Another ending

Today was the end of my month in plastic and reconstructive surgery. Although I went into the rotation with hesitation (even though I chose it as an elective) I really enjoyed and learned a ton. The spectrum of surgeries I saw was incredible, from pediatric cases to adults, burn surgeries, cancer reconstructions, and everything in between. I learned (albeit clumsily) how to do deep dermal and running sub-cuticular sutures, and learned the names of many of the surgical tools. I can confidently ask for DeBakey, Adson, and Bishop pick-ups, and know exactly what I'll be getting. I overcame many hurdles not normally there for most in surgery, as I am a lefty, and had to figure out ways to hold tools built for right-handed operators. It's still a learning process, but I hope with 3 more rotations involving surgery this year, I'll become better at doing things "wrongly.".

I saw just how much of a difference it makes being in the OR regularly over a month, rather than doing a 2-week surgical rotation in terms of learning how the attending operates, and how to best suit everyone's needs as the student. It was a much more immersive experience, compared toy short rotation that fulfilled the surgical requirement for my program, and only further demonstrated how well-suited surgery is to my meticulous personality, and my love of complex patient requirements. I look forward to what my first job will bring, and learning I have yet to accomplish.

Up next: Ob/Gyn. Here's to a nice combo of anticipatory health guidance, surgeries, and being involved in some pretty amazing moments of families.

Lots of suturing

I have definitely neglected updating this blog in awhile; Internal medicine has come and gone (which was the update from my last post; I had just finished my first week of IM, and now it's already done), and I saw and learned a lot.  It was a very nice introduction to full-time clinical rotations, with a wide variety of different patients presenting with different chief complaints, and very complex medical history and allergy lists.  I actually did a happy dance when the rare patient presented with no significant chronic illnesses and no known medication allergies.  However, my ability to use my pharmacology definitely increased dramatically when I was forced to integrate the list of the patient's medication allergies with what was available to me, and I learned the preferred 2nd and 3rd line drugs (especially antibiotics) for common disorders, when a patient was allergic to the 1st line therapy.  I also became confident in when I picked up on an abnormality, because I've already seen/heard so many normals.  It's nice when things start jumping out, like a subtle heart murmur, developing abscess/infection, or difference in a neuro. exam from what is expected.

This month has been with the plastic and reconstructive surgery service.  While I know that it won't be what I pursue professionally, it has been a great time learning about different common procedures used for breast reconstruction post-cancer, reductions, augmentations, and other reconstructive procedures that may be part of my patients' histories.  It has also been a great opportunity to learn different suturing and knot-tying techniques, although I feel like I'm the slowest suturer ever.  I have done (although very slowly) sub-cuticular and deep dermal suturing now, both of which I hadn't done in my previous surgical rotations.  Sub-cuticular is amazing, because they are done with absorbable suture material and buried beneath the skin; the resulting scar is minimized, and you don't end up with the "railroad tracking" appearance from sutures that are superficial.  I hope that with time, I will be able to do more than 4-5 sutures a minute.  It is also difficult that I am left-hand dominant, and many surgical instruments are built for right-handed surgeons/assistants.  I will have to learn many things in a different way.  It's a constant learning experience. 

I have one more week of plastic/reconstructive surgery, and then I start my Ob/Gyn rotation, which I'm very excited about.  It's at a community hospital, away from the academic medical centers that are not as conducive for students and getting individual attention, and less competition.  Hopefully I'll find more time to update things next month!

Internal medicine: week 1

Well the first week of internal medicine has come and gone, and I definitely love the confidence and learning that comes with being in clinic full-time. I have seen somewhere around 50 patients, and made 2x as many phone calls to follow up to others. Internal medicine is, if anything, an exercise in keeping the details straight, because most of the adults we see are very medically complex in nature. When I open a chart, I'm no longer surprised to see a history of heart issues coupled with diabetes, hypertension, cancer, psychiatric issues, and allergies to 12 different medications (thank goodness there are so many options, otherwise it would be very difficult to write any prescriptions for some of these people). Actually, I'm more surprised when I'm handed a relatively thin chart, or when the sticker plastered on the front says "NKDA," indicating that they have no drug allergies. I sometimes do a little happy dance in my head when I see that. But, I'm also discovering that it's the really medically complex patients that I learn the most from. I know which other drugs to avoid in allergies to a certain class of medications, resources to give patients, and where to go next when things would seem to get stuck at the fork on the yellow brick road just last year when I was a student in the didactic portion of my training. I'm very happy I had internal medicine as my first rotation, as I am able to use all of the information I've learned while it's still fresh in my mind. I also realize that time goes inexplicably quickly. I only have 12 more days left of IM, before moving onto plastic/reconstructive surgery. Stay tuned for the travails of week 2!

