Thursday, June 29, 2006

Party Time

Wow.

Our exam was changed from July 5th to July 3rd.

And we don't have class until 3pm on July 5th.

Party Time!

Wednesday, June 28, 2006

Top 5

What am I going to do after I graduate?

That's the question that has been swirling around my mind lately. Will I specialize? If so, what specialty? Will I move out of NY? If so, where will I go?

I did some research and according to the AAPA (American Academy of Physician Assistants) this is where the money is:

Tope 5 States for New Grads
Nevada
California
Alabama
Massachusettes
Maryland

Top 5 States for Experienced PAs
Arkansas
California
Alaska
Nevada
Connecticut

Top 5 Specialties:
CT/CV Surgery (cardiothoracic/cardiovascular)
Dermatology
Neurosurgery
Emergency Medicine
Surgical Subspecialties

I wouldn't mind moving to California...that would bring me closer to Hollywood. So, I can be an extra on ER or Grey's Anatomy during my downtime as a Cardiothoracic Surgical PA.

Um...I'm working on Plan B. (and C, D, E, & F)!!!

Tuesday, June 27, 2006

Knuckleheads

I am not a big fan of the 4th of July. Celebrating the Independence of America is great...but I could do without the knuckleheads that feel the need to blow things up.

But, I was looking forward to this year's holiday. One of my friends from class is throwing a party on the 4th. She started planning this party months ago and everyone from class is invited. We've all been looking forward to this party since we haven't really had the chance for everyone to get together for a "proper" college party. Yup...beer pong, keg stands, turbo cups, and jello shots were all on the agenda.

Well, we got our schedule for July today. There is only ONE exam scheduled for the entire month of July.

Guess when that is???

July 5th at 9am!

We offered to take the exam two days earlier than scheduled, but the admin refused. We got the same old speech..."We told you at the interview that you'd have to make sacrifices, that you'd be missing parties, weddings, funerals, etc. "

blah blah blah blah blah blah blah

Party or no party...I know I won't get much studying done on the 4th anyway! I'll be too distracted by the knuckleheads blowing up the neighborhood.

Geez, I can't wait until next year when I'll be treating these same knuckleheads in the ER.

Wednesday, June 21, 2006

Embryology

Embryology is no longer part of the curriculum. I don't know when that changed, but many of our instructors would refer to embryology during second semester and we'd always respond with, "we didn't take embryology!"

After a few weeks, when a new instructor would refer to embryology, the class would laugh. It became somewhat of an inside joke for us.

About a month ago, the director of the program addressed our class and our concerns about our education. One of the students brought up the fact that every instructor was referring to embryology, yet it wasn't part of our curriculum.

Well, a few days later, the director sent us a memo letting us know that if more than half the class wanted to take embryology then he would set it up. Only a handful of people wanted to take the class but before we had the opportunity to vote...we were informed that there would be a mandatory embryology class. The catch is we wouldn't receive any credit for taking the class nor would it appear on our transcripts.

Needless to say, that didn't go over well with the class. It is a 4 hour class, which doesn't sound that bad in comparison to everything that we've been through. But, the class is broken up to 4 days of 1 hour classes. And before every class, we will take a quiz. Although we won't receive a grade OR credit for the class...we have to pass the quizzes.

So, we had our first embryology class last Friday and the instructor is a PhD. Semester 2 was all MDs and PAs....we didn't have any PhD faculty. And there is a huge...HUGE...difference. Basically, the MDs and PAs teach us what we need to know and the PhDs teach us everything we never wanted to know!

This class is out there. This class is totally irrelevant to everything that we've been learning. It feels like we're going in reverse instead of forward. It feels like we're being punished for speaking up. Yup....that's what it is....punishment.

We had our first quiz today. 10 matching questions in 5 minutes. I thought the prof was kidding...but, she wasn't. Matching questions usually aren't that tough...but these sure were! Although there were 10 questions...she gave 15 choices...and you could re-use answers. It was a nightmare...all the while she was counting down the minutes.

