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

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Reflections on the First 3 Weeks of Medical School

I have just experienced my first three weeks of medical school and it has been amazing! The first week was a series of orientation sessions to get us familiar with the medical program while the second week was the official start of classes.

I would love to share my experiences with you!

  • What I love about the program:  Fantastic classmates, passionate teachers, fascinating material, plenty of support, small group sessions, mentors, a focus on wellness, and the opportunity to shadow physicians right from Week 1! So far, I have had some exposure to family medicine, obstetrics and pathology. I loved being in the birthing center where I got to meet a patient who had just given birth by cesarean section. There was something so profound about being with someone at such a life-changing moment. I have also enjoyed my histology labs where we have been identifying different types of cells and tissues. Interestingly, it seems that pathology is moving away from using microscopes and instead using very high resolution images on the computer screen.
  • Challenges: The biggest challenges so far are being away from my children and the 2-3 hour daily commute. Traffic has been much worse than anticipated so I am making the most of my commute time to listen to lectures and also to decompress at the end of a busy day. I am very grateful to my husband for his tremendous support in helping out around the house and with the kids.
  • Surprises: The orientation and first few days of class focused on physicianship, the social aspects of medicine, indigenous health and the disparities in healthcare among the aboriginal population. Where as I thought we would be diving straight into hard science and performing dissections in the anatomy lab, it was interesting to learn about the social side of medicine and how so many factors affect health. I have also been pleasantly surprised by the vast array of backgrounds that my classmates have. It is such a diverse group!
  • Strategies for survival: I have had to adjust my study methods compared to the last time I was in school. The material is too voluminous for one to completely master every detail so I am learning the art of determining what is the most essential and what fits into the big picture of becoming a doctor. So far, I am mostly using the lecture material and my own created flashcards to summarize the material. Upper year students have also created some useful summaries that they have graciously handed down to us newbies.
  • Tips and advice: An important tip that I have heard from many seasoned medical students and doctors is to not neglect my life outside of medicine. I am trying to create a positive habit early on of having protected time for my husband, kids, devotional time, adequate sleep and exercise. I will also try to keep up with one or two hobbies, some friends and family.  There are several activities and organizations on campus I am interested in joining but I will have to be selective and not take on too much. Flexibility is important and I realize that I may not always be on top of things, but I will do the best that I can and enjoy the adventure!

Although I am only at the very beginning of my training and there is much more to come, I am really enjoying medical school so far and feel so grateful to have been given this opportunity!

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My new stethoscope just arrived! If you are wondering what brand to buy for medical school, this one comes highly recommended and is offered in an array of colors.

 

Ten Tips to Be at Your Best on MCAT Exam Day

You’ve studied. You’ve given it your best. And now exam day is nearly here. I would like to share with you some tips that helped me to be at my best in the lead up to the MCAT and finally on the day of the exam itself.

  1. Start getting to bed early and slow down on studying: Because the exam is now about 7 hours long, there are no options to take the exam in the afternoon. Therefore you are going to have to be at the testing center by about 7:30am at the latest for the exam that starts at 8am. Training your body to get up early will help to ensure you get a full nights rest before the exam and give you the stamina to get through the exam and ace it! Depending on your philosophy, taking a day-off from studying the day and night before the exam could be a good way to give you a small break before you take the actual exam.
  2. Psychological factors:  I drove to the testing center location (which was 30 minutes away) two days before the exam, scouted out the parking options and went right into the testing center to see what the layout looked like. This had a profound effect on my frame of mind the day of the exam because I knew exactly where I needed to go. I wasn’t worrying about it the night before the exam. Not everyone has the luxury of going to the testing center beforehand. But in my situation, I found it to be a big psychological help to have been to the testing center before the actual exam.
  3. Take a deep breath: Before I started each section of the exam, I would take some deep breaths and try to get focused before diving into the passage and questions. It’s true that you have to be fast on the exam, but you can probably afford 5-10 seconds before the start of each section to regroup your thoughts.
  4. Test-taking strategies: You may have developed a strategy for answering questions as you went through the practice tests. Mine was not to linger on a question for more than 1 minute. If I was stuck, I marked it and came back to it at the end of the section. Also, if a passage had a lot of dense information, I did not read the passage word for word. I breezed over it quickly for the general idea then looked at the questions to determine what was really needed from the passage. This will save you time as a lot of information on the passages is extraneous.
  5. What is the basic science? As you have probably already gleaned from the practice tests, there are some passages where it will seem like you have no idea what the passage is about. The material will be disguising itself under a veil of the unknown. Try to remind yourself that the MCAT generally only tests the fundamentals of science you have studied. Try to tease this out from the passage and apply what you know.
  6. One answer is more “correct” than the other: There will be some answer choices that both seem “correct” however you have to ask yourself whether the answer is addressing the question being asked. Pay attention to key words like “Except”, “Most likely”, “Explicitly”, “Implicitly. This will guide you to the truly correct answer.
  7. Carry snacks, lunch and water: Its important to keep your energy up so carry enough food and water to sustain you throughout the day.
  8. Breaks are shorter than you think: Depending on the number of examinees and the level of security at your testing center, allow 2-4 minutes total to be “processed” in and out of the exam room every time you leave for a scheduled break. The 10 minute breaks in particular go by very fast so be quick if you need to go to the bathroom and have a snack. Psychologically, you don’t want to end up feeling flustered because the next section started before you got back to your seat.
  9. Finish a section and then forget about it: From my own experience and from other MCAT takers I have spoken to, it is difficult to judge your performance from how you feel. Therefore, I decided that no matter how I felt about a section, I was not going to dwell on it once it was finished. I was going to give the next section my best shot no matter how discouraged or unsure I felt about the previous section.
  10. Don’t give up: By the time I got to the last section of the exam (Psychology), my brain was exhausted. I had a hard time concentrating on the passage and was finding myself unhelpfully re-reading it over and over. I stopped reading, looked down at my desk, said a prayer for strength, took a few deep breaths and kept going. Don’t get discouraged. The MCAT is a marathon but you can make it through to the end! Taking a few seconds here and there to regroup your thoughts can be helpful in renewing your focus.

