Clinic Tales

I watched as Dr. P broke the news. Lung cancer. While the diagnosis was not a surprise to the patient (she had brought her sister and son to the appointment, I’m assuming for support), it was still a somber moment. I was impressed with Dr. P’s calm but empathetic demeanor during the conversation. In no way did I feel the encounter was rushed. Dr. P answered every question to the best of her ability in a straightforward manner.

That was a rough way to start out the afternoon.

Later, I was able to see two patients on my own, both with COPD. I learned very quickly that patients with COPD have breath sounds that are very minimal or often absent. I had a conversation with Dr. P that went something like this:

“So what do you hear?”

Me, listening intently for something but not hearing anything, “Umm… not much actually.”

“Good. Yeah, there is very little air movement.”

I was relieved and glad I didn’t try to make an uneducated guess.

Something else I have noticed as I spend more time in clinic is that Dr. P knows her patients very well. For whatever reason I had in my mind the idea that specialists spend less time with patients and don’t really get to know them outside of their disease. I realize now what a ridiculous assumption this is, especially because even in a specialty social and family factors are always going to play a role and a good physician should be generally aware of what is going on.

Gifts for Medical Students- Practical and Fun Gift Ideas for Med Students

Buying a gift for a medical student? Here are a few gift ideas that range from practical to fun.

-Cash

Tough to beat cold, hard cash.

– Art from the Street Anatomy Store

They have some really cool pieces of art related to anatomy and medicine.  You can find a great poster to hang up next to a desk they will be sitting at all the time.

– Nice Pens

Even though I use my laptop to take notes in class, I still write a lot. Having a nice pen actually makes a difference. I love these Pilot G-2 pens I picked up at Costco.

– Stethoscope

This can be a thoughtful gift for a medical student, especially if they are just starting school. I am no expert on stethoscopes but the general consensus is that Littman stethoscopes are the way to go. I have a Littman Classic II S.E. Stethoscope and it works great.

Amazon Gift Card

I love Amazon gift cards because I can use them to buy books for school, and if I want to buy something else (music, movies, games etc.) they have an enormous selection.

– Web Hosting

I love blogging. It gives me the opportunity to hone my writing ability, but more importantly to express myself as I venture through medical school. Owning my own domain and paying for web hosting ensures I have complete control over my website. I use HostMonster for hosting and have no complaints.

– Smartphone or iTouch

A little pricey but a smartphone or iTouch can be really useful for a medical student. The amount of helpful medical apps is astounding.

– A Vacation

This may take some coordination with the medical student but would be well appreciated. Many travel sites have vacation packages and Living Social has a bunch of short getaways.

– Any gift that shows you know them well

Medical students are people too. They have interests outside of medicine and school. If you know them well enough, you should be able to find them a gift that reflects the rest of their identity. They will appreciate a thoughtful gift that demonstrates that you recognize they have a life outside of medical school too.

I hope you find a great gift for the special medical student in your life!

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Third Year Schedule

In July of this year I start my third year of medical school.We recently had a lottery to determine our clerkship schedule. We have six core clerkships at Creighton and no options for electives the third year. Here is the order of my rotations:

OB/GYN

Pediatrics

Psychiatry

Winter Break

Surgery

Primary Care

Internal Medicine

So next year you’ll be hearing about my rotations in that order. I am pleased with my classmates that are on the same schedule block, it is a great group of people. It may be rough having the more difficult rotations at the end (Surgery and Internal) but there are positives as well. I want to get a feel for Pediatrics a little earlier, and Surgery will be in the dead of winter so being inside all day won’t be so bad.

Life Outside of Medical School

I’ve got to be honest, med school is starting to wear me down. Even though I am doing fine in classes, the amount of material starts to become Having some fun at Creightonoverwhelming. Add in the stress of figuring out how to find time (and motivation) to study for Step 1, deciding on my rotation schedule for next year and balancing life in general I feel… tired I guess.

And yet, med school does not dominate my life. I do other things. And that’s what I want to talk about today. I think it will cheer me up. So what else do I do?

I spend time with my wife. She is amazing and whenever I have the chance to spend time with her, I do. We are addicted to Netflix and have gone through several TV series’ in the past year. We love to settle down with some snacks or a meal and lose ourselves in a quality show.

We go out on dates. We’ve been to the Omaha Zoo, we have a membership at the Lauritzen Botanical Gardens and we recently spent an afternoon at the Jocelyn Art Museum. We like finding second run movie theaters and sneaking in candy to save money.