There were a lot of unhappy students after the quiz. And the student who initially brought the missing embryology class to the director's attention really should consider getting a bodyguard.

It's not solely her fault...but, sometimes you really, really, REALLY, have to be careful with what you wish for...

...I certainly wouldn't wish this class on anyone!

Tuesday, June 20, 2006

Senior Talk

We had the much anticipated "Senior Talk" today. Some of the PA preceptors that we will be doing rotations with visited and gave us an overview of what the next year will be like. We were congratulated for making it to this point in the program and encouraged to continue being successful. At that point, we all smiled and patted ourselves on the back. But...that didn't last very long!

The meeting lasted about an hour and we were hit with a lot of overwhelming information. We received a list of all of the doctors and PAs that will be our preceptors. A lot of the offices/hospitals are located in Brooklyn and NYC. We were also given a procedure log that we need to carry on every rotation. There is a list of 17 required procedures and 7 optional procedures.

Here is the list of procedures (all must be completed 3 times).

Required:

Venipuncture
IV Insertion
Blood Culture
Arterial Blood Gas
Fingerstick
PPD/SC Injection
EKG
Nasogastric Tube Insertion
PAP Smear
Foley Catheter Insertion
Pelvic Exam
Rectal Exam
Dressing Change
Throat Culture
Suturing/Stapling
Splinting/Casting

Optional x 3:

Chest Tube Intubation
Endotracheal Intubation
Central Line Placement
Wound Debridement
Newborn Delivery
Removal of Foreign Body From Eye
Fecal Disimpaction

Of course the goal is to do every single procedure as many times as possible. As well as do any type of procedure that an MD/PA asks of you.

Every rotation lasts 5 weeks. Here are the required rotations:

Internal Medicine
Pediatrics
Emergency Medicine
Family Practice
Surgery
Geriatrics
OB/Gyn

We have to repeat one of the required rotations as well as choose one elective rotation (ie. psychiatry, dermatology, orthopedics, neurosurgery...basically any specialty/subspecialty of our choice).

At the end of the 5 weeks, there is an exam. You must pass the exam to move on to the next rotation. We will also be assigned a medical topic and have to present a powerpoint presentation to our classmates and faculty at some point during the year. There is also a required community service project of our choice that we have to complete (30 hours). And faculty will be visiting us at the hospitals/medical offices where we will present interesting patient cases including history and physical, labs, diagnoses, treatment (etc) to them.

When the meeting ended, there were a lot of blank stares and strained faces.

The guy sitting next to me whispered, "I'm scared!"

I let out a nervous giggle and winked...

"Me too...but don't tell anyone!"

Sunday, June 18, 2006

On With The Show!

School has been pretty slow and laid back lately. So, I've been taking advantage of the hot weather that's currently blanketing Long Island with my usual favorite outdoor activities...mostly rollerblading and basking in the sun. Although, thanks to my dermatology class...I've become paranoid about every freckle on my body. If I don't become a hypochondriac by the end of this program it will be a miracle!

This past weekend I travelled up to Ontario, Canada to attend a wedding. This wedding was unlike any wedding that I have ever attended. In fact, this wedding is considered illegal in the United States. But, 130 people from around the U.S. travelled to Canada to witness the marriage of two of my girlfriends from college. Same-sex marriages are legal in Ontario and many people travel there to get married, but according to the locals, a same-sex wedding of this size has never been seen. Local news reporters were even there to capture the event!

The ceremony took place in a hotel overlooking Niagara Falls. The site was breathtaking. Both of the bride's fathers gave heartfelt speeches at the reception, and there wasn't a dry eye in the house afterwards. So, in that sense...it was like any other wedding I've attended...

Love is love is love is love. Love is Love.

Overall, it was a great weekend spent catching up with old friends, partying like rockstars, and forgetting that I'm a PA student (thanks to the cute bartender at the Martini Bar!). I came back to school feeling refreshed, refocused, and excited to get on with the show.