And the countdown begins

364.  It's a seemingly random number.  It's also the number of days left until I'm again wearing the fabulous (and ever fashion-forward) black pointy hat, gown with bat-wings, and a tassel, to receive my MPAS degree, and officially become a PA.  Today was the graduation ceremony for the class above ours, and watching it was very surreal.  Several of my very close friends (some of whom have been my classmates since college) graduated today, and the realization hit me that my fellow classmates and I will be there in less than a year.  The fact that we're out starting our 3rd year rotations is baffling to me in and of itself, because when we started anatomy our first summer, it seemed like almost a lifetime would have to pass before we would reach this point.  But, here I am, just 7 days away from beginning my first rotation, and I cannot wait! 

I passed!

I found out last week that I passed my comps, so I'm officially on my way to starting my amazing year of rotations.  I'm really excited for my summer ahead, and I can't wait to see what Internal Medicine holds for me in June!

Last week of classes

This week is my last week of classes, after 20 years of sitting in a classroom.  Only 2 more days this week left of classes, 1 day left at my AMAZING general pediatrics rotation, and then 5 final exams next week.  Still waiting on comps. results, but expect them this week.  While I'm not too worried that I didn't pass, I won't feel good until I get that envelope with the official results contained in it.  After final exams, we have a week of ACLS/PALS training, and then 2 weeks off before clinical rotations officially begin on June 1!  My first rotation is in Internal Medicine, followed by 3 surgery rotations (another month in Orthopaedics, ENT, and General Surgery), and Ob/Gyn....the first 5 months of clinic are going to be very busy, but I'm so looking forward to the intense hours and the amazing learning that's ahead of me!  I've been dreaming about this for 2 years....well, actually, my entire life. 

2 years of knowledge

Wow.  Tomorrow, I will take my written comprehensive exam, a 200-question, 4-hour exam that will assess my knowledge and processing skills on 2 years worth of material.  It's so strange, because when I think about where I was in June of 2010, essentially fresh out of college, and starting from square 1 of medical training, it seems almost silly that 2 years of hard-earned knowledge, sleepless nights, endless trips to coffee shops, PILES of notes (I can only imagine the amount of trees that are no longer living, having been sacrificed for 10 page handouts for every lecture, x2 years, x40 classmates) can be whittled down to just 200 questions, and 4 hours.  It's amazing to think that I will be practicing medicine in a year.  Wow.  Just, wow.  Where have the past 2 years gone?  When I started with my lab group in the cadaver lab in June 2010, 3 years seemed so long.  Now, I'm wondering where it has gone.  I can't believe my clinical rotations start in just a little over a month.  Looking forward to my amazing schedule ahead, and leaving the classroom behind.  But first, my comprehensive exam tomorrow morning.  I'll see you all on the other side of the dark cloud :-)

Tomorrow's the big day!

Well, tomorrow is the big day....well, one of them, at least.  The start of comprehensive exams, required to enter 3rd year clinical rotations.  While I'm not terribly worried about them, the thought that this is the exam that I must overcome before I can enjoy the glory of 3rd year is weighing on my mind. And the fact that I'm fighting a nasty cold, care of my very adorable pediatric patients, doesn't quite help things either. 

