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.