Reflecting on 2019…Looking Ahead to 2020

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I just wanted to wish all my readers a happy holiday season and an exciting year as we enter a new decade!

For some of you 2019 may have been a tough year (I know it was for me!). I think it’s important to reflect on both the successes and failures. A review of the successes allows us to see what we did right, how much we have grown and reinforces where our strengths lie. A review of the failures (as painful as this can be) allows us to see where things may have gone wrong and what can be improved.

img_9398I love this simple lesson that I learned from one of my young daughter’s story books entitled “I’m Not Afraid to Fail”. The main character is a little girl who has experienced multiple failures. Her grandfather encourages her by saying, “but failure is fantastic….because each failure takes you one step closer to success!”

Success and failure means different things to different people but if there’s one thing that this year has taught me is that in those moments where I felt I had failed…those moments always taught me something important to hold on to for the future. There is always room for improvement. And the better we become at our craft, be it in medicine, business, education, art, music, parenting, homemaking or other pursuits, the more we provide better service to those we serve. And to me, that’s a success!

Whatever 2019 may have meant for you, whether good or bad, a new year is upon us with plenty of new opportunities! Seize them! Dust yourself off if you fall down…and keep going! Be the best you can be!

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Wishing you a happy and fulfilled 2020…from my family to yours!

Clerkship Updates: Geriatrics

I cannot believe 2019 is almost at an end! This year has just flown by! I just had an incredible rotation in Geriatrics. It consisted of 2 weeks on consults and 2 weeks managing patients on the Geriatrics wards or off-service units. There were also two 1/2 weekends on consults.

Geriatrics was challenging in many ways:

  1. Patients often have complex medical histories
  2. Patients often have varying degrees of neurocognitive disorder (dementia)
  3. Patients are often frail and at risk of falls
  4. Patients may have delirium which can be difficult to tease apart from possible underlying neurocognitive disorder
  5. Patients are dealing with many challenges such as incontinence which can be demoralizing for them. For some patients, continence may be their last act of independent functioning.
  6. Patients are often on multiple medications (polypharmacy) whose side effects can put patients at further risk of falls or delirium.
  7. Patients are faced with what we often write in the charts as “disposition”. Where will they be going next after being discharged from hospital? They are often too frail or dependent to go back home therefore may be facing the reality of moving to a residence or nursing home. There can be complex family dynamics as the details of this transition is worked out.

Despite the complexity of geriatrics, I found this to be a truly rewarding rotation as I developed close bonds with my patients and got to know some of them very well. I was really touched by some of the conversations I had with my patients and how much I learned from them. I worked with a fantastic interdisciplinary team and found the geriatric physicians to be extremely compassionate. I also developed clinical skills that will be very useful in my future practice as a family doctor.

I am now on my last rotation of clerkship! It is an elective in Allergy and Immunology and has been an extremely fascinating rotation so far! More details to come!

Featured image courtesy of Emory University School of Medicine

Clerkship Updates: Family Medicine Elective

I just spent an incredible month on elective at a Family Medicine clinic in my community. The clinic is comprised of 6 family doctors, some of whom have been practicing for over 30 years and who had a wealth of experience to share. The clinic also has several specialists who visit at regular intervals.

I felt that my clinical skills really grew during this rotation, and it was very rewarding to follow-up on the same patients throughout the month. My days were constantly filled with variety from baby well checks, to adolescent visits to elderly patients. I also had the opportunity to practice several procedures such a pap tests, skin biopsies, cryotherapy and minor surgery.

Like many of my rotations, there were days when I felt I had a good handle on things, and other days, when I was humbled and reminded that there is still so much I have yet to learn. This rotation served to further confirm my passion for Family Medicine and I am very excited at the possibility of practicing in my community in the future.

I recently submitted by residency application (yay!). I’m excited for this next phase of my training! The journey continues! Up next is a one-month rotation in Geriatrics. Stay tuned!

Clerkship Updates: ER, Endocrinology and Residency Applications

Time has just been flying by! After an incredible experience on my Palliative Care rotation, I went on to complete a month of Emergency Room Medicine. The pace was fast and challenging but was definitely a good learning experience. The month consisted of daytime as well as evening and night shifts. The skill that I felt I had the opportunity to work on most in the ER was to develop a logical, organized way of structuring a differential diagnosis for the most common, life-threatening conditions.

After my month in the ER, I went on to start a one month elective in Endocrinology which I will be wrapping up this week. I chose this elective because I felt it would be very useful for increasing my knowledge on conditions such as diabetes, dyslipidemia, hypo/hyperthyroidism and other endocrine or metabolic abnormalities that I am likely to come across often during my Family Medicine practice. It has been a good experience with my days consisting of clinic, wards and ER consults.

