Day 71: Block 5 – Gastroenterology and Hepatobiliary

Today’s inane image of the day:

Once again not the recommended textbook for the course – but one of the resources I used.

Somehow we’ve already made it through two blocks of our M2 year – how can we slow time down? I’m not ready to be this close to the boards!

Course overview
GI was another 5 week block and ran similarly to the last 3 blocks [Renal, Cardiovascular, RespiratoryNeuroscience was an outlier] – we had 1 TBL, weekly quizzes, labs and lecture. Our final grade was determined from our performance on quizzes, TBL, a physiology podcast assignment [see below for details], Anatomy practical and final exam.

What I loved
Course Directors. When the course directors for the course insist on being at almost every single lecture, it really sets a positive tone. This is especially important for when we have questions about the material or the nitty-gritty about the course itself because we know we can rely on seeing our course directors in lecture.

Option for Weekly Review. In previous blocks, we had time set aside for a weekly review on Fridays. For GI, Dr. Harriott made a little lockbox for students to submit questions for the weekly review. If we had no questions that week, there was no review. I really liked this format since it meant that professors/clinicians would only have to come in if there was a need. Sometimes I felt bad that time would be taken out of their busy schedule to come to a review that might be sparsely attended – the option for submitting a question helped prevent this from happening.

Final Exam. NBME exams are wonderful. Really.

What I felt neutral about
Anatomy Practical. In Cardio and Pulmonary, the anatomy practicals weren’t something I stressed myself over because they were straightforward and I knew how to study for them. But this year, we have new anatomy professors and a new style of practical exam. While I wasn’t as disappointed with the GI practical as I was for the Renal one, I was still a bit perplexed by why 1/3 of the exam was histology. I understand that in medicine, integration is key and welcome some variety in questions, but in the past, histology was never more than a few questions or maybe ~10% of the exam. The sudden focus on histology really caught me off-guard. In the end, I can grow to appreciate the additional variety in questions, but I wish there was consistency in the exams so that once I’ve figured out the most appropriate way to study, I can stick to it [this is the beauty of NBME exams – many if not most of us study from First Aid Organ Systems and consistently do well].

What could be improved
Physiology Podcast Assignment. In lieu of a normal physiology lecture, we created a Podcast lecture and a handout within our TBL groups covering a small topic. Our group’s topic were the GI reflexes [e.g. gastro-colic] and their possible influence on diarrhea in irritable bowel syndrome (IBS). After creating a presentation and a handout, then recording it, each individual had to take a 10 question quiz on the material. Additionally, we were expected to provide feedback on other teams’ work through an online forum.

I think that this assignment has enormous potential as a learning tool but that the way that it was executed this block, made it more of a burden than anything else. The making of the podcast took a pretty significant chunk of time, but it definitely hammered the material into our head. The quiz didn’t really seem to correlate with the material presented in the podcasts, so it was frustrating to take. And it wasn’t very clear as to how much feedback we were expected to provide through the online forums [i.e. did we have to comment on all 10 podcasts or just a few?].

Overall, I think that this activity/assignment could be a great learning tool but that it needed clearer expectations and the questions created directly from the material presented by each group.

Final thoughts
100% of the class passed in both the Renal and GI NBME final exams – I think this is a good sign. =)

Dr. Cappell and Dr. Harriott did a wonderful job with this block and I applaud them for their hard work and dedication to making it a success!

Day 66: Custom designs, anyone?

Today’s inane image of the day:

In support of Breast Cancer Awareness month, AMWA is sponsoring a pink ribbon sale at OUWB. I had a lot of fun with other AMWA members making these ribbons…

These last couple of weeks have been interesting… I ran my first 5K [I’m not a runner at all… I was hoping just to beat a 35 min time], got through the GI final exam, have been hard at work planning AMWA events, tried to keep up with blog entries at Kaplan and The Differential, and apparently just discovered a new passion of mine [read on…].

Recently, I was asked by a staff member at OUWB to help design her wedding invitations. She showed me a card she loved on Wedding Paper Divas and asked if it was possible to make something similar. I immediately agreed to try it out and see what I could do.

Many hours later, I made this card with the free graphic design vector-based program, InkScape. And I was inspired to do more and minimalist design detroit was born. I make no claims about my level of expertise in graphic design [let’s face it, I’m a medical student], but I think that I am very capable of making some interesting pieces. At least… let’s hope they’re interesting [you’ll have to let me know after looking through my site].

