The Life of an MS3: Good Times and Good Riddance

USUHS fourth-years are officially done with classes/hospital rotations and have graduated this past weekend. So concludes the third year of my medical school career. Cheers to that!

My existential crisis [see last post], though ongoing, has abated in intensity. I have accepted my fate as a physician despite the occasional fantasies of retiring to a small town by the water, becoming a fiction novelist, and traveling countryside in an RV with Andrew. I signed up as the newsletter writer in Alpha Omega Alpha (AOA), so I will consider that my attempt to bridge between the worlds of medicine and humanities. It’s the little things, my friends, that keep you going.

I have lots of updates for the past year, and I will try to keep them brief. Last post, I talked about how pediatrics restored my faith in my career in medicine. That was a wonderful rotation (shout-out to Walter Reed’s pediatrics department and their fantastic program!). The entirety of the rotation, I reevaluated my life and thought, “Man, I should be a pediatrician.” Then followed Family Medicine in Offutt Air Force Base. Yes, folks. That is in Omaha, Nebraska. I have finally ventured to the real Midwest. I was lucky to go during the summertime with a lovely classmate and had the best rotation of medical school – a much-needed escape from life’s obligations at home. I learned that I love primary care and appreciate the family medicine physician mentality. For the first time on rotations, I truly felt like I fit in.

As the five weeks in Omaha continued, I saw the perks of family medicine – especially in the military. The options are endless. I can do primary care in adults AND children. My experience in pediatrics helped facilitate more positive experiences with children. Fun fact: I had never picked up a baby prior to my pediatrics rotation at Walter Reed. Now I am a diaper-changing professional. Anywho, the physicians I worked with in Omaha were fantastic. I fell in love with the field. I felt at home. Considering I always intended to be a psychiatrist, I also became very confused.

Next up, my elective! I chose addiction/substance abuse at Fort Belvoir, VA working in both inpatient rehabilitation of active duty members and in outpatient psychiatry with a methadone clinic. What a great experience where I felt involved in understanding the epidemic of addition in our nation. I worked with fantastic psychiatrists that made me feel at home in their field, despite the fact I hadn’t even rotated in my core psychiatry clerkship yet. One resident made it his mission to reaffirm my decision to pursue psychiatry considering my recent interest in family medicine. During the rotation, I definitely felt like I wanted to be a psychiatrist again (ie positive experience).

The theme of wanting to do the field I was rotating in continued (which I hear is common for those interested in family medicine). I really enjoyed my internal medicine rotation, especially the inpatient experience where I had the opportunity to work with residents and attendings who were dedicated to my betterment as a student. So much knowledge to be had. I was nerding out. Internists are definitely the Ravenclaws of medicine [Side tangent: that would make Surgery the Slytherins, Family Medicine the Gryffindors, and Pediatricians the Hufflepuffs… I need to figure out how to fit in the other specialties].

My last rotation of 2016 was psychiatry. Naturally, I was doing exactly what I wanted to be doing for my life but at a medical student level. I felt challenged and never experienced the “psych-ation” hours some students enjoy on their core clerkship. I had hoped that it would help clarify psychiatry vs. family medicine for me, but it actually made me more confused. I love psychiatry, but maybe I also love family medicine. How can I do both? I have been looking into joint residencies – there used to be an Air Force option to do family medicine/psychiatry at Andrews AFB way back. There is currently an internal medicine/psychiatry residency (5 years as opposed to the 3 years in medicine and 4 years in psychiatry) offered to Army, Navy, and Public Health Service. Unfortunately, a double-boarded position is not currently in the needs of the Air Force right now, but I am trying to sell it [wish me luck, folks]. 

So that is how I concluded my 2016 year of core clerkships (typically done during third-year for other medical schools). I am still unsure about what I want to do for my specialty, and I approached my schedule so that both psychiatry and family medicine remain on the table. 

Over winter break, I got engaged (hollaaaa) to the love of my life while on vacation in Dominican Republic. It was a beautiful trip with us and a childhood friend of mine (the one who I credit with our relationship because Andrew was originally her friend from college). We met some great people while we were there and are developing an international friend pool, which is a good deal for future travels. 

Winter break went straight into Step 1 study time. We take it later than other medical schools to make up for the fact we start in the hospital 6 months earlier. Not much to say there because not much happened. My score was pretty awesome, and I think it is because I chose to CHILL OUT for once, minus the occasional panics about how I was behind schedule and felt like I was going to fail. In case there are pre-step 1ers reading this, I’ll lay out my study plan in another post.

After Step 1, it was back to the classroom after over a year. We had 6 weeks of trainings and additional education on certain clinical topics. We got certified in BLS (basic life support), ACLS (advanced cardiac life support), and ATLS (advanced trauma life support), when only BLS is required for medical students. We had a fun military event called Gunpowder that’s a prelude to Bushmaster in September where we do military medicine scenarios like making a rope bridge to get a patient across the river, running codes, and climbing walls (or in my case, having someone help push you over a wall). My team consisted of a group of classmates I had never spoken with before, and we worked great together – made it in third place among 16 teams!

Despite the training, I felt rusty on my hospital skills and was anxious to go back. Day 1 back in the hospital was on my birthday at Madigan Army Medical Center at Fort Lewis-McChord in Washington state. Neurology was a great transition rotation because we acted as the inpatient consultation service, so I felt like I was relearning all of medicine despite our focus on neurology. I also felt like so many things were finally clicking from basic science neuroscience to clinical practice. Neurologists are definitely friendly, love what they do, and have a good lifestyle. The brain is cool, friends. I don’t understand how neurology isn’t a more competitive field!

