Thoughts on the GI block

Another exam done. Another block completed. Another step closer to being done with my preclinical medical education.

Yesterday's GI exam took a lot out of me. It was long and several questions were quite complicated. When studying organ systems, I love the feeling when everything just comes together a couple of days before the exam. I remember with Cardiology, I could think through the entire working of the heart and relate it to all the diseases by the time the exam comes around. For some reason, this didn't happen as much for GI (and for some parts of Brain Sciences in the 1st year). I still felt like I was memorising different disease states and different mechanisms but it felt very disconnected. I wasn't the biggest fan of the organization of the course but hey, such is life.

I hate it when I take an exam and have no idea what one of the pathology pictures is showing. Now make that now knowing what a series of 3 pathology pictures are showing - arghh!! What I do love is figuring out the pictures from the question stem - and thankfully I think I did exactly that for these 3 pictures!

On the bright side, I really enjoyed the small group portion of our GI block though. We have about 8 students per small group led by a faculty member. We had an excellent bunch of classmates in the group - many of whom I have never had small group with - and it's always nice to work with new peers in this setting. Our leader talked a lot but really incorporated the pertinent clinical information with the cases provided. I find that a lot of the information stuck with me very well (and hopefully I won't forget it any time soon).

So, 19/20 exams done. One more to go. 20 days and I will be done with 2nd year. Wow.

Cricket - after about a year

Yesterday was a fantastic day - and not fantastic because we finished our GI lectures. Fantastic because I got to play cricket after about a year or so, and it made me realise how much I miss it. It was about 37°F (Yup, that's about 3°C) outside but the 9 of us that were out (mostly undergrads) had a blast! It took me a while to get back into my groove but soon I was hitting the ball around the ground. I have calmed down in almost every aspect of my life, but any board game or sport like cricket will bring out the slight competitive streak in me.

I probably should have been studying for my Tuesday exam instead of playing cricket. However, I was inspired by a quote from an Orthopedic surgeon that spoke at one of our careers in medicine sessions earlier yesterday:

"Noone at their death bed says, I wish I had worked a little bit harder in my life"

I took that as my sign to play cricket for a couple of hours and find balance in my life. I do not regret a single second of that. But now, the rest of the weekend will be spent with my GI notes...

Full Physical Exam!

Today was our 1st final Doctoring OSCE (exam). Doctoring is the course in which we learn how to take patient histories, perform physical exams, talk about ethics etc. I actually was fortunate to do some curricular work last summer and throughout this year with this course (and it has been a fantastic experience!)

In today's OSCE, we had to conduct a full physical exam on our patient - head, eyes, ears, nose, mouth, neck, heart, lungs, abdomen, musculoskeletal - except for the Neuro exam and the female GYN exam (which I learned to do last week and will be posting about it soon) - all this in 25 minutes. Last summer, when our course director told me that we would be expected to do this in February, I had a hard time figuring out how we would be able to do so much in so little time. Well, I'm not sure where the months between last summer and today have disappeared, but now the time was here.

For the last few OSCEs, I practiced with 2 of my close friends - and so we met up yesterday (Wednesday's are our days off.. I mean "Self-Directed Learning Days") to get ready for the OSCE and to give tips to each other. Not only do we learn by performing the exam on each other but in fact, a lot of learning is also done through serving as the patient. You'd be surprised by how much you learn when someone actually does the exam on you. If my memory serves me well, this was probably the first full physical exam that I have ever received.

One of us made a comment about how this could potentially be the one of the last times when we do a complete physical exam on a patient (hopefully not). With the limited amount of time that physicians have with their patients these days, it seems that it is more common and perhaps practical to do focused physical exams on the organ systems that a patient may be having trouble with. I have been working with an Emergency Medicine physician (my community mentor) for the last 2 years and a full physical is simply not done in that setting.

I felt quite prepared for today's OSCE. The checklists that we follow for the physical exam are near and dear to me since I have spent a lot of time formatting them and working with them since last summer. It all came full circle - I was now expected to do everything on the checklists - and we have had a lot of practice with our peers, standardized patients and with real patients at our community mentor site.

Well back to the point - I went in and completed the full physical exam in the allotted time. I had a very nice standardised patient who made me very comfortable performing the exam. Time after time, I continue to realise how nice it is to have a cooperative patient and how useful it is to explain what you are doing to the patient so that they are not surprised by what you are doing!

The 25 minutes flew by and I must admit, I felt like a doctor for a brief moment. I had succeeded in examining a patient from head-to-toe. A good goal accomplished.

As I was writing up my findings, that feeling quickly dwindled away as I realised how much more difficult it was going to be do perform a physical exam on patients with actual conditions and when everything was not normal. How much more I had to learn. How we will be trained to integrate the science we're learning with these findings. As I left that room, there was one thing I was sure about - I am very excited for clinical rotations to start in about 3 months time!

GI Block

We are currently on our Gastrointestinal (GI) block. This started about 3 weeks ago and we have our exam next Tuesday (i.e. I should be studying instead of writing - oops). We've been learning a whole lot ranging from gastroesophageal reflux disease (GERD) to colorectal surgery to liver diseases. For being the second-to-last one, I must say I was surprised by how "busy" (read: lots of studying) this block has turned out to be. I have been trying to juggle boards studying with GI but that has been hard to do.

There's the constant feeling of "I should be studying for the boards" instead of studying for GI and vice versa. This next month will continue to be like this and hopefully by the time 2nd year comes to an end (on March 16th), I will be mentally prepared to take the following 6 weeks to buckle down and put in the required time and effort for preparing for the USMLE Step 1 exam!

How it all began...

"Writing has traditionally been another item on my to-do list, one which I am not very good at. I rarely enjoyed it and found better ways of documenting experiences such as talking to friends or family."

That was how I started my first field note of the second year of medical school. Part of that is still true - I am still not all that great of a writer. However, as time has gone on, I have found myself to enjoy writing more and more.

Medical school comes with a lot of exciting memories and experiences, and after being inspired by reading several medical blogs, I have decided to start writing one of my own. Why? Simply, because I decided that it would be a fun venture and a nice way to reflect on my experiences. I will probably also write about some of my other interests and how I continue to try and pursue them in med school (and find ways to procrastinate through them) - these include traveling, cricket, bollywood etc etc.

Why now? Well, it is exactly one month before I am done with the pre-clinical portion of my medical career, and then the mighty USMLE Step 1 exam is next (in terms of the importance of this exam, lets just say that this is the Cricket World Cup of Medical School). I have found myself increasingly wanting to document this experience as I anticipate it to be a stressful yet very rewarding one. My hope will be to continue to write as I progress through the different stages of medicine...

I ended that same field note with the following comment - and perhaps this blog is one way of following through with what I said earlier.

"So whether my writing improves or stays the same, I know I will be doing more of it and I look forward to reading these pieces in the future."