Draggin' & Doubt...

Well radiology is over and it was a nice relaxing two weeks compared to the worst I have seen. While I saw the appeal as in every specialty, I know it isn't for me. Lately in fact, I wonder if anything is for me... While these past months have been stressful, I can't help but reflect back over the last time I was truly happy with medicine. Honestly, the last time I could think of was January, my trauma surgery month. Even though it was so very busy, it has been rough since it seems. Surely you all know of my infamous countdown to come home in about 5 weeks for good and I am truly hoping this is the reason for my lack of interest in what I am doing.

I find myself not as eager to study, to see patients or even to drive to the hospital! The best way I can explain it is - remember if you didn't want to go somewhere but your mom made you go, kickin' and screaming? Yeah that is me, except it is kinda in my head. I wake up thinking, "I don't want to go in at all" while I am getting ready. I get in my car and say to myself while I am driving into the hospital "Just turn the car around or better yet hit the highway home!" I am kicking and screaming in my head yet I am constantly forcing myself into each day. It sounds terrible I know... I have definitely hit some low points and constant thoughts of doubt. If this is how it is going to be, should I do this? Is it only because I am so SO fed up with being away from home? Could it just be the constant stress of presenting patients and getting critiqued by every preceptor - not because you aren't doing it the right way but you aren't doing it THEIR way? There are so many things bothing me as of late that overall, well, I truly feel like I have lost my passion... and I can't find it.

What happened to me? I used to be so invigorated by it all... Sigh, I'm not saying I am quitting or anything. I really don't think there is a way out even if I wanted. I mean it is so much easier said than done. What am I just going to NOT show up for clinicals tomorrow and drive home only to realize I am nearing $200K in debt? Oh no problem, I can work that off in - psh - well whatever other career I would choose would go off to paying off my $200K mistake. Ok, so obviously I have thought of it... I just keep wondering it is because I am away that I am feeling this way. I felt so good rotating at home and being able to live my life. Maybe that is what is missing? Maybe then I'll get that passion back? Okay, let's think positive and say that will happen. I run into another issue... Say I make it through this crazy last year and actually obtain my M.D. degree, lol. I still am not sure what specialty I would want.

Truth or dare: Truth. What specialties have lingered in my mind for more than 10 seconds? IM, OB/GYN, FM and to a lesser extent ER. Why? Don't get me wrong, I loved my month in it but something gets to me everytime I hear an ambulance or when we'd have to take care of a drunk moron for driving his snowmobile into a tree at 3am. I know it must sound so cruel but I don't want to spend my days taking care of people that don't minimally take care of themselves. Yes, you could make that argument with IM or FM for people not managing their hypertension or diabetes but to me that is different at least. So ok, what to do now with my final 3? Well, I truly love them all but I decided to look into where residents do their curriculum rotations. To be truthful (and I think that I will mean this more when I find that passion again lol) IM is the best. They get the IM floor, cardiology, respiratory, heme/onc, pulmonary, GI and so much more that all strike my interest. FM has many of the same rotations but it seems in shorter amounts of time. Sigh, so much to choose from but I think I know the direction I am bound to take. Just ready to know for sure!

Life in a box...

Well, radiology is not as awful as I had thought. I am with a very nice doc that while he doesn't teach a whole lot, is not making these two weeks difficult either. Don't get me wrong, I love a challenge, but these two weeks were supposed to be vacation anyway ;). I cannot tell you how many films we have reviewed in only 3 days but I am enjoying it. I am not sure if it is going back to my anatomy roots, sitting in a dark room and getting all cozy or taking a break from endless H&Ps but it is a more relaxing way of spending these two weeks. I can see the appeal of this specialty though. It has to rank high on the lifestyle list with the hours they work, 8-4:30pm. Again too, I can see the appeal of being in a room alone just to get your work done and go home, but it totally is the opposite of what I saw my career to be like. I always wanted that patient contact. Although these past couple days, I don't have much sense of dread going to the hospital. Maybe because I know I just have to look at a screen and not worry about my interview or exam skills... Like I said though, for these two weeks it works just fine with me, a much needed relaxing rotation and hey - this is 2 weeks more of fourth year (now being a month total) that I have completed and will have that much extra time off early next year! Breaking it down, if I took no breaks for the Step and interviews, my medical school rotations end in the middle of February! How awesome would that be? Heck, graduation isn't until May and internship isn't until July!

I am not anticipating alot of time to study for the Step (planning on taking during my outpatient month of IM) and interviews - well, a topic for another post but I have I think about 12-15 programs I am looking to apply. After speaking with my medical education coordinator here in Saginaw, I supposedly should be applying to 60-150 programs... I can tell you now that will not happen. There are ~15 programs in Michigan and 2 in Ohio that I am looking to apply as I am not interested in doing a residency away from home. Yes, I know what that means. What if I don't match? What if I only get one interview? Well, I may be crapping my pants until the match - but if I don't match, then I don't. I had heard that people apply for 150 programs and only interview at a grand total of 7! I don't know if that was for a surgical residency or what but it really didn't push me anymore to go looking into out-of-state programs. I think that I will have a good shot especially if I can prove myself in my core this summer in Detroit. More of this to come in later posts but I just know how I feel about this situation and feel that I do understand the risks of such a choice.

Anyway, I better get going... I have more sitting around to do tonight (ok maybe some reading too). I just can't wait until the weekend arrives - home!

Finding a balance?

I'm troubled tonight thinking of what is to become of my life. To me, I know it will be everything I ever wanted and perfect. I will be a wife, mother and physician just to name a few...

I guess what has got me thinking more is just planning my final year and learning from the experiences of others. Tomorrow begins my attempt at securing more rotation spots to finish up medical school and it is completely exhausting to worry about finding places near home. Nothing else I can really comment on that now but I will keep you posted on how things go in that regard. Though tonight I watched a show on NOVA, "Doctor's Diaries". All were great physicians, all dedicated and all seemingly consumed by work. The men physician would get divorced or have wives that would stay home with the children and the women physicians would have no social life at all.

So two ends of the spectrum. My life as like the rest of the world will be indeed wonderful but not perfect. On the other side, I am not looking to be consumed by this career. I love it so much but there is point that I an not looking to cross. I know eventually, sometime in my career -years after residency ends - I will not be looking for a full-time job (in med terms, what like 60ish hours?). Whatever it is, I know I want to be there for my children. While I know I won't be able to be a full time stay-at-home mom, but I have no interest in sacrificing that aspect of my life for medicine. Reading that back to myself it sounded kind of harsh but what does that mean? Why do I feel like this awful person for not feeling different? Truthfully, when I am set in my career I feel fine about that statement. It is just this stupid 4th year I have to plan that is making this so difficult. I have the option of staying in Saginaw for the rest of my education - to have it all planned out and set for graduation. Yet, I am opting for making it more difficult on myself and planning it on my own to be near home. On the one hand I think I am an idiot. On the other, I think it is long overdue and I should do what is in my heart. Head vs. heart is what we have going on here people... The eternal battle. Wait no, that is good and evil... anyway...

Just what am I to do. At this point, it is April and I still have some time to figure this out. Hopefully some luck will strike me and I can work closer to home. The thing of it is, I just don't miss being around home - I am physically starting to feel it. Mentally, oh please that has been around for what probably is years, for which I have slapped myself out of many, MANY times. I am honestly physically feeling sick when I leave home. As I have told my own mother, my heart literally aches everytime as I begin my drive away from my home. It's just like, exactly like, I am just leaving a part of me there and without that piece I cannot fully engage myself in the tasks that are at hand. Again, on the one hand I feel so good having this thought, because I know my upcoming wedding is just so right, it is that piece of comfort and peace that I will have in my life forever. On the other hand, I want to yell at myself for not being tougher and sticking through this like other students - as I am not the only one to have sacrificed for this path chosen. All the years I have worked, I feel like wanting that comfort and peace is giving up or wrong. Again, in my eyes this is just another case of head vs. heart.

I am not expecting to come to a conclusion tonight. Haha, even if I wanted to - it wouldn't happen anyway. All I know is maybe I just need to ingore them both and go with another alternative - my gut. Tonight? My gut is telling me to start listening to my heart and pray. The rest will fall into place... at least I hope for that and maybe in my own heart my life will become maybe not a perfect life to all - but the perfect life for me.

*~Spring has sprung!~*

Guess who? Yes, I know I haven't been around in a long while. Lately this has been a hard thing to remedy. Like I always say, after my day is done it is hard to go back and relive the whole day so I had started to forget to write. Maybe that has been my problem too because my bitterness as of late has increased. So much has happened though since I have last written and all I intend to write about. First of all surgery is over!!! I had gotten through my last week with my second surgeon and could not wait for it to end. He gave me some constructive criticism for my last day, shook my hand and went on his way. I ran in the completely opposite direction, haha! See ya! I must say that my month with him was the hardest month in medical school for me. I have always been dreading my surgery rotation and for the exact reason for the month of February! I learned though - mostly to speak with confidence more and get thicker skin. Since that month has ended our program has our last month in the ER.

Let me tell you that I went in that month scared to ask a single question or to do anything wrong. I was like a neglected puppy that was placed in a new warm and educationally encouraging environment, and I felt... relief! I felt like I could be myself and actually enjoy being a student again. This was the whole month of March and I had 10 shifts of 10 hours. Shifts were either 6am-4pm, 1pm-11pm or 10pm-8am. The ER was full of encouragement and praise on my end. I felt like I went from being the stupidest student on earth to... well, someone that could actually pass as a physician next spring! For those looking for a great rotation before USMLE Step 2 CS - do ER! (Yes, in my absence from this blog I have taken my CS - don't worry I will talk about it too!!!) The ER gave me so much autonomy - freedom to take the reins of my own clinical experience. I was able to do my own H&Ps, differentials, workups (granted it was the resident ordering the tests but I was always asked what my differential was and what tests I would like to order). You guys - that's CS right there. A perfect month of preparation! :) That being said, if I fail my exam, my story will change. Since I just took this exam recently, I will save that for another entry but all in all it felt good and dare I say - kinda fun!

So, what is on my plate now? I just went home for two weeks after my surgery rotation completed and spent it planning the wedding, enjoying my time with family and friends and of course getting yet another glimpse of what life will be like in a matter of weeks (not months anymore!) when I move home for ever after with my Tony and puppy Maggie. Soon my time of travel will be over. No more island, no more living out of a suitcase in a hotel or a one-person apartment. Yes folks, after nearing 3 years I officially feel like my dues are paid and it is time to pick up where I left off. The summer will be spent in Detroit, which is very close to my home and I can only wish that I make a great enough impression to hopefully get the opportunity to interview there and obtain a residency! I can't wait. My homecoming has been long awaited and the emotions that I am sure will come over me will be something I have never seen. I appreciate all the opportunities that I have been given and the blessings I have had for being this close, but the time has come and I am at my limit for what my career is worth - and it calls for home... Having this without my family and friends is just less worth it as of late and it cannot come at a more perfect time. When I am home and working - it is the best of both worlds. To come home to my fiance and puppy (just turned a year old, so I guess not a puppy anymore right? :)), is just the best feeling ever. Knowing I can be with them all night long and go to work the next day only to return right back will be the best blessing ever after being through all I have these past years.

As for now, I have returned this morning to Saginaw to begin my radiology rotation which will be two weeks long. I really believe that this rotation is so valuable to any student. While they aren't the most stimulating days, maybe that is what I need now since I am kinda "checked out". After this on April 24th, I start my pediatric rotation which ends June 5th - the last day in Saginaw! I am sure I will be writing more as my countdown quickens and I just can't contain myself anymore! Well, I am sure I have some holes in my stories and have more to talk about but I will get to it soon. Today my day was 8am-3:30pm and with all that time I should have ample time to blog, hmm? :) I'm gonna read and relax but I will catch you all soon.

Nobody said it was easy...

Time is surely ticking down on surgery and I couldn't be more thrilled! I really wanted to post more on this rotation but when I take the time to write, it is like I have to relive it all over again. Usually when the day is over - it is the last thing I want to think about, unfortunately for you. Well, fortunately for you I am stuck here in Saginaw, as my attending as asked me to come in and round in the morning. Afterwards, I will have the rest of Saturday and Sunday off and plan on heading back home. So, here I am bored and realize what a perfect time to update people on my rotation ;)!

So this was the third week with my second attending and it was a better one. I don't know what it was but I have been getting most questions right, doing much better on my notes as far as my plans go and overall just getting along better with him. After last week, I really thought about how his work ethic affected me and how others (staff, students, residents, etc.) really had similar experiences as me. I know that it isn't just me. Being strict, unrelenting and at times condescending is just his way and maybe not even how he'd see it. I have felt like over this past week he has the military "break 'em down and build 'em up" style. I say that because my first two weeks were brutal. I mean to the point of crying most days and leaving the hospital feeling lower than dirt. Nothing I could do would please him and it was just a fight that I could not win. It is still somewhat to that point but he is seemingly more happy with my work, praising me more, joking with me more and generally a more pleasant man to be around.

I hate (really) to admit it and I am sure this happens with many students. When you are getting to the end of a rotation that you really did not like, you are sooooo happy but then have a sense of hindsight. I do not like the phrase "hindsight is 20/20", because well... duh. It's the same thing as finding something lost "in the last place you look". Anyway, I am slowly seeing how I have learned this month. While I am not learning ICU management or a plethora of information, I know I have become just that much tougher. Sure, I have gained some knowledge too, of course - but I think the majority of what I have learned is to work up a better plan, thinking to read up on patient's conditions while I have them and becoming more confident. My plans are improving, patient conditions I try to read on but when you never know where questions are coming from you just get sidetracked and completely are oblivious to thinking ahead to what the next day's questions might bring. Confidence is still something majorly in the works. It is coming along though.

Today, I had rounded and found out there was nothing else much to do for the day. Hoping I would get a break and allowed the weekend off, I was told to come in tomorrow morning to round and couldn't be happier about it (ahhemmm). Anyway, so tomorrow I will round and head home for a day or so. Next week? My last week of surgery baby! Well, there is still a month of ER to go in my rotation but it is completely different. No calls, no rounding, no lectures. Just 10 hour shifts. So next week marks a huge point for me in my medical education. As always, it hasn't and probably will not hit me for a while but I hope it does. There is a Hawaiian Ball next Friday that I cannot wait to attend for our local firefighters at home. It is dinner, dancing and... open bar! Also, it is on the same day that my surgery months end and I am sure I will be partying it up! I have really started to work on my diet (less junk and such) and began my workout regimen again that I have ignored for about 3 weeks. I am slowly getting back to my old self and can only hope that I see more of this. I know I will appreciate it as well as others who have heard me yabbering on about how stressed I have been.

Well, I am going to do some reading and relax a bit before heading to bed. I can't wait to head home in the morning!

Oh surgery, how I love thee - let me count the ways (not).

As you all probably know, I am sorry for my lack of posts over the past couple of weeks. Surgery is ... well, surgery. Overall I am sure that I will be getting a positive overall experience but I truly feel that I learned much more out of my first month than this one.

To start off, my first month ended spectacular. I found a wonderful book on the ICU call "The ICU Book" (haha). I really haven't had much time to read it since I started my new month of surgery but I can't wait to get to it once it is over! I truly loved trauma surgery and mostly I guess it was for the ICU patients. I think that I have determined that IM is the way that I am going to go in residency. Not 100% sure yet, but pretty darn close to that! I am thinking of specializing as well and at the top of my list is oncology but we will have to see. Anyway, at the end of trauma, I have learned so much, done procedures (PEGs, art line, femoral triple lumen, pulling chest tubes, etc), closed in surgery, done countless H&Ps (which I think I am kinda getting the point of *wink*) on top of learning so much in rounds! I was never criticized for having the wrong answer, sometimes told to check up on some things but for the most part having my attendings take the time to teach me. I left that month, feeling like I worked as hard as I could have and got nothing but good reviews of my performance. Who knows if that will translate into an 'A' but if not it is ok. Truly I am just trying to get through it.

So... this month. Yeah. Much different. Let me tell you, I would rather be on the trauma service for another month of 80-90 hours a week than what I am doing now. While my attending gives off a nice vibe, it is the majority of these last two weeks with him that I have felt just as how I thought the "typical surgical student" would feel. I am criticized quite often, rarely praised and pretty much nothing can please the man. When I get things wrong, I am given a good talk about how I need to read more (if I am even reading in the first place to him). If I am right, just more questions come until I get something wrong most likely. If I try to ask a question to clarify after I do something wrong, it is taken as trying to justify myself. I have already been told to shut my mouth when he is trying to make a point and to speak when he asks questions. It goes on and on. I know he has so much to teach and is a smart guy but I haven't learned 25% of what I did last month. Everyday I go in thinking that I will get SOMETHING out of this month - even to be more thick-skinned or quicker in responding to questions with more definite answers - but it usually comes out as a flop at the end of the day. I really am trying hard but I must admit that the constant comments and criticism of my work - to the point where he thinks I go home and just watch tv, MAKES me want to just go home and do that. If he will not believe that I am actually studying no matter how hard I try - why should I? What's the point?

We were in surgery for a total thyroidectomy and I read up good on it. I will admit I get super nervous when questions come. This is diminishing because for the 1/2 of the questions I get wrong (if not more) I am just getting used to that "oh shit" feeling in the pit of my stomach. So I read up on the thyroid well and in the 2 hour procedure I get 4 questions - 4! Out of the whole thyroid. Of course in the book I am reading it breaks down anatomy, physiology, diseases, surgical points in preventing complications, etc. Notta one question on what I read. So automatically, I must not have read because I answered 1/2 of the questions wrong. This was not the first time this has happened. At the end of the surgery when I was getting lectured, I was tired of it and told him that I did in fact read and he didn't ask anything about what I covered. I don't know what he thought of that but he told me to go ahead and tell him what I studied. So I spend a couple minutes telling him of anatomy, things to watch out for in surgeries, etc. Who knows if he was satisfied or more upset but I was tired of it. Some of his questions are just too advanced it seems for me - but I take it in stride hoping that I will learn even more. When I was asked to what I would like the D5 0.9%NS maintanence fluid rate to be set at for the patient post-op, well thank goodness I was wearing my mask because I was like whaaaatttt... Positive note? I now know how to do that. When I didn't know however it was shocking to him. His favorite line of this month is, "You have had a month of trauma surgery and you don't know how to do this/know this?"... sigh. What can I say, I am trying and furthermore... Only 2 more weeks! Less than that actually, as he is on vacation until Tuesday (so I am with his partners) and of course I have lectures to attend, conferences, meetings and still one more call. Only one more on-call in surgery!

I truly cannot wait until this month is over. Again, I will be in the ER next month for what is now 10 shifts of 10 hours thoughout the month. Umm, sweet!??? Plently of time to study for my shelf exam and Step 2 CS! Oy, but surgery just needs to end and I don't see why Ross has such a long surgical rotation. I was with a MSU student yesterday and he just had 4 weeks. Lucky duck. Anyway, I have made it this far and am currently finishing up the part of medical school I have been dreading for 3 years. It is almost over and to me, everything will be downhill from here. I have no idea what my grade will be in this rotation and as long as I pass... whatever!

Whew, felt good to get that off my chest. I still have a bunch more to talk about with other things but I will save it for another day soon to come. I am sure once this month ends (last day is February 27th) I will have so much more time to post! :)

Well, I am post-call and it is time to get ready to see my sweetie who is coming up to see me for Valentines Day! We are thinking of maybe going out to a comedy club which would be great. I could really use some comedy in my life at the moment ;)!

HAPPY VALENTINE'S DAY (or Happy Hallmark Holiday - whichever you prefer!)

Onward to week 3...

My one free weekend of the month - and what a relaxing weekend it was! It was so good to be home and to rest up a little. I had one trauma during call Thursday night, otherwise pretty much uneventful. Alas, here I am about to begin week three of surgery. Two calls left this month, one being tomorrow and my last on Friday. At the end of next week, I will be done with my trauma service, my time with the trauma team and be half way done with surgery. Whew. I can't wait. Once I start my 2nd month and get that underway, I will be so thrilled to start saying, "Only 3 more weeks!". Seems so far away but it is coming. Of course, after these two months I will still have 4 weeks of ER but from everyone I have talked to, it is alot of fun. Out of 31 days in March, I will have 16 shifts of 10 hours. Much more time off, no call and truly the start of a much better life as a medical student. The hardest part mentally and physically of medical school will be over and done with and I will be able to focus on all the great things to come afterwards.

Just on the drive back up to Saginaw, I was just thinking of how long this saga has been going. Since August of 2006 I have been away from friends and family, living out of a suitcase, moving from apartment, hotel, another apartment, etc. Granted I have been able to drive home many weekends and at times come home during a scheduling hiatus - but soon, June of 2009, it is finally over. I find myself so excited I can barely contain myself thinking of how strange it will be to use my suitcases for trips instead of another move back to a city that isn't my own. Also how strange will it be to be home with Tony and Maggie, to wake up knowing while my days are still going to be long, I will always be coming home to them each and every night. Just to be back home living life again, getting ready for my wedding, to be a wife, to take spring and summer trips to the cabin, gosh so much...

It is hard when so much stands in the way of getting to that point. Truly though, going back to August 2006 and looking forward to such things would be a bit far-fetched. Now, nearly February 2009 - it is really not so absurb to think of such things. I guess it is all in perspective. Heck even after this month of trauma, my 2nd month could be even better. I know my next attending has earlier hours but as far as weekends and times when the day is finished might be better at times that this month. How wonderful it would be to be an improvement from this month, considering this month thus far has been, dare I say, a pleasure.

As you can see, so much is on my mind tonight as it usually is when I have to pack up my car Sunday afternoon, say goodbye to my man and puppy, only to see them hopefully within the next 2-3 weeks... Luckily, my mind is in a good place tonight which traditionally has not been the norm when I have to leave home. I am hoping in this whole change of mentality, I am seeing the bright, bright light at the end of the tunnel. After 16 months on the island, 5th semester, the Comp (twice), the USMLE Step 1, FM, Psychiatry, OB/GYN, and my ENT elective - and in the near future to be surgery and a quick rotation in peds - collectively nearing 3 years (from August 2006-June 2009), I will be living the life that I have been dreaming of ever since the very day I left on that plane for Dominica. I'm holding on for that day and when it comes, life will just never be the same!

Pushing forward - Second call over...

Time just keeps on tickin' and a good thought for all of you out there dreading surgery - days go by quickly. Seriously, hours just fly and before you know it you are mid-afternoon so close to getting home. Of course, some days drag on but the majority of the time it goes fast - especially if you keep yourself busy as much as possible. Here is a BIG tip in surviving surgery (while I know I am nearing only 2 weeks into it):

1.) CHANGE YOUR MENTALITY!!! I had to very much so. Not so much physically but I thought that I would seriously die from this rotation out of exhaustion and harassment from the surgery team. Things truly now (at least for this month) could not be further from the truth. It is so hard for me not to say, "Three months to go.". It made me sad and cry everyday before I just came to change my mentality. I don't even count my 3rd month now because it is 16 shifts of 10 hours in the ER. Not bad, no call. So now from 12, I am down to 8 weeks, 2 of which are nearly over. Changing your mentality! It is hard for me to take it one day at a time but really, with the trauma team I am on, I do feel like I am a wee bit useful with my getting up way before the crack of dawn to pre-round on as many patients as I can to lighten the load for the rest of the team. Of course, I hope it impresses them, hope that it is appreciated and noticed - but above all I have changed my mentality. I now tell myself, "The more you do in pre-rounding, the quicker you can get to relax before rounds, finish rounds and get back to the apartment."

I cannot even explain how much of this is a mental game to convince yourself to push onward one day at a time. I resisted so hard to change the way I thought. I still will have hard days and some of the hardest are when my perspective is lost, in that I WILL be done with soon. It is just another hurdle and the best time of my life is yet to come when I move back home, get married and more! In this rotation though, getting up in the morning is still the worst part of my day, but knowing I will be in the hospital within the hour pre-rounding and getting the job done makes me happy because that probably the one time of the day I can truly shine and show that I am up for the challenge. Questions you can get wrong, procedures you can do and be talked though, but here is the one time you can show true initiative.

2.) Surgery cannot - I repeat - cannot take away your "me" time!!! I have a strict schedule (kinda). I need my time and I will have it - even if it means that I get less sleep. I shower before bed, have my clothes laid out so when I roll out of bed I get dressed and walk about the door (without breakfast (I can get some food in the resident on-call room), I can do it in 10 minutes!) I finish my day (12-13 hour days when I am not on call lol) - but then? Well, I workout! Something I refuse to compromise on. Before surgery I did 5 days a week. That is a bit too much I think to handle for me, so I count my on-call days as "workout days" even though it isn't much of a workout. Just the mental stress and physical stamina it takes is enough. So technically, with that I still get my 5 days a week. What else? I get in a bubble bath when I feel like I need one, have a cocktail or two (;D), watch TV (while looking up things I jotted down thoughout the day during rounds that I didn't understand) and do some leisure reading (reading "Marley and Me" right now). Whatever you would like to do - DO IT. There is time, even if it is cut short you don't come home to dread another day because you "don't have a life". Sure you are in the hospital 6 days a week - well that day off will be FAB-u-lous!

Can you see this post is really for me still, too? Haha, okay - I have more tips I am sure to come but those are so far up on the list, I had to talk about them. If anyone ever feels that dread or worry for what lies ahead - I am here if you need it. These past 2 weeks have really hit home for me and while I know I am here for those who need it, being able to talk about this here makes me feel that I am not alone either...

As my family says, stop and look back on all you have accomplished! Look at all the steps it took for you to get where you are! Be proud of yourself and know you have the strength in you to reach your dream. Stay as focused as you can, try your best to avoid the wrong mentality and always make time for the one of great importance - YOU! Everyone needs to be reminded of this from time to time... even me....

I'll be writing soon so stay tuned :)...

So begins surgery...

Well, good news? I will never have to do my first week of surgery ever again. Surgery began on January 5th with our orientation. It was so funny because with all my other rotations it was very welcoming. Surgery? Not so much. It was pretty much like, "This is your schedule, get used to it and just deal with it.". Interesting to say the very least. After talking with the last group that went though who the good attendings were and had the best of the worst hours. I've been told the two people I have are the worst hours but it seems like we all kind of have the same situation.

Anyway, my first day I was on call. I went in at 6am Tuesday (since it was my first day I didn't start rounding until the day after so I got to come in later), had office and hospital hours until 5pm, went on call at 5pm and stayed until 2pm the following day. 32 hours... Sigh. Luckily call was uneventful as there were barely any pages for trauma, so I got to sleep for about 4 or 5 hours. Call is technically over at noon but being my first day in, I was timid in any way asking for a break or to go home. So I stayed for 5 surgeries in the morning and went home at 2pm. The rest of the week comprised of me coming in to pre-round (on the floor at 5am) before rounds and staying to about 5-6pm at night. I am still pretty slow at seeing people and can see am trying to improve my efficiency. In FM or OB/GYN, notes were short and sweet. TICU/NICU (trauma/neuro ICU) notes are longer and full of detail. Right now I am seeing 3-4 patients before I see any resident or attending. By the end who knows how many I will see.