Washington was good to me. The lodging was comfortable. My residents were awesome. My USUHS classmates were fantastic, and I met some friendly HPSPers. A couple USU folks and I traveled on weekends – to Seattle, Portland, Crystal Mountain, and Tacoma. What a beautiful state! Despite all the rain, the sun managed to shine bright on weekends.

Although I had a great time on neurology, it was nice to come home, reunite with friends and family, and NOT have homework anymore. FYI to non-USUHS folks, neurology entails 10 papers, 1 take-home quiz, and a final exam. Fun stuff.

I am currently on ophthalmology where the surgeons are happy, and I am trying to get used to a new routine. I became re-engaged in group organizations after being welcomed into Alphi Omega Alpha and the Gold Humanism Honor Societies. I am working on a curriculum project with school and have two research projects going at the same time. I am also trying to get in shape for the wedding. So it has been pretty busy since I’ve come back home. Andrew and I had an epic engagement party with local friends/family this past weekend where his family was exposed to the beautiful wonders of Persian dining. With those wonderful memories and my social quota reached, it’s time to get busy. I have a book chapter due on June 1 and my step 2 CK on June 7. Cannot say I have been studying too much for this one…so I’ll let you know what my study plan is after I figure it out myself!

Surprised you’re still reading. It’s been quite the year, so I appreciate your time as I share my experiences 🙂

Advertisements

To Pandakar and Back

It’s time to break my longest hiatus from the blog. Alas, I’ve officially succumbed to the hectic life of being a medical student. I often choose the pleasures of sleep, food, and an occasional Netflix or Hulu episode over writing. I might need to reevaluate my priorities.

Fundamentals proved fruitful. Unlike the other modules, it’s a hodgepodge of information, and I personally liked the variety of subject material (most of my fellow classmates probably disagree and prefer the focused content of most modules). We were graded on more classical methods of class work (lab quizzes, weekend quizzes, NBME midterm, NBME final, practical final, faculty exam final) and some more society-centered studies (medical interviewing of patients, full physical examination, and humanities essays on medical history and emotion processing after seeing patients). I actually enjoyed myself during Fundamentals. Despite the stress and long days, I enjoyed the information and had a decent time on the weekends, not so social, but I at least managed to get relaxing time in, which I desperately need to recharge.

Within 20 hours of my last Fundamentals final, I found myself on a bus to Pandakar, our patient role-play destination where the four-year USU med students used first-year students as well as volunteers as guinea pigs for a mock deployment scenario of patient health care. We stayed in barracks, which were much nicer than I anticipated. Likewise, all the porta-potties around Pandakar were surprisingly well-maintained. It’s the simple pleasures that keep you going.

We began our first day by taking an emotion intelligence test, personality test, and by learning how to play patients (which included an understanding of various medical abnormalities, how to act them out, and how the fourth-years should be treating our conditions). The next few days in Pandakar were quite epic and exhausting with more or less moulage involved. We played patients in combat scenarios as well as in sick call scenarios to give the fourth-years a plethora of presenting conditions to treat.

I will have more on what the MSIVs do in a few years for their side of the story of Bushmaster (Bushmaster was this doctor-patient role-play experience in fake-country Pandakar/real-world Fort Indiantown Gap in Pennsylvania). They had several roles to play, including security, surgery, ATL, CSC (for mental health), medic, litter carry, and a few more I either cannot remember or never learned myself. The poor fourth-years seemed exhausted by the end and were organized by platoons into different clinical teams by helmet color. I happened to see the Red platoon all the time, and I also happened to play a couple of hilarious patients, one of which was an “odd person”. For the respect of not showing us goof off with fake injuries, we can’t share our photos from Bushmaster, but it was an awesome/exhausting/educational experience for both the patients and the physicians – an experience no other medical school gets!

After Bushmaster, we had our own military training experience as MSIs within our platoons that included M9 shooting/safety training, LRC (leadership reaction course – my COT training served me well), land navigation, preventive medicine, ultrasound, CBRNE (training for chemical, biological, radiological and nuclear defense), combatives (thanks to a West Point graduate I partnered up with, I learned way more and definitely enjoyed myself…slash we sparred in pairs at the end, which I found terrifying to watch but fun/painful to do myself), Health Service Support (strategy of establishing medical/military posts during combat), casualty evacuation, and movie nights to watch clips of videos/documentaries and listen to panels/speakers ultimately illustrating the realities of military medicine [besides my parenthetical insertions, I promise this sentence/paragraph wasn’t a run-on].

And thus, we reached the end of our time in Pandakar. I bonded with the members of Alpha company (the half of MSIs that did Bushmaster before MSI training), and it was nice to go home and have a few days off before classes started up again. Unfortunately, on my last day in Pandakar, I woke up with the world spinning around me. I basically crawled to the bathroom to vomit from dizziness. Luckily I found two kind classmates to take me to the medic who diagnosed me with vertigo due to a viral infection. Fun times. The next few days were mostly spent at home recovering and relaxing, with some occasional activities within the scope of my ability to sit and walk slowly.

This past weekend before classes started, I went to a pumpkin patch with some Air Force friends and had my first experience pumpkin-carving at my parents’ place with Andrew. Also got to catch up with a few local friends and family before classes began yesterday. After organizing my calendar and planner for this next module, MSK (musculoskeletal), I am both excited and terrified to hit the books again.

Here we go again.