11 weeks until rotations!

Wednesday, June 14, 2006

Still Here...

Well, I just realized that it's been a while since I've last written. We're finishing up week #2 of the final semester of didactic year and it's been pretty much uneventful! At this point, not much phases me. Classes have been cancelled and added at the last minute and our schedule for June has been revised five times already (that's a record!). So, it's hard to plan anything outside of school.

There are a few weekends where we have class on Sundays. That is irritating when there is plenty of time to fit it in during the week, but for whatever reason...we have to be there...on Sundays in the Summer. (bummer)

The best decision I made in choosing a school is choosing one close to home. I live about 15 minutes away from campus and my gym is located in between. Some students travel as much as 2 hours (each way) and I would have gone insane by now. Sometimes we'll have up to 6 hour breaks and I can't sit in the library and study all day.

I've been doing a lot of rollerblading lately and I validate that by listening to lectures as I work up a sweat. Or I go to the gym and read my notes while doing cardio. Or in my car at the beach or boat dock. This week it was warm enough to sunbathe and study at the same time! Always a multi-tasker, I will basically find any excuse to avoid sitting at my desk lately.

Another reason why I can't stand studying at my desk is because I've recently lost my email buddies. I had a few friends that I would consistently correspond with over the last several months. Some were email and others were through instant messenger. Some have gotten married, had babies, moved in with significant others, or simply faded. And these disappearing acts happened simultaneously within a few weeks time.

I didn't realize how dependent I had become on having friends to chat with while I was up all night studying. Most of them lived in different time zones so that always kept it interesting. I had friends in Italy and Japan that I would correspond with for hours on end. But within the last couple of months, things have changed. It's always an adjustment when your life steers in a different direction as your friends. That has probably been the most consistent development throughout my 20's.

Here today...gone tomorrow...life is constantly changing.

Life changes...but I still have studying to do! That has not changed. I can't wait for rotations to begin. I'm really looking forward to getting started and gettng a move on with my life. Things feel stale lately...somewhat stagnant. I know I am moving forward, but it feels more like I'm treading water lately. That is why they say the third semester is the hardest, I'm tired of drinking from the fire hydrant. I'm ready to start using this information that has been crammed into my head.

I'm ready to hit the ground running...

Sunday, June 04, 2006

Semester # 3!

Tomorrow is the first day of the 3rd and final semester of the didactic year! I start rotations exactly 3 MONTHS from tomorrow!!! I can't believe how fast time has gone by!

I thoroughly enjoyed our one week vacation. The last week of finals really kicked my butt. It wasn't fun, but I got through it. And from what I hear, we didn't lose anybody...which is awesome.

We have 8 more weeks of classroom work and then I am apparently ready to take on some patients?!? I have the same feelings about starting rotations as I did a year ago before starting the didactic year. Anxious and scared are a given, but I really feel excited to get out and start practicing. I'm looking forward to seeing what opportunities I find and the different paths that present themselves...and the people that I will meet.

We start off this semester with a bang. This week we have three 12 hour days and that seems to be the norm throughout the month.

I'm looking forward to seeing my classmates again. I'm looking forward to learning again. I feel rested. My batteries are recharged.

Bring It On!

Friday, May 26, 2006

It Takes a Village

It's Friday night and I'm totally exhausted. The week from Hell came and went...and I passed all of my finals! We didn't get our hematology grades back yet, but we were told that if we had failed, we would have been notified.

And I was not notified.

13 exams in one month. 6 of them were this week. Studying (cramming) a semester's worth of information into your brain the night before a cumulative exam, that would stand as your grade for the entire course, was daunting. And this happened 5 nights in a row!