While I'm a little nervous (who wouldn't be; I never really enjoy standardized patient encounters, anyway, knowing that 3-4 video cameras are recording my every move/sound, even though there's only myself and the patient-actor in the room), I know, and have known, that there is no real way to study for the comprehensive exams.  Everything we have done/learned for 2 years up to this point has prepared me for this week, and I know that I will do fine.  I just have to prove that I know what I demonstrate to know every day in clinic, and in other classes.  I just have to remind myself to remember to do the silly things we haven't done since 1st year, and the random physical exam maneuvers not commonly performed, except in specific circumstances....and to remember to properly drape the pt., and pull out the foot-rest on the exam table....having the pts. feet hanging uncomfortably off the table is never good form.  Wish me luck!  3rd year is so close, I can taste it!

Tiny humans....and minor freakouts

The last 7 weeks of my didactic curriculum (ever) include my rotation in general pediatrics.  Can I just say how much I love children?!  I knew this long before I ever started PA school, but after doing my last seven week rotation in palliative care, this rotation is a far cry from the end-of-life discussions I observed prior to this.  I walked into clinic on Tuesday morning, on the first bright, sunny day Denver has seen in a long while, coffee in hand, and found bright paintings on the walls of jungle and under-the-sea scenes.  "The Little Mermaid" was playing on a loop on the waiting room television (try getting "Under the Sea" out of your head after hearing it 9 times in one day; the calypso beat that Sebastian sings to is actually pretty catchy).  Immediately, I was welcomed by the doctor who started the practice, the office staff, and several other providers with whom I'll be working with this semester.  I was already having fun, and I hadn't even seen any patients yet.  Overall, my first day of this rotation was phenomenal, and I loved that all of the providers came in excited to see patients, and were so in love with their jobs.  I could get used to this.

The rest of the week was a drag, more so than is usual.  There are only 7 weeks left of the semester, including our week of the big comprehensive exam, and I had my first minor freakout session about the comprehensive exam.  There really is no good way to study for an exam that essentially tests everything we've learned in the past 2 years, before we're allowed to be let loose into the world of full-time clinical medicine.  However, I'm hoping that with the time I spend during spring break studying, I can use everything I know to prove that I'm SOOOO ready to leave the classroom. 

Back to studying for the 2 exams that stand between me and spring break (as much of a break as it will be with comprehensive studying).  Here are some photos from our recent IV lab (I got all sticks that I attempted successfully on my partner!)

Nice little blood splatter

Trying not to look at the giant needle

My turn....just threading the catheter into the vein :-)

And the letter that comes after O is.....

I'm pretty sure that in kindergarten, they stopped teaching the alphabet after the letter O.  I'm 100% convinced of this.  Why, you ask?  Because EKG interpretation is NOT my forte.  I really wish it was.  Sometimes, it just baffles me, because I'm a total physiology nerd, and how the body works just rolls off the back of my hand.  But how the electrophysiology of the heart actually translates into the rhythms that appear on a 12-lead?  I find myself always struggling to interpret anything more involved than the rate, rhythm, and whether there's ST-segment elevation or not.  Beyond that, it all looks like a bunch of squiggly lines that have varying degrees of points, depressions, and other things that seem as foreign to me as learning another language (full disclosure: learning foreign languages have never been easy for me, either).  So, needless to say, my weekend has been full of trying to desperately cram all of the rhythms into my brain for the exam that is coming up on Wednesday.  I have actually found the Dubin book to be very helpful, in addition to a few algorithms for interpretation that we've learned in class.  But, when all is said and done, I wouldn't trust myself to interpret an EKG.  I'll leave that up to the cardiology people.

Drinking from the fire hose

Ever since before I started applying to PA school, everyone I talked to said that during PA school, everything feels like you're trying to drink from a fire hose....getting completely doused in heavy, torrential flow of information, and struggling just to push back against the pressure.  Overall, I actually haven't found that to be true, but considering I'm in a 3-year program, it's most likely the pace of the program is a bit better than most.

However, I think this is the first time I've ever felt like that analogy is actually true.  I was out for almost 2 weeks recovering from a minor surgery, and I'm definitely struggling to catch up.  Even though all of my classes only take place once a week, 2 classes=2 weeks worth of material=Katie running around like a crazy person trying to get back into a routine.  Much like this:

HOLY CRAP! 

