Saturday, February 16, 2013

Stuck In the Middle With You

Howdy folks.

It's been a while.

I figured an update was in order. A very close friend of mine started her blog and it makes me want to write in here more... at least occasionally with some updates.

I'm going to do this in list form to save time.

I'm now approaching the end of my first year in med school.

Here are some realizations I've made so far:

1. Medical School is fun! I love to learn and we have so much dedicated time to learn new things. It's totally awesome! I'm happier now than I've been in a long time.

2. If you enjoy learning and don't mind longish hours, medical school is easier than grad school or a real job.

3. Maintaining personal relationships outside of medical school is hard. So much of my day is taken up with either learning or hurdles my school throws at me. Also, I find I am less able to talk about topics outside medicine, philosophy, or politics.

4. The administrators in charge of designing your curriculum have an agenda. Often times this agenda will get in the way of you learning in the fashion that suits you best. It can be very, very frustrating.

5.You will notice trends in teaching towards what is politically fashionable in the education world, but not necessarily helpful for you to learn the "language of medicine." Their counter argument will be, "We know what it takes to be a good doctor. We want you to teach you to be a good doctor."

6. Similar arguments, "We know what's best for you" will be used often. You WILL be treated like a child.

7. Professors are watching you. They are probably tied to a residency process to some degree. Don't tick them off.

8. My classmates are a bright and shining light in my life. Sure, there is rampant gossip and sure, people will judge you, but that happens everywhere. I know that if the chips were down, this is a group of people who really care about others. The more time I spend with them the more I feel like a family. People do douchey crap to eachother, but they get over it and love eachother in the long run. I love them.

9. The more I learn, the more I realize that pretty much everything will be covered by the end of the first year except microbiology. We follow an organ system curriculum and they sneakily teach us some pathology with the physiology throughout the first year. If you can cram that micro in somewhere you can start reviewing first aid pretty effectively by the end of the first year. That's my plan at least.

10. Problem based learning/small group learning is bittersweet. To sit in a group and try to solve a case (kind of like a who-done-it murder mystery) is super fun. The didactic back-and-forth conversation based on limited understanding of a subject is really interesting and helps you learn people as well as material. Going home and writing essays on particular topics related to the case is not fun and extremely low yield in my opinion. It gets in the way of you learning the big picture, broad concepts of the week and instead focuses you on learning a piece of minutiae about a disease related to the physiology which you haven't had a chance to fully learn yet since you're writing the figgin' essay. Uggh! Can you tell I'm frustrated by them?

At the moment I'm trying to sort out research for the summer. I'll let you know how that goes. There's a mad scramble for finding funded summer research around this time as applications are due by late March and getting professors to respond can be tricky.

On a personal note, I'm trying to be less dependent on personal relationships. I find myself getting lonely very easily. I like studying with people around, but not talking to them except on breaks. I'm also trying to work on expressing my opinion in a less aggressive way. I've always had problems with that. I'm trying to listen to people more instead of speak.... Kind of ironic in this case as there's no one to talk back.

Good night all and sweet dreams!

Friday, August 24, 2012

Once More Unto the Breach Dear Friends!

Ahhhhhh.... Sitting finally at my desk without any responsibilities to run off to... priceless.

It's been a crazy week.

This was my schedule today:

7:00 wake up
7:30 prepare for today's lectures
9:30 go to lectures
12:00 American Medical Association lunchtime talk
1:00 Embryology Lab
4:00 Eat dinner prior to clinic
5:30 Student Run Health Clinic
11:00 Prepare for tomorrow's lecture
12:00 Blog
1:00 Sleep

7:00 wake up and go to Problem based learning...


Today I had a very humbling experience. I like to think of myself as a nice person. I want my classmates and myself to succeed. I want people to find happiness. I believe once you've found what you love, the pursuit of that should be your primary life journey and I encourage others to make that journey.... 

...Yeah, I think I'm all right.  

