Check Out Our New Site!!

So, I've decided to switch sites completely!! I know, I know . . . I can't seem to make up my mind these days, but this is going to be permanent!! I will not be posting anymore on this blog, but rather both my hubby and myself will be posting under our new site that we share together (just beware that it is still under construction!). I just felt that a new web address was more appropriate! I will be copying everything over to the new site in the next couple of weeks (and under the same posting date as this site as well as any comments associated with it), so everything will be in one place. Anyways, check it out!!!!! We would love to have you visit, share your thoughts and experiences, and keep coming back for more!! See you there!!

Our Medical Lives

Out Rotation #1

I know that I am super behind on my blog and I apologize profusely to all my readers! I am now back to get caught up, and to announce the news that I have decided to make some additional changes to this site! I am making more format changes, but the most exciting of all is that I am adding my husband to the site as an author!! He has always had contributions (as noted by the different color of font), but they will be completely under his name now! He may be posting on a regular basis or just a few posts here and there; it all depends on his schedule! So, this site will no longer be the medical student wife's rantings and ravings, but the medical side as well!! Please continue to enjoy and come back for more!!

Now, on to out rotations!! The first out rotation that my hubby did was during the month of August in Portland, Oregon. You can find his point of view below, but from my point of view . . . it was DANG HARD!! We had just had our second child at the beginning of July. When he left for the rotation, our baby was only 3 1/2 weeks old. It also happened to be during the month he was gone that our older son decided to quit taking naps! I was not getting a lot of sleep, I did not have family around to help, and I was very, very tired. I did finally have a bit of a breakdown with about one week left. I was in complete and utter tears, I was worried that my poor kids were not getting the attention that they deserved from a mother, and I felt that I was just barely getting by. Despite the chaos of the month, I did survive, partly due to my fellow MSW's that helped to support me along the way and check in on me every now and then. I owe them a big thank you, more than I can ever repay!! I can now look back on that month and I am proud of the accomplishment of doing it all on my own. I have always considered myself to be an independent woman, but it was a rather different story considering the circumstances! We made it!! And, I firmly believe that if we can survive that month, we can survive ANTHING!! Afterall, during internship, my husband will at least be sleeping in the same house though we may not see him as often. He will not be thousands of miles away!! Just knowing that he will be there is more encouraging to me than I ever thought it would be!! I am still nervous about the next couple of years, but I am also empowered and believe that we can definitely make it through!! Now, enough about me . . . on to my hubby's perspective!!

I spent the month of August in Portland, Oregon doing an elective rotation through the anesthesia department at Oregon Health and Sciences University. It was an amazing experience and I enjoyed the rotation a ton. I learned a lot on the rotation and had a lot of hands-on experience. I got to do a lot of intubations, IV’s, and even got to do my first arterial line placement (not as easy as it looked). I had great interactions with the attendings and residents and on one occasion it was just the attending and I doing the surgeries (a little stressful as he usually expects the residents to do the work and I was a bit unsure of what I was doing during the case at times). As a student they worked hard on getting us into a large number of cases throughout the rotation. I got to see emergency surgeries as well as routine cases. In addition, the didactics were really really good. We would spend an hour with the first years and an attending (with food of course so that made me smile) during the first two weeks going over the basics that they should know. It really is amazing how much general medicine plays in this field. I know I made the right decision as I love medicine but just can’t stand the thought of rounding all day (it brings back flashbacks to one of my IM rotations when I just wished it would all end). Overall, I was very pleased with the rotation and was ready to come home by the end of it. One month away from my family, especially with such a young child at home, was not easy on me, and surely not on Tif but she pulled through well. We’ll see how everything works out with interviews for residency coming up right around the corner.

Don't Lose Hope!!

I am in the midst of updating a bunch of stuff on all my blogs! Don't give up on me! I will be posting again very soon! I have lots of excuses, but I will just leave it at that! Be back soon!

What About Us?

Lately, I have been surfing the web looking for blogs that are similar to my own . . . a spouse or significant other perspective on the medical school experience and beyond. In my search, I have come across quite a few med student blogs as well as intern/resident blogs and those written by physicians themselves. Here are just a few of those that I have found . . .

What, Me Worry?

Medical Student Musings

The Chloroform RAG
Notes of an Anesthesioboist

I know that there is quite a community out there along these lines. In fact, as I find more that I personally enjoy to peruse, I will post them on the sidebar as I have done for these ones. However . . .

WHAT ABOUT US?????

So far, I have yet to find any public sites that are fellow MSW's!! Are there no others out there willing to discuss their experiences? Afterall, it is more than just the student who embarks on this journey and makes sacrifices along the way? Maybe I'm looking in all the wrong places.

Whatever the case may be, I'm curious . . . what are some of your favorite medical blogs? I'm particularly interested in blogs or websites of fellow "widows", but am always up for a good blog by anyone in the medical field, particularly med students, residents, and physicians. Please share . . .

More Changes Coming . . .

Just wanted to let everyone know that I'm making additional changes to convert this site completely to my rantings, ravings, discussions, and sometimes, just plain crazy talk about our medical school experiences and beyond. All my craft and other such posts will be taken off of this site over the next few weeks. If you are interested in anything, but you no longer see it here, just email me using the link on the sidebar. I am still keeping everything, just no longer making it public!!

Expanding Your Family

I remember during the first months of our first year in medical school, we attended a panel that discussed relationships and how they are affected during this journey. One of the questions asked that night of the panel was . . . for those of us wanting to have children during medical school, when is the best time? I thought that was a very interesting question at the time. My husband and I had one child already less than a year old and planned to have another sometime prior to residency. So, what was the answer? Most recommended third year of medical school. Since then, we have expanded our family and I wanted to share with others out there my personal experiences on the matter!

