That’s a Wrap!

Kentucky Derby Festival Half Marathon finisher's medal 2015

Kentucky Derby Festival Half Marathon finisher’s medal 2015

Second year is over. Done. D-O-N-E, done!

And now the real fun starts: Step 1 dedicated study time. I am thrilled (kinda-sorta not kidding). Studying is going well so far. I’m nearly two weeks in and not totally miserable yet, although I am losing some motivation. Today it has been especially difficult to sit down and focus on the task at hand. I did take the entire weekend after the Pathology shelf (our last exam of second year) off as my “summer” break to spend with the kiddo and the hubby before I locked myself in my Step 1 dungeon. In that short time frame, we saw family and friends, played with the kiddo, and planned the kiddo’s first birthday party.

In speaking of said kiddo, since I started Step 1 studying, she has decided that she wants to try to walk, waves and says “hi”, tries to say “dada”, decided she will try her sippy cup all by herself, and she now likes the snacks I’ve been trying to get her to try now that she got her third tooth in. I don’t know why she decided that my dedicated study time was the time she was going to use to grow up too quickly, but that’s just how it is.

The end of the academic year was madness. Sheer madness. Between a sick kiddo on multiple occasions, and getting into a vehicular accident, things didn’t exactly go as planned. I only got in one full day of studying for the Pathology shelf, but I managed to go through the entirety of Pathoma so I still felt pretty good about the shelf.

Once all of that settled down, the only other “fun” thing I’ve done since school’s been out is to run my second mini (or half) marathon… 13.1 miles for the Kentucky Derby Festival Marathon and Half Marathon. David, God bless him, ran it with me so I didn’t have to do it all by myself. I wouldn’t have finished it this time if it weren’t for him; I didn’t get to train for it as much as I had hoped (never enough hours in the day), and so it was a long and slow process…. the rainy day was demoralizing as well, but we finished, and my medal is going to my Medals4Mettle kiddo. At ULSOM, our Medals4Mettle chapter pairs us with a kiddo in the Heme/Onc division and we can give them our medals. It is a great program and I am really glad I decided to do it this year. This was a painful race that has me trying to decide between never running again… or doing a lot more, and more frequently. Today’s verdict is: sign up for more. BUT only if I can train for them better than I trained for this one….

So, that’s it for my short study break. I’ve been pretty good about sticking to my study schedule, so I’d like to continue that streak and finish today’s sections before the kiddo comes home from daycare. See y’all in June!

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Spring Break

After much anticipation, my last real “break” before the beast Step 1 takes over my life has arrived.

The past few weeks have been pretty intense. We had our Block 6 exam, which covered four classes instead of three, and we had less time to study for it–it was held on a Wednesday instead of a Friday. This gave us some extra time to study for the microbiology shelf exam that is “must pass” this year, and counts towards the requirement of 70% average on exams for this year. To pass the shelf, we had to achieve a score higher than the bottom 4%… doesn’t sound too bad, right? It still works out to be around a 70%, so we couldn’t exactly totally ignore it.

To add to my already busy schedule, we had to make up LSP clinic time from the snow days. While it wasn’t a big deal, it just added to my jam-packed schedule. We are so very close to being done!

Over the weekend, David and I had an actual date night with just the two of us (not that I don’t enjoy date nights with all three of us, but it was a nice change–and Ladybug’s aunt and uncle enjoyed the playtime), I finished one of my projects, had lots of family time, took Ladybug to her 9mo checkup, and today I have a massage scheduled to work out the stress I’ve built up. It’s been a great “break” so far! The weather has been amazing too, which just makes my soul happy (or is that the Vitamin D?). This weekend, we take off for Memphis, TN on a mini-vacation that includes taking the ‘bug to the zoo for the first time (weather permitting), and I am so excited.

So this is it: Block 7. Endocrine, female pathology, psych. One ICM exam, the block exam, and the path shelf. That is all that is left of my second year of medical school. I have greatly enjoyed this year, sans pregnancy brain, but I am really looking forward to third year and being on the wards, finally!