And in other exciting news, I have been working on my applications for residency and am making good progress. The application consists of various components including a personal statement, CV, and recommendation letters. Despite how stressful this stage of medical school can be, I feel remarkably at peace and am sure that everything will turn out for the best. Regardless of the outcome, I feel extremely grateful for all the blessings in my life and thank God for his faithfulness!

I am really looking forward to the next month of clerkship which will be a Family Medicine elective in my community. Stay tuned!

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Beautiful Fall day with my munchkins

Featured image courtesy of healthcatalyst.com

Clerkship Update: Palliative Care

I had an incredible experience on my palliative care rotation. Going into it, I wasn’t sure what to expect. Whenever I informed people what rotation I was in, many wrinkled up their faces and said, “Ooh, it’s got to be depressing being around so many dying people”.

I have to say that my experience was quite the opposite. It is a different way of practicing medicine. Rather than focusing on curing a patient, one is focused on making them as comfortable as possible as they navigate the last months, weeks, days, hours and seconds of their lives. I found it a true privilege to accompany people on this journey.

I very much enjoyed how much time I got to spend with each patient and their families on a daily basis. It was certainly never easy discussing a short prognosis but in some ways, families found relief in having an idea of their loved one’s trajectory and in knowing they would be kept as comfortable as possible. The main things that impact heavily on dying patients, particularly in the context of terminal cancer, are pain, nausea, lack of appetite and a progressive sense of loss as they decline in function. Although it can be  difficult to do much about the loss of function, it is staggering to see how much better a patient feels when their pain and nausea can be controlled.

On this rotation, I worked with an excellent interdisciplinary team of doctors, nurses, social workers, PABs and art therapists.  I was truly inspired by their dedication and compassion for our patients.  I certainly struggled with my emotions when I lost a patient (which was almost on a daily basis) especially seeing the profound impact on the family members left behind. I truly treasure the meaningful connections I had with patients and their families on this rotation.

I also had the opportunity to participate in home visits. There was something especially touching about being able to go into a patient’s home and deliver care to them in an environment where they feel most at home.

Overall, my palliative care rotation was one of my best experiences in medical school. I encourage medical students out there wondering what electives to take to strongly consider taking it. It will change your perspective on life.

As my fourth year of medical school continues, I feel my confidence as a doctor-in-training progressively growing. There is still so much to learn of course. One of the great things about medicine, is the challenge of constantly growing and learning new things. As I ponder the current stage in my training, I am so grateful to be on this path to becoming a doctor, as difficult and challenging as it can be.

Featured image courtesy of https://www.medstarfranklinsquare.org

Summer Vacation Updates…and the Start of 4th year!

The summer is just flying by! I had a wonderful month of vacation in July.  The highlight was a trip to West Virginia to visit my cousin and his family. We were so touched by their hospitality. They totally spoiled us!

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12 hour road-trip to West Virginia

The 12-hour drive  from Quebec to West Virginia was spectacular. We took the scenic route through the Adirondack park in New York. I was impressed with how well the kids did on this long trip. They were excited to be the first to spot several deer as we drove by impressive rocks chiseled into the mountainside.

Our drive took us through Pennsylvania before we finally arrived in beautiful West Virginia. We spent most days poolside enjoying the beautiful weather with our nights perched on stools around the massive granite kitchen counter having hearty conversations covering all kinds of topics. I was especially happy to tinker on their beautiful grand piano majestically displayed near the fire place in the living room.

One particular evening, the adults had a night out on the town eating creole cuisine in a cobble-stoned square bubbling with vibrant music and laughter. The night ended with spectacular Tango music presented by the Pittsburgh Symphony Orchestra. The exquisite skill with which the musicians displayed their talents gave me goose-bumps!

The kids had plenty of new experiences, trying out jet-skis for the first time and painting pottery. As we neared the end of our vacation, we hiked up to beautiful Cooper’s rock where massive green rolling hills outlined the horizon, with crystal blue waters snaking through the leafy backdrop. It was truly a fantastic, refreshing trip!

In early August, I had the wonderful opportunity to join 10 other musicians on stage at the Hudson Music Festival where we belted out a variety of Contemporary Christian tunes. My Yamaha keyboard (nicknamed “Mahaya” and given to me by one of my best friends 13 years ago) did not disappoint! It has been one of my dreams to perform with a band in this context and it was an awesome experience with an enthusiastic audience!

After a challenging year completing my third year of medical school, I feel so blessed to have spent such precious time with my family and friends! I am now 2 weeks into my fourth year of medical school, having an incredible experience on my Palliative Care elective rotation. More details to follow soon!

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Soaking up the sun in West Virginia

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Ready to conquer the world!

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More relaxation!