It was a struggle to block out everything else going on in life to sit down and study a different subject day after day. Knowing that once you finished a 100 question exam, it was time to hit the books to tackle the next one. There was no time for distraction. No time for relaxation. No time to smell the roses. No time to simply have a bad day! I felt more like a robot than a human being as the week dragged on. A robot that had a few screws loose and was about to short circuit!!

The pressure over the last few weeks left me feeling really vulnerable and I found myself leaning on my family, friends and other classmates to help me get through it. Although I know that's a natural reaction to high stress and pressure...I don't like feeling that way. But, I'm lucky and grateful to those that stood by my side, listened to me and encouraged me.

It Takes a Village...and in my case...a village that spans the globe!"

Muchos gracias. Domo arigato gozaimasu.

Thank you very much!!!!!

Thursday, May 25, 2006

Great Story!

Now this is a doctor that I wouldn't mind working with! (Although his buddies taking his blood should be wearing gloves!)

http://news.yahoo.com/s/ap/20060527/ap_on_he_me/surgeon_s_blood

Wednesday, May 24, 2006

Bloody Insane!

This morning's Hematology exam was a mess. This is the third class that this instructor has taught us and his last three exams have been challenging, but fair. So, we weren't expecting a torturous exam. The first ten questions sent quivers throughout the classroom because you could hear people moaning and groaning.

We all left the classroom feeling the same way and saying the same thing, "I think I failed."

Unfortunately, those words came out of my mouth too.

There's no time to dwell on it though...cumulative dermatology exam 20 hours from now. It's rumored to be a very challenging exam...

...the insanity continues.

Tuesday, May 23, 2006

Halfway There...

It's Tuesday and three exams are behind me...three more to go.

Surgery Part 2,
Physical Diagnosis,
Radiology.............................Done!

Tomorrow: Hematology (not fun)
Thursday: Dermatology (interesting)
Friday: Rheumatology (somewhat interesting)

The worst part about finals week is the lack of sleep. It's the lack of sleep that exacerbates the anxiety, fear, tension...that leads to panic, tears....and more tears! Cramming a semester's worth of work into your brain the night before a cumulative final exam that accounts for your entire grade for the semester is INSANE. Absolutely insane.

This week has been the toughest week to get through since the program started. This finals week makes last semester's finals week seem like a cake walk. And I'm sure I'll be saying the same thing when Semester 3 comes to a finish. Word has it that next semester is harder b/c all of the exams are held to the end...and it's the summertime!

Summer + PA School = Lethal Combination

Saturday, May 20, 2006

SADD

I have diagnosed myself with a new disorder.

SADD

This disorder does not currently exist, but I'm sure every PA student in the country will back me up. Perhaps I'll write my senior thesis on this subject.

Springtime Attention Deficit Disorder (SADD).

I had no problem hitting the books in the Fall and Winter. But, ever since the birds started chirping...I have a much harder time concentrating on my studies.

Unfortunately, I think this disorder will carry through the summertime...

My motivation at this point is simple. I want to go to Washington D.C. for Memorial Day Weekend. If I pass all of my finals this week, I am off the following week. If I don't pass my finals, then I have to stick around to take a cumulative make up final. And that would ruin my plans for the weekend.

I basically only have one non-married girlfriend left in this world!! And she lives in D.C. We always have a great time together...and t-rex is definitely in need of some F-U-N!!!

6 more finals to go....

Thursday, May 18, 2006

Commitment Phobia

I can't believe that we finished our last class for semester 2 tonight!

Only 6 more exams (in 5 days) and then it's over! Unbelievable.

What's even more unbelievable is that I start rotations in less than 4 months! We were given a "wish list" a few days ago. We have to do 7 required rotations in family medicine, internal medicine, OB/GYN, pediatrics, long term care, ER, and surgery. Each rotation lasts 5 weeks. But, we also have to repeat one of the required rotations and choose an elective rotation. The elective rotation can be anywhere and doing anything. For example, forensics, plastic surgery, neurosurgery, cardiothoracic surgery, dermatology, psychiatry etc.

