Island Med Student

It is finally official! I have fulfilled all of the requirements to be a medical doctor. I won’t receive my diploma for a few weeks, and my graduation ceremony isn’t until June 4th. But for all practical purposes, I AM a doctor!

I’d like to take a moment to thank EVERYONE for all of their support over the past 4 years. I DEFINITELY could not have done it without all of you. I love you all!

Now, to the oyster part. So, I want nothing more right now than to go out and celebrate all my hard work and medical degree. However, I have one teensy weensy little problem. I’m completely broke.

I know this is going to sound totally lame, but it’s the only thing I could think of. I am asking for a donation. If you’ve ever gotten any good advice from this website, if I’ve ever made you smile, if I’ve ever pissed you off: I’m asking you to make a small donation. I feel really stupid asking for this, but hey, you do what you gotta!

So, I know this AWESOME joint just down the road from me that has a happy hour with ONE DOLLAR RAW OYSTERS!! Right now, this sounds like the VERY BEST way to celebrate my medical degree.

So, if you can donate even just one dollar to my pathetic little self, you can buy me a congratulatory oyster!

If you click the link below, you can easily use a credit card (or Paypal account, but don’t worry, you don’t have to have a Paypal account, just a credit card) to donate one dollar to my empty belly. There is also a description field, where you can include your name (if you like) and a short message (if you like).

When I eat each oyster, I will take a photo, and then post the photo, along with your name and message (unless you tell me not to) on my website for the world to see.

I hope no one hates me for this silly idea!

Anyway, here’s to being a doctor! And here’s to so much more learning to come! Thank you, everyone for ALL of your support!!

My apologies to everyone for my last rant/post about UPS. I actually had a great day today, save for UPS pissing me off (and I don’t piss off easily).

Anyway, let’s get back to the good stuff.

I will be a doctor in less than one day. Today was a very long day of endocrinology. I had to wake up very early in the morning, and I just now got home (it’s now 8 p.m.). Long day for an elective. But guess what? I learned sooo much. And so I am not upset about the hours.

Tomorrow is my last day of endocrinology. It’s also my last day of med school. MY LAST DAY OF MEDICAL SCHOOL! My apologies if I’m too excited. But guess what, I’M EXCITED!! In less than 24 hours I will have fulfilled all of the requirements to become a medical doctor in the USA. Yes, I will not actually receive my diploma for a few weeks. But that is merely a piece of paper. I am almost a doctor.

It’s exciting and scary and wonderful and terrifying, all at the same time. I’ve worked soooo very hard to get where I am now. And it has all been worth it. All the blood, sweat, tears, and money…. But after tomorrow I will be a doctor. And no one can take that away from me. Eat that, UPS! (Okay, I have obviously not gotten over that yet!)

Photos: I took both of them today. The first one was taken very close to my hospital. I parked far away enough to catch this on my walk. (RIP Kendoggz…one of my nicknames, by the way.) Second one was taken out of my car window on the drive home. Turns out you have to get creative if you’re not a “walker.”

“Yo Brooklyn, Fuhgeddaboudit” Photo Series

“To predict the behavior of ordinary people in advance, you only have to assume that they will always try to escape a disagreeable situation with the smallest possible expenditure of intelligence.”
- Friedrich Nietzsche

“And we should consider every day lost on which we have not danced at least once. And we should call every truth false which was not accompanied by at least one laugh.”
- Friedrich Nietzsche

“I would believe only in a God that knows how to dance.”
- Friedrich Nietzsche

“Sometimes you just have to dance the polka to get things done.”
- Kendra Campbell

There are a million reasons why I love psych. Actually, probably over a million. But don’t worry, I’m not going to bore you to tears with all of them. Instead, let me use an example from today to explain.

As I was just walking onto the floors of the hospital to begin my endocrinology rotation today, I heard the sounds of polka coming from one of the halls. Of course, I had to explore this wonderful anomaly, so I hurried down the hall to find the source of the music. What I found was so very, very extraordinary.

I found three nurses and one physical therapist dancing in the hallway with an elderly patient wearing a hospital gown. One of the nurses was holding out her hand, with her cellphone playing some polka tunes. It was definitely a party. I definitely had to join. Without thinking, I jumped right in and started dancing with the crew. We all had entirely too much fun grooving the the music. Afterwards, I found out that the patient was demented and refusing his physical therapy. One of the nurses knew that the patient used to play in a polka band, so she had the incredibly brilliant idea to use polka to draw him out of his room, and onto his feet. It worked beautifully.

