Happy 4th of July to all! I am actually enjoying gen sx, suprisingly more than I expected, but that doesn't mean I don't appreciate having a three day weekend and especially today off. I'm home in SD with my hubby and have plans to watch the fireworks later. In the meantime I'm enjoying the day. And I have a bit of time to reflect on what has been two weeks of gen sx so far.
I've seen some interesting cases and have enjoyed clinic, consults and pretty much everything in between. The new interns have arrived and the whole hospital is fresh with new faces and lost looking white coats. I actually feel like I have something to offer the team, my intern finds me helpful and it is kind of refreshing.
I have discovered that I like being in the OR. It is fun, which sounds weird to say and I can't seem myself doing the training or putting up with the surgeon types for 5+ years in order to be in the OR but I do see the appeal.
I have confirmed that I don't enjoy the ER. I don't like the pace, the noise or the rawness of everything. And I hate not knowing what is happening with the patient after they see me. I need follow through and the ER doesn't provide that. However I do like the ER docs. Shift work and cool colleagues are definite pros.
I like clinic. I like taking to and examining patients without too much of a time constraint. I like reading the chart, knowing the history and seeing someone who is going to be followed. I love it when I get to see the same patient for 2nd time, either post hospital d/c or follow-up appt, etc.
So to recap. Surgery- I don't like surgeon mentality but the OR is pretty cool. ER- not my cup of tea, but the ER docs are awesome. Clinic- seeing patients makes me happy.
I hope you have a wonderful, festive and safe 4th!
Showing posts with label Hospital Rotations. Show all posts
Showing posts with label Hospital Rotations. Show all posts
7.04.2011
5.31.2011
It IS brain surgery
So far I'm s/p day two of week two in my neurosurgery rotation and I have:
performed my first lumbar puncture
observed a craniectomy and tumor resection
watched a patient go into surgery talking and emerge aphasic
witnessed seizures and gotten crash courses in how to read an EEG and prescribe AEDs
assisted in a subdural hematoma resection x 2
seen a stroke patient in his final hours
held hands with patients pre and post-op
seen all varieties of aneurysms: s/p rupture, coil and clip
worked with three amazing residents that take the time to teach
scrubbed for surgery four times
been told I need to read and I should know this or that
been told I am the best medical student in a long time and that I should consider applying to neurosx
It is fascinating, it is exciting. It makes being at the hospital from 5:30am until 6pm or 7pm or 9pm seem like a blink of the eye. Clinical rotations make the first two years worth it. I know that I am only starting my third year and that I don't really know that much, but I know that I like clinic and I like patients and I like talking to their family members. I like being at the hospital. I don't always know what to do but at the same time, I feel like I belong. And so- being an MS III is a good thing. (And now it is time for bed.) I'll have lots more to share once I am done with my rotation (only three more days, -tear-sigh) and have had time to properly reflect...
Stay tuned.
performed my first lumbar puncture
observed a craniectomy and tumor resection
watched a patient go into surgery talking and emerge aphasic
witnessed seizures and gotten crash courses in how to read an EEG and prescribe AEDs
assisted in a subdural hematoma resection x 2
seen a stroke patient in his final hours
held hands with patients pre and post-op
seen all varieties of aneurysms: s/p rupture, coil and clip
worked with three amazing residents that take the time to teach
scrubbed for surgery four times
been told I need to read and I should know this or that
been told I am the best medical student in a long time and that I should consider applying to neurosx
It is fascinating, it is exciting. It makes being at the hospital from 5:30am until 6pm or 7pm or 9pm seem like a blink of the eye. Clinical rotations make the first two years worth it. I know that I am only starting my third year and that I don't really know that much, but I know that I like clinic and I like patients and I like talking to their family members. I like being at the hospital. I don't always know what to do but at the same time, I feel like I belong. And so- being an MS III is a good thing. (And now it is time for bed.) I'll have lots more to share once I am done with my rotation (only three more days, -tear-sigh) and have had time to properly reflect...
Stay tuned.
9.16.2010
Perd mon temps
Today was my fifth clinical/ hospital rotation visit and today my group went to the neighborhood of Perdmontemps. In case you don't speak French, Perdmontemps means "I'm wasting my time." I have to say, it is one of the more unique town names I've come across. I only wish the translation didn't have any literal truth to it for anyone involved today.