I was overwhelmed by all of the options and unsure of what elective I wanted to choose. The kicker was that the "wish list" is due tomorrow! Yeah, we were given 3 days to map out our future. We are able to change it as we go along next year...

So, for now I chose to repeat either primary care or emergency medicine. And I chose infectious disease, psychiatry, and dermatology as my three elective choices. We'll see how that turns out...I know I will be changing my mind often. I am somewhat of a commitment phobe!

But, that's the beauty of this profession...unlike MDs...I can change specialities throughout my career. I just want to make sure I get a very well rounded rotation experience!

Thursday, May 11, 2006

Million Dollar Baby

Going to the gym is my way of dealing with stress. 30 minutes on the arc trainer and life is good again! If I have extra time to lift weights...birds start singing and rainbows appear! As busy as the program keeps me, I still try to get there at least 3 times a week.

Last summer I took boxing lessons with some of the other personal trainers at the gym. I saw the boxing trainer trainer tonight and he started asking me about the program. I guess I sounded like a sissy, because he smirked at me and reached for his gloves.

He handed me the gloves and told me to start throwing punches. It felt good to be "back in the ring" again. We sparred together but he never actually hits me (hard, anyway). As we were sparring he kept yelling at me to keep my guard up. And he said something that really struck home..."Step into the Punch!"

"You know you're going to get hit and if you shy away from the punch, then you're going to knocked out! You have to step into the punch and take it. Then fight your way through it! Keep you guard up and step into the punch!"

So, I'm done being a sissy with this school stuff.

My guard is back up, and it's time to start stepping into these punches!

T-rex

Tuesday, May 09, 2006

Welcome to Hell!

So the feeling I had a few weeks ago that I was just going to cruise through the rest of the semester has been obliterated! There is a lot of stuff going on within the program and as a result, they've added on two more exams. Basically, the admin "forgot" to give us the surgery mid-term! So, now they added on that exam as well as another pharmacology exam. Apparently, the admin "forgot" to put antibiotics on the exam we took the other day. So, they're throwing together another exam for that.

Of course my class wasn't going to take this without a fight. So, the director of the program addressed the class and apologized for the miscommunication and carelessness of the staff. He also opened up the floor to hear all of our criticisms and concerns about how things are going. There are a handful of instructors that do not take their job as seriously or as professionally as we (as a class) would like. So, once that was revealed, I was surprised that the director actually took it to heart and promised that he would look into it. He is the type of guy that you DON'T want to get in a confrontation with!

He came back and addressed the class again the next day and told us that he is addressing all of our concerns. He even typed up a 3 page memo detailing the changes that he's making in the program. He also asked us to type up an anonymous letter with any other concerns we have about our education and the instructors. I was impressed...very, very, very impressed.

He went on to tell us that we are an exceptional class. He said that some of our concerns are the same as previous classes and that some of our complaints are common at all PA programs, especially at this stage in the game. But, he said that our class approached the issue professionally and that he is pleased with how well our class gets along and at how well we are all doing. Apparently, the senior class does not get along and they have a lot of problems. Our main class is next to the director's office and he says that he never heard so much laughter coming from a PA class before. There were other experienced instructors in the room that agreed with him.

So, that was very encouraging. But, then he went on to talk about the summer semester and our rotations in September. He went on to tell us that we are in HELL and will not be getting out of it anytime soon. He sympathized with our situation by acknowleding the stress we are under and the fact that unless you've been through this process you don't/can't truly understand it. The truth of the matter is that it's only going to get more intense, especially when rotations begin.

I tried to walk away from the meeting focused on the good stuff that was highlighted. But, it is getting tougher in the sense that we all feel like we don't know a damn thing. And they tell us that is exactly how we're supposed to feel. But, that is NOT a good feeling! As much as I enjoy learning about medicine, there is a constant, nagging, feeling of vulnerability and insecurity. And the realization that all of this training (torture) is for a J-O-B!

