So around this time of year, messy medics go mad with fears / anticipation re: job security! But last week was Match week and 15000 US med students + several thousand foreign grads (US IMGs and FMGS alike) found out on St. Paddy's Day whether they matched into residency or not. Fortunately for me, I came out on the happy side, no worries about having to scramble! Heading to Metropolitan Hospital / NYMC in June to start my life as an Emergency Medicine doc. I was overjoyed, but I have to say the climax was taken away a little as I'd gotten clues and really positive emails from the program so I sort of knew in advance. It was the only EM program I interviewed at so I'm really thankful they gave me the chance - EM is fairly competitive at the moment with roughly 50% of non-US applicants matching.
So on Thursday when people found out which program we matched to, we went out for dinner at a gorgeous Indian restaurant (Jaipur, St. George's street) and met up with one of our friends/classmates who's interning in Australia (perth). Went to a pub afterwards to try to celebrate with the RCSI people who matched, but all of us except 1 faded really early.
It'll be really exciting moving to Manhattan, I think Metropolitan give us subsidized housing. I'm a little nervous cuz it'll be a big change and I won't know many people there, but it's only a short hop over the pond to visit my Irish mates. We're already planning visits. The ED department there is a lot different from the ones I did electives in as it's smaller and a bit more cramped, but we rotate through 4 hospitals so should see a really diverse patient pool. I haven't heard much about this program and the chief residents were quite positive about it, but of course they sort of have to be...it seems like a program which has opportunities for growth, and I like that it could be a place someone like me could have a positive impact on and vice versa. Plus, it's manhattan!!! Haven't heard from them yet but it's a holiday weekend ...can't wait to find out my schedules, etc.
I applied to A&E jobs here in Dublin too and got great feedback. I applied for the AE scheme in SJH, and while I didn't get it, I think I was the only intern who got an interview. I realized I was really junior to be even applying. I did however, get one of the two 6 month posts and the other guy is one who is two years my senior, so I was chuffed about it. They thought my experience was really advanced for my level of training (electives, ACLS and ATLS + PALS certs this year). I got interviews for the other 4 Dublin AE hospitals, but I turned two of them down and went to the St. Vincents scheme interview for the practice. And, i really love my suit! (hehe) . So it'll be awkward rejecting my job offer here as I already told HR I was going to accept, but c'est la vie.
It comes at a great time because all of us are starting to get really really tired of being interns. I don't know of a single one of us who's really enjoying the job right now, we want our lives to start and call just sucks.
Right now I'm nearly finished with my Medicine for the Elderly (geriatrics) rotation and I've really not liked it. I'm more a surgery person anyway, but this job been absolutely mind-rotting. I'm redundant...there's no real reason why my team needs me, there's really no individual thought as there was on surgery, no independence and NO TEACHING! I've learned absolutely ZILCH on this rotation, although I have gotten a little more familiar with some drugs.
Med El call is so irritating because it's more frequent than usual and although it's more relaxed work-wise, I don't find myself getting any more sleep. Your sleep is so disturbed by the nurses calling you for every stupid little thing because except for the acute ward, the nurses in the rehab/long stay wards aren't accustomed to handling any even minor medical issue or prioritizing. You know, i really don't give a damn that someone's bp is 150/90 at 3 am. They are completely inflexible and get so nervous every time they think their protocol isn't going to be followed. You end up getting bleeped hourly and get very disturbed sleep, and I then am kept awake because I'm fuming. And then on weekends, you carry the cardiac arrest bleep and each time I'm on the weekend, I get a cardiac arrest at like 4 am and then can't go back to sleep cuz you can hear everything in the shithole that's our doctor's res. And to top it off, these acute old people have poor access and are really difficult to cannulate or get bloods off. Anyway, call turns the sweetest people into bitches on wheels and everyone spends the whole time so angry. It's exhausting and no one likes feeling that way on a regular basis. Anyway, rant over.
I'm starting in general medicine 1st week of April, which will be busier but I'm looking forward to it and hoping I'll learn something. I'm going to start studying again for USMLE Step 3, but it won't be really serious studying yet - I just want to refresh the info that i've lost. But as I'm "in recovery" today, perhaps I'll start tomorrow :).
Sunday, March 23, 2008
Sunday, January 20, 2008
Summary of the rest of 2007
Haven't posted in a long time - that's what being an intern does to you...sucks up your time and your life. But hey, the money's alright!!
So since the last post, I completed my surgical rotations of my intern year. Orthopaedics in St. James's and General Surgery in Ballinasloe, Co. Galway (Portiuncula Hospital) . I am definitely a surgery person. I like the independence and responsibility given to junior staff, and the no-nonsense direct approach to stuff.
But anyway, Orthopaedics was a bit mad. Ortho wards are like human zoos ... half of the patients are old folks who go nuts on the analgesia and anaesthetic meds. Another quarter are the drunks and druggies who demand a lot of attention. And the other quarter are those suffering from MOLS (miserable old lady syndrome) who block beds while you wait for suitable nursing homes for them. I came to work one day and found a whole ward dancing in each other's arms to some imaginary music which one of the patients had dreamed up. We were like..."what the hell?!?!" but hey, they were happy and weren't screaming like usual so we let them.
I loved Ortho. My consultants and registrars were awesome. The only thing I hate dealing with are the social issues, but other than that...i like tools, I like the in-and-out of patients, and I like the gratification you get from getting them back on their feet. A couple patients gave me presents...which was really nice and touching. Sure, there were a couple awful days when I questioned my sanity in choosing to become a doctor, but on the whole, I loved it. The worst day for me was in my first week, when there was a difficult case we had post-bilateral calcaneal fractures. Part of a vac dressing had adhered to a portion of the posterior tibial artery which sheared when his dressing was changed. Blood and screaming everywhere, which then set off all the other patients screaming, then the mother came in and started screaming at everyone about lawsuits and shit like that, and meanwhile the patient was taken to theatre like 3 times and had maxed out on pain meds because the tolerance was quite high (a nurse actually found some unprescribed "medications" in his drawer, if you get what i mean...) . and then right after the operation this patient goes for a smoke. GD it. That was a hairy day. And other awful day was only awful (regarding the same patient) because I was post-call and a miscommunication between the nursing staff, plastics and myself meant that I was there til 8 pm post-call. That was the closest I came to losing my temper at a nurse.
The thing that made SJH surgery hell was call. I hate call with a passion. Here, there are still no capped call hours. I've been working for 38 hours with no sleep before. My avg # of hours during Ortho was 85 hrs. per week...one week, I reached 102. Call is so irritating and you get called for all this stupid shit. I was absolutely furious at one of the most stupid ones I've gotten. I got urgently serial bleeped to review a patient for thyrotoxic crisis. So I rush up from A&E thinking "oh crap, what dose of beta blocker, which one, etc." and find the patient sitting in bed, reading a magazine. His only complaint was swollen hands (note: it was warm in the room, as it was summer). No tremors, no jitteriness, no feeling unwell whatsover. So I asked the nurse, "why did you call me to review this patient?" Her reply: "well, I thought swollen hands were part of a thyroid problem. Me: "Um... no." Her: "Well, could it be a paracetamol overdose or something?" Me: "Um...he's on 1g qds, which is normal. Also, you must have been a nurse for 20 years. In those 20 years, have you ever seen swollen hands from paracetamol." Her: "Umm..." Me: "Don't call me again." (and I was also thinking, "Go back to nursing school.") which is very mean of me, but come on.
Anyway, then moved to Portiuncula Hospital for General Surgery. At first I really didn't like it because it's quite remote, and lonely. But I made fast friends with the two UCD interns that were there, and we managed to have some fun. The best thing about it was that call was so easy compared to the big Dublin hospitals. the whole surgical population equaled one ward of SJH. Our bleeps worked from home so we could watch tv or clean up the house while doing rounds, and only got called maybe 3 or 4 times to do stuff. The nurses were fun too, but it's quite different there in that the nurses really run the hospitals since the doctors change every 6 months or so. My Consultant was lovely, and I got along with my team. I didn't ever go into theatre because I wasn't too interested in gen surg (not an abdomen person), and had other stuff to do (applying to ERAS, etc.) but it was interesting to go to a peripheral hospital.
In the first two weeks of December, I went back home to do interviews. I applied mainly for EM so had an interview in NY, then a prelim interview in NY as well, then a TY interview in Georgia. My number of interviews isn't great statistically, so I'm skeptical about Matching. But we shall see I guess. I interviewed at Metropolitan for EM, and I really liked it. But they treat interviews like informal chats sometimes, and everyone gets along well so it's hard to gauge where you stand.
I ended the year by being on call Christmas and stephen's days. Christmas day was grand (I was invited over to the main gynecologist's house for dinner because I knew his daughter, who's a physio there) and it was lovely. It only got really busy at like 11:30 pm and I didn't leave til 1 am, and then Stephen's day was busy but that's ok. Then I got like 6 days off afterwards because the teams treat the Christmas season as every day on call.
so for New Years, I went up to Letterkenny (Northwest Ireland) to visit a good friend of mine for a couple days, and it was absolutely lovely. She's an Olympic hopeful so spent a couple hours in the gym to kickstart my year off well (after a night of getting absolutely hammered), and her parents are lovely too. They treated us to this massive carvery for dinner one day and stuffed ourselves, and then went for a really nice drive to see some scenery. We didn't go out New Years Eve because we wanted to start this year off right, this being a big year for her, and I thought that we could go get smashed any night, but there are very few times we can actually just spend the night relaxing by a fire. It was a brilliant New Years :)
So since the last post, I completed my surgical rotations of my intern year. Orthopaedics in St. James's and General Surgery in Ballinasloe, Co. Galway (Portiuncula Hospital) . I am definitely a surgery person. I like the independence and responsibility given to junior staff, and the no-nonsense direct approach to stuff.
