Top Five Things I Wish They Taught Me In Med School

It is Top Ten Tuesday, but I don’t feel like doing their selected list topic about the top ten things that make blogging better/easier.  So, instead, I have decided to do another top ten… Well, five. The top five things I wish they had taught me in med school.

So, first I have to say that much of medicine is learned in an apprenticeship style.  Things you pick up along the way by watching people and trying to do things and such.  The problem is some of these things would be nice to actually be shown to us instead of us learning by trial and error, by begging people to show you or by just wandering in ignorance.

  1. How to fix beeping IV pumps.  I feel like I have mastered the silence button and can restart some of them if it is just a brief kink in the line, but I feel like I could be so much more helpful if I could stop the beeping or end empty bags of fluid and such.
  2. How to properly select and apply dressings.  I mean, I get the whole dry gauze and tape thing, but when you get into all of the different products and what is safe to use on what and when it is okay to take it off.  I know this is a whole field in medicine, but I would just like some basics.  More than what I have picked up thus far.  Because I feel bad when I rip dressings off of people and then don’t really know how to properly fix things back up (I mean, I try to stick things back on or create something makeshift, but I would love to do it better).
  3. Proper lifting/personal care techniques.  I have a background that taught me how to transfer people and how to do things like bed pans and such.  But, I would love a refresher and know that being able to do these things appropriately would be a huge help, especially in clinic.
  4. How to use a fax machine.  In this day and age, it is assumed everyone knows how to work a computer.  But nobody really thinks about the fax machine.  Those suckers are more complicated than they look.  One wrong page direction or a missed “dial 9 first” and the thing goes out into limbo.
  5. Where things are located.  I know this is on a hospital by hospital basis.  But someone should tell you that, so you don’t waste 15 minutes of your day trying to find a sterile towel.
  6. Depressing bonus:  How to deal with the sad, ugly stuff that comes from real life where things don’t go as you hoped or planned.

What do you wish they taught you in med school or taught your doctor in med school?

I am not a gold digger

It is guest post time.  My lovely husband Patrick volunteered to submit a post in a potential series of posts that he entitles “Married to a doctor, but I am not a gold digger.”  I take no responsibility for any sappiness to follow.

The spouse and I.

The spouse and I.

Yes, I am married to the lovely Doctor (Resident) that writes this awesome blog but I am not a gold digger as some well-meaning, but clearly paranoid,  people actually asked  if Trisha if she was worried about that possibility in the past.  For starters, I don’t fit all stereotypical qualities of a gold-digger such as being younger (I’m older) or more beautiful (Trisha’s personality wasn’t the only reason I married her). But, the main reason I’m not a gold-digger is due to the fact that I broke the cardinal rule of gold-digging- I married her way before she was financially ready to fund my globe-trotting, “charge it!” lifestyle!

When we started dating, she was a poor broke student who hadn’t even applied to medical school yet but that didn’t stop me from falling in love with her. After all, I wasn’t looking for a doctor or lawyer but a best friend to have fun, start a family and grow old together with.  I had so much fun with her that I married her just before her 2nd year of Medical school (which many people see as crazy in itself) when her finances were increasing…  In debt, that is.  As you know she was studying in the isolated but beautiful Rock. We spent our first three years of marital bliss (most of the time) living in a basement (but nice) apartment without cable TV (everything is online now anyway) and “Jag”, a car that wasn’t old in years but was known affectionately as the car with all the miles on it at the service department.  Our main source of income was my part-time jobs which sometimes added up to full-time depending on how many hours I got.  I didn’t even substitute teach until the last few months there.  I think we will always look back on that time as a very happy and unique time in our lives. We didn’t live beyond our means but still had a lot of fun with all the friends, many who became like family in a place where we had none.

Anyway, now that I’ve proved that I ‘m not a gold digger I’ll share a few thoughts on what its really like to be married to a doctor in training.

I feel like I could write a blog about it myself and many people have done just that.  Most of the blogs I’ve come across on have been written by a female, however, the highs and lows are still very much the same- except of course my inability to personally birth our future children.

