Clerkship Update: OBGYN reflections and tips

It has been 3 weeks since I started clerkship and it is going very well so far. I started off with Obstetrics/Gynecology outpatient clinic where I had to give two presentations on cases I encountered during the rotation. I was also exposed to various diverse clinics:

  • Obstetrics: following pregnant women at various stages of their pregnancies, interpreting prenatal screening tests, measuring fundal height, finding the baby’s heart beat with doppler ultrasound (one of my favorite parts of this rotation!) and taking GBS samples
  • Gynecology: managing endometriosis, menorrhagia, performing pap tests and colposcopy
  • Gynecology-Oncology: managing patients undergoing treatment for ovarian cancer
  • Diabetes: managing pregnant patients with Diabetes Type 1, Type 2 or Gestational diabetes
  • Fertility clinic: managing patients trying to conceive via IVF or IUI.
  • Ultrasound: observing the routine ultrasounds for pregnant patients performed at 12 and 20 weeks of pregnancy as well as measuring nuchal translucency.
OBGYN 2
Photo credit: parentmap.com

My reflections on this rotation: I found this to be a generally fast-paced,diverse environment with plenty of opportunities to do some procedures.

What I enjoyed most: I very much enjoyed the patient contact and sharing the joy of pregnant mothers awaiting the arrival of their little ones. I also enjoyed the clinics where I had the most autonomy to interact with patients on my own. My favorite clinic of the rotation was without a doubt Obstetrics!

What I struggled with most: There was a steep learning curve as I generally only spent one day in each clinic and every clinic runs differently. I had to learn to adapt quickly.

My take home message: I  learned so much from this rotation and felt that I improved in my history-taking and charting skills. I will wait until my OBGYN inpatient rotation to make a final decision about choosing this specialty but on a scale of low-medium-high, I would put Obstetrics and Gynecology as a “low” because I have much less of an interest in Gynecology than Obstetrics and there are alternative routes to practising Obstetrics (more on that later!).

My coping strategies on rotation:

  • I have a 2.5 hour daily train-commute which can be exhausting but I am using this time to study, read my Bible, decompress after a long day and also to read other topics/books that are of interest to me.
  • I make use of technology to stay in touch with my family and keep connected. For example, since I have to leave very early in the morning before anyone is awake, I Face-Time my hubby and kids every morning once I arrive at the hospital so I can see their adorable faces before I start my day. This is so energizing for me!
  • I have some prayer time during my 10-minute drive from my home to the train station (and on the way back as I reflect on my day). This plus reading my Bible on the train daily has kept me in a very positive state of mind despite feeling physically exhausted.
  • I aim to complete my reading/studying on the train so that once I am home, my focus is fully on my family.
  • It is challenging to find time to exercise so I wake up 15 minutes earlier every 2 days to have a short workout and then have my longer 35 to 45 minute workouts on the weekend.
  • Stay well hydrated and fed throughout the day. I carry granola bars in my white coat pocket or scrubs and carry around a bottle of water when feasible. This does wonders for your energy levels!
  • I had one particularly bad day last week where I felt extremely tired and did not feel my performance on rotation that day had been good at all. We have to remember that despite the really difficult days, there are better days to look forward to and it is all part of the learning process as we hone our skills.

I am currently on rotation in the Neonatal Intensive Care Unit and it has been both challenging and fantastic! I can’t wait to share with you my experiences on this rotation over the coming weeks!

Feature image photo credit: advocarepremierobgyn.com

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Gratitude: Appreciating the Big and the Little Things

One of the things that I wanted to improve on from my last year in medical school was learning to slow down and appreciate the little things around me. I loathed the fact that mornings were rushed and it seemed like we were always ordering the kids around and rushing them out the door. With better time management and changes to our parenting approach, the mornings during the past week have been beautiful. I know that not every morning will go smoothly but I am simply grateful for those that do. This morning I felt grateful for 4 things:

  1. Brushing my little girl’s hair: I had dreamed of doing this ever since I was a teenager. After my first pregnancy ended in a traumatic miscarriage, it sometimes seems like a dream that both she and my son are actually here in my life.
  2. Getting hugs from my dear son: As I was getting things ready this morning, my son suddenly stopped me and said, “Mummy, I want to do something”…he then enveloped me in a deep, long hug. Moments like these make the challenges of motherhood seem more than worth it!
  3. Being in medical school: As I looked over the voluminous material I need to learn over the next few weeks, I simply sat back and drank in the fact that although it’s a challenge, I am doing what I have been wanting to do for so long…and I love it!
  4. My Heavenly Father: I love the scripture in Psalms that describes God as a “Father to the fatherless” and a “Defender“. Having lost my father unexpectedly when I was 5 years old, I truly have seen God be a Father to me through the years. Despite the ups and downs, He has always been there for me. He is my hope and everlasting peace!

