Island Med Student

That’s what’s been going on in da life of Kendra. I’m STILL recovering from a cold, but feeling better. I went out on Wednesday to celebrate Cinco de Mayo, and had a blast. I received my “real” medical diploma in the mail on Thursday. Hopefully, I will be able to get it framed soon, before I spill coffee all over it.

Other than that, not a whole heck of a lot to say.

My apologies, readers, but being a bum just doesn’t stimulate me to write. But I promise to write some “real good” stuff soon. Promise. In the meantime, please enjoy these crappy iPhone pics.

1) A mural in Astoria, New York.
2) and 3) Cinco de Mayo fun.
4) My 100% legit medical diploma. Booyakasha!

Oh my little blog, how I have missed you. I am a very strange gal. You probably already knew that. I have had (another!!) cold for the past few days and with the coughing and sniffling and cold meds, I’ve been a little whacked out. One would think that with me having absolutely nothing to do all day long, I’d be mad blogging every day. But it turns out to be quite the opposite. I seem to blog MORE when I am super busy, and less so when I’m bored. Perhaps it’s because I really don’t have much to say. And yes, that’s the case right now.

So, today has been very nice. I went for a long run in the park with my doggies and then came home to find my diploma in the mail! Okay, don’t get too excited…it’s not the REAL one, it’s just a certified copy (I needed it for my residency program…and yes, for those of you detail oriented folks, I graduated with a very high GPA…summa cum laude…aka “with highest honors”). But my real one is in the mail, and according to the USPS website, it should be here tomorrow! I feel like I keep giving you all “almost” photos…me in my graduation garb, but not at graduation…a photo of my diploma, but not the real one. Anyway, the “real” photos are soon to follow. I promise.

After my run I made a smoothie and then took a bubble bath. I then packed up my picnic gear and headed again to the park, and again with my doggies. I basked in the sun (for probably too long) in my bikini and finished the book I’ve been reading (more on that soon) about a doctor’s experiences in her medicine residency.

None of this is very exciting, and I realize that. But I honestly I just don’t have anything else cooler to share with you, world!

In other news, I’ve been trying to come up with fun and creative ways to make money (I am 100% broke), but have so far only managed to make a meager amount. It’s amazing how unemployable I am. I’m overqualified for most things, and underqualified for most things. How lusciously and cruelly ironic! If anyone out there has any recommendations on how to make one million dollars (or $100) in one month’s time, I’d love to hear them!

Yesterday, I received my cap, gown, tassels, and stole thingy for graduation. I tried them on and realized that I look like a chess piece in the doctorate hat! Also, the stole thingy is blowing my mind. I can’t figure out how the damn thing is supposed to fit on my body. I even googled images of other people wearing it, and had two of my (non-medical) friends try to figure it out. I have this strange feeling that it’s perhaps the last test that I have to take before I become a real doctor. If I can figure out the stole, I have what it takes to be a doctor. If not, well, then maybe I shouldn’t have gone to med school!

Let’s hope that I figure it out.

Also, I have officially graduated in the eyes of my medical school. They sent me an email today notifying me and letting me know that my diploma will be mailed shortly.

Here is the end of the email:

Dear Dr. Campbell,

Congratulations on your completion of medical school at RUSM and good luck in your future endeavors.

Sincerely,
Office of the Registrar
Ross University

Pretty cool, hey?!

Some of you might be sick of hearing me go on and on about how grateful I am to all of my friends, family, and Internet buddies. Well, suck it up, because I’m not finished yet.

Check out the above photo! How cool is that?! That was sent to me by Elizabeth, a wonderful fellow Rossie who took time out of her busy day studying in Dominica to drink a dedicated coconut in my name!

I have received wonderfully thoughtful donations from many folks. I’ve received countless emails and comments from people all over the world. That makes me one lucky gal, indeed!

Anyway, I just wanted to again express my gratitude to all of you! I had to delay my celebratory oysters for a few days, due to lack of funds (takes time to transfer the donations) and my partner Micah being sick. But the transfers have gone through and Micah is feeling much better, so I will hopefully be going out to my favorite oyster bar tonight to enjoy the fruits (oyster meat!) of my four years of labor in medical school.

The second photo was sent to me by my sister. Isn’t that one sexy doggy?!

“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!

Clinical medical students are always discussing which clerkships are “the best.” Which hospital has the best surgery clerkship? Which nephrology elective has attendings who teach well? For us fourth-year students, we’ve been focusing on which residency programs are “the best.” Where will I learn the most and be fully prepared to be a competent doctor upon graduation?

Now that I’m only four weeks away from graduation, I believe that I can say with some confidence that my knowledge and skill base is partially attributable to all the wonderful professors, attendings, and residents who have taught me over the past four years. My medical school has prepared me well, as have the hospitals at which I’ve rotated.

However, there is one important fact that I’ve gleaned from paying attention to all the other med students around me over the past four years:

Your medical education is what you make of it.

This simple fact is frequently ignored by many. It’s equally applicable to just about anything else in life: you get out what you put in.

To provide two extreme examples, a very motivated and hard-working student could become a very talented doctor, even in a less-than-perfect learning environment. Similarly, a very unmotivated student who attempts to get by with the least amount of effort in a “perfect” learning environment will likely turn out a mediocre doctor at best.

(Obviously, there are a million shades of gray in between these two examples.)

I believe that I’ve received a very good medical education, and I’m lucky to have learned from and worked with some amazing doctors, who have taught me well.

But I also believe that my motivation to learn has had a huge impact on the “almost-doctor” that I’ve become.

One example that stands out in my mind is my surgery core clerkship. It was an incredibly intense, unforgettable 12-week experience. I volunteered to stay late on many occasions. I volunteered to scrub in when no one else wanted to. And I tried to go out of my way to learn. Not surprisingly, I learned a lot.

