Japan Bound!!

We finally got our April schedules...on March 31st. Waiting for the following month's schedule is perhaps the most frustrating aspect of my program. Especially when spring break is fast approaching!

I knew the dates of spring break, but I didn't know the exam schedule. To my surprise, April looks like a manageable month for exams. However, 2 more classes were added on: radiology and hematology. But, we're finishing up pathology and cardiology soon.

I've been weighing the pros and cons to taking an impromptu trip to Japan all week. The most obvious con is jet lag. BUT...I haven't slept well since the program began back in September!!! So, I know I can deal with it.

After I booked my trip, I felt relieved and excited! I have received welcoming emails from my friends in Japan. All I really want to do is visit the people that became my second family while living 3,000 miles from home. Life in Japan can be a very isolating experience. If you want a glimpse as to what I'm talking about, rent the movie "Lost in Translation".

When I decided to extend my teaching contract for a second year, I decided I would really focus on solidifying my relationships with my Japanese friends and surrogate families. And that decision has brought many blessings into my life.

And that is why I want to return to Japan.

Spring Break

Big decision to make.

Spring break is quickly approaching. I've been thinking about going to Japan to visit my friends and "family" for some time now. I met some amazing people during the two years I lived there and it would be somewhat of a homecoming for me. I left Japan in 2000, visited in 2003...and it's now 2006.

My former JHS students are now in college! More friends have gotten married and more babies have been born.

And I'm a PA student.

It may be time to introduce the Japanese to the PA profession...

OB/GYN

When it comes to OB/GYN...ignorance is bliss!!!!

OB/GYN

We have an OB/GYN mid-term on Tuesday. During class today (sunday class, mind you)...the guy sitting next to me whispered, "I think I have PMS!" He was studying the OB/GYN notes and told me he was suffering from the following symptoms:

Weight Gain
Headaches
Irritability
Aggression
Tension
Anxiety
Depression
Lethargy
Insomnia
Appetite change
Loss of concentration
Poor coordination
Clumsiness

Although these are all somatic/psychological symptoms of PMS, I opted to diagnose him with the most obvious differential diagnosis: PA School Blues. Then I swiftly reminded him that his symptoms will resolve in 18 months. Unlike the rest of the females in the class...

But, perhaps that is why there are more females in PA school these days.

We're genetically programmed to handle the recurring and unrelenting stressful symptoms of both PA school and PMS!

Who knew PMS could be such a blessing?!?!?!

Dept of Labor

The Dept. of Labor ranks the PA profession as one of the fastest growing occupations in the country. Because of this ranking (last I heard it was #4), it's been featured in magazines and newspapers around the country. I'm not sure which publication featured the profession in the NYC area, but everytime I'm in Brooklyn and tell someone what I'm doing...I usually get one of the following responses:

1. Why not be a doctor?
2. That's great, it's only a two year program!
3. That's great, you're going to make a lot of money!

For the sake of time, I usually only address the first statement and nod my head to the 2nd and 3rd statements. But...here's what I'd like to say...

1. The PA profession is a better fit for my personality, career goals, and personal goals. And PAs report greater job satisfaction in comparison to MDs!

2. It's not really a two year program. The professional phase is 2 years. The pre-requisite phase is 2 years. The health care experience requirement is at least 2 years. Considering my previous psych degree, healthcare experience and pre-reqs...I'm in year 10! TEN YEARS!

3. If you're motivation to become a PA is to make a lot of money, you're NOT going to make it through school. PAs do make a healthy living, but can you really equate a dollar amount to the responsibility that comes with having patient's lives in your hands? You have to be passionate about medicine, passionate about helping people, passionate about learning. Medicine is constantly changing, it is a life long educational process.

There are continuing medical education credits that need to be completed on a yearly basis as well as re-certification board exams every 6 years. In my opinion, there are easier ways to make a comparable salary...and if money is your main goal...re-evaluate your options.

You will not be a happy camper.

Mach Speed

Besides the absolutely insane, mind blowing pulmonary exam 2 weeks ago....March has been a very quiet month. We had a physical diagnosis exam a few days ago and I didn't even get nervous. I had to perform a neurological exam on a fellow student and it worked out really well. We are required to memorize a ridiculous amount of information for these practical exams as well as perform a ridiculous amount of maneuvers/tests that aren't really used in practice anymore. It can be frustrating, but at the same time, it is a confidence booster once it is all done.

We have our first OB/GYN exam next week and although there is a ton of material, it's the only exam next week, so it's definitely manageable. And that's the scary thing...March has been manageable.

