesday was the actual ceremony. It was a the Fox Theatre downtown and gorgeous. And just like the last day of rotations, completely surreal. It's really hard to believe that medical school is over and that I actually finished it. Wow.

Anyways, in sadder news, on Thursday of last week we got a email stating that one of our classmates, Francis Dossou had passed away unexpectedly. Although I did not know Francis very well, he was an amazing individual, originally from Togo, who had gotten political asylum in Germany and then the US, worked his way through SUNY as a cab driver and security officer before coming to Wayne. He had matched ophthalmology at Howard, and was so excited to start his career. As one of my classmates said at graduation, you could not walk away from a conversation with Francis without a smile on your face. He will be sorely missed by all who knew him. Thoughts and prayers to his family and close friends.

Finally, as this part of my life is about to end, so too must this blog. I have set up another one for residency... and although I hope to maintain it, I cannot make too many promises right now. But I'll do my best. There's nothing yet on the blog, but I'll post an official move notice once I do.

Thank you to all my faithful readers over the past 4 years and your lovely comments and emails. It's truly been an amazing adventure and I'm glad that others found some enjoyment.

Wayne Match 2011

2011-03-29T17:07:00.000-04:00

I got curious about the stats and decided to play around for a bit. These are by no means 100% accurate, but I thought I would share.

Caveats:

Location is based on advanced match, i.e. PGY-2 location
Transitional was listed only if it was the only thing given for an individual
0% means 1 person went into that speciality or to that location
I didn't do prelim medicine because there weren't many and also I only really was interested in the surgery prelims.

Fig 1. WSUSOM 2011 by choice of specialty.

Fig 2. WSUSOM 2011 by location of residency by region.

Fig 3. WSUSOM 2011 by location of residency by state.

Fig 4. WSUSOM 2011 by location of residency when residency is in the state of Michigan.

And in case you're interested:

Table 1. WSUSOM raw match data.

How I did it

2011-03-21T00:19:00.000-04:00

Now that the interview season is done, I thought I would share how I went about the whole process (not including ERAS/ personal statements/ etc).

One of the first things you have to do is determine which programs to apply to, which can be very overwhelming. So, how did I go about choosing programs? I'm a little OCPD (as you'll be able to tell as you read this post), but here goes:

Determine regions/ places you want to live. Remember that while you'll be working crazy hours, you also want to find a place where you'll enjoy yourself in your off hours.
Go to FREIDA. Narrow your search to the type of program you're applying to and the regions/ states.
Start narrowing the list. This process will be different for everyone, but I knew I wasn't really interested in community programs and that I wanted to be in large cities. That being said, if a program had a good reputation, I usually kept it in my list. I knew I wanted to apply to between 40-60 programs.
Balance the list. Let's be honest, unless you're AOA and awesome, you're not going to get interviews everywhere. So I tiered out my programs (with the help of the surgery "red book"). I made sure that my 40-60 programs were divided into 25% top tier, 50% 2nd tier and 25% 3rd tier.

From this point on I started making and updating my spreadsheet (see the first table in the document).

Click here to open the Interview Spreadsheet.

As soon as the interviews started coming in I did two things, I moved the website column from the first table into the Program Information table (where you'll find it in the document) and I started gathering more data to add to the Program Information table (i.e. Program Director's name, Program Size, Board Passage Rates, % to fellowship, etc).

Then the interviews started. The biggest advice I have is to debrief yourself within the day or two after the interview. I did this by filling out a Program Evaluation (see below), but also during all the travel time I had while driving between interviews -- there's nothing like driving 10 hours in a car by yourself to give you time to reflect and digest an interview.

Click here for the Program Evaluation Template.

As soon as I tallied up the ratings, I added them to the spreadsheet and started sorting them by score. However, at the same time I had a dynamic Rank Order List going. After each interview you can sit there and say, "That program was definitely a better fit than program X but not as good as program Y."

By doing this I found that I would commonly be able to reflect on why a program was better or worse than the one I interviewed at the day before. It also made me go back and reread the program evaluations. It also meant that by the end of the interview season I had a pretty solid idea of how my rank order list would go (and it was not in the order of the rankings, but pretty close).

