Rotation 2: Pediatrics

After my Surgery shelf exam, I had 2 whole days off before starting my second rotation. I didn't really know what to expect as I've heard really great things about Peds and some not-so-great experiences others have had. Overall, I was happy with my schedule and sites so figured it would be an interesting couple of months and definitely a respite from the OR!

I started off on Newborn Nursery. I basically got to play with babies all day, so I know you are all incredibly jealous. At first, I was very very very careful when examining the babies. After all, they were like 2 HOURS OLD. I would put my stethoscope on them extremely gingerly, so much so that my attending would watch me with a bemused expression on her face. She later assured me that I wouldn't break the babies and I could be a little more confident with the way I was conducting the exams. Ha!

I then had 3 weeks of outpatient. The hours on outpatient are glorious. It's basically 9-5 and I had to be in clinic 3 days out the week! It was such a change from the 13-hour-6-days-a-week schedule I had gotten so used to. It was nice to have the chance to catch up on some life things, like going to the optometrist, taking my car to get serviced, getting my laptop fixed, etc. I really enjoyed outpatient too, which was a little surprising to me. I've always known that I like the inpatient setting more than outpatient - I find the time constraint of appointments a little difficult to manage and I worry after the appointment if I did all that I could for the patient. At least on inpatient services, you can always check in on the patient whenever you want to, get more information, etc. Inpatient cases tend to be more acute as well, which I find exciting. It's like a puzzle you have to solve. And (at least in academic centers) you work in a team, so you feel less isolated and it's more of a learning environment where it's easy to call consults and bounce ideas off others. So when I found myself really enjoying the outpatient part of Peds, I figured it must be because of Peds itself. I told myself I would wait and see how my month of inpatient peds went and then figure out if this is something I want to consider pursuing as a career.

The preceptors I worked with in clinics were also really great about letting me take the reigns and seeing patients on my own rather than simply shadowing. I don't think all of my classmates had the same experience and that's really unfortunate. There's a huge educational benefit to being active participants in patient care so I'm grateful the pediatricians I worked with were willing to do that for me. I also felt I learned a great deal in just a few short weeks. Even though it was summertime, I still saw plenty of sore throat cases, rashes, ear pain, and of course sports physicals. Although some cases were tough and I couldn't get more than one-word answers even though I was trying really hard, other times it was just so easy to build rapport. One kid even gave me his sticker!

After that, I had 4 weeks of inpatient service on the Wards team. Initially, I had requested either the Heme/Onc service (blood disorders and cancer) or Nephrology (kidneys), so I was a little bummed that I had gotten my third choice pick. But it turned out to be the greatest thing ever. I absolutely loved wards so very much. It's the general service so I got to see what you call the "bread and butter" of pediatrics - the typical cases that you manage. Each of my patients had a different issue so I got to experience a variety of things and it turned out to be great not just educationally but also as validation that this might just be the field for me. I loved learning about pediatric conditions, loved interacting with kids and their families, loved working with the various interns, residents, and attendings, and just always felt a sense of happiness. I was happy when I woke up in the morning, exciting to go in to the hospital and experience my day. And I was happy when I came home in the evening, excited about the things I had seen or learned about. Studying pediatrics also did not feel like a chore. At the risk of sounding like a nerd (but we all know I am one, not ashamed to admit so), I would read for hours and not realize how much time had elapsed. From meningitis to botulism to irritable bowel to rashes to cystic fibrosis, I took it all in as a starry-eyed third year student is apt to do.

On our last day of service, the pharmacist brought over samples of the medications we give kids so that we can taste them and experience what it's like. (Before anyone gets bothered, we used the syringes so we were only taking in a few drops.) Let me tell you, most of these are just nasty. I felt bad thinking back on all the times I had to prescribe some of these. I'm sorry, kids! It was for your own good and I'm so glad you got better!

PharmBar.

Shelf day. Peds students have a dress code. 

What a wonderful rotation this was! I'm sad to leave but also excited to see what other surprises third year has in store for me. Check back in 8 months time to see if Peds is the winner.

USMLE Step 1

It sure has been a busy few months. Second-year finals ended in late February, which meant it was time to start studying for boards. The medical licensing exam has three parts: one you take at the end of second year, one you take in fourth year, and one you take during intern year. Step 1 is really important because you can't move on to third year and residency programs really look at the score to determine your competitiveness.

I decided the best thing for me would be to study at home. I didn't want to have any responsibilities besides studying. Plus, it would be nice to be treated like a princess for 2 months!

Words of encouragement around campus.

Studying wasn't actually too bad. I had made a schedule which broke down my days into 8am-6pm on weekdays and 8am-2pm on Saturdays, with Sundays off. I usually ended up taking the entire day on Saturday to finish up questions and whatnot, but for the most part my schedule worked and kept me in check. I had gone through all of First Aid throughout the year so that my study period could be focused on review and question banks.

The holy grail.

I also decided it would be a great time to pick up a new series to read! I read the Abhorsen books throughout my study period and I fell in love with them. It's got a perfect balance of modern-day and fantasy weaved in to what are essentially coming-of-age stories. Garth Nix is my new favorite author. (I eventually read Shade's Children as well. That wasn't my favorite, mostly because it was more science-fiction than fantasy. If you enjoy dystopian futures, then it's worth a read.)