We had heard from many that third year or the first year of clinical rotations was the perfect time to have a child. We took this recommendation to heart and we planned accordingly. Our second child arrived at the beginning of July, technically the beginning of the fourth year. My opinion (and I'm sure my husband will agree with me) . . . BAD TIMING!! Why? Between the third and fourth year, students are required to take the Step 2 exams. My husband took both the COMLEX and the USMLE. He scheduled these towards the end of my pregnancy, ensuring that they would be complete prior to having a newborn at home. Very good planning on his part. Unfortunately, I tend to have babies early! During the day he was gone for the USMLE, when I had absolutely no way of getting ahold of him, I began to have contractions! Thankfully, they slowed down and we were able to be together at the time our precious little one was born! In addition to the tests, this is the prime time to be doing elective rotations. We do not intend to stay in our current location for internship/residency. In fact, where my husband is doing his out rotations is thousands of miles away!! When our child was at the early age of 3 1/2 weeks, my husband left for a month for his first elective rotation. Did he have to? No! BUT . . . it will increase our chances hopefully in getting into our ultimate residency program, a more long-term decision . . . a sacrifice that we are willing to make at this time to save family time in the long run. Having a newborn at home with a preschooler, no family within thousands of miles, a limited support system in our current location, and no husband has been VERY difficult! My husband is planning on doing another elective rotation thousands of miles away. Am I nervous? No . . . simply because I am leaving and going to stay with family for the majority of the time! Two full months away from his kids, particularly his new one has also been very difficult on him.

So, my recommendation . . . if you are going to have children during medical school, third year is really the best time! Third year meaning between July and May AT THE LATEST of that year!! Things then begin to get crazy with tests, elective rotations elsewhere, and then residency interviews, sometimes scheduled last minute. Having a baby seems very possible the first two years, especially if you are attending a family-friendly school. Fourth year may even be a possibility before you have to move for residency and after your interviews are complete. In the end, do NOT have a child between June and November of your fourth year if at all possible!! I would not change anything if it meant I could not have our sweet little addition, but I would recommend and warn others that this is a busy and chaotic time. Do not add more stress at this time if you do not have too!

Boards AGAIN!!!

I remember back to about one year ago when my husband was studying away for the COMLEX and USMLE. I thought it was horrible that we never saw him!! He was always stressed out and this went on for weeks and weeks and weeks!! Even after the tests were complete, that feeling was still hanging over our heads because we had not yet received the scores. Ultimately, my husband did just fine, having a very competitive score for the specialties that he was interested in.

Half way through this year, I realized that the COMLEX and USMLE came around AGAIN!! I had no idea that Step 2 boards came around so quickly!! And, it definitely snuck up on me!! I was so worried that it was going to be the same story . . . absent husband, stressed husband when he was around, waiting impatiently and anxiously for the scores to be released . . . but I was completely wrong!! Don't get me wrong, there is definitely stress, but it is nothing compared to Step 1!! And, we had a lot going on immediately after the exams (the birth of our second child and beautiful baby girl!!!) that we were shocked to see the scores in the mail so soon!! And, to top things off, he did better the second time around!! GREAT JOB!!! I am so proud of him!!

Here's my hubby's point of view on the exams . . .

Step II is one of those tests that sneaks up on you a little bit. We all know it’s coming but we have so many things on our minds at the time that we put it off until we absolutely have to study. I took my boards on June 17 (Comlex II) and June 21 (USMLE II). I’ll start by saying that I studied for three weeks straight (weekends, 12 hour days) for Step I and for this I had seven straight days of studying and two weeks of afternoons to study (when I could) for the test, and everything turned out fine. No matter how you did on Step I this is just a different test in terms of content. Step I was all about memorization-pathways, pathology, bacteria, etc. This test tested your ability to put it all together. This was definitely a clinically-based test. In the long-run I studied for half as long and did better on both (which I think is the norm from my understanding). When I finished the Comlex Step II, I came out thinking it was one of the easiest tests I had taken in a long while. I honestly didn’t feel it was that bad and I know 99% of my classmates could have or did do just as well as I did on it. USMLE Step II was a different story. Unlike the first step where I felt I did about the same on both Comlex and USMLE, on step II, I felt that the USMLE was a much more difficult test overall. However, in the end, I did better on the USMLE that the Comlex…go figure. Anyways, the content of the Comlex was what was to be expected. We all have different tests but mine was OTM light and gastroenterology heavy with a mix of everything else in between. There were still the questions in the block format (2-3 per stem) and still had the matching (but I lucked out as 4 or 5 of my matching sets were clear-cut microbiology questions). I used First-Aid for Step II CK, USMLE Secrets, and USMLE World Question Bank. That was it. I would study the first-aid book throughout my rotations and it was helpful. Honestly, the majority of the test is in that book in some form. USMLE Secrets was well worth the money and I read it twice before the exam. I would highly recommend it. USMLE World wasn’t as helpful as I had thought. I finished a bit over ½ half of it (didn’t have much time with rotations and all) but didn’t feel that the questions were as helpful as question banks were for Step I. It did help with getting your mind in the right “mode” for the test but if I had to do it again I would probably not buy the questions. I can’t say anything about Kaplan or the Combank questions for this test as I didn’t use them and haven’t had a chance to talk with anyone that has. I think that one of the big things for the test is just paying attention during your rotations. You really do pick up a lot from them and from all your reading. You will be surprised how much you have learned during your third year. Overall, find 2-3 good resources for the test +/- a question bank and that should be all you need. It is tough to find 2-3 weeks straight for studying so that is up to the individual person. Good luck, and don’t stress (yes, I understand that it is easier said than done).

