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! :)