Okay now this is just getting ridiculous-I have sent in the majority of my applications, and a few of the optho programs want supplemental materials. For the most part this is easy, as they are merely requesting my CV and a photo, the photo presumably because nobody wants to be treated by an ugly doctor, and that will help me pass the first cut-off in interview selection.

One school however, the university of Miami, an amazingly good optho program requires this:

U miami Bascon Palmer: Additional
materials required aside from CAS: a signed autobiographical sketch
not to exceed 600 words

Are you freaking kidding me? Could we make this any more vague? I mean, i already sent in my personal statement (thanks internet for proofing that which covers the whole why i want to be a doctor and now they are requesting ANOTHER personal statement and I honestly have no clue what they expect of me. Including my alternate statement for my backup specialty, this will make the third ps i have had to write in 2 months. I am just about drained of personality.

In any event, like all my other statements, I am going to post it here on xanga. Not in the hopes that you, my ever so patient readership will assist in editing. No, I have asked that too much of you lately, and it is hard enough to get people to comment. I am posting it here because I have a functional writers block staring at a blank open office document, but I seem to be able to pound something out, no matter how inane or craptastic staring at this little text box here on xanga. So if you read this, thanks for your time, and if you dont…erm, thanks for nothing?

——————

Umiami Autobiographical Sketch: No Reservations

Scorpion doesnt sting quite as much as you would think-at least on the tongue. I discovered this at the Night Market in Beijing, China. I visited China for one month in the summer between my first and second year of medical school to study traditional chinese medicine such as acupuncture, moxibustion, and cupping. Learning about eastern medicine however, was only a part of the reason behind the trip, the remainder being to explore a new culture, country, and continent.

I have always loved traveling, and China was only my latest stop in a series of jaunts around the world. In each locale I always tried to find not only some activity unique to the country, but also to learn at least a few words in the language, and immerse myself in the regional cuisine. Considering myself a bit of a “foodie”, I figure the best way to start learning about another culture is to eat it. Nothing starts a conversation like a shared meal.

Which is how I found myself staring down the stinger of a deep fried scorpion. A group of us all in the acupuncture program has set out to complete an Iron Stomach Challenge, competing in a gustatory version of the game “chicken” to see who was most willing to fully embrace the full range of edible oddities available. We had already sampled the famous Peking duck complete with internal organs at a five star restaurant, rancid butter tea and yak genitals at a Tibetan restaurant, and “meat on stick” as the sign read at the stand adjoining our hotel. A travel guide listed Wangfujing street as the place to find exotic street food, so that was decided upon as our next stop.

The stalls were lined with vendors selling cockroaches, starfish, crickets, snakes, everything I could imagine and a few things of which I had never thought. My digital camera at the ready as always, I snapped pictures of everything to ensure I wouldnt forget the experience; I needn’t have worried.

The first bite was a cross between shrimp and french fries, crunchy on the outside with a chewy salty center that was actually rather pleasant on the tongue. The stinger while intimidating at first, was actually the easiest part and only pricked my tongue slightly while being consumed. Thankfully, no acupuncture was needed to heal me afterwards, though I am sure any of my fellow classmates would have been more than happy to put our newly accquired knowledge to good use should my qi have needed correction.

On my return to the states, I posted all the albums and journal entries on my blog where the friends I made on my travels could see the adventures we had shared like bento boxes at the summit of Mount Fuji, fresh caught seafood on the banks of the mekong river in Thailand, paella and rioja at a tapas bar in Madrid and many others. (do i come off as too pushy here?-if so, nix this paragraph)

I view life as an adventure, and among my goals is to visit every continent at least once and learn about its people, places and cultures while I am there. I hope to one day be able to combine my love of traveling with the career I have chosen for myself, and participate in medical missions which will allow me to interact with a place’s inhabitants as more than just a tourist, providing services in exchange for the opportunities I have been given to explore the world around me. At the very least, I can discover if everything really does taste like chicken.

