We have now finished half of our required clerkships for M3 year, and it feels a bit surreal. On one hand, it feels like we’ve been working in the hospital for so long that our studies before seem a distant memory. But the past rotations also seem to have passed so quickly that it’s hard to believe we’re halfway done.
For me, this may be partly due to having completed Family Medicine and Surgery last year with the previous four-week periods (starting with our year, periods are only three weeks long). So everything seems much shorter this time around.
I still feel like I have enough time to fully experience a specialty, despite the shortened time. We jump around from service to service, always switching just as we’re getting comfortable, but I suspect we would feel the same even if our rotations were not shortened.
Last week, to mark our halfway point, the first Intersession was held. In addition to lectures about useful topics (such as applying for residency – cue panic), we also participated in the Radrick Challenge Course. In addition to swinging on a rope to save dinosaur eggs (aka tennis balls), I had so much fun talking and laughing with my classmates.
This week marks my first on Internal Medicine. The rotation is split into three three-week blocks. I’m starting at St. Joe’s, and so far it’s been a great experience. Everyone on my team is great and really interested in helping me learn. And, the view from the 11th floor is spectacular!
I remember seeing this email one day toward the end of M1 year. To be honest, I almost deleted the email because I had no idea what the subject line meant and thought it might be spam. I decided to open it anyway given the mention of transplant and my interest in the field, and I’m glad I did.
Turns out the email was a job posting. The post was for an “on-call” position to consent patients coming in for solid organ transplants for clinical trials from 4 p.m. to 8 a.m on weekdays, or all day on weekends. At the time, I did not know what being on-call meant, but later came to find out that it meant carrying a pager so you could be alerted as to when an organ offer was official and a patient was confirmed for surgery. My role entails screening patients for enrolling trials to see if they are eligible for any. If yes, the next step is to approach the patient to explain the clinical trial, see if he is interested in contributing, and then get his consent if they agree to participate. This usually also includes collecting blood/urine specimens for processing.
Taking this position turned out to be a rewarding and tremendously valuable decision. My eyes were opened to both the world of transplant surgery and clinical trials. Before taking this position, I had no idea how involved clinical trials were. The studies are so intricate and timing is everything. I have definitely gained an appreciation for the work behind the introduction of new drugs and the optimization of evidence-based patient care. I am lucky that the staff was incredibly accommodating, which has allowed me to keep this side job during medical school ($$!).
While on the job, I also learned very quickly that the hospital at night feels totally different than during the day. The hustle and bustle is gone, yet there is still so much going on, especially in the world of transplant surgery. I loved being one of the first people the organ recipients get to meet. Sometimes patients are so nervous they don’t even want to hear about research opportunities. Sometimes they are eager and have actually participated in research before. Either way, there is something special about seeing their vulnerability and excitement before a life-changing surgery.
On a lighter note, I find the emptiness of the main hospital hallway intriguing and entertaining. During the day I am dodging people going from one end to the other; at night I always try to shoot a photo of the entire hallway if there is no one other than me in it.
Kerrytown Book Fest
After submitting my application to residency today, I went to the Kerrytown Book Fest and made some acquisitions:
(and by acquisitions, I mean a lot of this stuff was for free)
Ann Arbor is paradise for literature lovers, from books festivals like this one to the Ann Arbor Poetry Slam (every 1st and 3rd Sunday of each month) at Cafe Royale on State Street to readings at the local bookstore Literati and events at the University of Michigan Museum of Art. I also learned about letter pressing today, which was really neat:
Letter pressing kit
During my four years here as a medical student, I’ve had the opportunity to not only keep up with my writing, but to expand my horizons. I am applying to residency in psychiatry, and my interests are two-fold. I want to use poetry to explore the relationship between memory and identity, which has captured my fascination ever since M2 year, when I first interacted with a patient with dementia. In addition, I want to use language to change behavior. On my substance use disorder elective this month, I’ve had the chance to practice motivational interviewing, a method of guiding patients towards naming their own reasons and setting their own goals for changing their behavior.
In residency, I hope to incorporate medical humanities into my daily interactions with patients, helping to articulate the ways in which art and literature could be used to improve patient care. In the meantime, I can’t wait for what the rest of M4 year brings!
I’ve heard a (preposterous) rumor that my classmates and I are officially halfway done with our core M3 clinical rotations. I refuse to believe that this is fact, but figure it’s only fair that I pass the message along; never let it be said that I stood in the way of free speech or whatever.