April and May will NOT be the same. Once again, we KNOW this is the calm before the storm. Once again, we KNOW we're going to get slammed with several back to back exams for a few weeks in a row. Once again, we KNOW we will be challenged intellectually, emotionally, and physically.

Once again, we KNOW we'll do fine...but we'll freak out anyway!! I know I will get a phone call at 2am the night before an exam from one of classmates freaking out! I know I will call one of my classmates the night before and freak out as well! And I also know that as long as I walk away from an exam knowing I tried my best...I will sleep well that night.

April will be interesting. We have 7 days of class and then we have Spring Break! Unfortunately, we will have exams the week after break. And by then, it will be the end of April...the semester ends mid-May!!

Once again, life is about to take off at mach speed!!

I'm ready!

School Daze

School is going well again. And I'm enjoying all of my classes. Here's a list of the classes for this semester:

Cardiology
Pharmacology
Pathology
OB/GYN
Opthalmology
Dermatology
Physical Diagnosis Lab
Physical Diagnosis Lecture
Intro to Surgery
Surgical Nutrition
Lab Medicine
Pediatrics
Hematology
Pulmonology
ENT (Ears Nose Throat)

So, that's the reason why we're in school 6 days a week. At this point, I don't really mind it because I love learning about medicine. It does stifle social plans...but, I'm used to that by now. I feel really lucky to be surrounded by the classmates in my class. I've gotten to know everyone a lot more compared to last semester. Last semester for me was all about survival and making my mark. This semester is about embracing where I'm at and building confidence by gaining knowledge and next semester...next semester will be about breaking out my wings....cause in September, it's time to fly!!!

The greatest difference between this semester and last semester is the schedule. Last semester we had to be in school by 9am every morning. Each class was 3 hours long. Most days we had between 6-9 hours of lecture.

This semester, most classes start at 10am, but some days, not until 2pm! Lectures last anywhere from 2 hours to 6 hours!!! There is no routine, no flow...every week is different. We also have several instructors for one class. Nothing is routine. Nothing.

I'm handling it a lot better now. As are most of my classmates. It's so reassuring when everyone else complains about the same thing! But, it took us a while to figure out why we were all stressing out so much compared to last semester.

As excited as I am to start rotations (September), it does cause a lot of anxiety. I'm pretty confident sitting down to take exams now. If you give me a multiple choice question, I'm pretty good at picking the right answer. The real challenge for me will be when I'm doing rounds and my supervising physician asks me a question without giving me a, b, c, or d!!! I know this is a common fear shared by all of my classmates...but, the thought still freaks me out.

So, I try to keep it all in the day. I'll deal with it when I get there!

Read This

http://hotzone.yahoo.com/b/hotzone/blogs2986

This is an incredible story.

The "Fun" Stuff

Today was one of those days that I will remember for years to come. We learned how to perform pelvic exams!

Thankfully, we practiced on plastic models and NOT on each other! There are 2 guys in my physical diagnosis lab group and they had absolutely NO idea what women went through each year! Watching their facial expressions during the demonstration was priceless.

Although we were only practicing on plastic models, it was great practice for the real deal. And although I really am not looking forward to performing countless number of pelvic exams during my OB/GYN rotation, I'm excited that I now possess the knowledge and skills to perform such an important medical screening procedure.

Next week: Rectal exams! Once again, I'm thankful that we're practicing on practice models and not on each other!!!

Greater Perspective

I've been struggling lately with re-gaining my perspective on what I'm doing. The last few weeks have been really challenging, both intellectually and psychologically. The last few weeks haven't been that much fun either. And although I always try to focus on the big picture...I readily admit that I lost my perspective for a while.

Over the last few days, the universe helped me get it back. Thanks to the help of supportive family members (st. patty's day family party) and friends (www.bogotabistro.com) . As well as a phone call from an old soccer teammate, who is now the chief resident of pediatrics in Chicago.

My childhood friend attended an accelerated 6 year medical program (undergrad plus medical school) and became an MD by age 24! She is now moving back to NYC to complete a fellowship in pediatric cardiology. She empathized with my feelings and listening to her express how she felt while in medical school comforted me. I know she continues to make personal sacrifices in order to be the best doctor she can be. She's an inspiration to me, and always has been. Her phone call came at a time when I needed it most.

Thanks, Dr. Shetty!

Temporary Insanity

Just when you thought it couldn't get anymore stressful...

We now have classes 6 days a week! My only day off is Saturday.

I will continue to train clients at the gym Saturday mornings.
But, no more hostessing. No more sleeping in.

Something's gotta give.

My new daily mantra, "This is only temporary!"
Temporary insanity.

T-rex Ain't Going Down Like That!

