Monday, January 28, 2008

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

Thursday, January 10, 2008

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.

Wednesday, December 12, 2007

Rotations #3: Rural Family Practice Part I

During the month of November, my hubby rotated with a rural family practice doc approximately 30 minutes from home. This rotation was such a nice change from the previous month of OB/GYN (and even this current month of Surgery)!! Due to the rural schedule and commute time required to get to the clinic, my husband actually ended up going in about 8-9 times the entire month. Because Tuesdays are education days, he was given those days off! Because the doc only worked mornings on Thursdays, he was given those days off (though he did go in one time to participate in a particular procedure)! That only left Mondays, Wednesdays, and Fridays . . . and actually, there were a few of those days that he got off as well! How crazy is that!?!

My husband was more calm and relaxed than I have seen him in a while! We got to spend much more time as a family, and even on one afternoon while my son was at school, my hubby and I went on a date to the movies! This spontaneous little date between the two of us was such a nice little change! Though there was a downside . . . due to the commute time and the nature of the rural clinic, there were many nights when my hubby would not get home until 6:30-7:00. I would always wait to serve dinner (or wait for him to make it!!) and my son would end up staying up later than usual to spend time with his daddy! Overall, from my perspective, it was a great month! :)

Though FP is still not what my husband wants to do, he was able to get a lot of great experience doing a variety of procedures. He enjoyed it so much that he is looking to rotate with this same doc next year!! I can't wait!! :)

As for my husband's side . . . I will have to post his thoughts on a later date. Unfortunately, he did not have a chance to write anything up before his Surgery rotation started and will not have another chance until this rotation is over with! I don't want to forget to post at least my response, so until next time . . .

Thursday, November 8, 2007

Rotation #2: Obstetrics & Gynecology

My husband's second rotation was Obstetrics and Gynecology. He actually finished this one a couple of weeks ago, but between all of us being sick and him preparing for a big presentation, I have not had a chance to write about it yet!

Anyways, I had heard that the hours would be long during this rotation. And, I discovered that everyone was completely correct! My hubby was often gone before anyone else got up in the morning and would often come home late, typically around 6:00-7:00 in the evening. He was putting in at least 12+ hour days and would come home completely exhausted! And, of course, then there was call . . . he would leave at his usual time in the morning (way before I would wake up!) and would stay overnight at the hospital. The nice thing . . . he was allowed to come home in the mornings around 9:00. He would then get some sleep for a few hours (all depending on how much sleep he got the night before) before waking up to attempt to spend some time with us. We rarely spent time together during this month, and when we did, he was often exhausted and to be honest, NOT that fun to be around all the time! :)

Like I said before in the "I'm Stuck" post, this rotation was hard for me. Not only because the hours were long, but because my husband would come home exhausted, yet excited about the many things that he saw or did that day. I do believe that it is now safe to say though, they I do not have to worry about him pursuing this specialty! Yippee! :) I am definitely happy about that, but still wondering and waiting to see what he eventually decides . . . will it be Internal Medicine like he has said from the start or will it be something completely different?

Anyways, for those of you interested in the student perspective, here's what my husband has to say about the OB/GYN rotation . . .

I have to say that I was not looking forward to my OB/GYN rotation at all. I can’t say that I was dreading it but I hadn’t heard good things from other people’s rotations at different sites. However, I must say I was pleasantly surprised when I finished.

At my rotation site we spend 2 weeks doing Gyn surgery and 2 weeks on OB. My first 2 weeks were on Gyn surgery and it was a good experience. I hadn’t spent any time in the OR before this and so it was kind of a shock at first. However, once I got used to scrubbing-in and realizing what not to touch it wasn’t that bad. The attendings were patient (for the most part) and would let me “do” a lot of stuff. I was first-assist on a few operations and there were a couple of very difficult operations (vaginal hysterectomies) that the residents didn’t make it too so it was just me and two attendings!! These are usually cases that are fought over by the OB’s and I was lucky enough to have it all to myself. Needless to say I really enjoyed this aspect of the rotation.

The next two weeks were OB and I wasn’t really looking forward to it. I didn’t mind the idea of being in on deliveries but I was a bit anxious about what my role would be. All of the residents made us comfortable but at the same time expected us to help out and there was no room to just sit around. I was able to do a lot of the same stuff an OB intern would do (with guidance of course) and the nurses helped me out quite a bit as well. Most of the ladies I followed were accepting of students which helped a lot as well. We usually saw our own patients throughout the day and followed them until we left or they delivered. Every delivery I was in on I was able to help in some way. The OB residents really did let us handle a lot of the responsibility. In one particular case I was working with the chief resident on the delivery and the attending (the doc that was following this ladies pregnancy) walked in late didn’t even gown up. He gave me a few pointers over my shoulder and let me have at it. The chief resident let me deliver the baby and clamp the cord while she watched my technique. That made the rotation worth it. During the next week I got to repeat a lot of the above with the addition of being taught ultrasound techniques and getting to scrub-in on a lot of C-sections.

