And Breathe

Just a brief look into the life of a crazy shoe-a-holic, dog-loving, hair-braiding, nail-painting, life-embracing, medical student
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So my Family Med rotation felt like it was super busy, and I’m sorry I did not really make the time to update y’all on how it was going. 

I want to say that I really wanted to like Family Medicine. I like the idea of primary care, and I understand how important it is. I have this ideal image in my head of my being the doctor in this little town where I know everyone and I see the kids, their parents, and grandparents at my office. It sounds so nice, right? 

I didn’t love it…

My program broke down our time into 3 parts—3 weeks of outpatient at a doctor’s office, 2 weeks of outpatient at a clinic, and 1 week of inpatient at the hospital. We were also on call once a week for the 6 weeks, one of those being 24 hour weekend call. When on call you would have to be there for the 5pm sign-off from the day crew, and would then stay overnight until morning rounds that started at 8:30am. You stayed for the duration of morning rounds (typically ending around 9:30/10am) and would have the remainder of the day off for post call.

We were expected to see 3 patients per half day (6 patients per day). We would get a history, do a physical exam, and then present the patient to our resident (if you were with one that day). Then we would discuss the assessment and plan, and we (the medical student) would present the patient to the attending that was precepting. We were also expected to write SOAP notes on those patients to give to our attendings the following day to be critiqued. 

The hours were different depending on where you were. When I was at the doctor’s office, it was typically 8:30-5, but we could start as early as 7:30 on some days. At the clinic, it was typically 9-5. Inpatient you had to round before morning rounds, so we were expected there by at the latest 7am and would stay until sign-off was completed (typically 5:30pm). Not terrible hours. 

I would then get home, say a quick hello to my husband and start on my SOAP notes as he started dinner. If it was a slow day, I had only 2-3 SOAP notes to write, but on busy days I could have 8. Even if they’re straight forward, they could take a while (plus I get distracted when I look up differentials). Then I had to study on top of that. I would typically do 2-3 cases out of Case Files: Family Medicine, and then at least 10 questions from UWorld. The problem is UWorld does not have a Family Medicine section…so I just used Internal Medicine, Pediatrics, OB/GYN, and Psychiatry (everything except surgery, lol). 

My first 3 weeks I disliked where I was placed. My attending was fresh out of residency and she seemed to have something against me…It seemed like she didn’t want me there and that she did not care about teaching me. I would come out of the patient rooms with her with a question and she would literally put her finger up, never to address the question. She also only let me see new patients…how many new patients come in every day? Not many…I had maybe 1 or 2 a day…so I got a lot less exposure than the 6 patients per day I was supposed to be seeing. I felt like I was stupid the entire 3 weeks I was with her. It seemed like she wanted to put me down rather than build me up to be a great physician….which feels terrible…During my mid-evaluation she brought up my tattoos, which not one rotation has mentioned prior to her and are barely noticeable unless you’re staring at my feet (but who does that). I literally competed in pageants, including Miss New York with these tattoos showing without anyone 1-saying anything or 2-even noticing/calling attention to them. It just irked me that she brought them up, as if they made me less qualified to want to be a doctor…

My next two weeks at the clinic were SO MUCH better! I actually got to work with residents, most of whom actually wanted to teach me! It was so refreshing after my first 3 weeks! Even the attendings were approachable and really wanted you to learn. I loved the environment! I saw plenty of diabetes, hypertension, coughs, sore throats, etc. There were also some interesting cases, such as vastitis and even secondary syphilis! But I just wasn’t excited about it like I wanted to be…

My inpatient week was my last week. It was not much of a week as this was when I took my shelf exam. I was there all day Monday (which thank goodness was slow so I could study!), then I was off on Tuesday to study, Wednesday I had my shelf exam (I should get the results this upcoming week! Eek!), Thursday I was there ALL day (literally, because I was on call that night too), then Friday I was post-call so I had the day off. I didn’t really have the inpatient experience that most people get because I was there so little. Oh well. Inpatient just wasn’t my cup of tea any way…Rounding was great, seeing patients was great, but for the rest of the day there was NOTHING to do…It was boring to me. 

As I said, I wanted to like Family Medicine so badly…but the only days I came home excited was when I got to do ANYTHING OB/GYN related, like a well-woman exam or an OB visit. The rest of the visits were pretty much like this: You have diabetes? Do you take your medications? No? Oh well that could be why your HbA1c is elevated like crazy…It just wasn’t fulfilling to me. So it looks like OB/GYN is what I like, and I’m so excited! I started looking at elective rotations that I need to start scheduling, and I was so excited/nervous/but SO ready for them to start! I guess when you find something that genuinely interests you and you really love, nothing else compares :)

Now I’m in Pediatrics for 6 weeks (well, now 5 since I just finished my first week)…I’m not thinking it’s my calling either. Yeah, kids can be cute…but when they’re screaming and yelling because they’re irritable from being sick or don’t want a shot…not so cute. Plus runny noses/stuffy noses/sore throats/coughs/etc just aren’t doing it for me…sorry kiddos. 

Any questions? Just ask! :)

Had such a great hike today at Vickery Creek Trail! #hiking #active #family #dogsofinstagram #Chiweenie #furbaby #Barney #waterfall

Such a great day! I was post-call yesterday, so after morning rounds I had the rest of the day off. We went to the zoo (again) and we got to watch the gorillas and orangutans get fed! We even got to see the babies!

Then today we went hiking! We hiked to the top of a mountain and around a lake. Our little Chiweenie was super tired, but he was a trooper! He’s going to sleep really well tonight, lol.

