Exam results

Results were returned to us on Wednesday and I passed everything and medical school moves on. Grades are returned as percentages, even though they are officially recorded as Fail, Pass, High Pass and Honors. How that differs from an A/B/C/F system, I'm not really clear. You are not "high pass" compared to everyone else, you're just reaching the high pass standard for grades. With this set of exams I am now halfway through my first courses. Most courses are not cumulative for the next exam, but there were two courses that did not participate which are cumulative. (Of course everything is cumulative in the larger sense because board exams cover everything you were supposed to learn!)

In the grand scheme of things, official "terms" have little meaning because EVERY course I'm in continues into the next term. There is a big turnover after the second term because anatomy (including histology and embryo), physiology and biochem end. I'm not sure what comes after that because all the calendars I've been given only go until February, but I'll deal with those when they show up. Studying carries on, hopefully at a reasonable pace so I can continue my grades.

Wake up call

All the little details of fixing things around the house and remodeling can sometimes add up to unexpected fun. The house at school is from 1915 and needs a little work, so K's dad was working here last week while I was studying for exams. We've installed nifty smoke/CO detectors which communicate wirelessly so an alarm in the basement causes the detector on the second floor to activate. Pretty handy when your furnace is in the basement, less so when your chimney is under repair. K and dad had unhooked the chimney on Friday to insert a liner, found out the company shorted them 5 feet of liner and left it unhooked awaiting delivery of the missing 5 feet. Liner still hadn't showed up on Wednesday as the weather cooled with a night time low near 40 degrees. Everyone thought someone else had turned the furnace off and nobody had. 0430 rolls around with an ear-piercing "FIRE! FIRE! FIRE! Evacuate!" (did I mention the detectors talk?) followed by the same message in Spanish, at something like 90 decibels. My exam wasn't until 10a, but I was pretty well awake after that. I guess that's one way to avoid the dreaded oversleeping an exam.

Exams

My first set of exams is this week, one where I have to demonstrate skills on a patient, a cadaver lab exam, an histology lab exam and then the giant written exam. The written exam will cover didactic material from all the courses (see earlier post for list). This exam is six hours long, two fifteen minute breaks and a half-hour lunch break. I'm currently occupied cramming information into my head to attempt more than 70% recall since that is the pass level.

The amazing thing is the collective level of stress in the class. When I'm home, I feel as though I have a lot to study and not enough hours in the day but that somehow I will get enough to do okay. When I'm in the classroom with 124 other people, most of whom need to be peeled off the ceiling, my anxiety jumps from barely noticeable to overwhelming and I can't hardly get my thoughts in order. I've always been receptive to a collective mood and right now my best survival mechanism is to stay away from anybody who appears stressed or overly anxious. These are also the folks who appear to be getting the least done as they run around the building and consult with everyone else in sight.

Hours fly by when I barely even take note of the time and before I know it, another day is gone and I'm closer to the proving ground for classroom material. My biggest interest lies beyond the classroom though, I'd rather be heading for the proving ground of patient care.

Things I miss from before med school

1. My husband.
2. Reading things that entertained me and made me laugh in a good way (not in the current "you've GOT to be kidding me" kind of way).
3. Going to the grocery store or Wallyworld or the mall without trying to decide whether I'm going to stay up late or skip on some required reading. Food, underwear and an occasional pair of shoes are necessities.
4. Time to bake cookies.

I'm sure there's lots more, but these are the ones that occur to me at lunch time on my least busy day of the week.

First weeks: Survival

The information load during the beginning of medical school is massive, my science topics right now include gross anatomy, histology, embryology, physiology, biochemistry. These courses require massive amounts of reading and understanding of relationships, connections and general synthesis of information. The biggest problem is how to acquire all the information AND make those connections in the couple hours a day I'm not in class. One method would be to layout a coherent strategy of rotating through the topics for new reading, review and discussion, but my current strategy is more along the lines of reading and learning as much as I can for the next topic on the schedule then freaking out when I'm asked a question on an old topic that I "should know by now" and trying to emphasize that for a spare five minutes. Rather dizzying to be sure.

