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Thinking Ahead

I came into medical school fairly confident that I wanted to be an orthopaedic surgeon. I spent my first two years of medical school creating relationships with orthopaedic faculty and devoting a significant amount of free time towards research projects. Reality set in this past month when I had to plan my fourth-year schedule. The timeline for exploring and applying to specialties is basically this: apply for away rotations in early March, rotate in desired specialties at your home institution from May-July, get LOR by late-August, submit VRAS (residency application) in mid-September. Essentially 3/4 of M4 year is completed after a career decision is finalized.

As the commitment to a certain specialty became more real, I naturally started questioning if orthopaedics was truly the best match for me. In reality, I believe there are several specialties, both surgical and non-surgical, that I would find enjoyable and fulfilling. However, we just don’t have the time to explore every single specialty. Though there is adequate time to shadow during M1/M2 years and though shadowing gives perspective on what a career may be like, it is difficult to understand actual responsibilities without being an active member of the healthcare team. As M3s, we still have a limited perspective on post-residency life. For those interested in surgical subspecialties or lesser known medical specialties, the current M3 curriculum does not give us adequate flexibility for career exploration. One of the appeals of the new curriculum change here at Michigan is that it will increase the number of electives students will be able to rotate through before VRAS is due. This will allow students more time for in-depth comparison of specialties that they would not otherwise be able to gain exposure in, like radiation-oncology or otolaryngology.

I arranged my M4 schedule around preparing an application for orthopaedic surgery, with EM and family medicine as backups in case I decide orthopaedic surgery is not for me.

P.S. Switch weekends are great. Go Broncos!

Watching the Broncos in Fremont, CA with my family

Watching SB50 with my family in Fremont, CA


Back to work

The last two months of M3 year have flown by! From the end of November until break started in mid-December, I rotated on inpatient GenMed at the U. Coordinating care was much easier at the U than at the VA and I helped take care of patients with extremely interesting diseases, like Acquired Von Willebrand’s disease and groove pancreatitis.
After finishing my last week at the U, I flew home to Colorado for the holidays. I got in my outdoor fix with some pheasant hunting in Rocky Ford. After Christmas, my parents, sister, and niece went to Disneyland to visit Mickey and his crew. Disneyland was ALL IN for promoting the new Star Wars movie. I saw a squadron of stormtroopers (they were rude, just like in the movies), drank out of a Chewbacca cup, and ride Hyperspace Mountain! I spent the last week of vacation in Florida with my girlfriend, Jordan, relaxing on the beach and cruising through Key West on a scooter. It was great to see my family and friends, but I am ready to finish third year in 4 months and start taking electives.


Life in the big house (hospital)

Third year is flying by. Surgery was exhausting, but much more exciting that pediatrics. Here is what I learned during my surgery and neurology rotations:

1) I am a better fit for surgery than pediatrics. I rotated through general surgery, vascular surgery, acute care surgery, and orthopaedic surgery over the past 2 months. It is interesting how different specialties, even subspecialties, attract various personalities. The vascular attendings were laid-back, the general surgeons were straight-to-the-point, the trauma surgeons were straightER-to-the-point. I felt like I ‘fit in’ better with the surgeons than the pediatricians.

2) I want to do procedures. In clinic, my mind wanders and time crawls by. And then my mind slows down. Then I fall asleep. During procedures, I am attentive and don’t even think to check the time. I had to do two 24 hour shifts on acute care surgery. My first shift was relatively uneventful, minus midnight pizza house delivery. The sleep deprivation made it a miserable experience from 2-6AM. The second shift went by too quickly. We had a couple emergency procedures that I scrubbed in for and I had to be told to leave in the morning. I didn’t realize how late (or early) it was.

3) Support is everything. Okay, this one applies to some random things. Get a good pair of shoes! Your feet, legs, and lower back will thank you for it. Also, find some support from other medical students. We are going through a unique, mentally-exhausting experience that is hard for others to relate to. Just think, we pay ridiculous amounts of money to work hard, long hours in the hospital. Our free time is largely devoted towards studying for an NMBE shelf that ultimately determines our grades. And we are often reminded of our junior status on the wards. Other med students are one of the few groups of people that truly understand our whining. This brings comfort.

4) Cafeteria food gets old. The VA has the kind of food you’d expect for a VA–greasy, homestyle food cooked in grease and topped with lard. Just kidding, it isn’t that bad, but it does remind me of my great grandmother’s nursing home cafeteria without the cool soft-serve ice cream machine. The food at the U is amazing in comparison to the VA and most other hospital cafeterias, but the choices are limited (and sugar-free).

5) Neurology is not for me! I think that localizing lesions and relying upon the physical exam for diagnosing neurological diseases is fascinating, but the outcomes are too disheartening. Part of the reason I want to become an orthopaedic surgeon is because the outcomes are so great. Much of neurology is focused on preventing progression or recurrence of disease.

6) They say most med students change which specialty they want to go into 2 or 3 times during med school. I haven’t changed yet, but my number two choice has changed from EM to derm to sports medicine in a matter of 6 months. I don’t think internal medicine, psych or Ob will be too appealing to me, but you never know!

7) Took a weekend off to head home to celebrate the newly wed Mr. and Mrs. Brandon Kliesen in Pueblo and had more fun than I could have ever imagined. Congratulations Brandon and Jenna!



Hey, thanks for taking the time to read my poorly-written, hopefully moderately entertaining post. As this is my first post, I would like to introduce myself. I was born in Pueblo, Colorado, a town of about 100k people 1.5 hours south of Denver. I graduated from CU-Boulder in 2012 and worked as a medical assistant for an orthopaedic surgeon during my ‘gap’ year while interviewing for medical school. I grew up playing/watching most sports and love the outdoors (hiking, fishing, hunting).

My third year of medical school has gotten off to a wonderful start; I was lucky enough to get the same clerkship rotation schedule (commonly referred to as the bro track) as many of my friends. Here is what I have learned about life as an M3 after finishing my first rotation (pediatrics) and after a week of surgery:

1. Sleep is valuable- Some people are machines and seem to function at a high level with minimal amounts of sleep. I am not one of those people. My brain takes about 4 hours to wake up if I am sleep-deprived. I often found myself sacrificing study time, relaxation time, and ignoring friends phone calls to make sure I got at least 8 hrs/night. You could always tell which students needed to grab more sleep at night.

2. Eat when you can- You never know how long you will be with in a patient room or in an operation, and no one enjoys hangry people. I just spent $200 at Sam’s Club on energy bars and quick, pre-made snacks.

3. Third year is fun! You get to meet interesting families, each with an unique background, and work with some awesome, down-to-earth attendings and residents. I have been pleasantly surprised by the approachability of our faculty and residents here.

4. Take advantage of your switch weekends to have some fun- I booked a last minute flight home to Colorado for the 4th to boat, fish, and ATV with my family (photo above)

5. Make your free-time stress-free- I put this one last because I think it is the most important! You need to find a way to relieve your stress. For me, I know I would go crazy (figuratively, maybe) if I did not have a healthy way to let off some steam.

Life is good!