Halfway there, pffffft. Sure.
I just needed an excuse to use a picture of Bon Jovi. Mission Accomplished.
What I can say for certain is that I’m officially done with my psychiatry rotation. I returned to the VA (where I first started out – nostalgia!) for my month of psych. I was overjoyed to discover that I felt a little less, well, dumb to be perfectly honest on this rotation than my previous two. While I’d like to think that this was due to cumulative clinical experience, it’s far more likely that it was due to better background knowledge heading in… which means that my next rotation, surgery, is going to be a hot mess. Yikes.
Getting ahead of myself – back to psych! I particularly enjoyed my time on the inpatient unit, where I felt like I really got to know my patients well and genuinely contributed to their care. I was able to relay more detailed information to the team (because I had the time to dedicate to more thorough conversations), get in touch with family members/other health providers for clarification, and advocate for my patients. Every single attending and resident I worked with was supportive and just generally awesome. The VA cafeteria and I are still not on speaking terms, but we were able to tolerate each other’s presence and remain relatively cordial.
We now find ourselves faced with a strange new critter, something called an “Intersession.” It’s not really a break per se: we have required stuff every day of the coming week except for Friday, and some days are actually quite full. It is most definitely a break from clinical duties at least, and a break from constantly being evaluated. A couple of the activities are meant to be more leisure than anything else. There’s a challenge obstacle course or something and let me tell you – the only thing I enjoy more than physical activity is physical activity outdoors. (Is my sarcasm shining through? I can get sassier if need be.) In typical form, I conveniently have a broken foot (though nearly healed! In regular shoes since yesterday, wahoo!) to parade around so no one can accuse me of wimping out. I’m pro-level when it comes to avoiding athletics.
I’m not sure what’s going on here, but it looks treacherous.
Following Intersession I will start surgery and I am TERRIFIED. I’ve unfortunately gone right ahead and placed epic pressure on myself in regards to this rotation, hoping for an epiphany one way or another in regards to what I want to pursue as my specialty. Up to this point I’ve at least modestly enjoyed everything and truly disliked nothing so I’m pretty clueless. I’m also deathly afraid of sleeping through my alarm because, as I believe I’ve already established previously, I am the world’s worst waker-upper. My body doesn’t believe it should have to get up before the sun no matter what the circumstances. My brain tries to convince her otherwise, but doesn’t put up much of a fight before, say, noon. It’s bad news bears. Buried underneath all of the anxiety, however, there is still a great sense of excitement. I’ve certainly enjoyed all of my experiences in the OR so far and maybe, just maybe, my surgery rotation will be the best ever. Fingers crossed!
Co-authored by fellow M1 Nadine
Every year about 20 or so incoming M1 students are invited to participate in a pre-matriculation program during the summer before classes begin. The goal of this three-week program is to develop leadership skills and reflect on social disparities and health equity in medicine. Since we both took time off after undergrad in various other pursuits, pre-mat provided an ideal segue to our new lives as med students.
Bonding over a little Whirly Ball
To develop the confidence to lead, mentorship and early experience were key tenets of the program. We had a number of faculty, administrators, deans, M2 mentors and TAs who guided us through three weeks of anatomy dissections, introductory histology classes, and numerous conversations about leadership, personal development, and social disparities in healthcare. As an introduction to our nascent careers in medicine, we were made aware that thinking about advocating to improve social justice and health disparities is a profound responsibility that we have as students and future physicians. (more…)
Med students and residents with Dr. Howell at the concert.
This story starts back in February, in Rackham Auditorium at a piano concert. UM’s University Musical Society was presenting Sir Andras Schiff, with his program, “The Last Sonatas,” in which he played the last three sonatas written by Mozart, Beethoven, Haydn, and Shubert over a series of three concerts. Waiting for the performance to begin, a few classmates and I were chatting about our interest in music, and one announced that he was planning a small concert of performances by medical students, and we should all consider taking part. Music! A night full of music, for an audience of friends! I’ve long been involved in music, first with private lessons and then through school-based ensembles, but after graduating college it had been harder to find chances to play and sing. How could I resist? I agreed to perform. Voice has been my instrument of choice in recent years, but I decided on the spot I would play the piano. The unassuming Sir Schiff walked across the stage, sat down at the piano, and began to play Beethoven’s “Piano Sonata No.30 in E major, op.109.” A smile grew on my face as the notes danced around us. I tapped my fingers on the arms of my chair; soon they would be playing on keys. (more…)