I would GREATLY appreciate your feedback on my personal statement for internal medicine. This is only a first draft, so any criticism on it is helpful. That is to say, if you read this at all, please leave a comment with your thoughts on how it could be improved or even just the gestalt you get from it. That said, here we go

—

I have always loved detective stories.
The trained observer arriving at the scene of the crime, unable to
prevent the incident, but possibly capable of unraveling the mystery.
How one seemingly innocuous clue, one insignificant detail becomes
the linchpin to the whole case. How nothing more than wits and
determination transform a rather ordinary Joe into the framework of
an extraordinary adventure.

The trained physician, much like the
trained detective must learn to use all of his senses above and
beyond the normal. We auscultate heart and lungs, We peer both
superficially with our eyes, and deeply with our machines, we smell
illness from lesions, we feel irregularities in bone structure or
rectal tone, and back in the day, some even used to taste urine,
though that is one mystery I am personally glad to leave unsolved.

When I began my third year of medical
school, I was the Watson to the hospital’s Holmes. I could only
observe in astonishment as the resident or attending would piece
together unrelated symptoms and complaints into a diagnosis, often
within minutes, while i struggled to come to a conclusion with the
same basic information.

Like Watson though, as time wore on, I
began to follow the reasoning and even pick up on clues myself.
During my rotation in internal medicine, my team had a patient who
had presented with a sudden onset of fever beginning one week
earlier, myalgia and abdominal pain. While all initial signs pointed
to influenza, my history revealed that the patient had recently
traveled to Venezuela to visit family. That piece of knowledge helped
lead my team to discover the real culprit was dengue fever, and the
patient quickly recovered. The thrill in solving the case stuck with
me, and with each successive patient my ability to create
differentials and perform the clinical reasoning process improves.

Internal medicine holds the greatest
appeal to me as a field due to its sheer variety. The internist is
the doctor’s doctor, the archetype conjured by the word a figure who
through careful questioning teases out the problem and then provides
the solution. The internist not only helps to identify the main
problem, but often coordinates care between different teams such as
surgery or social work. Additionally, the number of sub-specialties
available provide near-limitless opportunity for the physician
looking for a further challenge.

In all my successive rotations, it was
the skills and abilities from my internal medicine rotation that I
turned to first. Each rotation had something new to offer me, but it
was against internal medicine that they were all measured.

Sir Arthur Conan Doyle began his career
in medicine, only later to utilize his talents in creating the worlds
greatest detective. Interest in his stories helped to stoke my own
interest in medicine as the ultimate mystery. A story is nothing more
than a predefined beginning and end. With graduation, one chapter
ends. But as for this character, many mysteries remain to be solved.

—

So there you have it…i eagerly await your thoughts

-Almost Dr J

Moving right along down the choose your own adventure posts, today’s question comes from Dare2BDifferent, who asks: “What’s the most awkward thing that’s ever happened to you involving your work?”

Oh jeez, I almost dont even know where to start with this one. The very first time I had to perform a rectal exam and got farted on? The first time I had to perform a vaginal exam on a none-too-hygenic female? That time in family medicine where due to the young age of a mother i mistook her child for her sister?

The truth is, medicine is a pretty awkward field. People are constantly coming to you with things that are embarassing, disgusting, pitiful, humorous, or some hodgepodge of all of the above. Nor is it just in a hospital setting either…people find out you are a doctor (or in my case, an almost-doctor) and suddenly feel it is perfectly alright to whip out that mole that has been bothering them, or tell you about that horrible diarrhea they have been having lately.

And sometimes the awkwardness is a result of your own actions. There was about a two year period where I simply lost the ability to carry on a conversation that DIDNT involve medicine. And you would probably not be surprised to find out how little people want to talk about the sick, the elderly, the vomiting, the bleeding, and the whole gamut of med school experiences when they are not actually in the field seeing it firsthand. All of which would lead to awkward pauses in the conversation until I could resort to…so, how about them local sports team, eh? Or recent celebrity scandal-that wacky a-lister.

