what is 46xy?

My 4 year old nephew asked me this just the other day, "what makes a baby a boy or a girl?" What a good question nephew. Well I'll save you the answer I gave him but offer a link instead.

Enter Grand Rounds last week's edition that I just got around to reading now... Zoe (I've always loved that name) is a rocket scientist from Australia that just happens to have a chromosomal abnormality. Her blog and story are both fascinating and enlightening. I spent the morning reading her blog and thinking about this. I invite you to do the same, this is the entry that got me started, They mean well (Part 1). Happy reading!

I have always been interested in ethics, maybe pediatric endocrinology isn't out of the question.

Pass

I haven't been able to sleep since I took Step 1.  I'm not normally prone to insomnia but the anticipation of my Step 1 results has made sleep these past three weeks a difficult feat. My niece woke me at 5:30am this morning and although she crawled in bed with me and immediately fell back to sleep I was wide awake. I knew that today would bring my results.

I'm not sure how I feel about my score but I know that I will be a doctor one day and this is another hoop I've successfully cleared.

I will write more later about what I think worked and did not work for me. For now, I'm just going to await my clinical placement and start planning 3rd year.  I guess I'm trading one anticipation for another. I've been doing a bit of networking and I may try to shadow a pediatric neurologist in my area. It would be nice to have options for 4th year. Time to move on. (After I enjoy the rest of my vacation that is.)  Happy Wednesday!

auntie love

I love being an aunt. I love the feel of little hands searching for mine in the dark theatre and not letting go, the entire show. I love the questions, the awe of a 7 year old and the smarts of a 9 year old. We had a most wonderful afternoon, just us three girls. No tears, no fighting, just a fun-filled time watching Cinderella (the girls favorite), Little Red Riding Hood (my favorite) and a few other story book characters come to life in "Into the Woods" the musical.  We only stayed for Act 1 and it was perfect in length and substance. Not too long, not too scary and everyone got their happily ever after...

I love being an aunt. I love that we had to dig up bugs with big sticks. I love that during hide & seek the same hiding spot never gets old. I love that at 4 years old he wants to know when his voice will change and that I am the one he thinks to ask. Boys can be fun too.

I love being an aunt and for the next 8 days that is my sole purpose. 
(I promise to return to normal med school blogging soon.)

one too many

So I am home (where I grew up, where my parents reside and where my sister and her three children live) for vacation.

I love being auntie to my two nieces- 9, 7 and 4 year old nephew. However three is just one too many. I can't possibly hold all three of their hands when crossing the street. I can only sit by two of them at the dinner table and no matter how hard I try someone is always left out. I just try to be mindful that it not always the same one. I try... but my iphone is often the surrogate me. Luckily my iphone is a big hit so the left out one is usually pretty happy.

I like to believe that children should not outnumber the adults. Of course I am breaking my own rule and taking the two girls to see a musical tomorrow afternoon. I hope I survive.  Right now I'm off to bed because my 7 year old niece likes to get up before the sun (yawn).

Correspondence

To: Spice Island Queen/Student
From: Clin Ed/SGU_LN
Sent by: ABC/USL/SGU_LN
Date: 03/25/2011 12:29PM
Subject: USMLE Step I Results

Hi Spice Island Queen!

At this time we still have not received the results for the Step I exam.  Please email a PDF copy to clined@sgu.edu  as soon as possible.

Regards,
ABC
Clinical Placement Coordinator

Dear Clin Ed,

I don't have my Step 1 results either! I am expecting them any day and will forward a copy to you just as soon as I receive them.

Fingers crossed,
Spice Island Queen

P.S. A friend who took the step 4 days before I did said he received his score report exactly 3 weeks after his exam so if that schedule holds I should receive my report on Tuesday the 26th.
 

7 words

Describe the thing you love most in seven words:

boyfriend is the perfect one for me

(my) rainbow in an otherwise dark cloudy sky

acts like life's purpose is my happiness

excellent doctor, like I'll strive to be

---
I don't often blog about my husband but he is my best friend, cheerleader, support, entertainment and the love of my life. I couldn't imagine medical school without him by my side (via Skype counts).

