What's Jessica Up To?

Ross University School of Medicine 2010 Graduation

2010-06-10T08:55:00.003-05:00

As of June 4th, 2010 it is official, I am now a physician! Graduation week ended awesome, just packing things up and ready to make the 10 hour drive to NYC. Nice scenic route with good convos the whole way. Along for the trip was my husband, dad and I in one car and my mom, step-dad, sister and grandma in another. My own little entourage, haha! We get there, pretty tired and ready to just have dinner, drinks and some sleep to get rested up for the big day we all have been waiting for!

My I woke up at about 5am just to slowly get ready with a shower, straightening my hair, makeup and truly not sure what to expect. I was able to meet up with my friend Robyn in the lobby of the hotel which she was staying at too! It was so wonderful to see her and walk over together to the Theater at Madison Square Gardens across the street! We went with gown, tams and hoods in hand ready to see what was in store. We arrived about 7am to what we thought would be an organized get together to see old friends from Dominica and mingle - weeeelllll, there was mingling but organized? We were packed in there like a can of sardines, haha! No places to sit until we walked in at 9:30am outside the doors of the theater, which was great for us ladies in high heels - ouch. We had a continental breakfast, though I wasn't too hungry... I was just anxious to get in there! Then the fun part of the day came... getting in alphabetical order - alllll 650 of us! I was kinda bummed because I wanted to be by a couple friends but turned out just fine. Then 9:30am came and Pomp and Circumstance began to play. We were broken up into two lines A-L, M-Z and I saw the first group walk in first. Finally when it was my turn to enter into the theater, I had my first thought. I rarely remember "what was the first thing on your mind", but it was God. I, as well as all who read this blog, know how difficult times would be for me throughout all of this. The times I thought I would fail; the times I didn't fail but wanted to quit; the times I didn't quit but found myself sometimes crawling my way towards the next goal or milestone only to come out, on this day, a graduate - a doctor. I remember giving my thanks to God, just knowing He made this possible by giving me the strength to push myself, dare I say straight to the edge haha... But then I walked in, of course looking for family in a huge crowd.

When we were seated, I was in the front row on the right side of the theater. Everyone was waving looking for family way up in the seats. I did the only thing I could! My mom and I have always outlined a heart to just say I love you. This started back in high school when I was at track meets waiting to start my races. I sometimes would be scanning the stands over and over because I never felt right starting a race without her. To get my attention we would do the heart and worked like a gem during this fine day! After the last of us walked in, a standing ovation for all the graduates. Cue in the tears! There was nothing I could do about it - and I didn't want to, so I let my tears roll. I think those next to me thought I was nuts. Oh well! Next were the welcomes and commencement speeches which were fantastic! Here is a link to the address: http://www.rossu.edu/news/Dr-Dexanne-Clohan-Delivers-Commencement-Address-at-Ross-University-School-of-Medicine-Graduation-Ceremony.cfm They all had great messages that seemed so relevent to me, especually this commencement address - truly touched me. After this, they stated our requirements were fulfilled and declared us fully qualified to graduate as physicians. One row at a time we lined up to go backstage, where we were again lined up like a snake wrapping around the poles to stop at each checkpoint: name card in hand, hood folded neatly on our left arm, smile and GO! We went out in sets of three, luckily I was the last in a set so I could stay on the stage the longest. As one of my old professors took my hood, I remember him saying "How are you today?" All I could tell him was how nervous I was! I didn't even have to do anything haha but it was just so exciting! I passed by the other professors who hooded others, saying hello and handing my card over to my old faculty advisor for the student council, which I was the president of on the island. It was great to see her. I still don't know if she truly recognized me, now that I was graduating under a different name but she gave me a hug and a familiar smile so I am hoping that she really did. Then she passed my name card down to the speaker and stood in front of the podium where he annouced my name, "Dr. Jessica Lynn S." followed by the screams of my family and friends! It was such a quick moment but I will never forget it.

Once the empty diploma holder was in hand (haha, fyi just got it in the mail today!) I walked back stage where each person from MSG I saw congratulated me. I kept thinking, "They are congratulating all 650 of us?!" I was impressed because it seemed so genuine. Moving towards the back I had one more picture taken and then I moved back down to my seat to watch the few others get their diploma as well, I swear I screamed for at least half of us - I forgot how many people I reall knew! I saw each of them get hooded, coming from a new, scared person just landing on "the island" not knowing what to expect from such an institution coming into their own now looking so professional, proud and most importantly prepared and eager student turned physician, ready to go out and make a difference in the world. I literally was in awe, as though I was watching the best fireworks show on the fourth of July. Again, I'm sure people looked at me like I was nuts - but that was just fine by me. I was soaking it in baby! After we were all seated, we recited the Hippocratic Oath and were proclaimed graduates, alumus and now forever fellow physicians heading out into the world of medicine.

The day was followed by good times in NYC, some drinks great food and another night of sleep in the city that doesn't sleep. We woke up early and were on the road by 6:30am Saturday, ready to get home for a relaxing day and night with friends. Overall, a wonderful, fabulous, time of my life, one of the best days of my life! I am so grateful to my family and friends who have supported me and finally have found myself to be proud of my accomplishments, in and of itself was no easy task! I had always struggled with looking back and being proud of what I did, and I can say now that I truly do.

I am now a proud graduate of Ross University School of Medicine and a prepared and eager new physician truly ready to make a difference in our world. Congratulations to my friends and now collegues - WE DID IT!!!

Hippocratic Oath (modernized)

I solemnly swear by all that I hold dear that I will carry out to the best of my ability and judgement the duties and responsibilitiesimcumbent upon one who practices the profession of medicine.

I will abstain from any act, either by omission or commission, that could harm those I serve; and never will I betray the confidences of those who place their trust in me.

In order to best serve my patients, I commit myself to a lifetime of study so that I may stay fully current in the practice of my profession.

With full understanding of the special place of trust physicians hold in the hearts and minds of their patients, I dedicate myself to the service of all who seek my care.

Graduation Week!!!

2010-06-01T10:02:00.003-05:00

Here we are - graduation week!!! Things are going well with my time off. I really utilized my time and made some great improvements to the house. My research for my third project is near completion (finally) and now time to get ready to forevermore hit the books for my upcoming residency, which I feel ready to begin.

Of course though, we can't have a smooth road to graduation, haha... Oh Ross. I really have not had to rely on the school for much in terms of obtaining rotations, I have done all on my own. The problem comes after the rotation is done and the more tortuous road to getting evaluations completed, submitted and graded. Goodness! I understand how many students there are but come on, no need for excuses. I have now been done with rotations for six weeks and still my last evaluation isn't graded. Of course it makes me nervous for graduation. Am I cleared? Can I go? If I show up with my tam and hood - would I even be on their list to call to the stage?! After a million (almost literally) phone calls, I am assured that I am set to walk. Basically at that point I just have to take their word! So frustrating when I am very punctual and proactive to get things done as soon as possible to have such a slow response.

Finally, the grading... Sigh, I don't know who came up with the grading system but I know for a fact that my attendings are not familiar with our system. Basically it is 4 categories of ranking students 1-5. The first two (knowledge based) are weighted twice as much as the last two categories (personality, responsibility). Anyway the point is I had a grade that was absolutely ridiculous. My worst I think since biochemistry, haha. When I called to check on it, there was a bit of shock how their rankings translated into that grade but it was a two week rotation which meant it wouldn't count for much anyway. It was so close to graduation that changing it would probably tack on an extra month or two of constant phone calls. It was looking like I would be graduating with honors but alas looks like I will just miss it although changing this grade would still not change that fact. So, I left it alone. Just think it is interesting how the grading system works. I think there should be some sort of reform to this like even having a part where the attending gives their suggestion on the letter grade to give because I am sure that some wouldn't agree to their translation of their 1-5 rankings... Anyway, just those last minute frustrations! Nice to vent it out and move on because let's face it - bigger things are on their way!!! :)

I am so excited for this week and really didn't think I would be. Now being June, this is my final month (not even) before this craziness begins... Again, going at it with a positive attitude. Can't afford to dread starting and thinking negatively - that will make it just a terrible and depressing experience. So I am really looking forward to it! Still working on planning a balance for the house, timing out more appropriate days for housework, grocery shopping, time with family, etc. It will all work itself about and hopefully soon will begin to get my first schedule!

