hi to any new/returning readers!

As you may or may not know, I am able to see where viewers are typically from. Whether you’re from the USA, europe, China, etc. the study of medicine is always the same. We’re constantly behind a desk, probably worsening our already curved spines. I don’t know what your goals are in going through my blog, but feel free to leave me a message or comment if there’s something I can help address! I recently completed my third year and took NBME examinations in each of the core rotations. You can see my study tips in the tabs above. I’m open to including more details and discussing things specifically if the suggestions are out there! Take care and happy studying.

also took step 2 CS

please cross your fingers and pray for me! i studied for CS during my family medicine rotation. it was really hands on and i felt that i was getting good training throughout the rotation. I was able to develop my interviewing skills and ability to connect with patients. I’m scared though my notes and ICE portion of the exam were not that great. Of course, I spent much time looking at forums and panicking. I won’t find out whether I passed or failed for a couple of months, so fingers crossed until then. I’m taking CK in the next 6 weeks too. Hopefully I get a bunch of good news in the future. Until then, take care!

family medicine – done!

later post – i finished my family medicine rotation two weeks ago, but didn’t manage to finish this post, so here you go!

Having wrapped up my last day of my family medicine rotation, I ¬†am happy to say my third year of medical school is now completed. I say this every time, but each of my experiences has been better than the previous one. From psychiatry to pediatrics and medicine, family medicine has really taken the cake. For my program, I was given basically provider level autonomy to make decisions to for patients and provide direct patient care in the way of nasal/throat swabs, performing EKGs, drawing and administering vaccines and therapeutic injections such as medrol. I was shocked to be given such freedom, but after a couple of weeks, I became comfortable in my clinical knowledge to perform. I remember at first, I was really timid and unsure of what to say or do. However, with the support of the staff, I gained confidence especially when the waiting room was full of walk-in patients. When the rooms were full of sick patients waiting to be seen, I was quick to see as many patients, write notes, provide recommendations, and perform procedures as I felt indicated. For example, when pediatric or adult patients came for a “cough” or sore “sore throat” it became appropriate to perform flu nasal swabs as many positive results had come back. After a physical examination and looking into their pharynx, I would decide if a rapid strep test and throat culture would be indicated/useful. I tried to be judicious in my time and came back to present to the providers. In telling them the patient history, I would follow with what I believe is the situation, what I have performed, and how to proceed. As a student, I was also able to send medications to pharmacies. As long as they were correct, it really helped expedite the process, and hopefully it helped the patient ultimately too! What a great experience. I cannot say any more great things about the people, the staff, the patient population, and the learning process. Family medicine really has its draw to me. I can be a part of medicine and still get to the know the people that I treat. Great time to be a medical student, eh? (Ok, fine, some might argue otherwise, but whatever!).

I also took the family medicine core shelf exam. It was interesting to say the least. I studied case files family medicine, did some AAFP practice questions, and re-did many Uworld questions. I also had access to the examguru family medicine questions, which I felt were really useful because it had much of the similar complexities I saw on the shelf exam.

halfway through family medicine

Everytime I think of my rotations, I pretty much find myself hitting a point where I’m so stressed out and thinking that this rotation is the hardest yet. Ok, with the exception of 1-2 of my previous rotations, this one takes the cake. Between learning how to run the front office and what the medical assistants/nursing staff do to run the back of the office, there is a lot of mental stimulation. In my first 1-2 weeks, this is basically what I was doing. All the book keeping involved even before you get the see the patient. Where are the samples kept, urine tests, b-HCG, etc. And then learing how to use the in-office tools such as portable INR. So that’s how it’s done! I remember in internal medicine, we would tell our patients they needed to follow up with the PCP in order to have their INR checked every four weeks. I can finally say that I have seen the continuity of care in that way, but I can also see where a lot of that continuity of care is lacking. Would a stronger patient-physician relationship improve this area? In working with one of the PAs, I learned that some patients are so willing to wait longer time just to meet with the person that has cared for them rather than just take the next available provider. That says a lot about the provider, and someone I hope to imitate in my future practice too.