But anyway, Orthopaedics was a bit mad. Ortho wards are like human zoos ... half of the patients are old folks who go nuts on the analgesia and anaesthetic meds. Another quarter are the drunks and druggies who demand a lot of attention. And the other quarter are those suffering from MOLS (miserable old lady syndrome) who block beds while you wait for suitable nursing homes for them. I came to work one day and found a whole ward dancing in each other's arms to some imaginary music which one of the patients had dreamed up. We were like..."what the hell?!?!" but hey, they were happy and weren't screaming like usual so we let them.
I loved Ortho. My consultants and registrars were awesome. The only thing I hate dealing with are the social issues, but other than that...i like tools, I like the in-and-out of patients, and I like the gratification you get from getting them back on their feet. A couple patients gave me presents...which was really nice and touching. Sure, there were a couple awful days when I questioned my sanity in choosing to become a doctor, but on the whole, I loved it. The worst day for me was in my first week, when there was a difficult case we had post-bilateral calcaneal fractures. Part of a vac dressing had adhered to a portion of the posterior tibial artery which sheared when his dressing was changed. Blood and screaming everywhere, which then set off all the other patients screaming, then the mother came in and started screaming at everyone about lawsuits and shit like that, and meanwhile the patient was taken to theatre like 3 times and had maxed out on pain meds because the tolerance was quite high (a nurse actually found some unprescribed "medications" in his drawer, if you get what i mean...) . and then right after the operation this patient goes for a smoke. GD it. That was a hairy day. And other awful day was only awful (regarding the same patient) because I was post-call and a miscommunication between the nursing staff, plastics and myself meant that I was there til 8 pm post-call. That was the closest I came to losing my temper at a nurse.
The thing that made SJH surgery hell was call. I hate call with a passion. Here, there are still no capped call hours. I've been working for 38 hours with no sleep before. My avg # of hours during Ortho was 85 hrs. per week...one week, I reached 102. Call is so irritating and you get called for all this stupid shit. I was absolutely furious at one of the most stupid ones I've gotten. I got urgently serial bleeped to review a patient for thyrotoxic crisis. So I rush up from A&E thinking "oh crap, what dose of beta blocker, which one, etc." and find the patient sitting in bed, reading a magazine. His only complaint was swollen hands (note: it was warm in the room, as it was summer). No tremors, no jitteriness, no feeling unwell whatsover. So I asked the nurse, "why did you call me to review this patient?" Her reply: "well, I thought swollen hands were part of a thyroid problem. Me: "Um... no." Her: "Well, could it be a paracetamol overdose or something?" Me: "Um...he's on 1g qds, which is normal. Also, you must have been a nurse for 20 years. In those 20 years, have you ever seen swollen hands from paracetamol." Her: "Umm..." Me: "Don't call me again." (and I was also thinking, "Go back to nursing school.") which is very mean of me, but come on.
Anyway, then moved to Portiuncula Hospital for General Surgery. At first I really didn't like it because it's quite remote, and lonely. But I made fast friends with the two UCD interns that were there, and we managed to have some fun. The best thing about it was that call was so easy compared to the big Dublin hospitals. the whole surgical population equaled one ward of SJH. Our bleeps worked from home so we could watch tv or clean up the house while doing rounds, and only got called maybe 3 or 4 times to do stuff. The nurses were fun too, but it's quite different there in that the nurses really run the hospitals since the doctors change every 6 months or so. My Consultant was lovely, and I got along with my team. I didn't ever go into theatre because I wasn't too interested in gen surg (not an abdomen person), and had other stuff to do (applying to ERAS, etc.) but it was interesting to go to a peripheral hospital.
In the first two weeks of December, I went back home to do interviews. I applied mainly for EM so had an interview in NY, then a prelim interview in NY as well, then a TY interview in Georgia. My number of interviews isn't great statistically, so I'm skeptical about Matching. But we shall see I guess. I interviewed at Metropolitan for EM, and I really liked it. But they treat interviews like informal chats sometimes, and everyone gets along well so it's hard to gauge where you stand.
I ended the year by being on call Christmas and stephen's days. Christmas day was grand (I was invited over to the main gynecologist's house for dinner because I knew his daughter, who's a physio there) and it was lovely. It only got really busy at like 11:30 pm and I didn't leave til 1 am, and then Stephen's day was busy but that's ok. Then I got like 6 days off afterwards because the teams treat the Christmas season as every day on call.
so for New Years, I went up to Letterkenny (Northwest Ireland) to visit a good friend of mine for a couple days, and it was absolutely lovely. She's an Olympic hopeful so spent a couple hours in the gym to kickstart my year off well (after a night of getting absolutely hammered), and her parents are lovely too. They treated us to this massive carvery for dinner one day and stuffed ourselves, and then went for a really nice drive to see some scenery. We didn't go out New Years Eve because we wanted to start this year off right, this being a big year for her, and I thought that we could go get smashed any night, but there are very few times we can actually just spend the night relaxing by a fire. It was a brilliant New Years :)
Monday, June 04, 2007
The world's a more disturbing place...
I'm getting more scared by some of the young patients I'm seeing, who at 10 years old are like 88 kilos. Young girls. That's like 20 kilos more than I weigh. What the hell? I wonder what it's going to take to make kids (and their parents) change. It's sort of analogous the increasing interest in hybrid cars. It took petrol prices to shoot through the roof before people started considering them. Yeah, environmental concern was part of it...but not the primary concern. What's going to make measures to be put in place in schools/families to decrease the chances of being squashed by someone decades younger than you?
And, I had a patient the other day who required me to write on her school note that she was allowed to drink a bottle of water at school. I was like...what?! Apparently, the school won't let any of them carry bottled water because they're afraid kids will bring and drink alcohol in school! That's nuts! I mean, I'm sure they could...but wouldn't it be obvious picking out the complete smashed kid? and smell it? And wouldn't it be really dangerous for kids not to have adequate hydration? Man, things have really changed from when I was in high school...and that wasn't that long ago!
And, I had a patient the other day who required me to write on her school note that she was allowed to drink a bottle of water at school. I was like...what?! Apparently, the school won't let any of them carry bottled water because they're afraid kids will bring and drink alcohol in school! That's nuts! I mean, I'm sure they could...but wouldn't it be obvious picking out the complete smashed kid? and smell it? And wouldn't it be really dangerous for kids not to have adequate hydration? Man, things have really changed from when I was in high school...and that wasn't that long ago!
Finally! I'm nearly done!! (with med school)
The last time I posted, I'd just finished Step 2 CK. It didn't go as well as I wanted, but passed anyway. So that's my ECFMG certification stuff done. I'm not that happy with how I've done academically during med school, but considering all the stuff I've been able to do apart from medicine, I'm fairly happy with the life experiences I've gotten from studying abroad in Ireland. I'll go more into specific pros and cons later.
The exams were nerve-wracking as we expected. The medicine and surgery papers were fair (except the surgery MCQ was a bit all over the place and definitely not very well organized). The day between the med and surg papers, I found out about a job opening in the US and given the uncertainty of getting a job in Ireland this year, I spent the whole day getting ready and faxing application materials, so didn't start cramming surg until 6 pm ! Definitely not good preparation, but I figured I had to take a shot at this opening, even if it was a long shot.
Then the day after the surgery paper, I was cycling a friend's racer to meet a couple friends for lunch near the hospital. My front wheel clipped and got stuck in the tram tracks, and I went flying. Must have landed under an out-stretched shoulder cuz I dislocated my left shoulder. Being in front of the hospital, I walked to the Emergency Department and was seen fairly quickly (it was quiet). It hurt like hell...I knew dislocated shoulders were supposed to be really painful, but I was really surprised at how much it actually did hurt (when the meds wore off). So then I had to be in a sling for the next 3 weeks - didn't take pain meds cuz they made me really sleepy, and then the diclofenac they prescribed made me quite ill, so stopped taking that. My friends took care of me that weekend though ;). Healing is really slow...nearly 6 weeks on, and I still can't extend my arm to its full range of movement. Abduction's back though!
The following Monday I had a psych paper, which was ok... I wish I'd done more studying for it because I could have done quite well on it. Studying was basically non-existant because the pain meds knocked me out or I was sick from meds. I learned my lesson! Then had a week off before the clinicals. The orals were strange given I only had one arm and couldn't do some of the physical exams....so I got asked some very weird questions instead. Can't say I'm the most loquacious... I wasn't really happy with the long cases, but the shorts in medicine went well. Managed to get through them fairly un-traumatically, one hand and all, and then had an agonizing wait to see if we got Dublin internships or not. After the school playing us around a bit, the postings finally came out 5 days late and fortunately I got a job! Unfortunately, 16 of my class didn't...I hope they've all found suitable alternatives that they're happy with. This whole situation is absolutely ridiculous.