I did find out that I will be having a Wednesday clinic to see my own patients! I think that is a good day, it will break up the week! It will not be on the main campus but that is alright. I will be with two guys I have been talking with on Facebook and am SO happy about that! All in all, looking up! :) I can't believe that my whole four year process is here, on this webpage - all my thoughts, feelings, frustrations, elations, etc. I definitely plan on reflecting on some of these posts throughout this week and REALLY try to take in the importance of this week. I will official be a physician forever after and feel truly humbled with a intense feeling to be sure I live up to not just my own aspirations but expectations of those who will train me and dedication to those patients I will serve from this time forward!

...For now, just gonna enjoy this week and celebrate in it! I will start it with a big WOOOOOOHOOOOOO!!!!! :P

Just a hello during my time off!

2010-05-18T07:42:00.002-05:00

Hi all! It's me in the middle of my time off! :) Things are going well which to me means, I am keeping busy. It is very hard for me to be able to kick back and relax, so I have been doing my usual housework and research but alot of fixing up around the house and outdoors. I wasted no time getting started as my first week off I began building a retaining wall/flower bed around our patio we got last summer. The week after that I had to rip up alot of rock and fabric liner around our house to prepare for a privacy fence and white picket fence on our corner lot, which will really expand our backyard space. Over the next week or so I have finished picking and planting my flowers and herbs in the flower bed (had to wait until it warmed up a little bit more). It is such a transformation! I am working on anything and everything to make the house as improved as possible before beginning residency - that seems to be my focus...

That being said, I have also become quite the coupon lady lol. My wonderful mother-in-law has been getting me into it for about a year now but now it has expanded to not just groceries but to things at Walgreens, CVS, etc. It's now an addiction! I only buy things on sale and what I have coupons for to make it a double sale (=clearance, lol?). This plan also is to prepare for residency. I enjoy doing alot of the housework around the house even though my husband is fantastic in doing this as well. I love trying to do it all, which I am sure will come back to bite me soon enough. Though, by keeping up with my sales and stocking up on things in our giant pantry, I am hoping that it will save me from having to do big shopping runs and saving time to be home when I am off!

I have been looking up different ways to prepare for residency, though not in my reading and studies -that is a given. But ways to prepare my home and protect my time off from certain chores that can either be done on a scheduled day or to find ways to make things easier/fast to do. Also, looking to make my own "happy bag" (name of the bag is a work in progress, haha!) for my time in the hospital. This will include things like food, my iPod for morning pre-rounds, organized rounding sheets that I have made, pictures, bathroom things for refreshing/on-call like face wash, toothbrush, deodorant, etc. I think it will help me get through the days easier. This will also be helped with finalizing my own plan of how to complete my work. Since I have done my rotations at HFH, I know what a day in the life is like as far as rounding, lectures and call nights. This will make my days run smoother and full of me frantically running around or confused at what needs to be done next.

Time is moving along quickly though. My graduation is later than most, coming up June 4th at Madison Square Gardens! Should be a nice trip spent with my family and fellow graduates. More of that to come! We are trying to plan little weekend trips but I am at least hoping to be able to SIT and relax. Slowly, I'm getting there but in the meantime I think I will keep getting things done! :) Gotta go for now, but plan on writing again this week of wrapping up rotations and getting set for my graduation audit!

Life's to do list: Medical school - CHECK! :)

2010-04-16T06:21:00.012-05:00

I really wanted to post before my final day, today April 16th, as a medical student. Particularly how I felt the day before. First of all, oh my goshhhhh the senioritis was in FULL swing. I was starting to find myself staring off a bit more, antsy to get the work done. I feel bad because this month was great and I didn't want to be disrespectful but I couldn't help thinking about the end. So yesterday I had clinic with my attending. It is pretty laid back, the only issue I have with this is for some reason new patients come in and I get a 5 second history then BOOM - go. In hindsight, it wasn't really any different than Step 2 CS, lol. But this was a patient referred to the clinic and not knowing the full story was a bit irritating. Just gotta forge through and get the job done. Really wasn't that bad and in the end thought it was good to just get thrown in there and be exposed to more situations that might not leave you feeling as comfortable as you would like.

Oh,the symmetry of medical school! Little did I know, yesterday April 15th, was my final day in medical school. This last day situation reminds me of the FIRST day of clinicals (see my July 15th, 2008 post!) where I had the same feeling of just wanting to be thrown into the uncomfortable situation and face it head on. "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 think this is a great attitude to have in clinicals. It makes you so unafraid to go in and do it again afterwards and makes you so much stronger!

Anyway, yes the LAST day of medical school. Turns out, the resident and two pharmacy students could not make it in for Friday's rounds and in the end my attending told me to turn in my paperwork, ID and pager and that this would now be my final day in medical school. I just paused looking at her, wanting to say "No, it's ok! I'll come in!" but I didn't say a word I was just stunned. She told me "Seriously!" (with a big smile on her face). I couldn't help smiling and truly tearing up to the though that this was the very end of my education as a student and made the fellow team laugh so much they had to give me a tissue! I felt bad and told her with my eyes welled up that it wasn't because she was letting me finish today but just the fact that this was the end of the long road of being a student, truly to what will be I'm sure the most challenging thing I will ever do in my entire lifetime. Of course though, I had my patient to present and I did with tissue in hand, haha. The rest of the clinic day was great (of course because in my mind I was done after just a few more patients!). She kept introducing me as the student becoming a doctor after the day was done. Not gonna lie, it felt good but tried not to get too excited and let that news overshadow the patient's reason why they came to see us.

In the end, I was told that I was an exceptional student and as a critique (I guess?) was that I worked too hard. Haha, I always had something brought in that I read from the patients before had plus all my research that I am working on - which she loved. We hugged and I went on my way to the hospital to drop off my pager and such. It still didn't feel over until I got all of that out of my way and I was on my way home!!! Just like I thought, I did cry when I was done. Tears of shear disbelief that it is all over. The four years of ups and downs, elation, depression, feelings of accomplishment and failures was done - in the end elation and accomplishment winning out!

~Just a recap!~
Dominica 16 months [X]
Saginaw 5th semester 12wks [X]
USMLE Step 1 [X]
Family Medicine rotation 6wks [X]
Psychiatry rotation 6wks [X]
OB/GYN rotation 6wks [X]
ENT elective rotation 2 wks [X]
Surgery rotation 12 wks [X]
USMLE Step 2CS [X]
Radiology elective rotation 2wks [X]
Pediatric rotation 6wks [X]
Internal Medicine 12wks [X]
USMLE Step 2CK [X]
Oncology Research 12wks [X]
Pulmonary elective rotation 4wks [X]
Gastrointestinal elective weeks 4wks [X]
Anesthesiology elective 2wks [X]
Infectious Disease elective 4wks [X]

So here I am, on what was supposed to be my last day - in my jammies, having a cup of coffee and watching the Today Show! I still haven't celebrated yet but throughout these four years I feel like I have been celebrating all along the way, I don't want to torture them with something else haha. But I will celebrate this weekend, I'm sure. After that I have definitely found some hobbies to do, inside the house and out. I plan on doing some things for fun and also brushing up on my Spanish, maybe ASL and working on my research. All in all, I am trying to be determined to relax, not get bored and prepare for the residency ahead as best I can.

It is over. And to all of you out there reading this - it does end, I assure you. Just hang in there and don't give up! I thought I had all the passion, drive and determination in the world. While I still feel like I do, even having that wasn't enough to keep me from feeling the shaky ground every now and again. Thank you all for your support, to my family and friends for their constant love and understanding through the good and bad. I love you all!

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.