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Precious family time…beautiful Cooper’s rock, West Virginia

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Ready for a dip in Horseshoe Lake, St-Agathe-des-Monts, Quebec

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Canoe-ride with daddy, Horseshoe Lake, Saint Agathe-des-Monts, Quebec

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Summer fun…and static electricity!

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Exploring the woods, Saint Agathe-des-Monts, Quebec

 

Third Year of Medical School…Done!

I can hardly believe that I am done with the third year of medical school! Despite the ups and downs, I am very happy with how much I have grown and learned during the course of this year.

These last 2 months, I have been busy with Internal Medicine Wards and Surgical Subspecialty rotations (Urology and Vascular Surgery). They were hard work but also a great learning experience overall!

All my electives for fourth year have been booked and confirmed (Palliative Care, Endocrinology, Family Medicine, Clinical Allergy and Immunology).  I will also be doing my Geriatrics and Emergency Medicine rotations during fourth year.

Now is that time of the year when we start thinking about the residency match! I cannot believe that this time next year, I will be starting residency! (As a recap, my plan is to apply to Family Medicine which I am very passionate about!)

For now, I am looking forward to the next month which is a month of summer vacation. I am excited to spend more time with my hubby, kids, extended family and friends. I am so grateful for their support and encouragement through this past year (which was undoubtedly, one of the most difficult I have encountered!). I thank God for the strength and grace He gave me throughout the year!

Thank you to all my readers for continuing to follow and support my blog. It is always appreciated!

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Breakfast on the deck, beautiful sunshine, birds chirping and a cute bunny skipping through the grass!

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Residency match timeline!

Clerkship Update: Internal Medicine and General Surgery

Clerkship updates! It’s been a busy past few months! I completed one month each of Internal Medicine (CCU/ER consults) and General Surgery.

What I enjoyed the most

I really enjoyed doing consults in the ER because I felt it really allowed me to hone my history taking and physical exam skills as well as come up with management plans. I met so many interesting patients and learned a lot from the fantastic staff and residents I worked with. In General Surgery, I had the opportunity to become more comfortable in the OR (I was initially terrified of going in there!) and practice useful skills such as inserting foleys and suturing incisions. I also had the opportunity to participate in laparoscopic surgery by assisting with guiding the camera, which was fun! I also developed a new appreciation for how difficult it is for patients to undergo surgery: the anxiety before surgery as well as the sometimes excruciating pain and post-op recovery.

What I struggled with the most

Internal Medicine and General Surgery have definitely been the most demanding in terms of work hours and I sometimes felt like I was floundering. I had managed to keep my mindset positive and motivated during my previous rotations but for some reason, I had moments of doubt and anxiety over the past few weeks which I can’t fully explain. So, I sat myself down, worked through my thoughts, prayed, and confided in family and friends about my struggles. I have emerged stronger and more motivated!

My take home message

Internal Medicine and General Surgery are great specialties despite the long hours. They each bring different perspectives and add richness to one’s medical training. The past few months have reminded me how important it is to guard one’s thoughts and to rely on others when we feel weak and downtrodden. Despite the challenges, I am excited to be pursuing a career in medicine and thank God for his ever abundant blessings in my life!

Featured image courtesy of BM Hospitals

When the Fog Lifts

The other day, I was on my daily commute to the hospital for one of my clinical rotations. The train chug chugged along and as it neared one of two bridges, I turned my head expectantly to view the expansive water and distant hills. But on this particular day, the view which I have come to treasure, was blanketed by an unrelenting fog. I could see absolutely nothing outside of the window. It was a disconcerting feeling. What was happening behind the fog? When would the fog lift? As the train made it to the other side of the bridge, the water and hills left behind, the fog gradually lifted, trees and buildings slowly appeared and my view of the outside world became crystal clear once again.

This two minute experience got me thinking about how similar life can be to this event. There are times in our lives when our path forward is clear. We can feel confident enough to proceed on our journey. There are other moments, when things become less clear, our confidence may become shrouded in uncertainty and we wonder where has the path disappeared to? One thing I do know. The fog eventually lifts, and we will see clearly again. It just requires patience, determination and the will to never give up.

I recently completed my second Psychiatry rotation and have just completed my first 2 weeks of Internal Medicine. Both have been great learning experiences with amazing staff physicians and residents. On some days though, I feel truly tired. I wonder if I have the strength and ability to become a good doctor. Or I struggle to balance medicine with family life. Doubts try to creep in. But I also feel so grateful to be in a position to help people so directly in their moments of crisis, illness or fear. It truly is a humbling and privileged position to be in! And even on those cloudy, unclear days…the fog eventually lifts!

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View from the train in winter-time

Featured image: View from the train in summer time, late evening (potentialdoctor.com)