Rotation #10: Pediatrics

Ahhhh . . . pediatrics!! The FINAL rotation of the third year of medical school (at least for my hubby) and the finale of it meaning that we are officially a 4th year medical school family!! It may not seem like a big deal to many, but this was a huge milestone for me personally!! We have completed 75% of medical school, the light at the end of the tunnel is becoming brighter and brighter every day, and I am excited to think that we will be settling in one place for at least four years! Who knows where that someplace will be, but we are almost there!! Woohoo!!

Since this milestone is complete, it has been interesting to reflect back over the year or even since the start of medical school to see how we have grown. I say "we" because our family as a whole has truly grown in so many ways!! My hubby, the medical technologist, has grown into a student doctor, learning so much each and every day. I have personally developed patience and learned to live by the seat of my pants (which tends to be a bit difficult for me!). And, physically, our family has grown from a family of three to a family of four! Wow!! So much has changed in the past three years! And, I truly believe that it is for the better!! There have been hard times and good times, but I can say with the utmost confidence that WE do not regret this decision one bit! Though this may change (ask me again during internship/residency!), I feel that this journey has made our personal relationship stronger, it has exposed us to so many different people and ideas, and we have both become better people through these experiences.

And, now most importantly for me, the countdown to graduation begins!!!

Moving back to peds, here is what my husband, the student doctor, had to say . . .

I should start out by saying that I had no interest in pediatrics but I ended up loving this rotation. In fact, I am doing my fourth year pediatric elective with this particular pediatric group. The days usually go from around 8 until around 5 in the afternoon. I will usually go to morning report at 7:15 and then report to the newborn nursery at 8:00. I will get a list of all the newborns and begin seeing them first thing. Usually there is at least one other medical student and sometimes an intern on the rotation which helps out a lot. The attendings are fantastic to work with and very patient. They will walk you through the newborn exam and tell you what you are looking for and help you to identify any abnormalities. This can be especially useful for all the students who don’t have kids and for those that are tentative about examining someone else’s newborn. It can be a little delicate at first but you get the hang of it. You’ll present to the attendings all the newborns that you saw and then go over the exam with them all the while writing your own notes of course (no different than any other rotation). After you are done with the newborns you’ll see the older pediatric inpatients. Usually there are only 1-3 patients for this particular group but that can be more than enough. We don’t have a pediatric ICU at the hospital where I am placed, so most of the kids are fairly stable. You’ll see your fair share of asthma exacerbations, diabetic kids, and diarrhea induced dehydration. When done with the older kids you will usually sit down for a presentation given by one of the medical students. After the presentation, the attending will usually add to the talk and give some tips and tricks. On certain days the attendings themselves will give lectures which are VERY good. They cover the basics-fluid management in kids, bilirubin, diarrhea and constipation, etc. These can be very useful. The afternoons are spent at the clinic with this group. To say this is a busy clinic is an understatement. There are 16 rooms and they are always full. You can see as many patients as you want during the afternoon and you will see a good variety of illnesses. Of course you will have a lot of diarrhea, viral infections, strep throat, etc., but you will also have a fair number of uncommon illnesses as well. Every one of the attendings are fantastic to work with and I would do this rotation again if given the chance.

Rotation #9: Anesthesiology

It was so good to finally be able to experience Anesthesiology!! Afterall, this is the field that my husband has chosen to pursue!! Though my husband's current placement is not with a teaching program and it may not have been completely reflective of what is to come, he still received some good experience. The thing that I enjoyed the most about this particular rotation is that he came home happy and excited to talk about what he did that day at the hospital. He was so excited to try new things, practice those that he was still learning, and just get somewhat of a feel of what he will be doing for the rest of his life.

Here's what my husband had to say about the rotation . . .

This was a 2 week rotation with no call. This is one rotation where it could be as difficult or as easy as you wanted it to be. It was not uncommon for several of my classmates to be in at 7:00 and leave by 10:00 (or not show up at all). It was a bit unique and a bit of a disappointment in that there was no real oversight or guidance to the rotation. There was no “checking-in” in the morning and you were responsible for your own education on this rotation. A typical day for me began between 6 and 7 a.m. where you would either check in on the 3rd floor and participate/watch line placements for cardiac procedures (central venous lines, radial arterial lines) or I would go straight to the second floor and begin cases with the anesthesiologists. Cases would usually start at 7:15 every morning. There are a total of 28 OR’s at the hospital I'm currently placed with “routine” surgeries (gallbladders, colon resections, breast biopsies, etc.) taking place mainly on the second floor and orthopedic and cardiac cases occurring mainly on the third floor. During my rotation I mainly hung out on the second floor. This was because I would have more interaction with the anesthesiologists and I would be able to intubate more (shorter procedures and quicker turn-around-time than cardiac or orthopedic surgeries). My day would usually only last until around 2-3 at the latest because the majority of cases were done by then. After that I would go study or head home. During my time I would interact with the anesthesiologists mainly with intubation as they had to be present for every one. However, after that I wouldn’t get much of a chance to be with them as they were each monitoring 3-6 rooms. The exception to this was with bypass surgeries where I had anesthesiologists walk me through several transesophogeal echo’s and discuss a large number of topics with me. The majority of my interaction was with the CRNA’s. Being as how the hospital does not have an anesthesiology residency program and the anesthesia is provided by a private practice firm with a lot of CRNA’s employed I did spend a lot of time with them. As I want to go into anesthesiology I felt that I did learn a lot from the CRNA’s as well as the anesthesiologists during my two weeks on the rotation. Overall, the majority of my classmates did not enjoy the rotation. A few of the anesthesiologists are a little tough to be around and some of them don’t like to teach at all. However, if you put the time in and show some interest there are a few that will take you under their wing and help you learn a lot.