I digress though. In my current rotation, I am expected to draw blood, give injections, and perform EKGs on patients that are there for annual physical exams or to patients that present with chest pain or other symptoms that may indicate an EKG.At first I was very timid about this because it had been some time before I had done any of these procedures. I’m currently in my 3rd week, and moving much more quickly and doing things with more confidence. So for future students, its ok to be anxious and shy at first. Watch closely, asking questions, and develop your confidence through trial. As student physicians, this is our time to make mistakes so we don’t make them as liable physicians! (lol).

In terms of studying, I am currently using case files: family medicine, re-doing all the uworld questions timed random, and examguru family medicine question bank.

That’s all folks. Talk to you later!

random thought

After taking my second to last shelf exam for core rotations, I again came to a similar conclusion as I previously had. Be sure you are covering enough outside material in review textbooks because often times, the rotation does not cover the minute details we are required to know. Also, it is not always as simple as seeing a patient and immediately spitting our differentials and information to your preceptor. On exam, there are the longer question stems that you have to sift through for the pertinent information, and make heads or tails of whether or not it is useful information or not. So with that being said, be sure you are also studying with material that is pertinent to board exams.

Currently doing family medicine and really having a great time! Take care.

Psychiatry rotation completed

I recently wrapped up my six week core rotation in psychiatry in Connecticut. It was yet another city and state I found myself for rotations. From finding housing, a convenient and not expensive gym, and adjustment to the driving of the city, it was quite the experience. Having just left the hustle and bustle of Baltimore, Connecticut was a much quieter experience. I was not rushed in traffic and the convenience of getting around was exactly the change of pace I needed. For the rotation itself, it was definitely an experience too. As I previously mentioned about being even more comprehensive in your physical exam and understanding the components of the mental status exam. You think you know, but you have no idea! I had some preconceived notions of what to it might have been like, but my expectations were wildly exceeded on my rotation.

We spent time in pretty much every setting of psychiatry: out/in-patient, consult service, and crisis intervention in the emergency room. In each environment, we learned about acute vs chronic care and the ways in which psychiatry is interwoven into pretty much every field of medicine. There were expectations of students for paperwork, administrative assistance, performing new patient intake and presenting patients to the attending or on morning rounds, etc. There is plenty to do that some might call “busy-work”, but if you do it well, people will notice, and that goes a long way. The other side note thing is not to complain about the work or complain about the hours you have to stay late. It serves no other purpose than to harm your chances of making a good impression. I felt I had an adequate amount of time to study as well. When I took the shelf exam, I did feel somewhat overwhelmed because I didn’t think I had really grasped many of the nuances in some conditions and ethical dilemmas, so that had me concerned. Once I find out my score, I will post again about study tips and trips etc.

So that’s all I have for now. Take care.

5th week of psychiatry in the books

Hey all! Sorry for not having posted recently. It has been hectic trying to beat the learning curve of psychiatry. It was probably harder for me than others because I had not had much experience writing good SOAP notes, let alone know how to write a proper psychiatric one. Then there was having to memorize the components of the mental status exam and be able to logically put it together. I had mnemonic “ABC STAMPLICKER”, which many students will end up using, but when you break it down into its components and try writing a decent SOAP note, some parts just don’t make any sense, lol. This is what I realized after I had done it and presented it to my attending. Anyway, psychiatry has been really interesting. I’ve had the chance to see adolescent cases, full blown bipolar patients, as well as paranoid schizophrenics in active delusions and hallucinations. It still makes me anxious though especially with the patients that have a known history of violence. I’m already an anxious person, so you can imagine what else it does to me! Between this and figuring out a new medical record system everywhere I go, and trying to fit in studying, it is always a race to the finish line. We also have numerous lectures during the week and really interesting case conferences too every Monday of the month. As time consuming as they may be, there is such a huge opportunity to learn from the senior attendings. Hopefully everyone has this chance! Anyway that’s all I have to say on that subject for now. Keep on studying!