There is so much room for creativity in medicine. But sometimes it seems to me that psych might have the most room out of all specialities. And not only that, but understanding how someone’s mind works can help you in any field. This is the stuff that gets me excited. This is the stuff that drew me to medicine in the first place.

Understanding the human (and non-human) mind and behavior has always been a passion of mine. It’s what motivated me to get a degree in psychology. As a psych tech, I put all of my knowledge and education to good use. You want a very delusional patient who doesn’t believe he’s sick to take a psychotropic medication? You HAVE to get creative. You have to understand people. You have to have a desire to understand behavior and motivation. And this is a worthwhile skill in any profession. And yes, this is why I am so excited to be soon starting my residency in psychiatry. I can’t wait to develop more skills, and more understanding. And I love putting those skills and knowledge to good use. And not just in medicine, but in my daily life as well.

Perhaps we would all be a little happier if we took the time to dance the polka with a stranger every once in a while. It certainly worked for me.

Photos: From my “Improv Thanksgiving Dancing Routine” with friends, two years ago.

So, I know you are all sick of hearing this, but documenting my life is one of my most favorite hobbies, and is therapeutic in many ways. Although I’ve used all kinds of expensive and nice cameras to take photos, I’m currently quite obsessed with my iPhone. No, the quality is not nearly as nice as other cameras. But guess what? Even the best camera can’t take a photo if you don’t have it with you. And I carry my iPhone with me pretty much everywhere I go. Because of that, I take many great photos that would have otherwise gone unphotographed. The quality suffers (in some ways, is cooler, though), but the quantity is much higher.

I could tell you all about my wonderful day today, but I lack the energy to do so. I went for a great run this morning and then I went in for my endocrinology rotation at the hospital. Today was a good day. I drove to the hospital, so I don’t have any great photos from my walks today, but I have some cool ones (in this post) that I’ve taken over the past few days in my neighborhood and in Manhattan yesterday. Enjoy. (And thank my iPhone for them!)

Photos:

1) The cool 3-sided painting beside the subway stop outside of my apartment.
2) Pay phones. They still exist?
3) Same painting, with a person passing.
4) Another pay phone. Think it actually works?
5) Same painting as above, sans person.

“Yo Brooklyn, Fuhgeddaboudit” Photo Series

Check out my post on Medscape to find out the answer. This post was inspired by you, Cindy! And is for all you pre-meds and aspiring docs out there!

Click Here To View the Entry

“What to expect when you’re expecting…to begin clinical rotations.”

Finally, the post I have been meaning to write for a very long time. I get questions about clinical rotations (also called clerkships) very frequently, so below is Kendra’s guide to medical school clinical rotations, in FAQ format:

1) What is a clinical rotation?

It’s a period of time that you spend at a given hospital (or clinic, doctor’s office, etc.), gaining hands-on clinical experience from seeing patients and learning from patients, nurses, residents, attendings, and anyone else who chooses to teach you.

2) How many clinical rotations do I have to complete?

Well, this varies slightly from school to school, but most students must complete required “core” rotations, and “elective” rotations. Core rotations include:

Pediatrics: 6 weeks
Obstetrics/Gynecology: 6 weeks
Internal Medicine: 12 weeks
Surgery: 12 weeks
Family Medicine (considered an elective by some schools): 6 weeks

“Elective” rotations are just that. They are voluntary. You can usually choose which elective rotations to do, but most schools require a certain number of “medicine” or “surgery” sub-specialty electives. Ross University requires a total of 30 weeks of electives.

3) How do I schedule rotations?

The answer to this question really depends on your school. For Ross University students, you apply for core rotations through the clinical department. You can request roations at any of the affiliated hospitals, and they will try to schedule you for them. Keep in mind, however, that they can only schedule you for availalbe slots. So, what you get will depend upon your schedule, and availability. For elective rotations, you can can request them through Ross’s clinical departemnt, or you can contact the hospital directly.

4) How do I know which rotations are best?

My best advice? Ask around. Word of mouth seems to be the best way to find the best rotations. I don’t think ValueMD has much merit. And see question numbers 13 and 14, for more information related to this.