Rotation #8: Radiology

I've only got a few words for you in regards to my opinion on this rotation . . . a VERY nice change!! My hubby was usually home early and it was not a stressful rotation at all! It was so good to see him in a relaxed mood . . . though it did not last long since Step 2 Boards snuck up on him!! :)

Here's what my hubby had to say . . .

This rotation was set up a little bit like anesthesia, as a two week rotation. There are ten areas of radiology that they like us to rotate through (CT, nuclear, mammography, etc.) over the two weeks and during this time we are to work with different radiologists. During my rotation I spent a lot of time with one radiologist in particular and then a smaller amount of time with several of the other radiologists. My day would start around 8:00 usually and end when I wanted it to-usually early afternoon or earlier depending on the workload. A number of the radiologists are happy to teach and a number are not. I (and my classmates) had to find who was willing to teach and then tag along with them. I spent a lot of time with the radiologist reading CT’s, doing CT guided biopsies, and doing PICC lines. I also spent some time with the ultrasound techs doing vascular studies. This was a good rotation in that I was able to see how the particular studies are done after they are ordered. It is easy to make the order for a particular test when you are on IM or surgery, but it really helps to see the process through on this rotation. Overall, I got out of this rotation what I had expected. I can’t say that it really helped me with my x-ray reading skills but it did help with my CT reading skills a small amount.

Sorry for the Delay!!

I am soooo sorry for the delay in posts!! I have a ton of stuff to post from both my hubby and myself, but just have not had the time!! We actually just welcomed a new addition to our family at the beginning of the month, so we have had to work on the transition of having one child to now having two! So, keep checking back to read our thoughts on the rest of the 3rd year rotations, thoughts on having or expanding your family in med school, elective rotations, residency applications, boards, and much, much more!

Rotation #7: Family Practice Again!

Yep, that's right . . . another family practice rotation! And, for some reason, my hubby was assigned to a location that required lots of travel time. Okay, not a lot . . . maybe 20-35 minutes one way depending on weather or traffic. Whatever the case, on a limited budget and high gas prices, it was a lot to me!! :)

For me, as the spouse, I really didn't think this rotation was that bad. Though my hubby was home a few evenings around 6:00 or 6:30, it was definitely a nice change from the previous month! However, I can see that my hubby definitely does not want to work as a family practice doc! I do not think that it is the best fit for him for a multitude of reasons! All these rotations make me so thankful!! He has really had the opportunity to discover where his strengths and weaknesses lie within the practice of medicine and without them, would not have chosen a field that would have fit him as appropriately!

To digress slightly . . . When people hear that my hubby has decided on Anesthesia, I think that they immediately think the money is the whole reason that he has made this choice. Honestly, this frustrates me to no end!! He has not chosen this area because of the money. Though money is a nice perk, it also does not happen to rule our every thought and action like we have seen it done in others. He has chosen this specialty for a variety of reasons . . . the science involved, its connection to other areas that interest him, the way it seems to be the perfect fit for him and his personality, and yes, even the schedule! But, just to make it clear . . . it was NOT because of the money!! Okay, enough ranting and raving . . . back to the family practice rotation and my hubby's thoughts . . .

My second family medicine rotation was with a physician about 25 minutes away from my base site. I have to say that this rotation was not as good as my first family medicine rotation in several ways. It may sound bad but the days were longer than I would have expected for family medicine. This physician didn’t start until late in the morning and it was the norm to not be finished until 6:00 or later. Part of this has to do with the current environment in medicine today. Family medicine docs (as well as IM, Peds docs, etc.) have to see more patients than they ever had before just to continue their current income level. The days did go by quickly though. However, I didn’t feel that the teaching was quite to where it was with my first FM rotation. It usually involved me seeing all of my own patients and then he would follow me in later. We rarely discussed patients before we went in unless I found something to be extremely unusual, but at the same time he would review my notes with the patient and agree or disagree with them as he went. He has been known to be a little bit of a tougher doctor to deal with as a student but I didn’t feel that it was an issue at all as he was very professional during my rotation and provided good tips at times.

As a side note, it is nice to see how you develop throughout the course of your third year. With my first family medicine rotation I didn’t know much as far as when to initiate treatments for common medical conditions (hypertension, hyperlipidemia, etc.), but by the time I had this rotation I had a general idea of what to do with a number of common illnesses. Overall, this wasn’t one of my better rotations but it could have been a lot worse.

Speaking From Experience . . .

A couple of posts back, I had shared the article, "Reasons Not to Become a Doctor" along with my personal response to it. (Click here for the original post.) Since then, I have heard a multitude of opinions, including the response copied below that was emailed to me by one of my readers. All identifying information has been removed, but her full perspective and points remain. I specifically asked her permission to reproduce this information, so that I can share it with all of you. Obviously, she has agreed! Thank you Anonymous! I think that your perspective is very important and I really appreciate you allowing me to share it with so many others that are just beginning this journey as well as others who are in the midst of it!

Just a quick background, Anonymous and her husband were married before the medical journey began. The husband started the journey approximately 30 years ago with the beginning of the application process and the matriculation of med school approximately one year later.

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One day a gal who had taught at the school where I taught came back for a visit (her husband was in FP residency). I told her that my husband had been accepted into med school. Her reply was, "Medical school ought to be grounds for divorce." (an exact quotation.) We have made it 32.5 years tomorrow. I will not guarantee that we will make 33 years, even at this point.

My husband does regret his decision to become a doctor. I do not regret being married to him. I told him before we were married that I did not want to be a doctor's wife. He said he didn't want to be a doctor. He changed his tune 3 years later and told me that he had always wanted to but didn't think it was remotely possible because of his family's financial and educational status. I married the man, not the doctor. It is still difficult.

From my husband's perspective, most everything in the article is true.

