Clerkship Update: Neonatal Intenstive Care Unit

I recently completed my 2-week rotation in the Neonatal Intensive Care Unit and it was a fantastic experience. The format of this rotation was such that medical students were integrated as part of the NICU team, attending sign-outs, rounding on patients, managing patients (physical exams etc), writing admission notes, progress notes and discharge summaries. We also took part in consults from the Obstetrics department and observed the resuscitation team who were prepped and ready for babies delivered by C-section.

What I enjoyed most: On this rotation, I had the wonderful opportunity to work with a a great team of staff physicians, residents, international medical students, nurses, nurse practitioners, nutrionists as well as various consultants. I very much enjoyed the teamwork! And of course,  I loved the patients (the babies) who were the real heros of the unit. I also really appreciated that we were assigned our own babies to manage and this afforded us plenty of autonomy and self-directed learning. On most days, we also had about 1 hour of teaching which was very beneficial.

What I struggled with most: Having to present my patients on rounds was quite intimidating some times but by the end of the 2-weeks, I felt much more confident, even if my management plans were sometimes off-track!

My take home message: The NICU was a fantastic experience and my favorite rotation so far. I am yet to do my core pediatrics rotation but I certainly enjoy working with the pediatric population. Since I also enjoy working with adult patients, I would currently rank pediatrics as a “medium” on a scale of low-medium-high, as a future potential specialty for me.

My current rotation is an elective in Pathology which has been very interesting and a different pace from clinical rotations. I will share my experiences on this in the coming weeks!

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Hubby and I on a date. We went on a nice long walk up Mont Royal, had lunch at a new vegetarian restaurant and went to see Mission Impossible: Fallout. We had a blast!
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We saw this piece of artwork on a park bench and thought it was quite unique (plus I had to take a picture of it for my daughter who loves giraffes!)

 

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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.
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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

Excited…Tomorrow is the Start of Clerkship!

Tomorrow marks the first day of the next phase of my medical training…clerkship rotations! I am filled with excitement…if not a little nervous! I am so grateful for the wonderful summer break I have had with family and friends. I felt the bond with my kids growing especially strong over this summer and despite the usual challenges of parenting that sometimes leave me wanting to pull my hair out, it has been such a joy to see them thrive!

Knowing that our lives are about to get very busy with me working long hours at the hospital and a lengthy commute, I sat the kids down to let them know that they will not see mummy as often. They were sad but said, “We’ll miss you but we’ll always love you!” This really warmed my heart, especially with how attached I am to my kids!

I know there will be days when I question whether my absence is detrimental to their well-being. I know there will be days when my heart is aching to be with them. But I am trusting that they will be well and that I will not give in to the overwhelming feelings of mummy guilt. I am so grateful for my wonderful husband who I know will take excellent care of them when I’m not there.  I pray for God’s grace to continually strengthen our family through this new phase of our lives.

To my dearest hubby and children, I love you dearly. It is truly a joy to be going through life with you all by my side!

So, onward we go to clerkship! Thrilled to be starting with Obstetrics!

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Last week of vacation before clerkship starts tomorrow!

Second Year of Medical School…Done!

It’s official! I am done with the second year of school and officially half-way through medical school! The past few months have been a whirlwind of activity as I completed my rotations in Surgery, Anesthesia, Ophthalmology and Radiology! This was definitely the most challenging block for me in terms of schedule and the overall demands of the rotations.

Some of the most rewarding experiences were learning how to bag-mask and intubate patients as well as put in IV lines. It was very hands-on and there were moments when I literally felt like the patient’s life was in my hands! I also enjoyed using slit-lamp biomicroscopes to look into the inner world of the eye. What a magnificent and breathtaking part of the body. It was moments like these that reminded me of the miracle and beauty of God’s creation!

I also had the opportunity to do a night shift shadowing an OBGYN resident in the Birthing Center. I had the privilege of assisting on 2 deliveries which was amazing! During the past few months, I have been praying for more clarity regarding what specialty I would like to go into and I am happy to announce that I have narrowed down my list significantly. I will have to keep you in suspense for now, but stay tuned for the big reveal at some point over the next few months.

