Sunday, June 23, 2013

Sage Advice

When I was little and people asked me what I wanted to be when I grew up I said "a doctor".

It wasn't until I started medical school that I realized how non-specific of an answer I was actually giving people.  Doctor.  Internist (I didn't even totally understand what that meant until M1 year)? Pediatrician? Surgeon? Pathologist? Orthopod? Psychiatrist? Family doc? Not to mention advanced fellowship training . . . cardiologist? intensive care doc? allergist? neonatologist?

The list is literally endless.

I've always had an inkling about what I thought I wanted to do.  I wanted to be a pediatrician--or so I thought.  It then occurred to me that this was likely because for the first 18 years of my life, literally from birth to adulthood that was the only physician I had ever seen.  Naturally thats what I thought I wanted.

When I started medical school I thought it was imperative to keep an open mind, there are fields of medicine that exist out there that I have yet to even discover as potential careers.  As a medical student prior to clerkship years how can you possibly already know what you want? Granted there may be those few who since birth have known what their one true passion is, what about the rest of us?

I'm itching to start my clinical years and put the pre-clinical years and step 1 behind me and forage ahead into the world of medicine.

I had the opportunity to spend some time shadowing in the NICU (neonatal intensive care unit) and struck up conversation with one of the Neonatology fellows.  One of my favorite questions to ask of people above me in the totem pole is "When you were in my shoes, what was one thing you wish you had known?"  He gave me one of the best single lines of advice I think I have received in all of medical school thus far

"Don't look at the fellows or the residents, we are all exhausted.  Look at the attendings.  Could you see yourself doing what they do for the rest of your life? Do you like them?"

So simple and in some ways so incredibly obvious.  I hadn't really considered things from that perspective, the one that lumps medical students in with residents and fellows.  Really its just a extension of the education spectrum.  They're still in the grind, they've got their eyes on the same prize as us.  Being a real doctor.

Maybe though when I finally reach attending status I'll be able to look back and chuckle and realize its not all that different on the other side.  Until then I've got my eyes peeled.

Thursday, June 13, 2013

May The Odds Be Ever In Your Favor


REWIND: My alarm was blaring, it was 5:30, I needed to get up. I felt around my nightstand for my glasses and grappled to put them on my face. Todays the big day. I trudged my way to the bathroom and took a quick shower--a burst of hot water propelled me further into wakefulness.

As I got dressed my mind was racing. It was racing with all of the last minute things I forgot to look up. I quickly ran to my desk and flipped to the equation section of First Aid. Waves of panic washed over me in a rhythmic beat. Clearance. Loading Dose. Maintenance dose. Renal Plasma Flow. Glomerular filtration rate. Inulin. PAH. As I scribbled those down to look over on the ride to the testing center my mind came to a screeching halt and starting leading me down another corridor of confusion. P450 inducers? What were they? Phenytoin, Rifampin. P450 inhibitors? Grapefruit juice. There are more, where is my mnemonic? I raced to the page where I knew I had scribbled a helpful note in the corner. Glancing over the list a momentary sense of relief, I knew them.

Flipping through the pages of first aid at every turn I felt like I was sinking. Did I remember the material? I don't know. My roommate was somewhere in the background packing a lunch and calmly getting ready. I'm not that person. I can't stay calm in those last moments and hand the reigns over to fate, not just yet. I believe in cramming till the 11th hour. Some people say you know what you know. I whole heartedly disagree. How many times on an exam are you searching for just that one little tidbit? Sometimes I find that little tidbit floating in the ether of my mind because I happened to see it as I unceremoniously shoved my notes into my bag before entering the exam room.

The exam itself was quite a marathon but in all honesty I don't even know where the time went. Not to say that I was completely rushed and racing the clock, but it didn't feel quite as long as I was expecting. It was tiring and long and at certain points I felt downright bored.

I did what I could to prepare, based on what I had seen and heard. Uworld? FA? Goljan? Pathoma? Pharmcards? Microcards? CMMRS? Rapid review path? So many resources and so little time.

The step 1 was like no other exam I have ever taken, I don't even know how many questions I answered with 100% confidence. I hesitate to share my study plan until I receive my score.

I set my goals high at the start of all of this, I walked away from that exam hoping, begging and pleading the universe for a pass.  Walking out of that exam felt very much like the end of the road for some of my hopes and dreams but nobody walks out of that feeling like a million bucks.

Stepping out of my testing center and onto the busy sidewalk I was again struck by the realization that it was only my life that had been on pause for the last month.

I'm really hoping that somehow Effie Trinket's words ring true for me, but until then I'll be holding my breathe. (I apologize for the Hunger Games reference, but I had to, I can't say taking the step 1 is all that different than being thrown into the arena)

For now I'm shifting my focus to gearing up for clerkships.  Ready to hit PLAY again.