I know things will get better again once we get through the next 2 weeks, but we're all freaking out. We're all questioning the process. We're all wondering how and why we got ourselves into this in the first place! So, we moan and groan and tears of frustration are pretty common. The thought of keeping up this intensity for the next year and a half is daunting. Knowing that it will get worse come September is downright frightening! But, as a class, we pick each other up and that is really what keeps us going. That is what keeps me going. I also bank on the satisfaction that will come when I start treating patients. It's a short program, but a long road to travel.

And right now we're traveling over some bumpy ground.

A Glimpse of the Finish Line

Semester 2 Completed Classes!
Cardiology
Pediatrics
Pharmacology
Pathology
Pulmonology
Ophthalmology

Final Exams on Deck:
OB/GYN
Lab Medicine
Radiology
Surgery (2 finals)
Hematology
Rheumatology
Dermatology
Physical Diagnosis

Monday, May 08, 2006

The Simple Life

I was talking to a friend the other day about how I feel like the weight of the world is back on my shoulders. He questioned why I felt that way and I didn't really have an answer. Besides the 10 final exams that are waiting for me, life is good. But, there is a heaviness that comes with this program, with this responsibility...with practicing medicine. And some days that heaviness simply wears you down.

But then my friend broke it down for me, in very simple terms. "You will study, you will pass these exams, and then you'll start the 3rd semester. You will study, you will pass exams, and then you'll start your rotations. You'll study, you'll pass your exams, and learn during your rotations. And then you will graduate, and study, and pass the board exam. And then you will work as a PA."

I couldn't argue with him, because he was right. But, it does not feel that simple. There is so much to learn about medicine and it's impossible for one person to know it all. And therein lies the responsibility...the heaviness.

On the flip side, if it were that simple...I wouldn't be interested anyway!!

Tuesday, May 02, 2006

Semester 2 Countdown

I really cannot believe that Semester 2 is coming to a close. Three finals are done...only 10 more to go!!

This week was a rough one though. I spent the majority of the week recovering from a stomach virus. That was not fun and it made last week's jet lag seem like a piece of cake! When you're not feeling great, it's hard to focus on anything...especially studying.

Today was our Pediatrics final exam. I did really well on the first two exams but I had a feeling that this exam was going to be a doozy. And, although my gut was out of whack this week...I was right. One of the best things about my class is that we all seem to react to the exams in the same way. And it feels really good when you walk out of the classroom and see your classmates in the hallway with expressions on their faces that match exactly how you're feeling.

After several minutes of moaning, groaning, and bickering about answers, we wind up laughing at each other and at ourselves for the different reasons why we chose an answer. My personal favorite is, "when in doubt...pick all of the above!" We've learned by now, that life goes on after ridiculous exams...especially on Fridays when Happy Hour begins at noon!

I have learned some very useful skills over the last few weeks. I've learned how to insert foley catheters, nasogastric tubes, and draw blood. Learning how to draw blood has been my least favorite experience. I do not have a problem dealing with the sight of blood...as long as it's someone else's blood! I do not like to have my blood drawn. I do not like needles going into my own arm. And I do not like having students practice drawing blood on my arm!

I was lucky though since my partner was an experienced phlebotomist!

Trust me, that was not a lucky coincidence! ;)

Scrubs

If you took the cast of Scrubs and filmed them during the didactic year of medical school, you'd get a really good sense of what it's like to be in my class! Tonight was yet another episode full of laughter!

We had two hours of Physical Diagnosis lecture tonight and the MD featured the entire two hours on the RECTUM. Normally this MD gives us powerpoint handouts, but tonight he told us that he just wanted us to sit back and learn by observation. Yup, that meant that we looked at slides of different rectal disorders for 2 hours!!! It was downright disgusting!!!!

The doc lecturing us has a great sense of humor so that encouraged the other comedians in the class to bring it up a notch. I laughed so hard that tears were streaming down my face.

It's nights like this that carry us through...