This rotation is full of the unknown. To me, this is my first seemingly medical rotation in terms of fully comprehending basic physiology to formulate treatment plans. I guess maybe its the ICU and not really surgery that makes me think this way. Even yesterday, the attending, resident, PA and myself sat to talk about hemodynamic profiles with a Swan catheter. I think I have never felt more unprepared for a talk. I have not even looked at that in months and months and here I am getting 90% of the questions wrong. I was getting so embarrassed. Truly on this rotation, I am sure I will learn a great deal but really in no way am I expecting an A. Of course, I will try for it but, really I do not hear alot of students getting that on this rotation.

So, the rest of the week basically was rounding and procedures. As far as my first week goes I have already gotten to help close up patients in surgery, pull a chest tube and place a PEG (or G-tube). I really enjoy the hands on aspect of it and really have no time to be nervous because once they say "glove up" you are pretty much commited to do the procedure. Overall the trauma team is very nice and I hope they don't think I am the worst student to ever work with them. After asking the resident what I can do for next week better, he told me to just work on suturing but as far as my availability and notes to just keep doing what I am doing. Hmm, not too sure what to make of that but ok. My resident is a real sweet guy though and pretty fun to spend the day with. So with all of us together it is a total of 6 people - attending, resident, ER resident, PA, med and PA student. Truly the days as of yet do not drag on because they are so jammed with work to be done. One thing I think is that time will go fast in this rotation. Days went by fast this week and I can only hope my energy stays how it is and time continues to roll how it has. Now that I am thinking about it more, it is probably better that I am doing this rotation in the wintertime. I thought it would make me more depressed but really, if I was doing this in the spring or summer and missing out, I would be alot worse. At least the rest of Michigan is semi-kinda where I am right now. I just am trying to keep things in perspective. I won't have to miss the opening of the cabin up north this May to go for great weekend trips, I will be home forever June 5th, I will get to have summer at home, etc. Overall, I am glad at the timing of this rotation now. All I have to do is get through it...

Tomorrow I am back on call but then I will be done by around noon on Monday. Since I have to go in early tomorrow I wasn't able to see any family or friends this weekend from home but next weekend is supposed to be my "full weekend off". We will see how that goes later in the week. Anyhoo, I suppose it is time to close this entry and start relaxing a bit and getting some reading done.

What IS Jessica Up To?

I cannot believe how fast time flies and I apologize for not posting for the past while. There is so much that I would like to talk about so I think I will probably break it down over the next couple of posts. When I last left off I was about to do my weekend call for OB/GYN. Of course, being there for about 16 hours pretty much nothing happened! Call was from 8am-midnight and not one delivery. Only by around 5pm were there any screeners at all! Luckily, my resident let me out at like 10:45pm and I was able to get some rest. I had one more call on Wednesday but the big news came in the last few days of L&D. All I wanted was to get in there for the deliveries and be involved in it. Days past and all that happened were C-sections. Oy. Well the time finally came! My first delivery (which I was able to actually deliver the baby) and the next day I was able to deliver yet another! After that week, we had our final shelf exam and I went on home. Ah, how the days flew by...

I know it has been so long since my last post but on vacation - posting or talking about medicine for me isn't really on my priority list, so I hope you understand! It was such a wonderful vacation. I had a week off before starting my ENT elective rotation to start off my 4th year a bit early. This was a more specific rotation in laryngology (the voice box). It was a wonderful way to see more specific areas of medicine and I had a wondeful time with my attending and residents. I really was bummed when it was over because I learned so much in two weeks and was welcomed so warmly by the staff. I will post more on that possibly soon if anyone wants to know more about it! Alas, it was time for vacation. 3 weeks of it. It was so great to be back home with my Tony and Maggie. We did so much with the house - painting, carpeting, new furniture, getting ready for our 2nd annual New Year's party, etc. Christmas was fabulous too and very busy. I can't believe it is already over and here I am waiting to start my surgery rotation tomorrow.

I think I will have to wait until tomorrow to tell you all how I feel about that. Everyone has to do it and I'll get through it somehow but I am not happy about being back. Practically bitter and very emotional about it (what do you know - again). I think if I was doing this at home near Tony and family it would be 1000x better. It is so much harder coming back here to an empty, quiet and cold apartment. I am just so sad again and know where this is headed, back to feeling low and I don't think I can take it again. But what is there to do? Quit or keep going. Man, I wish there was a middle ground. Taking a break though only puts me behind and really just prolongs the inevitable of finishing rotations if not here most likely further away. I hate this funk. After this rotation, I have a month off where I will be taking my USMLE Step 2 CS in Chicago and maybe squeezing in a radiology rotation if I feel up for it. If not - 3 weeks off after my exam then back to Saginaw for my last rotation here: pediatrics. Finally, I will be back to no call, no weekends which will be a great way to finish. Then on June 5th, I am done in Saginaw and back home FOREVER. I will beg whoever I have to in order to stay home for my 4th year and don't really see it as a hard thing to accomplish as compared to 3rd year. After nearly 3 years of my medical education, I can finally finish and start my career back at home. That is all that I want! Please God, that is all that I want.

I am sorry for the delay in my posts but am ready to start off 2009 and keep you all filled in as I go along! Prayers welcomed tomorrow and I am not looking forward to it in the least and can only hope I am kept so busy these three months fly by. Or just fly by without the work (either way!). Here goes nothing...

The Ups and Downs...

Rotations, at least for me are so love-hate. Some times of the day you are just soooo excited and others you can't WAIT to get out of the hospital. It is so back and forth sometimes, it becomes mentally draining. I am now half done with my OB/GYN rotation and surely think this is a rotation I will miss. It has been more than busy and always keeping me moving! My last call is this Sunday from 8am until midnight, which I have beeen dreading but since it is my last one - it's best just to push through it and be done. Next up is ENT 4th year elective! That's right! My dear, dear friend Anna is a miracle worker and is the only reason I got such an opportunity - I LOVE YOU! I will be doing two week of ENT from December 1st-12th (perfectly fitting between Thanksgiving and Christmas, wink wink. Doing this really will help in the end when I wished I took the extra time I had an used it do finish off some weeks of elective rotations - might as well start now. I figure the sooner I start chippin' away at 4th year (sounds weird to say that!) the sooner my Tony and I can go on our honeymoon!!! So much to do, oy. That being said, I thought it would be fun to try to explain just some my ups and downers of clinical years thus far - ENJOY!

Upper: being an "upper classman" in the medical school world.

Downer: more responsibility and can't just a take a day off or sleep in because you feel like it, ah the joys of years one and two!

Upper: In OB particulary, doing one of your first SVEs (sterile vaginal examination) and having your attending agree with you on your assessment of the cervix! 1/50%/-3 (means 1cm dilated, 50% effacement or thickness/length of the cervix to palpation (which an actual measurement might be nice to get as well) and -3 means the baby is still wayyyyy up there and not yet decended - see you can learn from me too!)

Downer: actually a literal one is passing out in the OR... Yes, it happened to me this past Thursday and it was mighty embarrassing but very funny now. I was supporting the uterus in a laproscopic procedure - long story short - big OR light on the back of my head for over an hour + little to no food in my system + sweats + rebreathing my own CO2 with hyperventilating = BAM. Luckily I didn't contaminate anything but myself and I got a cookie out of the deal! God bless the nurses and scrub techs! :)

Upper: the feeling you get after participating in a case, be it retracting for the first time or later being allowed to even do part of the actual procedure! On my first GYN surgery I was able to make the first incision on a hysterectomy case (mighty straight I might add, lol) have been able to deliver the placenta, do countless SVEs and speculum exams, abdominal stapling, yes retraction (woo., haha), even two days ago was able to use the curette in a D&C and work with the hysterscope, ultrasound and anatomy scans and much much more. Oh yeah, can't forget those lovely H&Ps.

Downer: the constant (constant) stress of trying to impress people, be it by bringing up the right questions and not just dumb ones, getting questions right (big one) asking "Would you like me to do that H&P for you?" (when in your head you are like - say no, say no!!!! hahaha) or truthfully just staying awake.

Upper: still being a student where making mistakes (albeit gross ones) are generally allowed. This is the time to get things wrong so you will remember it later and have it forever ingrained in you to do it right from then on!

Anyhoo - just a few of the ups and downs I have come across... I'm sure there will be more to mention as time goes on, but as for now - it is time to get some rest! Goodnight!!!

Still here - and trying to hold on...

Things are slowly getting better but it is really still day to day for me. Luckly, one week of OB/GYN down and things are going very, very well. I really didn't think I would, but I have taken quite a liking to this specialty. This rotation begins with two weeks of clinic, then two weeks of GYN surgery, then 2 weeks of OB L&D (labor and delivery). This week now is the last week of my clinic days and I am shocked how fast it went by. I still have 3.5 days left but I can't believe how much I have learned in this short of time. I definitely feel that my money is being well spent on this rotation. The days are long, most days being 6am-5pm but with so much to do and learn, it flies. I have done quite a bit of speculum exam, which I am getting more comfortable with now. It is so odd but for some reason the cervix just falls into place for me with the plastic spec. The metal ones? Not as good of luck, lol so wierd. Anyhoo, I have gotten to do plenty of those, bimanuals and even have been starting to do ultrasounds and fetal anatomy scans! Even today I had the privilage of being part of telling a patient she was having a boy. It was pretty neat.

We have 4 days of being on-call but they are only until midnight and not an overnight shift, so that is nice. My first night on call was really great. There were two deliveries and of course, both happening at the same time. I was in on a Cesarian section (C/S) when one of my residents (1st year) was paged out of it for another patient's vaginal delivery. With my other resident (3rd year) and the attending were busy delivering the baby and placenta, then beginning to close, I offered to take over for my resident paged out in assisting with the surgery. On my first delivery I was able to retract (cool now but I bet in surgery, 5 hours of that will be annoying haha), cut sutures and even staple the whole abdomen! One thing I really feel is that the OB/GYN staff here at Synergy are really dedicated to teaching. You can just tell that they love to take the time and I appreciate that. My patient is still in the hospital so I round on her everyday after her surgery for morning report at 7am. Residents round at 6:30am so I am sure to round and write my SOAP note before they come around. Then I present a short 10 second summary about her in morning report and once it's over, I head to my morning clinic assignment. Everyday at lunch is lecture then it is off to our afternoon clinic assignment. No time off for the day but when you are learning so much and have such eager faculty, it is hard to complain.

My next call is this Wednesday then it is downhill until the weekend when I get to finally go home. I was unable to go home last weekend due to my call on Friday night (17+ hour day) until midnight, so I was blessed to have Tony come up to see me. I can't say enough how much that meant. It was nice to not have to leave home on Sunday (even though I miss my Mags) as that is just the absolute worst time for me each week. Driving away makes me cry everytime and for the first time I was okay on a Sunday. Last week was probably the worst I have been - even worse than the island and was pretty worrisome but I am trying to take it a day at a time so I don't get back to that place. Looking at the whole road ahead it seems is overwhelming and as much as I want to look to the finish line, I know it is a ways away. I just need to take one mile marker at a time... Sigh. Just hoping I can continue to hold it together...

Anyway, I am going to relax a bit more before turning in. Another day awaits...

Take my hand, Precious Lord...

Psychiatry is now over and it is onto rotation #3 - OB/GYN which started today. I really enjoyed psych and while I don't think I could see it being a speciality I would do alone, I could see it in conjuntion with another specialty, like oncology to deal with both the medical and mental afflictions affiliated with being diagnosed with terminal illnesses. My presentation on DID (dissociative identity disorder) went very well and out of the blue our shelf exam was cancelled due to some issues with test delivery. So I was off to go home for a nice long weekend home - and it was fantastic!

Now, starting fresh with this new rotation and what do you know - feeling back in the rut. I was happy last week when I felt the accomplishment of another rotation but feeling at the bottom of another mountain being a new rotation, I find myself exhausted and utterly drained mentally. I'm sure most are sick of hearing my rants about being "down in the dumps" but as always, you chose to read this so it is up to you to read on. I am just having alot of issues with my emotions as of late, same as before yet in a deeper quality. Not to a dangerous point or anything but I have been having doubts as I am sure I have not been the only one. I just feel at the end of my rope lately and feel bad for that fact as I come off as just not that strong lately (which is scary considering I haven't even hit surgery yet). Things are better than before considering, but it almost seems as if being that much closer is a daily tease. Hearing things that are going on with my home, fiance, family, dog - even how the lawn needs to be cut or the laundry needs to be done is wearing at me at how I am just not there and how desperately I want to be so. I'm stricken with guilt too because even my future husband sees that I am not as optimistic and cheerful as I once was which makes me even more sad because even though it is true, I know that is who he fell in love with and I hate not being that person lately.

I've been back from the weekend about one day and have only had breaks from tears enough to get through orientation today. Waking up in the morning, my eyes are just so swollen. I am getting so tired of not feeling like myself to the point where in the back of my mind I have thought of taking a break from all of this. I literally have had feelings of being "stuck" knowing quitting now means a hell of alot of debt and disappointment in myself, who has never been a quitter. Even in signing up for Step 2 CS recently, I paused during submission of my payment, as I was unsure whether I wanted to spend $1200 because of these doubts. But after taking a moment, I know that stopping isn't what I want. Even taking a break means dealing with the rest of my education at some point - and no time like the present right? What kills me even more is that I am good at this. My preceptors have all liked me very much in the past, I truly enjoy the patient contact and being involved in their care. I am just so torn in my mind. I've had thoughts though, that why didn't I become something else in the medical profession? I thought about PA school and if I had pursued that I would be one by now. Why not be a nurse? My mom is the best of the best in that department and she is happy. I'm just back to the elemental question of any med school interview: why do you want to be a doctor?

I've heavily debated posting this. Part of me really thinks I should keep this to myself to save any embarassment or comments that I am not "doctor material". I have to admit that it is nice to vent it off though, even if no one reads it. Everyone is telling me it will get better and that I'm feeling this way because of one reason or the other. I just don't understand why it can't be me? Am I not as susceptible to feeling low like my previous patients? You would think knowing the signs and coping mechanisms I would have been able to talk myself out of this by now and believe me I am trying. To put it in psych terms, I feel like throughout school thus far, I am in a constant Adjustment Disorder by Axis I (little psych humor). I'm up and I'm down inside, repeat and repeat again.

I truly hope that it is just me getting into another rotation and feeling overwhelmed by it. As time goes on I am hoping and betting on the fact that these feelings will subside and only get happier knowing I am going to get to be home until the new year. I hope that my strength comes back and I can act and truly feel that I am coming back into my old self. I hope that God stays with me, picks me up and gives me back that toughness, optimism and joy that I feel has dwindled as of late. ...I hope...

"My precious child, I love you and I would never leave you. During your times of trial and suffering, when you see only one set of footprints, it was then that I carried you." ~Footprints in the Sand

Always room for improvement!

This rotation is ending so quickly it is unreal! Already in my last full week of psychiatry and just about time to take my shelf exam and move on to OB/GYN. Things are still going well and feel very comfortable still with working in this department. I still feel like I could be really good at it but don't know if it is right for me. But that is what it is all about, right? Constantly learning, constantly learning about yourself and what you can improve.

Even today, I had to interview a patient for a suicide attempt by overdose. I've done my fair share of these in my rotation - so sure, no problem! It went smoothy and the case was presented back to the department heads. After the interview, I was immediately in the patient's defense. This was no suicide attempt nor was she drug seeking. Some thought from their many years of experience that they knew the diagnosis right off the bat. While I respect their long career and endless patient encounters, it really turned me off that barely through part of my presentation, it was - oh has she been in rehab? - she must have known what she was doing! - or even the rolling of the eyes from the nurse about her and the jokes made from the Internal Medicine doc of how she must have been so desperate to get high. It was an utter turn off. Is this what years in medicine do to people? Make them this cynical?? It was truly disappointing. Luckily, after my presentation it was time for round two - the doctor to do a bit of interviewing after me. Afterwards, they were convinced that she was a legit patient in a great deal of pain that was only taking medications because her previous pain management doc is not longer available and she has been out of her pain medications for months, left only to OTC medications she was left to desperate measures of going to buy something a bit stronger off the streets . While social work needed to help find her a new place for pain management, it was found that she indeed was not suicidal.

Room for improvement, no?

In that interview, all appropriate questions were asked for such a consult. Specifically, feelings of depression - denied. History of abuse - denied. But when the physician came in for the evaluation, confirmed and confirmed to both questions. UGH, I thought. You just told me 'no'! Why did she lie? Ok, ok... those were my first thoughts. After thinking about it, I realized that during the interview how much she was holding back, trying to be strong for her family as she was known as the strong one. Then I thought about what I did wrong and found that the way I asked those questions weren't as good as they could have been. At times certain questions in some interviews may appear unconnected or less important so they are asked quickly with the interview then continuing on.

Room for improvement again!

I now have a better understanding of how to at least attempt in opening up patients more, after looking to myself and what I could have done better and not blaming the patient for 'making me look bad'. Because of her I will be better and so will others if they let themselves truly think about how their countertransference plays such a huge part in professional and adequate treatment.

Finally, tonight my mother and I watched a program on Public TV about those with no health insurance. Alright, talk about room for improvement! It is so easy to look at the uninsured as immigrants, the voluntarily unemployed, etc. Just the toil that these families went through was unbelievable. Prospering families, stricken with a horrific illness or debilitating accident had left them with less than nothing. Even those with insurance, but not covering every single base left them without a basic necessity, for example a leg. This man lost his leg and was unaware his insurance didn't cover him, as the insurance company approved his visit to get the prosthesis. So here he is with his new ~$10k leg (by the way which was supposed to be only able to last 4 months) and all they can do now is hand him the bill. Finally now able to go back to work and a year and a half later still on the same old prosthesis waiting for benefits to kick in for his family of 5 - but of course with pre-existing conditions would probably not cover him anyway.

I could go on and on but just the constant need for everyone in medicine and for the system as a whole to improve is seemingly overwhelming but its water that we must tread. Drowning in this sea of uninsured, debt, MORE debt covering the uninsured (many with chronic illnesses because without some very basic health care, they were unable to get the medicine for which a simple pill probably would have cured them 5 years ago). Sigh. Definitely preventative medicine in this election is key, one which is the gateway to a less strained (already stretched) health care system. I just hope that our future, with all that has been going on as of late, gets stabilizes enough to instill a plan of action worth our time and hard earned money. I hope that the next president realizes that more than abroad - many domestic issues have gotten too ignored for too long and it is time to reel it in before insurmountable damage is caused... if not already so...

Will it be worth it?

Onto week 3 of Psychiatry and things are going just fine. I am learning a great deal and feel like I am getting a wide exposure thus far to the specialty. While I do enjoy pretty much each day to the fullest, I really don't know if it is a residency for me. I really think that it would bring me down after a while and unless I was doing psychotherapy (talk therapy) I don't know if I would feel like I am getting to do what I feel is my full potential for helping people the way I want. Three weeks from Friday is my shelf exam and then onto OB/GYN! Moves fast it seems but sometimes it also feels like it can be dragging in the long run of things.

My emotions as usual are up and down. I truly believe that after my time here in Saginaw (finished June 5th, 2009) - things will be yet one more step better than things were before. I am just struck with all the guilt for leaving Tony home alone to take care of things and our dog, feeling so sad sometimes that I am STILL away after beginning this process September 2006 and feeling very much tension and anxiety awaiting for this stage to end and the next to begin.

I know that time is moving by fast and how lucky I am to be here but when you are in the thick of it - sometimes it feels like walkin' through mud. This is all I have ever known that I wanted to do with my life and I know I was meant for it, but this long, loooong road takes such a toll. Looking back I see how much I gave up, effort I put in and time I have dedicated to being where I am today and it really makes me feel better in the sense that I can see how far I have come. On the other hand, I think to myself sometimes - will it be worth it? I worry about the debt, if I will be able to start a family when I want to and even if I will be an effective enough doctor to make a difference - to get to the point in my career when I find that through my work with patients, it was indeed worth all the hassle, adrenaline and tears.

I am sure that it will all be fine but yet again I am hitting a tough patch lately. I think I should look back to my island days because for some reason it seems like I am hitting more of these times than I did there! Maybe it is because I am still in somewhat of a transition, even though I am 3 weeks away from finishing my second rotation. Just when I am getting into the swing of things, Step 2 is around the corner, CS (clinical skills) in particular. I have decided that I will be taking this in mid-April and signing up probably within the last week to take this. My CK (clinical knowledge) which is like Step 1 will take place probably in September, after my IM rotation and my wedding (yay!).

So many things on my mind now it is unreal. Then again, it has always been this way. I can't remember a time when it wasn't. Oh yeah I do - and it drove me crazy! Wierd huh? Seriously, now anything over a week or two and I get so stir crazy without tasks or goals. Is this even a good thing, lol? Sigh, well at least my rotation permits me to have my weekends free so each weekend I make my way back home to recover and put things back in perspective. I thank God for my home, family and friends. Sometimes I lose sight of how good I have it at home and being out living on my own is a great reminder of how badly I do want it back - days when I can sit in my own house and put those suitcases away for vacations rather than yet another move for my career. That day is coming, even if it doesn't feel so. I just need to be constantly reminded and hopefullyone day, when that day comes, I can look back and say not only that it was worth it but it was the one of the best decisions I have ever made.

Don't Quit

When things go wrong as they sometimes will,

When the road you're trudging seems all up hill.

When the funds are low and the debts are high,

And you want to smile, but you want to cry.

When care is pressing you down a bit,

Rest if you must but don't you quit.

Life is strange with its twists and turns,

As everyone of us sometimes learns.

And many a failure turns about,

When you might have won had you stuck it out.

Don't give up though the pace seems slow,

You may succees with another blow.

Success is failure turned inside out,

The silver tint of the clouds of doubt.

And you can never tell how close you are,

It may be near when it seems so far.

So stick to the fight when you're hardest hit -

It's when things seem worst that you must not quit.

Starting up in Psych...

My second rotation is underway and it is quite interesting for sure. I am still adjusting a bit to it and tomorrow I will complete week 1. Compared to Family Med, there is no where near the patient load (at least so far) that I am used to. I have been told that it has been a light week so maybe it will pickup next week but who knows. The consults however are much, much longer than FM. Today, I finally got to start the process of interviewing psych patients on my own and the interview lasted a good 45 mins or so. It was a case of depression which was a nice transition into the rotation, as this is the most common complaint to receive. Nothing really too difficult though. Prior to beginning this rotation, I have been doing my reading up on psych interviews, flow of questioning and laying out all of my handy mnemonics for psychotic disorders, mood disorders, PDs and more.

I do not think that this rotation will be overly difficult but I am very much enjoying it so far. I have not crossed out psychiatry as a specialty but already I can see how it would be a tough job, quite demanding of patience and energy. On the first day of the wards, I already got the pleasure of getting the "boot" out of the room. So many patients just hear "psychiatry" and feel the need to express how they are not "crazy" or "retarded". It is a shame that so many people feel that there is shame in talking to physicians in such a field. So far, there has been a couple suicide attempts, one in which I saw and plenty of BPD (Borderline Personality Disorder) to go around for all.

The biggest adjustment I think that I am making is getting used to different styles. For my first two weeks I will be in the hospitals then rotating a bit around with other physicians. While in the hospitals, students could be with one of three people - all with different styles of teaching, interviewing and treatment. In FM, it was better because I had one great model to follow and it made it easier to develop my own style quicker that would fit the liking of my preceptor. Now, doing interiews one way, isn't necessarily liked by all. So far, I am in no way getting any heat from how I do my interviews or presentations, but I assume getting to know my teachers (albiet - quickly, as I rotate from person to person on nearly a daily basis) will aid in my ability to blend better with them. I find that I have a pretty good flow with my interviews and alternately, many just do "bulleted questioning", sometimes not allowing the patients to really speak much. Of course, some patients have that gift of going on and on - but to me there are more creative and less abrupt ways of directing the interview to where you would like to go for investigation.

Also, I am finding that some of my teachers go above and beyond what we were initially called down to do. For instance, an initial depression consult (which was stable and basically a recheck) turning into a mild (very mild) dementia - ordering brain imaging, fixing metabolic disturbances noted in the electronic chart, etc. At first, I was turned off. Why were we doing this? It just seemed out of the realm of what we were called down for. It seemed like just doing it to... well, do it. I know that in consults you have to do what you can for the patient and CTA (cover your... hiney!) but I didn't know if it was thoroughness or overkill. Furthermore, the patient was even happy with her medication for her depression and felt that it was doing a good job as now with her recent illness, she is now facing the difficult adjustment of being more limited in her life activities. After discussing increasing her dose of her MAOI, she was not interested and already didn't feel completely comfortable taking any mediation for it - yet the executive decision was made to increase her dose anyway, of which was known to all but the patient, as this decision was made post-interview while charting. Even now, I feel it bad to cast any judgement on my preceptors (like my one week has any bearing at all on their lifetime experience) but it just really opened my eyes keeping an open mind to look at the bigger picture at times than just focusing in on the one thing that you were initially investigating.

Sigh, it has been an interesting few days though and I know it will be a really great experience in the weeks to come. The psych department here is really into teaching the students and getting us some wonderful exposure to a vast array of clinical senarios and ethical issues. Now, onto finish week one - I wonder what tomorrow will bring? :)

Back in Saginaw...

So, the journey continues. I am finally feeling quite settled in now and only awaiting the cable to be hooked up this week, which I am getting along fine without. It is so much different than the last time I was here. Last time, I was in a hotel two doors down from a friend to hang with and now I am in a pretty big apartment - alone. It is so quiet and it feels too big of a space for one person to have. Just have that lonely feeling creeping up on me again which I cannot stand. Sigh... On the up-side though, I had a wonderful Labor Day weekend at home with Tony and Maggie and miss them already. I even got to buy my wedding dress! YAYY! It is so beautiful and I just fell in love with it so long ago (found it while I was still on the island, haha). So now 3 things are down: church, reception hall and a dress! But alas after the weekend, it was time to head back. Maggie watched me pull out of the driveway again (getting used to the routine that mommy has to go away again) and ran after my car and jumped up to the window to give me kisses. Next time I see her she will be already fixed and probably in some pain which makes me sad I won't be there to take her in but at least I will be there by the time she checks out of the vet.

My apartment here though is very nice and fully furnished with towels, sheets - even silverware, pots and pans. Very easy transition, which is nice considering each time I do this "moving" business I grow bitter and am finding myself exhausted emotionally. All I keep hoping is that this will all be worth it. It's funny how on the island it seemed that it was flying by. I mean, it still does but now it is beginning a whole new chapter to medical school and I can't help but feel like it may never come to an end and I will never be permanently home. I'm exaggerating as I know I will be soon (hopefully only having to do my 3rd year away) but this process just feels so much longer than I anticipated. I can't imagine doing this schooling only if it was because my parents wanted me to go into medicine or only because my relatives were docs before me - without that passion, I know I would probably have stopped a long time ago. I just feel in the thick of it now and I guess that is better than starting from scratch. Soon enough I will be leaving the deep end and coming back to shallower waters where I can finally find my footing again - hopefully enough to walk those things on home, haha.

