The MSI Finale, Summer, and Beginning MSII

I have been living with a new motto recently: learn to enjoy the moment. That being said, I will blame said motto for the extended hiatus between blog posts. This past year has flown by, and I cannot believe I am already in the second year of medical school. It’s been an amazing journey, and I am truly grateful!

GI Module
Neuroscience module came at a great time after spring break and was extremely well-organized, fun, informative, and the easiest module for me. Granted, I was a neuroscience major at William and Mary, so it came in handy. GI module (let me clarify: Gastrointestinal Tract, Hepatobiliary System, Hematology, Oncology, Metabolism and Nutrition Module) was pretty horribly timed. As the last module of first year with no more than Saturday/Sunday to de-stress after our last final, I was burnt out and didn’t even realize it. The first couple weeks of school were killed in terms of productivity because the lottery to determine third year rotations took place throughout the school day and really distracted from learning – especially for the few lecture-goers like myself who found ourselves checking our lottery statuses instead of paying attention and taking notes.

Because the first two weeks of GI module were lottery weeks and the next weekend after that was Memorial Day weekend spent catching up with family/friends, including a lazy tubing adventure in West Virginia, I focused all of my energy studying like mad for the next couple of weeks before midterms. I thought I had appropriate catch-up time studying and actually felt prepared for my midterm exams. At this point, I have learned that feeling prepared for an exam is a major red flag. When I feel prepared – as I was for both MSK and GI midterms – I do far worse than when I have a mini-freak-out the night before an exam. Anywho, my midterm scores motivated me to kick it into high gear, so finals were fantastic. They were redemption for my bruised academic ego. I think I might be more interested in Heme/Onc/Nutrition, so that likely played a part as well. For current USUHS classmates, beware that the GI midterms were a dud across the board for our class and the class before, but I hear that the module directors are working on improvements to see how to fix that trend from the past couple years. Ultimately, it was my worst module academically, but I still passed and feel confident about the information we learned!

The Lottery: Third-Year Rotations
The lottery is quite the system. In the end, it all works out. Basically everyone was happy in the end, and we are getting a great experience at all of the locations. We started out with 100 points, and at least 1 point had to be used for each of the 9 rotations. You can prioritize based on the order you want to do your rotations or the places you want to go. I knew I wanted to get the surgical rotations over with, and being local to northern Virginia, I wanted to stay in the area as much as possible. My order of rotations was definitely not how I originally planned, and I am not going to Hawaii at all despite putting it #1 almost every time. However, I feel particularly lucky and am ecstatic at how my rotations came out.

We had two options: go homestead or go singles. Homesteads group three rotations together in one location. It’s a pretty great deal. It’s less stressful in terms of moving between rotations and less stressful in terms of time towards the lottery during GI module. I am doing my first set of three rotations in San Diego and my last set of three rotations at Walter Reed.

Local locations became vastly more popular this year than previous years because the system for housing at rotation locations changed. Now, we have housing provided for us at rotation locations rather than having an allowance for housing. I myself prefer this, but it was not a pleasant surprise for the folks with families who planned on bringing their kids to different locations. We were told that our lodging is comfortable for a spouse or significant other to stay, so I am excited for Andrew to visit while I am in San Diego!

Stay tuned in 2016 for rotation updates. My schedule is as follows:
– San Diego for Ob/Gyn, Surgical Subspecialties, and General Surgery, January – April [where my mom lives]
– Walter Reed in Bethesda for Pediatrics, May – June
– Offut Air Force Base in Omaha, Nebraska for Family Medicine, June – July [believe it or not, I’m actually excited for this one too]
– Fort Belvoir, VA for Psychiatry: Addiction, July – August [my selective rotation]
– Walter Reed for Internal Medicine (Outpatient and Inpatient) and my favorite for last, Psychiatry, August – December

AMP101
I had four days off after the end of the school year to run errands galore before leaving for my summer operational experience. All Air Force students go to the Aerospace Medicine Primary 101 (AMP101) course, the first of three required courses to become a flight surgeon/medicine doctor. I road tripped up to Wright-Patterson AFB in Dayton, OH with a few other USU students and was happy to see my fellow classmates as well as familiar HPSP students’ faces. Of the 70 attendees at our July 6-17 AMP session, the majority were USUHS kids, about 20 were HPSP, and four non-2nd-lieutenants were doctors and reservists who were given the responsibility for accountability. Our AMP session was booked to max capacity. The two June sessions were majority HPSP students and the July session after ours was reserved for mostly physicians rather than students.