Take a moment to stop and reflect. What are you grateful for today?

Featured image courtesy of versiondaily.com

When Striving Towards Your Goal Feels Like a Marathon

There is no doubt that medical school sometimes feels like a marathon. There are moments of high energy and exhilaration. There are also moments when we feel like we are running out of fuel. The pace is fast, intense and requires consistent focus. If there is anything I am learning, it is absolutely necessary to take moments to slow down, reflect and catch our breath. Why are we doing this in the first place? Do we still have our eyes on the finish line? Are we taking time to enjoy the scenery as we run the race?

This week I felt exhausted from all the demands of medical school and family life. I woke up this morning feeling mentally and emotionally tired. I went before God in prayer asking for strength that only He can give. As I opened my Bible, I came across verses that immediately encouraged me and reminded me that it’s ok to feel weak sometimes. It’s ok to fall on our knees, hang our head and call out for some help. In that moment, we just need to take stock of the attitudes permeating our hearts and minds, and lift our head back up to keep our eyes fixed firmly on our prize. We will get to the end of the race and reach our goals in due time!

Be strong and courageous. Do not be afraid; do not be discouraged, for the Lord your God will be with you wherever you go.” Joshua 1:9

I press on towards the goal…” Philippians 3:14

Be joyful always, pray continually, give thanks in all circumstances” I Thessalonians 5:16-18

Photo credit: http://www.towpathmarathon.net/

Highlights and Lessons Learned from the Second Month of Medical School

The second block of medical school is complete! We just spent the last 5 weeks learning about lung structure, function,  diseases, diagnoses and treatments, interspersed with a few lectures on clinical method, epidemiology and genetics. My favorite parts of this block were the anatomy and histology labs, and learning how to interpret chest X-rays and CT scans. We also learned the basics of how to perform bedside ultrasound. I love how hands-on the curriculum at my university is!

In mid-October, I had the wonderful opportunity to shadow a pathologist and two pathology residents for half a day and I loved it! The atmosphere was very welcoming and I was allowed to sit in on some cases at the microscope. Fascinating!

During one of my clinical sessions at a private Family practice, I got to perform my very first physical examination on a patient. I was a little nervous at first (especially since I have very cold hands) but the patient was very gracious as I stumbled along trying to figure out how to use my stethoscope and the blood pressure machine.

My final exam on this block was tough but I felt good about it overall. The week before the exam, I started to recognize signs in myself of feeling a little burnt out so I took a break from studying and went for the women’s fellowship at our church during the week. It was so rejuvenating to exercise with the ladies, chat and study the Bible. What I was challenged about most was resuming my daily devotional time with God (particularly first thing in the morning). I have to admit that with the busyness of school and  family, I have not been as consistent with my quiet time. I was reminded how important it is to have daily reflective time alone to recharge and gather my thoughts! Whenever you suspect that your life may be going out of balance, acknowledge it and try to address it as best you can. Medical school is demanding and it’s important to take care of your emotional and spiritual needs too.

The other item that challenged me during the bible study was to reflect on what things I can improve on in my character. There is always room for improvement. For me, the 2 areas I would like to work on are patience (particularly with my children) and humility (it is important to remain teachable, humble and remember that every person is valuable).

As I start Block C of medical school (Circulation), I am so grateful for all that I have learned during the past 2 months! It’s been both challenging and fantastic!

Each Day is a Gift

One week left to medical school! I cannot believe how fast the summer has gone by! I have really enjoyed spending time with my family and watching the kids grow. Some of the things that I was reminded of this summer was how important it is to appreciate each day and to let those you love know how much you care about them. Each day is truly a gift!

