November 6, 2017

“Someday, one of your patients might be me. So study hard!”

Filed under: "Me" updates,Med School and the MSTP,MS-3 — sanguinemare @ 3:15 pm
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Today, I happened to be off shift (I’m doing my Emergency Medicine elective right now), so after lectures this morning, I went to the Military Medicine Interest Group’s talk on Navy Medicine.  A DNP (doctor of nursing practice) told us a little of his experiences in the Navy and in Iraq, and showed up some pictures about the medical set-up and such they had there.  But what really stuck with me was what he closed the talk with, which I’ve put as the title of this post: “Someday, one of your patients might be me.  So study hard!”

I think as a medical student, you do sometimes lose sight of the bigger picture a little bit while you are trying to learn what you need to medically relating to whatever service you’re on, and meanwhile also navigate the hierarchical structure without overstepping your boundaries (since different attendings and residents have different levels of interest in teaching/interacting with med students, and in some services, you have a lot more turnover in who you’re interacting with than others.  For example, on Emergency Medicine, it’s almost a new resident and/or attending every single shift.)  It’s not really that one doesn’t think about the patients themselves, but I think partly because we aren’t allowed to do a lot of the aspects of actually doing anything for the patient directly (putting in orders for medications, consults, etc, or even writing notes on some services), sometimes one can feel somewhat impotent and not very useful, either to the patients or the residents/attendings for whom one is supposed to be helping on a team.

I think that’s the biggest issue I’m having right now in EM actually, which is that since we’re often not allowed to do much, depending on who we’re working with that day, and particularly when all the rooms are already full by the beginning of the shift with work-ups mostly done and just waiting for a room, I’ve felt like I’ve done the least out of any service I’ve been on so far.  The residents are nice and say that me seeing a patient and giving a quick H+P actually is useful, but sometimes it’s hard to see whether I’m making any difference in that situation (though I have definitely helped push to get some psych patients admitted for suicide ideation and other issues when they seem they might have otherwise been written off… and in part that’s because our hospital seems constantly overflowing with people with psych needs – something I could write a whole entire post about in itself).  Suffice to say that it’s sometimes difficult to be motivated to even learn more when one feels like they aren’t really able to contribute.  But the quote from the end of today’s talk was a good reminder.  We’re training to be doctors who will be the ones actually responsible for people’s lives someday.   And as a physician, people will look to us for answers, and we’ll be the ones making the important decisions for their healthcare and ability to live good quality lives.  So it’s important to forge ahead, study hard, and learn as much as we can, so that when we are someday on our own, we will know enough to take good care of our patients.

Also, my apologies for the sporadic updates – most of the rest of my surgical rotation (through mid-October) basically left me so exhausted by the time I’d get back that I’d literally get back to my place, get in a quick shower, and decide to get in a “quick nap”… and then end up waking up sometime around 10pm-12am being very disoriented, decide whether or not I’m hungry enough to get something to eat, and then plopping right back to sleep.  So I pretty much actually did not start studying for the surgery shelf exam until literally 2 weeks before the test.  Thank goodness I had medicine before surgery because otherwise I probably really would have failed that.  (They say the surgery shelf is mostly medicine and not surgery.  They are absolutely correct.  In fact, even though they say there’s a lot of trauma and GI on the test, there was basically almost nothing relating to almost anything I saw on either of my three services I rotated on surgery, which included trauma surgery, orthopedics trauma, and acute care surgery (mostly appendix issues, gallbladder issues, or small bowel obstruction).  Sigh.)  I did, however, do a little more digging to understand the shelf scoring system because I also really felt like I failed this shelf if we were going by raw score standards too, but still somehow managed to pass.  So apparently the shelf score is actually not a raw score, but based on how students have done on the test in the past.  Here are some of the NBME’s answers about shelf scoring from the AAMC in 2013.  Additionally, here’s an explanation by benwhite, who is a physician in Texas according to his website, which I found helpful.  Luckily, I don’t have a shelf to study for during this current elective, so it’ll be a good time to catch up on all those USMLE medicine questions I never got around to!  (And to also finally get my eyes examined… I developed some strange eye infection during my first week or so of surgery, and it’s continued to reoccur throughout the last 2-3 months, even after stopping use of my hard contacts.  Finally got a time scheduled with an ophthalmologist today for Thursday, so hopefully we can finally get to the bottom of it!  This is the one time I hope my symptoms will still persist until then instead of being in one of its minor remission stages so they can figure it out, haha.)  Wish me luck!

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