Went straight from finding out about job postings to Kerry to spend with two of my best friends (both rowers, both in medicine) and it was absolutely beautiful. 3 days of doing nothing except enjoy the gorgeous sun on the beach. Anna took us to places she grew up with during childhood, with some stunning spots that have and will remain untouched. Some of the area is very mountainous so can't really be habitable, and the water lying between the mountains is therefore pure. The views were amazing and it made me fall in love with Ireland again (the past couple years have seriously tried my enthusiasm for the place). But I think it's back :).
Then the 2nd week of May was a hectic one, spent searching apartments in the Islandbridge area for something suitable. As all my classmates were away on holiday and I wasn't really keen on sharing (8-9 years in dorms is quite enough, thank you!), landed myself a sweet little place right next to the boathouse (my 2nd home!) in a lovely complex. Quiet, young area and professional area, with a little fountain and garden...expensive but worth it. Especially after some of the infested ones I visited during my search!
That weekend, I was off to London - sent by the IARU (rowing union) to attend a FISA classification workshop for adaptive (disabled) rowers and it was really useful. Once my documentation's turned in, I'll be the first and only medical and technical rowing classifier in Ireland for awhile, until they send more to be classified. Basically, I'll be officially classifying the athletes into boat categories to optimize their rowing abilities. It's a great project to be involved with helping the IARU to set up a Paralympic team, now that rowing is part of the Paralympic games. And from a medical point of view, the neurological conditions the athletes present with can be very interesting...complete or partial transections, amputations, polio, etc.
A few days later, I was back home to do an elective in Pediatric Emergency Medicine in the Cincinnati Children's Hospital. After a flight back from hell (I had to spend a night on the airport floor and it was Newark, for god's sake) I had a couple days to become unjetlagged and catch up on movies. I've completed 2 weeks of the elective and now have my last 4 days (yay!). To be honest, I haven't enjoyed this rotation as much as my November one at CCF - I liked CCF's structure a bit better, as it can be over-staffed and over-structured here. Also, I think I'm more of a fan of adult medicine versus pediatric medicine. I've found it hard to get to know the attendings because there's not as much contact with them as I had at CCF, so trying to ask for a letter might be awkward. And this whole precepting to fellows who then precept to the attending thing gets kind of annoying. Plus, there's no computer charting at our level anyway, which I don't really like. On the flip side, the kids can be really cute! This elective hasn't deterred my interest in EM any, and overall it's a good experience - I've rediscovered my weak points and have learned not to make assumptions (even though my assumptions are usually right. Better to be completely thorough!). I just feeling "meh" about this rotation has partly to do with me being at the end of my med ed tether and just wanting a break for awhile.
I go back on Friday, and when I land I go straight to Belfast to try to catch my gals' race (Lomac Tiles against Queens University is always very fun!), back down to a 21st, and then to Castleconnell for an adaptive rowing meeting the next day. A couple days to fix up my apartment and set up utilities, then mom's coming for graduation (June 15th, yay!). Busy busy busy! I'll be with my friends again! YAYAY!
The exams were nerve-wracking as we expected. The medicine and surgery papers were fair (except the surgery MCQ was a bit all over the place and definitely not very well organized). The day between the med and surg papers, I found out about a job opening in the US and given the uncertainty of getting a job in Ireland this year, I spent the whole day getting ready and faxing application materials, so didn't start cramming surg until 6 pm ! Definitely not good preparation, but I figured I had to take a shot at this opening, even if it was a long shot.
Then the day after the surgery paper, I was cycling a friend's racer to meet a couple friends for lunch near the hospital. My front wheel clipped and got stuck in the tram tracks, and I went flying. Must have landed under an out-stretched shoulder cuz I dislocated my left shoulder. Being in front of the hospital, I walked to the Emergency Department and was seen fairly quickly (it was quiet). It hurt like hell...I knew dislocated shoulders were supposed to be really painful, but I was really surprised at how much it actually did hurt (when the meds wore off). So then I had to be in a sling for the next 3 weeks - didn't take pain meds cuz they made me really sleepy, and then the diclofenac they prescribed made me quite ill, so stopped taking that. My friends took care of me that weekend though ;). Healing is really slow...nearly 6 weeks on, and I still can't extend my arm to its full range of movement. Abduction's back though!
The following Monday I had a psych paper, which was ok... I wish I'd done more studying for it because I could have done quite well on it. Studying was basically non-existant because the pain meds knocked me out or I was sick from meds. I learned my lesson! Then had a week off before the clinicals. The orals were strange given I only had one arm and couldn't do some of the physical exams....so I got asked some very weird questions instead. Can't say I'm the most loquacious... I wasn't really happy with the long cases, but the shorts in medicine went well. Managed to get through them fairly un-traumatically, one hand and all, and then had an agonizing wait to see if we got Dublin internships or not. After the school playing us around a bit, the postings finally came out 5 days late and fortunately I got a job! Unfortunately, 16 of my class didn't...I hope they've all found suitable alternatives that they're happy with. This whole situation is absolutely ridiculous.
Went straight from finding out about job postings to Kerry to spend with two of my best friends (both rowers, both in medicine) and it was absolutely beautiful. 3 days of doing nothing except enjoy the gorgeous sun on the beach. Anna took us to places she grew up with during childhood, with some stunning spots that have and will remain untouched. Some of the area is very mountainous so can't really be habitable, and the water lying between the mountains is therefore pure. The views were amazing and it made me fall in love with Ireland again (the past couple years have seriously tried my enthusiasm for the place). But I think it's back :).
Then the 2nd week of May was a hectic one, spent searching apartments in the Islandbridge area for something suitable. As all my classmates were away on holiday and I wasn't really keen on sharing (8-9 years in dorms is quite enough, thank you!), landed myself a sweet little place right next to the boathouse (my 2nd home!) in a lovely complex. Quiet, young area and professional area, with a little fountain and garden...expensive but worth it. Especially after some of the infested ones I visited during my search!
That weekend, I was off to London - sent by the IARU (rowing union) to attend a FISA classification workshop for adaptive (disabled) rowers and it was really useful. Once my documentation's turned in, I'll be the first and only medical and technical rowing classifier in Ireland for awhile, until they send more to be classified. Basically, I'll be officially classifying the athletes into boat categories to optimize their rowing abilities. It's a great project to be involved with helping the IARU to set up a Paralympic team, now that rowing is part of the Paralympic games. And from a medical point of view, the neurological conditions the athletes present with can be very interesting...complete or partial transections, amputations, polio, etc.
A few days later, I was back home to do an elective in Pediatric Emergency Medicine in the Cincinnati Children's Hospital. After a flight back from hell (I had to spend a night on the airport floor and it was Newark, for god's sake) I had a couple days to become unjetlagged and catch up on movies. I've completed 2 weeks of the elective and now have my last 4 days (yay!). To be honest, I haven't enjoyed this rotation as much as my November one at CCF - I liked CCF's structure a bit better, as it can be over-staffed and over-structured here. Also, I think I'm more of a fan of adult medicine versus pediatric medicine. I've found it hard to get to know the attendings because there's not as much contact with them as I had at CCF, so trying to ask for a letter might be awkward. And this whole precepting to fellows who then precept to the attending thing gets kind of annoying. Plus, there's no computer charting at our level anyway, which I don't really like. On the flip side, the kids can be really cute! This elective hasn't deterred my interest in EM any, and overall it's a good experience - I've rediscovered my weak points and have learned not to make assumptions (even though my assumptions are usually right. Better to be completely thorough!). I just feeling "meh" about this rotation has partly to do with me being at the end of my med ed tether and just wanting a break for awhile.
I go back on Friday, and when I land I go straight to Belfast to try to catch my gals' race (Lomac Tiles against Queens University is always very fun!), back down to a 21st, and then to Castleconnell for an adaptive rowing meeting the next day. A couple days to fix up my apartment and set up utilities, then mom's coming for graduation (June 15th, yay!). Busy busy busy! I'll be with my friends again! YAYAY!
The future...mall walking?
I just wanted to say that I had no idea mall walking was that big in this country. I mean, I knew people did it...mainly old folks who were told by their docs to get some exercise...but I went to the mall early today trying to beat the rush and ended up having to wait around til they opened at noon. I must have been the only person there not walking...I was lapped by at least 150 walkers in the span of 45 minutes. On one hand I feel it's a bit sad...what happened to walks outside and enjoying the fresh air? But on the other hand, at least they're getting some exercise...and can spend some money afterwords. If I mall walked, I'd reward myself with at least some iTunes afterwords.
Monday, March 26, 2007
Ho hum
2 more weeks til my last exams start, and 5 more weeks of study until I'm done with my formal medical education. On Friday, I had my last lecture of 24 years of schooling. You would think we'd be a bit nostalgic about it, but no...all of us are just ready to get out. Our class has seen some rough times and it's only going to get rougher with this politics nonsense regarding jobs. I hope to god I get an intern job...otherwise I will be very very depressed and basically have no clue what to do.
Anyway, what's happened since the last blog... I took Step 2 CK, and while I didn't think I did brilliantly, I thought it was ok. I was a little unhappy that I wasn't completely confident in flying it, but c'est la vie...that rarely happens with these kinds of 8 hour exams. I could always narrow it down to 2 answers and then was trying to choose between them. Hopefully I chose right! Not as difficult as Step 1, but given limited time to study for it, think I may have been able to do better. A few of my classmates are taking it in May, and that gives them more time...but I'm happy to have it out of the way and not doing them after finals. I honestly don't think at this point in time that I would do better now than I would have 4 weeks ago.