5) What do med students actually DO during clinical rotations?

EVERYTHING!

Okay, let me be more specific. Here are some common things you will do:

- Perform, write-up, and present H&Ps (histories and physicals)
- Write SOAP notes on patients (progress notes)
- Follow up on things related to your patients. This includes (but is not limited to!) following up on lab results, radiological reports, consults, etc. The more you know about your patient, the better you can help them, and the more your residents and attendings will love you.
- Perform “procedures.” Examples include drawing blood, placing lines, placing NG tubes, suturing, putting in foley catheters, and anything else you can imagine. As far as what you are allowed/expected to do, this really varies from hospital to hospital. But at minimum you should be prepared to draw blood, place lines, and hold retractors (for long periods of time!). As far as training for the procedures is concerned, this also varies from hospital to hospital. But remember the golden rule: NEVER perform a procedure if you have no idea how to do it!
- Round on patients.
- Attend all lectures, presentations, etc.
- Present information on various clinical topics.

6) What are “rounds?”

Some attendings prefer sitting rounds, some prefer walking rounds, and some do a combination of both. Rounding on patients simply means going through the list of patients and presenting information on each one of them. If they are a new patient, you are expected to present the entire case. If they are not, you may just need to provide an update. You then generally go from room to room as the attendings and residents talk to and examine the patients. Expect to be asked many questions during rounds. And this is a great opportunity for you to ask questions as well!

7) What is the “hierarchy” in the hospital?

Med students are the lowest on the totem pole, then residents, then fellows, then attendings. Sometimes you will work only with the residents, and sometimes with the attendings, and sometimes all of the above.

8 ) Will I receive traditional (didactic) lectures during my clinical years?

Again, this really varies highly from hospital to hospital and rotation to rotation. I’ve received lectures in almost every one of my rotations (all the cores), but the amount of time I spent in lectures versus other activities varied widely. You will “learn” clinical medicine via many routes. This includes didactic lectures, “teaching” rounds, and of course, at the patient’s bedside.

9) What is “pimping” and should I be scared?

“Pimping” simply refers to a higher-up (usually an attending, but can also be a resident) asking questions (sometimes in a machine-gun style) about anything and everything. No, you should not be scared. But yes, you probably will be anyway. It’s scary to be put on the spot. And you will never know the answer to all of the questions. But you should remember that you’re not expected to know all of the answers. Keep that in mind, and you will be less stressed out by the situation.

10) What is the schedule like for clinical rotations?

Again, this varies WIDELY based on the hospital and the rotation. Expect to spend longer hours during your core rotations versus electives. Almost all core rotations also involve “on call” hours, which involves staying late or during the night. An average day at the hospital during a core might go something like this:

7:00 – Report to hospital for morning sitting rounds
8:00 – See your patients, write SOAP notes
10:00 – Walking rounds
12:00 – Lunch
1:00 – Follow up on patients
3:00 – Lectures
5:00 – Walking or sitting rounds again
6:00 – Go home

Again, this is just a template. Night calls vary from a few hours, to 12-hour or 24-hour shifts. Most rotations give you “post-call” days. This means that if you have a call shift, you are allowed to go home afterwards and have the rest of the day off before you come in again the next day.

11) Are there written exams?

Again, this varies, but most of the core rotations will have quizzes and exams. Of course, you will also need to take your board exams (USMLE, etc.) and Shelf exams, if your school requires them.

12) How are you evaluated?

This varies. But for most rotations, your grade is ultimately based on your exam scores and your “clinical performance,” which is based on your clinical skills, clinical knowledge, professionalism, and other areas of performance.

13) How do I perform well during clinical rotations?

Actually, I wrote a post that has some really important tips, to answer this question. You can view it here.

14) What’s the most important piece of advice you can give about clinical rotations?

That you get out what you put in!

Yes, the hospital matters. Yes, the attendings and residents matter. Everything matters. But the most important piece of the puzzle, and the one that YOU have ultimate control over? Yourself. If you show up early, volunteer to stay late, ask questions, and are a very motivated leaner, you will succeed and learn how to be an amazing doctor. It’s as easy as that.

That’s all I can think of for now! I hope this helps some of you out there. Please do email me or comment if you have more questions, and I will add them to the list!

“Every time I drive in rush hour traffic, I lose a piece of my wings.”