I have found that taking stock of each day and meditating on what I have to be grateful for helps to temper the worries and frustrations of day-to-day life. Three things I read or heard this past week also gave me pause for thought:

  1. Let those you come into contact with feel that they are important and worth something: In the book God’s Hotel by Victoria Sweet, a California-based physician tells her story of practicing medicine. One of the hospitalized patients was a woman who was on her death-bed. When Dr. Sweet asked what else could be done for her, the patient simply asked for something different to eat at her mealtimes and to have new eyeglasses since her current ones were broken. I can imagine that the physician was taken aback by this simple request that meant so much. Sometimes we may feel that we cannot make a difference but there is always an opportunity to show appreciation even if it means asking a simple question or demonstrating a caring gesture.
  2. Forgive from the heart: In Matthew 18 of the Bible, Jesus depicts a vivid parable of a servant who owes a large debt to his master and another servant who owes a smaller debt to his fellow servant. The  master forgives the debt but the servant shows no mercy towards his fellow servant. Jesus explains the consequences of an unforgiving attitude and implores his listeners to forgive from the heart. Jesus’ choice of words touched me because ‘forgiveness from the heart’ to me implies a deep, complete and unshakable forgiveness.
  3. Prioritize your life: I had an inspiring chat with my oldest brother who is a pediatric cardiothoracic surgeon based in Kenya. As I spoke with him about how he manages balancing his career with family, his words of wisdom rang true: prioritize your life. For him that meant 1) God 2) Spouse 3) Children 4) Career. Of course there are plenty of other things that make up our lives such as our social life and hobbies but often our family life and work are the most difficult to balance. Priorities mean different things to different people but having an idea of what comes first and what we are not willing to compromise on can guide us when trying to navigate the busy waters of life.
Family picture August 2016
 So grateful for my precious family! Each day is a gift!

Crossing the Bridge of Forgiveness

Today marked the fourth week of our study on the “40 Days of Love“. This week’s topic tackled the challenging issue of demonstrating love through forgiveness. We have all experienced hurt in our lives in some shape or form and it can be so difficult to get past it, to forgive and move on. What does forgiveness entail?

As difficult as this can be to do, especially when we are going through hurt and disappointment, forgiveness means letting go of the desire to get even, responding with kindness and not keeping a record of that wrong. The hardest part about forgiveness is that we are called to keep on forgiving even when the offense is repeated!

Forgiving is NOT minimizing the seriousness of an offense. In choosing to forgive someone of a wrong, we are not saying that what they did was of no consequence or was justified. The pain is real and it’s important that this is acknowledged. Once we have forgiven a person, what’s next? Candid communication, willingness to change negative behaviors and time are needed to rebuild and regain the trust of the person who has been hurt.

I am learning that forgiveness is a decision. We decide to move past the hurt and avoid falling into the trap of resentment and bitterness. In looking through the lens of forgiveness, we actually begin to see the hurt that the other person is going through. When people lash out or hurt us, they are often going through something difficult themselves, which gets taken out on others. Part of the healing between both parties is acknowledging the hurt on both sides, letting it go and moving towards reconciliation. This can be very difficult to do in some situations, but vital to the healing process.

Why forgive? Aside from the release and freedom it gives our souls, it shows a humility that we too are imperfect and need forgiveness.

Week 4 Challenge: Is there someone who needs your forgiveness? Try to work towards letting go of any resentment or bitterness towards that person.

“Love…keeps no record of wrongs” 1 Cor. 13: 5

“Love your enemies, do good to those who hate you, bless those who curse you, pray for those who mistreat you…” Luke 6:27-28

“Bear with each other and forgive whatever grievances you may have against one another…” Col. 3:13

 

 

Loving People Enough to Tell Them the Truth

Today began the third week of our study on ‘40 Days of Love‘. Today’s topic was one of the most challenging topics so far! How to have a loving confrontation…to speak the truth in love. I am personally not a confrontational person. I prefer to keep the peace and not rock the boat.  But I have been reminded that love is not just about warm feelings or happy smiles. It is also about facing hard truths and being able to impart that to someone else in a respectful but honest fashion.

How does one approach someone in order to tell them a difficult truth? It is certainly a scary proposition. We may worry how our message will be received, what the other person will think, whether we will be rejected or whether the relationship will end. But the reality is that in looking out for the other person, and in genuinely loving them, it may be a risk we have to take. Yes, the friendship may end…but it may also be a turning point for that person by showing them something in their lives that is negative or destructive. Or it may bring the relationship to a deeper level knowing they can trust you to tell them what’s on your mind.

Speaking the truth in love is one of the hardest things to do because we have no control over the outcome. But we can find ways to direct the conversation in a loving and respectful way through our tone of voice, body language, by recognizing our own inherent weaknesses, and by affirming how much you care for that person regardless of the current situation.

Week 3 Challenge: It can be a challenge to confront someone with a difficult conversation. But it could also be a positive turning point for the relationship if done in a respectful manner without being judgmental. Is there someone you need to speak to about your frustration or about their behavior?

Love…rejoices with the truth” 1 Corinthians 13:6