A big plus for me was that my girls won their novice colours race :). That was brilliant, and they stuck to the race plan exactly, and they rowed better than I thought they would. That was fantastic. And nice validation for myself and Anthony that we are doing something right in the coaching area, as the coach we were up against has been coaching for awhile. Everyone had a good night out but I wasn't drinking and left early. Ironically, I was hammered later in the week when we had Commons dinner for final meds. The malaysians weren't drinking so we took all their guinnesses and wine, then went to the Pav and Gingerman afterwards...all of us were fairly smashed after like 2 pints. hhehe.
So two weeks til the finals. They always say things will come together and consolidate. Maybe it's happening a little...but I'm still waiting to feel solidified!
Anyway, what's happened since the last blog... I took Step 2 CK, and while I didn't think I did brilliantly, I thought it was ok. I was a little unhappy that I wasn't completely confident in flying it, but c'est la vie...that rarely happens with these kinds of 8 hour exams. I could always narrow it down to 2 answers and then was trying to choose between them. Hopefully I chose right! Not as difficult as Step 1, but given limited time to study for it, think I may have been able to do better. A few of my classmates are taking it in May, and that gives them more time...but I'm happy to have it out of the way and not doing them after finals. I honestly don't think at this point in time that I would do better now than I would have 4 weeks ago.
A big plus for me was that my girls won their novice colours race :). That was brilliant, and they stuck to the race plan exactly, and they rowed better than I thought they would. That was fantastic. And nice validation for myself and Anthony that we are doing something right in the coaching area, as the coach we were up against has been coaching for awhile. Everyone had a good night out but I wasn't drinking and left early. Ironically, I was hammered later in the week when we had Commons dinner for final meds. The malaysians weren't drinking so we took all their guinnesses and wine, then went to the Pav and Gingerman afterwards...all of us were fairly smashed after like 2 pints. hhehe.
So two weeks til the finals. They always say things will come together and consolidate. Maybe it's happening a little...but I'm still waiting to feel solidified!
Monday, February 12, 2007
2 more weeks til Step 2 CK! AAAAAAAGH! At least it's slightly easier than Step 1, but still...AAAAAAGH!! I think I've planned my study a bit better than Step 1 though, so that's good. but there's always something to not know. I'm pretty much skipping the next 2 weeks of hospital to study for this exam, and a bit worried that that's going to bite me in the butt. I'll just have to work really hard to make up what I've missed and go see some patients! But I really want to nail step 2 cuz I recently received a couple fantastic recommendation letters from attendings at my last rotation which should carry me a good way during interviews as they come from a prominent hospital. That's always a confidence booster ;). But now I need the rest of my application to be solid, as I already have a blip in it from step 1. Sometimes I think I should have waited til May to take Step 2, but seriously...I do not want to take another exam after my finals!
Other than that, have mainly just been coaching. I'm really annoyed at the fact that I'm missing all the rowing parties (yargh!) but just have to have a willpower of steel to get through the end of med school. The girls have had a couple of races and I think they're starting to understand how to move together. If we can just find a way to solidify it (and quickly), regatta season should be a blast !
There've been a couple med parties - one was after the end of the biosoc inaugural and I stayed later than I should have, but it was a lot of fun. One of my Irish friends was really cute and telling me how much she'd miss me and kept hugging & kissing my cheeks. We were really starting to look gay, but ah well. And for med ball ...that was just messy. Another of my friends was hammered, puked on the carpet and left quite early cuz he was so drunk. I called him the next day and he wasn't hungover one bit, the bastard!
Anyway, speaking of drink, I want one. So I better stop before the temptation becomes too great and I end up drinking by myself at 4 pm.
Other than that, have mainly just been coaching. I'm really annoyed at the fact that I'm missing all the rowing parties (yargh!) but just have to have a willpower of steel to get through the end of med school. The girls have had a couple of races and I think they're starting to understand how to move together. If we can just find a way to solidify it (and quickly), regatta season should be a blast !
There've been a couple med parties - one was after the end of the biosoc inaugural and I stayed later than I should have, but it was a lot of fun. One of my Irish friends was really cute and telling me how much she'd miss me and kept hugging & kissing my cheeks. We were really starting to look gay, but ah well. And for med ball ...that was just messy. Another of my friends was hammered, puked on the carpet and left quite early cuz he was so drunk. I called him the next day and he wasn't hungover one bit, the bastard!
Anyway, speaking of drink, I want one. So I better stop before the temptation becomes too great and I end up drinking by myself at 4 pm.
Monday, January 15, 2007
The end's in sight :)
So one of my mates found this site which reminded me I should update it :). So let's see...after the last blog, that was two months of hell studying for the paediatrics and obstetrics/gynecology exams. The written exams were ok but the orals are so subjective, it's really luck of the draw as to what case you get assigned and they're hell! But it all worked out ok.
After the exams, I went back to the Cleveland Clinic to do an elective in ER. It was awesome, maybe not as much fun as MICU in the summer because it's more individual and less team-based, but I loved it. For the last while I've been considering ER for my career and this elective just confirmed it, and of course the great staff made it more appealing. Just my personality seems to fit in - active, hate waiting around, want stuff done with some intensity but like having fun too. Anyway, I think I performed well during the elective and I enjoyed being there so hopefully will get an elective in a Level I trauma center for May after my last set of exams.
I came back to Dublin for Christmas and had a very lovely Irish Christmas as my friend's house (I love real fires. I don't care how much work it takes to clean a chimney, I'm definitely having a real fireplace when I grow up). And probably ate a whole hog in ham :)! It wasn't just all lazing around though, went sculling with friends on Christmas and Stephen's Day - water was lovely, would have been a shame to miss it. I do miss not being able to do as much rowing this year, but am definitely enjoying coaching novices. They're such a fantastic enthusiastic bunch, they make me smile :).
Then for New Years, myself and 2 other friends (from rowing) went to Oslo for 5 days in Norway to visit one of our Norwegian friends. That was really really nice. Her house is really cozy and modern, and it was fantastic getting to catch up with her again since she's really busy at her new job and all of us are busy with life in general. Didn't get to go skiing, but went ice skating instead, and visited a proper ski jump place so we could see what it was like looking down. Only it was very foggy, but you got the idea anyway. Visited her boathouse and stood on some frozen water, walked around Oslo city (it's lovely! big streets, clean). For New Years, we got dressed up and had a fantastic dinner (for 22 at hers), got quite drunk of course and toasted the New Year at a hotel. It might have been the drink or my lack of contacts but when we got home and into our comfy pj's I nearly got into a fight with a guy I thought was a burgler (we still aren't quite sure how he got into the house), but fortunately it didn't come to that. Haven't gotten that agro in awhile!
Now back and straight into hospital work for the last 3 months before our finals in Medicine and Surgery. It's been really tough. Sometimes in from 7:30 (meaning catching the tram at 6:30) and sometimes not done til 7, with no lunch break. Everyone's now stressing cuz we have no time to study and they keep telling us they want us to see patients and we're like...when exactly do we have time for that? And I have to take USMLE 2 Ck at the end of Feb so I'm being antisocial and studying / doing questions in any spare moment I have (now doesn't count). made more difficult by coaching (which I'm not giving up) so I don't get home til really late sometimes. Anyway, where there's a will there's a way! So hopefully everything will work out. There's still so much I need to refine and revise!
After the exams, I went back to the Cleveland Clinic to do an elective in ER. It was awesome, maybe not as much fun as MICU in the summer because it's more individual and less team-based, but I loved it. For the last while I've been considering ER for my career and this elective just confirmed it, and of course the great staff made it more appealing. Just my personality seems to fit in - active, hate waiting around, want stuff done with some intensity but like having fun too. Anyway, I think I performed well during the elective and I enjoyed being there so hopefully will get an elective in a Level I trauma center for May after my last set of exams.
I came back to Dublin for Christmas and had a very lovely Irish Christmas as my friend's house (I love real fires. I don't care how much work it takes to clean a chimney, I'm definitely having a real fireplace when I grow up). And probably ate a whole hog in ham :)! It wasn't just all lazing around though, went sculling with friends on Christmas and Stephen's Day - water was lovely, would have been a shame to miss it. I do miss not being able to do as much rowing this year, but am definitely enjoying coaching novices. They're such a fantastic enthusiastic bunch, they make me smile :).
Then for New Years, myself and 2 other friends (from rowing) went to Oslo for 5 days in Norway to visit one of our Norwegian friends. That was really really nice. Her house is really cozy and modern, and it was fantastic getting to catch up with her again since she's really busy at her new job and all of us are busy with life in general. Didn't get to go skiing, but went ice skating instead, and visited a proper ski jump place so we could see what it was like looking down. Only it was very foggy, but you got the idea anyway. Visited her boathouse and stood on some frozen water, walked around Oslo city (it's lovely! big streets, clean). For New Years, we got dressed up and had a fantastic dinner (for 22 at hers), got quite drunk of course and toasted the New Year at a hotel. It might have been the drink or my lack of contacts but when we got home and into our comfy pj's I nearly got into a fight with a guy I thought was a burgler (we still aren't quite sure how he got into the house), but fortunately it didn't come to that. Haven't gotten that agro in awhile!