Anyway, so last week was our orientation to Synergy Medical Eduation Alliance, which I had already done in 5th. No real big deal at all but now since the long weekend is over, it is time to do my clerkship orientation - psychiatry. They said to dress for clinic so I am not sure if it means that we will be starting immediately or what but I have been trying to do some reading to get refreshed in psych. Nothing else much to do here anyway. Soooo, I guess that is my major news for now and I will let you all know how my 1st day of my second rotation goes! Just a hunch but I do think I will enjoy psychiatry alot - let's hope that is true!

Waving goodbye to FM - and home, once again...

It is hard to believe, but FM is over tomorrow. While the day was long as all Thursdays are - I found myself sad and even tearing up that it was coming to an end. I know I have a long way to go but I know that primary care is where I belong. It is very draining at times and can be quite testing of your patience but in the end of it I am all about the little things...

The small jokes and convos that go on between established patients really is rewarding. My preceptor has known these patients for 10+ years and even generations throughout the family. Some patients I have seen once, some 3-4 times in my 6 weeks and I know that there are so many I will remember and those I will miss (which is hard to say because you never WANT people to be sick but those who add a little joy to the day with their positive attitude or cheery smile really is contagious!).

I truly think I am quite tired from my 12 hour day today (which is rare) but I feel very emotional tonight. Of course it isn't the couple of beers that I have had while packing - no, no (:P) - but really I will miss my first rotation and probably the best preceptor a student could ask for. She taught me SO much over the 6 weeks and I hope she knows that. I thought that my fire and passion for medicine was strong but this rotation truly only ignited it more. At the end of the day, and only being a student, I have felt fulfilled. Sure, it isn't the big saves like like in ER but just to make a difference in the persons day was a pleasure.

My emotions however got huge once I got home. Luckily, I spared my parents in it (Thursdays are the days we go out to Slips for pizza and beers! So fun!!!) but I came home and was just frantic trying to - yet again - pack to move away. Of course, it is only 2 hours away but as you all who have been following this blog know - it is get...ting old. I finally got to packing my clothes and opened my first dresser drawer only to start bawling. It isn't such an awful things to move and I know how fortunate I am to be near family and friends - but I guess it is just the actual relocation - to a place that to me isn't my home. It has made me feel so sad to keep moving, almost like my house right now isn't really mine because, well, I'm never here. My time from after 5th until now is the longest that I have continually lived in this house. 6 months about. Then there is Maggie (our new puppy which I don't think I have written about). We got her at 5.5 weeks and she is now nearing 4 months old. She is such a heart-melter and joy to have around. I am not sure if we will split time with her but I am so worried that she won't remember her mommy. I love her so much and she is so smart - she'll have to remember, right??

Okay, It is time for me to keep packing and get some rest. Last day of FM tomorrow and need to be fresh for pics she said she would be taking and sushi we will be getting to celebrate (YUMM)!!! I'll write again soon once I am settled in Saginaw. I know that once I am away from home again, blogs will be pouring out of me! Take care all and talk to you soon.

Like a bad penny: The Comp Exam!

This post goes out to a student who asked me about the Comp exam and how my first attempt differed from my second (which is so late but I hope helpful!). Basically, like I said before the first attempt I didn't try that hard. I just got back from the island around Christmas and was scheduled to take my Comp in the beginning of January. I was just so excited to be home, I really put the studying off. My studying was mostly just glancing at some notes and - well I don't know how else to say it but really just wanting to take the thing and move on. Smart me, as I have never been good at tests in the first place - here I was... wingin' it.

Once I found out I failed, I was very sad but wasn't surprised. I had no one to blame but myself and I knew it. I couldn't say I tried my hardest... Well, I could because I did but I really didn't prepare at all to even 1/2 my potential. In my defense though, after everything I had been through, I felt like it is all I could give.

During my 5th semester in Saginaw, I knew this was my "make or break" exam. This determined it all: graduating on time, staying in Michigan for rotations, being able to secure my wedding date - everything. Luckily, in the area I was in and the hotel room (or as I call it the hamster cage) I lived in, studying was my entire schedule, with the exception of the gym, seeing Tony some weekends and of course - going downstairs to the bar later at night here and there to wind down from a long day. In the beginning of the semester, I made my strategy: knowledge, questions, practice tests. I calculated how many videos I had in each subject and divided it out each week. For me, I did a different subject each day. Mondays were an easy topic because it was Monday, so like anatomy/histology. Tuesdays were biochem, Wednesdays micro/immuno, etc. Whatever subject that I felt that would fit my mood for those days, I chose. I figured that doing mixed subjects would be better than all one subject then a new one after because by the time I got to my third subject, I knew the first would be half way out of my head. This way it was staying fresh and I didn't lose my comfort dealing with each topic. I did have the Kaplan texts but truthfully with my timeframe it wasn't feasible. I do think it is a wonderful idea though if you can read fast but it is pretty close to just the videos in text form.

Anyhoo, each day I would do my requirements for 5th then after go right to Kaplan videos. I would wake up early in the morning even sometimes to watch a few (of course on fast speed). I took notes from Kaplan and put it into my First Aid book so all my notes were in one place. I was done with Kaplan within about 5 weeks or so, give or take. I didn't finish path or pharm/micro in Kaplan videos because I liked Goljan better for path and pharm/micro - well it was just all memorization. I did though go over the beginning of pharm, like the fundamentals, equations, dynamics/kinetics, etc. That was useful.

Once the videos were done it was onto USMLE World. I finished probably close to 30-35% of the questions (which I got through them all by Step time) with the time that I had to prepare and after much experimenting with how to do it, finally chose random questions (as how tests were) and chose untimed/timed (never been a problem but if I found myself taking forever and lingering I chose to time myself to keep me moving). I made sure I read through each answer. To me, each question was loaded with up to 5-6 facts. Even if they were the wrong answer you learned from each one.

I never did amazing on the questions and I wasn't really looking at my scores much. I just wanted to get through as many as I could and understand them. I then started to take practice exams. I used the NBMEs and started with form 3. Forms 1 and 2 are old and dated to me - too easy. I did 3 and 4 (was saving 5 and 6 for the Step, which I didn't end up doing anyway). I think those were the only two I did for the most part but still was answering UW questions at the same time up until the second Comp. I knew where I would be taking it in Saginaw, so I took a practice exam in there so it was a familiar environment as well which took away 99.9% of the jitters. Then the day came and I thought it was harder than the first one. I was down but knew how much work I put into this one. Now, I could say I did my best and worked to my hardest potential and I had no regrets. I improved from a 62% to a 69% - not huge but enough to make me happy. Once 5th was over it was time to study for the Step and I'm sure you all know how that went! ;)

All in all, that is my story and I hope that it was more descriptive than my other Comp posts. I'm sorry to whoever was asking about this for so long but I hope this has helped. I will check the comments section in case you have more questions on things I may have not commented on but truly studying is all about what is best for YOU! I took many different ideas from people and made a study program of my own. So get many ideas and do what you will stick with - what you will look forward to and not dread when study time comes. Medicine is lifelong learning journey so hop on the ride and make the best of the study time that you have! :)

Long, long overdue...

Gosh, I don't know what else to say but I'm sorry for the long delay! I'm sure you know how busy I am but I didn't want to hold off blogging for this long, oy! Things are going amazing. I am enjoying my FM rotation very much. It isn't the exact hours I have said before, as now I am staying longer for charting and such - but I don't mind it at all. All in all, I think I am there around 50ish hours at most.

Truth be told, I am just so drained by the end of the day, I haven't felt like reliving it after again. The experience though has been wonderful and I am not being worked like a dog either. I find myself eager to stay longer, work harder and help in any way I can. Let's see... What have I done in this rotation. Alot! I see just about all patients before my preceptor. I interview, examine, present the patient and go in with my preceptor to wrap up the visit. As far as procedures go? I have been so lucky! I have been able to do countless injections of antibiotics, vitamins, vaccines, TB tests, allergy shots, etc. (one of which led to an anaphylactic reaction - a story for another day, lol - not my fault as no one knew she had an allergy to the medication but I freaked out a bit inside). I've done breast exams and paps, where my preceptor begins with the spec but we swap seats so I can take the cultures, remove the spec and perform the bimanual if the patient allows (which hasn't happened alot but I am confortable with it). As far as rectals, not something I am dying to get the experience of, but if asked - I'll dig in lol. I've been able to take rapid Strep cultures and probably the biggest of all been able to do hemangioma/mole removals. With my preceptor aiding me along the way, I have done it from anesthesia to cautery, and they have all been on the neck (not that I am worrying of nicking an artery with my scapal!). Of course, that would happen with the right technique but that though went through my mind with my first removal.

Even besides this, doing the H&Ps have been the most beneficial to me. I am getting very comfortable in my interviews and know with each rotation there will be new avenues to learn. My rotation ends next Friday and I have just enjoyed it so much. I know this rotation will probably be the most patient contact that I might get to have and I know that primary care will probably be where I'll end up. I just love interaction with my patients and I have gotten such warm responses from them. When I come in with my preceptor, there have been so many times where they complement my style and comment on what a great physician I will be someday. It just means alot to hear that and gives me that extra drive.

I really hope I didn't turn people off to my blog as I know that it has been lacking but hopefully I can post more before this rotation is up. Psych is up next starting September 2nd in Saginaw and I am sure there will be alot of posts during that time! But again, apologies for my laziness and I hope you all stay tuned as the journey continues! :)

Happy 2nd Birthday Blog!

I'm a day late but was too wiped out to write last night! I know I owe you a blog about my rotations and other things like the COMP but I am hoping that tonight I will get to it! Sorry for the delay! :D

Happy 2nd Birthday Blog!!!!!

7-29-06

I passed the USMLE Step 1!

My days of stress, at least for the meantime, are OVER! I had gotten my results July 16th (soooo sorry for the late entry) and I just couldn't help but cry of happiness! I didn't do amazing but I didn't 'just pass' either. 200/82 is my score and I am completely happy with it! I had already started my family med rotation and I was taking my lunch break at home when the email came saying my score was ready. Ugh, moment of truth! I cannot tell you how much I was shaking! But as I scrolled down I saw "PASS" and... well, eventually got the hint that it was all behind me. I just couldn't believe it at first.

So what now? I am now done with 2 weeks of family med and I love it. I really didn't think I would but I have a great teacher and she really gives me alot of freedom to do what I am comfortable with (which I never turn down an offer for a new procedure or task) and is giving me a great experience thus far. I can only hope that I am what she expected in a 3rd year and possibly even more! I will be writing soon about my past couple weeks and truly cannot believe after next week it will be half over! Usually I count down my days, but I am really not in a rush to finish this rotation. I am learning alot and am very glad I have this rotation first. Of course, I am sure there are benefits to having any of the rotations first but my perspective is that I am getting alot of patient contact and practice with a thorough interview for specific and common complaints and to me a way of working that makes it an easy transition into my clinical years. Next up will be back to Saginaw which the orientation begins August 25th and psychiatry will be my first rotation on my schedule there - yay!

I can't wait to write about my experiences, so many in just two weeks! I just wanted to finally pass on that my Step 1 is now over and time to look onward to Step 2 CK/CS! What a sigh of relief! Thank you for all your support and prayers, I appreciate it so very much!!!

Family Medicine is Underway!

I have just finished my second day in my FM rotation! I was so worried that it wouldn't be what I was hoping for but I know I am already getting some great experience. I am in an outpatient practice for the next six weeks with my preceptor and on my first day she asked if I would want to follow her around to learn the ropes or just jump on in and work up my own patients. I really wanted to be thrown into the mix and that's just what happened. We had about 15-17 patients my first day, 9 of which I worked up. My preceptor of course asked if it was alright for me to come in to do my exam and then the floor was mine! I took their histories (unless it was a complete physical, just a more directed history), did any exams that I thought were necessary, presented back to her and then re-visited these patients together with her to finish off the visit and fill in any gaps if needed. It was a great first day and really made me feel very comfortable right from the start to just knock, walk in the room and sit on that little doctor stool all by myself. Haha, I still think the stool is one of the coolest parts (weird huh?). I get to take in the charts write up my SOAP notes and even sign my own work. To me, it is very exciting - and I am so grateful to my preceptor for giving me such freedom on my first day. Most of my patients were pain: shoulder pain, headache, ankle injury, back pain. I also had some headcolds, possible kidney infection, spinal headache from an epidural and more. I write up lab orders but for now it is mostly by her discretion which is discussed while we visit together. I think though that very soon I will come out with my own orders as well. Anyhoo, all in all it was a great day.

Today was a bit slower but I didn't mind so much. I still got to do my own cases but was able to begin some procedures today. My preceptor is a "see one, do one" kind of doctor as long as patients are willing. I got to do an awesome ear flushing (haha) but then was able to draw up and administer 4 injections: 2 in the hip, 1 deltoid and 1 in the posterior arm. Only day two and with the experience thus far, I am just extrapolating that over the next 6 weeks. I am hoping though that I am making a good impression. Slowly the pimping is starting, some I get right and some I don't. She is very understanding and is very happy to teach me. I need to keep my nose to the grindstone and keep improving!

In the meantime, my scores are supposed to be coming out tomorrow. I don't want to delve into it to much but my Synergy deadline is tomorrow as well. I did all I could do and I hope that it comes on time. I know they are waiting on many students scores accepted into Synergy but I just hope the program doesn't drop us all because they have delayed our scores. Sigh, anyway - more to come! Stay tuned!

Feel 1/2 way there...

Well, yesterday went quite well. Long story short I will be allowed to begin my Family Medicine rotation on Monday! Why feeling half way there? I still don't know if I have passed my Step! There hasn't even been a chance yet for me to do the Oasis Trick. I feel like I will be soooo embarassed to start this rotation and then fail the Step, only to have to pull out of the rotation and begin studies again... I still don't even want to think about it.

At least I get the rest of this week to get my things together, get the house as clean as I can (cause I know I've been like the 'housewife' lately and I won't be around as much), just getting my mind adjusted to a new schedule. I am excited but confused with my new role that I will have in my clinical years. I'm not sure how my preceptor will want me to participate in the patient care. She is new as well to having clinical students, so it will be new to us both. If anyone has any advice from their FM rotation let me know!

Nothing much else is going on., but I guess it is time for more laundry and refreshing some Bates' in my head! :)

Crunch Time...

Well vacation is over and it is back to the real world. I am glad to get things going again though. Unfortunately to me, it seems like it might not be happening! I am still waiting for my scores and with Monday (the day I am supposed to start FM) being 5 weeks, I am finding myself in a bind. All my forms are in to start at this facility, including my health assessment form. The dates are set and ready to go. It seems like I just missed the right time to take the Step as people that took it just 2 weeks prior to me got their scores within 4 weeks. It seems like I might have to wait until the 16th to get them which cuts into my first week - of course. Luckily I have a very flexible preceptor and doesn't pose a problem but shifting a week forward then cuts into my orientation at Saginaw at the end of August! This is a bad game of Dominos.

Not only am I worried about starting FM on time but jeeze - I am still freaking about the Step! Did I even pass?? I must be rolling some dice because I feel like I am just setting up for a huge disappointment if I failed. That is alot of things to cancel in my near future. Ugh, I just can't think about that now.

Anyway, I have emailed some higher-ups just to get some advice, which I hope will be more than "tough luck". I just know I have busted my butt to get this far and to obtain the great opportunities that were out there and seeing it come to a screeching halt makes my stomach sick. It is just awful not knowing where I will be next week. I could be picking up Kaplan and beginning my Step 1 studies again or I could be starting my FM rotation. I hope and pray it is the latter, but I guess I am just on hold until I hear more. Until then, please pray as I am that I can move forward and stay on schedule...

YAY for VACA! ...(-tion)

YAYYYY! Vacation timmmeeee! I am so excited to leave for the beach - omg, 8 whole days! I have so much to do: laundry, last minute shopping, packing, road trip food - yikes!!! Too bad I feel lazy! After this trip it will be just about time to check on my Step score (gulp.) and hopefully buckle back down and get to preparing for my first rotation. As the day of my score reporting draws near, I am getting more and more nervous, so much so that I have supressed it in my mind and have tried not to think about it. I just want to enjoy my break (which I am!), not ruin it with negative thoughts and pray. Sometimes I feel like if I don't worry enough, it somehow equates to not caring and I will ultimately do poorly because I haven't spend my days consumed in anxiety... Aren't I somethin', haha!? My mind plays such mean tricks on me, to the point of making no sense at all.

Anyhoo, this post is a short one and not too interesting but hey - I got things to do! :) I'll be back after the 4th of July! So have a wonderful holiday!

Slowly feeling back to my old self...

I'm not gonna lie, the past 6 months or so have been a bit difficult for me emotionally. Oddly enough, it was right when I came home for good late last year that I found myself pretty down and out. You would think I would be the happiest of all people with how my situation after Dominica turned out. Though over the past months I have been full of anxiety, worry and basically bummed out. Things were going well, so why the long face? I honestly couldn't say. I was never that way. Tony has always told me how positive I was before, always cheery and having the ability to bring others up when feeling low. He had told me that I just have not been "Jessica-esque" lately. Yes ladies and gentlemen, I've been in a funk.

I just wish I knew why. Things are going so wonderful (especially if I get a "pass" on the Step) yet I still have found myself sad, even crying quite often from feelings over being overwhelmed. I don't know if I would call it a depression. I have always been able to pull myself out of such a feeling but have been really struggling with it. It truly came about a couple days ago when this shroud seemed like it was lifting. I don't know what got me there or what has been pulling me out, but it is seeming to pass over and thank God because I don't want to be a downer on the upcoming vacations! I just feel like I am slowly coming back to my old self. Maybe these trips have something to do with it. I am leaving today with Anna for Ohio to see my friend Beth for the weekend. While I love home, I think a few days away might be just the ticket for me to refocus and get a little closer to where I want my mindset to be. Next up, is our North Carolina trip and I know Tony and I both are looking forward to some carefree days on the beach where the biggest decision of the day is what to eat for lunch!

Today has been a pretty productive day with calling/faxing in forms for starting my first rotation, getting doc appointments in order, doing housework, giving the dog a bath, etc. I figure especially with rotation issues, it would be best to get it all in within the next week at the latest to ensure an abundance of time for Ross to get everything ready for me. Now, I am just beginning to pack a little weekend bag, get our road trip snackies together and get going to my weekend with the ladies! As most know, I have never been much of a girlie-girl but - but ya know - maybe that is just what I was missing all along!!! :) Yay for the weekend!!!!!

Been a long time coming...

Time for a summer vacation! As short as it may be, I think a month will be plently of "off" time. After it all - applications, interviews, preparations, 16 months of the island and its drama, COMP(x2), 3 months of 5th semester and the the USMLE Step 1 - I have earned (hopefully) a nice, cool 4 weeks off with nothing to do but relax! Of course provided I get the pass on the Step but after which I will be pretty much immediately beginning rotations!

It is so odd not doing anything. I think alot of my fellow students can attest to the excitement of vacation but after about a week or so, a sense of being ansty or bored sets in! We have been conditioned to go all year round and just be such workhorses we forget how to enjoy a break! So far, mine has been niiiice. Unfortunately, my finace has been working overtime since we have such severe weather now in my area but I am hoping he gets to hang out with me this weekend. I have just been relaxing with some brewskis, laying out, working out and trying to get my house back up to code with cleaning! This next week will probably entail the same but then starts some real vacations! Going to Ohio to see one of my girlfriends with Anna for the weekend, which will be really nice considering the whole next week I will be in North Carolina with the boys relaxing through the 4th of July! Actually, by the time I get back I might have my Step scores -gulp. Not gonna lie, that is still majorly on my mind. Everyone has their opinions on what is the best indicator of the score to expect. Trying to keep it out of my mind but am going through forums as a form of therapy for me to see other peoples' stories of success with practice scores like mine...

Anyhoo - just trying to enjoy my break. As of right now, I'm sitting next to my sleeping puppy, watching the weather updates while sipping on a hazelnut coffee - soon to take off for back-to-back gym classes of Zumba (cardio salsa) and kickboxing with Alisha! Tonight? Hanging out with some of my loves at Big Al's (our local bar down the street)! Yayyy! I think it's gonna be a good day! :) I hope you have a nice day too!!!

Done with USMLE Step 1!

It is over and it's not sinking in! I am praying and hopeful but worried at the same time. I just don't know how to read this exam or what to expect at all. So, I took the exam yesterday. I got a full 8 hours of sleep before my exam and had a decent breakfast but nothing too heavy. Honestly I was shocked at how informal it was. I mean there was still the signing in, photo, sign out for breaks, locker, etc. but barely anyone was taking an exam in Prometric but me and I had the whole room to myself. It was very nice. I did block 1 and 2 then took my first break, same with 3 and 4 then a break, 5 and 6 then a break, then 7. It went by fast but felt like I had plenty of time to take it. I finished each block very quickly (oddly enough) and with all the checks that I had I had a good amount of time to go back and think them over.

Blocks 1, 4 and 5 seemed doable and I finished those feeling pretty good about them. The rest were a bit tougher... There were QUITE a few that were "gimme" questions. I was sooo surprised! I just didn't understand how they were on the exam! I know there are experimental questions too so when I got to a question I had no idea about, I told myself "Oh, it's one of those experimental ones!", haha. I think though what has gotten me down the most was block 7. I don't know if it was the exhaustion or just a bad block but it left me at the end of the day sad, down and out.

Overall though, the day went smooth - no glitched, interruptions or distractions. I am just overwhelmed now with feelings of failure. I worked hard to get to the point I am at and just thinking I will have to take it again is just very worrysome. I am wanting to enjoy my break. If all goes well and scores are in on time, I start FM July 14th right near my home. Who would have thought that after all the sacrifice of leaving home for school I would get the chance to end up right down the street! Ugh, I just don't know if I should start studying again or what. Very confused, anxious and worried. It's only been a day since my test so maybe I should give it more time but I can't help but think of the worst. I'm just not sure how to read it. I don't understand if there is a curve or not, or whether the gimme questions would even make it a bad curve. I'm trying to think of how many I needed to get right for a pass, like what percentage. So many thoughts and so much time to swim around in them!Anyway, thanks for letting me vent! I will be updating my blog with anything else that springs to mind of that day so stay tuned if you wish! In the meantime I am going to start crazily cleaning my house to keep me busy and pray, pray, pray!

Wishing, hoping and praying...

Here I am a mere 4 days away from the Step 1 and I am thinking that I am ready to take it or bust. I am now nearing 1100 questions completed these past few days and am hoping to get in a few helpful videos that I think would be nice to review once more and a quick skim of FA. That's about it folks. I've squeezed in as much as I could and gave it as much energy I could muster. Considering where I was from my first COMP exam to where I am now 6 months later - I think I have done alot of work towards this moment, I just hope that it pays off and that God blesses me with the faith, confidence and endurance that Monday will be taking out of me. My exam is from 10am-6pm and hopefully I will be finished sooner but I am in no rush.

Tomorrow is most likely my last exam which will be the one I bought from UW. I'm sure this will play a bit of a mind game as this test I hear is much harder than what I should expect but I am hoping to keep that in mind and take it all in stride to help build my confidence. I'd rather do a hard exam to prepare than an easy one where the concepts are too basic to bother with doing.

Sigh, being now about 1am I am going to try to finish anymore questions I can tonight and get some rest. Tomorrow will be another long day and hopefully I can be comfortable enough to begin the winding down process!

Less than a week until FREEDOM!

The Step is in less then a week now officially. Wow! I was sitting in the sauna with Anna today just talking about it a little - I can't believe I'm here right now. I'm busting through USMLE World questions and started fresh from the beginning to go through them again. In about a day, I got through a whoppin' 574 questions but I'm sure tomorrow will pose a bit of a challenge as I move onto some questions I haven't gotten to yet. With only finishing about 50% of the questions, I'm just going over the answers alone. Hopefully by Wednesday I can take the exam that the UW has which I bought. If that test turns out alright, that will be the last one before the BIG one! The UW test, however, is much harder than the real deal I am told but I just have to keep that in perspective and continue on! Other than that, I want to go over a couple hours of Goljan, some of the topics which were most helpful.

My mom is taking Monday off work to be with me that day - THANK YOU MOM! It means so much when she is there on the days that matter most. It gives me a great sense of peace. I am definitely looking forward to Monday being over and to get a month to relax and soak in the day's nothingness - just to do what I feel like!

As for the moment, Tony is in bed with Maggie (omg, I never mentioned it!) our new pure Springer Spaniel who is now nearing 8 weeks old! We got her when she was 5 and 1/2 weeks and she is growing and learning so fast! She is very smart and surprisingly as crazy as it can get, really lowers my BP, haha! Anyhoo, she is in bed too and I just got done with UW and watching the Wings lose in triple overtime... Ugh. Game #6 here we come. Well, time to relax for a few, finish my night and head to bed. Another long and hopefully productive day ahead!!!

Jessica vs. the USMLE Step 1 Exam: June 9th, 2008!

Well the date is set: June 9th, 2008 @ 10am I will be taking on the Step exam! I am SO glad to have it scheduled but strange how such a little thing can finally make me start freaking out. Yesterday me and 10 other girls went to see the midnight showing of Sex and the City! Sooooooo very good! Loved it! As soon as I got back, I figured that I would check my email and there it was - my testing permit after nearly a month!

Since I took my COMP in Michigan and it was a new thing, they couldn't find or have record of our scores which delayed my permit by an EXTRA two weeks, grrrr... But I am lucky and as soon as I got my permit I could sign up for the next week. I wanted to do the Saturday but upon refreshing my browser - it was already gone!!! So I stayed up (now being ~4am) to decide when I was going to take this bad boy. I decided on the next possible chance on Monday at 10am. It is at the nearest site to my house, about a 25 minute drive. Starting at 10am means that I will be out sometime around 6ish in the afternoon so that isn't too bad. So strange to think that in 10 days it will all be over. I am starting to wig.

Since I have started my studying after my 1st failed COMP, my scores on practice tests have went up and up. 175, 190, 198! Yay, well... I took another test, the USMLE.org's 150 question practice test. I did very well on it and scored to what they said would correlate to a 219. I am now seeking advice on what to make of such a correlation. I improved from a 175-190 in a matter of two weeks so why couldn't I get a 219 after a month? Anyway, bottom line is I am practically disregarding that test because I don't believe it nor think it is valid. Maybe I will give myself credit and consider it to be a 209 to keep me grounded. Ugh, I don't know. I guess the best way to find out would be to just keep taking practice exams. I've done the NBME form 3 & 4 and the usmle.org's practice test and still have the UW one to take and forms 5 & 6 if I can squeeze them all in. I would at least like to take UW and one more form. As long as those scores are decent - I'm happy. If not, well I guess I am stuck now aren't I? Hahaha.

Anyway, time to start the day. Wish me luck on all the practice questions I can fit in!!!

Happy 200th Post!

Whew! I've done alot of writin' huh? It has been so great to get out all my experiences and just vent, I have to admit!

Well, studying is... going. I am really getting a tad anxious about how much I can actually get done before the first week of June. The ECFMG will be getting my paperwork on Monday (late, long story grrrr) and hopefully by the end of the week I can pick my date. I really am trying to squeeze in as much as I can before then but I am just a bit worried. Here is the biggest test of my life really and I have to take it ASAP for the Saginaw program or risk doing my clinicals away from home. Sigh. It's an obvious choice for me which some might not understand - but I choose home anytime.