It has been a decade of togetherness and although neither of us are perfect I do believe we are perfect for one another. This is my blog about medical school and becoming a doctor but my relationships are part of that process and his is one of the most important in my life.

To love and life happily ever after!

The Blog Challenge

Since I'm in third term limbo I have just a little bit of spare time on my hands. Today's entire agenda was getting a massage. Yep, that is it. Don't feel too sorry for me! And tomorrow.... I have absolutely nothing planned or anything that I must do. It is great but at the same time kind of boring, but I can always read another book. I talked to my mom today and she remarked how it would be nice if I could somehow bottle up the spare time and save it for some future use. Agreed. Anyhow, I've been spending my oodles of spare time reading and stumbled across a new blog and this idea. Post something every day- for a month. But I don't want to just write non-sense so I'm doing this- NaBloPoMo. Let me know what you think. If you also blog I challenge you do do the same.

Today's prompt:  Give us links to five must-read web sites you go to every day and tell us why.


Somewhere during 1st year I discovered Google blog reader, it saves tons of time and all my blogs are in one spot. I only have to check my home page to discover new posts. Here are my current favorite 5.

1) Grady Doctor heartwarming, thoughtful, poignant posts about life as a mother and physician in a teaching hospital. Often her posts make me laugh, smile and even cry.  She is truly inspirational.

2) Mothers In Medicine  I have been following this blog since the start of medical school. I hope to one day be a mother and this blog gives me hope.
 3) A three way tie for third-
A Thousand Times Over 
Tales of a Brown-Haired Freak 
A Caribbean MD is Good Enough for Me 
All three are written by fellow SGU upperclasswomen. They keep me grounded, anticipating what comes next and looking forward to the next step.

4) Getting Better- a hybrid of diverse medical bloggers all in one spot, what is not to love?

5) A Farmer in the Dell  A blog about food and farming. There is something appealing about contemplating dinner and dessert. Maybe I'll be a farmer in my next life.

So those were my daily blogs. But of course I don't read JUST blogs. The other website that I visit every day is The NY Times because every girl needs a news source. I like that I don't have to read about celebrity meltdowns on NYT and for the most part it keeps me up to date in current affairs. I don't like that I will very soon have to start paying to read this. So sad...

Well, that is all for today and this post. Until tomorrow!

Confessions of a Med Student Part IV

This is a little late in coming but welcome to the fourth installment of Confessions- my reflections of past terms, one at a time. If you want to read any of the prior confessions series you can find them here, here and here.
----

Term 4: the breakdown-
PATHOLOGY with my Path Group NOS 
the dreaded MICROBIOLOGY
plus to keep you on your toes- CLINICAL SKILLS

So this the term you have been waiting for. You have only heard scary rumors and sad stories of students that had to decel. And now it is here and you have already been on the island for six weeks completing third term and you just want to start already. You may have pre-read some of Robbins and every single upper classman has told you some conflicting thing about this term but you don't really know what to think. Do you go to class?  Do you use Goljan's Rapid Review or just rely on Robbins.  Baby Robbins and Big Robbins? Annotate into First Aid? To be or not to be?

Anyhow, for me I was apprehensive but prepared. The best part of fourth term is being able to pick your lab group. And I think this can make all the difference. I had my lab group solidified before 2nd term was over and having a group of classmates that I knew and trusted made lab fun instead of torturous. We were Path Group #1 aka Path Group NOS (yes, we named our group and we even wore matching scrub tops to lab occasionally... there is this whole must be dressed professionally thing that we were trying to do without actually dressing up or wearing white coats.)

Anyhow, my lab group started with two friends* that I had studied well with during first and second terms. We each then asked other study partners or lab partners from previous terms and in the end we had a pretty diverse group of students. Some young, some older. Some AOA, some not. Some girls, some boys. Some Russians, some Indians. Some from Canada and some from the USA. We met for pizza at Prickly before 4th term started in order for everyone to get to know everyone else. And we continued to hang out at Prickly during the term, once after the first exam and another time towards the end of the term for Dundy (think "The Office" TV show) style awards. We had fun and by enjoying lab and each other we kept sane and made it through.