Well - seem as though we made it through Chapter 1: The Island and Chapter 2: Saginaw and Clinicals! Time to turn the page in medical school's book to a new chapter! Chapter 3: Residency!!! All I can say is, buckle your seat belts and get ready for a great ride for not only my journey as a resident physician but with my life at home as a wife and many of these wonderful joys to arrive as well! You comin' along? :)

Only one Monday to go as a medical student...

2010-04-05T18:50:00.008-05:00

So, infectious disease. Not too shabby! This is a consult month, so really it isn't hard. The hard part for me is just these antibiotics (which is why I chose ID for an elective - to get help in this area). My attendings are very nice and am really not having any dread going in but I think I can confidently say - I am starting to get checked OUT. I am so happy I lasted this long without feeling this way but having my last day of medical next Friday, I am full of excitement and anticipation! I keep thinking about how I will feel!

April 16th is my last day and then freedom for a while! I am feeling that I don't want to waste away my vacation. Granted I do not want to study the whole time either but I just feel so determined to getting myself organized for residency - to make the most out of my time at Henry Ford Hospital (HFH) and at the same time getting what I want out of my own personal life as well. Balance. I'm working on my checklist for that now and am excited to feel like I think I can achieve it.

The rotation is going well though. I find myself finishing my pre-rounds and new consults in record time, just ready to get the day going and done with. Not that I hate being there, the teaching is great... but you know - kinda close to the eeeennndddd... gonna be a docctorrrr soooonnnn. Anyway, turns out that waiting for rounds takes about 3-4 times as long as it does to do my work - oh well, they are so nice to work with anyway! Luckily my attending has meetings like crazy tomorrow and told me to just take the day off. YAY! That never (literally) happens. There is plently that I can get done, especially that pesky task of ordering my cap and gown!!! Hopefully, I can do some research too :)

Well I hope everyone has a good day tomorrow too! I will talk to you soon <3!

P.S. It is barely April and I have already tied my total amount of posts for 2009, haha!

PGY-I Resident Physician in Internal Medicine at....

2010-03-19T06:14:00.003-05:00

...Henry Ford Hospital in Detroit, Michigan!!! I am very excited that not only will I be at the closest hospital to my hosue that I applied to, but that I am so familiar with the fantastic people and processes that would most likely be quite overwhelming for myself if I were to start off at a brand new place. It is so nice also to just have that weight lifted off my shoulder and constant questioning of "Where will I be?", "Will I have to reapply?", yada yada.

I know I didn't post the day of the Match but even a few days out it feels just as good. I had a small happy dance then afterwards crashed out of emotional exhaustion over these past 4 years. I am sure with my vacation to come after this month, I will be wanting to add up all the hours of sleep I can get! I have been able to get ahold of my fellow residents through Facebook and we have started a little group to get to know each other better! So far there are 12 out of the 37 who have joined in the past few days :o)! They are all so nice and I am really looking forward to working with them. Out of the 37 there are FOUR Ross University students! I am so proud!!! I know we will do an excellent job!

As for now, I am currently (3/23/10) in my first week of infectious disease. I'll tell ya getting the motivation to not just do this last month but get to know a whole new hospital system, people, processes and hospital layout for ONE month is quite challenging. Though I think I realize what indeed is at the end of this month - the END of medical school and the END of my time as a student! Granted I must wait until graduation to officially say so, but April 16th, 2010 - I am calling myself a physician! Then I will have until about the beginning of July to soak it all up!

There is quite the amount of paperwork to be done: first is of course - the contract - and a 44 page packet to seal the deal with busy days of filling out forms. I hurried and got it all day and sent everything out yesterday, as it is due this Friday. I can't see how the resident from outside the country can get it done and mail it in time?! Anyway, the forms are all for limited licensing, controlled substance licensing, health care forms, fingerprinting forms, computer access forms, ACLS/BLS forms... the list goes on. I was able to leave my first day of ID early (hated doing that) and get my fingerprinting out of the way which was the only thing from keeping me to send in my packet. What's next? Yes folks, I am still working on changing my name, lol. It isn't hard but just alot of things you need to change. Basically, I finished the important documents but needed to finish my passport and SSN.

So everything seems all set to start! I will keep you all posted on things as they go! Only about 24 days to go until medical ends!!!

I MATCHED!

2010-03-15T11:20:00.005-05:00

Oh yes, I recieved an email from the National Residency Match Program stating: "Congratuations! You have matched!" WOOHOO!!! I am an Internal Medicine physician at "fill-in-the-blank" hospital! haha, I think the anticipation for Thursday surpasses mine for today.

I was pretty confident that I would match but am just ever so curious to know which of the six hospitals grabbed me first! :) I am very happy though I have to admit, not as jumping off the rooftops as I thought I would be?! WHYYYYYY! Come on Jess, it's okay to celebrate! So funny, like I have said before - my family has always been telling me to look back and be proud of all I have done to get to 'x' point. Hopefully this time I can actually be able to do it!

Wow, granted I have my last month of an infectious disease elective - but darnit - I'm a doctor! :) I suppose I should continue in joining in the Facebook fun of congratulating everyone and probably cracking open a beer or two! This week is a celebration and I am so glad that I have it completely off so I can hopefully soak up this week and remember it forever as a time when I look back on these four years; the major- lol major - sacrifices my family and I have made, the energy, tears and doubt all for the feeling of success, accomplishment and privilege of knowing that I am a physician and will forever be for the rest of my life have a greatly blessed chance to serve and improve the lives of others!

Congratulations to all who have found their own success in the match! As promised here is something I had found that I wrote before I began this blog. It was a post on one of the forums I followed, after a 10 month long wait on the LECOM-Erie waitlist for enterance into their medical school. I was a nervous wreck, posted nearly everyday, wondering if I would ever get chosen. It was this day I was passed up and I then decided to attend Ross University and never looked back - enjoy!

~July 28th, 2006 @ 01:24 PM~
"Been a long wait but it's alright...

Thanks everyone! And also to everyone over the past almost 10 months that has let me vent about this school. It has really meant so much to me and been a blessing to be able to come on here and get so much advice and support.

I am still hoping for even these last few hours but I am going to begin to finish up my prep to get ready for Ross! Leaving in a few weeks with my mom so she can help settle me in on the Rock! She's the best!

At least I still get to become a doctor... I really do love ya'll, thanks for everything!"

...Well, looks like I still got that chance to become a doctor and here I am! Congratulations to all and celebrate this moment well!!! :)

"If I Matched" Day...

2010-03-14T18:55:00.002-05:00

EEEEeeeeekkkkkk! Twelve noon tomorrow! I will find out if I have indeed matched into an Internal Medicine residency program :)! Yes folks, I will be hopefully contracted in to be an employee, better said - a physician - at hospital on my ranked list. Me. A physician. Okay, not gonna lie, that is majorly cool to say! Me, a doctor. Lately sounding more like something that is more overdue than before when it was something funny and unbelievable to say, lol.

I posted on Facebook on how embarassing it would be to NOT match and to have told everyone, haha. Ah well, you know me - just telling it like it is and whatever happens, happens. To be honest, I am really not that worried about tomorrow. It is the anticipation for Thursday that is just starting to get to me. Funny looking at some forums and how freaked out people are getting - just about tomorrow!

Anyway, I think that it will come down to my top two choices. What are they? Tsk, tsk, tsk... Patience people! ;) I really don't see myself going past #2 but at most I see myself going to my #3 choice as I have gotten a great vibe from the program. That's it! If tomorrow equals a match, Thursday equals me completing my residency in most likely my top three spots. Not too shabby.

So, I leave my final question before my time as a student is setting and residency rises: Do I start to party and celebrate tomorrow? Wait until Thursday? Both? Believe it or not, this is my question haha. I definitely know that Wednesday will already be crazy with St. Paddy's Day... Hmm, maybe I should just commit to a week of celebration, haha! Welp, I am not sure what else to leave you all with but that this is a great feeling. I am more feeling a sigh of exhaustion and "it's about time" than "WOOHOO", but maybe that will change. Maybe it is just me but that's how I feel.