I keep forgetting all the work I did for the COMP this time - I worked my butt off hard. Now that it is over I'm like, "Ok, now to study for the Step!". That mentality is killing me. I haven't JUST started studying, I have been studying all along. In that sense I have been doing alot of work for the Step as well. I started Goljan path (again) Monday and am already past half way done so that is good but even though I still want to read mroe Kaplan notes and my First Aid (again), I have to start doing more and more questions and practice tests. I keep increasing my score but I really need to get higher to be more comfortable with the idea of taking this thing so much sooner than expected. I will be taking another exam next week, I hope. Then one more before the test. I am hoping that I can hit a decent score in the 200s, but we will have to see.

Prayers and advice are always appreciated! But I better get back to work! XOXO

Back on the study train...

Argh, boy-boy I wish I could just have a summer vacation like I used to in high school. Lifeguarding by the pool, getting a tan and pretty much no other responsibilities. Oh well, it's not so bad now. I am back to studying now for my Step exam and am pretty sure I have about a month to go or less. My date isn't secure yet but as soon as I can set it, I will be taking it pretty much as soon as possible. The Synergy program needs our scores by around mid-July so I have to be quick. You'd think this would make me want to study hard 24/7 until then - and then - have a nice looooong break until rotations start, but no. I'm tired and don't feel like doing much.

Despite this, I have done biochem videos again and am now moving onto physio. So I guess you could say there is progress being made but I am just ready to get to get a break and moreso, to get into clinicals! Life will be so different then. It's funny, studying medicine is just constantly starting new situations, getting used to them, then having to change it up all over again. There was applying, actually deciding to go to a foreign country, making it through there, starting up with our ICM classes which was new in terms of starting clinical experience, doing 5th semester, taking the COMP (in my case twice, haha - it's okay you can laugh too since I passed :P) and now working towards the Step. Each I have undertaken, gotten used to but just when I get used to it, it's time for something new!

Anyhoo - at least I feel ready for the next experiences coming up! In the meantime, I better get back to studying and, when I am taking a break, work on planning our wedding!!! Such a fun distraction!

I PASSED!!!!!!!

YAYYYYY! To my surprise, yes it is true - I have conquered the Comp exam! I am so relieved, so happy - I just honestly don't have words. I'm not going to lie, I cried when I got the email. I have been dreading getting the scores back but just knowing this is behind me now - wow, so ready to move on!!! I improved from a 62% to a 69% (approximately a 198 on the Step). That is just fine with me, I am constantly improving with each practice exam and now the Comp, that I am honestly ready to hit the books back up and get working to the USMLE Step 1 Medical Board Exam!!! I am sure that things will work out well with it and I am so ready to get to my rotations and get to graduatin' (okay a little far off lol)!

So now, I have filled out my Step 1 application and sent it in to New Jersey awaiting approval and ECFMG notification to pick my exam date and location! Craziness! It still hasn't hit me that I am at this point in my education - and I really think I do need to do what Tony and my parents and say and take a step back and just look at all I've done. It has been quite the road to get where I am and like I told my Dad, I wouldn't have it any other way looking back. Everything has happened for a certain purpose and has lead me to the life I am living now and person that I have become to be! Time to soak it all in and carry that with me through my next journey!

I just want to thank everyone for their encouragement and support. It would have been so hard to do this without it! From my family, friends, my Tony and those who post comments on my blog - THANK YOU! You are loved and appreciated so very much. So much work and prayer has gone into this exam and it's now time to continue on! No rest for the weary! Haha, okay maybe one more day of funness!

Much love!

Second time is a charm?

COMP #2 is over. I just don't know how to read this one. I cannot explain how hard I worked for this exam but some of the questions on that form... Oy. Maybe it is just the way people feel after exams all the time. I just can't remember how I felt after the first one. Maybe I will take a trip down to my old blog on it, haha. Pharm actually wasn't bad on this one... But jeeze who knows. All I know is the opinion of the 5 here that took it, which share my same thoughts. I wonder how it was in Miami? Dominica? My second practice exam - I swore I did so awful but really improved ALOT so maybe it is like this too?

To be truthful, I am just trying to think what would be the purpose of me failing. I can't change what has already happened. What's done is done. At least this time I know how hard I worked. It just seems so ironic that when I really wasn't studying hard like last time (be it that I was just SO thrilled to be home), I still pulled a 62%. Now, when I worked so very hard - I could do worse? I guess today, I am just trying to see why it would work out that way - just to prepare myself for the worst. Failing this means alot: no Saginaw program, no Step next month, possible COMP #3 and worst of all practically impossible to graduate in 2010. Okay, okay lady - slow down, right? Haha, I know I know, but hey you chose to read this blog and I am giving you exactly what is going through my mind right now. Anyhoo - I'm just wondering what lesson I was meant to learn if that were to happen. I am just not sure what it would be. I worked so hard, tried and tried.

Finally, upon getting home I was thinking that maybe I am just supposed to have faith. I prayed so much and put so much of myself into studying - I just need to believe that it is possible and stop being so negative. Maybe it went just fine and I have nothing to worry about. Of course I would love to do better but I would be lying if I said I wouldn't be happy with a 64% passing score. I hear though that just like the practice exams I have taken, there is a curve to US students, depending on the difficulty of the form taken. Far be it for me to just whine about how hard it was if I didn't prepare but it really was a tough one. Of course, there were some very easy questions, but how many I'm not sure. Maybe the ones I got right, everyone else did too and it doesn't matter. Anyway, I just remember getting my second practice exam score and being shocked of how I improved! It was so much harder, it seemed than the first one. So I am wondering if it was a curve based on it being a harder form.

Oy, these thoughts can go on and on. I am glad it is done though. I know this time was so much different. I slept well, ate breakfast, was very relaxed and confident going in, no traveling around the country or taking taxis and getting lost in Miami - and I worked my "tail" off - seriously... Things were so different this time. So will it be reflected when my scores come in? I honestly feel that I am so ready to move on to the next step of my journey. I just pray for the faith and belief that all the hard work will pay off...

Last day of 5th semester!

It is over. 5th semester is over, what?? And WOOOOO - what a last day! Today was full of learning procedures: IVs, central lines, IOs, LPs, blood draws, fiberglass splinting and more intubations and codes! It was very cool and the simulators were awesome. At the end of the day our teacher Dr. V told us that we were free to go unless we would like the chance to practice on real people! Umm, yeah! Everyone was so shy after the demo and no one wanted to stick anyone - after all the rule is, "If you want to stick someone, you have to be willing to be stuck by someone else." Great rule. I volunteered to go first and stuck, you guessed it, Dr. V and did my first blood draw! Then after, I got to stick him again and start an IV! He was such a trooper, haha. But as agreed, I let my classmate stick me afterwards. I was so happy to have my "first time jitters" done and over with. I feel like I can without a doubt go in and feel confident doing it again and looking forward to it!

It was such a great way to spend our last day of lecture. Now all that is left is my exams Monday-Wednesday, then move home! I am ready to get my last weekend of studying in before the big exam and am looking forward to relaxing with my sweetie before my last go at the books! I should probably get going though - he will be here any minute!!!

Revived and Ready to go!

Man that was a rough few days! I just couldn't get as much work done as I wanted! But now, I am back on track. I just finished my BLS/ACLS course (a whole day lol) and passed my exam. I am now certified! It was a very cool exam. Besides the two written exams we had to take, we had to go in groups to the simulation lab and each take our turn running a code. Very cool. Mind you it was not the perfect example by any means but really was, well an adrenaline rush and exciting to have a run at it! Now knowing not only drugs but moving into dosages is really yet another step in our prep for clinicals. Slowly but surely, we are getting ready for that next transition... Crazy that it is here so soon!

As for now, I have my final list of what to look over before my exam Tuesday and am making good progress thus far. Feeling confident and just ready to kick this exam out and get home. Of course, my homecoming week would not be complete without my 5th semester final exam and epidemiology exam (mind you, a 2 hour exam over 2 lectures lol) but I am sure it will all work out just fine. The COMP is my misson next week and everything else must take a back seat.

Today I had such a great morning. I woke up finding out my peds rotation was cancelled. Yes, sure would have been a nice experience, but we had been cancelled on once already and a few other classmates, when their rotations were cancelled - they didn't have to reschedule. My luck, I did. Being days away from the most important test thus far and going home, I was so happy for the extra study time! I definitely made use of it! After waking up, I found the front desk of the hotel put two cards under my door! Thanks Mom and Tim! Love you both tons!!! I swear their support is SO appreciated! Such a great start to the day! Today, I really was motivated as my Tony will be here tomorrow! It has been a rough week on me and when he told me he was coming made my week! I know I could make it until the end without him here but it means so much whenever I can see him and it recharges me - big time. He will be here for just a day but just enough for me to get back to work, finish here and move my bootie back home!

So today, I have looked through my practice exams one more time, started my flashards and continued on with my First Aid (this time knowing more what I am looking at then just aimlessly memorizing any detail to cram in my head lol). Still working, while watching the Food Network (Unwrapped!). Tomorrow is our last day of class where one of my favorite teachers who works in the ER (all my favs are ER docs lately, lol) is going to teach us more procedures - central lines, LPs, IVs etc. It will be a nice add-on to the catheters and intubation training and a "fun" last day!

Anyhoo - back to work, the end is near and 6th semester is almost in sight! Okay, I think we can lose the "semester" talk and just go for rotations! Please keep me in prayers and thoughts Tuesday if you can - nervous but confident at the same time!

P.S. Good luck down on the island - last push!!! Keep studying, homeward bound soon! :D

Feeling burnt...

This weekend, while semi-productive thus far, has left me feeling extremely burnt out. One week out from the COMP and I am just beat. Luckily, I know myself and that I will kick it into a high gear until the test but boy - I am getting mighty tired and ready for a break. Alot of my friends are out for my friends' Bachelor/Bachelorette parties - I wish I was there! I know it is good study-wise that I stayed here but I hate missing events, especially when it is as big as this! This is the first couple in our giant group of friends that are getting married! 2 weeks from today! So excited for them!!! Unless anyone gets engaged soon, I think Tony and I are next in line for next year! YAYYY! :) This summer will be the summer of wedding planning!

Anyhoo - I've been asked about how I feel on the new USMLE testing that is supposedly going to happen in the future. Basically instead of taking Step 1, 2, 3. It will be Pretty much 1&2 combined at the end of the third year and then take Step 3. I honestly don't know a ton about it but from my understanding, it doesn't seem like a great solution. I think being tested before entering clinicals is a great way to prepare students for their rotations. Without Step 1 before, I can see students slacking a bit more and just cramming at the very end. Clinicals expects you to know the pathophysiologies behind diseases - they don't reteach you what you should have learned in the classroom. In that aspect, I can see the good in being tested prior to third year. What benefit do students get by bypassing this exam?

Most importantly though, I do not see it being helpful to IMG/FMG medical students. The Step score is really what separates students from each other and is a level playing field for us all. Without the Step scores (as there were talks of making it Pass/Fail), I believe it would make things even harder for us and put yet another obstacle in our way. How will they distinguish the students for applying for special rotations or residency? What if a Ross student with a 230 Step and a US student with a 210 applied for a spot. Both would say "Pass" and my guess is that the US student would be taken above the other. It sucks because as of right now, our Step score is pretty much the the only major thing that we have going for us. It seems competition for us to stay at the same level in our applications would be more difficult. Seeing a "P", there is no way to tell if it was a 185 or a 240! Truth be told, I am not sure how Step 2 scores are ranked. I don't know if they will just use those scores or what, but overall I am not seeing a reason to fix what isn't broken - at least to me. I am not quite sure what brought about this thought for change...

Oy... I really think things are fine the way they are but that's just my opinion. As of right now though, I am about to get back to lovely hematology/oncology and work on until that exam 10 days from now... I can't wait for it to be over but more importantly to get that passing score!

Seeing a bit of light...

Well practice NBME #2 is over and was harder than the last. Last time I took form 4 and this time it was form 3. I won't give details about each because I don't want to give away any hints to ruin anyone's experiences with them but I thought 3 was a toughie! Ironically, I did... better! It was such a surprise and a great relief. My studying method is paying off! Last exam I got a 340, equivalent to a 175 on the Step. Not so good at all. This time? Still not as high as I want but a 390, equivalent to a 190. We are getting there folks! I am still planning on taking at least one more exam before the COMP but if I can improve 15 pts. in nearly 2-2.5 weeks, I am very optimistic for my next exam. Also - this made the difference between a pass or fail of the USMLE Step 1! According to my exam, I can pass the Step! Of course, I am don't feel like I can just rely or settle on that but it was such a great feeling to know that it IS possible to do! Next time, if I could break 200, I would be so very happy!

I know to some people these scores aren't anything to smile about but not to me - I am happy with my improvement and am ready to get studying again. I was a bit hesitant of posting my scores as I know others are scoring much higher than I am now. I am proud of myself though, as I am historically not the best test taker, but I am also doing this for others. So often you just see people who post their awesome scores and it really used to leave me feeling low. It seemed like everyone was scoring high because, well frankly, those who were average just wouldn't bother posting their score for others to see. Well, I am here to show all what hard work does and progress looks like! Hopefully it will help someone who might not be so lucky as to have exams come naturally to them. Just have to keep working, keep swimming (Finding Nemo!) and just push on when you feel like you can't do it anymore! So cliche and until I can come up with a better line of advice - if I can do it - YOU CAN TOO!

So for those studying for shelf exams, minis and even the COMP coming up - keep going!!! You are almost there!!! Don't give up!!! Take a break if you must, get a nice meal or go buy some good junk food to study with but keep going!!!

I will keep you all updated for my further progress! Looking foward to giving more good news!

Is it all about attitude?

So here I am studying as usual and going over my first practice exam. Mind you that I am not looking at the answers (NBME is hard to find them) but looking at my 2nd set of 50. Why didn't I do better? The questions were NOT that hard! I have to preface this by saying that my road to finding a good study strategy is ever winding. I always change it up and it seems to suit me. But before I took my first practice exam I was stressing, anxious and worried. After, I got my first glimpse of where I stood and it calmed me a bit and let me re-evaluate what I should be doing, even though the score was not what I was aiming for at all.

My next exam will be in a few days and I can't help but think that attitude has so much to do with it. I am very good at putting myself down as I am sure some of my classmates can attest to - I could always do better, easily disappointed and comparing myself constantly. Lately though, I am finding more confidence and am interested to know if this plays a role in my performance on practice tests. What do you think? I am always so admirable of others who just have that confidence. I try to say that I have it but as I am told, if you don't believe it - it won't happen. So does that mean if I do believe it, then it will? That is hard for me to believe, but if it does - I believe that one day I will have the perfect balance of work and home - I believe I will be a millionaire - I believe... Okay, I think I have made my point. But to me, it takes more than just believing it. I am traditionally a B+ student and always have been (post-high school that is - man I miss those high school As!), but I am completely fine with that. I have always been that way and I feel that where I lack in my GPA I make up for in other ways quite well. So why with this belief in myself can I jump in my exam scores?

The only thing I can come up with is that this belief in myself will lead me to think more positively, work harder than I thought I could and in turn produce a higher score. So it is time to wear that hat I guess, or permenantly bobby pin it to my head! I will keep holding onto that and see how my next NBME run-around turns out!

So here it goes... I believe I will get a good score!!!

Lazy McGee...

Okay, I'm not lazy - just busy and tired! Sorry for the lack of posts this month but for one, it's been a rough month on me and two, I haven't been sure what to write about lately. The weeks go by and it is the same schedule and nothing too exciting or boring is going on... just another semester. I feel much better lately but earlier in the month I was just going through a rough patch, pretty much just being sad most days. Not the best time to inspire and write happy thoughts on the blog, haha! Anyway, things are a little better now. I am getting ready to take my second practice exam next weekend and hoping that it will go better than the first. I'm sure it will. I have been working hard to figure out my study strategies and then re-figuring them out, lol, but I am looking foward to seeing how much better I will do.

I hear that the next 5th semester was chosen for Michigan? Congrats!!! You will love it! I am so happy I was chosen to be here - I can't say it enough. Just remember that you represent Ross and that even though we set the first impression - the job is now on you guys n' gals to keep it going!!! With applications going out (I think in June?) for the two year program, we will be leaving for home for the summer with hopes of returning in the fall... We will see! Having the rest of my education planned out for me would be such a blessing and the personality of this program just fits so perfectly with me.

Anyhoo - so today I am just sitting in my room studying as much as I can before my next NBME. I really want to go home this weekend but am not sure if that is such a good idea. My next COMP date is set to April 22nd, here in Saginaw. Of course, I am so nervous as alot is riding on this exam. But truthfully, I have put so much work into improving that I feel that I will be okay this time around. I really slacked last time but I was so excited to be home! Being here though really got me cracking the books... Anyway, I better get back to studying and doing more questions!

Are we there yet? Are we there yet?

What a day today. Great lectures on GI but a long day for sure. There is nothing I would like more than to take a whole day - better yet a week off and just relax. My practice exam is Saturday however and I need to keep studying. I thought I would be happy that I would not be doing Kaplan this week but studying has been hard, although it is getting better.

Tomorrow is a day off, a full day to get in as much studying as I can. It will be my last full day before Saturday so I hope I get alot done. Basically, on this test I just want to pass and score higher than my last one. I still have alot of material to go over but I would just love a good score to bring up my confidence a little. After tomorrow though I am busy busy! Wednesday I have my pediatric rotation in the morning and our midterm is scheduled for the afternoon. Thursday I will be at the nursing home and Friday we are going to another facility to do opthomology exams until noon. Then comes the best part of my week - my baby is coming up for the weekend yay! Luckily we both have to study so I will be able to get work done while he is here. After the exam though - I am calling it quits for the weekend. So I guess I will get my day off after all, haha.


Anyway, I am beat. Today was long and I had a hard kickboxing class last night (so sore but so fun!) This week is jammed with stuff to do but at least it will go by fast. As for now, I am just chillin' in my little hotel room and trying to get some work done... Better get back to it!

For those interested...

Hi all! Sorry for my lack of posts but between my tiredness and how busy I have been - yeah, I have been slacking. But things are going well. Our weeks are flying by here and I can't believe the end of next month I actually get a summer break! Gasp! What is a summer break? I forgot! Anyway, as for my studying I have been busting my butt to finish my Kaplan lectures for the past 5 weeks. I am proud to say that I am a week away from being done! This week however I am taking a break to study as much as I can over the notes I have made in my First Aid book to get ready for my practice COMP exam I will be taking on Saturday. After that, my studying continues and probably won't take another practice exam for another couple of weeks.

While I do have alot to talk about my own personal experiences here in Saginaw, I wanted to dedicate this post to those wondering about how the program has been working here. So here it goes....

As for us, Mondays are full days of class 9am-5pm. The lectures are good and are held here at the Ramada Inn. These lectures are a good review but with out feedback may become more clinical as what we are being told most days is basic and we feel we are ready to go beyond. Tuesdays sometimes we have class 9am-noon but other weeks we might not have anything. Wednesdays also are study days for the USMLE. While it might seem wonderful that there is time off - these days are stictly spent to study - so use them!!! Some weeks you might have a peds or psych rotation to do but for us it is only 3 weeks out of the semester. Thursdays are spent at the nursing home in Midland where we spend probably 8am-4pm doing examinations on residents. It is quite nice as the teachers there are doctors and NPs who pick out specific people to find pathologies on. For example, we have had Parkinson's patients, demential, carotid bruits, peripheral vascular disease, basal cell carcinoma, COPD, etc. We still have many organ systems to go which I am sure we will be seeing many more cases. We also do practice SOAP notes as well, which most of you are probably groaning at. The difference here is that we are being trained to do it the clinical way not how the island taught us. In this way, we really feel like we are stepping into the clinical realm and merging into how we need to be. It isn't about having every part of the H&P complete (say when your patient has a specific pathology but you still must do a full physical exam on systems that are not relevant). We are also graded by the faculty here in Michigan and our midterm is actually on Wednesday so we will see how that goes!

Finally, Fridays we have class usually 9am-noon as well. Schedules are subject to change and you need to be flexible! Weekends are open but if you must leave (which they encourage you not to) tell administration as soon as possible to avoid being penalized! As far as scheduling, that is about it! Everyone is so nice here and it has been a great experience so far! We are all looking forward to applying for the rotation program this fall and would love to spend more time with this great facility!

I know alot of people have been messaging me and I apologize for the lateness of this blog's info as well as my attention to their questions! I can say though, that the people here are truly dedicated to make this experience one that will be a great step in moving from the classroom setting into the clinical arena. Every week I am feeling more and more prepared - be it from my time to study for my Step or from my clinical experince as well. I hope this has helped a bit to those wondering what 5th is like here! Let me know if you have more questions! The next class to come through will probably have a different schedule based on the feedback we give and the new ideas that come as well! I can whole-heartedly say that I am happy to be here!

Sorry for all the delay, but I will write more about my own experiences soon! :)

Two roads diverged in a yellow wood...

So begins our 3rd week in 5th semester. It's funny - I was watching America's Next Top Model (reruns that I can't stop turning on!) and Ms. Tyra related to me, haha. She said that when you are being taught you just want to reject it because it is change, but when you learn and you come back to situations that you never thought you could handle on your own, you remember those who taught you and appreciate the work that you once struggled with. I think that the beginning of the semester was like this for me. Moving into clinicals in intimidating and makes me so vulnerable to make a mistake - so much to the point of doubting yourself and if you made the right choice. I think I am slowly warming up to the communication between myself and patients.

It is not that I am afraid to talk to people - I love people! I could walk up to a complete stranger and just shoot the breeze! But when they are relying on me to tell them what is wrong with them or to examine them correctly while making them as comfortable as possible - it is overwhelming. Of course I want to impress my preceptors, but doing right by the patients is most important to me. I want to know that they feel comfortable enough to be vulnerable with me and open up to me. I just want the nerves to go away! I asked my preceptor when they do, and she said, "Any day now." I guess there will always be patients that can test you. Whether it is a challenging person or someone that comes in with issues where it is the first time that you have had to deal with them. A lecturer today was really grinding in dermatological language and having us present different lesions to her. I just don't like being wrong but she spoke with me at lunch saying how much she probes students because this is the time to screw things up! Don't you remember getting something wrong - stupid or not - and you just NEVER forget the answer after? I do! So maybe I shouldn't be afraid of it but embrace my time as a student. Tomorrow I am going to the psych ward to evaluate a patient. Only two of us have gone so far and I am the third. I think there has been a bipolar patient and schizophrenic patient as well - so who knows what I will get! After, you present to the preceptor and then begin to prepare your evaluation writeup. I am excited and am looking forward to those mistakes! (Okay, not really but I'm trying to get it in my head that it is OK!).

My big issue is where my head is lately. I have to admit, I've been doing alot of crying lately. I am SO blessed and I realize that of how I am back in Michigan now. As my sister says, "This is what you were waiting for!". That is so true. I feel guilty because now I seem greedy that I want more. I want to be back home with Tony. I want to be near my family and start REALLY living. Basically, it breaks down to this - rotations at home are not looking too promising. There are many rotations I do not have filled and for Tony and I, out-of-state rotations our last choice for me to go to. We are slowly coming to the conclusion that staying here in Saginaw for the 2 year program might be the right choice. Okay, it isn't exactly 2 years (September 2008-March 2010) so 1.5 years. But still, to me it makes me sad again. Every time I leave Tony my heart just aches and it is so hard. Even though he makes me promise I won't, I feel so guilty for leaving him alone for so long. So many people I have gone to school with - nothing will get in their way. If that means that they have to leave their significant others/family, so be it. I am feeling less and less like that. I feel like my personality lately is not matching others, and while that is fine, I just feel like maybe it reflects how my personality would match medicine and it worries me. I know that if my rotations were near home and I could live in my house I would feel completely different. I know that I have my family's (including my new family's soon to be!) support and love. I have just never been through something so hard in all my life to be away for so long. People tell me how lucky I am and how I shouldn't complain which of course doesn't help me at all. Sure I am better off than some, but isn't someone always better off than another? Jeeze. Anyway, I know I am lucky and blessed to be in the situation I am in. Things could be alot worse. I guess I am just focusing on how it could be better. Probably not the best thing to do, yes, but I am really trying to get out of this mood. I know I am a good fit with medicine and am just sick of the doubt.

So here I am, standing in front of two roads. Which do I take? With the help of my Tony, family and God, I know I can do this. I could give up and still have a great life. Or I can gut it out and have a life I had only dreamed of before while knowing that I not only changed my life and my future family's for the better, but I gave my life meaning by being able to help others when they needed it the most.

My guess is most take the easy road... Well... I'll take the one less traveled by and that will make all the difference.

A day in the life of a 5th semester student...

Well, here I am! All settled in 5th semester now and in the middle of week two in Michigan! Let me tell you, it is really a treat to be doing this semsester here! Everyone is so kind and welcoming to all of us and for once - we really feel like we are wanted! Since I have started we went through a 2 day orientation followed by great lectures that were so clinically based, practiced pelvics with speculums for the first time (are told that hopefully soon we can start on real patients) and surgical scrub training! Very exciting things happening. This week has been nice as well. The only criticism I have (if you can call it that) is that I don't think that some of our teachers this week really know how much we have learned up to this point. Some have hesitated to take it the extra step because they wanted to go over the basics (e.g. the neurological examination). This is so new to everyone and far be it for the lucky 10 of us to say something wrong - we just let it go - heck, it was a nice review anyway.

Tomorrow starts our clinical time, which will be held in a nursing home every Thursday. I think some were bummed that it was not a "real" hospital but they are working out getting us in on weekends to get more experience so I think it is great. Not only that, but they are hand picking patients to see in the nursing home that have real pathologies - Parkinsons, Multiple Sclerosis, Huntingtons, etc. So it won't be just yet another examination but ones which I am sure we will remember forever, much like the VSD and upper motor neuron lesions from the island.

Our weekly schedule is just wonderful! Mondays are full days of lecture but they are held in the hotel where I am staying so that is so nice to just get dressed and head downstairs! Tuesday are usually a half day with lecture or on certain weeks psych and peds rotations. My psych will be on this coming Tuesday where I will be giving a psych evaluation to a patient, make a diagnosis and then meeting with the doctor to talk and help prepare my writeup for the case. Wednesdays (like today) are our off days - so this is nearly two days so far that we are getting off to study! So wonderful because we all want to do so well on the Step and this above all is what will make it possible! I have gotten SO much Kaplan done in the past 10 days (actually less). I have no doubt I will be able to get through all the lectures well before this semester is over. It is really sinking in too - not lazily studying at all. I am definitely making my time here worth it.

I am very excited for this weekend because Tony will be coming up to see me! I am so glad we can see alot of each other this time around. It is still a little under two hours from home but it is better than being out of the country! There is talk about the new 2 year program here at Synergy starting in September and it is starting to be something I am considering. After being here so far - I am so impressed and think it could be a great thing. I am torn though because while it would be stress free and I wouldn't have to worry about EVER leaving Michigan for rotations - it is still not home. Trying to get my own rotations is slow and while I am scheduled to start in Detroit in July, I am not sure if it is something I will do. Without having them lined up it is hard to do because I have no idea where half or more of my rotations would be coming from. I just hate the idea of not being home until graduation. It is just going to have to be something to think about. Applications do not come out until June or July so there is still plenty of time to try to do that.