1. Loans, most of ours were forgiven for practicing 5+ years in a rural county. It was still a drain to pay the remaining thousands to the federal loan program. We were student and residency loan free by the time we left our home state. We have never had the kind of income that people think doctors have. Family practice is not lucrative. We are comfortable this month (year) for the first time. We have begun to travel and can buy most of the small things that we used to have to consider very carefully. We still have to think about how much a new roof and new windows for our aging house will cost, and how to pay for them. We bought a new riding lawn mower a couple of weeks ago. This was possible because John Deere offered 12 months interest free. We will be able to pay it off in that time span. We do not eat expensive foods, go to expensive restaurants, dress in high dollar duds, get new cars every year. My husband does have some expensive hobbies, but his boat was used, and he got it for basically the price of a new boat motor. He has had a lot of work to do to get it usable.
2. From reading the article and comments, I think respect is one of the key reasons that there is so much dissatisfaction or the lack of respect.Yes, the comments about having to wait, the criticism of treatment, the arguments against paying, and the general attitude of many of the patients really make it hard to go on. Another problem for my husband are the patients who come back for chronic problems (depression, etc) and whine. He likes helping the patients who need the help and who he can help. It is depressing to treat people who will never get well. The best that the doctor can do is make them comfortable for their remaining years. Some are really quite young, but have chronic illnesses that will not be cured. And then their is the liability/malpractice situation to consider. I think that many of these cases are really a lack of respect for the doctor. Without the legal liabilty, the doctor can still be adversely affected by a bad outcome to his treatment. Doctors frequently have a lot of emotional investment in their patients. They genuinely like the people/patients and care about them as individuals.
3. Lifestyle--always being on call. Well, not really, but everywhere we go people ask for medical advice or tell their horror story. He is never just a person in a social setting. He is always a doctor. The limits on family time were hard on all of us. Our son hardly knew his father until he was 5 years old. Many activities were interrupted by phone calls from the answering service or the hospital. Even family meals out at a restaurant were interrupted by patients stopping by the table to ask about their meds or something. The boys' perception (as well as mine) was that the patient comes first. This is fine for the truly ill patient. But sometimes the interruption made us feel truly second class, unimportant. My husband regrets this and he cannot change what happened in our private lives for the last 21 years. He has made some changes, but that doesn't change the past.

So if the motivation to be a doctor is really to help people selflessly, then all of this should be unimportant. Well, doctors are human and need some kind of reward for their work. If respect is lacking (malpractice suits included here), then there should be ample financial compensation. Asking a person to give up a personal life for a job with little respect and having to live hand to mouth gives no incentive to do the job. I think that we were very naive. The bankers in the town where we did residency kept letting us borrow because after all, my husband would be able to pay back everything when he began making the big bucks. We thought he would have respect in the community because of his job. We didn't realize that for the first 7 years (while he did OB) that he wouldn't have proper call coverage. We didn't realize that patients have no respect for the doctor's personal time. (He once got a phone call at about 4:00 am from a patient who wanted a medication refill called in!)

So if he knew then what he knows now, would he have gone to med school? I really don't know. For him it was also an intellectual challenge, and I know that the challenge of diagnosis and treatment as well as business management is what keeps him in the profession. We are looking forward to some change in the fairly near future that will bring us closer to retirement. We are just not sure what it is.

Making Some Changes!

I just wanted to let everyone know that I am making some changes to this site over the next couple of weeks! I have decided to start yet another blog where I can share news about my family. Therefore, I will be putting my craft projects on that site from now on. I will be keeping this site active to keep talking about our med school experiences and beyond, even just commenting on things that are happening within the field periodically. I hope that you still will visit this site and continue to share your thoughts and even your own experiences with me along the way! And, my dream of hopes . . . maybe my experiences (and those shared by you!) can help those that come after us!!

In the meantime, as for my personal site . . . it will be private! If you want an invite, be sure to post here so that I know that I'm not missing you!! When the site is ready, I will send you an invite (as long as I know you!)! Hopefully, I can get it ready before this baby girl decides to make her appearance in the world!! :)

Reasons Not to Become a Doctor

My husband was browsing his usual news sites last night and came across this article. I have been reading through it this morning and thought that I would share with all of you to see what you thought. Here are some of my thoughts (I also posted this on the SAA website, but wanted to copy it here for those that do not have access to that site) . . .

First of all, many of the statistics coming out of the surveys mentioned appear to be coming from the allopathic route. I am very curious to know how these statistics compare to our field of osteopathy.

Secondly, I have already begun to witness first-hand the views of the public or as the article states . . . "There's a perception among patients that, 'I went to a doctor's appointment and he was 45 minutes late. He's probably on the golf course or driving his Mercedes.' The truth is, they're probably busy with patients." I personally get very frustrated because some of this even comes from my own families! Why is it that people have the image that doctors are out playing golf and making tons of money for it?

Thirdly, I highly recommend that you read some of the comments pages at the end of the article. I read thru the majority of them and was surprised at how few were actually defending the medical field! I was shocked that even those who are practicing, are residents, or even students are recommending people to stay away. My husband even says that he hears often from others he works with, that if they had the chance to do it again, they wouldn't do it! Yikes! How sad to see bitterness from those in the field, much of it stemming from such things as litigation, government restrictions, insurance, etc.! My thoughts . . . let's create our own list . . . "Reasons to Become a D.O.ctor!" My husband has recently decided to go into anesthesiology (according to the article, one of the more "lucrative" fields). He did not choose to go into the field because of the pay, but because of his fascination with the field. I get excited to see him come home excited about what he is doing! Will this wear off? Who knows, but I like to think not!