I am gonna dig up on old post from a forum for tomorrow if all goes well - from before I started on the island, lol. Quite nostalgic post, lol! So, yep - there it is... After starting this blog in August of 2006, here I am hopefully to post tomorrow about my new employment as an Internal Medicine physician! :) Thank you all for your love and support (even during my hiatuses, lol). Catch you on the flipside ;)!

It's the Final Countownnnnn! (by Europe, lol)

2010-03-12T14:54:00.006-05:00

It is official, there is one month left of medical school! I have just finished my anesthesia rotation of two weeks and am now on a little mini vacation for the next 10 days to celebrate St. Paddy's Day and of course, Match Day 2010! First off, anesthesia was really awesome. As compared to my pulmonary and GI months, which were all consult months, anesthesia was much different than anything I've done lately. Even back when I was in my surgery rotation over a year ago (wow...) I had always wondered what was going on behind those sheets with all those monitors and such.

For one thing, I actually was able to SIT through a Whipple procedure this time, haha. But really, it was great to learn the ins and outs of how they work and felt I got way more than 2 weeks worth of knowledge. While the organization for the rotation was a bit lacking, I was able to work with one particular resident at least 4-5 times who was extremely talented at teaching students and especially relating it to the field in which they were interested. For me, he tried to relate anesthesia to medicine, in particular to the ICU and vent management. Of course, there was teaching on general anesthesia too as is done in surgery. The days were not too long, except for those days when they had 6:30am lecture, lol. My days ended almost always between 3 and 3:30pm, though most students got out much earlier.

I was able to do multiple intubations though and definitely became more comfortable with them. and LMAs as well. Mostly though it was just taking in all the knowledge that the residents could offer. On my last day, I was able to leave around 1pm and was so happy. I was able to take my mom out to lunch one last time and thank the medical education department for allowing me to come and rotate there as Ross is not an affiliated hospital. After, I walked out the doors of Henry Ford Hospital after a near 10 month experience. On the shuttle back to my car, I looked back thinking whether or not I would return this coming July for my residency...

...Yes, it all comes down to this week! Match Week! What is in store for this week? Well, Monday 3/15/10: we all find out IF we matched. This is what we might see though email or our NRMP website:

1. Congratulations, you have matched! *YAY*
2. We are sorry, you did not match to any position. (...Boo...)
3. You are NOT matched because you did not submit a certified rank order list. (Submitted one so doesn't apply to me, but man if you missed the deadline - that would suuuuuuck!)
4. You are NOT matched because you are withdrawn. (Not withdrawn, doesn't apply)

Also, there are a couple more for preliminary applicants, those who did not apply categorical position...

Supposedly, this day opens up the Scramble as well, which is literally - a scramble - for open spots in different programs nationwide. Giving homage to 3/17 - St. Paddy's Day! Yes folks, due to be a sloppy mess but great times with friends! Finally, Thursday 3/18 is Match Day, where we all find out WHERE we matched. Our school kinda goes with the flow of other schools, depending on where you are rotating. If the affiliated school as a luncheon or something, our students tend to tag along and follow their tradition. Me? I was able to get this week off to celebrate on my own without the hooplah of being around other students. I just wanted to take this time for myself and be with family and friends for this week of my life. I am sure however it works out, I will be happy with it but just in case, I want them around me :P...

So, the week is near upon us and I am not nervous at all - just merely starting to get anxious. I go on studentdoctor.net alot for some advice or to vent and also valuemd.com (better for IMGs) and I cannot believe how scared and nervous they are. Maybe it is just me but I am happy with all the places I ranked and granted, while I might be a tad disappointed where I end up - I will know it was meant for a reason. I don't see how worrying and stressing these last days does anything. In my opinion, what's done is done - there is no changing it once our rank list was submitted. It is in God's hands and best just to cut loose and enjoy life as best you can!

In light of this, that is what I am about to do - off to Malarkey's with my friends to have some good times! More to come soon enough... :)

We're gettin' there folks!

2010-03-04T19:01:00.005-05:00

I am stumped at what to write about. I am chosing to hold off on my post about Match Day and my rankings until the day comes. I guess though I can start talking about it a little - gotta get ya a little thirsty for more later! Then I guess I will just figure something out as I go along.

So... it has come down to this nearly four years in the making of this blog - Match Day 2010. The day when I will find out where I will be obtaining my residency training in internal medicine for the next three years. Like I said before, I applied to 15 places and got 8 interviews:

St. Mary Mercy, Livonia MI
University of Toledo, Toldeo OH
Henry Ford Hospital, Detroit MI
St. John Hospital, Detroit MI
St. Joseph Mercy, Ann Arbor MI
Detroit Medical Center, Detroit MI
St. Vincent Mercy, Toledo OH
Synergy Medical Education Alliance, Saginaw MI

Of these I chose 6, leaving out Synergy and University of Toledo. As you all know I did most of my third year at Synergy and loved it. In the end though, this just proved to be to far away that I was willing to commute. I was getting enough invites from local places, I chose to decline. As for the latter, again I had the other 7 offers and felt that I would be in good contention for a residency spot with those I had interviewed at, particularly in Michigan - so I chose to decline. No real downsides to the programs, just a personal choice. This left 6 hospitals to rank in my ranking list.

First off, you must register with the NRMP (National Residency Match Program) which of course comes with a fee (come on, by now you know better than to think that we were gonna get out of ANYTHING without a fee). When the time comes and your ERAS application is submitted, it will be time for the rank list to open, approximately in late January of your match year. You get around a month to mull it over and in late February, your decision is final. It is this day that you are committed to joining the residency program you match. Not only does your list have to be final but the hospitals must submit their final list the same day as well. DUN DUN DUN - that's it. Then the near one month wait for the magical computers to do their work, lol. So I will tell you all how I ranked two weeks from today, March 18th 2010. And yes, it IS the day after St. Paddy's Day. Though what student would really take any time off, away from their patients to celebrate during this week. Really now, quite selfish! Psh, I wouldddd! I have one week left of anesthesia then an entire week off. Surely enough, as usual I will be going stir crazy with nothing to do but perhaps i can catch up on some research lol. I am real excited for a week off before my last month of school. Wow, last month. So insane to REALLY look back. Makes the last four weeks seem like a joke compared to all the rest.

Sigh, so what now? What else can I talk about today. I'm about to consolidate my loans lol. Did I tell you that? I got my grand bill in the mail and I am going to write it all out with the zeros for effect, haha: $220,000.00... Maybe I should have enlarged the font! I am taking donations! :P Ah well, knew this was coming so not much of a topic starter.

I guess I could talk about my anesthesia rotation, even though this is my first of two weeks. Umm, really like it alot! Besides the fact that I am in the OR (vomit) I am loving learning about the medications, being taught by tying in ICU vent monitoring and getting my hand at intubations. Ever since my surgery rotation, I have always been curious as to what exactly was being done behind those sheets. I am getting a boat load of knowledge in this and am getting pretty comfortable in monitoring the patient's sedation, paralytics, respirations and much more! Kinda nice to sit and chat with the resident and while being taught still, being able to take a break when we both notice something that needs to be adjusted in the medications. It is great experience though think two weeks will suffice for the time being...

Well, sorry that I don't have more to talk about. I will try and brainstorm for more ideas. Any burning questions out there, lol? Anyhoo, I'll be around! You stay classy ;)...

ERAS and Application Process...

2010-02-18T19:29:00.004-05:00

Haha, bet you thought I was gone eh? Just kidding... Had a couple exhausting days and really wasn't up for talking about this long, long process called The Match, lol. But man, what a ride it has been.