On the other hand, I truly feel that in spite of how overwhelmed I feel, every day is a day closer to clinic.  My schedule is almost complete for 3rd year, except for my required OB/GYN rotation.  Very excited to spend a year with patients, and (hopefully) figure out what specialty I'd like to focus my job search on.  It's only a slight comfort knowing that as a PA I can switch specialties throughout my career, but I'd still love some insight into where I'll start.  Every day I feel like I oscillate between wanting to do Endocrinology or Surgery, but I have an Endocrine rotation and 2 (hopefully 3 once my final elective is scheduled)  Surgery rotations next year, so I hope I can figure that out.

On a final note: think good thoughts....we have our IV lab in Emergency Medicine this week....EEEK!

"You're going to feel a little pinch"

We had our needles and injections lab last week, which was super fun!  Even for some of us who have already gotten plenty of experience giving injections in clinic, it was a great refresher on techniques, injection sites, and clinical pearls.

Knowing full well that we'd committed to being guinea pigs for our classmates when we started PA school, we chose partners, rolled up our sleeves, and exposed some nice arm flesh with plenty of sub-Q fat to practice injections on.  Here are some of the highlights from that day:

Ready to stick me with needles

Pretty wheal under my arm

   Otherwise, life has been pretty boring thus far.  Endless round of exams begins on Wednesday.                  

It's finally real!

On Monday, my classmates and I went to a meeting that we had anxiously awaited for practically the entirety of 2nd year, to this point: 3rd-year clinical discussions!  We got more information about the logistics of rotations (yada, yada, yada....I feel like I'm in the middle of a Seinfeld episode whilst typing that), and we finally got our "tentative" 3rd-year clinical schedules.  Knowing that some things will change, I was actually pretty pleased (thus far) with my rotations.  Since our program has a pediatric emphasis, I have at least rotations (general/ambulatory, inpatient, and pediatric subspecialty) in pediatrics, as well as the required internal medicine, family practice, ER, and OB/GYN rotations.  But since I'm seriously considering surgery for my future, I'm much more excited about my elective slots!  I already secured one elective in orthopedic surgery, and am waiting to hear the status on a requested general surgery elective.  Depending on how things go, my 3rd elective slot will either be filled by pediatric endocrinology (the only thing I love more than surgery), or another surgery slot. 

After working incredibly hard for nearly 2 years, I finally feel like I have some motivation to tough out the last 13 weeks ahead of me (and comprehensive exams....and ACLS/PALS certifications).  Although we have been doing clinical rotations all throughout our didactic training, I'm so excited to implement my knowledge full-time, and really delve into what makes me tick.

We're doing the first of many clinical labs tomorrow: needles and injections.  Pictures to follow!

Things I wish I knew before I started

It's been over 2 years since I learned that I was accepted to PA school, and would be beginning this incredible (albeit, extremely stressful, at times) journey that I am over 1/2 finished with.  At times, it seems so common place to get up in the morning, drag myself to class for another day, and stuff more into my brain than I thought would even fit just the day before.  But then again, I have my moments where I remember how worried I was that I'd never get to this point, and I was anxiously checking my email 8.3 times per day for any news about my acceptance status.  But every time someone asks me about any advice I have for the application process, or help out with an interview session with my program, I feel as though I have been transported back to my own interview, and how incredibly nervous I was feeling, worried that everything in my future relied on one decision that wasn't even my own to make.  Now, whenever a friend from college asks me about any tips they have for applying to PA school, I tell them I don't remember much, except for the things that I learned (unfortunately) from experience...the hard way, and will always recommend someone think about when they are applying to PA school:

1. Know (and be able to express in words) exactly why you want to be a PA.  I knew that I wanted to be a PA, but couldn't concisely express exactly what attributes of the profession appealed to me.  The 2nd time I applied, I knew exactly why, and they weren't the cookie-cutter answers many people probably give.  I knew what pieces of my personality were suited for becoming a PA, and the things of the profession that would satisfy each of the things I wanted and needed in my career.
2. Think long and hard about who you want to write your letters of recommendation.  They usually only permit 3 letters, and you want those 3 letters to be from people who can speak very well about your character, personality, work ethic, patience, etc., and not some generic form letter.  While getting a letter from someone with impressive titles, such as the head of a hospital department or a decorated college professor may seem like it is a good idea, if they can't talk about specific conversations you've had with them, or they don't know you outside of the classroom, steer clear of that person.  You really only want to do the application process once, and since you only have 3 letters to work with, choose people who have known you for a long time, with whom you have worked, or a doctor or PA that you've shadowed or volunteered/worked with, who can speak in detail and highly of your character and accomplishments.  Other than your first-hand account of your life and experiences, your letters of rec. allow the admissions committee to get another point of view of who you are, and if what your record shows is supported strongly by your letters of rec., it's much stronger than if your letters are generic and say something like "X is a good student who performed well....blah, blah, blah."
3. On that note, spend some time getting to know yourself....and know yourself well enough that you can both write and talk about yourself.  This seems like a stupid suggestion, but it comes in handy when you have to start writing essays.  The people who work in admissions read hundreds, if not thousands, or applications each cycle, which include at least one, if not more, essays to read.  You have to be able to stand out in 500 words or less.  Sit down and think about events/people/experiences/etc. that have changed the way you think, how you interact with people, etc., outside of school.  You have to be able to show that you can overcome adversity, stressful situations, and that you are passionate about things other than studying.  You've already gotten to the point where you have the grades and test scores that are impressive enough to apply to PA school....they want to know what ELSE you do!
4. Don't get caught up with thoughts of what you THINK they are looking for.  I feel into this trap the first time I applied: I was so worried about what I thought PA schools were looking for, rather than just being myself, and telling them about who I really was.  Whether or not the things you love to do (play an instrument, enjoy classic film, etc.) is something that is mainstream or not, just go with it, and if you think it's important for the admissions committee to know about you, then write about it.  When you're writing your essays or answering interview questions, talk about the things you love with so much passion and enthusiasm that you will make the people reading your application just as passionate about your activities and interests as you are.  It is all about building a picture of your character, and what makes you tick.
5. The most important thing that I tell people is to START EARLY!  If you plan on applying to more than one program, it is likely that you'll have to write a few essays, and you'll want to take plenty of time drafting your ideas, and working on edits (and having multiple people that you trust to edit them), and making sure that everything is absolutely the way you'd want the admissions committee to see them, and without spelling and grammar errors.  It will be much less stressful if you have some time to work on your applications, and submit them early, rather than starting late, rushing through your application and writing, and submitting in a hurry just prior to the deadline.  Applying is already super stressful, and taking enough time will help lessen that stress (if only by a little bit).

That's all for now....one more week of break to enjoy before tackling 15 more weeks of class, comprehensive exams, ACLS/PALS training, and then, on June 1, starting rotations!!!!  So close!

Do I really have to explain this one again?

I'm sure as pre-PA or PA students (or even practicing PAs) have had to explain what, exactly, is a PA to more family members, friends, and the general public than they can count.  Some days, I love explaining why I chose to become a mid-level provider, and how excited I am about having the flexibility that being a PA will provide, and all of the amazing contributions that PAs make to medicine.  Other days, I sometimes find myself rolling my eyes, and spitting back a cookie-cutter answer, or just feel carrying around a flier with the answers to everyone's questions ("No, I don't think it would be easier to just go to medical school;" "No, I am not selling myself short by being "just" a PA;" "Yes, we can prescribe medications, assistant in surgery, and treat our own patients;" "No, I cannot write you a prescription for vicodin;" etc....)

When I came across this video on Youtube, I found that someone (probably a frustrated PA student or PA-C) had already done just that, in a very humorous manner.  I think the monotone voices of the 2 characters make it even better.  All of my readers in the PA profession can probably relate very well to this video, and will laugh hysterically at the same time.