Lastly, I like to say that we had "life before med school", meaning that coming back to school to become a doctor is my husband's second career. He worked in healthcare in a different field and truly felt that there was a better way for him to help others than what he was currently doing. He wanted to work with patients! He wanted to do more! I was so proud of him that he was accepted and now that we are close to graduation, I am even more proud of him as I see the work that he has done so far. We consciously made that decision to start med school as a family, knowing that there would be sacrifices we would have to make. There are times that we even talk about what it would have been like if we hadn't made this decision. However, we always come back to the fact that we are happy with our decision and that it will all be worth it in the end. Knowing that we pursued our dreams to the fullest extent and did not "settle" is VERY important to us! On the other hand, I am becoming more and more frustrated and feel that the public has a stereotype of the field that we are already living with, even as students. When I tell people that my husband is a med student, they automatically assume that we are making big bucks and have a wonderful lifestyle. In short, that our lives are easy and full of luxury!! As you all know, that is wrong!! The general public does not know how much work and money and sweat goes into this process (and that it is not just the student that is experiencing this!). With articles like this out there, it is not helping the field . . . only hindering it!! I want to know how we can help combat this stereotype!

I have a lot more thoughts on different things mentioned in the article and the comments, but will quit my ranting now!! Anyone else have some thoughts on this? If so, I would love to hear them!

Seriously . . .

I know, I know . . . I have been horrible about updating my blogs these days!! To be honest with you . . . it's not because I have been busy . . . more like extremely lazy!! :) I have been working on many projects lately, but have just not had the time to blog about them or completely finish them either. I'm getting there!! And, as I finish more of them, I will be sure to share photos and even the news on the latest rotations as well!!

But, to my current little post . . . I have recently been cleaning up and making room for another baby in our household!! We have decided to turn our little office into a nursery for the little one, or at least part of it since our space is limited these days. As I was going through and cleaning things out, this is what I came across . . .

Ahhhh . . . the perks of being a student doctor and future physician!! The drug reps love to give away free stuff!! We have too many fancy pens and notepads than I think we will ever use. And, the sad part . . . this is only a portion of them!!! And, it is never-ending, so our pile will continue to grow and grow and grow!!

My only question . . . SERIOUSLY, how many pens and notepads does one need? Will we ever be able to use all of these in our lifetime? Does anyone else have piles like these? What do you do with all of them? I hate to put any of these to waste, so will not throw any of them out. What else am I to do with them? I am in need of some very creative ideas!! :)

Anesthesia Top Ten!

I got this little top ten from my friend Laci's blog! Since my hubby has officially decided to go the anesthesia route, I thought that I would post it on here as well. Though I don't think I completely understood everything, the ones I did understand were pretty funny! :)

Ten Reasons to Become an Anesthesiologist

1. You can intubate your friends at parties.
2. Have you ever met a happy internist?
3. You don't have enough ego hypertrophy to be a surgeon.
4. You can comfort anxious patients with, "I know just how you feel. It's my first anesthetic, too."
5. Any job where you can drive to work in green pajamas is a cool job.
6. You can park next to rich doctors like ophthalmologists.
7. You can cover your mistakes with Versed.
8. After spending the night with surgeons, they still won't respect you in the morning.
9. If you get bored on the weekends, you can give yourself a spinal.
10. No office, no overhead, no rectal exams!

Rotation #6: Internal Medicine

During the month of February, my husband did his second rotation in Internal Medicine. In fact, he was originally scheduled to do this rotation with someone completely different, but he had heard really good things about one service in particular. Since he has been contemplating between Anesthesiology and Internal Medicine, he talked to his rotation coordinator and had her switch his schedule to accomodate this particular rotation. It took a few pulling of strings, but he was able to make the switch and I believe that he was very glad that he did! We knew that this rotation would be more difficult in regards to hours and energy and we were definitely right!!

From the spouse perspective, this was a VERY difficult rotation for me!! The hours were long and my husband oftentimes worked longer than some of the residents. In fact, he was actually on for 19 days straight with NO break!! This included on-call time as well!! However, I really think that this rotation was very valuable to my husband for a multitude of reasons and in the whole scheme of things, do not feel negative in any way for not being able to see my husband! First of all, he learned a TON of information (which he will explain in further detail below) and came home very excited about the things that he learned. Secondly, he did AMAZING on his shelf exam, which would have helped him in either specialty that he was interested in. And, lastly, and in my opinion the most important, this rotation was able to help him to officially decide what he wants to do with his life!!! He was able to more fully discover his strengths and weaknesses and even his desires, and has made the decision that has been plaguing us for months about what he wants to do for the rest of his life . . . he has decided to go with Anesthesiology!! From my perspective, I am very excited about this change!! At first, I was a little worried because he has always talked about doing a specialty within Internal Medicine, but the more and more we discuss it, Anesthesiology is a much better fit for him!! Now, we just have to apply to out rotations and residencies, but we will get to that later!!!

Here's my hubby's thoughts and opinions . . .

I will start out by saying that this rotation was just a difficult, if not more so, than my surgery rotation (and those were some long days). However, I can honestly say that I learned more on this rotation than I did on any two of my previous rotations combined. That’s not to say that I didn’t learn a lot on my other rotations (I learned a ton on most of them); it’s just that I learned a lot on this one. Internal medicine is the base of all other rotations and it never hurts to have a good foundation before going into whatever specialty interests you.

During this rotation you are working directly with the residents of the internal medicine program at the hospital. You work with them all day and take call with them. The attending physicians will round with you during the day and they are fantastic. They all teach and they are very patient. However, the majority of your teaching comes from the residents. It makes sense since they are with you all day and with you during your call nights.