When it came down to it, my gut reaction to programs at the end of the interview season and how my dynamic rank order list stood was fairly close. I changed a few things here and there... like moving Wayne State to a position that would make it possible to match there and be close to my family, but also in a place that gave me a chance to go to other awesome programs, and moving one program a little lower because the location just wasn't my idea of a good place to live for 5-7 years.

I was methodical. Not everyone is... some of my friends didn't even think about what they liked or didn't like in comparisons to this and that program until it was time to sit down and finalize a rank order list. I knew, however, that by being methodical I would be less stressed out.

Other quick tips:

Send Thank You cards within the week after you interview. They will still remember you and your application will be fresh on their minds, rather than sending them later when they have to go back and remember your application. Also, send them to everyone who interviewed you and the program coordinator. I personally sent handwritten notes on Crane cards.
Remember that while they are interviewing you, you are interviewing them. Talk to the staff and residents... make sure you fit. There was one place an attending tried to debate creation vs. evolution with me, when he didn't even know where I stood on the debate. At another place the residents were way too different from me.
Grooming. Yes, I know... it seems silly... But girls, pull your hair out of your face, it makes you look more professional. Think about getting a manicure or maintaining a self-French manicure, it's a small details that set you apart. We're a suit that fits... wear a shirt that's nice but not overly distracting. Minimize the jewelry, but wear at least some that look nice. Take out that noise-ring on the actual interview day (I wore mine to the informal get-together with the residents though).
Minimize. Yes, you might have luggage, but make sure it's small and not ratty. Don't carry a large purse. The less is more phenomenon is true here.
Be nice to EVERYONE. Fellow candidates, residents, staff, the program coordinator.

Anyways, hope that helps. If you have any questions, leave a comment or send an email to drkatiegoestomedschool AT gmail DOT com.

Match Day!

2011-03-18T10:55:00.000-04:00

The front of the Match Day program.

I matched! Yes, I know we all knew we matched on Monday, but yesterday I found out where!

Yesterday morning started off with my roommates and I throwing a pre-Match breakfast & mimosas party. So many people came and it was so great to see everyone! My friend Mike came with his huge dog and my friend Paige came with her baby. There was food galore and I'm pretty sure we still have bottles of champagne left in our cabinet.

Around 10:30 my parents showed up and we headed to the Roostertail (a serious upgrade from the past Match Days, that happened in the school cafeteria). On the way there, I told them I was pretty sure I matched at the DMC (my #4 choice); I love Wayne and would be happy to be there, but I also wanted to get the chance to go somewhere new. I told them I thought this because surgery was so competitive this year, with many of my friends having to scramble into prelim surgery spots. I told them, should it happen, I would be happy.

We got to the Roostertail and my parent's found their seats and I told them I would come find them as soon as I got my envelope, then went to find mine in the sea of white chairs in the center of the room.

From about 11-11:50, we all sat and heard brief speeches and watched as dozens of awards were handed out to the more outstanding students in the class. At 11:50 the envelopes were passed down the rows of chairs. I found my plain white envelope, the only thing designating it as mine was the small sticker with my name in the upper right hand corner.

As soon as everyone got their envelopes we were told we could open them. Instead, I got up and pushed my way through the crowd to find my parents. I felt like Charlie trying to find the golden ticket when he unwrapped his chocolate bar as I slowly ripped the envelope and opened the letter:

I'm going to Tennessee!!!!

And then I cried, cried tears of joy and utter relief. University of Tennessee was my #1 choice! I had done it! I had gotten my golden ticket! And so did a lot of my friends.

Jacki is doing Peds at Baylor. Eileen is going home to Loma Linda for PM&R. Rich is going to Emory for IM. Liza is going to Boston for OB/GYN. Tracey is going to MassGen for Psych. Brandon got RadOnc at Yale. The list goes on and on.. Hopkins, Michigan, UCLA, Stanford.... It was amazing!

After much celebration and jubilation, my family headed out for real food at Andiamo's. My mom, being the amazing person she is, got me a new dress and the game Operation (and for graduation... an iPad, although details of which still need to be finalized).

I feel like the luckiest girl in the world right now.

For more info on the Match at Wayne, here's the release.

The one in which I'm awesome... Just kidding

2011-03-15T20:10:00.003-04:00

The past week has been crazy, crazy busy and crazy fun, so I thought I'd give you a little recap.