So trying to narrow down the multitude of awkward experiences that I have gone through in just a day, let alone the last 4 years is a pretty tall order. Despite that, there IS one particular instance that stands out in my mind as being incredibly awkward and uncomfortable.

In the beginning of my third year, my very first rotation and clinical experience in the trenches ever was internal medicine. Being fresh out of USMLE step 1 (shudder) and anxious to make an impression in whatever way I could, I made my senior resident aware of the fact that I could speak spanish relatively fluently. On the whole, this came in rather helpful, since rather than having to call and wait for a translator, I simply accompanied the resident to whatever patient she was interviewing and did the majority of the workup myself. It was a great way to both improve and accquire my medical spanish.

On one particular call though, my ability was definitely overestimated somewhat as I accompanied my senior resident to see Mr M. Mr M was rather well known to the hospital as he had been in and out with liver problems, kidney problems, blood problems…you name it, he had probably had it. Unfortunately, on this particular occasion, Mr M.’s test results indicated that he had finally reached complete kidney failure…endgame, if you will.

Oh yeah, and Mr M-spanish speaking only. So my senior resident pages me from studying to come talk to a patient with her. I arrive in the room and begin translating, only to realize about three sentences in that I am basically telling this man I met not one week ago that he is going to die. By the fourth sentence, I also realize that I lack the proper vocabulary to explain this to him in any kind of compassionate manner.

So before digging myself in to any trouble I cant get out of, I pardon myself and explain to my resident that this particular bit of linguistic acrobatics is going to be beyond my ability, and we will need to call for a hospital translator. Which we do, but all the while Mr M is waiting patiently to find out the end of what I was in the midst of telling him about the significance of his current test results.

The translator arrived and resumed from where we left off, and all the while I stand there in the corner with the resident, not speaking, just listening and watching as Mr M finally grasps what is going on. A silent observer, invisible to the resident who doesnt need me any longer, the translator who is telling the patient his options, and the patient himself who has long sinced cease to notice me amidst his own concerns.

One of my earliest experiences in clinical medicine, and certainly one that has and will continue to remain with me-I certainly wont be able to avoid similar circumstances, but I have done everything I can since to ensure that if I am caught at a loss for words again, it wont be due to my own inability, and it wont be in midsentence to the patient. Hardly the most amusing awkward medical story, but certainly one of the most important ones.

-Almost Dr J

Todays Choose your own adventure post topic is from Greek Physique, who asks “How frustrating does the endless cycle of rotations get?”

For those of you unfamiliar with medical school, third and fourth year consist of rotations. Med students spend approximately 6-8 weeks at a time in each of the core specialties (e.g. medicine, surgery, obstetrics, pediatrics) in various hospitals and during 4th year 4 weeks at a time in electives scheduled to the students own preference (gastroenterology, ophthalmology, etc.)

This can get a little disorienting as during the first week in any new rotation you are trying to learn the ins and outs of the hospital, the specialty, the area, your team and any number of variables. Compounding this confusion during the longer rotations is that the residents/attendings change each month as residency still includes rotations. For some, it can feel like by the time you finally learn what you are doing, and appear competent, you have to move on to somewhere else

Like anything else, this has its ups and downs. There were a few rotations I out and out hated (ER/Neurology). Knowing that they would be over relatively soon made suffering through them easier, even if time occasionally dragged out to infinity countind down the days.

Other rotations, such as OB/Gyn and Psychology, i knew I had no interest in, so these brief rotations would be my only exposure to the field, giving me a chance to learn without the pressure of looming years of the same monotonous work ahead of me. These made for some of the best learning experiences, even if they were not my favorite rotations, because I really made an effort to learn all I could, knowing I was unlikely to get another chance where i would be so able to ask questions and make mistakes

And finally for the rotations I was interested in as possible career choices (medicine/surgery/pediatrics) It gave me just long enough to see what I liked and didnt like about each specialty, and to see if I could mentally prepare myself for the long road ahead. At the end of the rotation I can think back and still remember how some rotations seemed to fly by and others drag, and that knowledge helped to limit my choices down to what specialty i would be applying for for my residency.

