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!