The past 2 weeks were filled with numerous exams, lectures and small groups to prepare us for clerkship which starts at the end of July. One small group about learning in the clinical setting particularly stood out to me. The main idea was that clerkship is not about performance but about progressive learning. Meaning that the priority is not about impressing with our knowledge but rather about having a willingness to learn and progress along a continuum. I think this is true for many things in life. We will never be perfect but we can have an attitude of humility that there is always room for improvement. We will make mistakes, but we will get better with time! Persevering and refining our skills (in any field) only makes us better and more capable of serving those around us.

So what’s next? Five weeks of vacation to rest, recuperate, have fun with friends and family as I look ahead to the third year of medical school…CLERKSHIP!

 

 

Spring, Updates on Rotations…and Looking Ahead to Clerkship!

Hello everyone!

The past few months have just flown by! We are slowly starting to see the signs of Spring after a long Winter! One of my favorite things about this time of year is seeing the green shoots of plants in the garden trying to make their way up out of the recently frozen ground, their tips emerging strong and ready for the next season! I also love hearing the honking sound of the Canadian Geese making their way back as the weather gets warmer!

Med school has been great! I completed a fun 2-week rotation in Pediatrics where we got some hands on practice taking a history and doing physical exams on patients ranging from a few months old to teenagers! I was based at 2 locations: a pediatric clinic as well as the Children’s Hospital where I shadowed a fantastic pediatic nephrologist. I felt very at ease with parents and young patients, perhaps because I have two little ones of my own. So as I spoke to parents, I thought about how I would want to be treated if my own kids were sick.

My next rotation was an 8-week rotation in Internal Medicine which I am just about to wrap up. I found it quite challenging at the beginning when faced with the complexities of the diseases I encountered on the wards and witnessing very sick patients compared to my previous patient encounters. As time went on, I began to feel more comfortable on the wards. At this point in our training, we still play mostly an observational role, but it was a really good experience getting to interact with patients, write up admission notes and work through differential diagnoses. Even just getting more familiar with the hospital’s electronic medical records was reassuring for me!

Aside from the invaluable experience we are getting as we transition to clerkship, I am also enjoying getting to know my classmates in more depth now that we are working in smaller numbers and it is easier to get to know people.

In other exciting news, we just received our schedules for Clerkship! Here’s what my next 2 years are going to look like:

  • Year 3: Obstetrics, Pediatrics, Elective, Family Medicine, Psychiatry, Internal Medicine, Surgery
  • Year 4: Electives, Emergency Medicine, Public Health, Geriatrics

In the lead up to clerkship, I have had mixed feelings…both excitement and fear. My main concern has been the longer work hours and how that would impact my husband and kids. But my husband continues to reassure me that we will “figure it out” as we have always done! I continue to rely on God’s strength to keep me positive and motivated! And I am thrilled to see my kids thriving and happy. They are so curious to know what I am learning, “What did you do in med school today, mummy?” I love it!

All-in-all, I am really looking forward to Clerkship in this next phase of our medical training. In the mean time, I am getting ready for my next 8-week pre-clerkship rotation which is a combination of…Surgery, Radiology, Anesthesiology and Ophthalmology. Here we go!

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It’s beginning to look a lot like Spring! Some green shoots in our garden!
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Still a lot of snow in the mountains though…picture of the Laurentians from my mother-in-law’s house in the woods
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This is the study spot that I sometimes sneak away to while we’re at my mother-in-law’s house in the woods. It used to be my husband’s bedroom during his childhood summers.
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And I just had to throw this in because I think it’s so cute…our Superwoman!

Featured image: My view from the train during my daily commute to med school.

Med school update…Loving my clinical rotations!

Hello everyone (and welcome to those who just recently started following my blog!)

The month of January has been a month of transition as I moved out of the classroom and into the hospitals and clinics. This new phase of my training is called “Transition to Clinical Practice”. It is to prepare us for third-year clerkship by giving us exposure to real-life medical settings. At this stage, we do not yet have the  level of responsibility of a third-year student but we are still considered a part of the team which is great!