*Note, I had other friends who were NOT in my lab group and this became important for several reasons. 1- If I ever needed to gripe about my lab group, which wasn't often but on the rare occasion when I did, I could to so with friends not in my group. 2- I studied with someone who was in another lab group so we could share what our tutors had highlighted, trade slides, etc.  My opinion is that it is okay not to have your roommate, best friend or primary study partner in your lab group, and in some ways maybe even better. 

So Pathophysiology... Lots of time spent in lab, but that can be okay, IF you have a good group. Or it can be time to sit and read Goljan or Robbins, it is really up to you. Same thing applies to concept maps. Most students hate them and think they are a waste of time. And I can see how that might be the case, but if you choose to make a concept map on something you need to learn, or have trouble remembering it can be helpful. I used my concept maps during pathophys and even studying for Step 1. But you can also scribble something out in 5 minutes and hand it in too, again it is up to you.

Besides lab, I did go to class but then I was always a "go to class" kind of gal. It really depended upon who was lecturing but most of the time I felt like I had to be there. If you sonic you miss the slides and since it is path slides are helpful.  Sure, not all the VPs were amazing but for the most part I like to think that going to class only helped me. 

Path was difficult, not because it is hard, but just because of the enormousity of it all. But it is doable and I found it fun. You are learning the stuff you came to medical school to learn, or at least that is how I felt. I didn't read Robbins cover to cover but I used it to prepare my slides and look up stuff that wasn't well covered in the notes. I tried to review all the green boxes and know the images. I also had Baby Robbins which lived in my bag through 4th and 5th term (plus it is pocket sized so I can use is during my clinical years too.) I didn't use Goljan or First Aid until 5th term but sometimes they would have been helpful. Best free resource, webpath! I made myself do the questions on Friday nights when I was too burnt out to study anymore. Also I did Robbins review questions with a study partner and found it kept me from falling behind. We had a standing date each weekend to do questions from the previous system. For me, staying caught up on the material was key. And by going to class and having regimented study dates I never really had a chance to fall behind. And speaking of falling behind, that brings us to micro.

Microbiology. I only think this class gets a bad rap because it is taught in the same term as Path. The key to this class is to not fall behind or let path overshadow it. Again I went to class (85% of the time) and being in class made me strive to keep up with the material. I would spend a full day every other weekend organizing my notes, making tables, etc. For practice questions I used High Yield the days right before the test. It wasn't the easiest of classes, but it was fairly straightforward IF you put in the time. (And SO important for later, aka pharm and Step 1.)

Clinical Skills. This was the class I expected I would love. But it turned into a pain and time suck which I blame on the lack of organization that is the Clinical Skills Dept. They have so many smart, capable physicians, but yet no leadership or organization. The class does teach you needed skills, how to interview a patient, do a physical exam, etc. it just isn't very efficient. As far as exams I found that doing practice questions from old exams was helpful. And pocket Bates is useful without being overkill. Also for the practical exams it did help to have a couple of friend and actually practice all of the skills with beforehand. (It amazes me how so many of my classmates just tried to memorize their way through.)

So that is fourth term in a nutshell. I think it really was my favorite term (but that doesn't mean it was easy or that everyone I knew made it through.) But with some preparation, a lot of hard work, a good lab group and a dash of good luck you will survive it too.

I promise to post on 5th term before another month goes by. Stay tuned.

Happy Match Day!

So, today is the day that all fourth year medical students await. Today decides their fate. You see on match day one is "matched" with a residency program and it isn't until match day that the medical student finds out where she will be completing her residency. Of course the medical student knows that she will be matched to one of the programs on her rank list (and if she didn't, she would know this and have scrambled, more on that in minute.) She has interviewed and carefully constructed her list, but it may be 20 programs long and involve five different cities and states so it is with trepidation, excitement and anticipation that match day arrives.