Studying to be a doctor is no cake walk as everyone knows, so it’s not that surprising that most people think it’s crazy to get married in the middle of medical school.  I’m sure that the same people think that I was crazy to marry a medical student because she clearly doesn’t have the time or energy needed to be a good wife after long days of studying and working with patients.  But I don’t think that’s true, at least not for Trisha.   Some people get tunnel vision when faced with challenging things and that is all their life is- eat, sleep and study (or other fill in the blank activity).  To each their own, but I’m very glad that Trisha is not that type. Yes, she is much focused but needs to have a real life that I and friends outside of school/hospital play a big part in.  That is not always easy, but we make it work because it’s more than worth it.   For example, Trisha was stuck in the hospital on call this past New Year’s Eve but I met her in the cafeteria to eat Chinese food and ring in the New Year a little early.  In the end I was actually glad I was home with the cat when midnight struck, so I could be there to comfort him (Jeter who is not a big fan of fireworks to say the least).

One of my main love languages is quality time, which may seem problematic with a wife who has a very demanding profession. I can’t say that I always get as much time as I or we would like.  But really who does?

We are both glad that we don’t work together (as many of her friends and their significant others do) because it makes reconnecting at the end of the day more interesting, not to mention our different working styles would probably drive us both crazy!  When Trisha and I first started dating, a person once told me about their brother, a teacher, who was married to another teacher and how perfect that was for them. Holidays and summer holidays together-what’s not to love.  In theory it does hold some appeal and we have married teacher friends who are doing just fine. However the reality starting out is not so rosy from the way I see it.  In most of Canada new teachers substitute for years before getting a full-time gig or have to move far away to get one (like to the Yukon). I don’t think it would be fun for Trisha and me to be competing for substitute and eventually full-time jobs, all while trying to make ends meet with part-time jobs that hopefully don’t interfere with teaching.  Plus, we would both be so sick of kids by the time we got home that we wouldn’t want anything to do with our own!  I kid (pun intended) about the last part but nevertheless I’m glad Trisha has chosen a profession where her chances of getting a job are a lot better even if we still may have to move farther away from home.

Does that make me a gold digger? I don’t think so but I’ll let you decide. All I know is that Trisha and I are still having fun and I think the best is yet to come. 

Weekly Photo Challenge: Change

This week’s Weekly Photo Challenge with the Daily Post is entitled “change.”

I have been through a ton of change over the last year or so.  At some points I felt like I was drowning in change.  I graduated from med school, we moved to a new city, we started new jobs, we left some old friends and made some new friends, we left an old  church and started going to a new church, etcetera.  So much change.

The photos I chose to portray are from my graduation last May.  It shows Patrick and I, some friends and family just after I officially became an MD, which was one of the biggest changes of the year, mainly because it led to all of the other change.

Why research?

Some of you may have read earlier this week that I participated in my program’s research day this week and that it was a successful endeavor.

I ended up having a conversation with someone there who also went to the same medical school I did, then moved here for residency about research.

Although both schools are small in the grand scheme, the place where we work and learn now is bigger and more “old school” when it comes to perspectives on research.

First of all, research is so important to medicine.  Without research, we would almost never come up with new treatments, we would have little idea what actually works better and we wouldn’t have such a good understanding of illness.  I still think we could do better on some fronts, but without research as a big and important part, we would miss out on so much.

Learning to do research properly, having it incorporated into our residency programs is huge.  The whole culture of research has evolved over the last number of years.  There is much more protection of participants, there are measures in place to ensure appropriate measures.  Back in the day, there were people making up whole trials, whole sets of data made up or altered (refer to the whole immunization and autism garbage).  We protect more against that stuff now.

Research saves and changes lives.

I am a huge believer in enrollment in clinical trials.  I think people who take part in them are not only giving themselves the best chance for excellent treatment and care, but they are helping future generations to come.  Taking part in any project can take a bit more time, but it contributes to so much more than what each individual can gain.  That is an amazing phenomenon.