So jeeze when did all of this begin? Right around June/July of 2009. This is when the ERAS application service opens up and basically you can start saying you are in "application season" when in fact you have until the begining of September until you are allowed to submit it - but yay anyway! So the application process is pretty straight forward. If you have gotten this far in your medical education this is just another hoop to jump through to be honest. By this time you should have your letters of recommendation written or soon to be written as the authors will have to send in their thoughts on you to ERAS directly (cover sheets are included in this section of the application that they have to submit as well). How many do you need? Most programs I think are 3-4. I had 6 but picked the top 4 that I thought would be the strongest. There were a couple people I asked early on in my 3rd year that honestly, and I say this in the most lovingly way possible - finished too quickly. I knew they didn't REALLY know me THAT well and that it was a possibility of being a "cookie cutter" LOR. In the end I ended up picking my family medicine preceptor (someone I've known for a great deal of my life and who was there to even write me a LOR for entering medical school!), my OB/GYN preceptor and assistant program director (absolutely wonderful woman who was so near convincing me that OB/GYN was for me, lol). My third came from my senior resident from heme/onc who prior to my interviews graduated to attending and staff in internal medicine. Finally my last was from my preceptor in my outpatient internal medicine clinic and division head of the program. I have to say, before I get to talking about my interview - this was one of the highlights of my interviews. In all of them, I was told how glowing and wonderful they were and in one instance how they had never seen a two page LOR before, lol! Someday I would really love to read them if I ever could do that...

Up next was my personal statement. I really worked for maybe a week on it. Not that I was lazy but usually when I get into it - I really do and I don't stop until it is perfect. I will post it at the end here to use as inspiration because after all, this is all about YOU! Stealing ideas is only refective of your own personality but getting inspiration to shine your own thoughts and journey to this point are what is important! Really there isn't much to say about this other than to show it to you but, again - and I swear that I am not trying to toot my own horn (come on you have seen all of my board scores lol) but it was loved by my interviewers as well!

There are many other aspects to the application but most are personal data, boring and obvious stuff... Though finally, it comes down to where you want to spend the next 3-5 years of your life. In the end, you submit the application in September or so then await emails to your ERAS message box - waiting for interviews! It's really that simple... Speaking of which, I had received a comment talking about how risky it seems to go the way I did. Well, could not agree with you more! It is a risky thing but the fact of the matter is - I have no interest in moving anymore, even if that means I do not match this year. Call me crazy but it has been a long road for me and Tony and right now we need to be near each other. I applied to most Michigan places and a couple Toledo places as well which were driving distance. I ended up with 8 interviews out of the 15 places I applied. I let go of two other places because I applied to them thinking - worst case I would do the distance for residency. Since I was blessed enough to receive six interviews very close to home, I dropped the other two.

I honestly think that this might be a two-parter, lol. I have so much to talk about regarding interviews that I think it is a topic in itself. So, I will let my next post deal with the fun yet at times nerveracking time visiting and interviewing at other hospitals! Until then, please partake in reading further if you so wish to :)!

So, as promised - my "Internal Medicine Personal Statement"!

In life, many hope to find their passion of what they were meant to become. It is this passion that sustains my own drive, determination and promise of a lifetime service to the health and well-being of others. Through years of preparation for this application, I have found my purpose in the practice of Internal Medicine. Since the beginning of medical school, I have always thought that this was my field of choice. Although not until my clerkship experiences fully exposed me to this field, was I completely captivated by numerous factors. Among these lay the fascination of an internist's practice. To have been educated in the foundation that all of medicine has subsequently developed, truly shows the depth of understanding and complexity of thought that must be utilized throughout any given day. In addition, the role of prevention proves to be an incalculable asset to this practice of medicine. Looking towards preventative medicine instead of chasing a cure not only provokes interest but should make even ourselves strive for such measures. Finally, throughout my clinical experience, I have discovered the perpetual importance of patient continuity. It is for these reasons to be expanded upon that I find Internal Medicine to be the specialty that I was meant to focus my innermost passion towards.

"There are, in truth, no specialties in medicine, since to know fully many of the most important diseases a man must be familiar with their manifestations in many organ" - Sir William Osler

Internal Medicine is the cornerstone of the medical world. Throughout my clinical experience, I have enjoyed my exposure to many different specialties. In their own time, however, each has fallen towards the way-side, unable to fulfill what I aspired to become as a physician. Upon beginning Internal Medicine, I felt that I had found a role that best complemented my personality. Over time, I found myself becoming more astute in my pursuit of diagnoses. I have developed a wider array of thoughts in my differential, pathophysiology and have begun to gain a strong foundation for my lifelong practice as a physician. Additionally, through my work in research, I have found a deeper appreciation for the efforts that make advances in medicine a possibility. This teamwork, which possibly could answer questions that have never been investigated, is an exciting experience. Being part of this team gave me a great feeling of self-worth; to impact how clinical medicine can be improved to become safer and more efficient in addition to positively influencing the future of our health care system.

"One of the first duties of the physician is to educate the masses not to take medicine." - Sir William Osler

Upon beginning my Internal Medicine rotation, it felt that I had found a role that complemented my personality. One core focus, preventative medicine, impacted me the most. In preventative care, seemingly under-appreciated in society today, lay the true foundation of the health care system. During my time in Dominica for the first two years of my medical education, I had spent a great deal of time working with the people of the island in preventative care. Most notably, the Ross Foundation for Dominican Health was a cause which I was delighted to take part. This became my most pivotal experience while in Dominica. After RFDH's first semester, there was no one willing to take control over its leadership, which left this organization a fallen victim to neglect. I found myself wanting to do more with the time that was given to me at this university and chose to lead it from that moment forward. Through RFDH, we were able to raise funds to provide their small hospital with some of their greatest needs, particularly in their neonatal unit. It was with this work that we were able to provide oximeters, an incubator and ventilator, as this facility had only one of each for a population of seventy-three thousand. For the first time in my life, I felt that my efforts made a difference and that without my efforts in this organization, these donations would not have been possible. It was an incredible feeling that will remain with me forever. In such practices of preventative care, we can find ourselves maintaining health instead of chasing after it, allowing us to remain one step ahead of the disease process.

"The good physician treats the disease; the great physician treats the patient who has the disease." - Sir William Osler

An aspect of this specialty which has great importance to me is patient continuity. I feel that it is my duty and privilege to broaden the minds of my patients in order to encourage them to become an advocate for their own health. At the same time, the patients have so much to teach the medical community as well. In my clinic and ward experience, it was wonderful to see how relationships developed that further served to be a stepping stone to improved individual health care. Never will I forget my most memorable patient during my entire clinical experience thus far. This patient was a middle-aged gentleman, kind-hearted with a fantastic sense of humor. Admitted for an exacerbation of his chronic obstructive pulmonary disease, it was soon found over his two week stay that he had inoperable cancer. Throughout the two weeks that I spent with him, I found myself wanting to be there not only for him but also for his family, whether it was for medical care, a shoulder to cry on or lended ear. In his last days before passing, I recall being there with him, now unable to recognize who I was, as he began to succumb to his overwhelming illness. Minutes after he had passed, much of his family came to visit, none of whom knew of his demise. Standing alone with this family about to enter the room, I was the only one to deliver the devastating news. It was from our continuity that they found at least some small amount of peace in my being there. It is with this patient continuity that I find purpose and potentially many future gratifying outcomes for those I will serve. This man will always be a reminder of why I belong in this specialty. To me, he represented not only the importance of continuity, but how the prevention of disease holds higher precedence than a cure. Past feelings I once had for RFDH arose in me once more, as I built a rapport with this man and many others, who have confided and trusted in me. In the future, I believe that I will incorporate into my practice this basic human connection. It is this connection that fuels my desire to continually create an atmosphere of patient education and trust, thus allowing me to guide each patient through their continuity of care.

For the next step in my medical career, I hope to join a residency program instilled with these characteristics. I further hope to be part of one rich in the tradition of teaching, as I aspire to one day pass on my knowledge to subsequent generations of physicians. Academic medicine is an extraordinary opportunity to not only continue in my education as medicine advances, but to interact with multiple levels of expertise in the fundamentals of medicine and engage in healthy, intellectual discussions.

All of my experiences that I have been through leading up to this moment have prepared me for the rigor of a competitive residency program. My affinity for teamwork will bring comradery among my colleagues and a deeper appreciation for what can be learned from each other. My goal-oriented, hard-working personality constantly challenges me to push forward towards my aspirations. It is my perseverance, determination and above all my profound passion for this profession which carries me through each passing day, dedicated to the study and the practice of medicine. I know these assets, that define my personality and character, will drive me to bring only my very best everyday to this residency program and throughout my entire career.