So in short, I didnt find the endless cycle of rotation particularly frustrating, because it ends up being a rather unique experience in the lives of medical students/doctors. Sure, your entire environment changes every couple months, but it also makes you fresher in your knowledge of certain fields when entering into others, and it also creates some intangible bond with other students and residents as you all had to ride this carousel of modern medical training before being allowed into the big kids world of healthcare rollercoasters. Though I may disagree with the emphasis placed on certain specialties over others, I wouldnt change the rotation education system for all those incoming students-its part of what being a med student is all about.

-Almost Dr J

This is the first of the choose your own adventure posts, wherein I answer questions YOU have asked about what it is like going through medical school

This is in response to TheBlackSpiderman, who asked “Do you wear your scrubs outside of work – and if so, does it aid in picking up women?

—

Prior to entering med school, I had a lot of preconceived notions about what it was going to be like. I think it is fairly safe to say that most people have an archetypal image of the med student, head down in an anatomy book somewhere in the back corner of a coffee shop, and of course wearing scrubs.

For two years before going to med school, I worked as an opthalmic technician, and my daily uniform was scrubs. I absolutely loved them…they were comfortable, they came in a variety of colors, and they made me feel like a grown up, an honest to goodness part of the medical profession. A vain egotistical part of me secretly harbored the hope that people who saw me walking around outside of work wearing scrubs would think I was on my way somewhere important to save lives, a surgeon in transit. For one of my birthdays, a girlfriend purchased me a pair of scrubs with my name embroidered in, and i would wear it even on days I had off…going to class just to be seen, like others would wear an armani suit or a louis vitton bag.

As I have gotten older, (and deeper into the medical profession) I have come to see how naive and foolish those earlier ideas were. I would wander around thinking people might confuse me for a doctor. That girls would see the scrubs and think oh, medical student let me go up and get to know that charming, handsome gentleman.

Turns out, not so much. You know what people think when they see a med student? Debt. Mountains of it. Not quite the sexy turn on you thought, is it? You know what I think when I see scrubs outside of a hospital setting? Not surgeon-anyone in a hospital operating room does not leave the building wearing scrubs as they are usually disgusting, covered in blood, bone, and whatever other germs were floating around. Instead I am thinking an exhausted resident on call, or maybe an ER doc, and they wear scrubs that are twice as gross as anyone else because wearing suits and ties in an emergency setting is just ludicrous.

As I come closer and closer to crossing the line between almost doctor j and actual doctor j, I could care less who sees me wearing what. It has little to nothing to do with the work i actually do, outside of being comfortable for long hours on call. It has been said clothes make the man. Well its about time this man starts making the clothes. But not in a literal sense, i would hate to put all those child laborers out of work.

Alright folks gearing up to post another personal statement on here for your perusal and constructive critcism. The first one was only made better each time for all of your input, and with that said, you may be wondering why I am writing another one

well, that is because Ophthalmology (my first choice) is a fairly competitive field and in the event that I somehow dont match into it (knock on wood) I was advised to have a backup plan. My second choice field is internal medicine, and somehow I dont think the internal med people will look too kindly on my application if they read right off the bat that they are the silver medal. So in a couple days I will post up the first draft and I look forward to any input you all have to offer me until it is as polished as the former.

That said, I have been suffering a bit of writers block lately, as you may have figured out from the recent string of comic related posts, so for those of you who dont feel like helping me with my personal statement (or even those of you who do) we are bringing back another fun game

EVERYTHING YOU WANTED TO KNOW ABOUT MEDICINE/MEDICAL SCHOOL but were afraid to ask

rules of the game are same as before-simply submit your comment about anything you may have wondered about the med school experience, and I will do my best to answer your query in a post. Last time i think i had only one unsatisfied customer, and that was because the question was excellently phrased but sadly beyond the scope of the experience I have as a 4th year student.