1. THIRSTY THURSDAYS

In an effort to actually see everyone before the end of medical school, I started planning weekly happy hours for the fourth year class (mostly just for my friends to have a reason to all go to the same bar at the same time). We're now in our 6th week, however, it's quickly becoming one of my favorite times of the week; You never know who you're going to see until you get there... It's so great to catch up with people after not seeing them for almost a year.

2. LAMPOON

Saturday was the day (among others, see below) I've been planning for almost all year: Lampoon! I was super stressed all last week just trying to tie down all the loose ends, but it came together the night of the show. It was a great show, or at least that's what people have been telling me (I'm hypercritical about shows and timing of scene changes and technical aspects... Blame my mother, the theatre director). Needless to say, the show went off with out a hitch (almost) and left me barely able to move the next day; I was on my feet from about 10:30 am to 1:30 am, running around, moving chairs and tables, running the booth, etc.

It was a success either way, and I am so proud of our 4th year class: Our class has won 7/8 of the all the Lampoons during our time at Wayne (we lost for best video our 2nd year).

This year it was a lot harder to watch though, because 1) I was in the booth texting the stage manager all night about screen cues while she was texting me about light cues, and 2) because watching the 4th year videos made me realize how close to the end we all are right now.

I'm not going to lie and say I would do med school all over again, but to quote ZDoggMD, "I definitely wouldn't not do it once." It has been a hard, but great four years, and I'm going to miss all the friends I've made here. Seeing the videos confirmed that fact, at least for me.

3. BLACK MONDAY

Even though Match Day is officially March 17th (3rd Thursday of March... which conveniently coincides with St. Patty's Day this year), I think most of my friends were more concerned about Black Monday.
Black Monday is the day you find out if you have a job for next year... To quote one of my friends, "It's like Christmas, if Christmas could go horribly wrong."

Surgery has gotten a lot more competitive in the past few years; this past year it was #4 on the list for unmatched US seniors (meaning the fourth most common specialty for which US graduates didn't get a job)... So, while everyone else was sitting there telling me it was going to be fine, I also knew it could go "horribly wrong."

I could not fall asleep on Sunday night and half convinced myself that I was not going to match (to stave off the utter despair that would have manifested should the worse actually happen). I almost got out of bed at 2 am just to check my CV and make sure it was in order in case I had to scramble. At about 11:30 yesterday I started feeling even more nauseous. Around 11:45 am I found a corner of the hospital where I could be alone and started to have palpitations as I was opening my computer to both the NRMP site and to gmail.

Thankfully, I was one of the people who got their email right away (Although, I could have just looked at NRMP if I didn't get the email; Some of my friends didn't get there emails until after 1 pm yesterday):

That's right, folks! I'm gonna be a surgeon! I have matched into a categorical surgery program, somewhere.

I find out Thursday at noon where I'll be going. Crossing my fingers now.

I think there were only 2 open categorical spots for surgery... giving it something like a 99.8% fill rate this year, which makes it more likely that someone could have matched RadOnc, Derm, or even ENT when you compare fill rates and open spots.

Anyways, I'm glad to report that almost everyone I know matched (including my roommates into ENT, OB/GYN, and PM&R). I only know 2 people for sure that didn't match; both of whom applied to general surgery, one of whom I know scrambled into a prelim spot at the program he ranked #1 for a categorical position.

=============================
I'm not sure the validity of this statement, but per one of my friends Wayne had to scramble 18 this year, out of a class of 347 (roughly 94% match rate), many of whom had board scores >240.

To make matters worse, the NRMP website was down until well after 1pm today; Scramble starts at noon. I'm not sure overall how we did, I can just hope they did well.

=============================
A Few Definitions (nitty gritty and most likely somewhat inaccurate)

Categorical: A program that once you match to, you complete your entire training with... i.e. Surgery, Medicine, Peds, Family Med, Ob/Gyn
Transitional: A 1 year program that is a prerequisite for another specialty's program; needed for things like neurosurgery, urology, orthopedics, radiology, radiation oncology, etc.
Integrated: A program for a specialty that usually requires a transitional year, but who's transitional year is guaranteed at their institution.
Preliminary (Prelim): 1 year program which does not guarantee a PGY-2 spot; requires the applicant to reapply for the match in the following year.