So blessed at the end of the year

As is customary for this time of the year (and because I finally have the time to reflect on everything that has happened of late), I have been thinking about all of the things in my life that I have been so blessed with during the past year:

• I am exactly 1/2 of a PA, with only one more semester left in the classroom!  I started feeling fairly early in the semester what past 2nd year PA students from our program have talked about before: the 2nd year slump.  Getting up, even for only 3 days a week, felt like such a huge chore, and every morning involved lots of coffee, blasting campy 80s music, and having a dance party/mental confidence booster in order to drag myself to yet another class.  However, clinic was something I looked forward to every week!  It was the one place where I could get away from the drama of being in class, and really hold my own.  I was blessed with 2 amazing rotations this semester, both of which I was treated with incredible independence and respect by my preceptors (especially during my second rotation in family practice).  I learned so much this semester in clinic, and gained huge confidence in my knowledge and abilities to accurately assess and treat my patients.  I even detected a heart murmur in an adult patient that had no history of a murmur in the past, which eventually led to a diagnosis of an aortic aneurysm.  I had so many moments like this where I have been able to synthesize everything I have learned in the classroom, and during past rotations, and I can't wait to start full time rotations in June.
• I have the love and support of my amazing family
• My sister came home!  After being gone for almost 4 months in London, she finally came home.  She even surprised us all by coming home 4 days earlier than expected, so we got to spend all week with her before Christmas.  
• I got to spend wonderful time with my mom and sister in the company of our amazing congregation for Christmas eve Mass, and I prayed the rosary using the beautiful Italian-made rosary that my sister brought back from St. Paul's cathedral for me!

I have been blessed by so many other things this year, including a phenomenal scholarship from my program, the opportunity to meet amazing people and have life-changing experiences in clinic and in my work experiences, and just happy to be surrounded by friends and family who love me.  I only hope that 2012 ends up being as wonderful as the tail-end of 2011 has been!  (That is, of course, if the world doesn't end :-)) 

Last-ditch effort to procrastinate

I should probably be sitting here, spending the next 1.5 hours studying for my last final exam of the semester, but I'd rather write, because there's nothing quite like supreme procrastination.

Yet again, I feel like my writing has lapsed in favor of studying, and there's far too much to write about in one post.  I'm so happy to finally be at the end of a tough semester.  The material wasn't too difficult, or maybe I've just become accustomed to constantly being so busy, but regardless, it was a long semester, especially with my sister not state-side.  She comes home next Friday, and I'm so excited I cannot contain myself.

On the school front, I have found myself caring less and less about studying, and more and more about application of the material, which I think is pretty normal, given the fact that I'm a mere semester away from my full-time clinical experiences.  I had 2 phenomenal rotations this fall, and love that I'm finally at a point where I can go in and see a patient, take their history and do a physical, and come out pretty sure (or at least thinking down the right path) of what is most likely going on.  I really loved my 2nd go-round in pediatric endocrinology (and am planning on a 3rd time during one of my elective rotations next year), and I also ended up really loving my family practice rotation.  I'm so looking forward to only 15 more weeks of sitting in a classroom (EVER) and finally doing my rotations.  I'm so excited, especially for my prospective elective rotations, and I'm hoping I'll be able to figure out what I want to spend my life doing.  I'm still torn between pediatric endocrinology and a surgical sub-specialty, and I have both lined up (tentatively) as elective prospects during 3rd year.

Well, now that my exam is a mere 1 hour and 2 minutes away, I shall get back to last-minute cramming....so close to freedom, I can taste it! 

Finally coming together

The month of October was a pretty rough one.  It felt like an endless stream of exam (after exam, after exam, after exam), papers, and clinic.  But, in the middle of the stress of exams and piles of papers, a classmate very aptly reminded me that there's only 20 weeks left of our didactic careers....EVER!  Only 20 weeks of sitting day in and day out in a classroom, for 8 hours of lecture, until it's over, and we're released into the "real" world of 3rd year clinical rotations. 


Outside of the classroom, I am having more and more days where I feel fairly confident in my abilities to receive a chief complaint of a patient (say abdominal pain), go in, do an H & P, and from that, figure out with fair certainty what they have (or the top possibilities, pending lab work/imaging studies), and coming up with a broad treatment plan.  I am in a fantastic family practice rotation right now, and, being the fall-early winter season, I am starting to see lots of URIs and stomach flu.  But, this repetitiveness has helped me really cement my abilities to convey information to my patients, which is great.  It's the first rotation thus far that I've been able to act as the primary provider, and follow through on an entire visit. 

However, a mild freak-out period has just ensued, because there are ONLY 20 weeks left to somehow learn the rest of everything that I will need to know to treat patients before being let loose in clinic.  I hope that I can somehow retain the important stuff, and know enough at the end of May to not look to stupid in front of my preceptors.