So wondering what is a 4th year students biggest fear? best memory? worst patient? best day? Anythign you can think to ask about any of the 4 years of med school, shoot, and lets see where it takes us

The floor is open to questions for 1 week until 11:59pm PST september 1st. Which incidentally is the first day med students can begin submitting their residency applications through ERAS.

And while I normally try to earn recommends, I respectfully ask that you rec this post to provide a larger audience from which to draw questions. Bonus points if we can get any xangalebrities involved.

a link to the previous episode-scroll down to the comments section to see what people asked, and check backlogs after that to see what i answered.

Ready? Set? Go.

-Almost Dr J

In the midst of all the stress of moving, I felt i should take a moment to let people know that I really am enjoying 4th year. 4th year is the breather for medical students, in the sense that we choose all our own courses, and so ideally you are spending the entire year doing not what you HAVE to do, but what you WANT to do, and often in locations where you want to do it. So while I dont have my entire schedule set yet, here is the tentative plan for my final year as a medical student

June 13-25: Essentials of Clinical Reasoning @ Chicago medical school
July 7-Aug 1: Gastroenterology @USC
Aug 1-Sep 8: up in the air due to unforseen circumstances…possibly 2 weeks of optho at UCI
Sep 8-Oct 3: Sub internship @ Mount Sinai chicago
Oct 6-Oct 31: Pediatric Speech Pathology, private clinic
Oct 31: STEP 2 CK….to be followed by crazy partying in West Hollywood, costume not yet decided
Nov 10-28: Ambulatory Care, random clinics around chicago
Dec 1-Dec 26: Online Nutrition, California and wherever I am interviewing
Jan 5-Jan 30: Online Ethics, California and wherever I am interviewing, also MATCH FOR OPTHO
Feb: Undecided
March: Clinical Forensics and MATCH DAY
April, May: Last big travel fling…ideas include Morocco, Egypt, Kenya…the Africa Trip
June: Graduate

So rather than a bunch of international electives, i chose to focus my time on studying for step 2, and doing a couple audition rotations, which will let me finish early enough to take 2 months of traveling and maybe hit up another few continents.

As part of my ECR elective, today I had to watch the new 3rd year students interview a standardized patient, their last such interview before they start seeing real people in the hospital. Afterward, us M4′s who have the vast experience of a whole year give them our feedback.

It was both cute and nostalgic watching them do H&P’s. I couldnt help wondering if I looked that naive and uncertain when I first began. And I dont doubt that I did. Some of the more notable bloopers included students using the otoscope (ear looker) to do the fundoscopic exam (eye looker), asking if a patient takes glyburide (a diabetic PILL) in both arms, and a few students getting so caught up in nerves that they FORGOT to do a physical exam.

Its hard to imagine that it only took a year from me to go from similar fumbles and faux pas to where I am now, feeling pretty confident in my history taking skills, and even writing assessments and plans. What a difference a day makes, eh? And while thanks to this blog both you and I know my thought process as this transformation slowly took place, actually being able to watch a student at the beginning of the final walk and comparing what I would do differently now, i almost lost the forest for the trees.

A few leftover questions I missed from the choose your own adventure challenge:
Nanumus: Do doctors really write GTFO on charts?

No, but there I have written things like FLK syndrome (funny looking kid), UBI (unexplained beer injury) and a couple others. With the advent of HIPAA, a lot of doctor to doctor slang is slowly going the way of the buffalo, but here is a link to a GINOURMOUS list of british and american medical slang that may still be used at a hospital near you.

Chinchujin: What do you do in the hospital that goes against your principles?

Technically, nothing yet. But i am still on the fence about the abortion issue, and I am a firm believer in letting people die with dignity, which comes dangerously close to euthanasia in the opinions of some. However, I am sure these moral quandaries will become more of an issue as I progress in years.