Step 2 CS/CK today anyone?

2010-02-15T17:48:00.002-05:00

I wanted to spend some time talking about my research but now that I am thinking about it, since all three are currently in the process of possibly being published, I don't know if I am supposed to be talking about it? Maybe I can but I would hate to not be sure and spill the beans on something I shouldn't. I will someday soon though. So instead, I thought I would write a little bit about my Step 2 experiences :)

Well as you would probably expect since I am about to graduate, I did in fact pass both exams - and what would you know - first time around, lol just kidding, some COMP humor :P I decided to take my CS in Chicago of April 2009 pretty much right after I stopped posting when I finished my ER month in Saginaw. I have to say again that ER was the absolute best rotation to do before this exam. This exam consisted of 12 patients (6 in the first session, 6 in the last) to do H&Ps on, write up notes and forumulate a plan. Each encounter got 25 minutes, 15 for the interview and physical exam and 10 minutes after to write up your note. You can choose to write or type your note and I thought that I would type because I type faster than I can write. After some thought, I decided to write it out as I realized that I could not type out any symbols or shorthand. I chose the right way for me though and glad I did because once you choose a way to do your note you cannot change it.

I am not gonna lie, all of my encounters took abotu 10 minutes. They give you a 5 minute warning but I took that as pretty much "time's up" so I could have extra time to work on my note. The cases are really not that difficult. You know what it is pretty much immediately on most cases, it is just that you ask the correct questions, do the correct examinations and provide a workup plan for the patient. If you forget to drape or shake hands a few times - you will NOT fail, lol. Alot of people freaked out about making small mistakes, it happens to everyone including me. I forgot to drape the patient and wash my hands on my first case. I probably did some exam maneuvers wrong but really at the end of the day, I knew I passed. The First Aid for Step 2 CS was a great book for this, especially the cases in the back.

You get 8 hours to complete this exam lunch provided and all. Really by the time you get to this point to take the test, you have interviewed a great number of patients and it truly feels like another day in the office! They are great actors too. Everyone gets nervous too but believe me, it fades down after just a couple enounters - if that. Overall it was a good experience (except for the $1200 cost) and felt great about it afterwards.

After this I went onto radiology for two weeks which I had written about then onto pediatrics and IM. Again, I am very glad my IM rotation was before my Step 2 CK exam on September 29th, 2009. I will be honest, I was exhausted by this time. 3rd year finished, some of 4th year done, just got done planning a wedding and getting married - I did study but honestly just wanted to pass and be done with it. Pretty much how that turned out. I was pretty big on my First Aid book but moreso USMLEWorld questions. The day was just like Step 1, I went to the same place to take this exam but really just was ready to get in and take it. I believe I did my first 2 blocks then a break, blocks 3 and 4 then a break and a break between the rest of the 4 (yes, there is an extra block in this one). I thought it went fine though wasn't thrilled at how I did and was so exhausted of worrying, I really didn't leave crying this time or think about me failing. I actually think Tony, my folks and I went straight to the bar! Anyway, time went on and I found that I passed with a 191/78. More of a sigh of relief than celebration, lol but even looking back on it - well, whatever it is over and I am just fine with that! Granted, I didn't blow away my interviewers with my scores but honestly, they didn't have any questions about it and were quite happy with the rest of my entire application - so I really was not kicking myself about it at all. I did what I could do but know for sure this had no bearing on the physician I would become. If you would ask the staff, residents and attendings I know that most have been extremely impressed by my workups, eagerness to learn and study on my own as well as the patients' own perception of me as a future health care provider. While this will most likely be my next post, my interviews went over so well that I never looked back wishing I had done something different with my time. During all of this craziness, I had found my balance and while I probably sacrificed some of my score to do everything else that was going on in my life - it was worth it. While I can in no way gloat about my scores I can't complain about how great my life was in spite of it :)! Life as I knew it did not end and I was still moving on - and with research on my way after my IM rotation - some much needed stress-free time and especially time to recharge my batteries and enthusiasm to continue on to finish my last year.

Overall, I will say these tests are just a way of sizing you up with other candidates but it in no way exempts you from other things you may lack. Of course, if you score in the top 5% of students and have no personality, yes you might get away with it but someday, when I am a patient with some illness in my ripe old age - I'd rather have someone dedicated to their practice with a personality to connect to than someone who does nothing but pride themselves for the rest of their career about a piddly test they took "x" years ago with nothing in their personality but the God complex. Granted this is an extreme example but believe me even a little arrogance goes a long way in this type of physician. Kinda went off a little but it is my blog so that makes it ok, haha!

Well, GI has some long days and being Monday I feel the need to put my feet up and relax with the hubs until bed. I think I will talk about this year's lovely interview season next! What a wonderful one it was :)! I'll catch you on the flip side ;)...

Going back in time (again) - 2nd/3rd month IM rotation

2010-02-14T11:20:00.003-05:00

Wow, three days in a row - I'm on a roll! Actually, I kinda want to get these posts up so I can begin writing more about current things, such as the match, interviews and preparation for residency! I spent a little of my day reading back on some older posts and cannot believe some of the things I got through and how much it really took to get where I am today... I am still trying to get these things in perspective because finally I am starting to feel that as I am making my way down to the last eight weeks of rotations that I am - gasp - maybe a little bit proud of myself.

My second month consisted of a general medicine floor. Basically, it worked the same as the heme/onc floor with calls and such but the turnover was much faster, with patients staying only 2-3 days compared to a week to two from the month before. This meant more H&Ps, workups, presentations and more. It was nice to experience a fast-paced floor as it would be once residency begins. Again this wasn't a sub-I for me but I still wanted to do as much as I could. We had a guy doing his sub-I in our group but really didn't see it much different from what I was doing. The main difference is that you are in charge of your patients and your note actually "counts" legally. I am telling you though that you can act as a sub-I, even if you aren't. Just like I said from the month before, just get involved. If you are there to work just keep asking to do things. If a new consult comes in, just take it work them up. If orders need to be written, do so. If consult calls have to be made, offer to do it. Literally these things take minutes, lol. But it really shows initiative. Anyway, that is my little rant on that!

During each month, our attendings would change at least once to round with which made it a little challenging as they all had their own styles as to how they liked things presented. But as rotations go on, you get used to listening as a resident presents another patient to the attending and seeing if the attending has criticism or praises afterwards. The order always the same but just the amount of information they really want varies. I had a very nice team again though. Of course, my intern rocked and we had a great time - even during calls! One call though was the night before my bachelorette party and yes, it was an overnight call. This team was more into me being involved all throughout the night but that night they were kind and let me sleep a bit :). It was a bit funny as my senior and three residents and sub-I on the floor were all guys. It was me and 5 guys sleeping/hanging in one room together, lol. Anyway, it was a good month. Full of the usual chief complaints but definitely learned alot.

My final month consisted of outpatient clinic work. I was set up for 8 sessions a week (a session being a 4 hour period, so Monday-Thursday all day). It was nice because my main preceptor allowed me to set up my own hours since I had just gotten married and I was preparing for my Step 2 CK exam. It was great exposure to working with appointments and such but as you can expect it was alot of clinic a week, lol. It was nice being around the same 4-5 attendings and getting exposure to their styles.

Luckily, throughout my time in heme/onc, I met some great fellows who connected me into their research department. I was able to secure a couple of elective months to doing solely research Sepember-November! It was very nice as I was able to connect to their CarePlus system from home and be there to take on more of a wifely role for a while. I really enjoyed that time. While I will end up writing about this most likely a little in my next entry, it led into the holidays which I took off December for our fabulous Hawaiian honeymood and to enjoy with family and friends. See? We are slowly catching up on things! :) We will be to the present in no time and I have spared you from many "oh woe is me" posts, lol! All there is after that is my pulmonology month and this gastrointestinal month. Just to tell you that as my first two weeks were more general GI consults the next two weeks will be hepatology, of which I am super excited to learn about!