Study break: hike

Study break: restaurant

I felt pretty good during my study period. I was doing well on questions and felt I had a good grasp on the material. I did fairly well on my practice tests. They were still a little below my ideal goal, but I figured I hadn't reached my peak yet and all would be swell come exam day. However, the test was absolutely brutal. It didn't help that I slept a grand total of 2 hours the night before. I didn't think I would be nervous but I lay wide-awake, tossing and turning. By some miracle, I had enough adrenaline pumping through me to make it through the entire 8 hours without feeling sleepy, but I did not feel I did my best. It was going to be a hard three weeks until the scores were released.

By that time, we had already had orientation and I had started my surgery rotation. The gossip is that you get paged the morning your scores are released if you failed. Of course I got paged and my heart just sank. Of course the page had nothing to do with me. I was still feeling shaky at the end of the day when I got home to check (I didn't have the guts to check while I was at the hospital). And I couldn't believe it: not only had I passed, I had scored above my goal! Such a relief.

HOORAY!

Lottery

3rd year is right around the corner! Pretty soon, we will be done with our pre-clinical curriculum, go off to study for and take Step 1 of our boards, and then we will officially be in the clinical half of the med school years. Third year is reserved for the core clinical rotations. Since everyone can't obviously be on the same rotation at the same time, schools have various ways of scheduling students. Some schools simply hand students schedules. Other schools have a few set schedules they have students rank and then assign accordingly. Our school is a little different. ;)

We have a Lottery system of choosing your clerkship schedule. Everyone gets to pick a number out of a hat and then based on your number, you choose one rotation at a time. The starting point changes with each round, of course. Anyway, you don't have to go in any particular order (e.g. you can schedule your third rotation before your first) and are free to choose any order you like, so long as there is an open spot. Now, see where it gets stressful? What if what you want isn't open, you ask? Well, you can't take it and have to figure something else out!

Over winter break, I came up with like 17 permutations for schedules I would be okay with. Which was a complete waste of time, haha. You really end up making decisions on the fly, because your strategy needs to change based on how other people are choosing their rotations. If it looks like one of the rotations is filling up, you choose it that particular round to avoid losing it. Regardless, about 1/4 of the class will end up getting locked out of their last rotation pick just because the spaces have filled up. There might be spaces open for other rotations, but they are not the one you need.

Of course, I figured with my luck, I was bound to get locked out. And I did! Good thing I'm consistent. I had picked every rotation except Pediatrics for my second rotation. What happens when you get locked out is, each person has to go through their schedule and adjust accordingly to fill in whatever is open. This might mean that you have to tear apart your entire schedule. Luckily, the person before me dropped Pediatrics as her second rotation when she was adjusting her schedule, and I swooped right in. Didn't need to adjust my schedule after all!

Behold, my 3rd year schedule (8 weeks each):

Surgery
Pediatrics
Psychiatry
Medicine
Ob/Gyn
Family

It isn't what I originally wanted, but it's close enough. I'm excited and terrified.

Prepping the night before.

The school decorated our room as Super Heroes! 

My lottery number.

Won a Starbucks gift card as well! 

Post-lottery celebrations.

Silent Auction and Wine Tasting Benefit

Every year, the second-year medical students help put together a Wine Auction in order to raise money for our student-run clinics. Co-directors from the various clinics come together to co-chair the various committees. Last year, I volunteered with the Decorations committee and so this year became one of the Co-chairs for Decorations! Our theme was Casino Royale, and we came up with a bunch of ideas to turn our building into the swankiest casino ever. This year we had the misfortune of not being able to borrow items from the main campus, so we literally had to assemble decorations ourselves, come up with creative ways to save money, and purchase whatever else we could not find. And it turned out great! The place really looked amazing and we got so many compliments. Hopefully, we were able to raise a lot of money for the clinics.

And although it was a lot of fun, I am so glad the event is over. Most of my commitments are wrapping up, since it's getting close to crunch-time for boards studying. In fact, I had my last clinic shift in December. It's so odd to have my weekends off (for now), and though I am thankful for the extra time, I also miss going there.

Spray-painted some wine bottles with my awesome co-chair.

Took me 8 hours to cut all those dots, no big.

Amazing. 

So cool!

Our catering department was able to put together this platter as well, ha!

My last day as a Co-Director. Sad :(

Fall in Sacramento

Yes, I know it's January and technically winter. But I've unfortunately been neglecting this blog, which I am sad about. Hopefully, I can pick up some writing this year, even though 2015 is going to be a huge change, what with board exams and starting rotations. Since I have a lot of pictures from the last few months, I figured I might as well share and pretend like I have been updating everything on a timely basis.

I've never gone apple picking before. I didn't even know it was a thing, until I saw some East Coast friends post some pictures a few years ago. Since then, I've resolved to do it, if anything to see what it's like. Unfortunately, we completely missed the season (PSA: go in August or September!) so there were no apples to actually pick! However, we still enjoyed our time and got to experience the beauty of Apple Hill. I will be on weekend-free rotation from late August to October this year, so hopefully I can get a chance to go during the season and pick some of them apples!

