Charlie goes to Medical School

I have no idea who these people are. Picture by ckroberts61

Just an FYI.  Tonight is Doctor Prom.  I’ll try to post about it in a few days.  Basically just a formal dance for the entire school of medicine.  Wife and I have been looking forward it for a while now.

Hopefully they’ll clear the place out by playing Don’t You Forget About Me at the end of the night.

You are here.

Okay, not really.  We wrapped up the nuerology module with a section on psych, the purpose of which seems to have been to demonstrate that I will never want to do psych.  I got raked over the coals on that last neuro test, so I took some extra time to put into studying for the upcoming cardio test (which was yesterday).

To mark the shift from one module to the next, our first lecture was kicked off starting with a slide of the Tin Man.  When faced with such references, I usually feign ignorance and make a joke about how we are going to learn about robot hearts instead of human hearts and some day I’ll be able to say that I got my MD from robot medicine school.  This was not a joke that a lot of people got.

So, we are done with the brain and have moved into the heart and the rest of the thorax.  This also means that we are neck deep into the physiology component.  Phys really hasn’t had a chance to represent up until this point, but we are currently in full physiology mode.  In fact, it got to the point where the faculty decided that they weren’t going to lecture us on physiology (cause you can teach people to lock themselves in a room alone until they understand what capacitance means).  We had Q&A/Reviews following self-directed “podcast” learning.  It seems like what works best is to work through problems to enforce the concepts…a lot of problems.

The physio component has given us plenty of opportunities to learn from problems in various ways.  We had another problem based learning session in small group where we were to diagnose and treat for a case of heart failure (decompensation in a patient with decreased heart function following an MI).  Then I went to my elective class in the emergency department where they demonstrated that what I had learned was wrong (well, wrongish…there are other things that you do first).  The class also broke into groups of four to run an exercise in the simulator lab.  Even in lecture, we are working through problems…reviewing the material from notes and the online videos.

The physio-heavy exam was pretty brutal.  Each question seems to take about twice as long to think through as most of the other problems, which makes sense.  A lot of anatomy and histology can be straight up recall.  Sometimes in might be application for a clinical case.  But physiology winds up being 4 or 5 answers that you have to consider in the context of the question…carefully.

Anyway, The test is over I’ve got a quick weekend to breathe before a group presentation next week.  Then a week and a half before my next series of tests.  Histo, anatomy and didactic exams over a period of two days covering the material from pretty much the entire module.

So, I’m actually making a little bit of money on the blog.  I feel like I should disclose this fact even though I’m not even close to breaking even with hosting costs…especially given the fact that Google puts your money in hock until you break the “payment threshold”.

Or to put it another way: “We aren’t paying you until it is worth the stamp.”

The reason that this has come to light is because Google has decided that it needs my tax information for the amount of money that I have earned (which doesn’t even cover the .com domain).  Sadly it is not because I am reaching my threshold…it is very far away.  I think they are just checking because of the end of the year.

In light of all this, I have set a resolution for next year.  If I hit the threshold and that glorious check shows up, I’ll actually get close to breaking even on the site.  So, for 2010, I’m going to try to get my money from Google.

So tell your friends, Charliemedschool.com.

Charlie White Coat

Over Winter Break, I plan on catching up on the blog a little bit.  In doing so, I will try to hit some of the highlights of the past four months which for one reason or another…mainly because I was busy studying…I did not find time to write about.  What is probably the greatest shame is the fact that I did not post about White Coat Ceremony when it occurred.

The White Coat Ceremony is a fairly common occurrence at medical schools these days, and with good reason.  Although the sheer magnitude of coursework does serve as its own reminder that one is in medical school, it does not serve to remind the medical student of the professional responsibilities associated with entering the field.  One thing that does jump out as a symbol of that professional responsibility is the white coat itself.

Although the short white coat of a medical student does stand out among the longer coats of the doctors of the physician, to the average person coming through the hospital it may not even register that there is a difference.  By wearing a white coat, a medical student shoulders a great amount of responsibility, especially on the grounds of the hospital where any patient might not be able to tell the difference.  He or she may not be able to do much with regard to treating illness, taking a physical exam…or even very much of a history (I’m still stumbling through my review of systems), but in professional clinical attire the student represent the hospital as much as anyone else in a coat or a pair of scrubs.

The White Coat Ceremony is a relatively new institution in medical schools as they have begun challenging their first year students to start thinking about professionalism from day one.  The actual ceremony usually takes place about a month into the first semester, to give students time to reflect on the responsibility that they are about to take on.  At my medical school, one exercise they put us through was to have our class actually write the oath that we took after accepting our white coat.

Our actual ceremony happened shortly after labor day.  We had finished our second test and completed the first fundamentals module.  The ceremony was planned during the college’s Parent’s Day with other activities occurring around the campus.  I believe the PA students also received their coats that day.  Earlier today I happened to drive by the church where the ceremony was held as the medical school did not have an auditorium big enough for the class and families.