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Columnist

Now that it finally went live, I can share with you the very first article of my new column on in-Training, Cheerios and Stethoscopes. (See, I wasn’t lying!) It was a hard piece to write due to its (obviously) personal nature, but I really wish I could have found something similar to it to ease my worries before I was pregnant.  

http://in-training.org/pregnant-first-year-medical-school-8380

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Elective Time in the NICU

For second year, we have to do 2 credit hours’ worth of elective time. The trip to Ecuador could have counted as my elective time, but since I didn’t get to go (which turned out to be a blessing, since the Ladybug made her entrance during the trip’s two-week timeframe), and since I didn’t want to take time away from my family during the school year by volunteering at the student-run clinics, I had to find something else that would count toward this requirement. One of our options was to do Career Exploration. We could do 24 hours with one physician for 2 credits, or split the time between two fields, 12 hours each. That choice was pretty simple; since I didn’t get to do my Pediatrics Externship in the NICU, I asked my Advisory Dean, Dr. T, if I could do my hours with her. I love getting to go into the NICU with Dr. T. We’ve had a ton of patients, I’ve answered lots of “pimping” questions (and learned this: being “pimped” means being Put In My Place… didn’t know that’s what it actually stood for!), and I’ve learned a lot not only about medicine, but about how to select a residency, things to consider for fellowships and employment… lots of stuff. I’ve listened to lots of murmurs, seen some really fascinating computer-generated models of heart conditions, and learned about rare genetic conditions.I tend to take awhile when I listen for murmurs, in attempts to hone my (limited) skills, and I’m always glad that Dr. T lets me take my time.

One morning, we even got to travel to another hospital on a consult for possible Down Syndrome/Duchenne Muscular Dystrophy. Another morning, we were doing well-baby exams in the regular newborn nursery (in the same hospital where I had Ladybug) when we got a page to L&D for a premature (36 weeks) delivery. This was the first time I’d been in L&D since I was a patient nearly a year ago. Dr. T had me gown up, and as I slip on my gloves, she turns to me and says, “When they bring him over, clean him off, suction him, figure out his apgar’s, and help with length and weight.”

“Ok.” No need to tell me twice.

And it was amazing. A big, healthy boy with wrinkling skin indicative of a gestation longer than 36 weeks. The dad was brimming with pride as we examined his boy.

On the next shadowing day, we got another page to L&D, this time to the OR. Twins! Incredible. OB is on my shortlist of career options, second to pediatrics, but I’ve gotta say, I was glad to be with the team that went with the babies.

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My First Diagnosis

…and it’s not what you think.

The memory of that day has haunted me ever since.

My grandma called on a Sunday afternoon, which used to be fairly normal. I talked to her for a few minutes, then handed the phone off to dad, since that was who grandma wanted to talk to on Sundays when she called. (I was still in high school, so yes, I lived at home.)

Once dad took the phone, I turned to mom. “Grandma has Alzheimer’s,” I said.

Mom looked at me, startled. “What did you just say?”

I told her about the conversation. In the few minutes I had been on the phone, Grandma had asked me several questions and each one she repeated multiple times, even after repeating my answer back to me.

My Grandpa had Parkinson’s, and later developed Alzheimer’s. Grandma was a retired RN, and took care of him in the home they lived in for ~50 years. He never spent a single day in a nursing home or hospital. I was quite familiar with what these issues looked like. During those few minutes on the phone with my Grandma, I knew. My blood ran cold and my stomach churned. A few years later, an actual doctor diagnosed her with Alzheimer’s (presumptively of course, since plaques and tangles can’t be confirmed until autopsy, if one is performed). We lost her tragically on Thanksgiving during my first year of grad school.

This week we’ve started our final new course, Clinical Neuroscience, and we started the week with neuropathology. Learning more about cognitive disorders has kinda freaked me out this week, and awoken some memories I guess I had repressed. I think what scares me most is wondering. I have no idea if maybe I carry the ApoE4 gene… And I do not want to know.

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Registering for Step 1

Over summer, while I was on bedrest to prevent preeclampsia, I spent some time researching how to register for Step 1 and how to build a study scheudule (mostly because I was so bored while on bedrest and had the free time). From what I found, it looked like I didn’t need to worry about that until at least November, which seemed forever away at the time.