I’ve also opened up a small Etsy shop – so if you’re in need of wedding invitations, save the date cards or anything related to graphics and you kind of like my style… consider asking me for a custom design!

Our GI final exam [everyone in our class passed – YAY!] and Anatomy practical was this past Monday. Look forward to an upcoming entry reviewing the course.

Now back to medical school related things…? [I’ve been spending an hour here and there designing new card designs and playing around with new techniques. This was really bad news for me as I was trying to study for my GI final exam, because all I wanted to do was try to make pretty things!]

Day 53

Today’s inane images of the day:

You’re invited to attend our Women’s Health Symposium – Unraveling Breast Cancer program! If you’re from the area and medically-related, consider attending. More information at our AMWA website. Registration is required.

First Aid Organ Systems is an essential study tool for our organ systems courses.

The above images are a great illustration of the things dominating my life as of late. Our Gastrointestinal and Hepatobiliary Unit final exam is right around the corner on October 15 so I really need to kick it into high gear. The first couple of weeks of this block I spent time catching up on AMWA events and life, but now I feel ridiculously behind and panic is starting to set in. There’s a lot of material in this block and and not enough time in the day to memorize it all.

Anyway, I need to get back to studying…

[If you’re in the Metro-Detroit area, please consider attending our RADSAG/AMWA Women’s Health Symposium! We’ve put a lot of time and work into organizing this program. Plus… dinner will be provided and this is a great way to observe Breast Cancer Month!]

Day 42: Fall is settling in

Today’s inane image of the day:

This is the “trail” I jog [it’s actually on the side of a road, which disqualifies it as a real trail, I guess?] [don’t be fooled – I’m a terrible runner].

There hasn’t been too much happening as of late. I finally feel like things are getting done in AMWA [though, this was at the expense of studying for GI] and I’ve had a brief window of opportunity to catch up with old non-medical-school friends.

Michigan has abruptly decided that fall is here, which means cider mill visits filled with hot cider and warm donuts [admittedly, I’ve already been to the cider mill twice to buy half a dozen donuts]. However, the cooler weather also means that it’s much more difficult to peel myself away from bed in the morning – it’s cold outside of my heavy covers and the sun doesn’t start its lazy ascent until I’m already at school. I’m already kind of dreading the end of Daylight Savings Time [November 4th for those of you who are curious].

When I visited L.A. last weekend, I wondered if I could really abandon having 4 true seasons [as always, it was Sunny and 100+ degrees over there]. As much as I dread the seemingly never-ending gloom of late-Winter when the holidays have passed and everyone is just ready for Spring, I also couldn’t imagine abandoning ethereal snowy mornings. Or breathing in the brisk, winter air. Or the quiet that often accompanies light snowfall.

Then again, as I type this entry, my hands are half-frozen, my toes are a suspicious Raynaud’s color and I’m bundled up in a blanket. I guess I wouldn’t mind flip-flops, flow-y dresses and sunglasses year-round.

Are you enjoying the changing seasons? Do you even like seasons?

Day 35: Updates and link love

Today’s inane images of the day:

A successful kick-off AMWA Dinner With Dr. Nuzzarello!
A beautiful sunset in Pasadena [this was taken from the top floor of a parking deck].
Pasadena night life.

This last week following the Renal and Urinary exam has probably been my most stressful one to date because 1) our Anatomy practical examination grades were held until Thursday afternoon and I was scared about failing 2) I neglected all of my other commitments [i.e. AMWA] to study for the exam and felt overwhelmed by having to play catch-up 3) we didn’t get a break Tuesday morning after the exam – nope, we started class at 7:30AM and went until 3PM. All of these things combined made for a very painful week.

Last weekend while I was studying, I felt empty and well, depressed… so I planned a couple of things to look forward to. One of these things was a weekend trip to visit Mike [as you can see from the photos of Pasadena] – albeit short, it was wonderful and worth the money and fatigue from traveling. Currently, I’m writing this from LAX, awaiting my flight back to Detroit [did you know there was free WiFi in LAX?! I’ve totally been missing out…].

Have you noticed my rather sporadic posting schedule? Well… that’s because all of my blogging juices have been directed toward my weekly Kaplan medical blog entries and the newest addition – The Differential. Here are some recent entries I wrote:

Also, the Oakland Post featured me and this blog in their last issue! Check it out here.
Time to pack up and pack into the plane…

Day 31: Block 4 – Renal and Urinary

Today’s inane image of the day:

This was the cover page for one of my favorite interactive sessions during the Renal and Urinary block. [Oh and this Nephrologist blogs and tweets, too!]