First week at AMP101 was death by powerpoint, but I enjoyed the presentations in the sense that I have a much better idea of real life operational Air Force now. The weekend of AMP I attended my first friend wedding at the Alumni House in Williamsburg, VA. It was a blast to my college past, and I was glad to have Andrew meet the fabulous bride and groom – two of my friends from William and Mary. It was a mess of stress to coordinate this. I had been emailing the AMP higher-ups as well as up my own chain of command for a few months to get permission because I needed to take leave and plan my flight back to Virginia – – note that on the Thursday afternoon of the first week, students had the opportunity to switch schedules around with other students to allow for personal trips. We were given three days off that were different based on your group, and I am happy I did all the work and coordination in advance because I would have originally been scheduled for a fly day on the same day as the wedding and would not have wanted to wait until last minute for scheduling.

Reunion of friends at William and Mary for the #LizGoesPro wedding

Reunion of friends at William and Mary for the #LizGoesPro wedding

That being said, I also was at the mercy of weather. For such a large AMP session, we had three groups scheduled to fly on Saturday, Sunday, and Monday. Unfortunately, Saturday had the best weather and not enough pilots scheduled, so a few students were pushed to Monday fly day when it rained in the afternoon. I was among 8 students who had to go in for a chunk of our Wednesday off to fly. If I had lounged around Ohio all weekend like most folks did, I wouldn’t have minded. However, I was beyond exhausted and sleep deprived. I do not regret going to the wedding, but it most definitely put a damper on some fun activities during the second week of AMP festivities, the highlights for me including the tour of the Air Force museum, flight simulators, and flying the SR-22 Cirrus with a pilot. We had to present a safety brief and study for the final exam, both of which were not difficult at all but involved time and energy I was horribly lacking.

Heads up for those afraid of heights, flying is an incredible experience and not-at-all scary because of how exhilarating it is. It helps that there was a seasoned pilot manning the controls in the passenger seat like driver’s ed.

About to fly the Cirrus SR-22

About to fly the Cirrus SR-22

Summertime Off
After coming back from AMP, I finally had time to catch up with friends and family in the area. It was so very necessary to see the important people in my life that I had trouble keeping in touch with over the past year. As an INFJ often mistaken for an ENFJ, I recuperate by becoming a bit of a hermit and organizing my life. I had to balance my excessive social life with scrubbing the bathroom and trashing random items I hoarded as mementos for my past or references for the future. And of course, there was lots of HGTV/Netflix.

Andrew and I attended a wedding in Long Island that should have been on MTV (it reminded me of those crazy impressive super sweet 16 parties). We also spent several days at Sebago Lake in Maine. I spent the first rainy day reading Go, Set a Watchman. The rest of the days were gorgeous and sunny, so they were filled with paddle boarding, paddle boating, canoeing, swimming, speed boating, and being lazy. It was lovely. We went to Portland for our last full day to shop, eat, and be merry. Lobsters all day, every day.

ACME: TCCC, BLS, ACLS, Antietam March
All the acronyms.
ACME – Advanced Combat Medical Experience, part of MFP 102 (Military Field Practicum)
TCCC – Tactical Combat Casualty Care
BLS – Basic Life Support
ACLS – Advanced Cardiovascular Life Support

We were split into two groups. One group started with TCCC (i.e. “TC3” or “T triple C”) and the other started with BLS/ACLS. I was happy to start with TCCC – we had longer days, but they included fun activities and were reflective of our combat medicine classes during first-year medical school. All we had to do to pass was to study TC3 guidelines and learn the primary/secondary assessment sequences for patient encounters. TC3 was especially fun because we had paintball guns, ran into the forest to save patients, and got to see ourselves on camera to realize we weren’t as much as a mess as we felt during the experience. We also learned medical skills like cricothyroidotomies and chest tubes.

