Posted tagged ‘rotations’

Blood on my Gloves – Surgery Core, その2

November 2, 2011

After 12 weeks of surgery, I have learned a great many things. I’ve listed some pearls below:
1.. Doctors treat patients, not CTs or X-rays
2. To be a good physician, one must make anatomy and physiology their bread and butter
3. To be a good surgeon, one might have to be a little crazy

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Operative Management – Surgery Core

September 26, 2011

Today is the beginning of my penultimate semester of medical school. It also happens to be the beginning of the second half of my surgery core. Up until this point, I’ve generally found something to enjoy about every rotation in which I’ve had the opportunity to participate. This time, it hasn’t been easy.

Surgery core at Wyckoff is divided into 6 two-week modules: Surgery Clinics, Day Call, Wound Care, OR, Ambulatory Surgery and Night Call. Clinic and Wound Care have been the least intense modules, generally allowing one plenty of time to study/de-stress in the evenings. As I mentioned before, day call is comprised of 14 days straight of twelve hour shifts (usually preceded by a week of clinic with no break in between). Night call is reportedly similar to day call but students are allowed to take one day off per week and are only required to attend morning lecture and grand rounds, not afternoon lectures, so as to rest up for the night shift and not go insane. One may have the opportunity to scrub in on an emergency operation during day call and/or night call but for the most part, the OR action primarily occurs during the OR and Am Surg weeks. Over the course of those four weeks, students are required to scrub in on at least 10 and observe at least 20 surgeries.

Part of the reason it’s been difficult to find things to enjoy over the past 6 weeks probably has to do with the general atmosphere of surgery, which while occasionally congenial (especially among the residents/interns), can be downright hostile. Things tend to be tense when you’re constantly in fear that you’ll be pimped to death or screamed at by an attending.* The expectation seems to be that we must know everything except how to actually perform surgeries. Everything else pertaining to bodies and/or diseases is fair game. Case in point: yesterday, two students in my group were drilled on Fournier gangrene while scrubbed in on a totally unrelated procedure. None of us had ever heard of Fournier gangrene until yesterday. In addition, there doesn’t seem to be a way to gauge one’s performance. We haven’t received feedback or grades on any of the assignments or quizzes we’ve had thus far and I’ve heard that hardly anyone makes it out with an A, which is pretty disheartening.

Nonetheless, there are a few cool things about surgery – I got to assist on a few chest tube insertions and staple the incision from an open appendectomy. Today, I’m going to observe a brain biopsy and scrub in on a BKA. I hope these little things will be able to sustain me for the next 5.5 weeks…

*Witnessing these incidents is also quite traumatic

Blood on my Scrubs – EM Elective Week 4

June 27, 2011

(note – this post was originally written on June 4th, 2011)
It was only fitting that my last shift in the SJEH Emergency Department was as hectic as any typical Friday 7 – 7. I had two patients literally sobbing with pain and one who was gushing so much blood that it spilled onto my pants. I had to tell one lady that she’d miscarried and examine three little girls who’d been brought by the police because their mother had tried to commit suicide. There were two attendings on call but only one resident who was new* so I didn’t get a chance to take a lunch break. It was all worth it though, when I overheard one of the attendings tell a consultant, “She can do it. She’s not [a] resident but she’s the brightest one here.”

Over the course of the past 4 weeks, I’ve worked harder than I’ve ever had to in medical school. I performed more pelvic exams than I did during my ob/gyn core. Even though I thought I wasn’t going to be able to practice for CS, the ER was actually a great setting for honing the skills I need to showcase on the exam. For some schools, ER is a core rotation and now I can understand why so many deem it to be an essential part of medical training. I’d definitely recommend it, especially at SJEH.

*The resident was actually a PGY-3 who’d previously done a month of ER during his intern year. When I asked if he needed any help, he declined.

Ob/Gyn – 今までの話

March 26, 2011

Checking in 2/3rds of the way through my Ob/Gyn rotation wasn’t how I’d planned to chronicle it but time has really flown by me in the past month. It started out with a harrowing adventure down the atlantic coast that my (dad’s) heretofore trusty Volvo* wasn’t able to complete but after that initial excitement, things have settled into a very comfortable routine. I’m assigned to Dr. P, a sometimes-intimidating yet very personable ob/gyn originally from Cuba. In addition to his private practice, he is also affiliated with Palmetto General Hospital in Hialeah, so I’ve been exposed to ob/gyn in both the office and hospital settings. There are also weekly ob/gyn lectures at the Center for Haitian Studies’ medical clinic, most of which have been given by the delightful Dr. C, who makes even the Kreb cycle seem magical. While I haven’t had the opportunity to actually deliver any babies myself, I’ve seen over a dozen deliveries (and got to scrub in on two c-sections), a few D&Cs, probably a hundred pap smears and even a circumcision! One of my classmates mentioned that ob/gyn in Miami was awesome and based on the past month, I must concur with his assessment. It has been pretty cool.**

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Internal Medicine, その2

February 21, 2011

I can hardly believe that there is only one week left of my Internal Medicine rotation. While it does feel like I’ve been at Wyckoff forever, it also seems like time has flown by, especially with the (grade-determining) final exam only a few days away. It’s been a busy month for me so I haven’t had time to update as much as I would have liked, but here’s a brief description of how the second half of IM went for me.

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Internal Medicine – 今までの話

January 23, 2011

It seems like in the blink of an eye, 12 weeks has turned into 5. This week was the beginning of the second half of my internal medicine at WHMC and things have unexpectedly shifted gears. Before I explain how, I needs must recap my experience of the first half of IM.