Beautiful Apple Hill

On our walk through.

Sundaes with apple pie filling and homemade caramel sauce!

Back in early November, I also attended my very first, bonafide, grown-up medical conference! It was a smaller, cozy Psychiatry conference in San Francisco, so it was easy to make a day trip out of it. I'm really glad I attended. I sat in on some excellent presentations and workshops, enjoyed the day with some classmates and friends, and felt like a professional (sort of!). Psychiatry is still one of the top fields I'm considering pursuing, so it was a wonderful opportunity. And free for med students, booyah!

Drive in the really early AM to get there on time.

Mid-conference lunch break.

Hanging out with one our attendings at the rooftop lounge! Oh snap!

Fall time in Sac can get a little chilly, but it sure is pretty.

Leaves just begging to get crunched.

The colors!

It's hot cocoa ;)

But now I'm back

Well, it's been a while. I feel like I've been less inclined to write and more likely to amass pictures that I want to post. This will probably ring even more true as boards study time inches closer and closer. We are already on Block 4 aka Pathophysiology aka the last block of pre-clinicals! Block 3 was all neuro and psych and totally up my alley. And as the new class started, it really sunk in that we are not the babies of the school anymore. Eek!

Orientation week party for the new kids on the block.

Med school is really hard.

Like really hard. Like so much so that your MS3 friends will bring you treats from their vacation.

In other news, my good friend L from like preschool (seriously) is getting married!!! I'm a little bummed that I won't be able to attend the wedding. It's on the East Coast and it would be nearly impossible with my class schedule. :(

BUT, I was able to attend the bridal shower, which was so much fun! And here are the cupcakes to prove it.

September Break Fun:

Chicken katsu.

Restaurant by my house that I did not know existed. 

Brunch with the fam.

Shakshuka for the win. 

And hot cocoa. Of course. 

I like to eat.

July (thus far)

Pizza night extravaganza with Year 1 Anatomy group!

K and I have an unhealthy relationship with colored pens.

Fam bam came up for a few days and wanted to do touristy things. Exhibit A: Sacramento River cruise.

Projected the World Cup finals at our lecture hall at school! Oh snap. 

Congrats to Germany! By the time the next WC rolls around I'll be finishing my intern year, ha!

This is what happens when you have neuroanatomy lab with clay. Brain modeling or professor modeling? ;)
All credit goes to the group that so expertly made this.

Harry Potter trivia night! Medical Muggles: Wingardium Mediosa placed a respectable 4th out of 46 teams.

On to MS2

Today is the first day of summer - the season, I mean. It's also the penultimate day of our "summer" break. These last six weeks have just flown by. I guess that was partly my fault since I split up my break. I did a two week "mini" psych clerkship where I followed around psychiatrists on the consult service in the mornings and outpatient clinics in the afternoons. Since I was going to be around, I figured I might as well be at clinic as much as I could as well. This meant the timing of things would be a little tricky. I ended up going home for 2 weeks after finals, then coming back up for a couple of weeks, and going home again for another 2 weeks.

I did learn a lot doing the summer program, though. My attending wanted to make me feel like I was part of the team so she had me do an oral presentation on the neurocircuitry of OCD and also present a paper for journal club. It was pretty cool being challenged at the level of an MS3. It makes me less nervous about the transition to third year. Anyway, psychiatry is definitely a tough field to go into. It's not necessarily physically demanding, but very much so mentally and emotionally. I really really liked being on the consult service though. It's a nice mix of medicine and psychiatry since these patients are usually brought in for a medical condition and need to be evaluated for an underlying psych issue or develop something throughout the course of their inpatient stay.

The rest of break was a mix of being sick right after finals, hanging out with friends, and eating a lot as usual.

Life lesson learned: I like inpatient much much more than outpatient - at least for psych.
Movies seen: 3 (X-Men, The Fault in Our Stars, 22 Jump Street)
Books read: 6
Binge-watched: alllllll of Sherlock and Game of Thrones season 4

The Fault in Our Stars was amazing. Amazing. Amazing. It's such a charming story and I bawled all throughout the book and movie. I'm a sap for YA lit. I tore through the Maze Runner series during the break. The movie comes out in September. Cannot wait. In the meantime, it's 12 weeks of Brain and Behavior and as many World Cup matches we can watch on the huge screens in our lecture halls.

Wet burrito at CaCao.

Traditional post-finals Porto's outing  with med school friend A. So happy!

Mmmmm cappuccino mousse.

Baked my brother brownies and a cake made with turmeric as soon as I got home. What a spoiled brat.

My brother's all-time favorite food. My grandmother made this for him even though it's blazing hot. It's yogurt-mint stew with meat/wheat balls and chicken.

Move night with high school friends. Those on the left are roasted strawberry-balsamic reduction-greek yogurt popsicles. The ones on the left are margarita mix-greek yogurt popsicles. 

I decided to chop off my hair for new beginnings. Wish me luck with Year 2!