Ready to save some lives!

Ready to save some lives!

In the weekend of ACME, Andrew and I attended our third wedding of the summer and saw two of our friends get married!

In the weekend of ACME, Andrew and I attended our third wedding of the summer and saw two of our friends get married!

BLS and ACLS were more fun for the emergency medicine/ICU personality types. It involved a lot more studying for folks like myself who did not have the background for it, but it was a worthwhile experience. BLS was the simple CPR and defibrillation sequences. ACLS involved leading a megacode team (and being part of a megacode team). It involved a team leader, time keeper, CPR, maintaining the airway, defibrillation, and medications. There was a practical where we could use the all-mighty ACLS card and a written exam based on classroom material (it helps to do the practice questions we were given as well as reading the book/supplementary packet).

I had been looking forward to the Antietam March. It was a 6.5 mile walk/trail/hike that is easy when you aren’t falling behind schedule and basically jogging it with all your gear on. Also, I didn’t mind the rain much because it cooled us down, but rain + jogging = blisters (and here I thought my boots were the most comfortable shoes I owned!). It was a fun way to end ACME and to allow us to compare military medicine from the days of the bloodiest battle of the Civil War to today.

The Official End of Summer
This past weekend consisted of a fun MSI/MSII mixer and an impromptu beach trip to Dewey Beach (the waves were so aggressive!), so I have definitely had some laughter and sun before hitting the books hard again. Cheers to this past year and making it to Reproduction and Endocrinology Module!

Advertisements

Phase One at COT: Weeks 1-2

Today signals my thirteenth day at Commissioned Officer Training (COT), and I finally found time to update the blog. Technically, we just finished training day 8 of 23 on Friday, but our schedules are packed whether it’s the duty week, the weekend, or the fourth of July. We usually scramble from activity to activity from 0430 to 2300 daily, so I’ll try to hit the big points of what’s been going on here.

Two Sundays ago, I made the full drive from McLean, Virginia to Montgomery, Alabama in about 13 hours. I had the horrible realization my drive was one hour longer than anticipated when I reached the Alabama border, with a sign indicating it’s in the central time zone (womp womp). When I arrived at the Air Force Inn on Maxwell AFB, I ran into two females in the hallway discussing COT. One was a captain who just graduated dental school and was beginning COT the next day with me, and the other was an enlisted female who shared some of her experiences in BOT (basic training). In comparison, COT is much less stressful, but at the time, I did not realize what was in store for me.

Let me preface the rest of my post by saying that it was crucial to read a few blogs beforehand and to do research on the training program. COT has been one of the most difficult professional experiences for me, challenging me in ways that I had not expected while also being easier in other ways. Everyone gets stressed out. Everyone feels uncomfortable. Everyone is sleep-deprived, which is why our large auditorium is referred to as the “big red pillow”. At the same time, you’re going to have a lot of fun and learn what it really means to become a military professional. Every person has a different experience here; it’s all about the perspective you take away from this opportunity to train to become an Air Force officer.

On day 1, I drove in with the dentist I had met from the night before, who coincidentally ended up in my squadron and lives down the hall from me. Our class of about 320 officer trainees is split into 4 squadrons with 21 flights total. My Falcon squadron has 5 flights (mine being the Bravo Bombers, the best flight ever).

Day 1 consisted of LOTS OF YELLING. I learned to stop talking, to march, to follow directions, and to stare straight forward with zero facial expressions as screaming comes from every direction. I quickly realized that this would become a regular deal, but bright side: the screaming stops phasing you really early on. They instruct by yelling. When you calm down, listen, and follow through, all goes well. Things are only a big deal if you make it a big deal (unless you’re doing something egregiously horrible, but most trainees I have encountered are individuals of high moral character). Buying uniform items was a hot mess that day, but it was refreshing to have normal human conversations with the people working at the store before being thrown back to OTS staff again.