The typical day begins at 6:30 a.m. (now it’s 6:15 a.m. I think). You meet with the residents for sign-out from the on-call resident (the resident that was on the night before). You print out your list of patients and divvy up the new ones among the students and residents. We then have morning report at 7:15 a.m. (which we are required to go to) and at around 8:00 a.m. we start seeing our patients. When you begin rounding is dependent on the attending you're with. The first two weeks of my rotation we were with an attending that liked to start rounding at around 10:00 a.m. which was plenty of time to see your patients and sometimes discuss them with the residents before rounds. As a side note, we would usually have around 3 patients as a third year medical student. This was enough, and by the end of the rotation you were able to handle the patients fairly easily. Rounds would take anywhere from 4-6 hours with this attending making for a fairly long day. After rounds you would either get a small presentation that you, a fellow medical student, or resident put together. We would then do H & P’s on any new patients in the ER or go home between 5 and 6 p.m., if there was nothing left to do. During the second two weeks of my rotation the attendings were switched and my new one liked to round at 8:30 a.m. I would have to come in around 5:00 a.m. and see my patients just to be ready in time. However, we were done rounding early, leaving more time for teaching. We still wouldn’t leave until 5 or 6 p.m., but it seemed like a more educational day.

In addition, you did have call responsibilities. It was usually one night a week and two weekends over the four week period. When all was said and done, I had worked 19 days straight at the hospital making it very exhausting. Like I said though, I learned a lot.

At one point I thought I wanted to do internal medicine but have since switched to anesthesiology. However, this rotation makes me see the draw to internal medicine and its benefits. You work hard during the rotation but you learn a lot. I would recommend it to anyone.

Rotation #5: Psychiatry

I have been horrible about posting about the different rotations lately!! Things have been a little hectic around here and they are now starting to calm down (sort of). With making the big decisions that come at this point in time, such as out rotations and ultimately, where we will want to go for residency, there is never a moment of silence when my hubby is around. We are always talking about our options and choices. However, that's not really the point of this post, so I will save that for another time . . .

I actually started righting about my hubby's fifth rotation in Psychiatry quite a while ago (so the timeline is wrong in what is written below!). In fact, it was more than a month ago!! However, I did not want to post until you could also get a student perspective as well which my husband finally got a chance to write. So now, I am finally posting it!! Enjoy!!

Well, as of last Friday, my hubby finished his Psych rotation. Let me tell you . . . I didn't even realize that he was rotating in Psych!! Okay, okay, it really wasn't that bad!! But, to be blunt . . . I personally think that he got the shaft on this rotation!! Coming from a pretty extensive background in psychology (only about 7 years in higher education in it!), I was shocked at what he learned or rather, the lack thereof, especially on the first-hand experience side. There is more to treatment options than just the drugs! And, when it comes to those treatment options, there are so many schools of thought that play such a significant role in the history and healing, that I was just plain bummed that my hubby did not get to see more of it in action. Of course, then again, I may be biased since I come from a talk therapy background! All I really have to say is . . . Good thing he was not thinking of Psych for his career! However, to give a little benefit of the doubt to those in charge . . . mental health issues can be tough to talk about. Many individuals that see a Psychiatrist will have to do so for very long periods of time. They tend to be more private or not as willing to share their experiences with your primary care provider, nonetheless some strange student that they have never seen before. And, considering that mental health issues are talked about more in today's society, whether they are truly more prevalent or not, they do play a huge role in the medical side of treatment, whether you are a Psychiatrist, Surgeon, or Family Practice Physician. Afterall, the D.O. philosophy is Mind, Body, & Spirit. It's just too bad that there was not more of a focus on the mind and spirit this month!

Now, as for my hubby's perspective . . .

I felt that the psychiatry rotation is the one true weakness that my particular clinical site has to offer at this time. During our year, half of the students went to one northern location about 1 hour away and the other half went to a more urban site south about 45 minutes. I was in the group that went south for my rotation. My typical week involved going to the physician’s outpatient clinic on Monday, Wednesday, and Friday (he had Thursday’s off and we had didactics on Tuesday afternoon making it pointless to go down there). On a typical day, I would arrive around 10:00 a.m. and leave by 3:00 p.m.. The day usually involved the student observing him interviewing the patient. On certain days of the week (I can’t remember which ones) his days were dedicated to medication review visits. Basically, this involved the patient coming in, telling him how the treatment was going, any side-effects from the medications, etc. The physician would then adjust the medication, take away or add another medication, and send the patient on their way. This would take about 15 minutes total. He would have a couple of new patients mixed in during these days, but not many.

The new patients were the interesting ones. These would be individuals new to the practice and the interview would take close to an hour. It was very in-depth and he would eventually quiz you a little on what you felt the patient had by making you leave the room and discuss the diagnosis with him later.

The major downside to this rotation was that there was no inpatient care. It was all outpatient, making it difficult to learn a lot. This may change in the future, but I am unsure of that at this time. The northern rotation did have inpatient psychiatric medicine however and those individuals had only a slightly better experience (but still not that great from what they tell me).

Overall, I didn’t feel this was a great rotation. I did most of my learning from a book and felt it was almost a waste of time and money being on the road for 2 hours for only 2-4 hours of limited exposure.

Young Doctors in Debt

A while back I posted this link to a great article, featuring D.O. docs in particular, on a different website! I felt that it was a very interesting read (though maybe a big depressing at times!!) and wanted to pass it on to those that have yet to see it! As graduation quickly approaches for us, the topic of loan payment comes up quite often in our household (among mortgage payments, retirement accounts, childcare expenses, etc.). I thought that maybe some of the tips at the end may be helpful. Anyways, if you are interested, just click on the link below:

Young Doctors in Debt

Rotation #4: Surgery

I will be honest with you . . . this is the one rotation that I was dreading THE MOST out of all of them! I had heard that the hours were horrible, that the days were long, and that the students get very tired. Well, let me tell you . . . it was ALL true!! Combine all of this with it being during the month of December . . . the holidays, so many things that were scheduled, shopping, etc. I personally could not wait for this rotation to be done! In fact, towards the end, we were counting down the days until we could spend time as a family again!