Ed8e: Something really long about my views on privatized health care versus univeral

I will admit to being a cop out on this one. I dont know anywhere near as much as I should about the differences between the two, and I lack the time right now to properly research it. However some things worht looking into for the controversey value alone are single payer, and franchised or concierge care. Another thing that will have to wait til i am a bit older and actually involved in the business of medicine before i can properly post something.

I think I managed to answer almost everyones question, and hope you enjoyed the choose your own adventure…next game in a few weeks when I am all settled in back in LA. In the meantime, i return you to your regularly unscheduled posting

-Almost Dr J

Some rapid fire answers to folks who shot me some rapid fire questions. These were all excellent questions, but try though I might, I couldnt think of a way to do an entire entry about each indivual curiosity you may have had, though I may change my mind later

Ablossoms

1. What are you using to study for Step 2?

ritual  human sacrifice. I think it is beginning to pay off. But if it doesnt, then USMLE world and all my old case files books. Gosh I love those…I wish they would put out a medicine for dummies series

2. 
What do you think about the relationship between nurses and doctors,
nurses and medical students?  Have you had any problems?

Relationships with nurses are alright…at least i dont feel awkward when i forget myself and start to bring up hospital happenings in the conversation. Nothin kills a date like, “so there i was doing a rectal exam when…” Other than that, The nurse relationship can best be explained by scrubs…when you start in the hospital, the nurses know so much more than you and you are intimidated…but as you gain more knowledge and experience, the tables begin to flip and it can be hard to hold on to some of those friendships.

3.  What frustrates you the most about your chosen career?

See previous post…So frustrating

4.  What has surprised you most about medical school?

The things that dont bother me, and those that do. For example…some of the “grosser” things like rectal exams, chest tubes, and foley insertion-totally cool with. Touching people feet for any reason-i wash my hand at least 6 times immediately after and even then still feel nasty. Feet are disgusting. Other than that, I am surprised by how much knowledge i sometimes have and even more that my friends and family consider me enough of an authority to ask medical questions. I guess a lot of things surprised me about medical school. This one may warrant its own individual post later on

5.  Where would you see yourself in 10-15 years (private practice? ninja pirate? academic setting?)

Private practice, in a city or at least close to one, with an established patient base, my loans paid off, and a couple medical aid trips a year for vacations. Possibly also beginning the procedures to open my own restaurant or bar. Maybe even in a relationship…who knows, I will be out of med school and possibly even have a social life again…anything could happen. Except academia…research for me if i have to do it, is nothing more than a means to an end

Kimmy

How do you adjust to such a messed up sleep schedule?

how long have you known me? I have always had a messed up sleep schedule. But I guess you learn to catnap and sleep in any position, no matter how uncomfortable, even standing up…which happened once during my surgical rotation…just like a horse, i drifted off while retracting and slept for almost 10 minutes before someone awoke me, and that was just because my grip had slackened

How do you get through nights on call?

Despite my complaints in earlier posts, call does not always mean you are awake for 24 straight hours…it just means you stuck in the hospital that long. If you can get all your work done by 4 or 5, then you can sometimes nap almost three hours straight and then it is just on and off sleeping as you are needed. If you are well liked by the nurses, you get more sleep, as they wont call you for trivial things…if you piss the nurses off, they will call you every 10 minutes to ask about something they already know the answer to.

The worst time on call is usually right around 4am. Anything until 1 or 2am you are pretty awake, in that college mode, especially if you have some fellow residents to chat with, or note writing to catch up on. 3am you start to lose your steam, and some folks turn to coffee or coke, or in my case tea. 4am-5am is the hardest time to stay awake, and usually when a difficult admission will come in, when your performance is at its nadir. after 5, the energy levels usually pick up enough to last you through til the end of call around noon, when you go home and crash like a japanese fighter pilot.

I also would frequently use gmail to chat with some of buddies to pass the time…thanks, nakochan, calimari, and y2kenh…you guys have been lifesavers in those early hours

What do you do in your “down time” at the hospital, if there is any?

