Objectives and evaluations

Tomorrow is my exam for my clinical skills immersion experience (this week and a half course with the procedures and whatnot). To study for the test, I figured I'd go through the objectives that they have on-line for each of the procedures, since I hadn't been doing my reading every day like I should have (the first two years of medical school took away my old habits of keeping up with all the reading--there's just too much of it, so we learn to be selective about our reading). Unfortunately, I've been a bit too selective--I haven't read anything. I figured going through the objectives would be a good, quick study technique, but that was definitely not the case! I didn't realize how detailed some of these objectives could be. For example, on the lecture about reading CT and MRI, one of the objectives is "Explain T1, T2, PDW, FLAIR, and diffusion weighted MRI". I actually paid attention to that lecture and I still have no idea what that question is asking. For the chest tube procedure, one of the questions was "What is the pathophysiology of a tension pneumothorax? Know the physiologic changes regarding inspiratory and expiratory pressures." On paracentesis (drawing fluid from the abdomen): "What are the pathophysiologic classifications of ascites, and what are the major etiologies of each?" If I had realized that I would have to know the physics of CT, MRI, and ultrasound, the anatomy the neck muscles, the physiology of fluid shifts, and the stages of wound healing--in addition to the steps of each of forty or so procedures--I probably would have studied a little bit more.

Playing Army

Today I took a brief break from practicing procedures on cadavers and played Army for a couple of hours. After putting a chest tube and interosseous line (like an IV, but directly into the bone) into someone who really isn't going to benefit from either, I changed out of my scrubs and into dress clothes to meet with Major General Bostick, the Commanding General of the US Army Recruiting Command, and his entire entourage. I, along with Dr. Hitchcock, the Military Medicine Interest Group advisor and retired Air Force major, showed them around the medical center and all the cool things we have there. In the process, I got coins.

The one on the left is from MG Bostick, the one on the right is from LTC Rice, the commanding officer of the 3rd Medical Recruiting Battalion. And the backs:

After the tour, I ran home to change into my class B uniform (green skirt, green short sleeved shirt with 2LT bars on the shoulders) and headed for the restaurant to socialize with people with much higher ranks than my own. Fortunately, there were a couple of dental students there, too, so I wasn't alone in my second lieutenant-ness. After that, it was running home again, changing back into my scrubs, and heading back to school to do a kidney biopsy on someone with much larger issues than that (another cadaver). All of the running around made me a bit tired, but they're paying for my education, so it's the least I could do. Besides, it got me coins :)

Back to the "grind"

Well, it was a nice and relaxing weekend, but like all weekends, had to end. After Adrienne and I went on our usual Saturday morning long run (nine miles this time), I threw some clothes in a bag and headed over to Dayton to spend some time with the McNachtans before I head out to Washington for a couple of months. It was good to spend time with Ed and Tina and the kids and just relax. Saturday was mostly just lounging around the house and somewhat trying to convince myself to at least do some practice questions for the boards (I think I did 25...). On Sunday we went out to John Bryan State Park and went "hiking". I just the quotation marks because going on a 2.6 mile loop with a seven-year-old and five-year-old hardly constitutes hiking in my mind, but it was on real trails, and the kids seemed somewhat tired when we were done (Paige was getting rather fussy), so I guess it qualifies. Then we went out to a late lunch, I threw my bag back in my car, and after a brief detour to the Air Force base to pick up a wireless router and fill up on gas that was less than $4 a gallon (I think it was $3.95), it was back to Columbus to discover that I can't even manage to set up a wireless network properly. I'll give it another shot later tonight after Adrienne gets home. Until then, it's stealing the neighbor's unsecured wireless for me.

So today I was obviously back at school. We had another lengthly session of procedures this morning, with incision and drainage of abscesses, ventilator management (complete waste of half an hour; that's what respiratory techs are for), intubation, central lines, and more practice running a code. Then we had journal club in the afternoon, and were off at two. If it weren't for the fact that the pool at the gym is closed until 6:30 this evening, it would have been a perfect day all around.