Tomorrow I have to prepare for my Pediatric rotation that begins Monday morning! Soon I will write a post on my family medicine experience as how I’m feeling now that 3/6 core rotations are completed, so stay tuned!

End of a 27 hour shift, and end of my family medicine rotation! 3 cores down, only 3 to go! #futuremd #ms3 #tired #oncall #familymed #medstudent

I may not have been happy about waking up super early to work out, but it feels so good after! Stay on track with your fitness goals this weekend, friends! #beachbody #teambeachbody #PiYo #PiYoStrength #fitness #fit #healthyliving #early

THIS is my breakfast?! Heck yes! It gives me energy to make it through rotations all day, study all night, and stay away from junk food! It has all of the vitamins, minerals, and even veggies my body needs while tasting deliciously chocolatey! Plus, I think I find my go-to fall recipe: 1 scoop chocolate Shakeology + 1 cup almond milk + 1 T natural peanut butter + 1/2 T cinnamon + ice = yuuuummmmm! #teambeachbody #beachbody #Shakeology #breakfast #chocolate #healthy #healthyliving #fitness #fit

I study, I read cases, I look up journal articles, yet I still suck at UWorld questions…2 more weeks of studying before my Family Medicine shelf exam…I’m definitely going to need it!

So much to do, yet so little desire to actually do it 😞

To all of my MS1 followers just starting out, this is some pretty solid advice. It also made me think what I would tell my MS1 self. It seems like so long ago that I was a scared/excited/optimistic girl sitting on the plane to a developing country to start my first semester of medical school. I thought I would be like college, just a little harder. Try a lot harder. With our 2-years-in-16-months curriculum, you got it the first time or you were lost. I had to learn how to really study for the first time in my life—it didn’t “just come to me” like everything had in high school or college. I had to really work. I stressed, I cried, I contemplated quitting and just going to work at a zoo the rest of my life (still my back-up plan, by the way, because I love the gorillas) on at least a weekly basis. I guess if I could go and tell my MS1 self anything, it would be to stop trying to be perfect! Work hard, yes. Do your best, yes. But don’t stress yourself out trying to always get an A. Don’t beat yourself up because you didn’t understand that biochem pathway, or had to go to the tutor (just go get the help you need!), or endocrine still makes your head spin. You’ve got this, you’re capable of so much more than you think, and you WILL succeed. So chin up, MS1 self, put in the work, believe in yourself, and go kick some ass!

Well I had the worst day of rotations to date…

This morning started out on a good note with Grand Rounds. Apparently I didn’t have to show up until 10am, but I got there at 9am. No big deal because I learned about paying back student loans (not really the pick-me-up you’re looking for in the morning, lol). One of my colleagues surprised me by bringing me coffee (yay!) to celebrate my anniversary that was over the weekend! Today’s actual presentation was on alcoholism and DTs, which everyone gets to see at one point, so it was very helpful and informative. The medical student portion actually ended by 11am, so I was able to go home, spend some time with my dog, and eat lunch before having to be to the office by 1pm.

Tuesdays at the office are a little different because it’s OB day, and a resident is there. Therefore, I really don’t get to see patients. I got to see one patient in 3 and a half hours…and I didn’t get to see them on my own. It was a follow-up visit so it took all of 5 minutes…With follow up visits I’m basically a fly on the wall, listening to the conversation between my attending and the patient, and not even allowed to participate in the physical exam…It’s frustrating. So I did a whole bunch of nothing with patients today.

But what truly made my day terrible was giving the presentation I prepared for my attending. The only information she gave me was “I want you to do a presentation on asthma.” Nothing was said about her expectations for my presentation. So I followed the set up of the presentation I gave during OB/GYN—very detail oriented, going into all of the pathophysiology, the mechanisms behind each treatment, etc. I prepared a powerpoint that was 34 slides—enough to get me through a half hour to 45 minute presentation. Apparently this was not what she wanted. She stopped me 3/4 of the way through my presentation to inform me that what I was delivering was what she would expect out of a 1st or 2nd year medical student…That alone just crushed me. I am very Type A, and am definitely a perfectionist. I take pride in my work and put a lot of time and effort into everything I do. For her to insult my presentation and my intelligence was too much for me…She continued into how my presentation was sub-par and I tried so hard, but I could feel my face getting red and my eyes watering.

I am NOT a crier in front of people, but the frustration about this rotation for the past 2 and a half weeks just came to the surface and spilled over. I was so embarrassed and I felt stupid and weak for allowing it to happen. When she asked why I was tearing up, I could only get out that I felt like I failed…All I can think of is what a terrible evaluation she’s going to give me, especially now. I excused myself and had to go to the bathroom to just cry it out…

Thankfully it was the end of the day and there were no more patients to see. She then told me not to be embarrassed, but to learn to control it because I should never allow myself to get emotional in internal medicine or surgery because they would not be understanding, and that I would need a thicker skin to be in this business…Then she told me to redo my entire presentation as well as prepare another presentation about acute pancreatitis outpatient management by tomorrow…

I am just dreading going back tomorrow…I hate complaining like this…I want to like Family Medicine so badly because I’m really thinking of going into it, but I have disliked this rotation so much thus far! I like the patients, but I feel like my attending hates me, which makes me anxious and nervous every day…I know I need to just get over it because there will be attendings like this for the rest of my life; no one said it was going to be easy. I just hate that I let her get to me and that I let her see me like that because now I DO feel weak. I am done at this location this week, so I just need to get through the next few days; hopefully the next location will be a better experience for me…