Now back and straight into hospital work for the last 3 months before our finals in Medicine and Surgery. It's been really tough. Sometimes in from 7:30 (meaning catching the tram at 6:30) and sometimes not done til 7, with no lunch break. Everyone's now stressing cuz we have no time to study and they keep telling us they want us to see patients and we're like...when exactly do we have time for that? And I have to take USMLE 2 Ck at the end of Feb so I'm being antisocial and studying / doing questions in any spare moment I have (now doesn't count). made more difficult by coaching (which I'm not giving up) so I don't get home til really late sometimes. Anyway, where there's a will there's a way! So hopefully everything will work out. There's still so much I need to refine and revise!
Friday, October 06, 2006
It has all begun again...
Well, London (last weekend of August) was awesome. Went over for the World Rowing Championships to cheer on some friends, and it was fantastic. A lot of Irish people there cheering for the crews, and during the lightweight men's 4- race (with the Irish being up for the gold medal), the buzz was electrifying...it was so exciting! They ended up with the bronze, which is a good result coming into Olympic years. And my friend in the lightweight women's double won the B final and was so cute afterwards, just beaming. Lot of late messy nights, took me like a week to recover!
So then in the beginning of September I started my last official rotation of my med school career - General Practice (same as Family Medicine). It's like a merge between medicine and psychiatry. They do more "medical" stuff but are into all the touchy feely social and emotional stuff too, you don't know whether to be happy it's a more relaxed version of practicing or whether to gag with the corniness and groan at lectures about common-sense crap. We were placed for two weeks in an "inner" Dublin ring and one week in an "outer" ring. My inner was Leixlip (1 hour from Dublin) and my outer was in Kilmuckridge, Wexford (about 2 hours from Dublin). 3 weeks observing was quite enough, I found it very boring. The first clinic treated those who were on methadone, so I just sat watching paperwork being signed. The second clinic was quiet because apparently business was taken away by the National Ploughing Championships (I kid you not). I didn't see anything terribly interesting...but I definitely heard some weird stuff...what goes on in the country....geez.... Anyway, I would definitely Not do GP outright...it would be something I would retire to. At least no ward rounds.
At least this rotation is quite relaxed with a lot of time (not that I have been using it wisely), which is very helpful coming up to my first set of final exams. Irish universities are different in that your grades in previous years don't really count towards your final marks that go towards your graduation mark. That's why final year exams are so pressurized...and it's gotten to us from the first day. We now have 4 weeks to go to the day, 4 weeks to learn all of pediatrics (eeps! it's like all of medicine but for small people) and hopefully get in Obs and Gyne along the way. There are two parts to the exams...a written paper and a clinical one where you're assigned a long and short case. You could be given anything under the sun and asked even more. Scary stuff!
So time to hermit! At least I'm living in a single room on campus which is great for hermitting!
So then in the beginning of September I started my last official rotation of my med school career - General Practice (same as Family Medicine). It's like a merge between medicine and psychiatry. They do more "medical" stuff but are into all the touchy feely social and emotional stuff too, you don't know whether to be happy it's a more relaxed version of practicing or whether to gag with the corniness and groan at lectures about common-sense crap. We were placed for two weeks in an "inner" Dublin ring and one week in an "outer" ring. My inner was Leixlip (1 hour from Dublin) and my outer was in Kilmuckridge, Wexford (about 2 hours from Dublin). 3 weeks observing was quite enough, I found it very boring. The first clinic treated those who were on methadone, so I just sat watching paperwork being signed. The second clinic was quiet because apparently business was taken away by the National Ploughing Championships (I kid you not). I didn't see anything terribly interesting...but I definitely heard some weird stuff...what goes on in the country....geez.... Anyway, I would definitely Not do GP outright...it would be something I would retire to. At least no ward rounds.
At least this rotation is quite relaxed with a lot of time (not that I have been using it wisely), which is very helpful coming up to my first set of final exams. Irish universities are different in that your grades in previous years don't really count towards your final marks that go towards your graduation mark. That's why final year exams are so pressurized...and it's gotten to us from the first day. We now have 4 weeks to go to the day, 4 weeks to learn all of pediatrics (eeps! it's like all of medicine but for small people) and hopefully get in Obs and Gyne along the way. There are two parts to the exams...a written paper and a clinical one where you're assigned a long and short case. You could be given anything under the sun and asked even more. Scary stuff!
So time to hermit! At least I'm living in a single room on campus which is great for hermitting!
Saturday, August 19, 2006
Finally!! SUMMER!
Woooo hooo! Finally finished my MICU elective at Cleveland Clinic, and as fantastic as it was, it was loooong. I'll miss the environment & my team, but I won't miss the 30 hr. shifts and the 3-4 hr. long ward rounds. I enjoyed the work in MICU, but man, those ward rounds...seriously, it's nearly the biggest thing keeping me from going into medicine. I definitely need an active medicine where ward rounds and conferences are minimal. I'd be more of a surgery person, but I can't stand the thought of such repetition, doing the same procedures day in and day out, or those really long 7-hr. ones. I think I'll be able to do an elective in ER at CCF in November, so they won't get rid of me for too long! It'll be great to see what ER is like here, I loved A&E (accident & emergency) in Ireland. I'm glad I learned loads, saw a lot of interesting cases, got over acting like a med student idiot and got an idea of what working in the US is like. Also met some really fun people, med students and residents alike, got a good eval and hopefully an LOR (if he doesn't forget).
I might have said before...I can completely see how doctors get so absorbed into their work and become married to medicine (which doesn't bode very well for social life/relationships!) and I can conceivably see myself being sucked in in the future. That thought is a little depressing, but at least I know now that I love medicine and I'm definitely going into something that's right for me, which I suppose is good! And I also got to see the crazy work that'll have to be put in to advance or direct your career in the way you want it to go. Scary, but who doesn't like a good challenge?
But now I'm ready for my few days of summer next weekend when I go to London for a 3 day pissup!
Before that, have to take the Step 2 CS. I haven't prepared much for it, but I don't feel I really need to. It's mainly English proficiency, H&P and physical exams. I'm not the best with HEENT and Neuro exams, but we'll see how it goes. Will post about it. Anything would be better than my Step 1 anyway! So driving to Atlanta on Sunday to take the damn thing on Tuesday. I hope I don't crash and burn in London!
I might have said before...I can completely see how doctors get so absorbed into their work and become married to medicine (which doesn't bode very well for social life/relationships!) and I can conceivably see myself being sucked in in the future. That thought is a little depressing, but at least I know now that I love medicine and I'm definitely going into something that's right for me, which I suppose is good! And I also got to see the crazy work that'll have to be put in to advance or direct your career in the way you want it to go. Scary, but who doesn't like a good challenge?
But now I'm ready for my few days of summer next weekend when I go to London for a 3 day pissup!
Before that, have to take the Step 2 CS. I haven't prepared much for it, but I don't feel I really need to. It's mainly English proficiency, H&P and physical exams. I'm not the best with HEENT and Neuro exams, but we'll see how it goes. Will post about it. Anything would be better than my Step 1 anyway! So driving to Atlanta on Sunday to take the damn thing on Tuesday. I hope I don't crash and burn in London!
Wednesday, August 09, 2006
Life in the Cleveland Clinic
So I'm post-call yet again, seeing how coherently I can ramble on before I fall asleep at the keyboard. I'm not sure whether napping during call actually helps or not. Cokes definitely don't keep me awake, just make me crash further plus have to pee. I'm still enjoying it and learning a lot, but things are a little slower now than my first week - for some reason, my team isn't getting slammed with codes and new admits like other teams are. Which I suppose is lucky and good, but we're just feeling a bit bored and slacker-ish :). I got a new patient yesterday, but then she was floored and out of our service so the most I did was the admit note. Doing less doesn't make you any less tired though, you're probably more awake when you're up and running around. I still enjoy calls, but they're starting to wear me down a little. Only 2 more left!
The living quarters here are pretty basic, and you can hear everything! When someone goes to the toilet or has a shower, when someone's typing, etc. So can't get a lie in past 6 am! Most of us have long days, and most everyone tries to do a little reading if we can and aren't too tired, but it's hard cuz all we want to do is have fun and watch tv. I've met a few fun and awesome fellow students here, which is a relief. And the residents/fellows/attendings themselves are nice and not averse to some fun, so that's a relief too. This would be a really nice place to do a rotation, I think, although I imagine it'd be hard to get in. Maybe it helps that I know the city too.
Taking the Step 2 CS in 1.5 weeks. I haven't "studied" as much as I've wanted to, but I'm not too worried. All I need to do is review some exams, maybe practice with people (it hasn't really helped that my patients aren't conscious, although I could possibly get in some practicing without feeling like I'm intruding! sounds bad, I know). Seems like my whole life for the past year has been just studying and reading, and it'll definitely be like that next year too if not worse. I hope some of it's going in!
The living quarters here are pretty basic, and you can hear everything! When someone goes to the toilet or has a shower, when someone's typing, etc. So can't get a lie in past 6 am! Most of us have long days, and most everyone tries to do a little reading if we can and aren't too tired, but it's hard cuz all we want to do is have fun and watch tv. I've met a few fun and awesome fellow students here, which is a relief. And the residents/fellows/attendings themselves are nice and not averse to some fun, so that's a relief too. This would be a really nice place to do a rotation, I think, although I imagine it'd be hard to get in. Maybe it helps that I know the city too.