I Love Med School

2011-03-13T13:27:00.005-04:00

Lampoon wrap-up later today... once my entire body stops hurting.

Until then, some of the amazing 4th year videos:

So proud to claim Detroit as my home

2011-03-09T23:04:00.000-05:00

Although I am hoping to go outside of Michigan for residency (fingers crossed)... I am so proud to have called Detroit home for the last 4 years.

I love this city.

Period.

I will miss it sorely when (and if) I leave. And I will be very happy to complete my residency here, if that's what happens.

When people ask me why I love Detroit so much I usually respond with, "It's hard to explain. But there's something about the grittiness of Detroit and about the hope that is constantly rising up from the ashes of this once great city."

I really cannot wait for Detroit to make it's comeback... it's in its infancy right now. Just wait.

4 Days Left!

2011-03-08T22:36:00.000-05:00

Only 4 more days until Lampoon 2011!!

For your viewing pleasure, our latest and last ad:

http://www.med.wayne.edu/aesculapians/lampoon2011.asp

Radiology can be disturbing

2011-03-07T16:19:00.000-05:00

Today I had the explicit pleasure of observing something called a "defecating proctogram." This is by far one of the more disturbing exams I've seen. It consists of taking a caulking gun (just like the ones at Home Depot) filled with barium contrast and depositing the entire tube of contrast into the patient's rectum. The patient then sits on a toilet and has images of them defecating under fluoroscopy taken.

Now before you starting saying, "Why in God's name?!" The study exists to diagnose things like rectoceles, fistulas, and the like. But let's just say it is by far the strangest piece of medicine I've seen, or at least have seen in the last few months.

If you would like to see a humorous article (written by some of the radiology residents at the hospital I'm working at, here's the unedited Wikipedia page. Please note, that the edited page removed the picture of the actual instrument they use (and some of the false humorous parts). And for more humor, please see: Defecating Postures.

Other interesting things I learned today: UGI studies and barium enemas require gymnastic abilities in the patient; turning and spinning and standing on their heads (not really). It made me a little more conscious about how some patient will never be able to do some of the studies we order.

Current Motto

2011-03-05T22:47:00.001-05:00

Yes, it may be overused, but it's because it's so good. I have set the above image as my computer backdrop and will continue to tell myself this every time I find myself getting stressed out between now and next Saturday (Lampoon) and between now and next Monday/ Thursday.

What happened to my radiovacay?!

2011-03-05T12:00:00.000-05:00

It is a well known fact by 4th year students (and attendings) that after about December, when interviews start rolling in, that your mind will not want to actually do work for the rest of the year. This "senioritis" is so entrenched in medical knowledge that most residents and attendings don't really care if you're there*.

Thus, most 4th year students make their schedules as much of a cake walk as possible for the second half of their final year (getting all the hard, required stuff out in the first few months). One of the known easy rotations is radiology, also known as radioholiday and radiovacay.

Why? Because radiology consists of individuals sitting in front of computers scanning images... it's pretty much a one-person job, which leaves the medical student asking a few questions, but mostly just sitting and watching. And usually, the residents or attending will send you home before or right after lunch, or tell you to just not bother showing up for a few days a week.

So how is it possible that most of these facts have seem to have been missed by my radiology elective?! Not only do I have to show up every day (which I don't mind)... I have required noon conference and required med student lectures at 4 pm... including every Friday. And then there's the fact that the guy in charge of medical education decided to put the required ethics breakfast at 7 am the day after Match (a day most medical students are nursing rather large hangovers... especially this year as the Match is on St. Patty's Day.)

What the hell?!?! Don't these people know what the Match is and the importance of the day?! They should know that at this point in the year, we really are only thinking about the Match and getting our lives ready for July 1 (including finding a new place to live and moving).

Yes, I want to learn some radiology... but come on... give me a break here. Everyone else on the elective is working 2 hours a day and have already been told they don't have to show up after the 16th.

I'm so annoyed.

*that is unless they are part of medical education and then they just complain about how 4th year is such a waste of an educational year and come up with ways to change the system

Muggle Medicine?

2011-03-05T11:17:00.001-05:00

Love ZDoggMD!

Just a little more medical humor for all you HP fans out there.

The Match Morcelized

2011-02-27T12:00:00.052-05:00

I figured it might be a good idea to share with you all non-med people what the Match is and how it works... Here goes.