It was a good 35 minute drive up and down and around the island to St. David's Parish. I had been prepped by my roommate and other classmates but still, first impressions were not much. We pulled up to an unassuming cement building just off the road with a sign that said Perdmontemps Health Clinic. As we entered there were at least 30 patients crammed into a small waiting room. There was small window and door on one side of the waiting room (the pharmacy) and on the other side a small divider was set up, behind it a nurse took vitals and triaged the patients. There was a make shift lab area and two examining rooms. Two other assistants helped organize the patients and there was one doctor. This was at 8:35am in the morning. When I later asked our patient if it was always this busy she said yes. She told me that she had arrived extra early this morning, much before 8am so that she could be patient #1 (and as a reward for coming early she got to see 5 medical students and hang out at the clinic for several hours instead of just a few minutes, lucky her!)
We were escorted into one of the examining rooms where our preceptor and physician, Dr. Drum came in to greet us. He gave us a brief run down on how public health care in Grenada worked and how patients were seen in their neighborhood clinics on a set day, once a week. Medical care is free but patients pay a nominal fee for prescriptions. Each neighborhood has its own clinic and the doctors rotate through different clinics much like traveling circuit pastors use to do in rural areas of the US. He then brought us a patient, instructed her to let us ask whatever we needed to ask and left us to do our interview and exam....
And so we did. Now our patient was diabetic and hypertensive and she took medications for both. But she explained that usually when she came to the clinic (she said she came every three months for check ups) her visit was only a few minutes long, and since she was coming so early this morning she didn't take her meds or eat breakfast beforehand. Dr. Drum came back to check in on the group once but he was so busy seeing other patients that it really was just 5 medical students and our patient for over an hour. As the time passed on she started complaining of being hungry and wanting to leave and I began to wonder exactly why she should continue to let her blood sugar fall at our learning expense. (Of course, me who ALWAYS has a snack in my bag of some kind, had only water today.... And no one in my group had anything either. Our white coats are not yet the hold all bags and walking storage units that they will soon become.) Finally we were finished and our patient was threatening to walk out so I went in search of Dr. Drum on behalf of her blood sugar. Dr. Drum came back. I presented the patient. (He critqued me and I didn't fell all warm and fuzzy, but he ended up giving my 5/5 for presentation skills so I guess I did okay.) We presented our clinical findings. He made us demonstate our technique and any pathology had to be examined and appreciated by all five of us. This was not a waste of my time, but I felt complicit in a relationship that I am not sure the patient wanted to be a part of, she was clearly ready to go at this point but Dr. Drum felt that he still had teaching to do. When we finally finished and she bolted from the room we had been there for over 90 minutes.
We (as 5 students) had seen one patient. There was a waiting room full of patients to be seen and we still had plenty of time left before the bus would be back to pick us up. A group member asked Dr. Drum if we might be able to see another patient and he replied that we should have taken more time with our given patient. (Now I think that 90 minutes is more time then we will ever get in the US healthcare system and more time than we needed. We could have subjected her an entire complete physical, instead of a focused, but to what end? She didn't even want to be examined by us. And she certainly didn't want to sit around and be reexamined again and again. I didn't ask if this wasn't a "Perdmontemps" for the patient, but I wanted to.)
I am grateful for the opportunity to see medicine at a community level in Grenada. I am thankful to Dr. Drum for allowing medical students to come to the clinic and see patients with him. He also comes to SGU and is a preceptor in our clinical skills course so I know that he cares about students and is a physician educator. But I also feel more than just a little bad "using" patients to learn when I don't think they they really benefit from the encounter. Maybe this is something that I will have to accept and come to terms with. But as of now I am still wrestling with how to be a medical student that has something to give. I don't want to simply take.... I know that more often than not what I will have to offer is time, a listening ear... and hopefully I can be a good conversationalist for whatever time we have together.... the patient has so much to teach me. I only hope I can give something in return.