Anyway, I am going to get back to Kaplan and hit the hay. Clinicals from 8am-5:30pm tomorrow - oy. At least after it is happy hour in the lounge under us, then maybe we might go to Timbers. Have a great Valentine's Day! I am considering Friday V-day for me since Tony won't be up until then, haha! :)

Disappointed but ready for a fresh start...

Okay, so the COMP didn't go so well. I missed my mark by 2% (4 questions)... So okay - poor me, poor me - now get over it. I was upset sure- and embarrassed but honestly in a way I think it will be nice to have an extra exam before my Step. The only worry is that if it will throw off my schedule but it shouldn't. As far as I know, I will take the COMP again May 13th and still be able to take my Step by the end of May or early June - so no worries. Of course, it would have been nice to kick its butt this time around but I am trying to think of the brighter side of things. I really would feel uncomfortable getting a 64% and JUST passing because then I really wouldn't know how ready for the Step I was. I know that just getting by would probably be an overall better situation than what I am in now, but I have developed a sudden intense feeling to just crush this test for making me feel all these different ways that I am actually looking forward to take it again.

Now, I am looking at it as studying for my Step exam. Sure I have to take the COMP first but seeing as I will be taking my boards soon (very soon) after - it is better just to look at it from that angle. I will be studying from the time I get to Saginaw until May so the COMP exam will be pretty much my last bit of studying for the Step, so it will serve as a great indicator of where I will stand for the Step the following week.

So, right now I have got all my books together for 5th, my USMLE World question bank, Kaplan's QBook (not using their Qbank) for extra if I want it - it only cost me $6 on Ebay. I am just ready to get to Saginaw and get going. I'm very excited to be staying in the hotel, even if it is more expensive. I am just taking my newly bought dress clothes and a bunch of books! Everything else will be set and I think that is just wonderful. No setting up a new place, just unpack a suitcase and I'm good to go. I love that! I can just picture me and my books now :)!

So yeah, I guess I was a bit disappointed. Tony and I had to put off the champagne for another day - but better days sure to come very soon! As for now, I am enjoying my last week of having NOTHING to do. Although I will probably go through my Bates in preparation for my 5th semester. It's really hard for me to sit around and do nothing and I think I am jsut about ready to get it going again! Yay for staying in Michigan!!!

Another hoop jumped through...

Aaaaaand it's over. The COMP exam was 4 hours and 200 questions and boy I could not be happier to have it over with. I am not sure how well I did - but I am just hoping so badly that I passed the mark I needed. I don't even want to think about taking that exam over... Anyway, just praying and thinking positive.

Now? Just got back from the Cheesecake Factory with Lynn and her mom and watching TV! I will be heading back home in the morning and I can't wait! I miss Tony so much and just miss being home after 3 teeny days. He is sick now with Strep throat it seems and I just hope the medicine he is taking makes him feel better over the weekend. All that is left to do now is relax and soak up some solid vacation time before heading up to Saginaw. It is pretty nice because even though I spent so much time worrying and studying for this exam today, I still have the same amount of time left over to have a pretty full break like I did on the island! Yay for that!

I had a nice time though here in Miami but honestly, I could not imagine staying here. I'm SO blessed and lucky to be able to come home. I am just so over moving and living in foreign places, haha. I am so ready to just settle down and start my life. Looks like that is going to happen though and I am so excited!!! Sigh, well time to enjoy my last night in Miami (skipping parties and watching Grey's and ER instead :D) and wake up to fly back home - where I belong!

Almost time for Miami...

Just about two days left until I take off for Florida to take my exam... Yikes. I am nervous. I am honestly now just looking forward to it being over and getting to enjoy my last 2 weeks in the house before heading to Saginaw. I'm so glad not to be dreading 5th semester. I know I would be if I was going back to the island or Miami. I'm so lucky!

When I get down there I will be staying with my friend Lynn (thank you!!) and I can't wait! It was so nice of her to offer me a place to stay and it will be very nice to save the money. But, I will only be staying from Tuesday night until Friday morning and will be back by 2:30pm! So glad I will be back for the weekend and just get to focus on relaxing - like REAL relaxing.

Well, I'm going to head to bed - I want to hit First Aid and Goljan first thing tomorrow and do as much as I can. I probably won't be able to write until I get back but if I can get on the internet I will! Wish me luck and say prayers for me! I really needs this to go well...

Preparing for the NBME Comprehensive Exam...

The new year is here and off to a great start! I am so happy being home. I have been studying but really need to rev it up a bit more. My exam is on the 17th of this month and am hoping that the work that I have done will benefit me a bit. I really just want to pass. That is all I have to do - pass. A 64% on this exam would approximately equal a 185 passing score on the USMLE Step 1 exam that I will be taking in May hopefully.

Otherwise, I haven't been up to very much. Just hanging out with friends on the weekends, taking care of my sweetie and the house and studying while he is off at work. Looking forward to this week and getting some good work done. I will be leaving for Miami, where I will be taking my exam, on the 15th (Tuesday) and coming back on the 18th (Friday) hopefully in complete celebration. I have been told that no matter what, I will feel like I failed the exam. I hate that feeling and hope I am not feeling too low after... ah well.

I'm definitely have been getting in some good 1st year review which is really nice - time to get back to my 2nd year material again but I just keep finding more to go through. I am mostly using my First Aid book and the Cases book that goes along with it. Well, time to get some rest and start up my day tomorrow - so much still that I can go over!!!

Goodbye 2007, Hello 2008!

Hard to believe but it is the end of the year! Getting ready to start up our big New Year's bash at our house with ~50 of our closest friends! I can't wait! People will be getting here any minute so this will be short but I just had to put in one last entry. This has been the most challenging year of my life - being away from home for nearly the entire time. Last year at this time I was dreading the new year of 2007 - knowing what was ahead, what I was giving up and what I had to get through to have the island past me. Well, it is all over now - the hardest year thus far of my life but also the best is just another year to put away and remember. Time for a new beginning, a fresh start with my life back at home! I know each year will be getting better and better - but with all I have been though and the huge changes my life has made in this past year - if 2008 has a chance to top that, I can't wait to see what is in store for Tony and I in the new year.

Blessed with family, friends (who are family anyway :) ), great home and a wonderful life! May I not forget this in the new year and always work to better myself for the good of others! All my love! See you in 2008!!!

Getting settled back in my old life...

This is the greatest! I have made it back home before the storm and am sitting cozy in my new house (ok, we got it back in April so semi-new) with TONS of snow on the ground!!! It's so beautiful! I have unpacked my first 4 bags - whew! My folks still have I think 3 more for me but I will get to that later. But getting home was great! I had so many surprises!!!!

My mom wanted to catch some drinks at a restaurant inside the airport to celebrate so of course, how could I turn that down!?! But walking inside I looked up and saw my family, Tony's family and some of my closest friends all waiting for me!!!!!! I was so touched and, yes, I cried. I figured I would see them all but my parents put it all together with Tony's help and it was just so wonderful to hug everyone that is so very close to my heart and that I have missed all this time! But the surprises didn't end there! Tony took me home where I have traditionally hugged the back corner of it and we got to relax for a few. Then he wanted me to see my Christmas present a little early.

He takes me downstairs - ooooooh he set up an entertainment center with couches and our old big screen (I got him a flat screen for Christmas for the upstairs). But no, that wasn't it! I turned the corner and he flicks on some flights then *heavenly music* Tony built me a wet bar in the basement!!! The mother of all bars! With the help of Andy and Phil (thank you!!!) I see a 10 foot oak bar with that honey laquor kinda stuff to make it all soooo shiny! There is also a lighted display case in the back for our glass mugs, shot glasses and soon to be a wine rack for me! I see a 19" LCD screen tv!!! Also, my college mini fridge all is tucked back and into the wooden casing of the bar next to a beautiful sink! It is beautiful and amazing! They did such a wonderful job - I am actually in awe of it! It took them nearly a month to make! No wonder Tony wasn't online much my last month in Dominica, hahaha.

But those were our presents to each other. Of course you can tell how we both will benefit from them and will love them - but it adds so much to the house! After that we went out to Big Al's for the night and had another great time! So nice to see everyone! We sure packed alot into one day!

Tony's off at work now and I have just started up my COMP exam studying. Back to the basics of biochem and anatomy. I don't want to dwell on those subjects too long but I better get back to it before I have to go shopping with Corey (Tony's sis)! All I have to say is - IT IS GOOD TO BE HOME!

One flight away!

Greetings from a newly made 3rd year medical student! This trip has been amazingly smooth so far! I just hope it keeps up! I am one - ONE - flight away from being home in Michigan! Ahhhhhhhhhh! Last night was alot of fun. I was in Puerto Rico with Simran (hi!!) and we got sushi, cheesecake, chocolate cake and Coronas - yummmm! I had alot of fun, thanks girl! I woke up at 4am to get the traveling back on again and am now here in Miami waiting to board in about 45 mins!

Tonight will be fun I'm sure, I hope I get to see alot of my friends - I've missed them so much!!! Well, not much else to say besides I am happy, happy, happy!!!!! Wish me luck on my last flight, I hear that there is a storm brewing! It just needs to hold off until tonight!!! ;)

Leaving Dominica Tomorrow!

In less than 24 hours I will be in a taxi on my way to the airport to head back to Michigan! My time here on the Rock is over! One more exam to take in the morning and that is all that is left. I have just a huge sense of relief. While I still have alot of work to do today - I'll get it done and just do the best I can tomorrow. I am trying to imagine myself now how I will feel when I sit myself down on the prop plane to get out of here - I just can't wait!

My path is what is taking the most time out of my day but pretty soon I am going to head to the gym for my last workout and then grab my security deposit from James. After that, I will be back in the apartment to study out the rest of my time, head to my 8am exam then back to be picked up by Alexis... for the last time! I am sure it will all hit me more tomorrow that my time is over here because right now I still feel a little under pressure to study and get some things done.

The next time I write I will probably be in San Juan, at my lovely hotel! The taxi is picking me up so quickly that I most likely will not have a chance to write before I leave! So, as my last post in Dominica, I want to thank the people for their hospitality and bid the island farewell. I have never been pushed so hard, felt the biggest highs and lows and especially feel the sense of accomplishment that I have over the past 16 months. My first two years end tomorrow and then begins my time as a 3rd year medical student. I will no doubt strive to be the most eager, ambitious and hard-working student in the future hospitals - I just can't wait for it! It will be nice too when I can start posting about my experiences during rotations as I am sure my posts have gotten a bit "blah" over all these basic science years, haha.

Well, time to move on! I'm going to get in my last bit of studying before my LAST exam ever on the island! So until I return to United States territory - I love you all and see you very soon!!!

***GOODBYE DOMINICA!!!***

Trying to study, haha...

Wow, this seems like the impossible! Trying to study when I have 3, count 'em, 3 days to go! How can anyone be studying right now??? Luckily, I started on the weekend so I don't feel overwhelmed with it but I am finding myself being a little lazy this morning. Ah well, as always - it will get done - one way or another! Last night was alot of fun though! I got to just hang around with some buds from my class and just chill out - definitely a nice last night out! Thanks guys! :)

So... 3 days. Pretty much feeling that that will be more than enough time to get in all my studying but I am sure that opinion will change, haha. I am jsut so lazy right now I can barely move - I don't even feel like working out and that is rare. I have cleaned up my room a bit to get ready for James to come in and check it out tomorrow to get my security deposit back! Also, tomorrow I am getting my last laundry stuff done and going to be probably completely packed by tomorrow night! Craziness! I just hope I can bring everything home that I want and I don't go over the weight limit! Anyway, today is just all about relaxing, studying and packing! It's so fun when I get to convert my money back to US, get to charge my home cell phone and all that stuff! It really starts to get you all excited!!!

I still can't believe this is almost over - well - practically is over. 475 days. 16 months. I never thought that I could make it through this. Well, that isn't exactly fair. I knew I could, I just wasn't sure sometimes if I had the strength to get through it - but I guess I did, huh? So weird that by the end of the week I will be leaving here a 3rd year medical student. I just keep thinking what if I didn't come here. What would I have done? My mom and I can't figure it out. Would I have reapplied? Tried for the P.A. program that I was thinking about? Would I still be working in the nursing home? No, haha I at least know I wouldn't be doing that (and for all who have worked in one as a nursing aide - hats off to you!!). I guess it doesn't matter what I would have done because I know I chose the right path and coming home now is just icing on the cake!!! Well, I better get back to studying as slow as that may be. Maybe it is time for some chinese food? :)

ONE... EXAM... LEFT!!!!

Finally my Shelf exams are over! Just one stupid (lol) mini exam is keeping me from leaving this place and starting my life back at home!!! The exam was fine but alot of these exams have review sheets that go around from past exams - so really if you review them it's good but so is the rest of the class lol. So it doesn't matter it puts everyone back on the same level because the Shelfs are curved. Ah well! One more!

I am gonna head out tonight one more time (how can I resist!) but tomorrow it is back to work for 3 more days of studying for my last exam! I can't wait to get in that transport and head home - I'm actually going to go take a nap and dream about it now!!!

Leaving this week!

I am now entering my last week on the island! Friday, I fly out and head back to Michigan for good! Just have a little over 4 days to go! Last night was alot of fun, I got to hang out with my friend Lynn at Tomatos, have dinner and just chat for a few hours! Sooooo nice! It made me even more excited to get home because I finally got a taste of what it was like just to TALK to someone! Everyone here can get so uptight and competitive but just talking with her was just so great - felt like I was back home! HUGS Lynn! Love ya and going to miss you alot!!!

Tomorrow is my last Shelf exam, ICM. I am working my way through High Yield Internal Medicine right now and that's about all I am going to do. I doubt the test will be that bad but am so excited for when it is over - then just ONE exam to go!!!!!! After my exam tomorrow I have to track down James so I can get my security deposit back and say goodbye to some of the faculty who have helped me with my organizations! After that I am done with my "errands" I have to get done with and can just concentrate on packing and smiling my bootie off! My mini is this Friday at 8am and I leave for the airport at noon! :) So excited, I can hardly wait!

My folks are putting me up in a hotel when I get to San Juan, too! Usually, I just huddle all of my luggage together and stay up all night to save some money but I am so excited I can sleep in a nice hotel, get some room service (maybe take a bubble bath?!)! I get in to San Juan at about 5:30pm and my next flight isn't until 7am the next morning - so I am going to do, you guessed it - ABSOLUTELY NOTHING! :D The hotel is actually attached to the airport so that is great too! I will fly into Florida around 10am and my next flight is directly after to get home at 2:20pm!

So excited to see my family and Tony! I can't believe I haven't seen him in nearly 4 months. I'm so glad I will never have to do it again! We made it through these 16 months and I know it has made us so strong. There doesn't seem to be much now that can be that difficult - doing this is definitely the ultimate test for any relationship, haha. Well I should get back to ICM stuff, I want to finish it so I can work on my mini (last exam EVER in Dominica!) aaaaand maybe daydreaming a little about home!

Happily I say, it is time to go...

The micro shelf was interesting at best. It was rough to be honest and that one is making me think about how much work I have to do in the next month to rock out my COMP exam. Again, so glad I am taking it in January! At least it is mostly physio, pharm and path I hear!

After the exam, I went back to my apartment to get ready to go out for my last OLAS E-board dinner and then out for probably my last night out in Dominica. I can 100% say that it is time for me to go home. I love spending time with my classmates here but I found myself out until 9pm last night. That's right friends from home - when do I ever do that!? To be truthful, I ate a lot of food last night and didn't even really have room for many drinks! By the time the heavy drinking rolled around I had to tap out. It was great though, honestly! How often do I get to eat, drink go home and watch a bunch of tv, sleep - wake up EARLY (7am) and happily start up studying without a hangover?? :) I think that is pretty awesome! Plus today is my "off" day at the gym - yay!

Anyhoo, now I am entering my LAST WEEK of my time here in Dominica - less than a week actually! A week from right now (8:30am) I will be flying to Miami, FL and soon after to Michigan to get home at 2:20pm! Yay!!! I can't believe it! This weekend is already flying and soon it will be Monday and time to take my last Shelf exam then my last couple days before I take my mini and fly out! Craziness! Right now though I am working on pathology. Trying to do alot of campus today so I can keep studying at home during the week. I better get back to it! :D

Down to three...

Well it is time for yet another Shelf exam - micro this time. Luckily my last two shelfs are at 1pm so I don't have to wake up at the crack of dawn. My next one that I will have to get up early for is my LAST ONE! I guess that is alright because it is the day I leave!!!!!

Today was alot of errands on top of studying. Mostly everything is taken care of! I am signed off the bank accounts for my two organizations, closed my personal account (yay for seeing American money again!!!), and other stuff too. After my exam tomorrow - oh yes - time to go out and have some fun! My last OLAS E-board dinner will be tomorrow night followed by some good times at Fusion most likely! Saturday though is back to the books for one last weekend of studying (on the island at least!). Then I will just have my ICM Shelf and my mini #3 exam. Ugh, I am so excited I can barely hold it in! I just want to gooooo!!!

Ah well, it has been 16 months and nearly 475 days, 7 more won't kill me :)! Nothing much else to talk about besides how much I DON'T want to study and how much I just want to fly home now! Yup, that's about it! Haha, well back to micro I guess... I'm sure posts will get more exciting with the last week countdown to come!!!

The Ultimate Coundown - Single Digits!

Today marks the day that after all this time - 475 days - I am finally down to the single digits! 9 days from today I will be packed up and eagerly awaiting my taxi after my mini exam! So great to think about! Everyday my smile just gets bigger and bigger!!! Alot of people in my class are taking the COMP exam here and so they won't be leaving until about a week or more after me but that is yet another reason why I am glad I am waiting to take it until January!

These past couple weeks I have really been working on setting up my rotations at Henry Ford Hospital in Detroit. Nothing is promised although my dream is to get my entire 3rd year there! After many, MANY emails I have finally got the paperwork filled out, sent to be signed organized by our clinical offices in New Jersey and sent off to the Medical Education Department at the hospital! The only issue I now have to face is timing. I have put in to begin my rotations on July 1st, 2008 (soooo excited!). The problem lies in that while the clinical department approves my rotations, I cannot begin them without my passing Step 1 USMLE score. My plan was take my Step in the first week of June but traditionally the May-July time is the busiest. Most students take their exam during this time. So while I might have passed, I will not get my scores back for approximately 6 weeks. If I want to start on July 1st, I will have to take my Step much earlier - possibly the beginning of May. I am curious as to if it will be smart of me to make this sort of move.

After I get my Shelf exams back and especially my COMP exam, I will know better of where I stand. If a student passes the COMP they are very likely to receive a passing score on the USMLE Step 1 exam as well. So, while I want to know the answers now, it looks like it is a wait and see. If I could take it in May and do well - of course I would love to do that! So much is up in the air, even if I pass I still need to hear back from Henry Ford to make sure they will let me in to rotate as they already have spots secured for Wayne State and UofM students right now. So let's all cross our fingers!

Getting back into what is going on now - the path shelf was fine. I thought it wasn't bad at all. Of course, somehow I tend to do average on them. Hopefully my 4th semester shelf exams will be better than my 2nd. Next up is my pharm shelf tomorrow at 8am. Then just 3 more to go and I am home-free! Micro will probably be my last big challenge with the time restraint. The time I have for my ICM shelf and mini exam is much greater than the 5 before it - so I am going to be able to really put in some solid work for those which makes me relieved. I am really hoping to leave with a GPA that I find acceptable - so doing well on this last mini would really solidify that (at least I hope!).

I'm just so glad that I am going to be home so soon! A week from Saturday and I will be back in Michigan and it will be the best homecoming of my life! So clear your schedules everyone for Saturday the 15th! I'm sure it will be a fun night!!!

5 to go!

Its about 5am in the morning and I just can't sleep anymore! Maybe because I have been napping so much lately but oh well. Today is my pathology shelf exam and I am ready to take it, get it over with and move onto pharm. Everyday I am just staring at my 16-month calendar I started when I got here and just see one little tiinnnny week to get through and it's killing me! I'm SO excited! Maybe that is why I can't sleep, haha?

I still have a nice list of things to do before I leave, most of which I am hoping to knock out after my exam. This week so far though has just been relaxed studying. I am doing as much as I can for the shelfs but really I am getting to sleep alot and relax a bit too! Too bad there isn't more packing to do! It's pretty much all done! That makes it harder, just to sit around with nothing to do waiting for the time on the clock to run out, haha. Oh well. Anyway, I'm gonna shove a few more facts in my head before the exam then get the day started. YAY for tomorrow being December 4th - then only 10 days to go - the ULTIMATE countdown ;)!!!

IT'S DECEMBER 2007!!!! IT'S HERE!!!!

December is here, I CAN'T BELIEVE IT!!! This is my last month (not even a month, I leave a week from Friday!) that I will be here in Dominica. After all this time - it is finally just about over. The pathology lab exam went ok... I hope. It was so much cramming for 30 questions but hopefully it will come out alright. Next up? Shelf exams!

In second semester I tried so hard to study for them and it definitely didn't pay off. Not that I am saying that people shouldn't study - but high yield is the way to go if you want to. This semester however we will have 4 shelf exams: pathology, microbiology, pharmacology and ICM. These are all about two days apart so kinda hard to study hardcore for them. But again, high yield. So I am doing that and after my shelf exams, I will only have mini #3 to go before I get on a plane out of here (one hour later!).

I am just beyond excited! I am just coasting until the end now and it feels so good! My room is so empty and I just have to fold up my clothes and I will be all set to go! Anyhoo - I am going to get back to shelf stuff but I will be seeing you all very VERY soon!!!

And of course - a shout out to my dad on his big day!
HAPPY BIRTHDAY DAD!!!! I hope you have a nice birthday!!! See you soon! :D

NOW it feels like I am coming home!

ICM IS OVER!!! Wasn't nearly as bad as I thought it would be - as expected, haha. I had one senario, two tasks and Harvey (our patient simulator). So today I was asked to examine a patient complaining of breathlessness (pretty much a reinactment of what I did in 3rd! Haha!), examine the thyroid and for hyperthyroidism, visual fields and identify a murmur, mine was innocent, haha. It could have been so much worse! Even typing them out right now I know how easy they are! Of course I managed to mess up a couple small things but it went really well and am hoping I made the A! Now, I am cramming for my pathology lab exam in the morning. I am not too worried about it as I am planning on staying up all night so it will all get done. Hmm, what else?

Oh yeah right after my ICM exam I was in my first earthquake! The epicenter was in Martinique at a 7.3! Sana and I were in the library and I started feeling some shaking (I have felt this twice in my own bedroom but not to this extent!) and all of a sudden it gets worse and worse! The walls of the library start shaking and everyone starts rushing towards the exits! We were outside only a few minutes before heading back in but it was wild! Mother nature must be getting back at me for missing out on the hurricane a couple months ago!!! Very interesting though because we even saw some of the staff squirm about! Usually they think it is funny how we all over-react to things, like the hurricane. They have been through it all before and know what to do! So that was interesting.

Anyway, I have like 15 hours before my path lab exam so I better get my butt into gear! After tomorrow morning I am down to 5 exams from 7! Five exams keeping me from all the loves back home!!! Happy days sooooo soon to come!

Exam marathon begins tomorrow...

I decided to write this blog on the eve of my bunch of exams when I am feeling most confident. I figure this way I can look back and hopefully get the confidence on the days when I am feeling a bit nauseated about everything - like tomorrow. Well, to me at least, ICM will be my hardest exam in the sense that I am being graded for examining 4 patients. I know that I have it all in my head but it is just a matter of not choking up and getting all nervous. Of course, the other exams will be hard but for some reason after doing an exam like ICM, multiple choice exams seem so wonderful. Haha, well I will have six of them after tomorrow so let's see if I stick to that!

As of right now I am done with ICM. I feel pretty confident I know what I am doing and that I will be able to answer the secondary questions that will be coming along with each patient. We will see though. The exam begins at about 1:30pm but we are all being sequestered in the classroom - so who knows when I will actually get in there. I hope I go first!!! I want it over with! Then, after that exam I have to get my butt in gear for my path lab exam which is the next day. Ah, cramming - how I missed you... I am acutally working on it now in hopes that I will not need to pull an all nighter tomorrow night, but if need be, I will do it.

After that I will have the whole weekend to prepare for my shelf exams and mini. The shelf exams, like in second semester - well, you just do what you can do. It is so much material to remind yourself of and cram into your head that you can just do your best. I am really glad I chose to take the COMP in January. For me, getting ready for that on top of the classwork I have now plus my extracurriculars just wouldn't be wise. So, I am figuring after my lab exam on Friday I am home-free. I will be studying alot but I won't be so pressed for time!

So I better get to my pathology before my last little ICM review. Just have to keep that confidence!!!

475 days down to 17...

Tick tock... Ugh, I just want the ICM practical to get here! I am in the very last group Thursday afternoon and I think I am working myself up for nothing. I was at the gym earlier today talking out my examinations and it was going just fine! I know I will do alright but just the anticipation and anxiety I can feel (not to mention the nerves) when the profs are watching me examine patients just makes me queezey. Of course, once I am actually in there doing the exam I am okay most of the time but still.

Then I had a new thought to calm my nerves: If the only thing that is standing in my way to getting home to my Tony is this exam - bring it on. You know what? It works. I am just ready to get it over with. I have alot of exams after (6) but none of those bother me as much as ICM, seeing as they are multiple choice exams, haha. Sigh.... Thursday, you here yet? Nope. On the upside, I am studying in my apartment in my PJs all comfy-cozy. Nice knowing I don't have to move except for the gym and exams!

Just countin' down the days...

Well that night was alot of fun - so much so that after the Kubuli blocked half of my memory and got me sick in the middle of the night - I feel that I now have had enough until I get home, hahaha. Funny how power hours were so easy in college... I did think I was getting old but then again Kubuli is a stronger beer - yeah we will go with that excuse!

Anyhoo - so yesterday went okay just worked on bits of things here and there. I got to talk to my baby today while some of our friends were over the house! Seeing them all made me so happy! I just wanted to squeeze them all! Ah well 18 days. YES - We have hit the teens!!!! 18 days to go and I am home free. I am really trying to figure out what I am going to miss from here. I'm sure that will be in another post to come, as of right now I can't think of anything!

It is going to be so weird tomorrow when I don't have to go to class! I never have to go to campus again - only to take exams! Slowly but surely, the excitement is building as I am realizing this is mere DAYS away from being over... Wooooohooooo!

Classes on the island - FINISHED.

It's over! Lectures for my first two years of medical school are over! Now only 7 exams stand in my way from finishing my second year! This is so wierd. After 18 years of learning in the classrooms, I am finally done. While in 5th semester is between 2nd and 3rd year and we have a few lectures here and there - I can't help to extrapolate a little and say to myself that I will be beginning my 3rd year, forever done with the classrooms and now continuing my education in the hospital (Of course to my patients, I will be a "5th semester student"). Such a great feeling!

So what's on the agenda today? Well, I'm thinking I will study a bit for today, head on home then get ready for a fun night out. Why not! Been waiting for this day a long time and at times I never thought it would come! Studying this weekend will mostly be at the apartment I'm sure but it is definitely time to get the nose to the grindstone. I have been able to pump out some good work but I know it is near impossible to finish all I want to before the Shelf exams. I will get it done before the COMP which is ~1.5 months away luckily but I am darn well going to try to do as much as I can. I figure, the more I get done before the shelfs the more time I will save myself for when I come home to study for the COMP!