In our discussion, we talked about how the school we went to before valued research.  We were told we were encouraged to do it.  But, projects available to medical students were few and far between.   Most people were too busy with their clinical work and big trials and projects to come up with database things for med students to do.  And there wasn’t a whole lot of pressure to do that stuff.  If you were super motivated, you could come up with something.

Where we are now, we notice that many students do projects.  Most of them small, chart review type things that get them a presentation at a conference.

We agreed that it was frustrating competing against people in the CaRMS process who had these opportunities.  That had research projects, however small, under their belts.  That as residents it continued to be frustrating because we couldn’t say we had done something like that before.

All residency programs require some research.  Again, we agree it is good to expose us to the value research has in medicine.  That it is important to teach us to appraise research, to experience and understand the process and to have us do a bit ourselves.

We agreed we feel more pressure to do research than some of our friends elsewhere.  Yet, we have less pressure than some others.  Every place is different and we don’t think it is a bad thing.

The thing with research is, although it is super important, it is not the be all end all in medicine.  I think we have a good balance where we are.  We are encouraged to be evidence based, we are to focus more clinically, but we are expected to do something research related.

I question sometimes programs or even just people who focus so much on research, they lose out on other aspects of medicine.  Yes, research got us where we are today, but it is clinical medicine, that art, that really makes a good physician.  And yes research is a part of that art, but it is just a piece.  I don’t think you have to have research to be a good physician.  I also don’t think one has to be a good physician to be a good researcher (some people are just built for labs and numbers).

I wonder sometimes what having a million little chart reviews on topic x or y just to impress a program really gives.  Sure someone learns a bit on one topic, but sometimes I question how much the medical world or the individual gleans from some of the little tiny chart review projects except padding their CV and maybe providing a springboard for more research we all knew needed to be done anyway.

I know people who did a bunch of little projects in med school.  Or one big one on things that they ended up not pursuing as a career.  I think it is cool that they learned so much about a topic and about research.  But, I do know people who did it just because it would look good for applying to residency or because they got paid.  The end does not always justify the means.

Sometimes I think time could be better spent on other things.

I feel like sometimes in the medical world, we put too much emphasis on research.  That we glorify people that do tons of research, especially in an area that we think is important.  That we can sometimes do things more to fill a void on our CV or meet a requirement than to better medicine.

It bothers me.

Again, research is important.  But, I wish we didn’t push so much to judge people based solely on their academic reputation.  I have worked with fabulous physicians who choose not to partake in big projects.  I don’t think that makes them less of a doctor.  Sometimes, it feels as if we are taught physician as scholar must equate researcher on the academic sense.  I will NOT agree with that.  I also do not think a program is better than another based on the volume of research put out.  A school/program is better than the sum of its research.

So yes, I do research.  I do it because my program requires it.  I also do it because I am enjoying the project I am doing and think that it will help me to be a better physician and that it will truly help people.  I am happy to have that sort of opportunity.  I am glad to work in an environment where it is encouraged.

I will do research in the future.  I plan to help med students with research.  But, I don’t want to push projects on someone because I need a minion.  I won’t do projects that I think won’t make a difference.  And it will not ever be a greater priority than my clinical work (unless something crazy changes).

Research is important.  But, it is not the only side of medicine.

Procedure

Image from hoMed.

“Hello, my name is Trisha.  I am the junior resident.  No, this is not my home service.  Please, let me now stick a needle in your abdomen.  Of course I know what I’m doing.”

Such is life off-service.

I am now back in the world of livers again, which means I am back to doing paracentesis (aka draining extra fluid off of people’s bellies).  It is an immediately satisfying procedure in that you see instant results.  It is dismaying because people often reaccumulate the fluid quickly and you have to do it again in a few days to months.

I am not a procedure person.  I never have been.

Don’t get me wrong, I do them.  And I am decent at them (although also a bit slow and shaky).  But, I don’t derive the same sort of joy other people do in performing procedures.