I was fortunate that my family could make it down.  Wife and I were very happy to have my parents and my sister there for the big day.  After a morning reception at school, I drug my folks over to a local burger joint where the staff had apparently gotten to know me well enough to start harassing me in front of my wife and family.

At the church that day, we were instructed to get in single file according to a number which was emailed to us earlier that week.  I stood there for a few minutes before I realized that we were in alphabetical order much like our assigned anatomy groups, so I started introducing myself to the people ahead and behind me.  The four of us have been working together once or twice a week since.

We filed in and took our seats.  When my turn was up, I handed a card with a phonetic spelling of my name to the Associate Dean of Admissions, I walked across the red-carpeted stage, held out my left arm to be placed into the coat being held by the Vice Dean of Academic Affairs, got the coat around my right arm, straightened it and then shook hands with the Dean of the Medical School trying to face forward for any pictures that my family might have been taking at the time.  I then walked down the center aisle back to my seat and then as professionally as possible, tried to take a picture of the embroidered names and sewn on patch with the logo of the college.

The names were mine and “School of Medicine”.

As I recall, the oath was administered after the coating.  That was the only time that I saw the final draft.  Perhaps once a little time passes, I’ll post it here.  Following this, I believe that I was about to have a migraine from dehydration, so I actually bolted to the reception before most everyone else to grab a few diet cokes and a few waters as I didn’t know where to find any medicine at the time.

To cap off the day, my family ate at the small inn down the street from our little apartment.  I believe that I had a steak, but I only remember this because I was insisting that we go to a steak house and the restaurant at the inn was the best compromise for everyone.

Since then, I’ve worn the coat a half dozen times.  Some people have put logo buttons on them or sewn other patches on the sleeves signifying some other research lab.  The second years also wear them but usually with a lab cheat sheet or a reference guide in the pocket, sometimes with their stethoscope tucked in the pocket instead of around the neck.  Third and fourth year coats usually hang a little lower after the months of toting around the stethoscope along with other various reflex hammers, pen lights and some even oto/ophthlamoscopes.  The neck and pockets have given in and sag under the weight of medical student clerkship.

At some point, this white coat will be shoved into the closet next to my robe from college graduation and my Hawaiian shirts and will probably be taken out for moves or when someone’s kid wants to dress up as a doctor for Halloween.  Maybe I’ll hang it up at the office or God forbid someone future-me knows wants to go to medical school and is looking to me for guidance.  I’ll pull it out and talk about responsibility and weight and ring around the collar.   Then I’ll put it back up and show them the neat toys that doctors get to play wi….I mean use responsibly.

That’s not actually true.  I just updated the wordpress software.  Good deal.

Next, some back evals on professors and courses.  They claim to actually read that stuff, so I’m going to claim to actually do it.  Just kidding.

I also have half a dozen honey-dos around the house.

Edit: Minor issue with WP to Twitter plug-in so there won’t be any twitter updates for a while.  Sorry.

Edit2: Sorry for the test posts.  I though I would clear all of those out before they leaked into the feed.

Admin Cat likes to hang out with me when I study at home. It usually isn’t bothersome, but sometimes you gotta trap him behind some pillows to get your work done.

That’s one semester down.  Probably something like 21 to go…if you count half years as semesters.

I need this break.

I’m also trying to nail down something for summer.  I’m going to be doing research hopefully.  I am applying to programs and speaking to some of the research organizations affiliated with the school.  It is actually pretty exciting stuff.

I want to post some over break, but for now just know that I am on a well-deserved break.

Just a quick post.  Patient HM is a famous patient with amnesia.  I haven’t actually had time to look into his story with my own studying going on, but I’ve been watching the microtome video while studying (and when I’m supposed to be studying).

They did a lot of the frontal lobe last night and are right now in the genu/rostrum/body area of the corpus callosum.  If you haven’t had neuroanatomy yet, this is where the brain anatomy gets interesting.  The middle third in any axis is where most of your smaller structures are located, and also where most of our neuroanatomy lab focused for the last exam.

Exciting stuff.

Here’s the link to the video:
http://thebrainobservatory.ucsd.edu/hm_live.php

And some other links:
http://science.slashdot.org/story/09/12/02/2248233/Brain-of-Patient-HM-Brain-Being-Sliced-Streamed-Live
http://en.wikipedia.org/wiki/HM_%28patient%29

Sphygmomathingy by CDC

Alright, everyone take a deep breath and begin relaxing…NOW!!!

I have a million of those jokes.

It turns out this blog is a good barometer for how quickly time is going.  Last night I was talking with a friend about time slipping away.  So much is going on in such a short amount of time, that you just don’t realize where the days go.