We weren't supposed to have class until 5pm on Thursday (the day after the "Nerds Gone Wild"). I was really looking forward to sleeping in, making eggs, and watching The View with a nice cup of coffee. But when my phone rang at 10am, I knew my plans for a relaxing morning were ruined.

I wasn't a very happy camper when our class president called saying that we were EXPECTED to be at the school at noon to review the test (massacre) from the day before. The stress from the day before was still lingering. And the post-test anxiety kept me awake half of the night. Needless to say, my nerves were still frazzled.

I received a few phone calls from classmates that were thinking about not going in early as a form of protest. I fully understood where they were coming from, and as much as I didn't want to go in early, I couldn't not go. I signed up for this. I chose this path. And this was part of the game.

About 90% of my classmates showed up. When our pulmonary instructor walked through the door he smiled and said, "Don't attack me!" I was relieved to see him smiling. I was certain we were going to get yelled at for doing so poorly on the exam. But, to my surprise, we heard the opposite.

The instructor said, "I know you guys were upset with me and with the exam, but I am VERY happy with the results! You guys did a great job!"

WHAT?!?!?!

The instructor then addressed EVERY SINGLE one of our concerns. He listened to us as we expressed our disgust at getting tested on information we never learned. He listened to us as we expressed our dissatisfaction with some of our lectures. He listened to us as we told him about the unnecessary stress we went through.

The bottomline is that HE LISTENED TO US. And that made us all feel better.

Then the director of the program came into the room and also congratulated us on doing a good job on the exam. He told us that they purposefully put 30-40 questions on the exam that they knew we weren't prepared for. They did it on purpose. They wanted to see how we would do. They wanted to see if we'd crack under the pressure.

The highest grade on the exam was an 80. They told us that if we scored between a 60-80 then we did well. They told us that the majority of the class did score in that range and that our scores were higher than the national average for board questions at this point in our training. They told us to be proud of ourselves.

I felt very confused and overwhelmed by what he was saying. My classmates weren't fully buying it. The director also fielded questions and addressed our criticisms and concerns about our education. The director responded with, "You guys have to TRUST ME...we've been doing this for a long time and we want every one of you to succeed and pass the boards...TRUST ME!"

After he left, the instructor spent the next 2.5 hours reviewing the exam with us. He reviewed the questions that the majority of the class got wrong. There were 35 questions on his list and with every question he asked us why we got it wrong...what we thought the answer was...and if it was a fair question based on the education we received to that point. It was unbelievable and even moreso when the class accepted responsibility for the questions we legitimately got wrong.

I have to say that my classmates are extremely professional and mature when it comes to stuff like this. It's refreshing to be surrounded by classmates that hold themselves accountable for their actions. A class that is more concered with learning how to take care of patients than outscoring each other on exams. Although I have a hard time believing everything we're told...I do believe them when they say we're a "special group". Your classmates make all the difference.

After we finished reviewing the exam, we all went upstairs to the program office to get our "unofficial" grade. The grades will be curved after all. But we all wanted to know if we fell within the coveted 60-80 range. So we waited on line, single file, and one by one went into the office to get our grade.

When I walked into the office the instructor said, "Good job!" I scored within the range. But, I still felt uneasy about the experience.

It's taken me a couple of days to recover from that traumatic day. For the first time in my life, I've put ALL of my eggs into one basket. My life revolves around school. I've never had to work so hard before to achieve a goal. I've made many sacrifices to get to this point and to sit down at an exam and not know the answer to 20+ questions is a very unsettling experience. It freaked me out and I got scared. And for the first time since the program started, I caught myself thinking, "What am I doing this for?"

So, my next challenge is to turn that fear into motivation. I'll be damned if I sit down for an exam and get hosed like that again.

T-rex ain't going down like that.

Nerds Gone Wild!

Today was not a good day.

We had a cumulative final exam on the pulmonary system. I did well on the mid-term so I felt somewhat secure going into the final. But, I still studied my butt off and sacrificed yet another weekend to hit the books. But, for some reason...in the back of my mind...I felt like no matter how hard I studied...it wasn't going to pay off.

I started the exam and the first 5 questions were easy. I was getting into the groove and felt optimistic about the next 95 questions. But, for some reason, I noticed that the room was especially quiet.

It was, indeed, the calm before the storm.

Twenty minutes into the exam one of my classmates busted out laughing and said, "Are you kidding me, we never learned this!" This classmate is usually very reserved and quiet (no, it wasn't me!) and shocked the proctor. In fact, she shocked the entire class. The proctor quickly walked over to her, but by then, it was too late. The ENTIRE class had erupted into chaos.

For the record, our class is normally well behaved and professional.

"Who wrote this exam?"
"Where is the instructor, this is ridiculous!"
"Are you ***** kidding me?"