Taking the Step 2 CS in 1.5 weeks. I haven't "studied" as much as I've wanted to, but I'm not too worried. All I need to do is review some exams, maybe practice with people (it hasn't really helped that my patients aren't conscious, although I could possibly get in some practicing without feeling like I'm intruding! sounds bad, I know). Seems like my whole life for the past year has been just studying and reading, and it'll definitely be like that next year too if not worse. I hope some of it's going in!
Wednesday, July 26, 2006
medicine! wooooo!
Well, it's been awhile, so much has happened!
Finished my OB/GYN rotation in June in the Rotunda doing Labour Ward nights (ie. the 10 pm to 8 am shift). I thought I'd hate it, but I really enjoyed it. I delivered my first baby on June 19th @ 4:51 am, and he was the cuuuutest little baby boy I've ever seen. The parents were fantastic, and let me give him his first bottle and play with him for awhile, took a picture of me feeding him and brought me the picture the next day! That was really sweet. It was a good rotation but I don't think I'd want to do it for my life. Delivering babies and everything involved with that region...it's just kinda gross.
Spent the month of July finishing off the rowing season. This month is my "holiday" month, which wasn't much of a holiday between moving to different places, catching up on errands, and the rollercoaster that is rowing. The national championships were on the 14th and 15th, and in our 8's race, we came 2nd. We rowed decently, but we were pretty disappointed with that. The team which came 1st beat us by a long way, but at least we'd gained some back on them from our last race in June. Anyway, that's team rowing done for me - will probably scull next year since I can't commit to team training while doing finals. It's been enjoyable, and Captaining this year has also been enjoyable, but I think it would have been even more so if I didn't have so many things going on (ie. stupid group projects and the TSMJ (student med journal) which became the bane of my existence for 2 months). Definitely glad to have a break!
Now doing an elective in MICU (medical intensive care) at the Cleveland Clinic. This is only my 2nd day, and it's awesome. I love it, and I love being here. And I love that I know this job will be the right one for me. So my first day yesterday was eventful enough with consults. Today was a little harder because my team were on codes (as in "code blue code blue!"). Since Cleveland Clinic is so large, you actually have to run from floor to floor and building to building every time a code is called. It's like ER or Scrubs. But what made today hard was not the fact that we were dealing with patients nearly on their death beds, but talking to their families afterwards, and they're crying and appreciative of your work but obviously very sad, and it's really touching. You try to remove yourself a little without being cold-hearted, and it's hard to do. I nearly cried, my junior resident actully did cry. And several codes happened within the space of like 2 hours so you couldn't get a break from the depression. So that bit obviously no one likes, but it was really good to see how the jr. and sr. residents handled it. Then after work, we went to a happy hour/dinner that was being held for the residents (I think I was the only med student there) and it was just my team + fellow there, and we just had the best time making fun of each other. My team is awesome, everyone is really nice, and I actually got a speech from the fellow yesterday about how we're all one big family and if I'm unhappy, they're unhappy, etc. This is the most organized rotation I have ever had with orientation, accommodation, pagers, nearly everything for free, and they're so keen on teaching.
The work hours are long but time passes by without you realizing. So I usually start at 9 am, which means 8 if I have to pre-round (everyone else is there at 7), and then you're done by 6 or 6:30 pm. Unless you're on call, which I am tomorrow...then you don't finish til noon the following day. So unfortunately, haven't had time to visit the gym any, but maybe I will my post call day or tomorrow morning before pre-rounding. And, I love that this rotation I can stay in scrubs and sneakers. So much more comfortable! And, hopefully by the end of the week I'll have put in a central line, several IV and arterial lines, ABGs, Corpaks (PEG system), etc. AWESOME.
I'm really impressed by this rotation so far, I'm considering internal medicine now as well (ie route to EM and ICU). ICU wouldn't be a bad field to be in. It's definitely an active medicine (although ward rounds do take 3 hours, which I don't like), and it's chaotic enough without being too chaotic. I loved A&E (ER) in St. James's, but that emergency dept is a lot smaller than the ones in the US. I visited the ED in Cleveland Clinic, and that seemed a bit insane - unhappy chaotic, not a good kind of chaotic. And in MICU, we're probably doing all the same procedures they're doing in ER anyway.
Oh, and I passed the USMLEs. Not a great score, but I always knew that'd be my downfall. I don't study enough, so it'll be cool to see what happens next yr when i actually do study!
Finished my OB/GYN rotation in June in the Rotunda doing Labour Ward nights (ie. the 10 pm to 8 am shift). I thought I'd hate it, but I really enjoyed it. I delivered my first baby on June 19th @ 4:51 am, and he was the cuuuutest little baby boy I've ever seen. The parents were fantastic, and let me give him his first bottle and play with him for awhile, took a picture of me feeding him and brought me the picture the next day! That was really sweet. It was a good rotation but I don't think I'd want to do it for my life. Delivering babies and everything involved with that region...it's just kinda gross.
Spent the month of July finishing off the rowing season. This month is my "holiday" month, which wasn't much of a holiday between moving to different places, catching up on errands, and the rollercoaster that is rowing. The national championships were on the 14th and 15th, and in our 8's race, we came 2nd. We rowed decently, but we were pretty disappointed with that. The team which came 1st beat us by a long way, but at least we'd gained some back on them from our last race in June. Anyway, that's team rowing done for me - will probably scull next year since I can't commit to team training while doing finals. It's been enjoyable, and Captaining this year has also been enjoyable, but I think it would have been even more so if I didn't have so many things going on (ie. stupid group projects and the TSMJ (student med journal) which became the bane of my existence for 2 months). Definitely glad to have a break!
Now doing an elective in MICU (medical intensive care) at the Cleveland Clinic. This is only my 2nd day, and it's awesome. I love it, and I love being here. And I love that I know this job will be the right one for me. So my first day yesterday was eventful enough with consults. Today was a little harder because my team were on codes (as in "code blue code blue!"). Since Cleveland Clinic is so large, you actually have to run from floor to floor and building to building every time a code is called. It's like ER or Scrubs. But what made today hard was not the fact that we were dealing with patients nearly on their death beds, but talking to their families afterwards, and they're crying and appreciative of your work but obviously very sad, and it's really touching. You try to remove yourself a little without being cold-hearted, and it's hard to do. I nearly cried, my junior resident actully did cry. And several codes happened within the space of like 2 hours so you couldn't get a break from the depression. So that bit obviously no one likes, but it was really good to see how the jr. and sr. residents handled it. Then after work, we went to a happy hour/dinner that was being held for the residents (I think I was the only med student there) and it was just my team + fellow there, and we just had the best time making fun of each other. My team is awesome, everyone is really nice, and I actually got a speech from the fellow yesterday about how we're all one big family and if I'm unhappy, they're unhappy, etc. This is the most organized rotation I have ever had with orientation, accommodation, pagers, nearly everything for free, and they're so keen on teaching.
The work hours are long but time passes by without you realizing. So I usually start at 9 am, which means 8 if I have to pre-round (everyone else is there at 7), and then you're done by 6 or 6:30 pm. Unless you're on call, which I am tomorrow...then you don't finish til noon the following day. So unfortunately, haven't had time to visit the gym any, but maybe I will my post call day or tomorrow morning before pre-rounding. And, I love that this rotation I can stay in scrubs and sneakers. So much more comfortable! And, hopefully by the end of the week I'll have put in a central line, several IV and arterial lines, ABGs, Corpaks (PEG system), etc. AWESOME.
I'm really impressed by this rotation so far, I'm considering internal medicine now as well (ie route to EM and ICU). ICU wouldn't be a bad field to be in. It's definitely an active medicine (although ward rounds do take 3 hours, which I don't like), and it's chaotic enough without being too chaotic. I loved A&E (ER) in St. James's, but that emergency dept is a lot smaller than the ones in the US. I visited the ED in Cleveland Clinic, and that seemed a bit insane - unhappy chaotic, not a good kind of chaotic. And in MICU, we're probably doing all the same procedures they're doing in ER anyway.
Oh, and I passed the USMLEs. Not a great score, but I always knew that'd be my downfall. I don't study enough, so it'll be cool to see what happens next yr when i actually do study!
Friday, May 26, 2006
Man, I have GOT to start studying! Two weeks to the day until boards and not much to show for it. I've done a few practice Q's here and there, made some notes in the USMLE Bible that is First Aid, but I seriously have to step it up! I'm taking all of next week off, today's the last dossing day.
But it was a good one ;). Went to the gym early to release all the pent-up energy from the last few days - we're on a little lighter schedule of rowing training to accomodate the exam period. Didn't work too well cuz I'm still wanting to go for a run now. Then spent this morning running errands and splurging a bit before a few of the rowing gals came over for lunch. We're really close - I suppose a few of us have been together a few years now and seeing someone every day for like 2-3 years tends to bring you together :). It gets a bit bitchy sometimes, but we're each other's psychologists too. So myself and Anna decided to give people an exam pick-me-up, especially since one of the girls has had a tough time of it lately, and made a gorgeous lunch, I love lunches like that. Anna brought over a warm loaf of multigrain brown bread from Avoca that seriously could have been like a cake, and some salad leaves/tomatoes. I had corn for the salad and ham/cheese for the bread and ice cream to top it all off! I'll miss those lunches when I leave - they started about 3 years ago when Dor was Captain - a really good salad +/- potatoes with mayonnaise and bread in Rowing Rooms. And of course something sweet to top it off afterwards with a cup of Barry's Gold or coffee. Simple but perfect.