This, mostly Also study, or read uptodate, an electronic summary of medical journals and knowledge. Run errands via the telephone. There is always something to do

What is the best thing about being an almost-doctor?

If and when I make mistakes, i am still only an almost-doctor, and thus the axe doesnt fall as hard on me, as I am expected to still be in the learning process. Also, the hours are still mostly 7-5, as I dont usually have extra paperwork to see to. And the respect from peers and family at the almost doctor status certainly doesnt hurt.

What are you most anxious about?

Residency. Or more accurately, the entire residency process. writing a personal statement, applying to programs…will I get interviews? will I match into the specialty i want? will i match at all, or will i have to scramble? where will i end up living? how will i pay back my loans on a residents salary?

Frankly, i am a big ol bag o crazy at the moment, and its only going to get worse before it gets better

Last few choose your own adventure posts coming up, and it looks like they are some difficult ones. So next will be the food post, i swear. I just happened to have downtime at the hospital today.

Todays Adventure may be a little bit frustrating…or more accurately, about frustrations. There are of course numerous things that can frustrate one in medical school-the long hours, the lack of nonmedical social interaction, the endless testing, the sheer number of things you need to know, the calls, the bad residents or attendings, the list goes on and on.

But you have probably already figured most of that out, and the question burning a hole in your pockets (pardon my mixed metaphors) is what is the most frustrating aspect of medical school TO ME. The author of this blog. The ginourmous, invisible egomaniac who sits here and doodles on this her interwebs for you.

Well, lets briefly go back to the beginning. A nod to hidden beside me, who posed the classic question, why did you want to become a doctor in the first place?

Lets clear one thing up here: my main reason for going to medical school and wanting to be a doctor was not “to help people.” There are lots of things to do if you want to help people. Plumbers help people, Internet hookup guys help people, Mechanics help people. Every premed and their mother thinks that this is what interview boards want to hear. Not that i DONT want to help people, but for the record everyone who actually gets in has some motive above and beyond this altruistic bullshit.

As an addendum, I didnt get into medicine for the money either. Which is good, as with my MD will come roughly 200,000 in debt. Probably closer to a quarter million once all the interest is figured in.

So now that we have established that I am broke and hate people, why did I get into medicine? For the challenge. For the sheer joy of solving the puzzle that you people are. You come to me with several different hints, and i get to put it all together, and even when the picture is the same, it never happens exactly alike twice. Yes people, even at your worst, you present as unique as delicate little snowflakes. Or perhaps obese, smoking, alcoholic, elderly snowflakes…but i digress.

During my interviews, this is basically what my answer came down to. Sure it was gussied up a little bit in pretty language, but the thrill of the chase, the joy of discovery and the actual titillation achieved solving a problem, particularly one as complex and invisible as sickness are what get me through the day.

So now that you know why i got into medicine, what are the most frustrating things about it?

Not what you might think. The studying and the long hours on call were thing i knew i was getting into. Actually, what all my pet peeves basically boil down to is: INCOMPETENCE.

Now I dont actually mean stupidity by this, though i saw my fair shair of that in every rotation. I mean things like Attendings who micromanage, nurses who wake residents every 5 minutes to ask if the patient can have a sip of water, people who cant figure out the computer system despite having worked in the hospital for more than one week

In the beginning of the year, the major source of incompetence and inefficiency, was, well, me. I had no clue what it was like to work in a hospital, where anything was located, how to write a note, or do basically anything. Very frustrating, especially since right about the time you learn how to do everything well, either your team changes, or you switch rotations, so you dont get a chance to look competent when it counts. Of course, as the year went on, I learned my way around so this became less of an issue