Every fourth year medical student starts their last year of medical school with just a few goals: have fun and get a job. The getting the job part is where the Match comes into play... but there's a lot of ground work before that comes along.

Starting in July fourth year students start getting all paperwork ready to apply for residency and enter it into ERAS (electronic residency application system). Grades, community service, research, letters of recommendation, and personal statements all get entered and then submitted on September 1st.

Then comes the first episode of hurry up and wait... You rush to enter it all hoping that submitting the application on the first day possible that your application will rise to the top. But you wait... Obsessively you check your phone at any bing that signifies an email and curse the first and second year students for fooling you with useless emails about post-exam parties.

However, slowly but surely the interview offers (and rejections) start to come in. You don't turn any down (at least at first) and start scheduling every one. Pretty soon your phone is not only your lifeline to potential interviews, but the only thing keeping your calendar straight.

Then come the interviews. They're fun at first, I mean, you get to travel to places you've never been before, get served free dinner (including drinks, if you're lucky). You put on your smile and have a stock pile of questions to ask in your back pocket.

The programs may be interviewing you, but you're also interviewing them... seeing if you fit. Cause God forbid you end up at a program where no one likes you or you feel completely out of place (I've very much a "city-girl"... at one program I felt immensely out of place, because they were a bunch of granolas.... nice people, just not like me at all).

After the long and arduous (and costly) process of interviewing all over the country you have to sit down and make your list... your RANK ORDER LIST (ROL). This list is a list of which programs you want to go to in order of preference. While you're doing this, the programs are making their own list of who they want, in order of preference. These then get entered into the National Residency Match Program (or NRMP). The NRMP is the agency that determines the best match between your list and the programs' lists. It spits out the answers through a complex algorithm (that is externally verified) in the form of The Match... a legally binding agreement between you and the residency program you're matched at for the coming year.

Enter the second episode of hurry up and wait. After a year of running all over the country and the emotionally exhausting decision of finalizing your rank list, it's due. This year ROLs where due on February 23rd. And we won't hear anything until March 14th.

March 14th is known by med students the world over as Black Monday. It's the day when you find out if you've matched, but not where you've matched. If you don't match, you enter the scramble... a frantic 2 day process that involves you and your deans calling all the programs and finding an open spot for you for the coming year... there's no guarantee and many spots are gone within the first 1-2 hours of the scramble opening.

Match Day is the 3rd Thursday of March and occurs at 12:00 pm every year, all over the country. It is when all students are handed an envelope that contains their fate for the following year(s).

So... right now.... I'm in that waiting period between submitting and finding out where (and if) I've matched.

---
If you're curious and want to read more about the Match, I recommend Match Day by Brian Eule.

I'm so blessed.

2011-02-26T15:06:00.000-05:00

Fourth year adventures (part 1)

GET WAYNED!

2011-02-26T12:20:00.001-05:00

It's almost March, which means it's almost time for LAMPOON!

For those of you "not in the know," Lampoon is the annual med school roast at Wayne. It's put on by the Aesculapians Honor Society and is a charity event. This year we will be making a donation to City Year Detroit.

And this year I'm one of the event coordinators (along with the guy in the ad videos below and Paul, our 2nd year protege).

So... Gear up and get ready to get Wayned!

Who can say, "EXCITED!!!"

For more information, to buy tickets, or to make a donation, please visit: http://www.med.wayne.edu/aesculapians/lampoon2011.asp

Waiting...

2011-02-25T22:06:00.000-05:00

Rank lists are in... which means there's no reason to be hiding anymore (at least, I hope that's the case). So, after a long absence: I'M BACK!

How have you all been? (I have to say that those I follow on Twitter seem to be doing well...)

Now, where does that leave me.... Let's see...

I'm just about finished with my Advanced Surgical Skills (ASS) course, which was awesome. Imagine spending a month with some of your best med school friends, who are all going into surgery, and the inappropriate jokes that come along with them just being your friends and add the jokes pertaining to the course title... Wowza!

Rank order lists were due on the 23rd. Which means my fate is in the hands of a computer algorithm and unknown until the 13th of March (when I find if I matched) and the 17th of March when (God-willing) I find out where I've matched.