And then I come across what REAL nice people are like ... and I realize that I'm not one... that I could never be one. That what it takes to be one of those people is beyond my capacity to give. I'm too selfish, too focused on success, or maybe I'm just too embarrassed that my moral compass isn't as demanding. These people sacrifice all of themselves and more to the betterment of others. It's a shocking and humbling experience. Like finding religion I imagine. Maybe what I'm feeling is what people must have felt when they first met Jesus or Buddha or Gandhi or any person willing to give all of themselves. I encountered some of these folks at the Student Run Homeless Clinic tonight. 

One was a fellow student, a tiny man with a huge heart and curly hair. He organized the students attending and every action he took, every word he spoke, every glance and touch he offered projected compassion and caring for those around him (for students, for patients, and for those above). He gave his time to all. He made sure no one was left out. When everyone else was tired or chatting, he would be found doing what needed to be done. He asked nothing in return, just that we learned something from the experience. It was obvious he was in his element helping those most in need. 

Another was the attending physician in charge. Clearly over-worked and in a "beyond-chaotic" environment, she kept a cool-head and friendly demeanor. She took the time to teach us lowly MS1's and answer any and all questions as they came. Much like my fellow student, every action she took, every word she spoke was kind, competent, and caring. She had clearly devoted a lifetime of hardship and effort to helping underserved and homeless people in the area. I just don't know what to say really. I don't think I could live her life, but I'm glad that someone does. The world needs more people like her. Though I can't really imagine how hard the road is to walk. Would you be willing to give up your pride, your ambitions, your fame to help those most dejected by society? To be unsung and unknown? Possibly, to be unremembered and to have no family, but those you treat? It's a sobering thought to be sure. And definitely one that makes me question myself and what kind of man I want to be. I want to help people, it's why I went into this profession. It pleases me. But at the same time, I stand back in awe when I see what true selflessness really looks like. 


On a lighter note. I got to treat my first patients today! Whoo hoo!!!
Checked lung sounds, heart sounds, ears, eyes, palpated glands, administered drugs, yippee!
The MS2's were all so friendly and nice and I ended up feeling much closer to my peers who were there. We went through a hardship together. It was chaotic and exhilarating and crazy, but oh so so fun! When can I do it again?

Strong work my friends. Strong Work.

Saturday, August 18, 2012

Week One.... Week Done!

I finished my first week of medical school... Huzzah!

Alright, begin week 2. Go!

That's what it feels like. Each week seems like a hurdles race. The gun goes off and you start to run.

Oh, look out! Learning issue ahead! First hurdle...Jump!

Shit, is that a journal club paper? Get ready.... Jump.

Lunchtime meetings and sign ups!!!? Crap! Stumble, swerve, dodge.

Where's my lab? Where am I? Damn  you empty and dilapidated neuroscience building! Got to get back on the track!

Screw it! Time to go home. Wait! I've still got to make today's cards, study tomorrow's lectures, and chat with my med school mates! Ahhh.... it's ok, someone posted a google doc. I can relax..... Thank you angel.

Did I forget the required reading for tomorrows lab? Oh shit! What about the residency roundtable and career builder? Am I not serious about my goals? Arrrrggghhh!

Ahhhh, it's Friday. All done. Time for sleep and to catch up.

Bang! Sunday's race begins for week 2! Yeee haaa!

Perhaps this paints too grim a picture. I'm actually still super happy and excited to be here. Perhaps it would be different if we started with a subject I was less familiar with. It's definitely the case though that before I've even reviewed and internalized all the material from this week, I'm worrying about all the lecture slides and required reading for the following week which is available online and calling to me either through faculty reminder emails or through my own insistent conscious.

This is not necessarily a bad thing. In fact, it's kind of what I was looking for. I was expecting medical school to be an immersive experience. I often described my future goals as getting "stuck into medicine" and "swimming around in it." I look forward to living it. I want to be one of those annoying blokes at parties who loves talking about new diseases and treatments. I believe it's this immersion which is the best way to learn and remember and quite frankly, I came to study this stuff because I love it.  I love the subjects, I love the people, I love the dialogue.

In many ways, medicine is another language, another culture, another country. The first step to travelling there is learning the language and the best way to do so is to dive in head first.