Most of the people I went to med school with liked their given field for the procedures.  You get to do blah to people.  And they get a big kick out of that.

This is what happened to us on procedure day… Casts, IVs and blood draws all around. Plus some pig guts and dummies to boot. Image from medschool.lsuhsc.edu.

I remember med school procedure days.  I thought they were neat.  I love the feeling of fresh casting material and it was fun to be better at taking blood and doing IVs than average (thank you undergrad), but I was never as pumped as some of my peers.  They could practice hand ties and sew pig guts until the cows came home.

Maybe part of it was that I have always struggled with fine motor skills.  And I hate not being the best at something (and I will never be the best at most surgical-type interventions).

Another part of my procedure issue is that I just plain find it bizarre how we learn in medicine by practicing on real people.  Its not like we can learn on fake people.  And we do sometimes get to do stuff with dummies or each other first.  Some things just need to be done on real sick people.  But, nothing is more awkward than telling someone, “yes, you are indeed the first person I have done this to.”  I don’t know many other professions where you actually torment live people (under adequate supervision) for the sake of both learning and their theoretical betterment.

I am a person who learns by reading and understanding, so the whole “see one, do one, teach one,” thing is irritating when I have yet to read about one.    I generally like all procedures better once I have a few under my belt.  Because then I don’t feel like a bumbling fool (or at least less of one).  Competence is a requirement for me to like something, me thinks.

When I was in Nuc Med, I loved injecting radionuclides.  I loved taking blood.  But, it was that along with the other stuff.  The other stuff made the bits of hand-eye coordination cool.  I worked in Specimen Collection for a summer and it was quite possibly the worst job ever.  In fact, I use it to this day as a standard to compare all other terrible jobs… Gen surg is the only thing that came close.  I liked taking blood.  I did not like doing it 8 hours a day, 5 days a week.

My Nuc Med buddies teased me because I have a ridiculous tremor when I do take blood and such.  It scares people at first, but I really am quite competent (and the tremor diminished with increased practice and caffeine tolerance).  They made me promise when I got into med school to not do surgery ever.  Because my tremor would terrorize everyone.  Have no fear folks, that isn’t the only reason I won’t do surgery.

I picked my field for the variety.  And because once I am out, I have the option to not do a whole heaping lot of time-intensive technical procedures.

I like giving immunizations.  I am cool with the odd blood draw (just not an 8 hour day consisting of 100+ draws).  I will do your pap or use a scope to peer at your larynx or sew something up once in a blue moon.

I, however, can’t do that all day.  Or every day.  I love my sit-down chats with people.  I love clinical medicine and tolerate procedural medicine.  I enjoy paperwork and computer work, but most of all people work.

As cool as it is to impale people with large needles and suck fluid out to make them feel better, I like making differences in other ways (like prescribing drugs or radiation or talking).

My kind of instruments! Image from benitaepstein.com.

It is a personal preference.  I know it is an important part of medicine.  And some aspects of Rad Onc are super procedural as well.  It is all about what you make of your practice (and what sites you focus on and how much time you spend on certain sites).

Will I do procedural stuff?

Heck yes.  Everyone does.  And some of the sites I think are cool may require me to do procedures.  And I am fine with that, if I like the procedures and I get the variety that comes with the career I chose.

I will also enjoy the procedural stuff more when it is better within my comfort zone and training niche. Knowing what one is doing and its relevance to the care of your own patients is huge in enjoying it.  At least it is for me.

It is good to know what you like or not like.  But, sometimes I wish I could get the same kicks out of sewing or impailing that other do.  Instead, I grin and bear it and take joy in the fact that it helps that person and that once I grow up, I will be able to somewhat tailor my practice (or defer to the off-service junior resident… Muahahahaha…. Okay, not so much).

“She’s tough, she went to med school in _____”

The other day, I was seeing a patient who was floridly delirious who began screaming and telling me off.

As much as it took me aback, this isn’t exactly something unusual.

In fact, in the hospital, lots of people become confused and some become aggressive like this.  I continued to calmly speak to him and redirected him.  He calmed down.  At least for a little while.