The first 2 weeks were quite the adjustment as no longer was my medical ‘world’ centered around campus but rather in various hospitals and clinics around the city. I ultimately decided to switch from driving to public transport which was an adjustment in itself! But now I feel much more settled and have come to enjoy the pleasant 1-hour train ride to and from the city. I am using the time to study and catch up on emails.

My husband also came up with the excellent idea of listening to audiobooks which I have been doing during my drive to the train station, subsequent subway commute and walks to the clinic/hospital. It has all turned out really well because I am able to come home earlier than last semester since I do not get stuck in traffic! There is always a bright side to new changes, even if they throw us off at first!

Here are my impressions of the rotations I have done so far:

  1. Family medicine: I liked the variety of cases that I saw and that the family doctor/resident has to have such a breadth of knowledge on many subjects. I am looking forward to gaining more exposure in clerkship.
  2. Neurology: I absolutely loved this rotation! I met wonderful attending physicians, residents and patients. I had a variety of experiences from doing consults in the ER to rounding on patients in the wards, to taking a history and examining patients in the clinics. I also had the chance to visit the electrophysiology lab where the Nerve Conduction and EMG studies are performed. There were plenty of opportunities to review CT and MRI scans. Overall, I found this to be a very intellectually stimulating experience. In addition, the patients I met were truly inspiring and humbling as they battled with debilitating and life-changing conditions. Since there are no core rotations in neurology in 3rd year, I am considering taking an elective in neurology in 4th year.

Other than school, the family is doing very well! We have instituted a new family tradition which is for each of us to say something we are grateful for every night at bed-time.  I also have a journal on my bedside table where I jot down a few things I am grateful for every night. This is really helping me to remain thankful and positive despite the busy and demanding weeks!

What’s next? My next rotation is pediatrics which I’m looking forward to! Will post an update on that in the next few weeks.

Keep striving towards your goals! Be positive in the moment and don’t wait to reach your destination in order to find happiness. It’s about the day-to-day living and what things we can be grateful for on a daily basis!

Thanks for reading!

 

Med School Update…And a Trip to Kenya!

As I write this, I am sitting on a paving stone step, listening to the wind blow through the slender pointed leaves of majestic eucalyptus trees towering over me, forming a blanket of protection against the omnipresent African sunshine. My family and I are thrilled to be spending the Christmas holidays in my home land…Kenya, where I was born and raised.

It has been 7 years since my husband and I were last back. And this is the kids’ first trip to Africa. They have loved every moment of it, from the perfect weather, to the friendly people, to the delicious food, to getting to meet cousins, aunts and uncles for the very first time. Words cannot express the joy in seeing my own children embrace the culture of the country where I grew up and of which I have so many beautiful childhood memories. It feels like I have come full circle!

During our 2 weeks here, we have been staying at my mum’s house in Nairobi and the kids have already reignited the bond with their Gran who they hadn’t seen since 2014. We have been having a wonderful time and I am not sure the kids will ever want to leave at this rate!

And what about med school? The last block (Neurology) was fantastic. Without a doubt, one of my favourite blocks! The last month of school was quite intense with block and anatomy exams, presentations and standardized clinical exams. It is bittersweet to have come to the end of my “classroom” learning (already!) but also very exciting to be starting TCP (Transition to Clinical Practice) in January. My rotations will be in 3 main blocks:

  1. Family Medicine, Pediatrics, Neurology
  2. Internal Medicine
  3. Surgery, Anesthesia, Radiology, Ophthalmology

TCP will run from January to June and then, after a one month summer break, I will begin my 3rd year clerkship rotations at the end of July.

The next few months will be quite an adjustment for our family due to the long hospital hours. I will have to be strong being away from the kids so much but I know they are in good hands and we will work through this as a family!

In the meantime, we will enjoy our last week of vacation here in warm, sunshiny Nairobi before heading back to snowy Canada in the New Year. Merry Christmas to all my readers and thank you for reading! I hope to continue to hear from you in 2018! Whatever dreams you may have, continue working towards them and never give up! All the best!