I've never seen anything like it. A class full of angry, smart people revolting over the fact that they were getting hosed on an exam.

"Nerds Gone Wild!"

When other people freak out, I get calm. So, I sat back and observed. Some were so angry, their faces were bright red. Some were muttering curse words under their breathe. Others wiped tears from their eyes. One girl even stood up and walked around to calm herself down. I'm telling you...it was CRAZY!

It may sound strange, but some of the questions provoked strong feelings of anger and betrayal. And I will try to explain why...

We were set up by the same man that told us..."there ain't no crying in PA school". The same man that reminded us that we would be held accountable for everything that we've learned up to this point, on any exam, at any time. So we studied our butts off...and we were given questions on information that was never EVER presented to us. I'm not talking about a few questions here and there....I'm talking about blocks of questions...between 30-40 questions on a 100 question exam!

There were clinical questions that included lab results and radiology findings. Yet, we haven't taken lab medicine or radiology yet. Clinical questions require critical thinking and that is what this exam was all about. Critical thinking was not the problem. But, when you haven't been taught two major components that would lead you to a diagnosis...it's frustrating. VERY VERY FRUSTRATING!

The worst part was that halfway through the exam, the proctor left and brought in one of the instructors that wrote questions for the exam. With a smirk on his face, he said, "these are the types of questions you will get on the BOARD EXAM!" That didn't do anything to help my psyche. Although we don't take the board exam for another year and a half (!!!!)...it still struck a nerve within each and every one of us.

Some students left the exam early. Others put down random answers. The majority of us stuck it out and battled through it. We were given 3 hours for the exam. It took me 2 hours and 45 minutes.

I felt completely drained afterwards. As well as the stupidest PA student to ever walk the earth. It wasn't a humbling experience...it was a demeaning experience. Nobody likes to feel stupid. But for some reason, they put us through it. For some reason, they upped the ante without dealing out all the cards.

For some reason, they wanted to strike that nerve within us.

And T-rex doesn't like that.

The Art of Practice

Medicine is not an absolute science. Our pediatrics instructor constantly reminds us that practicing medicine is an art form. There are so many variables and so many different treatment options. When you become a PA or an MD, you get a license to PRACTICE medicine. The key word is practice.

Now, I didn't learn that from a PA/MD/PhD instructor. I learned that from a man living with AIDS. A man who was told he was going to die since he only had a handful of t-cells left. For 2 years, that man was continually told he was at the brink of death. But, he continued to live. And one day, his t-cell count began to rise. And suddenly his medical team was telling him he was going to live. And he did...for 8 more years.

Before he died, I told him I was considering a career as a PA. I had many doubts about whether or not I had the brain capacity to know all there is to know about medicine. And that is when he told me, "Medicine is very challenging, but you have to keep in mind that you will get a license to PRACTICE medicine. I used to get very angry with my medical team until I realized and accepted that there wasn't one person with all of the answers. Until I realized that no 2 human bodies are exactly the same. And I found great peace when I discovered the power of the human spirit. I was told I was going to die 8 years ago...and my spirit said NO!"

So when I find myself getting aggravated by the "know-it-all" PA/MD/PhD instructors...I think of this man, this man who defied the transient laws of medicine and I quickly regain my perspective.

I am a student studying the art of medicine. And like every artist in training, I'm developing my own style. A style that will incorporate the power of the human spirit.

STOP Smoking People!

If people didn't smoke, I'd have a lot LESS studying to do.

Smoking is a risk factor for a bizillion different diseases. And I have to know them all!!!

So, if you're lacking in motivation...please do it for me!!!

This PSA announcement is brought to you by a very tired (sick of studying) PA student.

Academy Awards

Life requires skillful acting at times.

After my performance this weekend, I'm likely to be nominated for an Academy Award next year.

So, after PA school, I think I'll head to Hollywood. Afterall, I wouldn't mind playing opposite Patrick Dempsey on Grey's Anatomy.

I've got the medical terminology down...

Good Stuff!

The messy fog of doom and gloom has lifted.

1. My Godson, Cross Alexander, was born Monday night!
2. I can read EKGs!!!
3. Mid-terms have ended!
4. I slept for 7 straight hours last night...the most sleep I've gotten in 10 days!
5. I will be hostessing Friday night at Bogota!

I feel like a new woman! (actually, it's just nice to feel HUMAN again)

Although mid-terms ended last night, FINALS begin next week for some of the classes. Time is going by so fast that it's hard to figure out what is going on at all times. I can't believe it's March 1st!!!

I START ROTATIONS EXACTLY 6 MONTHS FROM NOW!!!!!