Unknown to me, the other resident and the clerk were walking by the room when this was happening.  This is apparently the conversation that followed.

Resident: Wow, that guy is pretty agitated.  Maybe we should go see if he’s okay.  He is Trisha’s, though, right?

Med student: Yes.  But still.  It sounds kind of wild.

Resident: Wait a minute…  Trisha is in there.

Med student: I hear her voice.  Should we go in and help her out?  It sounds kind of bad in there.

Resident: Nah, she went to med school in N____, she’s tough.

Med student: I suppose.  All the fishermen and drunks and rural stuff.  Are you sure?

Resident: Yeah.  See, its fine.

Both laugh at me when I come out and recount the story.

Ninja doctor. That would help with some difficult situations. Image from surbrook.devermore.net.

The thing that struck me funny about this conversation was the whole “she went to med school in N____, she’s tough,” line.

It is kind of true.  There are stereotypes sometimes for a reason.

Maybe.

I worked in a lot more rural settings and thus saw a lot more people on my own.  We were a smaller school, so in turn, we get a lot more one-on-one teaching and more of our own patients.

A lot of people drink there.  I don’t know it is proportionally higher, but it is an issue.  And once you have to debate through a few emerg consults with drunken patients, you learn.

Plus, at my school, we were actually coached through sessions with fake delirious patients as a part of our teaching.  And we spend a lot of time on medicine clinical teaching units during clerkship.  So, I guess I am tough.

Whether it actually makes me tougher than other people from other schools, I don’t know.

But it is good to know my colleagues at least think I can survive.

It is funny, though, because generally, we have been known for communication skills or some of the nice fuzzy stuff.  At least that is what I have been told.  Not for our secret ninja skills.

Image from lostsarawakdoc.blogspot.com.

I don’t ooze toughness.  One of the same guys teased me the other day that I seep sunshine and rainbows out of my butt.  Also true.  But, I can hold my own in a difficult situation.  Maybe partially because of the sunshine and rainbows, but also because I can switch on an intense seriousness.

I guess I am tough in the able to handle getting crap from people in a clinical setting kind of way.  I would just never really think of it as based on the geography of my med school.

The whole thing cracks me up a little.

Tomato-Tomato: Answering some questions of distinction from the world of medicine.

Image from mentalfloss.com.

“You say tomato, I say tomato.”

You know the saying.  So, did my delightful teacher in Nuc Med, Debbie.  Except when she said the saying she pronounced tomato identically both times.

It cracked us up.

In life there are some things that sound the same but are different, some that look the same but are different and some that are indeed the same, but sound different.

Confused yet?

I have been asked a few awesome questions about some medicine-ish sorts of things by my readers and patients and family and have decided to answer some of them now.  These are answers to some of the “what is the difference between” sorts of questions.

Question 1: What is the difference between a ward clerk and a clinical clerk?

A ward clerk is the lovely person who takes care of all of the administrative things on the hospital ward.  They are the sunny face that directs people to rooms, answers phones and keeps the place organized.  They get paid for this job.  A clinical clerk, also known as a senior medical student is someone who is in their last couple of years of med school and is rotating through the hospital learning in a hands on sense how to be a doctor.  They are different from residents or interns.  They are NOT doctors (yet).

Question 2: What is the difference between an intern and a resident?

Not much and yet a fair bit.  An intern is a first year resident.  All residents are doctors.  They are doing training so that they can practice independently.  It is like another gradation of training.  You can’t just get a job working as a doctor out of medical school.  You get a job working as a resident.  In many places, there is a first year of “rotating internship” meaning the first year resident has to do rotations in a number of specialties of medicine to get well rounded before focusing on one area of medicine.  That is kind of what I am doing now.  Sometimes people say interns are off-service first year residents.  First year residents and fifth year residents are very different in that the level of training is obviously different.  You learn more as time goes on.

If I didn’t hate graphic t-shirts, I would need this shirt. Image from zazzle.com.