We love to travel. Obviously this is difficult to manage in medical school, but we had an amazing road trip last summer and have found time to spend long weekends in Chicago, Kansas City and St. Louis. We also love visiting our families in Colorado and Oregon.

We have game nights with friends. Last year we were obsessed with Settlers of Catan. We also love Smart Ass, Apples to Apples and Ticket to Ride.

I do my best to find time to read. And I do okay. I recently finished reading The Hunger Games trilogy. Over winter break I read Cat’s Cradle by Kurt Vonnegut and The Art of Racing in the Rain by Garth Stein. I am currently reading Steinbeck’s Travels with Charley.

I play intramural basketball and when the weather is nice I take our dog for a jog. I don’t exercise as much as I would like to. I’m not a big fan of going to the gym and unfortunately the winters in Omaha make it more difficult to bike and run outside.

I write. I have dreams of being an accomplished writer someday but for now I’ll settle for this humble blog and the occasional article for Student Health 101. I have an idea for a novel that’s been bouncing around my head for years but I’ve only written a small portion of it. I am hoping I’ll have some more free time next year to spend a little more time on it.

And that’s a good chunk of what I do outside of medical school. Overall life is good!

Fellow medical students, what is your life like outside of medical school?

Lecture Pet Peeves

After enduring hundreds of lectures during medical school, I’ve noticed a few things that professors do (or fail to do) during lecture that drive me crazy.  I’ve often asked myself, “How would I lecture to medical students?”

With that in mind, here are a few guidelines I’ve come up that I hope to follow whenever I get the opportunity to lecture.

I will:

  • make sure all animations, videos and internet links work before I start the lecture.
  • limit the number of PowerPoint slides to something reasonable. We’ve had lectures for which we were given 180 slides. For a fifty minute lecture.  That is an average of 16.67 seconds per slide. Poor trees.
  • finish the lecture on time or even a couple minutes early.
  • ask multiple choice questions during the lecture. While most of these are based on negative things lecturers have done, this is something I have really appreciated. It gets us thinking during the lecture and gives us an idea of the type of questions that will be asked on tests.
  • speak with a little passion about the topic! I will avoid a monotone voice for an hour.
  • throw in a couple jokes, even if they are really cheesy.

I realize this list makes me sound like a whiny med student. Which is true! Med students are really good at complaining, myself included! But regardless it feels good to get those out there.

Do you have any lecture pet peeves?

Fall Semester 2011 Review

Wow, that went by so fast. 2011

Writing went by the wayside this semester as I became bogged down in difficult courses. And I was so motivated at the beginning! The best laid plans…

Anyway, I wanted to write a brief overview of the semester to give you all a taste of what to expect in the second year of med school.

In general, the course difficulty shot up a notch or two. This actually started late last year when we started with our systems courses, the first being Neuroscience. This last semester included Infectious Disease, Hematology-Oncology, Cardiovascular, Behavioral Medicine and Respiratory.

Cardio and Hem-Onc were the hardest for me, although Infectious Disease was a rough way to start the year. Cardio physiology was brutal and will definitely be an area of focus for me as I think about Step 1.

Agh, Step 1. It’s like an evil shadow always lurking in the back of your brain. While very few of my fellow students have actually started studying for it officially, it is a topic that seems to come up in conversation often. And it is always there when you’re studying. Countless times I have considered glossing over something I didn’t really want to put the time into when the thought that I could be missing an opportunity to master something for Step 1 enters my head. This usually motivates me to push on.

Clinic was a welcome relief from the monotony of lectures. I am looking forward to continuing that and honing my physical exam and interviewing skills.

Overall, the semester was a success. I passed all the courses. I feel refreshed after winter break. While posting on this site has trailed off, I actually have a several posts that just need finishing touches. So expect some fresh material!

Wishing you all the best this New Year!

(Photo Source)

An Interview with Dr. Anthony Youn, Author of “In Stitches”

Medical school often seems like serious business. Life and death situations, daunting exams, all night study sessions: it all sounds a bit heavy, no?6v7_In-Stitches

A recently released memoir shows us it doesn’t have to be this way. Through self deprecating humor and his talent for telling a good story, Dr. Anthony Youn exposes the lighter side of med school with his book In Stitches.

After receiving a copy and thoroughly enjoying it I asked Dr. Youn if he would answer a few questions about In Stitches. He was kind enough to agree and his responses are below. Enjoy and be sure to check out the book!