I had no idea, but the last post was practically two weeks ago.

I have a test this week.  The neuro/psych module is well underway.  We have wrapped up gross anatomy lab for the time being and have started a brief neuroanatomy lab section.  We have had about two labs a week for the last little bit.  Basically we float around from station to station.  There are around 6-8 students per station where we review tag sheets of items to identify.  Occasionally an instructor stops by, and we’ll review a few sections of the brain.  The instructor will walk through the internal structures that can at times seem like two tiny objects of very similar shades of the same color on contiguous field of another similar shade of the same color.  It really isn’t that bad, but you do have to appreciate how complicated the brain is considering how similar most of its structures are.  Much like histology there is also a lot of two-dimensional presentations of three-dimensional structures, so there is a lot of spatial reasoning (the non-dominant side of the brain) that must go on.

One of these past weekends, I had a nice break from studying.  Our class went out to one of the local homeless outreach organizations and set up a health fair.  The first year dental students were there as well.  We had booths talking about dental hygiene, foot care, health in general and stress relief.  There was also some high school students who I think were on the back-end of a coat drive, handing out supplies for the upcoming winter.

I was in the stress relief booth which was pretty slow until a second year student stopped by with a blood pressure cuff (i.e. sphygmomanometer).  The main point of the booth was to promote stress relief practices (diet, exercise, socializing) and for us first years it gave us a chance to learn and practice taking blood pressure.  I had actually done this in my freshman A&P course that I had taken right before coming to medical school, but doing it on other people…who are waiting…is much different than taking your own in lab.

Most of the last few weeks have been spent with my notes.  I’m actually quite stressed about this upcoming exam.  I think I’m getting the material down, but I’m just repeating a lot of this stuff over and over again to make sure that I know everything.  The good and bad news is that I have the last time slot for my practical this time around.  This means that I won’t be in one of the groups getting the test out of the way, but I’ll have 3-4 hours to study in between the written and practical exams.

I’m going to get back to studying.  I actually wrote like half of this earlier in the week and just now realized that I left the draft just sitting here.  Hope everyone is doing well.

And don’t let the stress get to you…

From Real Genius.  Go rent or buy it at your local video renting/buying place.

Behold the Resplendent Anatomy of the Human Fry...by Futurama

So…

The end of the last module hit me much harder than I expected.  I managed to get through without any major damage to my grades or my ego.  Wife feels a little ignored and my caffeine twitch is a little more pronounced, but all-in-all it was a rousing success.

Musculoskeletal was a very interesting module because it gave me a chance to think about some specialties which I had not considered yet.  We did have a bit of lecturing on integument which meant that we also had a dermatology clinical lecture.  We also had a radiology clinical lecture, which was a jumping off point into the radiograph studies that we made use of in the gross anatomy material.  However, the majority of clinical correlations during this module had to do with surgical specialties, orthopedics and surgical oncology.  It has been interesting to listen to these clinical lectures, because I hadn’t given a lot of thought into surgery.  However, the major sticking point still seems to be that an early retirement age (or at least retiring from surgical procedures) means that I won’t get to practice as long as I would in other fields.

A lot of significant first occurred during this lecture.  Gross Anatomy Lab kicked off which we’ve already talked about.  We also started Histology Labs which I’d like to spend a post talking about.  This has also started a round of lab practical exams, which I should probably also include.

Mostly, however, this module has been a lot of grunt work.  Biochemistry has started covering a lot of metabolic pathways which means memorizing the pathways, the enzymes, the regulation and the clinical conditions associated with their dysfunction.  Anatomy is mostly memorization with a little bit of sussing out function (once you have the origin and insertion of a muscle, you can figure out what it does…and sometimes vice versa).  Histo is more visual memorization but basically the same thing as Gross on a smaller scale (if a cell has a lot of secretory vesicles…it secretes stuff, if it needs a lot of energy…it has a lot of mitochondria), but with some accompanying Cell Biology.  Some Physiology and Development were also in this module.

Neuroanatomy Lab...by Futurama

The Nervous System has gotten off to a slow start with some intro lectures…until today which was basically a four hour laundry list of structures that we need to memorize, the skull, the brain, the supporting structures and the ventricles (I’m going to go with the description “brain holes” for the ventricles).  We are wrapping up some of the muscular dissections with the neck and face and quickly moving into the brain next week.  We’ll also have a separate series of neuro anatomy labs.  This module is more lab-heavy than the last module.

Neuro/Psych is what people are considering to be the hardest of our first year (but I bet they say that about every module), so I’m going to be doing my best to stay well ahead.  Luckily both Thanksgiving and Christmas breaks occur during this module, so I’ll have a couple of chances to catch my breath…or at least study a lot without new material.

Futurama is a show that was on Fox but is now showing on Comedy Central or somewhere.  Go watch it or buy it.  Thank you.