Right before the Block 2 exam, my class got an email about how to register for the exam. Being so close to block week, I put that on the backburner. It wasn’t until a week and a half before Block 3 that I finally went through and looked at the email we got from school about how to register for it.

I was officially registered for my test date by early November. Most people don’t register so early for the exam, and it’s really not necessary to do so, but I had my reasons for wanting it done and out of the way.

Over that previous summer, we were told the date we needed to take the exam by (June 23rd or 24th) so that we have it done before third year orientation. My daughter’s birthday is in mid-June, and we wanted to have a few weeks between my Step 1 date and orientation for a family vacation. Knowing this, and knowing how many weeks I wanted to take for dedicated study time, and factoring in days off for special events (my brother’s college graduation ceremony, running my second half marathon, etc), I knew the target date that I wanted to take the exam. I also knew which testing site I wanted (the one where I took the MCAT, a very small testing center close to home). Since the testing site was really small, and since I still had plenty of funds from my loan disbursement (this test is more than $500 to take), and knowing that I HAD to have that exam over with before my daughter’s birthday, I knew I wanted to register as soon as possible.

It was actually a really easy process. I went to the NBME website, logged in, and selected my three month window of when I wanted to take the exam. I then could print off the form I needed school to sign saying that I was eligible to take the test (gotta love security measures, right?). Luckily, I still had extra copies of my last passport photo, so I could use that for the form (again, gotta love security). Then I had our academic affairs staff sign the form and add the school seal (security…). I then had the letter sent overnight mail that required a signature so I could track it, and so that I knew without a doubt that my sensitive information was received (it was only a couple of bucks, so I didn’t really care about the extra cost). When the NBME received my paperwork, I got an email saying that it would probably take 3 weeks to get my official testing permit sent to me; I needed the testing permit before I could log back in to the website and look for a testing center and select a date (the security on this exam is nuts!).

It didn’t take three weeks. I had my testing permit in less than three days. I immediately logged into the NBME site, chose my testing center, and they still had plenty of seats open on my target test date. It was so easy, and so quick to get it done by registering so early. Everyone’s situation is different, but doing things this way made it a lot less stressful, and I didn’t have to think about the registration process anymore. If there’s any advice I could give about registering for the exam, it would be to register early to get it out of the way.

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Stagnant

To say that this blog has been a bit stagnant lately is an understatement.

I know every med student blogger goes through this phase of long stretches without posting, but that doesn’t mean that I have to like it. What have I been doing since the new year? Mostly, focusing on family and doing well in classes while gearing up for Step 1 prep. But there’s plenty of other stuff too.

One of the reasons that there hasn’t been much posted here is because of how I’ve been writing for other sources. I agreed to be one of the Class of 2017 bloggers for the new ULSOM blog that I shared earlier on this post, but I also have been working on a piece of writing that was very personal. My editors at in-Training have liked my work so much that they asked me to write a column. I mulled it over for awhile and agreed. They’ve been waiting on my first post for the column since around Thanksgiving. I don’t like that I took so much time to write the first piece, but I wanted to make sure I got it absolutely perfect.

The first piece is about my experience of being pregnant while in medical school. In all of the blogs that I have followed over the years, I’ve stumbled upon some really good ones of both moms and dads in med school, but they already had kids before starting. I hadn’t found ANY that actually talked about being pregnant while being in school–so last year, I really did feel like I was isolated. So when the editors approached me about a column and I pitched my ideas to them, I was ecstatic that they thought these experiences would be valuable to others.

And so, I wrote. And wrote and wrote and wrote. Then deleted. And deleted some more. Then took a break from it all.

Pregnancy was much harder on me than I had imagined it would be. I did have a few hormonal breakdowns, usually on mornings where I was running behind to get to school on time, my clothes didn’t fit, I couldn’t even bend over to tie my shoes, I was always sick, but yet the only thing I wanted to do was study. I didn’t really feel like there was anyone I could talk to about it, either. None of my close friends understood what it was like to be pregnant and be a medical student. David tried his best to be a great husband, but he still didn’t really understand. Not every day was that horrible; in fact, there was quite a lot of excitement and joy, but the feelings of inadequacy and doubting myself took a serious psychological toll on me after awhile, especially since there really wasn’t anyone to talk to about it.