At Wyckoff, IM is split into two modules: service and private. For six weeks, one is part of a service team (mine was the blue team) which consists of one attending, two senior residents, 4-6 interns (first year residents) and 6-8 medical students. The team is responsible for service patients (patients who are admitted to the hospital and assigned to a random team) as well as certain private patients (usually, those who have been admitted by the attending but sometimes, just patients that are under the care of the intern and/or resident). The role of the student varies, depending largely on how willing one’s intern is to take one under his/her wing. A student may be asked to obtain clinical data, ferry samples to the lab, perform physical exams, research topics related to the patient’s condition or to present the patient during attending rounds. Basically, whatever any person on the team asks a student to do, the student must do it. Students are also required to give a 20-30 minute powerpoint case presentation related to one of the service patients for the team*. In addition, every 4 days, the team has short call (from 7 am to 7 pm), during which time, the team admits new patients from the ER. Of course, students are required to attend lectures during the day as well (this is also true for the second module). Residents and interns rotate from team to team every month, so I actually shadowed 2 interns (and thus, had two different experiences) during the service half of my rotation. (more…)

11 Resolutions for 2011

January 1, 2011

Happy New Year/明けましておめでとう/¡Feliz Año Nuevo!

Apologies for the ridiculously long hiatus to all those have been wondering what has been going on with me. 4Q of 2010 had quite a few challenges – a case of hyperthyroidism that I didn’t pay attention to until I nearly fainted during attending rounds*, some disappointment from Ross, and the start of my Internal Medicine rotation at Wyckoff Heights Medical Center (which I am now ⅓ of the way through). Nonetheless, I shouldn’t have left everyone hanging so long. That is why the first of my 11 resolutions for 2011 is as follows: (more…)

Family Medicine – Day 12

November 6, 2010

I’m two weeks into my family medicine rotation and over the past 12 days (Sundays off), I’ve drawn blood, given shots and consulted with dozens of patients in every age group – highlights include a one-month-old with a cold,  a 7 year old who burst into tears at the mention of a flu shot but once done, mercilessly teased his sister about being scared and a psych patient whose son had died due to complications of Marfan’s syndrome. Although my heart still belongs to neonatology, I don’t think family medicine would be so bad.

Dr. Y continues to be amazing – it seems that he knows everything! Every morning, we go over at least one of his past cases and if we have time between patients, we discuss more. One of his practices serves and almost-exclusively Orthodox Jewish community so we’ve been able to review dozens of real-life case studies of some rare diseases that are prevalent in populations of Ashkenazi Jewish descent – today, we reviewed a case of Hemophilia C.

The only downside to rotating at Dr. Y’s practice is the neighborhood. The office is one block away from a housing project with a pretty bad reputation. Also, there’s a ton of construction going on in the area and the roads are horrible. Nonetheless, it’s turning out to be an excellent learning experience. 4 weeks to go – I hope they’re even more interesting than the last two.

Family Medicine – Day 1

October 25, 2010

Finally, after six weeks of idleness, I have returned to action!

Well, the past 6 weeks weren’t exactly idle. Among other things*, I helped display an authentic set of samurai armor with some folks from the Consulate General of Japan at the NY Anime Festival, marched for the end of divisive politics, helped organize a Diamond Jubilee for my grandmother’s 75th birthday and spent a lot of quality time with my cousin’s baby, whose favorite things to do are jumping and gnawing fingers. Not that that stuff wasn’t exciting, but nothing beats the thrill of returning to my training.

Although my family medicine rotation is through St. John’s Episcopal Hospital, I will be spending most of my time at the office of Dr. Y in Rockaway Beach. When I stopped by the education office at the hospital on Thursday, another student told me about how awesome Dr. Y’s rotation is, so when I found out that I was assigned to him, I was delighted. The hours are 7:45 – noon (sweet!) and right from the beginning, Dr. Y put us straight to work. Having been out of practice for so long, I was a little flustered when Dr. Y directed me to call a patient in and begin the evaluation myself but by the end of the morning, I had gotten a little bit of my groove back. I even got to write someone a sick note! They also expect us to draw blood (which I’ve never done), so I can’t wait for tomorrow to see what we’ll be doing next. My rotation partner got to give a flu shot! We did get pimped a little and we covered a case of hypercarotenemia (lesson – don’t feed your baby strained carrots exclusively!) so it seems like we’ll be getting a lot out of the time we’re there. I even learned a little Yiddish (vainesh? = don’t cry). To top it off, some pharmaceutical reps came in a brought me a free grande hot chocolate! I’m really thankful for such a gentle reintroduction to my studies! Let’s hope that this rotation gets better and that I learn more by the day.

*One unfortunate event that occurred was the funeral of my 26 year old cousin, who was murdered in his home on October 11th, 2010. If you would like to take a stand against gun violence, please visit these websites or write to your elected officials.

♬Wasting my time/in the waiting line♬

September 21, 2010

♬Everyone’s saying different things to me, different things to me♬

At long last, I have a clinical schedule, and in keeping with the theme of things, I got it in the most frustrating and stressful way possible. On Friday the 10th, I (やっと) received that long-awaited call from the clinical department, beside myself with relief that I’d finally be hearing from someone, only to have my bubble of hope brutally burst by Ms. F, one of the two advisors for students with last names A-L. She, rather callously, informed me that Mr. P, the head clinical advisor was out of the office and would not be able to discuss my schedule with me, but that they knew I’d been waiting to hear from them for over 10 days, so if Mr. P didn’t get in touch with me by the following Thursday, I should check back in with the office.

I’m surprised that my head didn’t explode. (more…)