Continuing on my reflection... I love Trinity. And I love that all students of Trinity love Trinity. It gives us a really unique sense of community and pride, moreso than any of the other Irish colleges. It could have something to do with the fact that it's a closed campus...literally...it's walled all the way around and all open space is contained within the college campus itself. But I feel like I'm catchin up on that sense of school pride that I missed while attending CWRU, since I really didn't like being there, everyone was apathetic and that place really didn't suit me socially. Apart from a few friends, I wish I never wasted my time going there not from an academic point of view (the educational opportunities are endless)but for my own personal happiness and sanity. Ultimately it's what led to me and Viv coming to Trinity in the first place on junior year abroad...we just had to escape from the confines of that soul-sucking place. I hear it's better there now with the new renovations. Good for them, but I'm so happy that I came here. I'll be an IMG (international med graduate) but it's been worth it!
But it was a good one ;). Went to the gym early to release all the pent-up energy from the last few days - we're on a little lighter schedule of rowing training to accomodate the exam period. Didn't work too well cuz I'm still wanting to go for a run now. Then spent this morning running errands and splurging a bit before a few of the rowing gals came over for lunch. We're really close - I suppose a few of us have been together a few years now and seeing someone every day for like 2-3 years tends to bring you together :). It gets a bit bitchy sometimes, but we're each other's psychologists too. So myself and Anna decided to give people an exam pick-me-up, especially since one of the girls has had a tough time of it lately, and made a gorgeous lunch, I love lunches like that. Anna brought over a warm loaf of multigrain brown bread from Avoca that seriously could have been like a cake, and some salad leaves/tomatoes. I had corn for the salad and ham/cheese for the bread and ice cream to top it all off! I'll miss those lunches when I leave - they started about 3 years ago when Dor was Captain - a really good salad +/- potatoes with mayonnaise and bread in Rowing Rooms. And of course something sweet to top it off afterwards with a cup of Barry's Gold or coffee. Simple but perfect.
Continuing on my reflection... I love Trinity. And I love that all students of Trinity love Trinity. It gives us a really unique sense of community and pride, moreso than any of the other Irish colleges. It could have something to do with the fact that it's a closed campus...literally...it's walled all the way around and all open space is contained within the college campus itself. But I feel like I'm catchin up on that sense of school pride that I missed while attending CWRU, since I really didn't like being there, everyone was apathetic and that place really didn't suit me socially. Apart from a few friends, I wish I never wasted my time going there not from an academic point of view (the educational opportunities are endless)but for my own personal happiness and sanity. Ultimately it's what led to me and Viv coming to Trinity in the first place on junior year abroad...we just had to escape from the confines of that soul-sucking place. I hear it's better there now with the new renovations. Good for them, but I'm so happy that I came here. I'll be an IMG (international med graduate) but it's been worth it!
Wednesday, May 24, 2006
On some down-time waiting for lecture to begin. So I'll continue updating my life :). It's a nervous time right now because although we're not in final med yet, all the rotations/study/tutorials are being geared towards doing the obs/gyne and paeds finals in November, then the medicine/surgery finals in April. Lecturers are going through what they're looking for when you present, how to make yourself shine, and all the stuff they expect you to know...and some of the things they want as basic knowledge seem like honors questions! That plus trying to figure out what you want to do and narrow down your field choices.
I'm definitely more a surgery person than medicine. Medicine's too boring for me, can't stand the 4+ hour ward rounds and 2+ hour conferences. Guess it won't be a life of free pens for me :). So I'm considering more active medicines like Emergency Med (which I really enjoyed) and am also interested in musculoskeletal medicine (PM&R), following on my natural inclination to fields like anatomy and exercise physiology. Problem being that physiatry doesn't really exist anywhere other than the US, so I haven't had any real exposure to it yet except for 2 days shadowing I did at Christmas. I also would consider general surgery, but I haven't heard anything good about surgery in the US in terms of lifestyle and colleagues. Lifestyle I wouldn't have a problem with. People being dicks to each other for absolutely no reason, or trying to one-up each other all the time, I would have a big problem with. I always think people work best when each person tries to be cooperative with everyone else, and I would not deal well in a situation where everyone keeps to themselves and hoardes info/ambitions. I'd really like orthopedic surgery (more an jocks/boys club than anal surgery) or even ophthalmology, but those are impossible fields to get into especially for IMGs like me.
Right now, planning on returning to the US for internship/residency. That's where the best post-graduate training and resources are, even though primary med ed is pretty standardized universally. And a life of large space, luxury and efficiency is appealing. To be honest, I like the european lifestyle (and dare I say people) better but it would be nearly impossible to advance career-wise over here, since I'm non-EU and non-Irish. If I could stay in Europe with an equal chance for career advancement I would, though probably would explore somewhere other than Ireland. Wouldn't mind doing a bit in Australia either, and I think eventually I would like to join one of those groups like Doctors-without-Borders to explore a different side of medicine and expose myself to problems/issues that I would never encounter otherwise.
But first things first, I've got to pass this damn USMLE first. It's an annoyingly difficult exam, and my studying hasn't been the best for it. I can't seem to concentrate very well, and it's a bloody 7+ hour exam! Each subject you study in medicine is huge as it is, and this exam combines them all! Whoever devised this exam must've been a big time nerd with a chip on his shoulder who's getting payback on those docs who've managed not to have social problems. Well it's working, it's KICKING MY ASS.
I'm definitely more a surgery person than medicine. Medicine's too boring for me, can't stand the 4+ hour ward rounds and 2+ hour conferences. Guess it won't be a life of free pens for me :). So I'm considering more active medicines like Emergency Med (which I really enjoyed) and am also interested in musculoskeletal medicine (PM&R), following on my natural inclination to fields like anatomy and exercise physiology. Problem being that physiatry doesn't really exist anywhere other than the US, so I haven't had any real exposure to it yet except for 2 days shadowing I did at Christmas. I also would consider general surgery, but I haven't heard anything good about surgery in the US in terms of lifestyle and colleagues. Lifestyle I wouldn't have a problem with. People being dicks to each other for absolutely no reason, or trying to one-up each other all the time, I would have a big problem with. I always think people work best when each person tries to be cooperative with everyone else, and I would not deal well in a situation where everyone keeps to themselves and hoardes info/ambitions. I'd really like orthopedic surgery (more an jocks/boys club than anal surgery) or even ophthalmology, but those are impossible fields to get into especially for IMGs like me.
Right now, planning on returning to the US for internship/residency. That's where the best post-graduate training and resources are, even though primary med ed is pretty standardized universally. And a life of large space, luxury and efficiency is appealing. To be honest, I like the european lifestyle (and dare I say people) better but it would be nearly impossible to advance career-wise over here, since I'm non-EU and non-Irish. If I could stay in Europe with an equal chance for career advancement I would, though probably would explore somewhere other than Ireland. Wouldn't mind doing a bit in Australia either, and I think eventually I would like to join one of those groups like Doctors-without-Borders to explore a different side of medicine and expose myself to problems/issues that I would never encounter otherwise.
But first things first, I've got to pass this damn USMLE first. It's an annoyingly difficult exam, and my studying hasn't been the best for it. I can't seem to concentrate very well, and it's a bloody 7+ hour exam! Each subject you study in medicine is huge as it is, and this exam combines them all! Whoever devised this exam must've been a big time nerd with a chip on his shoulder who's getting payback on those docs who've managed not to have social problems. Well it's working, it's KICKING MY ASS.
Monday, May 22, 2006
Summary of the year so far
Well, after nearly a year I've decided to rekindle my blogging efforts. I've joined the bebo and myspace craze (great inventions!), and as awesome as they are, ya don't want to read a lot on them...makes them crammed. I like my internet aesthetically pleasing. So I've recently gotten in touch with a few mates who I haven't talked to in literally years, and since I'm cutting myself off from AIM cuz I get a bloop everytime I try to study, I figured this blog would be a great way of staying in touch!
I'm still in Dublin at Trinity College (I love this place!), one year away from becoming a full-fleged doctor. Right now I'm doing a rotation in Obstetrics and Gynecology, which to be honest, I'm not a huge fan of. Today in my group was me and 3 guys - we went to see a C-section of a woman with placenta accreta (a complication of pregnancy). Because it's relatively rare, there were like 20 people crammed at the foot of the bed trying to get a view. So the placenta dislodges spontaneously, and there was huge gushing of blood...like seriously, waterfall coming out of this tiny woman. And the surgeons are in there tugging away trying to get the baby out but one of them was rather rattled from all the blood spewing forth and her hands were shaking badly. When they got the baby out, it was blue and not breathing and was the most awful shade of pale grey imaginable. If anyone had looked at us 4 med students they would have seen 4 people who couldn't have gotten out of there faster! None of us were particularly keen on seeing a baby die. So they whisk the baby away and are slapping it to get it to respond and eventually have to intubate the baby (the instruments are kind of cute actually cuz they're like mini versions of the adult tools) , which they had trouble doing so there was a bit of panic. But after what seemed like ages, they got the baby tubed and she turned a nice normal color, and they controlled the mother's bleeding too (after a Lynch suture which makes the uterus look kind of like a pork round...) . So all was good. I'll give it more time, but not really falling in love with obs/gyne right now.