Question 3:  What is the difference between medical and radiation oncology?

Both are oncologists (although most people only consider their medical oncologist an “oncologist”).  Medical oncologists are doctors specialized in giving systemic treatments for cancer, like chemotherapy and hormone therapy.  Their background is internal medicine.  Radiation oncologists (not to be confused with radiologists) are doctors specialized in using radiation to treat cancers, often in a more localized fashion.  One is not better than the other.  The medical, radiation and surgical oncologists all work together to provide cancer care.  Sometimes for one cancer, it responds better to one thing and not another.  Others need all three modalities.  It depends on the cancer.

Question 4:  What is the difference between radiation oncology and radiology?

There were people in my med school class who I am pretty sure thought up to the day we graduated I was going into radiology.  Because they are clearly the same thing.  They are not, although back in the day, they were.  Then a lot more oncology started happening and things got more specialized and they branched off of each other back in the 50s and 60s.  Radiology is a field in which you read diagnostic imaging (CTs, MRIs etc).  Interventional radiology is a subspecialty of radiology in which you use radiologic imaging to do some surgical procedures, like putting in chemo lines and special drains.  Radiation oncology is a field in which you treat cancers with radiation.

Question 5: What is the difference between Hospice and Palliative Care?

At surface, there isn’t a major difference.  Often, the two are grouped together.  Hospice is a type of Palliative Medicine.  Palliative comes from the word pallium, meaning to cloak or comfort.  Pretty beautiful term, if you ask me.  Palliative medicine is a field of medicine in which you provide pain and symptom management, generally to people with life threatening illness.  Being cared for by palliative medicine does not mean death is imminent, but that cure is unlikely and comfort is important.  Palliative medicine is all about quality of life.  In a hospital, there may be a palliative care unit – an inpatient unit that provides comfort care.  In the community, there may be a Hospice house or organization.  Hospice is a type of palliative medicine and a sort of philosophy.  It is home-based palliative care.  Meaning, people are supported at home through outreach teams or they can go and live in a hospice house, which is a home like setting providing palliative supports.  Often, a palliative care unit is a bit more hospital like and can provide a bit more hospital-type supports compared to a hospice house, which is basically a home away from home.

 Question 6: What is the difference between the short white coat and the long white coat?

Good question.  My first guess would be the amount of white fabric available to get dirty (I am not a fan of white coats).  Apparently it varies from school to school.  Where I came from, the short white coat was a symbol of you not being in your clinical years.  You wore it to shadow, to clinical skills and such.  It was a sign of being a rookie.  Once you hit clerkship, you could wear the long one.  In some other places, all medical students go short.  I have no clue.  I guess it depends where you are.

This image, taken from an article in boston.com demonstrates the different styles and people wearing white coats and how although long white coats are traditionally associated with attending physicians and big accomplishments, it does not mean only attendings wear them and the reverse is true of the short white coat. Bet you can’t tell who is who.

Question 7:  What is the difference between an allergy and a sensitivity?

An allergy is an immune response.  A sensitivity is kind of like a nasty side effect or irritation.  People claim they are allergic to all sorts of things they are not.  If you vomited or itched or got constipated on morphine, you probably had side effects and may have a sensitivity.   If you develop hives, intractable vomiting or difficulty breathing, then it is an allergy.

Question 8: What is the difference between nuclear medicine and radiology?

Nuclear medicine is awesome.  That is the clear difference.  Seriously though, nuclear medicine involves imaging radioactive tracers as they behave within someone’s body (physiologic imaging).  For instance a bone scan images a tracer that acts like calcium and binds to bone.  Areas of fracture, wear and tear, infection or cancer appear brighter because that bone is turning over more quickly.  Radiology generally involves external radiation projected onto a film through the body.  It images anatomy only for the most part.   Think x-ray.

Upper left is a bone scan of a hand with a fracture of several carpal bones (with pins in place). Upper right is an x-ray of the same hand). The bottom left is an example of a fusion image with the two modalities showing how activity can be localized to an anatomic site.  Image from HERMESmedical.com.