Overall, I was extremely happy with the rotation and had a blast during it. I was on call 5 nights and one weekend. The downside was that my weekend shift started on the Saturday AFTER we were technically done with our rotation so that was difficult as I had no time to relax before my next rotation. During call nights we would follow labors as well as do ER consults and occasionally get some sleep before rounding on our patients at 5 the next morning. This made the rotation a bit exhausting and I did miss my family quite a bit. It wouldn’t have been worth it if I didn’t have such a good experience.

I would SERIOUSLY consider this job if OB/GYN’s didn’t work so hard. Don’t get me wrong, I am not lazy, but when I see them come in at 2:30 in the morning after going home at 10 p.m. the previous evening to deliver a baby and then have to go into the clinic or start surgeries at 7 a.m. that morning is too much for me. A lot of them looked very tired and worn out and I got more than “I am too old for this” comment. Being a doctor isn’t easy but they just work to hard for my sake and I am too old to do that to my body again. I can definitely see the draw to the specialty though.

Coming soon . . . Rural Family Practice!

Saturday, October 13, 2007

STUCK!!

There have been times recently where I feel that I am stuck between an rock and a hard place. I want to be so supportive of my husband through his medical school journey, BUT yet, I also want to steer him away from certain specialties. For example, my husband is currently doing his Ob/Gyn rotation. There are days that he comes home sooooo excited about the different things that he got to do that day. And, I get so excited for him! I'm so happy that he is enjoying what he is doing and I love to see his passion for the field of medicine shine through. And, I am glad to see that he is actually enjoying Ob/Gyn. From the very beginning, he has stated that he would never go into this specialty! I mean, he has made it VERY clear about the NEVER part! And, now that he is doing it, he is actually enjoying himself!! I love to see that!

On the other hand, I personally do not like the hours on this rotation AT ALL!! I HATE that I rarely see him. I HATE that he is gone for 12+ hours a day. I HATE that when he is on call, which is at least once a week, I don't see him for more than 24 hours at a time. So, in the end, it makes me want to persuade him to not go into this field. I mean, I kind of enjoying spending time with my husband! :)

So, there's the dilemma!! I want to encourage him to do what he finds the most fascinating, the area in which he can see himself working for many years to come, and that he is going to still enjoy and be fascinated with for those many years. HOWEVER, there is a reason that I married him . . . I love him and I love spending time with him. If it is a specialty that I will rarely see him, what is going to happen? I know that this is very selfish. I try not to be, but he's my husband for goodness sake! Don't I have the right to be just a little bit?

I know that my hubby is a family man! He does not want the long hours at the hospital. He wants to be able to see his family on a regular basis. Family is our priority. BUT then again, I can turn his favorite line around to include him instead of me . . . if the husband ain't happy, the family ain't happy! SO, I'M STUCK!!

I know that I'm probably jumping the gun here . . . it is only the second rotation! BUT, we do have to start deciding on the elective rotations that are going to be the most important in his residency interviews in just a few short months. This is a constant conversation in our household. My hubby is worrying about not finding the specialty that gives him the "AHA!" effect. I worry that that effect is going to come from Ob/Gyn or Surgery. What can we do!?! I guess we will just trudge through this leg of the journey, just as we have the others, and wait to see what life will bring us! Until then, I wait . . .

Monday, October 1, 2007

Rotation #1: Internal Medicine

My husband has officially finished his first clinical rotation!! Yippee!! During this past month, he was doing his rotation in Internal Medicine, one specialty that he has at the top of his list of interests. I had heard from many people that Internal Medicine could be one of the worst rotations (after Ob/Gyn and Surgery, of course!) because of the hours. I had braced myself for the worst of rarely seeing him and spending some nights alone while he was on call, but it was far from what I was actually expecting!

Most mornings, my hubby had to be there between 6:30 and 7:00. He was expected to be done around 5:00, but oftentimes, he was home between 3:00 and 4:00. He was never on call and never had to stay late. Totally unexpected!! Though he was not required to study for the most part, he did try to spend a little bit each night reviewing different diseases to stay on top of things. Overall, this past four weeks has really been enjoyable. I have had the opportunity to spend time with my family as a whole. The one thing that I have to keep in mind . . . if he does end up choosing IM, then I cannot expect him to spend this much time at home as an intern, resident, or practicing physician. From what I have heard from others as well as from my husband regarding his attending and resident's schedules, he would be spending a LOT more time at the hospital!

Now, from the medical student perspective . . . yes, you could say that I performed a little mini interview on my hubby! :)
  1. What was the most difficult aspect of this rotation? Managing 5-10 diseases for a single patient.
  2. What was the neatest aspect of this rotation? Being able to follow patients for several days and watch their progress.
  3. What was your overall perspective? It was overwhelming for a first rotation for the first two weeks (i.e., trying to read a chart and figure out the computer system on top of everything else), but it got better as a flow was developed.
  4. Any additional comments or thoughts? It definitely makes one realize how much you have to learn!

Next Rotation: Obstetrics & Gynecology . . . that should be interesting! :)