What was your inspiration for writing "In Stitches?"

First time out, I decided to shoot for the stars. I set out to write the definitive book about growing up Asian American, going through four years of medical school—all true, unadulterated, unfiltered, behind the scenes, warts and all—and becoming a doctor. I think, ultimately, In Stitches represents what medical school really is.  Medical school can be laugh-out-loud funny, shocking, heart-breaking, and heart-warming. That’s what I wanted In Stitches to be. I’m gratified by what readers and reviewers have said so far. They’ve called it “disarming,” “fast-paced,” “hilarious,” and “touching.”

Who are some writers you look up to and how have they influenced your writing?

I can honestly say there is no one person whom I would consider my favorite writer.  However, I’m a big fan of the depth of Atul Gawande, the humor of Wade Rouse, the imagination of JRR Tolkien, and I can’t forget my good friend (and co-writer) Alan Eisenstock who wrote a fantastic book with the late Robert Schimmel, Cancer on $5 a Day.  As you can see, I enjoy a lot of different types of books!

Towards the end of the book when talking about plastic surgery, you say "I like the variety of surgeries that you do. I like doing re-construction where you can really see changes. I love the immediate gratification. I love that you don’t have to wait for lab reports or anything else to to see the results of your work. And being a plastic surgeon is very creative, very artistic. I also believe that a plastic surgeon can change a patient’s life." With the experience you have now, is there anything you would change or add to that statement?

Not a thing.  At one time or another I considered many different specialties, including orthopedic surgery (these jocks of medicine wouldn’t be interested in a skinny nerd like me), general and trauma surgery (I nixed this one the moment I saw a sixty-year-old attending stumble out of a call room at 2 a.m. for a trauma), psychiatry (my fear of falling asleep on a depressed patient mid-session cancelled this one out), and family practice.  To me, none of these compared to plastic surgery, truly the only specialty that really inspired me.  The field of plastic surgery is so broad, with such a variety of procedures and patients to treat.  I love my field and wouldn’t change my specialty for anything.

What sort of perspective can you offer students who are struggling through medical school?

When you are done with work, do things you enjoy. As physicians-in-training, you are accustomed to delayed gratification. I think the turtle in Kung Fu Panda said it best, “Today is the present, and that’s why it’s a gift.” Find moments of happiness in medical school. And once you finish med school there is no excuse to delay. Enjoy yourself, because the worst is over.

Do you have any plans for another book?

I would love to write another book, probably about the horrors and humor of residency, fellowship, and starting a medical practice from scratch.  At this point, though, I’m focused on the release of the paperback version of In Stitches, due Feb. 14, 2012.  Once the paperback comes out, then I hope to begin writing the sequel – a real-life House of God!

Thank you for responding Dr. Youn, I am looking forward to the next book!

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Switching Gears

Last Monday we started a Hematology/Oncology or Hem/Onc. The Friday before we finished Infectious Disease. After a week of Hem/Onc I am beginning to realize how difficult it is going to be to switch between classes so quickly.

You just start to get into a groove, everything is starting to click, then boom you’re done and onto a different course. New professors, new material and a whole new approach to studying.

This last week was hard but I think I’m getting a grip on Hem/Onc. It is more conceptual than ID which means less brute force memorization. This is a change of pace I appreciate. But it is still an adjustment.

Do you readers have any advice on how to adjust to the changing pace of second year?

First Clinic

Last week I started seeing patients in an actual clinic!

I will be going to the same clinic every other week for the rest of the year. Second year students at Creighton are spread out at clinics throughout Omaha. My preceptor is a pulmonologist who is great to work with. She asked me questions but I never felt interrogated and was eager to teach.

Seeing real patients and real disease was a welcome change from memorizing dozens of bugs and drugs and trying to apply them to fake cases. In clinic we saw a couple people for respiratory infections. Each patient was different and the doctor had to consider allergies, prior lung disease and likely cause of the infection in deciding the antibiotic to treat with. We had learned all this in Infectious Disease, but seeing it in practice was incredibly refreshing.

I was able to interview one patient on my own and it actually went really well. It helped that the patient was very nice and easy to talk to, a thoughtful way for my preceptor to ease me into seeing patients.

Tomorrow is a different story however. Tomorrow is my Infectious Disease final. Yikes. Wish me luck!

Fellow med students- what was your first experience seeing patients like?