There you go.  Eight awesome questions I get relatively often about things that seem very different or kind of the same.  Let me know if there are more questions.  Or more answers.  Either are delightful.

Career Fair

Image from standfordmedstudent.blogspot.com.

Last night, Dr. Bond and I participated in the medical school’s career fair.  Our mission… Convince unsuspecting medical students they want to be radiation oncologists when they grow up.  Or at least tell them what we do.

It is funny because everyone up until they get into med school can pretty much get away with claiming they want to be a doctor.  People are satisfied with that answer for the most part.  They assume you will be a generalist and drop it.  However, once you get in to medicine, it is a whole other ball game.  That is when people start (jokingly or not) asking you to add them to your wait list and asking about your specialty of choice (all the while assuming you can probably be their family physician too.

The thing is that most people in undergraduate medicine have no clue what kind of doctor they will be.  Or if they do, they are wrong.  Most people either don’t know or change their minds in the first few years.

It is fascinating to look back at the beginning of medicine and then look at what people actually become.  Sure there are people who do what they say they were going to do.  Others change their minds right up until the match.  And still others go in swearing up and down they will be an orthopedic surgeon, a family doctor and a general surgeon and end up becoming a urologist, pediatrician and family doctor, respectively.

In a way, med school is a coming of age.  Like a second undergrad where you sort out who you are and what you really want to be.  Yes, medicine is a career, but there is another step within it.  There are so many options, some of which you don’t even realize exist until you are in that world that the first few years of medicine are often spent learning what is available before you make a final decision.

I think it is good medicine is set up the way it is.  That you learn a bit of everything before you hone in on a specialty.  It helps with making an informed life decision.  Plus, it makes you more well rounded.

Career fairs like the one we were at offer opportunity to ask questions and really get a grasp of what life might be like in a specific specialty from residents and doctors in the field.  Although there is an element of competition (booths offering treats or prizes for visiting), there is more an element of education.  The goal is to put your program out there.  Make sure people know what you reall do.  And yes, recruiting is always a bonus.

Kind of like our experience next to the intubation station at the anesthesiology booth. Except we did have people stop. I swear.

Many students don’t know a thing about my specialty.  They always assume it is radiology or something too crazy to get involved with.  In fact, 90% of them avoid our booth.  We kind of stand there waiting for people to stop by like awkward kids on the wall at a dance while everyone flocks to the “cool” booths with intubation sets or baked treats (we vowed that next year we will have contouring stations and baked treats…. This is career fair war).  We do have good conversations with the people who do stop.  Teach them a  bit about the specialty.  Give them some information.

Most of the students at this fair were the Med 1s and the odd Med 2.  I did see a few of the third years there.  It kind of corresponds with the degree of indecisions.  By this time in fourth year, CaRMS applications are just about in, so this is pretty pointless.  By the time I was in second year, I gave up on these fairs because I knew where I wanted to be and they offered no new information.  I wasn’t alone.  But, in Med 1, this is a great place to learn more about medicine in general and line up shadowing and such.

Image from thoughtsofdaktari.wordpress.com.

 

It was interesting to talk to the students.  Most of them were interested in learning more.  As I said, it isn’t a very widely taught specialty.  Plus, so many were unsure of their interests, it offers a good chance to suggest trying it out.  Who knows?  Maybe a future fellow resident was in that group.  I love getting to know them and what interests them.  Even if it isn’t our field, it is cool to be able to tell them about how we may interact in the future and such.

Career fairs aren’t just for high schools or undergrad students.  In medicine, people need to make those decisions too.  The funny thing is, most people don’t realize the process it is.  But, it is really cool to be involved.  And ask the hated questions about what interests them in medicine.  Sometimes the answers may point them in a direction they did not know they had.

I now remember why I am glad to be done with that and working towards my field of choice.  Though, in a few years fellowships and such will come up (ugh).  For now, I will marvel in being in Rad Onc, just like the med students can marvel at just being in medicine.