I hope you all have a Happy Valentine's Day! We don't celebrate it much but I was actually sent flowers, chocolates and a new teddy ('Lil Tone, after my first teddy Tony Bear, haha!) to the hospital but after a crazy mix up, I never got them, someone else did and took them home only to call ProFlowers.com to tell them of the mistake. I think that they just didn't know who I was since I was only on the floor once in a while over these past two weeks. They told the lady to keep the stuff and they would resend it out the stuff Monday. So I ended up calling them to get it delivered here today and they surely did - yay! Anyway, while Tony was upset it was no longer a surprise, I am now sitting in my robe eating chocolates and watching tv :). This is the life!

Going back in time - 1st month IM rotation

2010-02-13T09:11:00.005-05:00

First of all, I just wanted to thank those that had made comments on my last blog. I really didn't expect anyone to have kept checking up whether or not I was still writing, which makes me feel bad but really does make me want to continue on! Maybe it was the wedding planning with rotations. Or actually I bet it was because I had moved back home I could bounce things off my husband moreso than when I was away all the time. It is probably possible that I felt that I might not have needed the blog anymore... I have found though recently though how much I had missed it and actually that I might be able to get advice or give it to other students (and start sparing my hubs from my venting, haha!) In any event, thank you again and will try my best to keep up with it!

So I thought for this entry I would take a little trip back to June of 2009, my first month of my IM rotation. Pretty much was heading into a new hospital system and a quite well known one as well which made it more nerve-racking. I had been asked about how I was able to get a spot there since it was not an affiliate. Well, actually none of my 4th year elective is at affiliate facilities either, which is something else I should speak about. I obviously was sick of moving and I wanted to be home with my little family more than anything and I was willing to do anything I had to in order to do that. I does depend on your state as to how many elective you can do as a non-elective but for me it was alright. Generally it requires you to contact the medical education coordinator and jsut ask how to apply. They will tell you what you need to fax them and this is where the Ross Non-Affiliate Rotation form comes in. Once you submit that to Ross and you submit your application to the hospital, Ross will then process your application and send your transcripts, scores, vaccination records, etc. to the hospital. This takes about 4 weeks, sometimes less if you are lucky. Once it is processed the hospital will contact you that your rotation is set up. Generally this is probably just as easy as an affiliate hospital but just a couple more hoops to jump through. I have done this throughout my whole 4th year and some of my 3rd too. It doesn't take too much and definite worth any extra effort!

Anyway, so I was fortunate enough to meet much of the IM staff over the years with a relative working there. Getting to meet them and stay connected throughout my first couple of years in school, I was able to maintain some contact to hopefully one day be allowed to come for my core. I was very lucky and as far as I know, it was very hard to even get that for me. It took me six months (actually at least) for this to be ironed out with administration, faculty, etc. I was getting nervous as months were going by without it coming up on my schedule. Eventually though it worked and I was signed up for 3 months of IM! From that time, I was able to meet more people in medical education and was able to secure a couple more months of 4th year. Basically, this was all possible through the inital connection. It would be really nice if we could get that affiliate back as I know they were once ours before. From what I see, I know that we would totally rock as students for this facility. Most seem very impressed with my efforts and I feel very comfortable and welcomed to this hospital!

Getting back to my first month, I was placed in hematology/oncology. It was in June so I was placed with an intern and senior resident both about to advance in their training the next month. I have to say, I have actually ALWAYS had awesome teams to work with and this team was just the start of me realizing it! This floor, while the turnover was less - meaning longer stays for patients - it was a busy, busy floor. Basically anyone with potential cancer or someone admitted for a health reason who had a history of cancer was admitted to our floor. We had call q4, though only had to spend the night on Friday/Saturday calls, otherwise they were till 10pm. I had my own patients, though yes unless it is a sub-I, the intern is still in charge of those patients. I just pretty much followed hers. I would do as much of the admission that I could as she taught me how to write the orders, H&P, etc. I would be able to do my pre-rounds, present them daily, keep up on their daily orders/tests and have some responsibility of doing their discharge summary updates in preparation for their discharge. It was great being given so much responsibility! I really felt liek a part of the team. I was even lucky enough to start getting my own med students! I had probably 2-3 recently finished 1st years come in to shadow, here's the funny part - me! It was really great though because it was at this point where I found out how much I have really learned. Their experience in clinical science was little to none so pretty much anything I was doing or seeing could have a teaching aspect to it which made my day that much better!

I tried my best to help in calls, though my team really wouldn't push much to wake me up sometimes but really I wanted to help. I didn't just let myself sleep through my rotation, lol. Anyway, patients on this floor really touched me and for some reason I really wasn't disheartened by these people who in great proportion were in hospice. In this month, I was given great exposure to end-of-life talks with family which was hard at first. I even had a patient that was such a pivotal point in my education, he became a huge part of my personal statement. It was with this patient I had spent two weeks with, through him learning of his terminal illness, to help managing his treatment and be there for his final days. It was even with this patient I gave my first family talk, completely alone mind you, as his passing took place between visits. Maybe this is something I could post for an example for future applicants if anyone would like to read it...

Anyway, staff were on this floor as well, some of whom still recognize me today 8 months later and still are great to chat with! My senior as well the heme/onc fellow were wonderful about letting me get exposed to procedures too. This month I was able to a thoracocentesis and a bone marrow biopsy on my own. The biopsy was a tad difficult pushing hard enough, so yes I had to get help from that but it was great. Maybe it was how hard I worked that they allowed me a chance to try my hand at a procedure.

All in all, this month was fabulous and I am seriously considering a fellowship in hematology/oncology. I really enjoyed my time and I know that must sound so morbid but I felt like it was a place where I belonged. It also seems to be a less stressful fellowship (althought mentally I am sure it could be seen as challenging) to choose from. I have been told that to apply for fellowship requires preparation as soon as my internship year. While applications and interviews begin in PGY-II year, connections, recommendations and research should be pursued from the beginning. I am not sure how true this acutally is but at least if I chose to do this, I think I might have a nice start. I have been doing research for some time now in the heme/onc department and am currently on research project #3 (I will talk about in another blog!). So at least I am some comfort in knowing that I am on track in case I would like to pursue this!

Well, this has been quite a long post but next up I will be talking about my general medicine month, which was my second of my IM rotation! :) As always, let me know of any questions! Talk to you all again soon!

Once upon a time...

2010-02-12T21:47:00.003-05:00

Well, I thought I would begin where I left off - pediatrics. Definitely surprised by finding out that this speciality was not for me. I, along with many of my classmates were having a hard time getting a great teaching experience in this rotation as there were not any residents to work with. We had some time on the floor, outpatient clinic, PICU and dabbled in a few curbside days in endocrine and allery clinic. Really, I have to say that this was probably one of my rotations I have to say the least about. I thought a long time ago I would be working with children, particularly in hematology/oncology but that is no longer the case. While I enjoy seeing kids, I came to a single realization. If I were to do peds, I would have to specialize - meaning it would be at least 5-6 years of post graduate training. There is no way I could do general medicine for children. All the well-child visits were just a little too monotonus to bear with the crying, screaming, etc. Just not in the cards for me but this was good! Narrowing down my options for residency.

Then came the big day... MOVING DAY OUT OF SAGINAW!!!

The day I handed in my apartment keys and permanently moved home was more than I could ever explain. Now, being done with my 16 months on the island, 5th semester gone and my nearly entire 3rd year away from home, it was time - my time to come home and yes, as I can say now since I am now months out of this time, permanently.

As soon as I came back home it was a great weekend back then onto my greatest challenge yet - Beginning at Henry Ford Hospital for my internal medicine rotation! Really I felt that IM was the route that I was going to take as it was June and application season began early in July to start working on applications. I could write for hours, no, days on this topic. I absolutely had the best months of my medical education here. This rotation consisted of three months. The first was a specialized floor, just randomly picked for me but in guess what? Heme/Onc! It was a fabulous month and definitely one I will be elaborating on in the future. My second month was in a general medicine floor that was absolutely bustling with business, a very fast-paced and high turnover floor. My last month was in outpatient clinic which was a nice break form the q4 calls.