It was a good 35 minute drive up and down and around the island to St. David's Parish. I had been prepped by my roommate and other classmates but still, first impressions were not much. We pulled up to an unassuming cement building just off the road with a sign that said Perdmontemps Health Clinic. As we entered there were at least 30 patients crammed into a small waiting room. There was small window and door on one side of the waiting room (the pharmacy) and on the other side a small divider was set up, behind it a nurse took vitals and triaged the patients. There was a make shift lab area and two examining rooms. Two other assistants helped organize the patients and there was one doctor. This was at 8:35am in the morning. When I later asked our patient if it was always this busy she said yes. She told me that she had arrived extra early this morning, much before 8am so that she could be patient #1 (and as a reward for coming early she got to see 5 medical students and hang out at the clinic for several hours instead of just a few minutes, lucky her!)
We were escorted into one of the examining rooms where our preceptor and physician, Dr. Drum came in to greet us. He gave us a brief run down on how public health care in Grenada worked and how patients were seen in their neighborhood clinics on a set day, once a week. Medical care is free but patients pay a nominal fee for prescriptions. Each neighborhood has its own clinic and the doctors rotate through different clinics much like traveling circuit pastors use to do in rural areas of the US. He then brought us a patient, instructed her to let us ask whatever we needed to ask and left us to do our interview and exam....
And so we did. Now our patient was diabetic and hypertensive and she took medications for both. But she explained that usually when she came to the clinic (she said she came every three months for check ups) her visit was only a few minutes long, and since she was coming so early this morning she didn't take her meds or eat breakfast beforehand. Dr. Drum came back to check in on the group once but he was so busy seeing other patients that it really was just 5 medical students and our patient for over an hour. As the time passed on she started complaining of being hungry and wanting to leave and I began to wonder exactly why she should continue to let her blood sugar fall at our learning expense. (Of course, me who ALWAYS has a snack in my bag of some kind, had only water today.... And no one in my group had anything either. Our white coats are not yet the hold all bags and walking storage units that they will soon become.) Finally we were finished and our patient was threatening to walk out so I went in search of Dr. Drum on behalf of her blood sugar. Dr. Drum came back. I presented the patient. (He critqued me and I didn't fell all warm and fuzzy, but he ended up giving my 5/5 for presentation skills so I guess I did okay.) We presented our clinical findings. He made us demonstate our technique and any pathology had to be examined and appreciated by all five of us. This was not a waste of my time, but I felt complicit in a relationship that I am not sure the patient wanted to be a part of, she was clearly ready to go at this point but Dr. Drum felt that he still had teaching to do. When we finally finished and she bolted from the room we had been there for over 90 minutes.
We (as 5 students) had seen one patient. There was a waiting room full of patients to be seen and we still had plenty of time left before the bus would be back to pick us up. A group member asked Dr. Drum if we might be able to see another patient and he replied that we should have taken more time with our given patient. (Now I think that 90 minutes is more time then we will ever get in the US healthcare system and more time than we needed. We could have subjected her an entire complete physical, instead of a focused, but to what end? She didn't even want to be examined by us. And she certainly didn't want to sit around and be reexamined again and again. I didn't ask if this wasn't a "Perdmontemps" for the patient, but I wanted to.)
I am grateful for the opportunity to see medicine at a community level in Grenada. I am thankful to Dr. Drum for allowing medical students to come to the clinic and see patients with him. He also comes to SGU and is a preceptor in our clinical skills course so I know that he cares about students and is a physician educator. But I also feel more than just a little bad "using" patients to learn when I don't think they they really benefit from the encounter. Maybe this is something that I will have to accept and come to terms with. But as of now I am still wrestling with how to be a medical student that has something to give. I don't want to simply take.... I know that more often than not what I will have to offer is time, a listening ear... and hopefully I can be a good conversationalist for whatever time we have together.... the patient has so much to teach me. I only hope I can give something in return.
8.26.2010
Feeling Fine with New Shoes and Wine
Fifth term is picking up the pace and life is in full swing. I've been busy, but I love it.... here are a few highlights.
Tuesday: I made from scratch, pumpkin soup and cornbread with my neighbor. We then had family dinner with the roommates. And of course I did the pre-requisite class, small groups, study time, etc.
Wednesday: I managed to buy a new pair of shoes and a cute top to wear to the Hospital. This was in between studying all morning, reviewing 90 questions from Exam Masters and 4 hours of class. I also went for a sunset walk and swim. Not too shabby of a day....