I was with Dr. Boyfriend on his match day. Most US medical schools, his included, hold a special ceremony where everyone is given an envelope and at noon they open the said envelope and smile, scream or cry with relief or disappointment. I was with Dr. Boyfriend and his classmates and most of them matched to one of their top programs (like #1 or #2 or maybe #3 or #4, rarely further down the list. Plus 96% of US medical students match so the scramble is the exception.) Anyhow, I was with him and he matched at his top choice in OB/GYN and it happened to be where I was living/working so we were both happy, relieved and excited. Most of his classmates were also happy. I remember one girl who matched to her #1 choice (but for some reason in her mind she thought she was going to match further down the list to a NYC program.) Anyhow, there she was crying and upset and we all wondered what to say, "I'm sorry you matched to your #1 program????"  Well fast forward a few years and she is married and very happy at said program but the thing is, you never know, and the match is out of your control is so many ways.  It shapes the next three-five plus years of your life and this decision comes via a computer.

So back to that day of Dr. Boyfriend's match. His graduating class was around 100 students so there were just a couple that had to scramble. I know that they all did scramble and I forget details but I think someone matched for categorical but needed a pre-lim year and hadn't matched, so he scrambled and ended up in Hawaii. We all laughed and thought, well that isn't too bad, I mean it is Hawaii for a year! So yeah, that has been my personal experience with Match Day.

So now six years later I am in the middle of medical school, but it is not a US school and so Match Day for my types goes a little differently. I still have two more years until I will be the one matching but I pay attention to my upperclassmen and where they match, how many match, etc. It is still early in the day so SGU has not yet updated the list but here is the link. Right now it only contains those that pre-matched (aka signed outside of the match, this is one of the only advantages to being a IMG), matched to a Canadian program (their match was last week) or matched into a program that uses an early match system (mainly competitive programs like ENT, Plastics, Ophthamology so that students that don't match can try to again with the regular match in a different field.) Anyhow the list is just a fraction of what it will be. So keep checking if you are interested.

So far I haven't heard too much about students scrambling, but then again I'm two years out and don't really know that many upperclassmen. I guess only time will tell. In a given year we are told that 85% of SGU student match. Now that includes everyone and being an international medical school not everyone tries to match. And we know that some sign outside of the match. But there are of course an unlucky few... So, fingers crossed for all of those matching today, that they did in fact match or were able to scramble.

So, about the scramble. On Monday those students that did not match were notified. And on Tuesday a list of program that had not filled was released. Last year there were 8,794 unmatched applicants and only 1,060 unfilled spots. So if you are one of the unlucky few and not taking in account anything else, you have a 1:8 chance of scrambling for one of the coveted unfilled spots. And it is a scramble, the student and any help she can recruit calls, phones, faxes, emails and begs for an interview in hopes of gaining a spot. This is another time when being a US medical student has its advantages. If you need to scramble and chances are, you don't,  most likely your Dean will make some calls on your behalf. If you go to SGU, well good luck with that. Needless to say, you don't want to scramble.

I cannot even fathom what it would be like to finish four years of medical school and then not have a place to go for residency. This is the real underbelly of being an IMG, what they don't tell you at the open house and what you hope is only a rumor or thing that happens to those less fortunate students that go to lesser schools than the Harvard of the Caribbean. Now it is looking a little bit better for next year. The NRMP is introducing SOAP which from what I gather will be a controlled scramble, basically a 2nd match. To read about these changes see the NRMP website and SOAP pdf. I don't know if it will help IMGs like myself but I guess time will tell. I think it will help the highest qualified applicants secure a spot and will take much of the "luck" out of it. Sure the US students will be served first, but that is how it is now anyhow.

So to all those matching today, I hope that Match Day gives you much to celebrate. Go enjoy a green beer and cheers, you've worked hard for today!

What WIll I Be?

What kind of doctor will I be when I grow up??? Match Day is tomorrow and as my fellow classmates find out where there will be training I can't help but wonder what I will be matching into in just two short years from now.