Pep Talk

When I was doing my surgery clerkship, I shared a locker with a lovely friend named M, who was one of my med school “people.”  Our rotations never aligned and we were rarely on the same schedule, let alone off at the same time, but we communicated via notes in the locker and the occasional post-call or evening coffee dates.

One day during my general surgery rotation, I found this in the locker.  It stayed up all year as a form of encouragement and I brought it with me when I moved.

I found it unpacking the rest of the office (yes, I am just finishing unpacking now).  It made me feel grateful for those special people in my life.  And that I have survived surgery in clerkship and  thus far in residency and will hopefully continue to do so.  If not, I will have to call M long distance… And take a field trip to hug it out.  So, it has to be okay.

What kinds of encouragement have you found this week?

Hello, Surgery!

I am actually torn right now between writing about the rest of the awesomeness and adventure that was L’s wedding… Or the fact that today was my first day as a surgical intern.

So, for those of you who are dying to hear about L’s wedding reception… You must wait.  Though… Spoiler… I broke something in a big, public fashion (fortunately it was an inanimate object, not me) and helped start a new trend.  Come back later this week for more info.

As I said, today was my first day as a surgical intern.  This induces masses of anxiety related tremors, palpitations and nausea from me.  Two months of surgery… Eight weeks.  Sure, I am somehow managing to pull of 2 weeks of vacation, thus decreasing things to 6 weeks.  But still, I am half terrified.

We also don’t have an awesome hall like this to hang out in. Plus, I am the lone intern on my service… And not a surgeon. My life is not at all like this.

This is not Grey’s Anatomy people.  Not at all.  Real life means very unflattering scrubs, significantly more crowded  hospital with fewer resources and no McDreamy.  Just saying.

I have written before about my pre-rotation jitters.  The ones I had for this rotation were surprisingly not that much more significant.  Well, except for the big rant I had at Patrick on the drive home last night all about how I was going to kill someone.  When he would tell me that it would not be me doing the killing.  I argued that I was a bystander and it was my omission that did the killing.  It went on like this for some time.  Not making much sense, but in my head I was perfectly logical.

This was also my first day back at my home-base hospital after being away for the last couple months.  Also strange.  My desk was as I left it, and my computer continues to be ancient.  Though, the screen did not want to turn on this morning.  Big fail number one.  By the time I signed in, I had to change all of my passwords.  That gave me rage.  I mean, I was gone for two months.  I still know my old passwords, why make me get new ones.  I am sure the hackers will figure it out just as quickly.  Plus, I really don’t know how many people actually hunt down resident’s user names and passwords to creep on other’s medical information.  Really.  Especially when I have been away.  Just let me keep my password.  Make the transition easier.  But nooo.

I somehow found my way to the residents’ lounge, which was where I was to meet my new team.  Thankfully, my very keen chief resident showed me where it was (yes, the surgical lounge) back in July (because it was totally useful then).   This only involved me wandering a bit, looking a touch lost and then finding the right door but chickening out only to walk in a circle and see the same people twice.   Why must I be so awkward?

The team seems nice.  At least so far.  It is also a big team – 4 residents including me and 3 clerks.  Eep.  But, helpful for the whole divide and conquer concept.

The team is a hepatobiliary surgery team.  So, lots of liver and pancreas.  Very interesting.  A lot of oncology mixed in there.  I am grateful.

One of the attendings likes to round around 5.  I think it is going to be a month of late nights.  Good thing the spouse is a superstar.

Although it was a busy first day with trying to get a grasp on patients and such, it doesn’t feel entirely insurmountable.  It will be a good learning experience and I will have good back up (at least I think I will).  The days will be long with rounds at 6:30 (I have to be there by 6:15) and 6 on Wednesday, but I am efficient, so maybe I can keep a good handle on things.

I am doing my best to say “yay surgery” because it means learning.  Including me having to present at rounds next week (at least they said I can do it on a related radiation topic).  Bonus is that my OR time will be limited due to all of the time I have to spend working on the floors.