I don't want to sound completely negative about this rotation, however. My hubby got so much experience and mentoring during this time, it was amazing to me! (I've included his little write-up for all of you interested below.) And, I knew that the students, interns, etc. were spoiled with their nice journal club dinners, but seriously, this month took the cake!! I am still hearing about the 4 hour meal at the local sushi place . . . the shrimp, steak, and lobster . . . and that was only one course!! It is really too bad that the spouses can't take along! Oh well!! My hubby does try to bring home some leftovers and extra desserts whenever he can!!

Anyways, here's some more detail from the student aspect:

I’ll admit I was dreading this rotation. It was going to be long hours in the hospital, I had heard some not-so-nice things about some of the residents, and I never thought once that I wanted to be a general surgeon in my entire life. In fact, I wanted it to be over as fast as possible. My typical day went like this: I would show up at around 5:00 and round on patients before the residents arrived, we had morning report at 6:00, then we would round on more patients or jump in on our scheduled surgeries if we were assigned early ones. Surgeries usually started around 7:30 in the morning and would go to around 4:00 that afternoon. After that we would round on our patients that we scrubbed in on (provided they weren’t an outpatient surgery or they were out of the recovery room and on to the floor), then meet at 5:30 for sign-out, and we usually left by 6:00. That was a typical day. In addition, we had 4 nights of call (our group only had 3 because of a scheduling issue) with one weekend of call included. Call on this rotation was a little bit pointless. The residents were PGY-2’s who were very protective of everything they were called on (understandable as it is them that would get their butt chewed if a patient had issues) so you spent a lot of time following the resident around, not doing much, and going to bed early. Don’t get me wrong, I like my sleep, but if I am away from my family for call I want to make it worth it by seeing something interesting. I did see a trauma on my call nights, and had a lot of ER consults which were all good to see if nothing else.

However, there were about as many non-typical days as typical days. There were at least 3 or 4 days when I didn’t get home until 8:00 p.m.. I would be wrapping up one surgery, just finishing for the day when another resident would grab me and ask if I had any place to be or if I had plans that night. We all know what you HAVE to say….”of course not, I would LOVE to help out”. Don’t get me wrong, the nights that I stayed late I really enjoyed looking back on it, but it made for a very, very long day. The late nights were usually with either a young surgeon that was only out of residency a couple of years but was very talented, or was with a surgical oncologist. They both worked in the same group and seemed to be real workaholics. Well, the surgical oncologist was the toughest to work with. For all of you who haven’t had experience pimping yet, be prepared. He is a VERY intelligent surgeon, trained at a prestigious program etc., and knew his stuff. The only problem with working with him is that his cases were always very long (3-6 hours) which doesn’t sound bad but after you have been doing surgery all day it gets a little tiring to start that at the end of your day. Also, long cases=extra questions. Anyways, he would grill me just like an intern, but was very courteous about his responses. It’s tough to explain but you’ll see if you ever rotate with him. In addition, I did the most with this doctor than just about anyone else (even though I wasn’t assigned to his service). On one particular late case he let me remove the appendix myself!!! It was an open abdominal case and we had just removed a teratoma from a young lady and the appendix was next to be taken out. He let me isolate the blood supply, ligate it, remove the appendix, and finish the procedure with intra-abdominal suturing. It was fantastic at the time and he let me do it for putting in the late hours.

Overall, I LOVED my surgery rotation, I really did. Not to the point where I would become a surgeon but I could definitely see the draw to the profession. The residents were helpful (as long as you didn’t tick them off, show up late, did some reading, etc.), and they all worked hard to get your hands dirty. If you hadn’t sutured before this rotation you will get your fair share with it trust me. For all of you that are coming to our area in next year don’t stress about the surgery rotation, it’s fun, and you should approach it that way, even if you are a surgery gunner. I was very pleased with my experience overall.

Some additional thoughts from me in response to my hubby's . . . during Surgery, expect your hubby to come home, study, and then go straight to bed (early!). They oftentimes do not get to study that much during the day, but are so tired at night to do much either, but they have to study HARD for this shelf exam! Also, NEVER be late!! I am not speaking from my hubby's experience, but we are aware of someone who was . . . he never lived it down and I am sure that it will pass on to future rotations. Everyone in the hospital is so intertwined; doctors will talk and word will get around if you mess up! And, some surgeons can be very brutal! I don't want to scare anyone, but I do want you to be warned!! :)

Rotation #3: Rural Family Practice Part II

I am finally getting around to posting some more info on our latest rotations! Here's my hubby's side of the rural family practice rotation:

I was pleasantly surprised by family medicine to say the least. I was working with a good doctor who let me “do” a lot of stuff. I did a lot of the expected stuff, histories and physicals, dealing with URI’s, medication checkups, bloodwork reviews, etc., but I also was able to do a number of things that made it worth my time being there. I was able to do injections into knees, helped with suturing and suture removal, skin tag removal and other dermatological procedures, assist with a vasectomy, among other tasks. I would have to see the patient, interview them, perform the physical exam, and then report to him with an assessment and plan. We would discuss the patient (which he knew well being as how he has lived his whole life in the area) and go from there. The doctor I was shadowing also did colonoscopies as well but there weren’t many scheduled when I was on the rotation so I wasn’t able to assist in those. Overall, I had a good time on the rotation. I felt that he made me think and at the same time made it worth my while to be there. He gave me many opportunities for “hands-on” work and it actually made me consider going into family medicine which is one field I was sure I would never go into.

For my viewpoint of this rotation, just click here.