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!