When I reflected on my experience, I realized that I didn’t want anyone else to feel the way I did. So I wrote about the truth of my experience. And I wrote and wrote and wrote some more. And I hesitated on submitting the piece for a long time, because I wanted to make sure I got it just right. Because this is important. In this day and age where there is still a glass ceiling, and there are still some who would criticize a woman physician’s right to start a family when and how she chooses during her training. I wanted to make sure that I conveyed how difficult it was to try to pursue my dream of being a mom and my dream of being a doctor simultaneously, and yet also give hope that both can be done, and can be done well. It wasn’t easy for several reasons: for the undue stress I put on myself, for being much more sick than I had ever imagined, for finding mentors, for figuring out how to budget for a baby and figure out my school schedule and daycare… the list goes on. There were many things that I wish I had known before we made the decision to start a family, but as it turned out, first year wound up being a great time to welcome a baby into our family.

So early last week, I decided enough was enough, and I needed to pull the trigger and submit the darn thing. So when I did, I left a note for the editors explaining why it took me so long. Not long thereafter, I got a very nice email from my editor saying that it was a great piece and they can’t wait to publish it, which should be sometime this week. I am so excited that they liked it already, and I’ve got the “go-ahead” to write more pieces for the column (hopefully without taking so long this time).

That piece of writing took up a good deal of my time, and the blog was neglected. I also wrote a few pieces for journals, and of course the entry for the ULSOM blog. It didn’t feel right to C&P those into this blog, so it’s been sitting and pretty much off of my radar. For now, though, I hope I can get back into the habit of sharing what medical school is like from a second year’s perspective.

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Spring Semester Commences

Hello all,

Spring semester is in full gear now, and with it, Step 1 prep mania has ensued. Our first week back to classes after winter break (which already feels like a lifetime ago), we had three days in a row of exam prep companies trying to get us to buy their products–which led to the (hopefully unintended, yet still unfortunate) phenomenon I was dreading…. white noise and seemingly mild panic. Now what I wanted to return to in the new year. But, it happened. And now a lot of what I’m hearing in passing is “DIT, Kaplan, Step 1, Boards, prep, blah blah blah…”, and it’s really, really getting old. We are +/- 5 months out from taking this exam, and the last thing we need to is start psyching ourselves out already.

But I digress.

We are now a little over a week and a half out from our Block 5 exam, and there are only 7 block exams this year (plus too “shelf” exams, which are more like cumulative, standardized exams, that we take and are must pass for Microbiology and Pathology). Basically, we are in the home stretch of being done with second year.

This is nuts.

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Of Bookstores and Past Lives

I miss the smell of a bookstore.

I haven’t been inside a bookstore since before school started in July of 2013.

This is really more devastating than it sounds, it really is.

Last night, after a wonderful dinner with my in-laws, lots of playtime for the little one, and then getting little one into bed, I didn’t know what to do with myself. Friday was our Block 5 exam, which means this is a truly “golden” weekend. So I opened a book, a book I’ve been trying to finish reading since last summer and my ‘maternity leave’. There was also a basketball game on tv… I haven’t sat down to watch a basketball game in so long. And I started thinking about bookstores and basketball and traveling, of my past life before school started.

When we used to live in Indy, I spent a lot of time in bookstores. We had a Barnes & Noble a few minutes away from where we lived, and we also had a Half Price Books. When I had my first job and was miserable, buying (and then reading/basically consuming) books was my retail therapy. Stacks and stacks of books are my remnants from that first job.

I adore stories. I always have, and always will. While I just knew that I was meant to be a doctor, I also knew that my desire for reading novels would draw the short straw once that dream commenced. There are so many days where I’d like to just curl up in my recliner with a stack of books and my favorite hot chocolate and leave medicine alone for a day. This isn’t to say that I’m ungrateful for my opportunities, just that sometimes I miss the things that make me “me”, and reading has always been a part of that.