Even though I complained about writing up Learning Issues, I actually love PBL. It begins the week-long medical dialogue that doesn't stop until Sunday morning's hang-over. Our proctors keep it a very high energy experience and I always come out feeling charged and excited. I hope my group mates feel the same.

Regarding lectures:

I have a very good memory, and can more or less retain a week's worth of discussion in my head at a time, so it really excites me to see how all the information comes together from multiple sources to paint a complete picture. However, having a good memory is dangerous as well. It makes me lazy. Instead of making flashcards in lecture, I sit there and listen, absorb, and understand with the intention of going back and writing the notes later.

... It turns out I hate writing notes later.    ... A lot.     I'm sitting here at my computer screen staring at the lectures and wishing they'd convert themselves into the pretty notes that exist in my head.

Remembering a weeks worth of material is useless 2 weeks later when all that material has been replaced with new. Oh well.

Clearly, something has to change. I'm going to try taking notes directly in class next week, directly into ANKI. We'll see how that goes.

Also, I was at a fourth year party last night chatting to some wiser, drunker companions who were offering advice about the Dean and about studying. One bloke warned me on the dangers of review books and that I should keep my notes wide at the beginning. That I really should focus on all that the lectures encompassed. He also warned me on the dangers of starting a Qbank too early as I don't want to run out of questions (too late for that... Damn you overly excitable me!)

I understand his argument and while I do agree that it's important to learn all of the weeks dialogue (whether from lecture, lab, or PBL), I like the review books as they give me focus. I can't memorize all that each week contains, so what's the point of repeatedly studying everything? I don't know. There isn't a right answer at this point, but I'm going to move forward with trying to make my flashcards in lecture and focus a little bit more broadly than the review books.

Oh yeah, we get these 2 quizzes each week (an open and a closed book one). I think they're a great idea. My biggest complaint is that the answers are not described afterwards. There's no digest for why certain options are wrong. Also, I wish the quizzes were 10X as long or that there were 9 more of them we could take later. I've never really appreciated just how important practice questions are until recently. We're not graded, and so the questions they give us really are gifts to help us study. I guess I'm greedy. I want a bigger present. I want to know more of what I don't know.

On a lighter note, my boogie board, climbing shoes, and wok arrived recently. Time to hit the waves, the cliffs, and the kitchen! Oh yeah!

Rock on med school! Rock on!

Wednesday, August 15, 2012

First Impressions

So Med School has begun.

I've been looking forward to this for almost two years now. It still doesn't feel completely real.

As I write this, I'm not sure what exactly my intentions are for this blog.

  • Do I want to share my experiences with my classmates and friends? 
  • Do I just want to vent and let off steam privately? 
  • Do I want to encourage public discussion from the wider world as a whole?

I guess I'll just let this thing evolve as I go and start it off as a mix of self reflection, a description of what I'm doing, and an invitation for comments/suggestions (preferably not antagonistic).

It's Wednesday today, and we kicked off "real" school two days ago. Before that we had a week of orientation and before that we had a week of orientation to orientation (otherwise known as Prologue).

Before coming here, I'd already decided to give myself 2 weeks of fun. I would let myself eat unhealthy food, concentrate on meeting people and socializing, and not worry so much about the road ahead. That was 3 weeks ago. Now I'm in the midst of my planned "self-crackdown" and I find myself tired a lot. I came to med school, because I like interacting with people and I like learning from them. There are just so many new faces and stories to learn from. It can be exhausting. Exciting too! But exhausting. Exciting too! But exhausting... you get the picture.

We have these mini essays to write every week called "Learning Issues," given to us at our PBL "Problem Based Learning" sessions (Medicine loves its acronyms).

While I love the PBL environment (you piece apart what's happening to a mysterious patient through a group clue hunt), more and more I'm viewing the learning issues as road blocks to actually learning what I need to during the week.

I understand the intention of the instructors.

They want to teach us medical students how to research information on our own, how to teach ourselves for lifelong learning. But at this stage in our careers we know very little factual information. I'd much prefer to have a solid groundwork of medical knowledge to stand on and apply to the mystery cases rather than feel as if I'm sinking in quicksand while we frantically try and find the rope to pull us out before the end of the week.