- Kendra Campbell

I’ve learned two important things this week (my first week of endocrinology, and first week of driving to the hospital):

1) I really like endocrinology. It’s interesting and not too complicated and I’ve learned a lot. My attending is the bomb.

2) I will NEVER drive to work. Ever. Again.

I’m pretty sure that driving is perhaps the worst torture that exists. It beats down your very soul. Traffic can turn the very best mood into the very worst. I am no longer able to take photos and videos along my route. I have no control over how fast or slow I can go. I am at the mercy of traffic. You might think that I’m exaggerating, but I’m not. Driving to work even for one week has taken away a piece of my soul. Now I will have to regenerate that piece via walking for a year.

I have one more week of med school (endocrinology) left. I might decide to take the subway to the hospital (even though it would be a longer trip), just because I think driving is killing me.

Anyway, 5 more days of work until I am a doctor. Yes indeedy.

Photo: Taken today during endocrinology rounds. Infection control does save lives.

“Fire escape gardens are so 2009. Plantar boxes hung from child safety window guards are the new black.”

- Kendra Campbell

I feel very accomplished right now. I managed to get quite a few things done today. I woke up this morning and wrote an article for Medscape (soon to be published). Then I went for an 8-mile run with the doggies in the park. Even at 10:00 a.m. this morning, it was close to 70 degrees (it got up to 86 today!), and the doggies were panting like freight trains by the time we got home. I then managed to plant my new veggie/herb garden. Since I no longer have a fire escape, I purchased planter boxes, which hang from the child safety guards on my window ledges. I planted tomatoes, lettuce, broccoli, mint and thyme. My local nursery was out of basil, but I hope to add that (and more!) soon as well.

I had a very “Kendra moment” when planting this morning. In order to do the planting, I had to put a ladder outside of my window and climb in and out with bags of soil and such. When I was climbing out of my window, I slipped on the ladder and fell down to the concrete below, crashing onto my knees. As if my knees didn’t have enough to worry about, now they are EVEN MORE bruised than usual.

After about an hour, my knees hurt so badly that I could barely walk. I contemplated calling in sick to my endocrinology rotation, but in the end guilt won out, and I went in to the hospital.

I hobbled around and actually had a great time. My attending is so incredibly awesome. He teaches so well and I very much respect and admire him.

When I got home from the hospital, I took the doggies on a nice walk and picked up some grocery items. My new neighborhood is so very awesome. I’m starting to befriend a lot of my neighbors, and I love how incredibly friendly everyone is.

Tomorrow is going to be a long day at the hospital, so I guess I should go to bed early tonight. I’m starving as well, so it’s time to make some din din.

Enjoy the photos of my new “garden” with this post. I hope to take some better ones in the future. (I was in a hurry today.) I think everything will soon start filling out nicely. Something about having a pseudo-garden in the city is oh so very satisfying to me!

Just got home from my first “real” day of endocrinology. I worked at the endocrinology clinic at my hospital, did one consult, and rounded on all the patients. I just got home around 8:30 p.m. No, I really should not be complaining because I didn’t have to go in until 1:00 p.m., but I think I’m just spoiled from certain electives with “cake” hours. I actually learned a lot, too.

Since I moved 2 weeks ago to be closer to my residency hospital, I am now not within walking distance of the hospital at which I am doing my last rotation. This means that I actually have to DRIVE to the hospital. Drive? What’s that?!

This experience has confirmed for me what I already knew: I am not a driver. In fact, I’m not a commuter, at all. I need to walk to my place of work. Not only is it a perfect way to de-stress, but it’s great exercise. Not only that, but I’ve realized that I take all of my best photos and videos during my walks! Who has time to take photos or videos when you’re zooming (or even not zooming) by all the wonderful things on your path?

Because of this, my daily photos have suffered, and so has my “2010 Video a Day” Project. I will either have to scrap the idea all together, or come up with some sort of creative solution.

Only 8 more days of actual work at the hospital, and then I am “qualified” to be a doctor. Life is very sweet.

Note: Photos are all “trashy” pics taken in Brooklyn a while back. As soon as I’m back to my daily walking again, I will post some trashy photos from my new ‘hood.

“Trash Talkin” Photo Series

Check out my post on Medscape to learn about how much I enjoy being a part of my community.

Click Here To View the Entry