Just gotta keep pushing and not get too down when time runs out - I can only do what I can in one week. So, back to it so I can get out tonight! Hopefully, I will get a good sleep and wake up semi-refreshed, haha!

Happy Thanksgiving from the island... again.

Wow, a year has passed. Thanksgiving is here again. I wish I was home for it so bad to see all of my family. I am trying to keep a more positive attitude than last year but it was honestly the worst day here on the island last year so today is second to only last Thanksgiving, haha. I have quite a few things to do today to keep me busy so I am hoping that makes the day fly for me. Ah well, now I am on campus to study all day. I thought it would be easy to think of other things but I just think about my family and friends, fooooooooood, parades, cool and crisp weather... Sigh...

Let's see what am I thankful for? Family, friends, everything from home... lol. Down here? Well I am grateful I made it through these 16 months. I am grateful that I have been privileged to really be a part of Ross as a leader in so many different clubs. Grateful too that I now have knowledge to teach others under me (like today I am a TA for 1st semesters). I am grateful that while I have had to cram so much in my head, that even though I feel like it's so hard to retain it all - I still have my determination and passion for medicine. I know I am grateful for so many things, especially that this is the last holiday I have to sacrifice in my time here. 3 weeks from tomorrow I leave for good. That is one the greatest of all things to be thankful for.

I love you all SO very much and don't know where I would be without all of your love and support. So close to coming back home to you all and words can't even explain how that makes me feel. Have a Happy Thanksgiving!

Last week of classes ever...

Strange. So strange. After this week I will never be in the classroom again. Of course, we will be having a few here and there for 5th semester but nothing like the setting I have had for my first two years of medical school. Friday I will be bringing my video camera just to capture the last glimpse of us as we finish our last lecture! I am so excited this to be all over and behind me. Just knowing I am coming home 3 weeks from Friday is just blowing my mind!

Today, I am just in class then hitting up the gym before I head home. Most of my studying now is for the COMP exam (which will also help me with my Shelf exams) and the mini is going on the back burner for now. Exams start off next Thursday and don't stop until the day I come home! Tomorrow is our last day for ICM and it will be dedicated to practicing different scenarios they will be throwing at us for our exam. Sana and I have been studying really well together so my anxiety about that exam has really lessened.

So... 24 days to go. Tony and I can barely believe it! I am so incredibly happy how well we have gotten through the past 16 months apart! Finally we will be together again and not have to worry about me moving 2,000 miles away after 2 weeks visiting. It is going to be such an amazing feeling to wake up after being home for 3 or 4 weeks and realizing that I never have to leave him again. Of course, I do have 5th semester but I will still be so close to home, just 1.5-2 hours away from him. So much better than >24 hours of travelling to get to him. Being 2 hours away for just 3 months will be a BREEZE compared to this - so much so that I am not even thinking or worrying about it at all. I will be home in Michigan and that is what matters.

Well I better get back to class, after today only 2 more days of classes to go!

Goodbye Roseau!

Today was one of the best days I have had here in Dominica. You might remember when I made my first donation to Princess Margaret Hospital for the neonatal ventilator early in the year. Well, since then - alot more fundraisers and such with RFDH (Ross' Foundation for Dominican Health) and we have been able to make another! This time we delivered two pulse oximeters and a neonatal incubator.

Last time a donation was made, it was very quick. Just a quick "handing over" of the equipment and we were back on the hour drive to campus. This time? SO DIFFERENT! It was a big deal. I am so glad that in my time running the foundation I was able to have an awesome E-board! We had about 7 of us go to the hospital along with our faculty advisor, dean and much other faculty and staff of PMH! It was so great. Not only that - but there was media there for Dominica! The presentation was going to be broadcasted all over the island! Everyone on the E-board that went had a great time and I am so glad. There is nothing more that I want from this than for those I worked with to feel like that really made a difference and I think this experience will stay with them for a very long time. It has been so nice to be in all the extracurriculars that I have been in and have them pay off as much as they did. But in RFDH's case, it has so much more meaning. It is nice knowing that I didn't just come here to Dominica to study but that the donations we have made can really be put to use to save lives and help in the health care here. Just to leave a little bit of our work back here makes me feel like I made a difference.

Not to toot my own horn but without taking over the foundation after the two girls had founded it - RFDH would not exist. Kinda makes me feel good knowing that. I always have the feeling that "Well, if I didn't do it - someone else would have.", which isn't true for this. Sure, someone might have done another club like it years later, but no one else knew about RFDH after that semester and it was up to me to keep it going. I am just so glad I did and got to work with so many of my classmates. It was just so nice to be recognized for the hard work we are all putting into the foundation because it really means so much to us all.

I am so happy that I was able to record everything with the camcorder my Mom left so that will be a nice memory to have. But alas, once all the fun was over and my time with RFDH pretty much had come to an end - we had to leave PMH and the city of Roseau for the last time. Next up will be leaving Portsmouth and the island forever... in just 27 days! It can't come soon enough...

Less than a month...

28 days to go and trying to motivate myself to plow through some material. I am slowly moving studying back to my apartment. After sitting in the same seat for nearly 3 months everyday, I am officially getting sick of it. Not to mention most of my extracurricular duties are just about over so I am so excited that I can do what I want with my own time again.

It is strange though with the end so near I was thinking about the day I leave. My mini 3 ends at 11am and then the taxi is coming to get me at noon! That give me an hour to rush home, chug a couple beers (hehe) and head to the airport! With all that rushing, I just kept thinking how I will be rushing out of campus not even realizing that it will be the last time I will be there! Not that I am looking for a great goodbye but just strange how quick I will be leaving.

Time flies I guess and almost time to leave here. Who knows if I will ever come back - probably not. But hey - Tony and I still need to figure out where we are going on our honeymoon :P! Yeahhhhh... Ah well, back to studying - oh wait I've been lazy all day... Here goes nothing...

Coming to an end!

Time spent with my parents was very short but also wonderful. I really am glad that I had been able to see them even if only for ~20 hours. They are on their way back home now, back to good 'ole Michigan. Me? Well, I'm only 30 days behind them.

Things still are going full speed but luckily with an end in sight. 10 days until my classes here on the island are forever over and then I just have to plow through a handful of exams and I am home free. It seems so long since I have been back. I guess it will be - I haven't been on the island for the whole semester since my first semester here. Thanksgiving is coming up too and I don't even want to think about it. That was the worst day I think that I have had on the island was last Thanksgiving and not being there for it. This Thanksgiving I hope I will see the good because it is the LAST holiday I will have to miss because I am here. Ah well...

So anyway, I am back in the health groove - wanna look nice for my man when I step off that plane ;). Started going to the gym yesterday and am already looking forward to going back. It's so nice just to take an hour of the day for myself and to straighten out my head. Today, Sana and I are making a study schedule and we are sticking to it!!! I hope it works out. I just think things will work out better if I am not doing it alone and am able to get more thoughts in my head than just my own. We'll see how that works out.

Classes end next Friday. Then what? Here we go: ICM practical exam, Pathology Lab exam, Pathology Shelf exam, Microbiology Shelf exam, Pharmacology Shelf exam, ICM Shelf exam and out Mini3 the day that I leave! Whew. Seems like alot but I know it will fly by. So - better get back to it! Missing you all tons... I mean TONS!

Dominica and her good humor...

The day is finally here! The day my parents come down to move my things out of Dominica!!! Oh wait, they missed their flight. Thanks for waiting for my parents American Eagle, grrrrr. Well their two day trip here is now cut down to 1. I am still be thankful for my ~20 hours I will get with my parents but I still wish there was more time. It was heartbreaking hearing my mom cry about it. After all, she planned and planned for this trip and was so excited just as my stepdad and I were. Ah well, what's done is done.

Tonight is the 4th semester banquet so campus is so quiet. I am just finishing up a couple lectures then heading home at 7pm to start packing up bits of my room so it doesn't take very long for us to do that tomorrow... Sigh, what a day.

On the upside I got my mini scores back and I did SUPER well :D 2 As and 2Bs (very close to As but yes, a B is a B :P)! I know for sure that I am getting out in 33 days. 33! I need to get out. I know I say this all the time but I need my friends and family back. It's just time lol. Only about another 12 days and my classes here are over forever! Crazy besides a few classes here and there with 5th semester this is pretty much the end of me sitting in a classroom! Just about time to move up and start working in the hospitals! Sooo weird.

Okay, well time to go pack my things!!!! I'll write again soon hopefully after a splendid time with my folks!

After 16 months, finally on the homestretch...

It's over! I can't believe it. I think the mini actually went really well - like really well. But of course I will never know until I get my scores back. I hope I'm not wrong about this one. It would be so great if it all paid off... Sigh... No sense lulling, I suppose. I'll just have to wait.

So, now I am pretty much all organized again and ready to finish off this semester and my 2nd year! What is left? Well, I have my ICM practical exam, pathology lab exam, 4 Shelf exams and my mini #3 exam. Seems like alot. Our classes end 2 weeks from Friday and after that the exam marathon begins! I am actually excited about it though. So close to coming home - it is hard to believe I am going to be cramming all of this into 36 days but bring it on - because this chica wants to get out of here.

4 days until my parents get here! I CAN'T WAIT! I hope we are able to just relax and have a nice time catching up! They are only staying Saturday-Monday but I know that will give me a huge boost, which is much needed. This week is pretty laid back and I am sure the weekend won't be productive at all - but I'll make up for it with my new energy that I know my family will be bringing me! YAYYY. By the way, did I tell you I had 36 days left? Oh yes. 36!

Tick, Tock!

It's about 5:30pm the day before mini #2 and I am just killing time now. I'm looking over a few things here and there but feel pretty ready to take it - or at least as ready as I am going to be. I just have been thinking all day that next time it is the day before the mini, it will be the day before I leave the island forever! So excited.

I am really looking forward to this week, too. Tomorrow after the exam I am planning on taking a nice loooooooong nap. After that, I think Sana and I are going to sit around and watch some tv, get some dinner then go OUT! :D Last after-mini party for me in Dominica! Wednesday will be alot of catching up from last week but I'm not too worried about it and then just waiting for the weekend for my mom and step-dad to arrive! WOOHOO!!!!

Ugh, what to do - what to do! I guess more studying and tv... I'll write soon to let you know how it all went!!! :D

Just about ready to rock the mini!

Studying has been going oddly well the past couple days. So hopefully that's a good sign! Since there is the Dominican Independance Day on Monday, we get an extra day to study and take our exam Tuesday. After that - the homestretch of not just 4th semester but of my time here on the island! It is nearly all over! Unbelievable.

After the exam? Of course, playing some catch up with lectures I've missed - but not before some celebrations!!! I am not going to be able to stay after mini 3 to party with everyone (oh yeah because I am moving off this rock :P) ... so this is it!!! I'm sure I'll get my work done among my catchin' up but then Saturday will be rolling around and my folks are coming down!!!!

2 whole days with my folks are going to be pure gold for my spirits! I can't wait!!! I can't tell you all enough how much it is going to do for me to see them! I don't want to think about them leaving but after they do? Just about less than a MONTH till I am back home restarting my life among my family and friends! I almost get too excited to even think about - it gets distracting - but in the best way possible!

Well, I got home around 1:30am and it's already past 2, so I should get to bed soon! Miss you all and I'll write again soon!!!

My last full month on the island!

It's November! :D I can't remember being this excited since... well, LAST November!!!!

What does November mean?
*My parents are coming in a matter of days!!!
*Classes forever end on the island THIS month.
*I can finally say that I am moving back home for good NEXT month.
*It is officially time to start playing Christmas music!!!

So much! I can't imagine how I will feel a month from now (a month!!!!) when I realize I have 2 weeks left of this place - forever. It's so crazy! Studying is going... ok. I'm visiting some professors to get things down for sure but my pharm professory says that I know things very well. I was laughing in my head. Suuuuure ok. We'll see how it goes Tuesday. Maybe I do know this stuff? Even now, over 15 months since I got here I doubt myself. At least now it is mostly in a joking matter and not driving to tears anymore lol.

I'm taking a break from pharm and moving onto micro... Then probably back to pharm. Wow, my life is SOOO interesting, haha. Okay, back to it so I can get this test over with and start writing more interesting posts!!! :P

Mmmmm sleep.... 0:-)

It's now less than a week until my next midterms and I am already tired! Uh oh... I can feel my eyes getting sleepy right now as I'm typing. I'll try to put in some more time tonight but I think that the battle is about lost for me. I really want to push myself to act like the exam is Saturday or so - just so I really push to get through material. Doing well on this mini will really leave me feeling comfortable for the final stretch so I hope it works out.

I've been so tempted to go home tonight at 7pm, then 9pm, etc. I'm trying to stay as late as I can but I think my body knows that my mind is just evaporated. I've gotten a good amount done but I need to make sure I retain it. I'll probably have to find some way to quiz myself. We'll see how it goes. Anyhoo, I'm sure tomorrow will be productive as well. As for now, I'm gonna put in my last bit of work before I finally get to shut my eyes and dream of home.

Goodnight! * Zzzzzzzzzzzzzzzz............*

New Season of Increase

Waking up this morning and motivation was low. I blame it all on being drained. Why can't this be over? Why can't I just get back home to my family and friends? Why can't I just have a break?

Every Sunday I turn on the television hoping to catch part of Joel Osteen's sermon for the week and today it was about following in God's footsteps leads to new seasons of increase. Believing in Him, knowing that my life has been set with all the trials set in place for a reason and to be ever mindful to that fact and give praise for the good and the bad that come to pass because in the end it is meant to make you stronger. Acknowledging and trusting in His plan and living your life to be as best an example of God's word leads to these blessings. While I have my times of complaining, I am so grateful to have made it through all of this. I have never been though anything so hard in my life but I know that my opportunity to come here was just the beginning of my "new season of increase".

I have really came back to something I lost a while back. Before my grandmother passed away, she really brought be back to the church and gave me a whole new perspective of how to look at worship. I fell in love with it! It wasn't like those mornings where you had to be draggggged out of bed at the crack of dawn to get all dressed up all just to fall asleep during mass. The place we went to was all about songs and preaching - really bringing home things in scripture to apply in your own life. I couldn't wait to get out of bed and go to, not to the usual 45 minute, but 2 hour service! After she passed away, I just didn't want to have to go back to that place. I didn't want to see all of the people who knew her and the memory just makes me sad, even now. I never went back but the feelings I had about worship went dormant inside.

After listening to Osteen's sermons - they really hit home. I've been thinking to myself how badly I want to come home and really forgotten about my season of increase that is coming. I have passed all semesters and moved right along when I thought I might struggle, I have friends and family who have supported me all along the way, gotten engaged to a man who has always been such a big and wonderful part of my life, bypassing Miami and coming to Michigan for 5th semester, have people willing to help me secure rotations close to home (which by the way - yet another blessing - a beautiful new home!)... SO MUCH has happened over these past 16 months. I feel sometimes like I have missed out on things back home but really my life has never changed so much in such a short period of time. It is really amazing and a wonder. The person who left nearly 16 months ago is not the same person coming home in December.

I truly feel through my belief and relationship with God that He has blessed me with a new season of increase - there is no other explaination. I feel like I have been forgetting this. I walk around exhausted, which is understandable, but I forget how much I have to look forward to! Finally moving back home (3 months sooner than expected!), planning my wedding and just setting my life back up in Michigan. I am just feeling so bummish feeling like "Ugh, 46 more days..." when I should be like "WOW, only 46 days!!!!". Think about it, total on this island I have had to spend 475 days. Out of that today is my 429th day on the island! Somehow 46 days seems so small this way.

All in all, while I know I might still grumble about my time left here - I just have to keep reminding myself to keep pushing for 46 more days. 46 more days and I will be flying home to my new season of increase and life will never be the same. Praise God :)!

...to my Grandma (or as she said, my sister in Christ), I miss your company and guidance everyday...

Senioritis

Yes people, it's official. I have senioritis. Being that there are four semester's down here in Dominica, I am now a senior on the island - and like both high school and college, senioritis is in full swing. I am so anxious to get home but still have another 47 days to go before I get my final plane ride out of here. It isn't like I am slacking, I am working as hard as I can. There are times, however, when I just want to go out to Fusion and stay out all night or go home with some snacks and vino and park it in front of my tv for 12 hours straight.

Alas, now it is turning into crunch time and my next midterms are looming ahead. Of course. No rest for Jessica, as usual. I used to thrive on this - all my hard work pushing me to want to do more and get ahead. Now? I'm passing everything so I just want OUT. There's a good attitude! I think it is the attitude of most though. As long as I am passing everything, I have a guaraunteed ticket out of here. I am going to keep working hard but some days (like today) I just want someone in the same mindset as me and just knock off a few hours early tonight to go hang out. No such luck among my classmates tonight. So I guess I will just follow suit and keep working...

ZZZZZzzzzzZZZZZzzzzzzZZZZZzzzzzz..... OKKK! I'm awake, I'm awake! Back to the books...

Time's chippin' away!

Class for today is nearly over and I am glad. Finally, I have time to study. This week I have been leaving early nearly everyday because I have had to get up early to do clinicals but it's all over now. No more Stan sessions (simulated patient) and no more hospital rotations! The semester is starting to wrap up (or so I'd like to think).

My mom and step-dad are coming down to the island 2 weeks from tomorrow and I couldn't be more excited! I am dying to see anyone from home without the help of a webcam. I really think that my not coming home this semester after mini #1 really hurt me mentally. It was just so hard after coming back my second and third semester to not come back home. I stayed here the 4 months for my first semester so I know I can do it again. Actually, it is almost over so I'm sure of it - haha. But seeing my family will be wonderful. Unfortunately, they will only be here for 2 days which is such a tease but nearly one month after they come - I will be going back home - FOR GOOD. Nothing special planned really just some nice time together and catching up. I decided not to attend the 4th semester banquet. It is partly because my folks will be arriving that day but also - I really just don't feel like going. Yeah... so that is settled.

My countdowns are just getting ridiculous. I have my countdown to home (48 days) my countdown for lecture hours (after today 49 hours) and constantly updating my Facebook and AIM profile as well. I think out of the whole class I have to be one of the people who wants to leave here most. So much is waiting for me back home and I need to get there now more than ever. I hope to God I never take things back home for granted again because this island has showed me how much they mean to me. I am planning on setting up a little study area in the house so I have a place to quietly study away from distractions and just keep all my work organized. I can't wait to set it up! My mom is worried that I will be like I was on vacation and not be as productive as I would like to be. I can see that, but really know that it will not be like that. Studying is a huge part of my life now and it isn't like high school studying, college studying - but studying to pass my COMP exam that I have to take in January and my first of three medical board exams coming up in June. I'm very excited to begin working towards that in a more focused way!

Not too far now - just a matter of a little over a month and it is all over. Hard to believe and I am sure it will be filled with emotion when it really sinks in! I can't say that "I did it!" yet but I can definitely see the finish line! :)

Last Hospital Day in Dominica!

Another hospital day over with and my last one! I never really wrote about my previous visit but while I learned a bit - it really didn't compare to today's rotation! This time I had my
anesthesiology rotation. It was great! We were in surgery for about 4 hours in the morning for a partial gastrectomy. The patient had an adenocarcinoma of her LES (cancer of the sphincter between her esophagus and her stomach). Overall, not a good prognosis but in a flash procedures were underway. All together in one case, I saw an epidural, intubation, surgery (obviously), central line, drainage tube and chest tubes all performed.

As soon as the operation started - man - did that surgeon go to town. It all seemed SO rough the way he was doing everything. The point of the surgery was to resect the portion of the stomach (cardia) along with the tumor. All of a sudden we see a spleen go flying - what? why? Don't ask me! We all just looked at each other trying to figure it out. He also cut through nearly the entire greater curvature of the stomach... The best I can come up with is that I noticed the surgeon had to cut out the spleen because of the short gastric arteries that led up to the stomach - and this could have let to a more massive bleed? I feel dumb for not knowing but it's good trivia for me to think of after I write this blog. She did have a large loss of blood, nearly 2 liters I was told. But for a woman of her age, she handled it very well. I hope good things for her. I know when she wakes up she will be in an extraordinary amount of pain. She will require a long recovery and need much extra care.

Working with the anethesiologist was great although we all were bouncing back and forth from the surgeons to anethesiologists the whole time - trying to catch a glimpse of everything. I really enjoyed it but still do not consider either in my future. What bothers me most? The patients are unconscious! I think I feel that I bring alot of my personable qualities to this profession and that I would be wasting them if I spent it in a lab or with patients that I couldn't even speak to and in that way make an impact. I know that is ONE THING I want for myself in my practice.

I did learn alot today however and I think it gave me the kick in the butt I needed to start plowing away at my books... So - here we go! :)

This one goes out to my fans!

After this blogger talking about enabling my "cookies" (in which immediate hunger followed) - and again, internet constantly goes out 30 mins after I get back to my apartment and the blogging has halted again. After going to the bookstore - I found out I have a mini fan-club!!! :D HI EVERYONE!

After hearing that it is time to update, I put in a little effort into fixing "my cookies" (still have no idea) but the genius that I am has fixed it! So HA!

So.... Where to continue from... Well, I got mini #1 back and I passed everything with flying colors. Well, maybe like half-staff? Haha, no I did alright. Everytime I take an exam I tell myself that I will be happy if I just pass - but it somehow always turns into - ahhhh, I wish I had done better. Ah well, another chance is around the corner - mini #2. Yes, I have paused on blogging so much that it is just about that time again. I am taking it a week from Monday and then I'm really on the downhill to getting off this Rock! It's crazy how time flies.

Besides school things are SO busy. Honor Council is keeping me busy with a couple things which is pretty time consuming. The foundation is going FABULOUS - except for the stupid customs agents in Dominica still holding onto our equipment!!! We found out we don't have to pay the $3,000EC to get it to us (ridiculous - it's a donation!!!) but we will have to pay for storage fee. Fine. I say whatever - can't be more than $500EC... I hope. I am so thrilled though because there are wonderful students interested in taking RFDH over after most of us leave! I am so happy that I found passionate people that I know will do a fantastic job.

As I have probably said before, sometimes I look back this time last year to see what I was doing. It makes me laugh. The pre-reading, 5am wake up calls, the giant physio book that only a master's student would read - yep, all me. I just can't believe it is nearly time for me to move on from the island and start building my life back up at home. So much has changed. I came here an eager, freshly graduated college student leaving behind friends, family and a boyfriend and am coming home an exhausted, 3rd year (nearly) medical student coming back home to my family and finace!!!

I must say, that is a nice transition. Of course, there is all that personal growth and all, haha. That's a big one that I overlooked. I can now say that I am quite the independant person. I remember telling my mom that once when I was in college. She flat out told me that I wasn't - which was so true. Yes, I lived on my own in college but still pretty much had gotten everything I needed from my parents (thanks again for the millionth time!!! :D). I know that anything that I have to deal with from now on will be nothing compared to some of the things I have went through here.

Will I miss it? Of course now I am so busy with EVERYTHING I'd love to say heck no - but I might sigh and admit that a part of me will... somehow haha. So, on that note, I better get back to studying - I have hospital tomorrow all day, so I will write sometime after and let you know how it went! I love hospital days!!!

Hugs to all and to those in my fan club (don't worry I'll stop calling it that) leave a message and kick my butt if I am slackin' on this! :)

Take care.

Will I be ready for my upcoming clinicals?

My LAST first mini is over... wow. Never again!!! After the exam, I just couldn't help to think that now it is downhill - the first mini is just about at the half-way point in the semester (odd I know) but next week is week 8 of 12. Then exams and done! The mini I think went well - I know I worked hard so I hope it pays off.

So as you all know, I am going home to Michigan for my 5th and hopefully the rest of my clinical education before I can finally receive my M.D. degree. Knowing my clinicals are coming up - it is quite nerveracking! I know it will be 2 years of pimping, along with some self-doubt, times of pride and also disappointment as well. We have learned so much in my near two years that it makes me wonder how much I have retained! I know I have retained alot. With my classes now, so much is being integrated together. For all those that don't believe - biochem DOES return haha. Of course, I'm sure alot of preceptors ask about such details but I would still like to be able to recall them. I'm just so excited to put all I have learned to use and be that person where the others on rounds say "She's the one that always seems to know the answer." I hope that is me.

A week or two ago there was a small private session for our Harvey (patient simulator for cardiorespiratory systems based on different anatomical abnormalities of the heart). After we got into it, I just looked around the room. It was two other girls, myself and three different professors. It was the three professors on one side and us three students on the other. It just hit me and stuck with me that they were passing down their knowledge to us just like one day we will do to others. Just felt like we were that "new generation" of medicine and gave me a bit of excitement.

Even after that I met a great professor who taught us our breast, pelvic and head/neck exams. Dr. K had such a huge knowledge base, could break everything down so easy a chimp could understand and made us feel like medicine was not some impossible task but gave an enjoyable and simplistic approach to it all. After we had him teach us for two hours, we all wanted to know his story - how he got to be a successful doctor that so many people I am sure adore. Another professor who also has been so helpful and wonderful teacher, has taught me on and off for my two years. She comes across as so confident, intelligent and like Dr. K - just a wonderful and personable individual! Who would have guessed it but both of them were gradutes of Ross graduate. I don't know why it surprised me. I know Ross is a great school but it just for some reason took me by surprise. It made me hope that someday people would want to know more about me and my story someday too. I know I will have alot of them to tell!

I am now mere months away from my rotational years and actually - less than that! We do them in 5th semester and even overnight on-call shifts too. So scary but exciting! Before I start I have to take the COMP exam. This exam is taken by all out-going 4th semesters which they must pass in order to register for the Step 1 exam. I will be home to study for this and I will be flying down for my exam (which I have to take in Miami) January 17th. Then it is back to Michigan to begin taking everything from my 1st and 2nd years and applying it to my patients (or my residents' patients that I have to do the scut on, haha). Will I be ready? I hope so. I hope I can be someone patients want to come see and students that actually look forward to my teachings. Until then, keeping the nose to the grindstone so I can get my butt out of the classroom and in the hospitals helping people - where I belong.

4th is well underway!

Why hello hello! Look at who's internet was back to acting up *raising hand*! Yes, on campus there it's hard to get on my blogsite and at my apartment - well, internet hasn't worked in my room in a while - ah Dominica! I am plugged into the internet in my kitchen which we just got plugs for so yay!

Anyway, trying to figure out where I left off! Semester 4 is amazing - I absolutely love it. I am just finishing up week 5 right now (well our mini is on Monday and the week beforehand we have lectures on material that will be on mini two, so I will have to catch up!). Again, our first mini is this coming Monday and I couldn't be more excited! It is my LAST first mini!!!! We have learned so much so far this semester it is unreal.

I have had a habit since I haven't been able to blog to look way back when to my first days on the island last year. How time flies! I can't believe it is almost time to leave. It is like the science summer camp that has finally come to an end! I am sitting at about 2.5 month now until I will be leaving Dominica and moving onto my 5th semester. Ross does 5th semester here on the island or in Miami, FL. BUT - recently they have approved a site in Michigan for 5th semester!!!! Well... slow down, no. It isn't approved until May 2008 when I will be already done with 5th... boo. BUT WAIT! Then they thought they might try to set up a cohort of 10 people in my class to go for a "trial run" this upcoming February (which I was pushing and pushing for) - and they APPROVED IT! Guess who was on the list of 10 to go - yours truly, that's right!!!!