It also didn’t help that the book I was reading was all about hiking, adventure, and work-life balance.

It’s also true that I knew ahead of time that my traveling days would be markedly reduced once school started, and then with the baby even more so. But I didn’t expect to feel so cabin-feverish so frequently. It also doesn’t help that we live in the midwest, and Louisville is particularly flat and dull. David and I have such a love for the outdoors and hiking and there is just nothing to even look at here. I’m afraid the west has turned us into mountain-snobs; if there isn’t even a treeline, it’s not really a mountain. So when I read about someone climbing the four-thousand-footer’s on the east coast when we’re used to the 10-12 thousand-footers in the west… I’m like, huh? What fun is that?

I’ve thought about doing a wilderness medicine elective during fourth year. I think that would be so cool, and get me out into the west again (bonus being that I’d be “required” for school, right?). Fourth year just sounds like fun. And it’s actually kind of scary how close it already is; we’re on the downhill slide of second year, Step 1 becomes closer every day, then we start clerkships, and then it’s fourth year and we interview for jobs and then we’re DONE. Four years of medical school in a flash. I’d be lying if I said that traveling during 4th year wasn’t one of the things I am most excited about. Having a variety of possibilities is exciting–we could literally go anywhere for residency. While we’d be leaving behind family and friends here, I think we’d both like some adventure for a few years, especially while Ladybug is young enough that she’s not in school yet. When I do have free time from school, the things that we like to do–like hike in Yellowstone or Glacier–are a good two days of driving away, just to get there.

Work-life balance in medicine can be tricky. It can be tricky in any profession, but it seems like medicine enjoys being so consuming. I love studying medicine. I love finally being able to pursue this dream of mine. But sometimes, I still want to do things that remind me of me. I miss those days where I ran the lab, taught other labs, learned new research techniques and felt like a valuable team member. Hopefully someday I will feel like a valuable team member again; I still feel like I will never know enough to be as good of a doc as some of my mentors. I would love to sit down and reread the entire Song of Ice and Fire series again–but that won’t happen for a long time. We try to read to Ladybug every day (she is currently being read The Hobbit), but I know she’d get more stories if I had more free time. Where we live, we don’t get a lot of time outdoors, especially when we’re at home–I want Ladybug to have a big backyard and lots of fun outside. Not being able to do that stuff now is disappointing, and not helped by my impatience for the days ahead. I’m supposed to be “enjoying the ride”, right?

This morning is gloomy and full of rain–it’s not helping my mood or my desire for something more. It’s strange that I’m wanting to read a book, when during the week I get so tired of reading books and notes. It’s hard not to daydream about warm weather and being outside. We haven’t even had any real snow this year, so I’ve had no excuse to pull on my hiking boots. There’s a piece of me missing, I feel.

I know this morning my thoughts are jumbled and this is probably the worst flow-of-consciousness posts I’ve ever penned. There is just something that I need that is missing from my current big picture, and I’m hoping that someday, maybe with the opportunity of moving for residency, that all of my hobbies, interests, and passions can all be indulged….

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Compilation of Summer Research Programs for Premeds

One of the highlights of my undergrad career was the summer research program I participated in after my sophomore year; this experience gave me a background in pediatric oncology drug development, established friendships, and ultimately was a great stepping stone for my previous career in biomedical research. In other words, it was invaluable.

Finding programs to apply to was a challenge. A database was not available then. It look a lot of online researching and tracking down specific universities that I was interested in. In the end, I applied to 6 programs and got my top choice. It was a paid experience, and it was also the first time I had to find housing on my own and live in a new city without knowing anyone. It was such a great experience on so many levels, and of course it looks good on your CV when you go to apply for medical school. Also, my first scientific publication came out of my work in my summer program.

The newest blog post by Accepted.com has a convenient listing of program opportunities for premeds. If you’re interested in research but don’t know how to get involved or where to start, this could be a great source of information for you!

http://blog.accepted.com/2015/01/26/pre-med-summer-undergraduate-research-programs/

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