Rotation 1: Surgery

I started off third year with Surgery. It wasn't my original choice, but I convinced myself that it would be a good idea to get a hard rotation out of the way early on. I knew there wasn't a huge chance I would choose surgery as a career so it would function as way to get familiarized with the hospital and be comfortable seeing patients, charting, and just figuring out what 3rd year is like.

Ready with my clogs and pager. Please page me! (Please don't.)

I had one month of cardiothoracic surgery and one month of general surgery. I ended up liking the rotation a lot, especially general surgery. CT had some really cool surgeries, but I felt like I grasped general surgery much better. CT was especially challenging with regards to management as most of the patients are in the ICU. Although I did get to see open heart surgeries, LVAD placements (don't cut the LVAD wire! (loyal Grey's Anatomy fan reference there), lung removals, and esophagectomies (yep, pretty much get rid of the esophagus due to the cancer eroding it. I got to hold the stomach up while it got stapled). General had more "bread-and-butter" cases that I thought were more within my scope - bunch of hernia repairs and gallbladder removals; I also scrubbed in on plenty of colorectal cases which are so complicated! I got to do plenty in the OR too: suturing, being in charge of the camera during laparoscopic procedures, putting in Foleys, retracting, etc!

"Practicing."

The hours sure are long, but the days go by so quickly. The one really hard thing is carving out time to study. There just isn't enough time after you come home and eat because you have to be in bed soon after that in order to wake up at 4am! I did okay on the shelf exam, but not great, so I will be adjusting some study strategies for my next rotation.

End of rotation assessment:
I didn't expect to like surgery as much as I did. However, I found that I enjoyed reading up about patients' conditions and their management much more than being in the OR. I also think the structure of the rotation prepared me well for the rest of the year. It was definitely cool for 8 weeks, but I find myself more intrigued by the medicine than the procedure. Good effort though, Surgery!

Fam came up after my shelf and we went to Tahoe for the weekend!

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 :(

The home life

There's nothing like going home for the holidays.

Made sure to stop by my alma mater!

First time making sweet potato pie!

Cousin's wedding. What's that fluorescent stuff? ;)

Pretty chocolates.

J's birthday party venue.

Annual Christmas cookie party with high school friends.

Banana pudding!

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 ;)

All you need is pasta and salad

So, I used to be pretty skeptical about these "one-pot" recipes. But they really work. Here is one I've tried a couple of times.

ONE POT WONDER TOMATO BASIL PASTA
(taken from www.apronstringsblog.com/one-pot-wonder-tomato-basil-pasta-recipe)

Serves 4-6

12 ounces linguine pasta
1 can (15 oz) diced tomatoes with liquid
1 medium sweet onion, cut in thin strip *I skipped this
4 cloves garlic, thinly sliced *I used crushed garlic from Trader Joes
1/4 teaspoon red pepper flakes
2 teaspoons dried oregano leaves
4 1/2 cups vegetable broth
2 tablespoons EVOO
1 bunch basil, diced
Parmesan cheese for garnish

1. Place pasta, tomatoes, onion, and garlic in a large pot. Pour in vegetable broth. Sprinkle on top the pepper flakes and oregano. Drizzle top with oil.

2. Cover pot and bring to boil. Reduce to a low simmer and keep covered and cook for about 10 minutes, stirring every 2 minutes or so. Cook until almost all the liquid has evaporated.

3. Season to taste with salt and pepper. Add basil leaves and stir pasta several times to distribute the liquid in the bottom of the pot evenly throughout the pasta as you are serving. Serve with parmesan cheese.


I also paired this with a a salad:


SAVORY PEAR POMEGRANATE GORGONZOLA PASTA
(taken from www.serenabakessimplyfromscratch.com/2014/01/savory-pear-pomegranate-gorgonzola.html)

1/3 cup while balsamic vinegar
1/2 cup EVOO
2 tablespoons water
1/2 teaspoon sea salt
1/4 teaspoon pepper
1/2 teaspoon honey
1/2 pound baby salad greens
2 whole red anjou pears, sliced thin *I used 1 bosc pear instead
1/4 cup gorgonzola or bleu cheese, crumbed *I was more generous ;)
1 whole pomegranate, seeded
1/2 cup walnuts, roughly chopped *pecans would be okay too

1. In a blender, combine white balsamic vinegar, EVOO, water, sea salt, pepper, and honey. Blend until creamy. *I found this was A LOT of dressing. I used it for additional salads two-three more times.

2. Add salad greens and pears to large bowl and toss with desired amount of dressing to coat pears to prevent browning.

3. Add gorgonzola, pomegranate seeds, and walnuts. Toss well and serve.