Most activities here revolve around five main things: 1) drill/marching, 2) physical training, 3) academics, 4) your duties/leadership roles, and 5) team building activities.

1) Drill.
I have no idea why this hasn’t been mentioned in previous blogs more. Marching and saluting and rendering military customs and courtesies are way more difficult than I thought they’d be. They also play a huge role in the COT experience. We passed our pennant test yesterday and Bravo flight came out as the #1 flight in our class. This is a BIG DEAL, especially because we really got our act together and practiced drilling meticulously the couple days beforehand. We were underdogs, but we rocked it. Our success earned us a most professional flight of the week award within our squadron. THIS GUIDON IS OURS. WE OWN THE GUIDON.

After receiving our pennant and professionalism award!

Bravo flight after receiving our pennant and professionalism award!

2) Physical training.
We head out for PT at 0440 most mornings. Per other blogs, I assumed the workouts wouldn’t be challenging, but they’ve actually been good thus far. Lots of running and group stretching. I can tell certain individuals are struggling more and others are breezing through it, but I am getting some good workouts in and my physical abilities are clearly improving. We took our baseline PT test on Monday, and I got all my personal bests for the 1.5 mile run, the push-up portion, and the sit-up portion. I surpassed my goal of hitting the excellent mark (scoring 90/100) and got a little over 95. #Winning.

3) Academics.
In the first week, there is so much paperwork processing and drill that you forget you’re here to learn the logistics of being a military officer. It has definitely picked up week two, after we took our big test on the officer training school manual (I got 100%, which was a huge pick-me-up when I was getting mentally exhausted from sleep deprivation. Sleep is huge, people. You’ve got to get it.) I had assumed classes would be more on Air Force history, rules, and regulations, but it’s a lot better than I anticipated. Courses thus far have focused on team building, motivation, and leadership skills. We also have classes on warfare studies, profession of arms, as well as communication. Big test coming up Monday that I should be studying for as we speak. Also, I am giving a brief on Wednesday about human rights in Iran. Stay tuned for how those go.

4) Your duties/leadership roles.
There are dozens of opportunities to get involved in leadership here. I will admit that most people who pick those higher-up roles seem stressed out of their minds, but if that’s your thing, then definitely jump on it. Leadership comes in many forms though, and everybody plays a part here. I lucked out with my flight job as the photographic officer. I would like to consider myself a morale booster. For weekend #1, I had to crank a lot of things out, but now my main responsibilities are to take photos and update the flight board (which is pretty difficult in a place where there is basically no functioning internet and you’re not allowed to print). My flight and squadron have excellent leaders. I am grateful for the opportunity to train with such a fabulous group of people (shout out to my Bravo Bombers – BOOM BOOM – as well as my flight commander).

5) Team building activities.
I think this will come more into play later, but what I really wanted to emphasize is how closely we work within our flights. My flight consists of 16 amazing people, including mostly medical students and dentists, as well as a couple psychologists, a pharmacist, and a chaplain (who’s my roommate!). We have done some field leadership training as well as countless group activities together. Our Bravo flight is a cohesive unit, and our team morale is always high. None of us are prior-military, so it has been quite the process where we are all learning how to be military officers. These people are going to be the #1 reason I might miss COT after graduation.

Ready for the next leadership mission

Ready for the next leadership mission

Other random points worth mentioning:
-Alabama feels like a toaster oven. How we wear boots, pants, and long sleeves still baffles me.
-Tight meals consist of shoving as much DFAC (our dining facility) food as you can in under 10 minutes. Sitting at modified attention and the no-talking rules aren’t painful in comparison to the stomach pains I get after meals from eating too quickly. The food is pretty good though AND very cheap.
-Being feminine is quite the challenge. Not much time for make-up or pretty hair. Luckily, OTS staff has not been passing out demerits for hair that “looks like a rat’s nest”. In defense of all the females here, we try.
-Andrew and my dad are flying down for graduation in August. Happy happy happy happy. 3 weeks and counting.

Peace, love, and Bravo.