Yay Friday!

So today is Friday (as if you didn't already know that). It was quite a nice Friday, too. We had an hour an a half of clinical skills this morning--half an hour each of running a code (when someone stops breathing/doesn't have a pulse), learning how to put on casts, and anoscopy (if you don't know what that is, you probably don't want to). That was pretty fun, but they wouldn't let me walk around the rest of the day with my arm in a cast, which would have been great. After that, we didn't have anything scheduled until 1:30, so four hours of free time, which I spent going home, doing some of my on-line course for my internation rotation in January, doing some practice questions for step 2 of the boards, finishing my evaluations for OB, and actually making lunch. Then it was back to school for two hours of lecture, which I somewhat paid attention to, and we were done at 3:30. I have a few homework-type assignments to do over the weekend, but for the most part, it's completely free. I think I'm going over to Dayton to see Ed and Tina and the kids (Tina is a third cousin, her mother is Margaret Hampton).

Adrienne and I decided to celebrate the free weekend-ness by going to North Star for dinner. It's currently one of the top in our rotations of restaurants, but it's a little spendy for our budget and really hippie-yuppish--all organic food and all that. But it tastes good and they usually have a table or two on the patio, so it's a nice place to sit and have dinner when the weather is nice. While we were there we talked about our other roommate, who is moving out in eight days (not that I'm counting down or anything...) but decided that she just has to take the wireless router to the new place tomorrow, without giving us advance warning to buy a new one. So that started a whole rant about how inconsiderate she is and how glad we are that she's moving out. I'll stop by the exchange at the Air Force base down in Dayton while I'm there and buy a new one, that's not a big deal, but it just frustrates me that she never considered that her taking away the router was something that we should know about. The only reason she told us today was because Adrienne asked specifically if she was going to take it to her new place (it is hers, so I can't fault her for that). Grr. Oh, well. She'll be gone soon enough.

End of rotation celebration

Well, the written exam for OB was yesterday afternoon, so I'm now completely done with OB/GYN (assuming I passed, of course, which hasn't been a problem yet). My oral exam score was posted, and I got a 95%, so I guess Suchi and Adrienne were right when they told me I have nothing to worry about. I won't get my written exam score for another week or so, and it'll probably be two months before all my evaluations get in and I get an official final grade for the rotation. Grading is a little bit different here at OSU College of Medicine. There are no A's, B's, etc. Instead, the top 10% in each rotation get honors, the next 15% get letters of commendation, and the remaining 75% who pass (which is almost everyone) get satisfactory. So, whether you are the 76th percentile or the 1st percentile of the rotation, you get the same grade. Needless to say, I've earned satisfactory in most of my rotations (I did get honors in my research elective :)). Each rotation has slightly different criteria for grading, but for all of them, evaluations carry the most weight, then the written exam, and then for the rotations with other tests, like the oral exam in OB or quizzes in Internal Medicine, those carry the least weight.

So after we all finished the exam, we celebrated in typical medical student fashion. We got cleaned up (that was a big deal after rarely wearing anything but scrubs for six and a half weeks) and went out to a bar for dinner, drinks, and sitting around decompressing for a few hours. I have pictures.

That's me and Adrienne.

There was pool being played--Erin, Madhu, and Adrienne (Erin was at Grant Hospital, Madhu was at OSU but on a different team, and Adrienne and I were on the same team).

Sam was obviously happy to be done with OB, and Sunny was either so exhausted from the last six weeks that he fell asleep at the bar, or was so relieved that he couldn't stop laughing. I think he was laughing.

So that' s what we do when we're done with a rotation. Unfortunately, we had class today (we have a week and a half of clinical skills immersion), which was a flashback to the first two years of medical school--we just sat around in the classroom for 8 hours while people lectured to us. It was kinda nice not to have to think, though, and I'll never complain about two extra hours of sleep.