Clerkship Update: Pediatrics Inpatient

Clerkship updates! I just completed a 4-week rotation on the pediatric wards and it has been one of my favorite rotations so far! My schedule consisted of 2 weeks of day shifts and 2 weeks of evening/night shifts plus 2 weekends. During the day shifts, my day consisted of teaching sessions/lectures, rounding on patients, writing progress notes and discharge summaries. My night shifts mostly consisted of admitting patients to the ward and writing admission notes. I also spent one amazing afternoon in the newborn nursery where I had the opportunity to refine my skills in conducting a newborn physical exam.

What I enjoyed the most

I very much enjoyed working with children of all ages and worked with a fantastic team of staff physicians and residents from different specialties (pediatrics, family medicine and pediatric neurology). There was also excellent teaching during this rotation with plenty of support. I felt I grew in my history taking, physical exam skills as well as coming up with a differential diagnosis and management plan. I felt that having had my own children really helped me communicate with young children and relate to the anxieties that parents have about their sick children. Also, although I used to dread the night shifts, I decided to change my attitude about it and focus on the positive aspects of working at night such as avoiding rush-hour traffic and getting to spend the mornings with my children, go on walks with them, or surprise my son at school at lunch time.

What I struggled with the most

My greatest challenge during this rotation was having to communicate in French. Many of the patients and families I encountered were Francophone and did not speak much English so I was forced to put my French language skills to the test! It was not easy getting a history or communicating plans to families in French but it certainly gave me plenty of practice! I definitely feel that I am improving!

My take home message

Pediatrics is a fantastic field if you love children and interacting with families as a whole. I also find the environment to be very positive and supportive! When it comes to night shifts, working strange schedules in medicine can be a challenge both mentally and physically. However, trying to find ways to adapt, adopting a positive mindset and getting creative with our time can ease the strain and pleasantly surprise us!

This ends my very first block of third year!  I am very excited to be starting my rural Family Medicine rotation next! Stay tuned!

Featured image photo credit: lakeviewpediatrics.net

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Clerkship Update: Medical Genetics

I just completed my 2-week rotation in Medical Genetics and it was an incredible experience. My first week consisted of clinics where I got to meet pediatrics patients with a variety of genetic conditions. During my second week, I was assigned to the in-patient service where we were consulted  by the neonatal and pediatric Intensive Care Units to evaluate newborns and toddlers.

What I enjoyed most: 

This is a very intellectual specialty that requires extensive reading around cases. I very much enjoyed coming up with a differential diagnosis of possible conditions. The best part of this rotation was getting to spend an hour or more with each patient as we require much of this time to work through family histories in great detail as well as conduct a very thorough physical exam looking for dymorphologies, skeletel dysplasias, and any other abnormalities that could signal a possible genetic condition. I also appreciated refreshing my knowledge about the different types of Genetic testing such as FISH (Fluorescent In Situ Hybridization), aCGH (array Comparative Genomic Hybridization) and karyotyping.

What I struggled with most:

There is a vast amount of information to know in Genetics such as various syndromes, which definitely poses a challenge! Genetics deals mostly with diagnoses and counselling of patients. Although being able to provide a diagnosis for a child’s condition was very satisfying and would assist parents in learning how to manage the condition going forward, it was also emotionally challenging to not have a cure or solution for their condition. I wished there was more I could do for these families!

My take home message: 

This rotation increased my knowledge and understanding of congenital conditions which I feel will be important to consider when  assessing patients in the future. Medical Genetics is a fascinating field and this rotation increased my appreciation for the molecular intricacies of the human body. It was also humbling to witness how just one single DNA mutation could result in severe disease. It reminded me that having good health is something we cannot take for granted.

Featured image: Plethrons-Basics of DNA

Clerkship Update: Pathology

I just completed my 2-week rotation in Pathology and I really enjoyed it. My days consisted of a variety of activities such as grossing specimens in the lab (that is, examining and cutting them in preparation for creating microscopy slides), looking at slides under the light microscope and electron microscope, plenty of studying as well as attending autopsies, tumor boards and rounds. I also had the opportunity to observe intraoperative consultations which is when a surgeon excises a sample during a surgery and asks the pathologist to make a quick slide (better know as a “frozen” section) in order to have a preliminary diagnosis, usually in the context of cancer.

What I enjoyed most: 

First of all, I think microscopes are just so cool! Secondly, I had a fantastic team to work with! I also liked the flexibility and variability of the day with a lot of autonomy and self-directed learning.  For example, my main interests for this rotation were renal and gynecology pathology so I was able to tag along with the residents and staff physicians specializing in these areas.  I particularly enjoyed “sign-outs” when the staff, resident and I would sit at the teaching scopes (several microscopes connected to a main one so that you are all viewing the same slide) as this is where you get a lot of useful teaching on how to identify various structures. I also really appreciated that I got to brush up on my anatomy! The schedule was fairly light and I got to see my kids more often than in other rotations which was great!

What I struggled with most:

I missed patient contact and also sometimes felt helpless in cases where we diagnosed cancer since the clinical management is not done by the pathologist.

My take home message: 

I think Pathology is a great rotation for  medical students to consider regardless of your interests because it exposes you to a different side of medicine and will increase your understanding of various disease processes which is very useful to know in the clinical world. For example, I now have a much better understanding of glomerulonephritis, nephrotic syndromes and gynecology-related cancers. I also have a much better idea of how to interpret pathology reports and the amount of work that goes into creating one! I would currently rank Pathology as a “medium” as a future potential specialty for me because I still have to reconcile the fact that there is not much in the way of patient contact. However, it really resonated with me in terms of the intellectual aspects and I loved the detective work behind it.

My next rotation is an elective in Medical Genetics which sounds fascinating! Stay tuned!

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My assigned desk…reading up on some renal!
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My little monkeys climbing trees in the backyard. Love them to bits!

Featured image: lookfordiagnosis.com

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!

 

White Coat Ceremony…Donning the Healer’s Habit

Today was a very special day as my classmates and I celebrated a milestone in our medical training…The White Coat Ceremony! It was a beautiful and inspiring ceremony as we reflected on the next phase of our training, the moments when we will get to experience the triumphs and challenges of helping our patients navigate their illness.

In January, we will be transitioning into clinical practice which is when we will begin observational hospital rotations (alongside lectures and small groups) before beginning our official rotations in the 3rd year of medical school. I am very grateful that our curriculum offers us this opportunity to gradually transition into the world of clinical practice as we wrap up our Fundamentals of Medicine block in December.

Today was a reminder of the immense challenges ahead, but also what an incredible privilege it is to be in this profession.

 

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My amazing, supportive husband by my side
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White Coat Ceremony!
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Going on stage to receive my White Coat. So humbled and proud to be a part of the medical profession