SGU's office of career guidance website hosts a Pathway Evaluator, so I took a few minutes and filled out the questions and came up with this list of my top 10:

Internal Medicine
Geriatric Medicine
Child Neurology
Endocrinology, Diabetes and Metabolism
Neurology
Child and Adolescent Psychiatry
Pediatrics
Psychiatry
Rheumatology
Medical Oncology

The thing is, if you asked me today, what I wanted to do I would tell you pediatric neurology (and it shows up on the list above as #3, for what it is worth...) And I do think I could do that and be happy. But there is so much to medicine that I have never experienced and who is to say there isn't something else I would like better or be better suited to.

I know (or at least I think at this moment) that I want to work with children. Soon I will start clinicals and I'll get my six weeks of pediatrics to confirm my intent. But I have to wait until fourth year to do a sub-I so if I am interested in pediatric oncology or child-neuro or genetics it will be at least a year before I am experiencing them first hand, so that means that for the moment I'm stuck waiting. I've been thinking of trying to find an SGU alumni in the area to shadow. What it really comes down to is that I'm getting impatient. I want to be on the floors yesterday. And I really just want my Step 1 score to arrive in the mail so I can stop thinking about it.

A Day at the Museum

It was resident free Tuesday so I went for the afternoon to the Museum of Man. My favorite moments had to be:

1) when viewing a skull with lytic lesions due to syphilis a couple walked by and the girl said, "honey look, this is what happens to your brain when you get infected!" True, syphilis is bad and not just for your man parts. Maybe this is a good way to keep STDs at bay.

2) watching the very pregnant woman and her husband (no children were with them so I assume primigravida) in front of  the Being Born exhibit. I mean it was pretty good exhibit showing the baby in different labor stags coming down the birth canal but it just seemed ironic that there she was, about to pop and she was studying how a baby is born.

Clearly, life after step 1 is pretty good. I also finished my third book in a week while I sat in the park... I love people watching.

Boyfriend's Carrot Muffins

Since I have time to bake again and husband was craving some carrot muffins I came up with these. They were inspired by this NYTimes recipe but I didn't like the recipe contained oil so I made my own, aka adapted from several others. (Dr. Boyfriend is doing Weight Watchers and I try to make baked goods that he can eat and not have to sacrifice many points for....)

To make this is what you need:

• 1 1/2 cups all-purpose flour (or soft white-wheat flour)
• 3/4 cup brown sugar (or 1/4 cup Splenda brown sugar blend)
• 2 teaspoons baking powder
• 1 teaspoon baking soda
• 1/4 teaspoon salt
• 2 teaspoons cinnamon
• 1/2 teaspoon nutmeg
• 2/3 cup nonfat vanilla yogurt
• 2/3 cup skim milk
• 1 1/2 cups grated carrots
• 1/2 cup chopped walnuts (or raisins or both!)

Preheat oven to 400 degrees. Mix all dry ingredients and slowly stir in yogurt and milk until wet. Fold in nuts/raisins and divide evenly into greased muffin pan. Makes 12 medium sized muffins. Bake for 20-25 minutes, toothpick should come out clean. Enjoy!

Muffins as made with wheat flour and Splenda blend (no raisins) are 2 points per muffin for Weight Watchers Points Plus.

Life After Step 1

Step 1 is over!!!! 

Yep, I sat for it last Tuesday and life after Step 1 has been good. SO good that I just haven't sat down to blog or reflect. I've been too busy trying to cook/bake/read/walk/explore/spend time with Dr. Boyfriend/make travel plans/etc.  

I won't know until my score arrives if my study method worked but for all of those wondering about how I studied I'll try to put together an overview and post it at a later date (once scores are in hand).  In short I used all the normal stuff, First Aid, UWorld Q-bank and personalized schedule with some help via CramMasters iPhone App.

Right now, it is time to enjoy my vacation. I'll be back later. Match Day is Thursday, good luck to all of those matching!