We started our M2 year off delving into the convoluted structures and functions of the Renal and Urinary system.

Course Overview
This block was 5 weeks and ran similarly to the the last 2 blocks [Cardiovascular, Respiratory… Neuroscience was kind of an outlier…] – we had weekly quizzes, TBLs, Anatomy labs and lectures. Our final grade was determined by our performance on the weekly quizzes, TBLs, the final NBME exam and Anatomy practical.

What I loved
WHITE SPACE. Dr. Augustyniak started off the block explaining just how he designed the course to have a significant chunk of white space. Looking back upon the last month or so, I have to say that this extra time made Renal & Urinary much more pleasant. Not only was I getting a decent amount of sleep each evening, I had more time to study and digest the material. Although there was definitely more time off as a whole, unfortunately the last week before our final exam was jam-packed – I would have much rather had those classes earlier and more time off later.

Improved lectures/interactive sessions. A couple of professors really stepped up their game – it was really great to see some of our feedback in action [I guess this isn’t so much a Renal-specific thing, but more of a school-specific thing].

Final exam. Just like the last couple of blocks, our final exam was a customized one written by the NBME. I thought that this exam didn’t do a phenomenal job of assessing my Renal and Urinary knowledge, however, it was still a pretty darn good exam [it doesn’t hurt that I passed, haha].

What I felt neutral about
Weekly quizzes. In the past, I’ve raved about the Weekly Quizzes and for the most part, I still think they are a positive thing. However, as time passes, I’m starting to see them more as a burden and less of a way to study/assess my knowledge. At this point, I think the pros and cons of having them cancel each other out.

What could be improved
Anatomy. When I realized that we would only have 2 Anatomy sessions, I figured that it made sense since the kidney and urinary tract were not phenomenally complicated structures on a gross level. However, we soon discovered that we were also responsible for the abdominal wall and the parts of the inguinal canal region. Come examination time, I was surprised by how little we were accessed on our knowledge of gross kidney Anatomy and how much emphasis was on abdominal wall muscles. Additionally, the examination didn’t run as smoothly has it has in the past, which only added more stress to an already painful situation.

I am confident that this issue will be resolved, but it was still frustrating.

Attendance policy. [This is another school-specific and not really Renal-specific item] OUWB has implemented an attendance policy – although this change does not really affect me [I attend every lecture to take care of classroom technology, anyway], the way by which we track attendance is a bit rudimentary. Surely the system will be improved as time goes on, but for now… we’re signing a physical paper every single hour. It gets to be a bit nerve-wracking and distracting to feel like I have to chase a piece of paper around every hour, but for now, it’ll have to do.

Order of material presentation. It is likely that the order was dictated more by the clinicians’ schedules than anything else, so I’m not sure there’s much that can be done on this front. However, I think order of presentation is important in organ systems, particularly learning Anatomy, Histology and Embryology relatively early on so we can build upon these basics. For Renal, we had Embryology the last week before the exam – although there wasn’t a ton of Embryo to learn, I still felt like it would have been better placed earlier on.

Final thoughts
Like in Cardio, Dr. Augustyniak was really dedicated to making this course a success. Additionally, Dr. Dumler [clinical course director] was available for the majority of the course, which added to its overall high level of cohesiveness. Overall, I’d say the course was a success, albeit a little bumpy here and there.

Day 22: A day in the life of a med student

Today’s inane image of the day:

Back at it again with Netter’s Atlas and my laptop. Oh, and why not throw in a game of Gin Rummy while we’re at it?

Mike visited for a couple of days, then left again. As always, the visit was too short-lived and now I feel like a part of me is missing. We spent most of his visit doing what I always do – school, study, eat, exercise and sleep [admittedly, I got some shopping in, too].

Generally, my day runs something like this:

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Day 13: Frustration turned around

Today’s inane image of the day:

When we help out during interview days, we are given these notecard packets with maps and other useful information. I was an “escort” [heh…], which means I accompany applicants to their interview and back.

We had a TBL yesterday that put me in a rather foul mood. It wasn’t necessarily because of the TBL itself, but more due to my personal performance on it. It’s no secret that I struggle with multiple-choice exams, but I thought I had been improving in that department – well, apparently not so much. Sometimes I’m able to convince myself that often these tests aren’t representative of my true knowledge, however, there’s no escaping multiple-choice assessments so I’ll have to make due and just keep trying [at least I’m not failing!].

