Non-invasive reading [i.e. echocardiograms]

Today’s inane image of the day:

The Heart & Vascular Services at Beaumont Royal Oak have been headquarters for my summer cardiology experience [“internship”]. I can actually find my way around at least a small part of the hospital now!

Nine of us elected to do a Cardiology “internship” [I’m hesitant to call it a true internship as most of what we’re doing is like “advanced shadowing” since it’s definitely more hands-on than shadowing prior to medical school and everything makes so much more sense, however, we still aren’t doing as much as if we were doing a clinical clerkship] [more appropriately, it is a summer Cardiology experience] – and I hope I’m speaking for my group when I say that it has been tons of fun. As with most things, there are definitely high points and mundane points, but overall I am extremely happy that I elected to spend six weeks hanging out with the Cardiologists/Cardiac Surgeons.

Our particular program is setup such that our weekly schedule mimics a Cardiology fellow’s monthly schedule – basically, each week we rotate through a different service [e.g. inpatient, SICU, Cath lab, etc]. We are expected to attend noon conferences [and there’s really no reason for us to skip this – they provide lunch everyday] and Cath conferences [early morning on Tuesdays]. Additionally, each of us spends at least one half-day in clinic following our mentor [each of us were assigned an attending]. Finally, we are also assigned a fellow to follow around each week [the only exception is the SICU/surgical week] – from my experience so far, the fellow generally dictates our schedule outside of the “required” activities.

My first week was spent in “non-invasive reading” which basically translates into performing and interpreting echocardiograms. Imaging is definitely one of my interests so I was pretty excited to start off with this service. The fellow I was assigned to had worked with our TBL group during clinical case studies so I was already somewhat acquainted with him.

The schedule for the week was pretty much performing ultrasounds in the morning [both transesophageal and transthoracic], noon conference, then reading/interpreting the images in the afternoon. Although this may seem somewhat slow-paced… I thought it was an extremely appropriate way to start off, plus I was able to get some experience doing the transthoracic ultrasounds [not that we saved any of the images I got, but hey, I could totally do a mean four-chamber apical view!]. Plus, I’m a big fan of dark rooms with images [this is, of course, assuming I have coffee] [this does not mean I’m going to become a radiologist].

I thought that the best part of my first week was probably picking the brains of the fellows – it’s great to hear their experience going through medical school, residency then finally this fellowship [two of them actually took a year to be a hospitalist prior to starting their Cardiology fellowships – I didn’t realize that this was so common]. Their advice was priceless and they were just a lot of fun to hang out with.

Anyway, I have to get up early to make it to Cath conference – I hope you’re enjoying your summer [I know I’m loving the sunny days!].

A bump along the road to summer

Today’s inane image of the day:

Over Memorial Day weekend, Mike and I made our way to Western Michigan to South Haven for a quick day visit. Here’s the scene at the beach… even though it was rainy earlier and the water was chilly, there were still a number of dedicated beach-goers!

Although May 25th was our last official day of classes, sadly it wasn’t quite my last day. Our Art and Practice of Medicine [APM] course only had two graded items for the entire year — both of which were exams that took place during our last two weeks of classes. The requirement for passing was a 75% on our written exam and 85% on the OSCE — although I passed the written portion, the OSCE didn’t go as well. As with all of our other courses, I had to remediate the exam.

On the upside, of the six or so exams we had to take, this was the most predictable one — there is a set format and a very specific number of tests to memorize. Furthermore, I failed on two accounts: 1.) I didn’t ask enough open ended questions and 2.) I didn’t include enough detail in my write-up [honestly, I don’t know what I was thinking when I was doing it — looking back at how sparsely filled-in each section was, I guess I had temporary amnesia]. Basically, I had a pretty good idea of what I had to fix and could do them relatively easily.

On the downside, I was extremely disappointed in myself and went as far as to question my ability to become a physician [yes, I know that this was taking it too far, but hey try failing something like this and see how it makes you feel!]. All of the other courses require at least some rote memorization [something I really do not enjoy doing] and I could always blame insufficiencies on my laziness to memorize certain things. But this course is essentially the heart of medicine; we interview patients and perform physical examinations to lead us to reasonable differential diagnoses. Not doing well in this course could translate into not “being good at medicine.”

This discussion leads me to the question of whether certain skills and traits can really be taught through the medical curriculum. Can we be taught empathy and compassion? Can we be taught caring behavior? Or are we just shown what these things look like and through enough practice, we are expected to mimic it? Surely the admissions process disqualifies applicants who do not meet these criteria, but it’s not a perfect process so it makes sense that certain humanistic aspects of medicine need to be covered during medical training. These are interesting questions that I often ponder during our APM and Medical Humanities [MH] courses [with no definite conclusion].

Anyway… with all of this being said, I passed my exam [apparently with flying colors] and officially started summer as of Friday. Yay!

Look forward to a review of our Respiratory block, what I’m doing this summer and the exciting news I wanted to share with all of you!