My last rotation was Ophthalmology, which was really cool. I enjoyed it, found more doctors to add to my list of people I want to be when I grow up, and learned loads. I thought it was going to be incredibly boring when I first came into it, and I don't like things poking eyes and whatnot, but it was cool watching the cataract surgeries and finally learning how to use the fundoscope. The only thing I didn't like was watching the unblocking of a lacrimal duct in a kid - that is viscious! They take this wire and literally jam it down the inner side of the eye...EW. I'd consider Ophtho if it wasn't so bloody hard to get into.
Before that was ENT. Which I pretty much skipped because of all the work that had to be done for the Trinity Student Medical Journal (which I directed this year). This year ended up being a hell of a lot more work than it should have been for various reasons - laziness on the part of some people and type A personalities of medics. Seems sort of ironic that the two happened simultaneously. Fortunatelly for me, the ENT rotation is a bit of a joke and as with some other things, it's "teach yourself medicine" time. I went in for two hours the whole rotation, and learned how to use an otoscope. Not well.
Before that, I was doing Anesthesiology which was an AWESOME rotation simply because the anesthetists were so keen on teaching. I really wish I could have spent more time there, but because of the feckin TSMJ, I had to skip a bit. I don't think I'd do anesthesiology, but it was way better than I thought it would be and not too boring because in theatre when anesthetists are just basically monitoring, you'd get a tutorial so you're not just sitting there staring into space. This rotation was split with radiology, which was also quite interesting. I liked viewing the MRI interpretations. For some reason, I just like MRIs in general. Not any specific body part, but MRIs of anything.
In January, I did Paediatrics. That was hell on wheels. A whole load of bitchiness came out of everyone. All I'll say for now is that MEDICAL STUDENTS AND GROUP PROJECTS DO NOT GET ALONG. DO NOT ASSIGN MEDICAL STUDENTS GROUP PROJECTS! I mean, it's pretty self-explanatory isn't it? What happens when you put 10 type-A personalities in together? And add to that a couple people who rank 10/10 on the laziness and stupidness scale? (trust me...there are some really stupid people doing medicine. I know that's not reassuring to the general public). That just really ruined the rotation for me. Plus I've never seen such flagrant examples of subjective grading in my life, with examiners hiding behind the excuse that "life isn't fair." Why the hell does that give them license to ignore the universal best practice of standardized examinations? The kids were the actual fun part. And I'm so glad I didn't drop any of them.
In December, I did Hepatology. That sucked because the team sucked. I learned nothing and felt it was a waste of time so essentially skipped it.
For October/November, I was doing Psychiatry. It wasn't as bad as I thought it would be. But that's probably because I started off interviewing a bipolar patient, who are mad fun people (I don't mean "mad" to be a pun). When they come into hospital, they're in their manic phase and delusional, but really fun to hang out with and interview. My patient even sang for me! So I got a good introduction to psych :). The rotation was enlightening and not too difficult. Some people in my class are now enamoured with it...but not for me. I find it still a bit waffly and psychiatrists are a different breed - sorry to the psychiatrists out there, but man...they say in 45 minutes what they could have said in 10, and what makes it worse is that you can anticipate what they're going to say about 3 minutes before they get around to saying it :).
Anyway, that's just a long brief recap of my rotations so far. All this + studying for USMLEs and Captaining my rowing team + TSMJ + SDN! I'll be glad when I can look back at this year and laugh.
I'm still in Dublin at Trinity College (I love this place!), one year away from becoming a full-fleged doctor. Right now I'm doing a rotation in Obstetrics and Gynecology, which to be honest, I'm not a huge fan of. Today in my group was me and 3 guys - we went to see a C-section of a woman with placenta accreta (a complication of pregnancy). Because it's relatively rare, there were like 20 people crammed at the foot of the bed trying to get a view. So the placenta dislodges spontaneously, and there was huge gushing of blood...like seriously, waterfall coming out of this tiny woman. And the surgeons are in there tugging away trying to get the baby out but one of them was rather rattled from all the blood spewing forth and her hands were shaking badly. When they got the baby out, it was blue and not breathing and was the most awful shade of pale grey imaginable. If anyone had looked at us 4 med students they would have seen 4 people who couldn't have gotten out of there faster! None of us were particularly keen on seeing a baby die. So they whisk the baby away and are slapping it to get it to respond and eventually have to intubate the baby (the instruments are kind of cute actually cuz they're like mini versions of the adult tools) , which they had trouble doing so there was a bit of panic. But after what seemed like ages, they got the baby tubed and she turned a nice normal color, and they controlled the mother's bleeding too (after a Lynch suture which makes the uterus look kind of like a pork round...) . So all was good. I'll give it more time, but not really falling in love with obs/gyne right now.
My last rotation was Ophthalmology, which was really cool. I enjoyed it, found more doctors to add to my list of people I want to be when I grow up, and learned loads. I thought it was going to be incredibly boring when I first came into it, and I don't like things poking eyes and whatnot, but it was cool watching the cataract surgeries and finally learning how to use the fundoscope. The only thing I didn't like was watching the unblocking of a lacrimal duct in a kid - that is viscious! They take this wire and literally jam it down the inner side of the eye...EW. I'd consider Ophtho if it wasn't so bloody hard to get into.
Before that was ENT. Which I pretty much skipped because of all the work that had to be done for the Trinity Student Medical Journal (which I directed this year). This year ended up being a hell of a lot more work than it should have been for various reasons - laziness on the part of some people and type A personalities of medics. Seems sort of ironic that the two happened simultaneously. Fortunatelly for me, the ENT rotation is a bit of a joke and as with some other things, it's "teach yourself medicine" time. I went in for two hours the whole rotation, and learned how to use an otoscope. Not well.
Before that, I was doing Anesthesiology which was an AWESOME rotation simply because the anesthetists were so keen on teaching. I really wish I could have spent more time there, but because of the feckin TSMJ, I had to skip a bit. I don't think I'd do anesthesiology, but it was way better than I thought it would be and not too boring because in theatre when anesthetists are just basically monitoring, you'd get a tutorial so you're not just sitting there staring into space. This rotation was split with radiology, which was also quite interesting. I liked viewing the MRI interpretations. For some reason, I just like MRIs in general. Not any specific body part, but MRIs of anything.
In January, I did Paediatrics. That was hell on wheels. A whole load of bitchiness came out of everyone. All I'll say for now is that MEDICAL STUDENTS AND GROUP PROJECTS DO NOT GET ALONG. DO NOT ASSIGN MEDICAL STUDENTS GROUP PROJECTS! I mean, it's pretty self-explanatory isn't it? What happens when you put 10 type-A personalities in together? And add to that a couple people who rank 10/10 on the laziness and stupidness scale? (trust me...there are some really stupid people doing medicine. I know that's not reassuring to the general public). That just really ruined the rotation for me. Plus I've never seen such flagrant examples of subjective grading in my life, with examiners hiding behind the excuse that "life isn't fair." Why the hell does that give them license to ignore the universal best practice of standardized examinations? The kids were the actual fun part. And I'm so glad I didn't drop any of them.
In December, I did Hepatology. That sucked because the team sucked. I learned nothing and felt it was a waste of time so essentially skipped it.
For October/November, I was doing Psychiatry. It wasn't as bad as I thought it would be. But that's probably because I started off interviewing a bipolar patient, who are mad fun people (I don't mean "mad" to be a pun). When they come into hospital, they're in their manic phase and delusional, but really fun to hang out with and interview. My patient even sang for me! So I got a good introduction to psych :). The rotation was enlightening and not too difficult. Some people in my class are now enamoured with it...but not for me. I find it still a bit waffly and psychiatrists are a different breed - sorry to the psychiatrists out there, but man...they say in 45 minutes what they could have said in 10, and what makes it worse is that you can anticipate what they're going to say about 3 minutes before they get around to saying it :).
Anyway, that's just a long brief recap of my rotations so far. All this + studying for USMLEs and Captaining my rowing team + TSMJ + SDN! I'll be glad when I can look back at this year and laugh.
Tuesday, July 19, 2005
The Messy Medic
Hi,
First off, I'd like to say that I'm not really messy. Well, maybe a little, but I will actually clean my room when I can't open my closet door due to the piles of crap stacked in front of it. At the moment, my crap consists of un-ironed clothes, training kit and books strewn across the disarray that is my floor. Fortunately for me and everyone else, *most* of it's clean. To be honest, I really don't understand the concept of blogging. Who really wants to know what someone did at 3:07 pm on July 19th, 2005? But I'm creating this mainly for myself, since I don't keep a diary and I type faster than I write. I would some day like to be able to look back and ask myself "what the hell I was thinking?!" as life progresses to a point that eventually will make no sense :). Also, currently studying for the U-Smellies (USMLE), blogging as a procrastination device is self-explanatory. But I won't be one of those who posts every day, or even every week.
First off, I'd like to say that I'm not really messy. Well, maybe a little, but I will actually clean my room when I can't open my closet door due to the piles of crap stacked in front of it. At the moment, my crap consists of un-ironed clothes, training kit and books strewn across the disarray that is my floor. Fortunately for me and everyone else, *most* of it's clean. To be honest, I really don't understand the concept of blogging. Who really wants to know what someone did at 3:07 pm on July 19th, 2005? But I'm creating this mainly for myself, since I don't keep a diary and I type faster than I write. I would some day like to be able to look back and ask myself "what the hell I was thinking?!" as life progresses to a point that eventually will make no sense :). Also, currently studying for the U-Smellies (USMLE), blogging as a procrastination device is self-explanatory. But I won't be one of those who posts every day, or even every week.
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