Regardless, I've been keeping more or less on top of things. I'm lucky (or unlucky depending on how you look at) to have quite a bit of experience with biochemistry and genetics so I feel fairly confident when approaching these lectures or "murder mysteries." I'm also very grateful to have wound up with such a friendly group of classmates. Folks are so polite and friendly here.

My PBL partner and I meshed extremely well. Right after our PBL session we decided to make our way to a private room in the library and churn out the Learning Issue together. I think our strategy was quite good, so I'll repeat it here for fellow students if they'd also like to try something similar.

Goal: To churn out an acceptable LI in the shortest amount of time. It doesn't have to be perfect as our priorities lie elsewhere (studying other material).


  • Both partners sit at adjacent computers. 
  • Partners look up sources independently for 30 minutes on shared Learning Initiative topic. 
  • After 30 minutes, one partner dictates their favorite sources out-loud and converts them into "non-plagiarizer" sentences (what ridiculousness it is to dance around something so much that matters so little to us who are so small) while the second partner types all that is said.  
  • After the first partner is done, we switch roles until both are done. 
  • Finally add any interesting pictures and use pubmed or to generate AMA citations.
It helped to have such on awesome partner and friend to work with and in the end we finished everything in a little over 3 hours with minimal stress. I highly recommend the above method.

Finally, I'd like to comment on studying (but with an important proviso).
I've been getting asked by a lot of folks about what or how I'm studying, so I figured I'd post that here. I, like the rest of us, felt a little bit lost as to what was important and what could be left on the wayside. I feel that our administration is already giving us far too much material to read and as such are diluting it's total effect. (It's electronic organization also leaves something to be desired, but that's another story.)

My personal decision has been to go to lecture and absorb what they're telling me, but not to read all the suggested reading and instead study the relevant material that contributes towards the STEP exam.

Proviso - Our dean warned against heeding advise from your fellow med students because they don't know anything and don't have experience and he's quite right. I don't know anything or have experience. The following represents my best guess of a good plan to approach studying and is experimental at this point. 

Ok, so what a lot of folks have suggested to me is that in my second year, I buy a copy of "First Aid for the USMLE" ( and follow along in the book as I go through lectures. I've also been told I'll need to know pathology like the back of my hand (

However, both of the above review books are so concise and cryptic that I couldn't even begin understanding them at this point. So, I won't try. 

However, the folks who publish "First Aid" also put out a 2 volume set that contains the same "high-yield" testable material, but that is better explained and expanded. I've decided to study the relevant chapters from those books as well as from a more basic and better explained pathology review book. I'll follow along in these two books with lectures and take notes as necessary. 

The books I'm using currently can be found here:

So, since we're covering genetics this first week, I'd read the relevant sections in the "General Principles" book in the biochemistry and genetics section (there's even some pages on blood born genetic anemia's!). I'd also pop open the pathology review book and take notes on the genetic diseases chapter.

For notes, I've decided to try something new. I'm doing two things. 
1. Making a super condensed review sheet per week.
2. Taking the majority of my notes as flashcards. I use a program called ANKI to make these cards. It's neat, because I can make the cards on my computer and then view them on my iphone later. So I can study from them on the go. The program will show you cards that you get wrong more frequently until you get them right so it's good for continuous learning through a semester or year.

And, yes, I will share my cards with whoever in my class would like them.

Bare in mind, this is still all experimental. I'm not sure if this will be an effective way to study what's important. I don't even know what "important" is at this point. However, I do like how this limits the amount of information I have to learn. It gives me focus and puts the material I'm learning in context for my eventual board exam. I also like how review books get to the point instead of waffle around with needless details. I only have to pass my school exams and I hope that the lectures alone will allow me to do that.

We shall have to see if I keep this up or if it's helpful.

I wish the rest of my classmates who might be reading this well. Feel free to follow along, although I warn you I might spout off some personal thoughts through the course of this blog. Please don't take offense. The last thing I wish is to offend or upset anyone. 

Take care world!