I wish you the very best as you prepare for your exam. You can do it!

Related posts:

How to Achieve Success on the MCAT…Lessons Learned from Two Retakes

Ten Strategies to Avoid Burnout While Preparing for the MCAT

Image courtesy of Stuart Miles at freedigitalphotos.net
Image courtesy of Stuart Miles at freedigitalphotos.net

Ten Strategies to Avoid Burnout While Preparing for the MCAT

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I received a question from a reader about how to handle burnout when preparing for the MCAT. How does one maintain stamina while studying for this important exam? I would like to share with you my tips on what helped me get through those months of preparation. There were certainly moments when I felt exhausted so I knew I had to find ways to attain balance in my life.

Everyone’s situation is different, be it as a student, being employed, having children or other family members to take care of, among other scenarios. Some of the tips below may or may not be applicable to your situation but hopefully there will still be something you can take away from this post that will help you handle those intense months of studying without burning out.

My situation is that I was working full time during my first two takes of the MCAT (in 2005 and 2008) and then on maternity leave during my third take of the MCAT (2015). All these scenarios required effort to maintain balance. Below you will find my suggested tips for keeping your head above water as you prepare for the MCAT:

  1. Draft a study schedule: On my first two takes of the MCAT, I did not have a clear idea of my study plans. I simply opened books and started reading. The result was that I started to get overwhelmed by the sheer volume of material and I ended up running out of time towards the end to complete all the material and to practice questions. On my third take, I created a flexible study schedule that gave me an idea of what chapters to study each week. This put me in a good frame of mind knowing that I would eventually cover all the required material and still have time for practice questions.
  2. Strategic studying: It is tempting to put in hour and hours of studying at a time for the MCAT. I have fallen into that trap and it was not the most efficient because our brains only have so much staying power. I found my recall and grasp of material to be much better when I broke up my studying into blocks of approximately 1-2 hours then took a break for about 15 to 30 minutes. A regular change of pace helps to get the brain back in gear for studying.
  3. Rotate subject areas: At some point, you may get tired of reading from the same subject area. When I set up my study schedule, I alternated subject areas on each day, for example, Mon-Chemistry, Tue-Biology, Wed-Physics, Thurs-Psychology, and then threw in a verbal reasoning (CARS) passage 1-2 times a week. This kept things somewhat fresh and helped to keep me motivated. Develop a study format that works for you.
  4. Take care of yourself: Exercising, eating healthily, getting enough sleep and perhaps engaging in one of your favorite hobbies will help you feel more active, physically and mentally strong. Even just a brisk 15 minute walk in the fresh air can do wonders for your frame of mind. Taking the time to pray, meditate and clear your thoughts can also help to renew your focus.
  5. Take an extended break: Depending on your situation, you may or may not have the luxury of taking a break but if you are starting to feel really burnt out, stop all studying for a few days and if you are using a study schedule, adjust it accordingly. Trying to study at the brink of burn-out may make things worse.
  6. Be creative with studying: If you are starting to feel a little overwhelmed with how much material there is to cover and you have limited time to study, look at ways to sneak in some additional study time. I listened to Khan Academy videos while washing dishes, cooking or folding laundry. I had flash cards taped to the elliptical in my basement as I exercised, I had flow-charts taped to my bathroom mirror as I brushed my teeth. I also always had flashcards in my handbag to whip out if I was out somewhere and I had to wait in line etc. Yes, you may look a tad bit nerdy but you are on a mission to conquer the MCAT!
  7. Let some things go: As a mother with young children at home, I learned to let some things go so I could focus on my studying. The house was not as clean and tidy as it could have been, the meals I cooked were a bit boring for a while but I kept in mind that all this was temporary and my husband was on board and understood that there were sacrifices to be made.
  8. Get help if you can: I used to be very poor at delegating and wanted to do everything myself. I learned the hard way that this can lead to burnout in many situations so I enlisted my husband’s help and was very specific about what help I needed. Depending on your situation and your responsibilities, if you can get some help to offset some of the other pressures in your life, this can help you to feel less overwhelmed so you can focus on the MCAT.
  9. Write or talk about it: Blogging has become a therapeutic way for me to deal with the pressure of the whole medical school application process. I have found a wonderful support group in the blogosphere and I remember receiving many words of encouragement. If you prefer a more personal approach, writing in a journal can also be therapeutic. Talking about your stresses with others can also alleviate some of the pressure and allow friends and family to give you the support you need.
  10. Be confident: Recognize the person that you are, an individual full of potential who has made this important decision to pursue a noble calling. The MCAT is certainly an important exam but take some of the pressure off of yourself by realizing that there is more to you than the MCAT. You have unique life experiences to bring to the table and the MCAT is not the end of your story! Be confident in your overall ability and uniqueness!

Don’t give up! You may be feeling fed-up and frustrated with preparing for the MCAT but you will overcome it. Be confident and stay positive! You can do it!

Related post: How to Achieve Success on the MCAT…Lessons Learned from Two Retakes