I signed up to participate in the first interview day of the 2012-2013 application cycle, which was yesterday immediately following my TBL. I was a bit concerned about my ability to talk about OUWB when I was feeling rather unhappy – but my mood markedly improved after chatting with some prospective students. One of them asked why I took time out of my busy schedule to do interview days, and I told him that it was because talking with interviewees reminded me of how excited I was to start medical school and proves to be relatively good motivation to keep moving forward.

My evening was topped off with some unexpectedly fun company. And today things are looking rather up [including the weather, which is 90+ degrees – I thought it was almost cider and donuts time?! Oh, Michigan], especially since I checked off a number of tasks this morning and I always feel better when I get stuff done.

Happy weekend, everyone!

Day 8: 2.5 years in (another long distance relationship update)

Today’s inane image of the day:

From my trip to San Fran – we made a pitstop in Malibu to visit one of Mike’s friends who was camping on the beach.

Today, we are 2.5 years into our relationship. Over 1 year of it has been on almost-opposite ends of the country. Sadly, it is likely that we will be permanently reunited only after we’ve spent more time separated by 1000s of miles than together.

Things have not necessarily gotten easier with time [whoever said time heals all, lied] – in fact, I’d argue that it has gotten harder as I move forward with medical school. Although I have arrived at a relatively comfortable point of treading the enormous volume of material, I cannot help but feel apprehensive about Step 1. I do not feel like I adequately learned the basic sciences last year, nor do I feel comfortable identifying a lesion in the spinal cord when given the results of a neurological examination. Although these fears cannot be erased by having Mike around, he could at least help keep them at bay.

But I guess we all yearn for the things we cannot have. Admittedly, I should be grateful for the endless hours he spends with me over FaceTime, merely watching me stare at textbooks or listening to me talk to myself about the pathophysiology of this, or that. I should be happy that I have someone so supportive and stubborn. I should feel lucky that he can visit on such a regular basis.

I recognize that I definitely have a pretty optimal LDR situation, but I cannot help but feel pangs of jealousy when I see my happily married peers at social events or hear about regular weekend visits from significant others in places only a couple hours away. Through my eyes, everyone else has a more optimal situation – however, I know that this isn’t necessarily true. I just have to keep reminding myself that appearances are not always representative of the truth.

My frustration comes in waves – most of the time I keep myself so busy that there isn’t enough time to let the negative feelings surface – but, sometimes they escape and morph into a fight. Mike is so accustomed to them now that he just seems to ride out the storm until the sun rises again. I really try not to let my emotions get the best of me, however, by the end of the week, I am sleep-deprived and stressed, which tends to turn me into a blubbering ball of anger and tears. Usually, if sleep it off, everything is better the next day.

We still have something like four years of long distance to go – hopefully it will all work out in the end.

Day 5: Back at it again

Today’s inane image of the day:

This time around, I decided to select my own resources to learn from [and tried to save some money by purchasing an older edition].

We just wrapped up our first week back at OUWB. Everything feels essentially like a continuation of where we left off, but not quite. This time around, there are more students [shiny, new M1s!], a different classroom [yeah, thanks a lot M1s for demoting us to the smaller classroom…] and some new facilities at Beaumont [more study space is always welcome]. Half of our building on the Oakland University campus is under construction [in order to get from the study rooms to the classrooms, we have to go down a flight of stairs, over, and then back up a flight]. Oh, and we also now have an attendance policy [I’ve updated my FAQs to reflect this recent change].

A couple weeks back, I was dreading my return to school. Honestly, I don’t necessarily feel much better now that we’ve started. I still love medicine and find everything we learn to be fascinating, but these things do not absolve the frustration of a perpetual state of exhaustion and stress. Plus, this year scares the living daylights out of me because Step 1 feels way too close for comfort.

As I went through my Google Reader [thank you dedicated, subscribed readers of this blog!], I noticed that Ali Binazir’s post, “Why you should not go to medical school – a gleefully biased rant” resurfaced in the blogosphere. I decided to revisit it [I read it maybe 4-5 years ago when someone brought it up on Student Doctor Network] briefly, and couldn’t help but nod in agreement at many of his sentiments.

Lately, I’ve been feeling extraordinarily young and naive. Although I am those things, it’s hard to come to terms with the thought that there’s so much left to learn and experience. Like many, I spent much of my childhood striving for adulthood, but now that I’m in a sort of transitional period, I can’t help but feel more like a child than ever before.

Anyway, reflective writing won’t help me understand the kidney…