I am so happy that the month of October is behind me, and November holds the promise of only 3 exams (feels like a wonderful break ahead), a 6-day Thanksgiving break, and having the time (if I choose to actually utilized it) to study for final exams, and not end up cramming during the first week of December.  Tomorrow is a self-declared snow day, since there's a rather large winter storm warning, and a pile of snow, ice, and very windy conditions expected for tomorrow.  The thought of making some mocha mint Dunkin' Donuts coffee, sitting at my desk, and studying for my exam on Thursday sounds better than dragging myself to campus for 4 hours of class.  Maybe I'll even put on some Christmas music (hey, Halloween has passed....I take it as license to start the Christmas preparations!)

Plugging along...

The past few weeks have been busy, with my sister leaving the country for London, and preparation for upcoming exams.

Sarah was so happy to leave the country, and see somewhere else different for a while.  I miss her so much, but I know she is very happy there, and we get to Skype every few days, which has helped.

I had my meeting with our clinical coordinator to discuss how I would like my 3rd year to pan out.  It went really well; in addition to my required family practice and general pediatric rotations, I have decided to focus my electives on surgery, and have at least 2 orthopedic surgery electives in the works, and a general surgery rotation that I'd like to do.

Other than that, everything is just settling into a routine.  Classes begin and end, and the amount of information being thrown at us about how to treat patients is never-ending.  However, once in a while, we do get gems thrown in there, like our suture workshop that took place last week:

"This little piggie went to market, this little piggie stayed home....this little piggie cried wee, wee, wee"....because they were cutting off his feet to use for suture workshops

I got practice in surgery this summer doing some sutures, and it was nice to drive home what I had learned, and really work on dexterity, and learning some other fun stuff.  I love my Emergency medicine class (suture workshop was part of EMed), and have always considered working in the Emergency room sometime in my life.   But for now, I am content with my pig feet.

That's all for now; gotta get back to studying for the 2 exams that are scheduled for Wednesday :-)

The (very) beginning of the end

Last Thursday, our 3rd-year clinical coordinator scheduled our first official meeting to discuss the specifics of 3rd YEAR!!!! (aka, the year of no more classes, no more scheduled exams, no more wanting to be in clinic, but you're really just camping out in the classroom).  It's the year that, from day 1, you look forward to, because it's when we actually get to apply the stuff we've desperately tried to cram into our brains for the past two years about how disease occurs, populations, clinical pearls, treatments, alternatives, things to beware, etc.  First year was exhausting, and at times, very disconcerting, and while 2nd year is already proving to be more enjoyable, I know it will quickly become much like the first, where I am aching to finish the didactic portion of the curriculum, and just see patients.

That being said, hearing about scheduling of our 3rd year rotations was so exciting, and a little overwhelming.  I'm part of the regular track, so I'll have my standard inpatient/ambulatory peds, internal medicine, family practice, OB/GYN, Emergency med, and some electives thrown in there (which I'm hoping will be surgery-related).  I have been thinking more and more that surgery is definitely in my future somewhere, but I just don't know exactly how that will eventually play out.

Each month during our second year, we will have meetings regarding 3rd year information, as we get closer to finding out our schedules, and where we will be going for our required rotations.  I am just anxious to get out there and start using what I have learned, although, with only 2 weeks down in 2nd year, I still have quite a long way to go before I know any more than I did during my first year about practicing medicine.  I just wish the light at the end of the proverbial tunnel was a little brighter, because I'm already getting a little tired and worn out.   June, please hurry!

I also know that, starting next Friday, this semester will undoubtedly become much more difficult for me emotionally, because my sister will be leaving the country to study abroad in London for the semester.  Whenever I have a God-awful, horrible day that makes me seriously question my decision to become a PA, or even enter medicine in general, she seems to have a sixth-sense about it, and knows just when I need motivation the most.  Not having her around will be hard as the semester drudges on, even though I know she will be having the time of her life in London.  Excited for her, but scared for how I will hold up while she's gone.  As said before, June: hurry the hell up!!!!