Until then I plan on doing a whole lot of almost nothing alongside a radiology elective (read: radiovacay). The only big thing happening before then is a huge fundraiser called Lampoon, of which I'm one of the coordinators (mad props to my friend Lindsay for the amazing photoshop work!)

After March... I'm done. As in, no more rotations only waiting for graduation!

Wow, I cannot believe that med school is over! Where has the time gone?! How has 4th year gone by so fast!?

Anyways... hopefully now that my life is a little more lax, I'll have some extra time to update. (Hopefully I still have a readership :| ).

So, until next time... :)

Surgical Boot Camp, Day 1

2011-02-02T14:42:00.004-05:00

This month I am taking an honest-to-god real class as an elective. The class is "Advanced Surgical Skills", or as everyone in the class calls it, "ASS." The class is put on by the department of surgery for students going into general surgery or a surgical subspecialty (as a way to beef up on surgical knowledge and skills before internship begins). It is the same class that they give to all the surgical interns at Detroit Medical Center.

Yesterday was day 1.

Day 1 kicked my ass.

The day started off slow, mostly because the snowpocalypse of 2011 was hiding around the corner, waiting to pounce, resulting in many people arriving late. Dr. Steffes, the surgery clerkship director, treated those of us fortunate enough to live 5 minutes away with a wonderful story about how no one becomes anything without practice. This finished with Dr. Mattos, the course director, stating, "I know some of you think this is a blow-off course. I can assure it is not. You will need to work hard this month to make this course worth your time. You will also have to keep working after it ends to maintain your skills until July."

Then the day really started... 8 hours of testing.

Test 1: 50 surgical instruments were laid out and we were required to name each one and their category. Now initially this doesn't seem too horrible, but then you realize, that although you've heard the names of them all, you don't actually know what they are all called. Needless to say, it was an uncomfortable test that resulted in many answers of "curved clamp" and "pick-ups without teeth." My categories were tying, cutting, holding, grabbing, and visualization; pretty sure those are not legit categories.

Test 2: Knot Tying. Here is something I'm good at... Or so I thought. For you non-surgical types, yes there is a way to throw a correct knot, and there's more than one type of knot. We will be taught the correct way to tie knots tomorrow. Pretty sure I got a 60% or less on all 4 exercises.

Test 3: Suturing. Now mind you, everyone up till this point has complimented me on my suturing technique. Not here, my friends. I don't think I finished a single task in the allotted 5 minutes and the clerkship director commented on how horribly I handle a needle-driver. Crap.

Test 4: Anatomy. At this point I wanted to cry out, "KILL ME NOW!" 199 blanks later, 60% were blank and probably another 37% were wrong, I wanted to cry and was barely able to pull my fractured ego across the floor to lunch.

Lunch was at least a little reassuring. All 12 of us were in the same boat, feeling like the last 3 1/2 years were a complete waste, as we knew absolutely nothing.

Test 5: The Bead Task. 1 Suture. 10 1 mm beads, 10 3 mm beads, and 10 5 mm beads. 1 needle driver. 1 Debakey and 1 Adsons. The task, string the beads forehand and backhand. This means 4 different configurations (forehand/backhand with the Debakeys and forehand/backhand with the Adsons) plus a 5th of string as many as possible forehand/backhand in 3 minutes (90 seconds each way). Also, you have to count your bead/ needle drops. It may sound easy, but my hands beg to differ. Muscle fatigue sets in and the tremors get worse.

That's all we were able to finish yesterday... but we still have yet to take the FLS (Fundamentals of Laparoscopic Surgery) pre-test tomorrow.

On the docket for every evening: 100 knots. Prepping PMP (read: pimp... but it means patient management problems). Prepping Surgical Anatomy. Prepping Surgical Skills Modules.

So much for an easy rotation.

All that being said though, I'm super excited for the month. I'm excited to learn. I'm excited to spend time with my friends as we slowly pull ourselves through the class. Generally, I'm just excited.

The Private Life of DrKt

2010-09-07T16:58:00.001-04:00

So... I have decided that now is the time to make my blog private. Applications are in and have been downloaded, I have 1 secondary to fill out, and am currently just waiting to hear what else is going to happen.

I know I've been horrible about updating, but I've been super busy with my acting-internship (or as we call them, "sub-internships") and studying after work for my national board exam at the end of this month.