Then I've got three other, softer side classes, including one appropriately described as "how to be a doctor". I suppose it is good they require this class because some of the questions asked by fellow students seem to imply they believe they are training to be a life coach, a counselor, a law enforcement officer or something other than a physician. Community physicians come in and work with us in small groups on how to physically perform exams, how to get collect information from patients and then answer all our random questions on the social, business and lifestyle issues of being a practicing doctor.

The program I'm in also includes a large amount of "clinical correlation" which means that every time we talk about a scientific idea, we also get a patient presentation or diagnostic test result or something that would relate that idea to actually being someone's doctor. I can't decide whether I like the amount of it we get. I mean, sure it is great to go through some examples, but when every second or third paragraph in the text is interrupted by "this is why people get tennis elbow" or "clavicular fractures usually occur in this area" or "testicular swelling can cause discomfort", it makes for difficult reading. I know the program is responding to the complaints of prior students about making the information real and this is a nationwide trend, but I'm not convinced yet.

Welcome to campus

So, this was the first week of Medical School, two days of orientation and three days of classes. Orientation was pretty much the only preparation I had for how many hours I was going to have to sit still in a classroom. I can't speak for everyone, but my undergraduate and even graduate education included a number of different classes, scheduled specific days of the week at somewhat random times which allowed for a long lunch some days or an early afternoon or less often, a late morning. The transition from having an active, moving job to sitting still has not been easy. Count me as fully unprepared for what 8 hours of lecture might do to my rear end, my brain and everything in between. Today is the first day I left the building before 5p and I haven't even been studying on site!

We have already started dissecting our cadavers and the good news for me is that apparently I've already killed any negative olfactory response with some of the other odors I've encountered on the ambulance for the past 3 years. The dissection promises to be an interesting experience and I hope I can feel confident enough in locating the structures not to be completely annoyed by the process. We've also been dumped into the deep end for physiology and histology, hopefully I'll be able to get on top of some of the material soon so I feel less than completely lost.

It has been a long time (if ever) since I have felt so out of place and overwhelmed in an academic environment. The only saving grace is that most folks seem to feel pretty much the same way which means I'm not way behind, but ultimately the assessment is based on competence not on a comparison to the other students. I guess the only theory right now is just to keep plugging along and do the best I can.

Moving day, part 1

I can never decide if short distance moves are a curse or a blessing. There is less pressure to actually be organized and get everything done in one trip, but this also makes it drag on and on. Today K and I got a trailer, filled it full of stuff, tossed a couple more things in the back of the pickup and drove to the new house.

Before we left, I knew the power wasn't on in the new house, but it is mid-summer after all, so there was enough light to see by as we hauled everything inside. We resolved the power issue with a phone call I was expecting to be pleasant but was actually quite annoying and required me taking a certain "tone" with the company rep. Sorry to you company rep, but the lady the day before had quite clearly stated same day hookup was not a problem and made NO mention of an "extra convenience charge". Good news, just before we left this afternoon, the guy showed up and performed the magical 1.5 minutes of work required to "install" the power and we returned to life in the 21st century.

Problem #2 was discovered shortly after arrival, the water was off. K searched the basement and was unable to find a valve, so I got on the phone with the water company to make sure it was an issue with us and not with them. This rep was able to confirm that the account was square on their end, and eventually we found the valve. Which had been shut off because it was leaking. It had not been leaking at the time of the house inspection. The limited assortment of tools we took with us did not include a wrench large enough to tighten the valve and return water to the house. A visit to the locally owned hardware provided us a quick tour of the new town I'll be living in and a wrench, a pair of pliers and copies of the new house key.

Problem #3 was discovered fairly early on, but unfortunately this one has not happy ending yet. Apparently the stairs in the new house are so low ceilinged and so narrow that the box springs for the bed do not fit. We tried, twisted, moved, squished, wriggled and did everything we could think of and got the box springs half way up the stairs and entirely wedged. We were able to get it down again, but as of right now, I might be sleeping in the living room.

Last shift

Tomorrow is my last full time shift on the ambulance, the last time I will be certain to work with The Asian. I've been gradually saying my goodbyes to folks as I don't know who I'm going to see again. Plus, turnover at the ambulance company is high enough that I'm not sure who will even still be working there by the time I work a few shifts again. It is weird to be saying goodbye to a place I never intended to stay. Three years of applying and waiting for school have made for some interesting times with a fun, caring group of people. There are a lot of things I've learned while working on the ambulance and it has been great experience.