Of course, nothing during this time could compare to August 1st, 2009. That's right everyone, I am now a happily married woman! Tony and I are married and it was the most wonderful day in my life! Now, I know alot of people say that because maybe they have to but I'm telling you it was SO FUN! Our reception rocked so much that no one even left, we had to be kicked out to close the place down! The wedding actually took place between my 2nd and 3rd months of my IM rotation. I was SO lucky because I realized that I scheduled 13 weeks instead of 12 for my rotation. So I had to drop a week. I strategically placed it a week after my 2nd month ended, so I acutally ended up with a whole week off before the big day! It worked out awesome and have God to thank for that little blessing! Also, my attending for outpatient clinic allowed me to come in the following Wednesday to begin my outpatient month so I could enjoy a long weekend with my new husband! So kind of him! Of course, with school and his work we just couldn't take time for a honeymoon (which was later taken in December, three days in Waikiki and a seven day hawaiian cruise!!!) but we were able to drive up north the day after the wedding and relax together in peace and quiet! :)

Then it was back to work. Outpatient clinic began but it was much lighter than my inpatient months so it still felt like a vacation. I will be commenting on my IM rotation I am sure multiple times, perhaps one month per blog entry to catch up but they were wonderful. Internal medicine is truly the most facinating residency in my eyes. You get the best of all worlds and see everything! So by this time, my application was submitted the first week of September - and yes I have applied for a categorical position in internal medicine!

While we are on this topic, I might as well comment that I limited myself by applying to only local hospitals. I was told this was a dangerous strategy as I might not match but I knew that I would never want to move again and if that meant that I would have to match next year, so be it. Luckily, the interviews came rolling in! I received 8 interviews and took 6. They all went quite well actually great - I still say interviews are my thang ;). My personality has the chance to come out and I feel that I can read people and situations well to the point that I come across very personable. Throughout my interviews, I got comments back on how great my personal statement was and how impressed they were by my letters of recommendation and extracurriculars. Very positive interview season which began (surprisingly early) in late November with my last being mid-January. It was a great time but I still can't imagine being one of those people who applied to 100+ programs with over 10-20 interviews. Six was plenty for me.

As for now, I am still in my fourth year. I have some research under my belt now, a pulmonary elective and half of a GI elective down with only this month, two weeks of anesthesiology and one month of infectious disease to go! 2010 has been great to me so far!

I think though that I have quite a few topics to talk about in future blogs, that is if anyone ever looks back on this since I have been quite inconsistent over months and months... To be honest, I want to keep up with this blog. I think I have missed out on giving advice, venting and reaching others interested in this field by stopping my entries. It be nice to hear if anyone would even still be interested in me continuing but maybe I just will anyway for me :)! I will plan on talking about my floor months of IM, application process, interviews and catching up with my electives/research that I have been doing over the past few months. Let's see how well I do!

Living the much updated and better life!

2009-10-06T08:46:00.003-05:00

Well, being now the beginning of October - WHERE HAVE I BEEN? So many stories to tell! I have heard though from family that I really need to update my blog. Just letting all know that I am back and will be slowly updating what I have been up to lately.

Now being in the research department, I will have ample time to start where I left off and bring everyone to the present! :) Stay tuned, coming up next: Step 2CS, pediatrics and the end of Saginaw!

Draggin' & Doubt...

2009-04-29T16:21:00.003-05:00

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...

2009-04-15T20:11:00.003-05:00

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?

2009-04-14T19:56:00.003-05:00

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!~

2009-04-13T19:11:00.002-05:00

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...

2009-02-20T18:42:00.002-05:00

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).

2009-02-14T07:52:00.003-05:00

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...

2009-01-18T19:09:00.002-05:00

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...

2009-01-13T20:20:00.006-05:00

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...

2009-01-10T13:40:00.002-05:00

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?

2009-01-04T21:37:00.001-05:00

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...

2008-10-31T10:00:00.004-05:00

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...

2008-10-20T17:14:00.003-05:00

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...

2008-10-13T18:52:00.007-05:00

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!

2008-09-30T21:26:00.002-05:00

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?

2008-09-15T19:07:00.003-05:00

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...

2008-09-03T19:01:00.005-05:00

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...

2008-09-01T20:27:00.004-05:00

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...

2008-08-21T21:23:00.004-05:00

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!

2008-08-13T19:09:00.004-05:00

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...

2008-08-09T12:16:00.002-05:00

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!

2008-07-30T06:08:00.003-05:00

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!

2008-07-25T16:03:00.002-05:00

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!

2008-07-15T18:10:00.004-05:00

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...

2008-07-09T13:42:00.002-05:00

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...

2008-07-08T06:55:00.003-05:00

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)

2008-06-27T07:01:00.004-05:00

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...

2008-06-20T11:39:00.003-05:00

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...

2008-06-13T06:13:00.003-05:00

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!

2008-06-10T08:40:00.000-05:00

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...

2008-06-04T23:55:00.002-05:00

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!

2008-06-03T00:02:00.002-05:00

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!

2008-05-30T07:51:00.005-05:00

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!

2008-05-13T06:43:00.003-05:00

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...

2008-05-07T09:27:00.003-05:00

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!!!!!!!

2008-05-03T12:55:00.002-05:00

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?

2008-04-22T13:39:00.003-05:00

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!

2008-04-18T17:23:00.003-05:00

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!

2008-04-17T22:36:00.003-05:00

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...

2008-04-12T20:33:00.002-05:00

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...

2008-04-08T20:01:00.006-05:00

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?

2008-03-31T22:32:00.003-05:00

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...

2008-03-30T09:01:00.002-05:00

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?

2008-03-10T17:41:00.002-05:00

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...

2008-03-09T22:19:00.003-05:00

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...

2008-02-18T19:13:00.002-05:00

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...

2008-02-13T12:32:00.002-05:00

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...

2008-01-27T18:21:00.000-05:00

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...

2008-01-17T20:33:00.000-05:00

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...

2008-01-13T22:17:00.000-05:00

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...

2008-01-06T22:14:00.000-05:00

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!

2007-12-31T19:39:00.000-05:00

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...

2007-12-17T09:22:00.000-05:00

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!

2007-12-15T09:47:00.000-05:00

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!

2007-12-13T11:24:00.000-05:00

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...

2007-12-11T09:15:00.000-05:00

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!!!!

2007-12-10T14:59:00.000-05:00

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!

2007-12-09T10:27:00.000-05:00

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...

2007-12-08T07:26:00.000-05:00

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...

2007-12-06T16:19:00.000-05:00

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!

2007-12-04T01:45:00.000-05:00

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!

2007-12-03T03:54:00.000-05:00

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!!!!

2007-12-01T12:00:00.000-05:00

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!

2007-11-29T15:13:00.000-05:00

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...

2007-11-28T13:49:00.001-05:00

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...

2007-11-26T16:56:00.000-05:00

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...

2007-11-24T17:21:00.001-05:00

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.

2007-11-23T08:24:00.000-05:00

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.

2007-11-22T01:47:00.000-05:00

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...

2007-11-19T08:13:00.000-05:00

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!

2007-11-16T18:27:00.000-05:00

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...

2007-11-15T18:06:00.000-05:00

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!

2007-11-13T10:20:00.000-05:00

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...

2007-11-10T16:05:00.000-05:00

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...

2007-11-07T14:26:00.000-05:00

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!

2007-11-05T17:19:00.000-05:00

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!

2007-11-04T01:00:00.000-05:00

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!

2007-11-01T12:51:00.000-05:00

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:-)

2007-10-30T20:56:00.000-05:00

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

2007-10-28T10:36:00.000-05:00

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

2007-10-27T19:43:00.000-05:00

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!

2007-10-26T11:54:00.001-05:00

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!

2007-10-25T17:47:00.000-05:00

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!

2007-10-24T18:42:00.000-05:00

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?

2007-10-09T20:28:00.000-05:00

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.