Thursday, May 26, 2011

Week of Lasts

It has certainly been a week of "lasts" as my 2 years of basic medical book learnin' draws to a close. As someone said in my PBL today, it has been kind of anti-climactic. Which, to a certain degree, it has. Mostly I think it is because the crushing stress of finals coupled with the looming USMLE has most of the Canadians in my group nervously fidgeting and mumbling, "yeah, feels great?"

Regardless I am seeing that these two years have whipped by at almost criminal speed and on Aug 2nd I will finally be able to set foot in a hospital again. With nurses, and doctors, and receptionists, lab techs, and....wait for it...real patients!!! I actually like the smell of hospitals. I like the throb of controlled chaos. I like making terrible tasting coffee at 3am. So naturally I am looking forward to heading back into the fold, as a lowly medical student.

To start, last Friday was our last clinical skills session. I capped the session by letting one of the girls start an IV on me and I am pleased to discover (again) that IV's actually aren't that bad (though I know I am blessed with my non-sliding-minimal-valve-garden-hoses).

Now turn your head and cough. wait...

Next up was our last lecture. The school kindly decided to round out our two years in pre-clinical work with a 2h afternoon stats lecture on SPSS. If I ever have to go through something like that again, can someone please just take me out back and slowly stab me to death with a 24G needle. That would be more enjoyable. To be fair, though, I actually greatly admire our stats prof. She is a brilliant statistician, for starters, and a big supporter of the medical research here at the University. She knows we hate statistics and that we are rubbish at it, so she's designed the course very specifically to make us critical interpreters of medical articles. WIN. That is all this girl wants!

'Twas the night before collaboration
Last night I didn't quite finish all the homework for our last PBL session. I figured it just wouldn't be right to break from tradition and not scramble at 0630h the next morning to get all my prep work done. [To the uninitiated PBL is problem based learning which means as a small group we work through case studies together each week, come up with what we don't know, and learn it on our own (or as one prof put it, PBL means if you don't understand a concept it's your problem, not mine). Then we reconvene 3 days later and the group discusses all the unknowns. It is a great way to learn, I think, but at this stage of the game everything feels like a scald. Give us patients!! ]

The thing I have found very challenging is not remarking everyday, "one the hospital..." because for almost every case we've done I've had some experience in the ED with the exact condition. Sometimes I've cursed not doing a more specialized type of nursing so that I'd be going in with a deeper understanding of...something...ANYTHING!! But I must say, the ED background is good for being able to think, "yeah, I have seen cases of [malaria, spousal abuse, anti-freeze poisoning, full thickness burns, heart attacks, bulimia, insect bites,  allergic reactions, amputations, strokes, sore throats, intussusception, gout]...once and..." I may not know much about anything, but at least I have a vague notion about how condition's look when they rock up to the emergency department's sliding doors.  I tried hard (and failed many times, I am sure) to not be the annoying person in the group who had an anecdote for every medical condition that came up. Patients faces are still so fresh in my mind though, especially for certain was hard to not reminisce.

Bubbly + Learning = awesome
There was cause for a celebration this morning I tell ya. As we wrapped up the last case I popped the cork and went about divvying up a small toast of bubbly for everyone. Normal people would have probably gone our for beers at the end of an era like this, but students who are facing final exams and boards are not normal people. The real cork popping is 2 weeks away still (for some) and 8 weeks away for others (like myself who doesn't really get to shake it up until the USMLE is in my rear-view mirror). That said, I will be sending up a few woots on the 10th of June.

Workin' in a coal mine...goin' on down down...
So this was our final clock-out. Yeah, you read me right: clock out. Due to some major truancy issues in the year ahead of us the school implemented a biometric clock in system, wherein we'd have to clock in and out for every clinical skill lab and PBL class. Only 4 clinical skills or 6 PBL classes could be missed for the entire year. Needless to say the whole process was met with major resistance. The thing that killed people was that if you forgot to clock in, even if your tutor told the school that you were indeed there, you were marked as absent. I avoided the town-hall-pitchfork-esque meetings on the whole issue and just went to class. I figured the schools solution was a bit extreme, if people are skipping tutorials it is their problem. Hospital reality will come crashing down upon them soon enough.

Ryan sticking it to the man with his compliance.
I wish I could say something profound or touching about where I am at today, but to be honest I am just feeling sleep deprived, stressed, and very inarticulate. Classroom work has just started to feel like a distraction from the pressing volume of information I have to review from the past two years. TWO YEARS. It is cruel and unusual to test someone on curriculum from that far back, as far as I am concerned. Especially us old folks, our brains are hard and crusty...information just doesn't stay in there like it used to.

Bottom line: nearly there. Pre-clinical years will be behind me soon enough, and a whole new set of hoops shall appear. 

Back to the books for me.


Grumpy, M.D. said...

Good luck!

Grumpy, M.D. said...

I can't fucking believe they made you clock in & out of class. I once went several weeks without going to class in med school, and got a hell of a lot more done from home than I ever did in class.

Albinoblackbear said...


I was mostly irked by the fact that I had to attend clinical skill sessions on taking BP's, doing EKG's, IV cannulation, measuring blood glucose etc. That was an eye-poking waste of time for me.

NPO said...

Hospitals, yes the smell of cheap coffee and c-diff in the morning, you can't beat it.
I laugh thinking of how you ask and get those pictures of you with the mock patients?

Albinoblackbear said...

NPO--I know it is weird, I actually thought I must be the only person to ever say that. Turns out my good friend Erin feels exactly the same way, I was relieved when she told me that this spring! =)

Hahha, it isn't a fake patient, just Ryan allowing me to manhandle him while practicing my mad'peripheral pulses' skillz.

PGYx said...

Apparently many schools have implemented a tracking system to ensure people go to lecture. My PBL curriculum was much more flexible but over two years I don't think any of us missed more than 2-3 sessions as we were such a small group and the schedule was so friendly (MWF 9-12).

Glad you will be in the hospital soon! Hope the study is going well and completely agree that during board study class requirements feel like counterproductive distraction.

OMDG said...

You had to CLOCK IN???? I would have been so livid! You're not in kindergarten for Christ's sake.

Congrats on all your lasts!

Anonymous said...

Clocking in? Wow.

And as for chiming in, I actually found the opposite problems in my groups. The person who used to work in healthcare (nurse, lab tech, etc) was immediately branded:
1) Wanting to do whatever field they just came from (OR nurse - surgeon; lab tech - medical microbiology)
2) The de facto expert on any and all clinical presentations. (Or, as the phrase that used to make my skin crawl went, "Maybe Karen can tell us based on her clinical experience, what you would see in [esoteric thing A]

And congrats! Kick some ass in the hospitals!

Anonymous said...

I have had to deal with those "clocks" in hospitals for the efficacy of keeping track of times for paychecks - but for University??? That is absurd.

James said...

Good luck studying. Just try to remember that while it's a bitch, it's doable. Everyone who has come before you has passed this exam, so you will too.