The next major source of frustration was the enforced mandatory lectures given by my school. Now it took me a while to learn this, but I am not the type of person who learns by sitting in a lecture unless i am very interested in the topic material…and even then, the span of attention is limited. Yet for every rotation i went on, at least once a week, clinical duties were interrupted by some lecture or another that I had to attend. Now if these lectures were at least on site it would not have been so terrible, as I completely understand the rationale behind noon conferences and morning report and things like that. But too force me to drive out to the middle of nowhere at a hospital i am not even assigned to to listen to a lecture about something i could better learn by asking my residents or reading? ANd to make this lecture at a time when the commute is during rush hour with inclement weather or road construction? Now that really grinds my gears. I understand that if the school doesnt make these lectures mandatory, many people wont show up. The obvious solution then, is to make the lectures worthwhile, or provide an alternative to attending lecture…perhaps some written presentation or something to that effect. Not making me drive several hours to sign my name on a sheet of paper and then fall asleep

Another source of frustration was how limited certain hospital sites kept the medical students. I am perfectly aware that as a third year there are some things I am not capable of performing or the hospital might be liable for. By the same token however, this is the year when I am supposed to experience a lot of hands on learning. So attendings or residents who are fans of having the student merely take a history can be quite irksome. The catchall is “see one, do one, teach one” not “see one, see another, see a third” As an active learner, give me something to do, and I will do it…then we can review what needs improvement or what went well. But please dont assume by the end of my third year that i need to be taught how to do a physical exam unless you have seen me fail at it. Sitting in a corner watching you work doesnt make me think, wow, what stunning technique, but rather, what else could i be doing to more efficiently spend my time in the hospital?

The final major source of frustration in 3rd year is, well, 4th year. Trying to schedule electives who dont have the decency to tell you if you are in or out or on a waiting list until you have called…sites that get your paperwork, but lose something and blame you for it. My troubles with 4th year could be a post in and of themself. But in short, those were my greatest frustrations, and ones shared I think by certainly many of my classmatess, if not by many med students in general

On an unrelated note, the next med post will be preceded by a very special cooking with almost dr j. What with the top chef season finale airing tonight, my friends and I will be doing our own cooking challenge, letting every technique we have learned all year bust out. And pics of course will be included. In the meantime, hope i am answering all your questions. I still have a lot left to go!

No this post is not going to be about the 80′s book series, though it was by far one of the best books to read as a kid, right up there with R.L. Stine (who my brother met! it gives me GOOSEBUMPS just thinking about it)

Instead, I am suffering at the moment from a bit of writer’s block. In the sense that while i derive a great deal of satisfaction from posting, i have had a lot of trouble sitting down and just writing freeform. And given that i need to start thinking about my personal statements, I have decided to play a few writing games with you folks in an attempt to get the creative juices flowing as well as spruce up my writing. So here is what we are going to do

The point of the new blog overhaul was that most of my writing lately has been focused more on the medical training and education. So you all know what i think about the things I have gone through…but I have no clue anymore what questions, concerns, or wonders YOU have about the medical establishment. I am already too much a part of the machine, as it were.

So for my next couple of posts, I would like you to leave questions or comments about the things YOU would like to know about the medical school experience. Maybe you want to know how i got interested in medicine, or what I hate about it. Maybe you are curious as to the general perception toward death in western medicine, or hospice care, or HMO structure. Maybe you wonder how doctors and students manage to find the humor in daily life despite seeing people at their worst, or about the patients who are so terrible that we reconsider medicine. I dont know, but if you can offer up a question, I WILL do a post about it. No excuses. I may try and squeeze several into one post if they relate, but this is an exercise for me in topical writing, so they will ALL be done.

(gratuitous parenthetical phrase)

I will leave this post up til the end of the week, unless commenting is sparse…then i may leave it up longer, pick a new game to get you involved, or just give up altogether…there is no way to know unless you play!

So, here is your chance…everything you ever wanted to know about medical school, but were afraid to ask. A tell all expose by an average medical student. I look forward to it, and I hope you do too

***If any other medbloggers want to get in on this, I would be happy to host the discussion. I am looking your way grssh, futuredrjulie, and freakforjc. mostly because you are among the more active commentors on my site ***