Today: My hospital group was assigned a local GP to follow and I examined a 7 year old, interviewed a young man for his annual work physical and saw textbook anemia in a women with Hb of 5 (don't ask me how she was even walking around). I ran home to change at lunch and on my way stopped to visit my local wine store. I chatted up the owners and staff while picking out 2 bottles of wine for the weekend. I then sprinted to class for 4 hours, followed by powder puff football practice, woo hoo! I think I can manage 3 good hours of study time before I call this day done.
Tomorrow: I have the morning free to study and then my first (mini) test of 5th term. Depending how that goes I'll open the wine or hit the books again. The weekend is almost here and I cannot wait to study without distractions (yes I know I am a med school dork, but I'm okay with that because I have new shoes!)
Tuesday: I made from scratch, pumpkin soup and cornbread with my neighbor. We then had family dinner with the roommates. And of course I did the pre-requisite class, small groups, study time, etc.
Wednesday: I managed to buy a new pair of shoes and a cute top to wear to the Hospital. This was in between studying all morning, reviewing 90 questions from Exam Masters and 4 hours of class. I also went for a sunset walk and swim. Not too shabby of a day....
Today: My hospital group was assigned a local GP to follow and I examined a 7 year old, interviewed a young man for his annual work physical and saw textbook anemia in a women with Hb of 5 (don't ask me how she was even walking around). I ran home to change at lunch and on my way stopped to visit my local wine store. I chatted up the owners and staff while picking out 2 bottles of wine for the weekend. I then sprinted to class for 4 hours, followed by powder puff football practice, woo hoo! I think I can manage 3 good hours of study time before I call this day done.
Tomorrow: I have the morning free to study and then my first (mini) test of 5th term. Depending how that goes I'll open the wine or hit the books again. The weekend is almost here and I cannot wait to study without distractions (yes I know I am a med school dork, but I'm okay with that because I have new shoes!)
8.22.2010
Reflections on a Sunday in 5th Term: Hot & Humid but with a View
I love the sound of the rain on our tin roof in my new off campus apartment. I hate the humidity and bugs that come with the rain. On the upside, living off campus means a wonderful balcony overlooking Lanse Aux Epines and the marina and it is breathtaking, worth the bugs and humidity for sure. (And my room has a/c, I just feel like a hermit always running into my room to escape the heat.)
I'm here in my (cross my fingers, nose to the books) last term and week 3 is about to start. I think I've grown complacent, I still enjoy the island but the goats wandering into the middle of road and the chance to swim in the amazing Caribbean Sea whenever I want have somehow lost their luster.
Fifth term is.... well, busy.... lots of exams, small groups, plus hospital rotations and class 3 or 4 or 5 hours a day. I might have time if I stopped going to class like more than half of my colleagues but I don't really enjoy sonicing and I figure it can't hurt (well as long as I put in the study time despite the time suck) so that is about all I have to say about 5th term. I started my clinical rotations in Peds and I loved it! Physical exam and reflexes on a 3 day old, what's not to love?!?
Here is hoping for inspiration to blog more often and that fifth term flies by so I can go study and take my boards and start 3rd year already. Senior-island-itis... who me????
Happy Sunday!
P.S. I found a new favorite med blog and my title is a clue, any guesses?
I'm here in my (cross my fingers, nose to the books) last term and week 3 is about to start. I think I've grown complacent, I still enjoy the island but the goats wandering into the middle of road and the chance to swim in the amazing Caribbean Sea whenever I want have somehow lost their luster.
Fifth term is.... well, busy.... lots of exams, small groups, plus hospital rotations and class 3 or 4 or 5 hours a day. I might have time if I stopped going to class like more than half of my colleagues but I don't really enjoy sonicing and I figure it can't hurt (well as long as I put in the study time despite the time suck) so that is about all I have to say about 5th term. I started my clinical rotations in Peds and I loved it! Physical exam and reflexes on a 3 day old, what's not to love?!?
Here is hoping for inspiration to blog more often and that fifth term flies by so I can go study and take my boards and start 3rd year already. Senior-island-itis... who me????
Happy Sunday!
P.S. I found a new favorite med blog and my title is a clue, any guesses?
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