I promise that I will try and be better in the future... Sorry for my fails.

sometimes medicine sucks

2010-08-27T11:35:00.002-04:00

we had a young patient that came in about 2 weeks ago... he was sitting up and talking to us, but in acute heart failure with critical aortic stenosis.

he became hypotensive... the aortic stenosis wasn't allowing enough blood out, which made his heart more ischemic, which made his hypotension worse, which made his heart failure worse... it spiraled down and down.

there was nothing we could do.

we exhausted all of our options.

we all go into this field in an effort to make a difference, to save people. what do you do with medicine fails you... when you can offer no options... when you're sitting there after the fact replaying every decision trying to find a way to have approached it differently?

how do you approach a family in tears as they watch their loved one, while watching the BP monitor as it spirals down towards death? how do you accept their thanks when you felt like you've done nothing and could do nothing?

In honor of step 2 studying...

2010-08-10T20:42:00.001-04:00

school photos... really?!

2010-06-16T19:29:00.004-04:00

On Friday I have to get a senior picture taken.

The picture will be taken at school... elementary school style.

It's required for the "Class Composite" that will be placed in the hallway of the school for years to come.

The session costs $29.

And for an extra $20, they'll add the photo of your choice (from the 4) to ERAS (isn't that nice).

Once you add tax and shipping... sitting down for 10 minutes is going to cost 1 dollar and 6 cents shy of $60.

Does anyone else feel like this is complete robbery?

just documenting...

2010-06-15T16:52:00.003-04:00

sorry in advance for the ADD post...

today was the last clinical day of third year! all that's left is the daunting medicine shelf exam and the end of the year osce... then VACAY!!!! for a whole week and a half!!!!
july = surgery sub-I! and not only that... it's pediatric surgery!!! i didn't even request it... who can say, excited?!?!
also, i got my away elective for october. :) but not for august. :( trying to finagle my way into an anesthesia month (1. cause it's good to know, 2. i need to be studying for step 2 during that month and september). we'll see how that goes.
i got nominated for an organization that i really want... i won't hear back for awhile, but i'm really hoping (without getting my hopes up)
my continuity clinic preceptor offered to write me a letter of recommendation for residency... this makes me very happy.
the weekend attending (who apparently wrote the pathology curriculum for a med school at the age of 20) told my resident he was impressed with me... my other resident told me she thought i did excellent this month as i was leaving.... i don't know why, but it makes me happy (and feel like i'm fooling everyone).
i was actively involved in my first code on saturday, doing chest compressions... after 4L of hematemesis, 30 minutes, multiple rounds of medications and levophed drip, we transferred him to the unit (fixed and dilated). the family choose terminal wean...
my mom opened and closed an AMAZING rendition of "light in the piazza"... she was nominated for 11 awards (in one of the three different award given organizations for lansing)... and her show won 10!
i'm no longer blonde... but kinda red... i've been blonde since forever. i'm still not sure how i feel about this, but i know i don't hate it.
the last few days have been really good...

HAPPY DAY!!!

2010-05-11T18:04:00.004-04:00

Despite the rainy cold Michigan weather... I am happy! God blessed me with great lottery slots for my 4 year scheduling! Our school does it in 2 phases (1st = required stuff: sub-I, ER, ambulatory; 2nd = electives)... and I was in the 6th out of 15 groups for phase 1 and 4th out of 15 groups for phase 2. The only thing still up in the air: getting my away electives and convincing the school to accept a surgical ICU month as a medicine elective (I'm gonna sell this really well).

With all that said... my registration is complete (more or less) and I can give you all my 4th year "promised land" (and my dream) schedule:

July: Surgical Sub-Internship
August: Transplant Surgery (pending host school approval)
September: Ambulatory Medicine (taking Step 2 CK)
October: Surgical ICU (pending host school approval)
November: ER Medicine
December: Off for Interviews/ Christmas
January: Off for Interviews/ Step 2 CS
February: Advance Surgical Skills
March: Radiology (at "ClubB")/ MATCH!
April: Off for.... well, traveling?
May: Off for... partying, finalizing stuff??
June: GRADUATION! Holla!

Can I just say again that I am very happy right now!

4 years later...

2010-04-26T17:36:00.000-04:00

Remembering 4.26.06. Please be lifting up the families of those lost.