There were other students who put in minimal effort, literally “hid” at times, and tried to just “get by.” Not surprisingly, they learned very little.

So, when I hear these same people complain that the clerkship was horrible and they learned nothing, it understandably makes me what to throw my hands into the air in exasperation!

Sir Wiliam Osler really summed it up for me when he said, “The best preparation for tomorrow is to do today’s work superbly well.”

Click Here To View the Original Post on Medscape

Okay, so the title of this post is very misleading. I am attending Ross University School of Medicine, and I would like the world to know that I have had a very positive experience with Ross thus far. I have never regretted my decision to attend a Caribbean medical school. But I’ll admit that I am also a “chronic optimist.” I tend to always see the glass as half full, and I very rarely complain about things. However, I receive emails all the time from people who want to know the “dirt” on Caribbean schools. And I received an email a few days ago from a student who asked me to list the “top 10″ things that I don’t like about Ross (in order of importance). This will be a very hard list to create. But here goes:

1) The stigma. As I’ve said many times, there is obviously a stigma associated with attending a Caribbean medical school. However, I must say that I have found this to rarely be a problem (again, my darn optimism!).

2) The large class size. Yes, Ross accepts many students every semester. And for some people, this makes it challenging to “be heard.” But again, I will say that this has never been a negative for me. I’ve almost always found that I’ve gotten the attention I needed…but that leads me to number three.

3) Scheduling clinical rotations can be challenging. Because of our class size, and because of the fact that there are limited clinical spots for us students, it can sometimes be difficult to get individualized attention, and the “best” spots available. But all in all, I must say that I have been “mostly” satisfied with my scheduling, and most of my rotations.

4) The cost. This might be the worst thing that I can complain about. Ross’s tuition and fees is on par with the more expensive U.S. medical schools. And when you add on the additional costs related to traveling, the price really adds up. If I have one regret, it is the astounding amount of student loan debt that I’m facing.

5) Living in Dominica. This one is really difficult for me to count as a negative. For me, this was one of the TOP reasons for choosing Ross. I was truly excited about living in Dominica. But for those people who can’t appreciate the beauty of this wonderful country, I guess they count it as a drawback.

6) There isn’t really a “home base.” Since you spend a portion of your time in Dominica, and then the rest at various sites in the U.S., it can sometimes feel a little discombobulating. For me, this was actually a great advantage. But for others, it can be unpleasant.

7) It’s difficult to place into competitive residencies. Yes, it’s harder for Ross grads (or other non-AMG grads) to place into more competitive residencies. But the reality is that you CAN place, and it does happen. But you may need to work harder and have a better CV than your AMG counterparts.

8 ) Not enough administrative guidance. Since we really don’t have a solid “home base” and because there are so many of us, it can be difficult at times to get good guidance from the school. Although, I’d say in my experience, I have been mostly satisfied with the response I’ve received.

9) Having to repeat semesters. Many people complain about the fact that if you fail one class by even one point, you must repeat the entire semester. While I can understand and appreciate this complaint, I also understand Ross’s policy. If you are struggling with even one class, it means that you really need to get a better hold on your studying routine, and try again.

10) It ain’t Harvard. Nuff said.

Sorry if you were expecting better complaints, but I am just not a good complainer!

Note: I actually had to google “Ross Sucks” and go onto ValueMD to come up with this list!

I say this all the time: I am a chronic optimist. I really do tend to see the glass as half full, at least most of the time. However, this does not mean that I’m not immune to those darn pessimists, and the comments of others. People email me all the time, asking for the “down low” on med school, Ross University, and other related topics. My general response is that I loved almost everything. But that’s really related to my chronic optimism. There aren’t many things that I hate.

I’ve been trying to keep a very positive outlook on the whole residency match process. I want to believe that when a program says they like me, they are telling the truth. I want to believe that I have a good chance of matching at my program of choice. Perhaps I’m just fooling myself, but that’s the way I tend to think.

But lately, I’ve found myself being influenced by all the other med students who are also matching. I hear their stories of people interviewing at and ranking 15+ programs, but then not matching. I hear them say “just because a program says they like you, that doesn’t mean it’s true…they say that to everyone,” and I’ve found myself taking their comments to heart.

But today I found a reason to again believe in myself. I want to believe that I will match. I want to believe that other people have the same confidence in me that I do. And I’m going to try to block out everyone else’s voice, and just listen to my inner “happy” voice.

On another note, I just got back from a wonderful doggy walk, just as the sun was setting on the horizon. All the photos in this post are from my journey through Bushwick tonight. Enjoy.

“Yo Brooklyn, Fuhgeddaboudit” Photo Series

I had a wonderful weekend, which including going out with Micah and my Son Tom on Saturday night. Today I started my first day of an elective rotation in infectious diseases. I’m hoping to improve my antibiotic selection skills, which could certainly use much improvement.

I now have my official schedule in place, except for my very last 4 weeks, so I thought I’d share it with everyone:

Infectious Disease: December 7 – January 1
Nephrology: January 4 – January 29
Pain Management: February 1 – February 12
Pediatrics: February 15 – March 26
Hopefully a sub-internship: April 5 – April 30

And then I will be finished! Yes, I am doing pediatrics very late in the game but that is a whole another long story.

Also, for all ye curious souls out there, here is my schedule for the residency Match and graduation:

Residency Interviews: Now – February 12
Deadline for Ranking the programs: February 24
Find out if I matched or not: March 15
Match RESULTS: March 18
Official Graduation Day: April 30
Graduation Ceremony at Madison Gardens: June 4
First day of residency: July 1

More to come about infectious diseases!

Check out my post on Medscape to read about some common med school myths dispelled!

Click Here To View the Entry