I'M COMING HOME!!! NEVER TO LEAVE MICHIGAN AGAIN!

I can't wait to come back home and spend MORE than 2 weeks in the new house. I haven't ever lived in there that long before! As I told Tony (from my last post my newww finace!), "We will finally be together long enough to be able to get on each other's nerves!" I can't wait to be back with him, friends and family! What fate though! Out of ALL the places in the US, they picked Michigan and out of ALL the students they picked me! I thank God so much for this blessing. We prayed and prayed for it and He has come through more than I ever hoped for!

So that is the big news lately - the lastest buzz. I know the blogs lagged but you really didn't miss much - studying, studying, working on my organizations and OH YEA - studying, haha. There are so many things I want to talk about that I feel like I have bottled up waiting to say but it will have to wait! I have a mini in 4 days after all!!!

Back to studying for now but I'll be back :D!
With love, Jess

The last battle: Ross' 4th Semester and ME!!!

Well, I have made it! I am a fourth semester student here at Ross University and am shy only 3.5 months to getting out of here for good! For those that I left so suddenly with - I did manage to get off the island that next day through standby. It was a ROUGH day. I got there at 6am and, while there are plently of stories to go with this - 10 hours later - standing in the box of a room with no A/C I got on a flight! So many people went with the charter planes - their pilot never showed! I'm so glad I went to try to get standby.

So break... WOW - best time of my life. Tony and I took our awesome trip up north to his family's cabin. Not more than 3 hours after we got there we just weren't tired (4am) and decided to go out on the boat and watch the sunrise - little did I know he had a plan all along ;)

HE PROPOSED! I'm engaged!!! Ahhhhhhhhh!!!! :D It was so wonderful, right out in the middle of the lake at sunrise and I never saw it coming! I thought he'd wake until December or something but nope! Guess he just couldn't wait ;) I am SOOO happy! Right now we are thinking of Spring '09 but not set in stone yet. It's all so exciting. When I can't study anymore I just can't help going online and looking at wedding stuff... I really AM such a girl! Hahaha...

Well, I know I am behind on telling you about 4th semester but as every semester I have to get all of my clubs up and running and make sure I'm all settled in. It's about the end of week 2 so I am just about there and plan to write a good entry this weekend! Sorry for the delay!!!

The calm before the storm... literally.

Just about a day out and I want OFF this island!!! There is so much to talk about but first of all our final exam. Due to the storm looming ahead we were given the option earlier today to take the final exam or "opt" out of it and average out 3 midterm scores to give us our final exam grade. Of course, mind you, we have no idea what we got on mini 3 yet! It was SUCH a crapshoot: do you take the average and risk what you got on mini 3 or take the final and risk being screwed because of all of these distractions?

Well I chose to take the average. I was studying but very slowly. The Weather Channel is all I could seem to watch - just watching the storm get closer and close - and of course, on the day I am suppose to leave. BUT, since I am getting out of the final, I decided to do something about it. Tomorrow, or I should say today, I am leaving at 5ish-am to go to the airport and try to get standby for a flight. The chances do not look good but I am desperate. IF I can get off this island I am good to go and should get home fast but it is very hard getting out of here and am not very optimistic about the morning. But I am praying and hoping. There are tons of people taking charter flights out of here but at 700-900 (and I have even heard of $1200!!!!) JUST to get to Puerto Rico it was just not worth it to spend that much. That is an insane amount of money just to take you 150 miles and frankly I just couldn't afford it either. But I don't think it is worth it either. Worst case I am hoping I can get out Sunday - but we will see.

If flying out tomorrow doesn't work, it looks like I will be riding out the hurricane here. I can't stay in my apartment because it is basically a death trap. Okay, it isn't that bad. My room though is exposed to the elements (on the balcony) and there are 3 big windows so I can't stay. We will have to see. I packed up most of my room (papers, pictures, etc.) and hid it away in my closet space which is a little off the ground. I am hoping nothing gets ruined!!!! I might take some pics to the airport with me, just because I am afraid of that.

Sigh, so - yet again, we will see how this goes. I miss you all and hope I can get back to you all again really soon. Getting home would just be so wonderful and I'm sure I'll cry when I see D-town again... Please keep praying and I'll see you soon.

Hurricane Dean???

Ha, well as luck would have it - there is a tropical storm brewing out in the Altantic Ocean off the coast of Africa. The Weather Channel says that it is a depression now but is most likely to get stronger and hit the Lower Antilles (where I am) in the next 4-4.5 days (when I leave). UNBELIEVABLE! Not to mention I still have 2 other test to take while waiting this news out, haha... No problem.

I'll keep you all updated but it looks like things are going to get kinda close to whether I will just miss the storm or have to stay here and ride it out. Of course, I want out of here but I am also worried for those that will miss their flights and the locals as well. I just hope everyone is safe...

Prayers would be great on this - not just for safety but for me to get home :(...

5, 4, 3, 2, 1...

Finally it is here - the final week of the semester! I got my path lab exam back - got a B. I was hoping for higher but doesn't everyone, haha? I am happy with it though and will gladly take it. I heard alot of people did really poorly so I am grateful. Next, I took my behavioral shelf. I was really happy with how that went and am hoping it went as good as I thought! So... what's next on my agenda??? Mini #3 time on Tuesday and my final exam (gulp) on Thursday. Studying is going alright but I still have alot to do to get ready for it. Pharm is giving everyone a really hard time but I am starting to think that I will be able to get a handle on it. But there is still all the other subjects to worry about too. I just hope I can get through it all. We will see.

This has been on my mind and I think It's kinda funny how now that I think about when people say "I would never go to a doctor that got Cs". Okay, I'll admit I got one already - biochem in my 1st year - big woop. But the time that they give you to study for some of these exams is just ridiculous. I have my final exam 36 hours after my mini... While - yes, it is possible to work on final stuff before - it is not as easy to let go of studying for the mini exam. You want to do well and giving up precious time to study for the final - well it is a toss-up. What to study for? Same when I was in second and even now I am reminded when I hear second semeters talking about it. They have - what - 5-6 Shelf exams in a week??? THEN a mini two days after? Now come on. I do understand some people have "the gift" and think that "oh it's not so hard if you just try". Right, lol... It is very hard and even if they are showing off like they "supposedly" have it all under control... Well, I call your bluff lol. :)

Just a little rant that caught my attention lately. Not being a perfect 4.0 doesn't mean you won't be a good doctor and if patients don't come to you for that reason - well who needs 'em anyway, right? Just kidding! Haha - what I mean is though that I think that they are missing out because most of whom are not book-worms make up for it in character. I know too many people that - well, it just comes easy for them and I am happy for them - really. But at the same time I think it doesn't really help them in the end because they (some not all, so no one yells at me) have never had to be pushed, never had to persevere over some hard times and keep going. That's at least how I think. I think with all the hard work I have put in, while I am not a 4.0, I make up for it in so many other ways and in the end I will be a well-rounded, competent and respected physician that will be a great teacher and guide to those that I will mentor in the future - which is something I am looking forward to more and more everyday!

Okay, more work to be done if I am coming home this week!!! Well - either way I'm coming home :P but you know... Love, love, love! :D

Three exams to go...

The path lab final has come and gone. I know I messed up a couple easy ones but I finally got over it so I am moving on lol. My behavioral shelf exam is tomorrow morning. I hate 8am exams! What if I don't wake up?? Haha, I always worry about that. But I feel really good about it and am ready to get it over with.

After the exam I am probably going to the gym, shower, then we have our semesteral OLAS dinner! Yay, free food at Tomatos! I am proabably going to be studying at home tomorrow too and start back up on campus Friday. Have my LAST two exams next week and then I am homeward bound! 8 days... wow. I can't wait! I have SO much work to do for my last two exams, mini #3 and the final. The final, we never had 2nd semester but we did way back when I was a little first semester lol. But I will bust my butt so I can do well and just GET HOME!

This is kind of short I know but I just haven't posted in a while and wanted to give an update. Nothing much new is going on besides my ridiculous studying schedule and exams. Just trying to make it to 4th semester (FINALLY!) and get out of here for good!

I'll post more soon but until then - have a wonderful day :)!

If this week were only a prelude to the next two!!!

So this past week has been amazing! Where to start? Well my clinical exams are over and they went well. I mentioned by physical exam assessment but after that I also had my clinical history assessment too. Basically we went in to our own little "offices" and was greeted by a professor and an 2nd semester student posing as an actor to be our patient. Everyone had a different case and our task was to take a thorough history and give our differential diagnosis. Mine went very well. My patient had a tension headache accompanied by GI problems due to his overuse of aspirin. Really the diagnosis isn't the hard part to get, but in taking a history you have to be sure to hit all of the right questions and rule out any other possibility. For instance, this headache could have been a multitude of things: migrane, cluster headaches, from high blood pressure, stress, etc - which you must ask about all of those through their possible symptoms. For his GI problems, one must ask: medications the patient is on, drug use, sexual history, stool characteristics, family history of cancers - and so on...

As far as my patient, I nailed it. My professor said that I did a very good job and would receive a grade in the 90s. So that made me very happy. She even used the actors opinion in my grade and he said how comfortable he was with me and how I seemed to come across as being genuine and very thorough. So that is another test down. Next was my paper... Again, things went well - it is not graded as of yet but I did ask for one of the 4th semester ICM professors to revise it and I believe that really helped smooth it all out - I am definitely feeling confident about that.

As for now, it is all studying (which after writing this blog I am going to start on) but some BIG news. Our newly hired Dean of Clinical Medicine came down to Dominica, introduced himself to us and allowed us to ask as many questions as we wanted. As most students were all eager to ask about their own individual states and what new things are happening, of course I asked about Michigan. So many lies, exaggerations and rumors are on ValueMD lately that it was great to hear someone first hand. So basically I wanted to know if there were any developments in Michigan rotations. I found out many things - all good. Seems like it shouldn't be too bad to get rotations to stay home (provided the timing works out) but then he said something amazing. While nothing is yet signed, there is a contract out in Michigan pending to begin a 5th semester in Michigan! "That's nice", I thought. Probably wouldn't happen for a year or two. He gave details about it and within the next couple months he was hoping that it would be final and that this January it would begin. Not to sound too wimpy but when he said that my jaw dropped and my eyes began to well-up. This January??? Are you kidding me?! What this means is that I may possibly leave Dominica this December and be home in Michigan for good! No Miami!!!! Of course, as Tony is trying to tell me, to not get my hopes up too much - and boy and I trying - but WOW! This would be an amazing end to my time away from home.

Even that doesn't end my good news. After all of this we had our SGA elections (Student Government Association), where I was running for Honor Council President. This was such a fiasco because we had complaints about how it was happening and after the elections were over we had to throw them all out and start over! I was so bummed. All my work to get people to go out and vote for me, ruined. BUT, elections were held yet again and to my surprise I won by a huge margin with 208 votes! I was SO happy - so after 3 semesters of being a representative - I have finally moved up to being President - and it is a good feeling. We are a pretty active council and I am excited to be in charge of it! So much will be on my plate next semester but most of what I am in charge of is running like a well-oiled machine, so I think I will be able to handle it.

Finally, we come to today. All I wanted to do was "close" all clubs for the semester - just be done!!! So, I needed to get all of our banking done to get our donations ready and let that be the end. OLAS was able to donate to two causes in Dominica - totaling about $4,000EC! RFDH was able to put in our 2nd wire-transfer for our medical equiptment for a total of about $9,000EC! Hopefully, all of it will get here by the time we get back so we may bring it to the hospital but - wow - I mean it isn't everyday that you get the privilege of donating nearly $13,000EC in one day!

Overall, I am so very pleased with how this past week has gone. But I can't forget about my studies! Still TONS to do - so I am going to go get started!!!! I hope that this past week is a good omen for the next two weeks of exams!!!!

HAPPY BIRTHDAY BLOG!!!

Wow, I can't believe it has been a year since my first post! I have great news to post later on - many great things have happened over the past couple days - so I will try to write about it all soon! I just couldn't let the day pass without telling my blog...

HAPPY 1st BIRTHDAY!!! :D

Getting through this with Him by my side...

Another rainy day here in Dominica and studying in my aparment for a change. As things are drawing closer to an end I am finding a little more flexibility in studying. Just seems like there is more time but I hope I am just going to still use it wisely. Getting a little nervous for my exam tomorrow because I really want to nail it and don't want to get nervous like I did before. So, I studied a bit today and will still do that a little here and there but I really just want to prepare for tomorrow. So I am going to work on that and start organizing for my final exam in a few weeks :) Just do little things that aren't hardcore studying but still get some work done at the same time.

Though all of this though - since I have been here and especially this semester though - I have had to rely on such a higher power helping me out along the way. While I am starting to see the light at the end of the tunnel for the semester, I can't help but think about this whole semester and how I have gotten through it. I had prayed here and there before but it has become such a second nature here to do that just because I feel like I need Him and Mary now more than ever. This semester has been the hardest yet here mentally and without having prayer I don't think I would have made it through, at least as well as I think I will do.

His "divine intervention" into my life isn't just in how I feel inside but how much I know that it's done though the people in my life too. I could never be here and make it through all this without everyone at home pushing me on and just simply telling me that everything will be alright and that they will love me no matter what happens. Sounds silly, but really you forget that "hey - they actually WILL love me no matter what" - and things then don't seem so horrible. Being in such a remote area you forget so many obvious things like that - and especially that you are not alone. Sure there are tons of people here doing the same thing and truly the island is not a bad place to live at all - but as anyone would say - it's not home.

I find myself turning on someone like Joel Osteen just to watch one of his sermons sometimes (that guy is so great!) and just taking time for myself at the gym or something to bring me back to "center", because it is so easy to lose that. I am so close to coming home again and to look back on all I have done here makes me realize how much I have grown and how the things that I am most looking forward to in life and getting so much closer - like moving home, starting rotations, enjoying the new house, getting engaged - and gasp - becoming a doctor! Hard to believe that a year ago I still was at home waiting to leave for the island, but here I am now only about 4.5 months away from leaving here with two years deep in my medical education! It's a crazy feeling like it almost isn't real.

I just thank God for so much that I can even begin to write about but have to admit that because of Him and his blessing in my life like my family and friends I will finish these last few months here strong and make this Christmas definitely a "Merry" one! :) Aaaaamen! ;)

Another taste of clinicals...

Well my birthday was a great time. Matt took me out to eat but when going into our little restaurant here - 5 or 6 of my friends just popped out to surprise me! I knew something was up! Haha. It was so nice though, there was a cake, decorated table and everything. It was so sweet of all of them so thank you so much!!!

Studying is sluggish but picking up. Today was our last day of clinic - so our group was up! We went to Vielle-Case Clinic where we met with our patient to take his history. This time it was actually a real one. I wish I could have gotten him all to myself, but there were limited patients so we had 3 people in the room, myself with another guy and girl. So we alternated taking the interview but - wow - did he have quite some story! If you ever have visited Dominica (because I am sure soooo many of you have lol) or have read my early on posts from last year, driving here is... there really isn't any words - it's just insane. Speeding, driving on the edge of cliffs, cutting SO close to people walking on the side of the road and animals - it can really freak you out, not to mention what it does to your stomach... ugh... Anyway, our taxis here are called "transports" and M.L. (funny how the initials are the same from my other interview, haha, but this was a guy) got caught in the door and was dragged THROUGH GLASS along with the transport! This happened years ago but with all of the injuries he sustained he ended up having a plate put in his leg. All in all, he ended up having the plate taken out but after the stiches were removed he started to develop a wound infection.

It was the most interesting case I have seen so far here in Dominica and I felt so bummed that I started my paper on my other case because this would be a great case-writeup! But after we were all done we thanked him and headed back to Portsmouth to present to the attending (supervising physician). It was quite intimidating talking our patient up to him. He was kind, but was pretty demanding. This is something we will all have to get used to but I couldn't help think he was looking at us like we were the dumbest people ever! Before I continue on that note, the other girl in our group really got on my nerves. While she was quite thorough in her part of the interview, she wasted SO much time. After the patient would tell us part of his story, she would go all the way back to the beginning and confirm. Of course, you do not want to miss anything but with the limited time we were given and expected to perform a complete history (which can be a lengthy process) it was hard to keep the flow going. She would constantly cut both myself and the other guy in the group off but moreso in presenting the patient. When I would begin talking she would cut me off and just go on like she did everything. Nothing but "I" statements. "I asked him" this... or "I wanted to rule out" that... It was so obnoxious and with her cutting me off I couldn't help but give a little glare in her direction. I could tell the physician saw my frustration with being cut off and when she would get frazzled or go too fast she would finally shutup and then I would just continue on. It really killed the flow and that disappointed me. We are supposed to be a team here and she just - well - I'm not sure what she was trying to accomplish. There really wasn't a grade for this, more for practice. I can't be 100% about this but her tag on her ID had a 4th semester color so she might have been a repeat-3rd semester that has done this before but just wanted to seem like she was "all that" and a bag of chips... Who knows. After that, I went to the gym and worked that all off my mind.

It was a great experience though and I look forward to more! He had us go through our whole case, making sure we missed nothing and even went as far as to us giving our DD (differential diagnosis)! It was actually pretty fun and in that short morning, I really learned alot. I'm not so worried about being criticized (positive or negative) by the attendings. That will be my life for many years to come and I can't let it get to me and consume me. They all have their preferences of how they want cases presented and if you can just feel them out and able to be flexible in that sense - I think it makes for a less stressful time and a more enjoyable experience.

As for now, I am back at my apartment after a wonderful nap and studying! Classes are basically over. Just a few hours here and there but they are officially over I believe Monday. Before that though I have my oral exam this Thursday then nothing but paper-exams after that! So - on that note - time to kick it into gear! Where's my energy drink??? :)

Time for some fun...

Well Tony made me promise something - that I would have some fun tonight for myself. I agreed without hearing what I was promising to, because heck - I'd do anything for him! That was a bit of trickery! But I promised so I guess it's about time for some fun.

He's so sweet. The day started off bummish because all I want to do is be home with all of you. But everyone here has been so nice and wishing me "happy birthday" all day long, leaving messages on facebook, etc... It's helping. I figure if I don't let myself have some time to myself - especially on my birthday I will regret it. I don't want to have all "what I missed because of the island" thoughts, so tonight will be a nice time (hopefully not too crazy) of memories I will have and miss from here.

Well, sorry for the shortness but it is time to go for the semesteral powderpuff game, then Matt wants to take me out to eat (n' what not) so sweet and hopefully meeting up with Sana after... Something tells me that somethin' is up... but I'm just happy to spend time with my favorite people here - hopefully I'll see some people at Fusion tonight and be able to live in the moment and forget about everything ahead of me (studying, studying annnnd studying)... Happy Birthday to meeeeee!

Goodbye 22, hellloooo 23!

I can't believe I am going to be 23 years old. I really don't want to be lol. Sure, it is still young but wow, 23! I remember my 16th like it was yesterday my 19th, my 21st! Goodness. Thinking about it though and I honestly don't think I could have crammed much more into my 22 years so far on this Earth lol. Even now I am trying go to through everything I wanted to accomplish by now and I am right on schedule, haha! That is a great feeling inside just to know that you are so happy with your life and love it just the way that it is.

I wish I was home to celebrate it but it's okay. It will just make me appreciate my 24th even more (eww). But at least I did get a nice party when I went home (Tony threw me a surprise birthday party!!!)! It was so soooo sweet and I never thought I would be so lucky to have someone that would go to so much trouble just for me. I thought it was a Father's Day BBQ but then I slowly started hearing "Happy Birthdays!" (I thought they were just wishing it to me because they knew I'd be gone), seeing a couple cards and a cake with a pink flower on it (hey, a cake with pink flowers totally says "Happy Father's Day" lol). But then Tony brought me inside and right like family tradition I got to sit in "the circle" lol.

The circle is where the birthday guy/girl has to sit in the middle of the whole family while they all sing "Happy Birthday" to you but it's not such a nice musical tune lol. They just all sporatically yell/scream whatever part of the song and random words - and all you can do is turn beet-red and laugh! Even though I did a bit before, I really felt like I was part of the family after that day... I was there for a couple birthdays and saw them doing it to them and I thought that it would be so fun to be part of that someday! Well, I definitely got a taste of it! It was the best thing ever.

Sigh, well back to reality here in Dominica lol, jk. It's those kind of memories I will remember forever and I'm so blessed to have Tony's family in my life - they are such an amazing family! Well, as for now I have alot of studying to do - so much that I feel a bit guilty to go out tomorrow but I will! I can't be so deluded as to skip my own birthday... Not lookin' to be some kinda martyr here. Soooo I should probably get to it.

Just a special shoutout to my family, to thank them for putting up with me for these 22 years and to my Mom for having such a great kid! jk!!!) ... Love you with all my heart!

Homestretch #3!

ICM physical exam assessment is over! Finally feel like we are getting the ball rollin' to wrap up semester 3. Thank goodness. I got an A, but got a couple points off for how my technique took a long time - yada yada - I didn't make any "real" mistakes - yada, yada - I got an A so whatever lol. After, I had our LAST behavioral lab of the semester (which was the best of them all!) where we got to practice for our patient history oral exam we have next week. I feel much better about this and much less nervous.

Nerves, lol. Yeah, that is a funny thing. As comfortable as I thought I would be the adrenaline really hindered my flow today. But live and learn. I feel so much better and oddly feel more like I have taken huge steps this semester to becoming a physician. It looks so easy to do things like we are tested on but it really takes alot of out of you!!! I'm also really getting better at worrying about myself and not other people and how well they did on exams/assessments. To me I always felt like I had to be the best at everything, an impossible feat where it leads to CONSTANT disappointment in myself. I still do this sometimes but I get over it more easily. I never want to fully let that go because I think a little disappointment/let downs have lead me to push myself harder. But over the past while I have learned it is about doing your best at everything and learning how to pick yourself up after a disappointment. It's all about how you rise after you fall and boy - I have fallen more times than I can count. But I have never given up and have always pushed myself harder.

I can see my personality changing alot since I have been here. I even told my Mom that I look at pictures of myself from last year and I don't really feel like the same person at all. I've grown so much and feel like such a better person just being here - putting aside all of the med school pride lol. I really feel that nothing will ever compare to this experience and whenever something seems so hard just think about my time here and everything I have had to overcome mentally, physically and especially emotionally.

What a ride. But at least it is almost over - at least this semester. As for now, I am looking forward to Friday! It's my 23rd birthday, which of course I wish I was home for, but after class it will be an afternoon/night to relax and party! So excited!

One thing at a time I guess here. I still have so much to learn, not just here in med school but about myself as well and what more I am capable of... I have a feeling it is alot and much more than I have been giving myself credit for...

Last full week ahead!

Finally it is time for our last full week of classes! First up? My ICM physical exam assessment. Woops, I accidentally thought I had this next week but nope - Monday! It's okay I have been working on it for a few days and I will be ready. There are 9 objectives that they can ask us about, ranging from - cardiovascular examination, pulses, respiratory exam, general assessment, etc.

But yeah, after this week classes wind down we will still "officially" have class for another week and a half but with our oral exams and what not they are very short days indeed.

Otherwise, as far as myself goes - I am doing a little better. I am seeing the end coming and I am so ready. My mini 2 scores came back. Again, I didn't fail anything which is great so I am not in the doghouse for any classes as of now but I still wish I did better. Still alot of exams to go so it should be just fine. 32 days and counting. This semester has just taken such a toll on me but I just know it will be worth it. At least I have my birthday to look forward to on the 20th! I will let myself have Friday afternoon/night off from studying (but I still have 6 hours of class that day)... Ah well but after that - I'ma going OUT! Come on, it's my birthday! I'm not that mean to myself... am I? Hahaha.

This weekend I am trying out typing out my notes to more concise and organized pages because some of the teachers I have now - their powerpoints are so lacking in that. So with that, I better get back to it - alot more to go... Luckily, after my exam Monday morning I have all day to work on it still (just one hour of class - woohoo!)

Okay, wish me luck world - it's only 7 minutes but 7 minutes I can't mess up! :)

Pushing forward... alllllmost there!

This semester has been full of emotion, I have to admit. I have never been so excited, happy, stressed and drained in my whole life. I can slowly start to see the end coming of semester 3 though. While there are exams, papers and clinical exams ahead - it will come and go very fast. Tomorrow I will get my mini #2 exams back and I am as usual, worried. No matter what though I always have the drive to keep going but I am hoping for the best tomorrow. Good grades would really be a spirit-lifter for sure.

I have my clinic on Monday where I will be going to either a clinic or hospital to practice my patient histories on real patients. After which we present to the resident so he/she can critique us. I'm excited about it but haven't had much time lately to practice. Although, it is pretty second nature just have to work on timing I guess - I can chat a while lol.

Next week though is the last full week of classes and that will be nice. We are again getting slammed with work but it's almost done. Now that I think about it next Friday will be really nice because it will be the 20th - not just my birthday but 5 months till I get out of here, the end of the last full week of class and hopefully a nice night out (to ring in my 23rd year lol).

Things are slowly getting to be better but nothing will compare to stepping off that plane in Michigan. Well, onto more stuff - have a couple more hours of lecture to watch, then I am going to work on my case write-up and finally onto what has become my favorite pasttime - a good workout!

...gotta look good for when I go up north next month ;) !

Homesick...

Mini #2 is over. That's crazy. I don't know how it went but all I can do is hope for the best. Last night was such a bust, for me. There were a few things that led up to it but I just got so homesick and I cried and cried. I would have done anything to get home. Sana and I hung out at a place that really didn't make us comfortable, then trying to call home my phone says I am out of minutes - plus I hadn't slept since 30 hours prior. I just lost it. I don't even know why I try to go out anymore because when it comes down to it, I just think about home and all my friends that I miss. I get so homesick that I can't enjoy my time after a big exam.

So I ended up going back home to finish crying and just sleep but today I am waking up feeling the same way. The difference is now I have to start working again. I feel like I cheated myself of a good time by getting homesick, but what am I suppose to do? I'm not like alot of people here that love going out all the time and have a million friends. It is kinda hard to disregard how I feel about home. I don't know - my birthday is coming up next week and Sana wants to go out for that. I don't know how I feel about that. It's hard enough spending your 23rd birthday in a 3rd world country being away from everyone you know and love compared to being home and walking in your mom's house to see crepe paper, balloons and a little cake for the 23rd year in a row and it making you feel so special everytime. I think that will be kinda hard. Up there with these past couple weeks and last Thanksgiving which were really hard on me too.

Sorry if this is a bummish post but I just need to vent this off too. I know home is getting closer so that is good but I guess in the meantime I will just be homesick. At least you all know how much I miss you! I'm gonna get going but I will write again soon. Hopefully when I am feeling a bit better.

Nothing without you... :)

Wow, never had to review so much in so short of time. I never got behind but it just seems like info isn't sticking with me. Well I am trying at least and in about 24 hours from now it will be over. Good, because I am getting burnt out if not already. I'll give it what I got and hope for the best!

I was staying up real late last night (till 6am) because I just wasn't tired, so at least I got alot of work done. But there was something that kept me going and it was all of you back home. I have been working from my desk the past week which is FILLED with pictures, cards, letters and drawings (thanks Anna *wink*) and it made me smile non-stop. I was so happy to think about "all I need to do is get though the next few months and I am back with all my loves".

I just hope you all know that even though I am out here doing all this work - I couldn't have done it without you all. Sounds corny but it is true. What do I do when I am at the end of my rope and start crying because I am yet again feeling overwhelmed? Read mom's cards or look at Anna's pictures! What do I do when I feel like I will never get off this island and feel in a slump? Read Tony's letters or look at pics of everyone in the t-town crew! I mean it when I say that I wouldn't be here without you guys behind me and I love you so much for that. So thank you for helping me live my dream!

Back to studying I guess if I wanna be outta of here in 39 days! Yay!

The race is on...

Well, here I am - back again. I had such a great time visiting at home but had to get back and catch up on all my missed lectures and get ready for mini #2. I've been away from my blog - so what do you know - mini #2 is here!

It's been probably the hardest time so far on the island being here. Catching up only took me like two days so that wasn't bad at all. But just the adjustment back was harder on me. Not to mention studying for the mini has been insane. Over 100 drugs on this mini alone and while our mini is on Monday we still have over 10 hours of lecture left to go this week. Crazy. Oh well. Once this mini is over - we start going DOWNHILL - again for the 3rd time. I can't wait to get back home next month. The last semester break before my LAST semester in Dominica!

I finally have been able to do some things for myself now to keep my spirits better than before. I had my "shoe fiasco" where the store gave me 2 left shoes when I was home in May but I got that fixed so I have been able to go to the gym pretty much everyday! Ahhhhh so much better! I also made a nice Victoria's Secret order that I will get when I get home next month! New bathing suits! I haven't even touched water since I have been here (so sad I know) but Tony and I are going up north to his cabin for a few days and now I can look good while I am there! *wink*

But mostly I have been thinking about home more and more. I used to stop myself from doing it because it made me so sad since I missed it. But the stress this semester is unreal and I find that i have to think about being back in Michigan. I think alot of people in my class can see how irritated I am alot of the time but most agree that they feel the exact same way as I do. 43 days and it is the end of semester three - and then I will be nearly half way done with my second year of medical school!

So, with that said - I must go again... I'll be back though, alot sooner than last time! Miss everyone at home so much!!!!

P.S. I hate missing holidays and at the closing of yet another holiday away from home I hear popping outside - FiReWoRkS!!!!!! Just a about 20 little fireworks but put a smile on my face!

In transit... yet again.

Here I am in Orlando and I am not too happy about it. Fortunately, I have a pretty big hunger to study so I guess that is good because I have alot coming after me when I get back tomorrow.

I know I will back home in less than 2 months but I just keep hearing everyone say, "Oh just two more months and you will be home again." THat BUMS me out so bad to hear that. At least July is right around the corner and I am hoping that will fly by. Mini #2 will be coming up quick and then my birthday is on the 20th! After that August is soon to follow, no doubt and homeward bound I will be once more.

I have been troubled thinking lately whether this is all worth it. Of course it is what I want to do but the thought of "Where will I do my rotations?" and "How much debt am I in by now?" is really starting to take it's toll on my mind. After this break and getting more and more excited to come back to everyone and Tony it makes me nervous thinking whether or not all my hard work will pay off. I see all my friends getting great jobs and starting their careers, and I guess in a sense I have too, but I can't help but feel a little jealous of their security. I feel on edge all the time with everything I study and get examined on.

I am starting to sink back into the, "If I'd only gotten into a US school..." fill-in-the-blanks. So pointless and depressing. I just think of money I could save (be it not much but I am a tight-wad), be closer to family and friends, feel like I have support more nearby... Just makes me sad thinking about all that - so why do I bother? Maybe because it makes me appreciate home or (most likely) because I have always been a person that has just felt that my best could always have been a little better. Even if it was impossible - I should have done things different and better. I don't know how I can expect so much of myself - it will disappoint you everytime. For instance, I bumped into my old Chem I & II teacher from high school while I was home. I was excited to see him and tell him what I had been doing and he was very happy for me. Then he asked me to come to the high school sometime and talk to his class! Funny thing is, ever since I saw the medical school/professionals panel our teachers had done for us - I wanted to be that. I wanted to come back and tell others that they can do it too.

But then - self-doubt. I thought - well if it is a panel, why would he want me? To most, I am at the lowest part of the food chain by medical student standards (the Caribbean stigma). I don't want to endlessly answer the question "So why all the way out there?" all day long... I know it sounds awful. The truth is though that this self-doubt plays in your own mind and it is up to you to move past it. Typing here now I am working on it. With my own self-doubt I am playing into that stigma and truth-be-told, I am proud of where I go to medical school. Of course, I whine about getting out of here someday (live down here and you'll figure it out for yourself lol) but I feel like I am getting a great education - and while I am being force-fed information non-stop all year round I know that I will be able to retain and pull all this knowledge together to become a successful and competent physician someday.

I think it says alot for us to be down here - giving up our lives - family, friends, comforts and for me - especially special times missed with everyone at home (I hate missing anything that happens... I have been friends with everyone so long, it feels strange not to be a part of their "everyday life"). No offense to U.S. students or anything because I know they work their butts off too but it is just different down here and unfortunately it is something only us Ross students and grads will ever know about. Of course, anywhere I would have gone to school I would have developed my own sense of "school pride" but to me, the experiences at Ross have made me a stronger person (even right now when I feel a little weak). This place toughens you up and you can just (as much as I hate this phrase) suck-it-up or just let it spit you right back out. When I think of our class moving onto rotations, I think of us not whining about scut-work, hours we work, whether the A/C and computers are working and whether or not we get a decent meal every night. We have been though it already and we know to accept what we get and to let the rest just roll of our back.

I look forward to the time when I see a fellow med student in rotations whining about petty things and I picture Ross' students just being able to overcome such things with a smile and upmost dedication to doing the job and doing it well. As much as I need to take heed of my own advice and dare I say, take some of my own medicine haha, just don't play into the stigma. "Why did you go to school all the way out there?" Me? I sigh in my head (exhausted from this question) but say with pride "Because they gave me an opportunity and I grabbed it with both hands and ran with it." I have pride being a Ross student and while I know there are going to be issues ahead of my education - I'll do what I do best - persevere.

... I guess that is all I have for now - I am organizing my computer to prep for the insane amount of studying I have ahead of me. Speaking as a Ross student, all I can say is bring it on... but please send me home after!!!!

Leavin' home tomorrow...

Well, this one will be short but I am leaving my favorite place in the entire world - Trenton. I had a great last night at home, nothing too big just hanging out with a few friends at Big Al's for a bit with a few drinkies. But all along I was waiting to get back home to wait for Tony to get home from work. We are going to the movies tomorrow morning then to lunch before I take back off to The Rock. I am bummed I have to leave but now it is less than 6 months until I am coming home and I am so happy.

This break was great - I got to relax, be with family and friends and get my head back straight a bit about school. I needed a break and know I got one. I am ready to work hard and get back to it. Sadly, this break - actually just recently, my dog Mindy passed away and I am so sad about it. Long story short and not wanting to be a downer - I'll miss her. I remember when we first got her when I was 12. She was THEE CUTEST puppy EVER. She had a great voice too (I used to sing to her and she would sing right along...)! She was such a great girl and I will miss her so much. I hope she knows how much I loved her even though with college and Ross I haven't been home that much....

But also, on a different note, Tony and I did something quite exciting together - went shopping for engagement rings! It was so strange to do that but amazing at the same time. Tony is the love of my life and even though we have been best friends for almost a decade - I know God brought us together just now for a reason. Pretty soon we will be celebrating our one-year anniversary and I can't believe it! He has been a great support and I can't imagine my life without him! After shopping I took his sister to look at the ring and maybe tomorrow if there is time, his mom wants to go take a look! We aren't buying it yet, actually - it is all up to him. As he says, "It can be sooner and less romantic or later and more romantic." (because he has it all planned out how he wants to do it). We are both so excited for it but are trying to hold off... now that I think about it, I don't see why. We love each other and know we are meant for each other so we should do it. Anyway, it was a very exciting experience for us!

Well, he should be home soon so I better get going. Next time I post I might be in transit back to Dominica or if I am tired back to Dominica completely. So much work to do when I get back - but I am so motivated, as always, by my trips back home...

P.S. Tiff you rock! :) You can always put a smile on my face by your comments - love ya girlie!

Exciting News!!!

Well, mini 1 didn't go as well as I had hoped but at least I didn't fail anything. But I am so disappointed though still and always am even if others are wishing they had my scores - just who I am I guess... But anyway, while I was in the airport, I DEFINITELY did NOT get as much rest as I wanted to for this trip but it was such a different "turn of events"!

On my way out of Dominica I sat next to a lovely woman named Valarie. We spoke a little about her kid in NY and herself as well. I slept most of the way. But then as I woke up and we began talking again about how long my trips can be and how I came to be a student at Ross - then out of nowhere she was like "I know you don't know me and I don't know you - but I would like to give you money." Umm... what??? I was flattered by her offer, which she was making because she had told me that others had helped out her daughter in NY with small things and she was I suppose thinking of it as a "pay it forward" kinda thing. Of course, I declined over and over again - thanking her but telling her I would not feel comfortable doing that. But she persisted on for a long time and frankly seemed a bit offended if I refused again. She reached in her purse, pulled out and gave me $40US! I was stunned really. A stranger just giving me money to help me out? Wow. She told me to remember her when it seemed stressful and when I became a mother as well to remember this and in a way "pay it forward" to someone else. I thought it was such a nice gesture. I am very grateful and still feel a bit strange about the situation but that $40 came in handy. It helped me with my taxi ride from JKF to LGA airport and bought me some dinner and coffee! THANK YOU VALARIE!

So, I get to San Juan - and await my flight to NY. I tried to give my ticket back because they were giving comps but in the end it didn't work out. I sat by a man named Frankie. Such a sweet, funny and personable man and we spoke for nearly the whole four hour flight! We spoke of course of Ross, then his businesses (a man who never graduated college but had become a great success) and all the little things inbetween (we nearly had a spat over Paris Hilton - I couldn't believe he loved her so much!!! HAHA)! After some I found out that his success was in the MILLIONS. I'm sitting next to a millionaire lol, nice... That honestly didn't phase me in the least - good for him! But then we began talking more about Ross and got into the conversation of the RFDH foundation. Immediately he was interested, wanted to know more and was just intrigued by some stories I would tell. He looked at me and said something like, " I would like to do something here and and have my company help the foundation buy an incubator - the whole thing." THE WHOLE THING! I was floored!!!! How amazing is that?!!! I was floored!

Well I hope I hear from him soon. But as for now - I'm home! I am so happy about that but trying to get over this mini for right now. Hard to gather the motivation to keep going but then again I am no stranger to bumps in the road (<--- really). But I am going to go work on that motivation! Catch ya'll soon...

Everything comes full circle...

What an interesting few days. Well I had my mini and I think it went really well. I am tempted to check my grades like everyone else has but I could never bring myself to do it! But I hope it went as good as I feel like it did. The OLAS boat party was great and everyone said they had a great time which made me feel good and my efforts worth the work. After that though I just wanted to go home and sleep so I did. Of course only until the construction workers came at 6:30am to use all of their circular saws and jackhammers or whatever they were using to wake me up. Ah well - I had a long day of things to do anyway. On the way to campus I realized that it was the day of Pass the Bucket. I was just EXHAUSTED from OLAS and now more things to do for my foundation. But since most were hungover and not attending class, we postponed this until the next day. I swear though, after all of that I was so ready to get out of Dominica. I just couldn't take it anymore. I was so tired... and still am.

...But I must say after the mini, out on the OLAS cruise and even the next morning passing by the locals who are always so warm to my morning greetings - I found myself rethinking how I felt about the island. Maybe it was just the high stress but I have come to realize things like that - be it a "good morning" or a hug from a friend on campus and more that I will mention later - it all comes full cirle and for me when I just least expected it - I found simple joys out of such stressful days.

Well it is now Thursday morning and I have saved you from blogs of bordeom from being in airports all day and night; but here I am, in NY's LaGuardia Airport awaiting my last flight home at 8:40am! I havea about 45 minutes until I board and I am so - not even excited is the right word (even though I am) but RELIEVED! I need to be home right now so badly. I am just zonked from all the studying, all of the extracurriculars and the island as a whole.

...But again looking back I recall a day or so ago getting so much praise and thanks for my work with the foundation and getting a replacement monitor for the neonatal ventilator we got Princess Margaret Hospital here in Roseau. Customs was giving us SUCH a hard time and I was getting BEYOND frustrated. After all, it was a donation and I just wanted the hospital to start using this equiptment we worked so hard to get to them. Well, once the day was about over I washed my hands of it (of course just for the rest of the day) but I was upset because it seemed that no one else (meaning the head of the hospital or even our advisor was too concerned). Of course, I knew this wasn't the case but I just felt like as usual I was doing ALL the work and I was just so tired of it. But upon getting nearly half-a-dozen emails from Dr. Grell, Dr. Burnett, Dr. McIntryre, Dean Myers and the founders of how great I was doing with running RFDH - it kinda melted my heart a bit which was once so frigid and cold about the whole situation. I realized that others did care alot about what I was doing and felt it was important, which inspired me to keep going.

All in all, I guess that this post is all about knowing that while the bad comes with the good - the good also does come with the bad. While I still desperately need this break at home I already feel a sense of excitement about continuing my work in the foundation. I am just hoping that those students out there that not necessarily are with extracurricular things but even just with school - take the good with the bad. Sure maybe a mini didn't go well or maybe you are more homesick than usual. But take any negative energy you have and just work to make it into a positive. Use that bad mini to push yourself hard for the next one and use that homesickness to use as motivation to study hard and get home to those you love and miss! Of course, when you are feeling near the end of your rope (like I do a bit now) - take that break! Use some extra loan money to take a trip home - your mind and body will thank you for it and you will get such a refreshed feeling from being back home.

It is all worth it in the end and I know this experience I will always cherish. I joke around with my mom that I will be in years and years of therapy for all this - but of course I know that oddly enough going through this will make me such a much stronger person in the end and I can truly get through ANYTHING life throws at me.

First mid-term of my second year tomorrow...

It is here already!!! Mini #1! All I have to say is - it's about time. So many people are behind and worried but I really am not. Sure I have more to do, but you can honestly study for this exam till the cows come home and still forget stuff. But I have been working so hard the past five weeks and I hope and think that it will pay off tomorrow!

Aaaaand of course what is after the mini??? BOOZE CRUISE!!! I hope it is fun! Tuesday is my busy day... I want to have all my studying done (there were a few lectures I skipped last week because they weren't on the mini) then I still have to pack - because - OH YES - I am leaving Wednesday to go back to Michigan. I can't wait! I might cry on the plan - well maybe just pass out from pure exhaustion!!!

Doing well on mini 1 puts you in great position not just for this semester but for 4th semester too. So let's hope I can pull that off! Well back to the books for now - but maybe I will pack a little later for fun, hahaha.

26 hours to go till the exam! :D

Sigh...

Friday nights. Boy do they mean something different now, haha. It's going on about 8:30pm and I have been exhausted since the day began. Tons more work to go tonight and I'm really not all that excited to get back to the apartment either since I missed my laundry drop-off and will have to sleep without sheets tonight... nice.

Still looking for my second wind - it must be lost over the stacks of books, lectures and coffee cups I have laying all around me, haha. I feel like that train, "I think I can, I think I can, I think I can!". Maybe another coffee would do it! I could soooo easily go home right now but I won't do that. I am going to keep going most likely till 2ish in the morning. If I could do that (and of course REALLY get some fine work done) I would be so proud of myself. Since the laundry has to come in the morning I can't make it to campus until around 9am - boo! But that means I can sleep till then too! Yay! All the more reason to stay up a little later!

Oooooh I just saw my mom sign onto AIM! Yes, I was just starting to feel lonely!!! Aww, okay well I am going to chat with mama (hi mom!) and get back to work! I can't wait till I can start posting stories about myself working in the hospital - I always worry everything I type is so boring lol. Ah well, everyone has to go through the classroom stuff before the clinicals! And my classroom time is just about up! ;) Holler! :D

Race to the finish line...

It's Thursday night and I am sitting in my usual spot in Classroom 5, doing everything I can to push myself until the mini. I'm exhausted but motivated still. I know I am leaving for home in five days and I can't wait. Not only have I been busting my hump with school but also with the organizations on campus I am running. After the mini on Monday, I am putting together a boat party for OLAS or a "booze cruise" lol. It should be fun but man - parties are exhausting to plan! Ah well, at least something to look forward to!

With all this studying over the last 10 months, I think one of the worst things you can do as a medical student is worry about other people, in the sense of how well their studying is going. Have they read the book? Did they do all the suggested questions? How long have they been on campus? Then you worry about the volume of material and who seems like they have mastered it and who doesn't. Maybe it is just me but in everyone's own way, you think about how well others are doing, and while you don't wish any ill will, are wondering whether you are just a step above them or below...

It isn't so bad now for me but it was. With the mini coming up and watching people pack up and leave campus to go home for the night at 8pm I wonder how they can possibly be done! So much to do and so little time to do it - especially in such an accelerated program. Is there something I am doing wrong to where I can't be finished as quick as them? Well, it is all about mind games in medical school too - actually in any kind of school. In my opinion, when I see others leave early I think of them going home and watching tv and nothing more. Then I think of how much more I will be ahead of them if I can just "gut" this out! So that is what I am doing now. So for all of you getting ready to come down here - get your mindset into these kind of mind-games. It works! When it comes time for the mini, give yourself all the goodies and energy drinks you want if it will make you happy - you are giving up so much by coming down here - treat yourself for working so hard and you mind will thank you and allow you to push yourself harder... Speaking of which this cappacino is really good - mmmmmmm.

Well, more pathology questions to do but I will most likely be alone in classroom 5 pretty soon so I may write again before I go home tonight - whenever that is! Love, love, love! :)

Overly frustrated...

Well today was just - UGH! I don't know what it is, but sometimes days just get to you here. I'm sure this is the same anywhere but I swear I just couldn't take campus today. Everything frustrated me, mostly the people. No offense to those reading (which are my friends anyway, so you should know I'm not talking about you) but I'm just so sick of trying to study and I just have to deal with so much random stuff or conversations that annoy the crap out of me. Today I had someone I know in class bug me about files I had. I was nice enough to give a real helpful one but then while I was in my email looking to print off flyers for my foundation (Pass the Bucket is next week), he was like "Oh what's this file? What's that file? Can I have this? Is it helpful? Why is it helpful?" Oh my gosh! STOP!

There are two things that have got me irritated today: those who can't do there own work and those that honestly don't seem to belong in their second year of medical school.

I know this post must sound harsh, but it is true. I hesitate to use specific times and people but I will at least say I just don't know how some people pass. "What is the cause of epigastric pain?" says my prof. We go through the differential and everyone either isn't participating or is stumped. After GERD, peptic ulcers, etc - of course I say pancreatitis. The professor agrees and right after that someone says "Pancreatitis!" Umm, okay wow. Just said that. Don't act like it is your idea (which this has happened so many times!). Then there are those that act like they know the answers to everything but in all actuality have no idea what they are talking about and try to weasel their way out of it by making up some ridiculous reasoning, e.g. why stress causes ulcers or whyoxygen is so important (alright that last one was made up out of sarcasm) Okay, okay I'm being unfair - I don't know every single basic questions either but I mean for one, we learned these basic things a LONG time ago and second if I don't know a question to which I am already supposed to - I don't waste my classmates and professor's time by asking. I look it up before I embarrass myself. I guess my point is, that there are just some people I don't see how they passed.

I am also so frustrated by the lack of "street smarts" I see some students have. Sure, they can be book smart but when I am around trying to have a basic conversation, see their interactions for behavioral with patients or really their whole personality - I just don't see how some can cut the mustard. I mean they will pass but in clinicals? How will they survive? I guess butt-kissing might get them far (which I though I would finally leave behind in high-school but that is still around ad-nauseum). Note to future med students - patients aren't scary!!!! They aren't dumb either. I already see it lightly. In interviews, "Have you had any previous blood transfusions?" "No.", the patient says. "Well, you just told me you had two surgeries so you must have had transfusions." Umm okay, WHAT? Were you listening to her? Wouldn't you think she would know if she has had transfusions? But of course because EVERY operation requires transfusions... and of course for the fact you are a second year medical student - hey - it's practically a doctor, close enough right? Again, we are still so young in our studies I should not be so critical. Just from time to time things get to me and I guess it builds up.

I'm not saying I am a perfect candidate for being a physician. I have plenty work to do as well. This is just my rant I guess and just meant as nothing more then to vent. The mini is just a few days away and I am at my wits end here on this island and I want off! Ah well 6 days more then I get a break. Don't mean to upset anyone because now I feel better lol. But I just hope that those that leave this December with me from 4th semester are a group that I can be proud to be a part of. Don't get me wrong like 95% of the class this is true for - just those select few that always put a cramp in my day.

Sigh, okay more books for me. I'll talk to you all later.

I LOVE MY GIRLS!

Okay, another post! I just went to the mailroom and got my card from Anna. She is great and always sends me letters and drawings of holidays I miss while I am gone - very sweet. But this??? OMG - so wonderful!

Back at home my girls, Anna, Bethie, Stebba, Erin, Julie, and Stace got together for a girls night and throughout the night drew me a HUGE banner with pictures, quotes, notes, "Jess loves Tony" with hearts (hehe) and so much more!!!! It is HUGE!!!!! I have been looking at it for like 10 mins and I STILL haven't read everything!!!! I am honestly the luckiest person ever. Seeing that, even though I love you and miss you all like crazy, reminded me how blessed I really am to have each of you. So thank you all SOOOO much!!!!! I love you with all my heart!

I can't wait to hang this up in my room! I don't know if it will fit!!! :D

See you all in a few days!!!!

Undying motivation...

Today I found myself awake at about 5:20am. I got up, got ready for the day and busted out of my apartment and got set up to campus by 6am. Yesterday, I was on campus from 7:30am until 11pm and the last 3 days last week I was on campus from about 7:30am-1am the next day. My eyes are as red as can be and sore though my body and mind are ready to go another 10 rounds. Where is this coming from? Is it because I am going home in a few days? Or that I am just determined to kick this mini's butt next week? Maybe both, I don't know but the hours I am putting in I think are going to pay off big time. My study techniques have always been, well - sub-par in my standards but lately I find my studying more effective. I must give credit to the new topics I am learning too I suppose.

I am very happy with how things are going and while it is still early in the morning now (6:55am) I can't wait for that bookstore to open so I can get a nice, big, hot coffee!!! Aaaaand maybe put in some eyedrops - these babies are REAL red lol.

Let's just hope I didn't jinx this! Back to practice questions for pharmacology...

Okay, back - it's about 9am and I am having issues. Every now and the Ross brings in people who are interviewing for positions on the faculty. To do this they also teach a class or two. Okay, this person has been having like 10 lectures and I feel bad to say, they are very disappointing. Not only are the notes scattered and all over the place, but alot of it too is basic and what we learned about 10 months ago. Not to mention she is telling us about every single strange bloody bowel movements she has ever had. *Shudder* I know I shouldn't complain because if I think it is easy, what's the problem? I know I know... But I am slightly offended by being taught some of this stuff. "I don't expect you to know the different kinds of DNA polymerase but I do expect you to know that DNA polymerase, polymerizes DNA." Well - yeaaaa. This is old hat, why is she teaching us this? I guess I just feel that this is time wasted that we could be learning new things and taking time away from studying. It's just a bit obnoxious that a person comes in to teach us, but is completely oblivious that we have learned alot of this. Sorry had to vent about it. Only like 5 or 6 more lectures with her but jeeze - I can't get over it yet.

Anyway, alright NOW I gotta go lol. Catch ya'll soon.

My first patient history...

Yet another milestone to add onto my educational experience!

So we get started and I walk up and sit down next to her saying, "Hi, my name is Jessica and I am a second-year medical student and I am here to just take your history if that is alright." "Yes, okay." she says. Crap why couldn't she say no! No you can't take my history - get out! Okay :) and I'll just zooom on out of there :P

I actually was not nervous at all today like I thought I would be. At first I was trying to memorize all the questions to ask a patient but as it was approaching I realized - dude, just have a conversation. Lord knows I know how to do that - I love people!!! So I walked in today and met my patient M.L. who was very sweet. I was so glad I could understand her accent too. We get to talking about her demographics, then her problem that brought her in today to see me. A couple months ago she fell and had trauma to the back of her head and since then has been having contant headaches even with the medication she had been given by her previous physician. After that we got into her past medical history, family and social history and finally a review of systems.

Everything went real smooth with of course a few bumps along the way. She seemed to be receptive to my smile and cheerful attitude even though I was trying hard not to be too perky or anything like that. I did forget a few things but not too much! She said that comdoms "scratched" her (alot of history taking here is learning their own words for symptoms - e.g. instead of having "diabetes" they have "sugar"). But I didn't ask the type she used, even though most problems tend to be latex allergies. Also, she had to remind me to talk about the number of partners she has had. But all and all I think I did well. This will be my case write up for the semester for sure for the final exam.

Afterward, I went up to my professor as well as the patient to get their opinion on how I did. The professor was pleased and I think mostly he was impressed by how comfortable I made the patient by sitting at her level, not being intimidating, making lots of eye-contact and so on. To me - I never thought about that - it's just how I am! So that made me happy. I knew my cheery bedside manner would pay off someday :P M.L., who has participated in these groups before also told me that she thought I did well - and that made me happy too. She has seen alot of students go through this so it gave me some confidence - thanks M.L.!

But now it is time to get back to the books. It is going to be a long night of studying - the mini is less than a week away! I just have to keep thinking about coming home in 8 days and push on! I can do it, right?

Well off I go, but I will write again soon!

Sleep is good...

Well, it's a new day. Last night I finished up around midnight and headed over to Fusion (a "bar") here on the island and stayed up a little past my bedtime. Okay, when I went to bed the sun was up. Ah well, I had my few hours of fun and back to the grind. I'm sure another nap is in order but it isn't so bad because it is hot studying in the apartment here during the day. Campus is being shutdown in a few hours for electical upgrades so home it is.

Tomorrow is my 2nd ICM day (intro to clinical medicine). Basically, we have locals come in and let us perform physical exams on them so we get more comfortable with the whole process. Last time we just basically did a head-to-toe survey of the patient and pulses. Tomorrow we are working on JVPs, blood pressures and normal/abnormal heart sounds and murmurs. It should be awesome but I really haven't done too much for this class so Iwill have to brush up tonight if I can. Then in the afternoon we have our behavioral lab where we take histories - and of course I volunteered to go. It will be nice to get that out of the way - I just hope I get a local who's accent I can understand! I'll give it my best shot I guess.

Only 9 days until I am out of here for a while! Heading home June 13th and staying home until June 22nd! I am so excited!!! 8-9 days at home is going to be such a nice break. But I have to get through the next week of studying and work hard to do well on Mini #1 next Monday.

I better get to it! Miss you all but I'll see ya in a few days!!! Muah!