Primary Care Preceptorship (PCP) Sessions 1, 2, & 3

I'm been meaning to write a post about my experience so far from my primary care preceptorship sessions, but I kept procrastinating. Tomorrow, I actually have an assignment due for ECM for which I'm asked to write a one page reflection about what I've seen and learned from my PCP sessions, so I figured, 'Hey! Good time to do the post I've been pushing back!"

Anyways, as I said earlier, I've had 3 sessions so far. It's basically a chance for us as students to get a glimpse of the daily interactions between a physician and his patients. Although as students we are distributed to many different offices of many different medical specialties, the point is not to expose us to specific areas of medicine, but to allow us to observe, and hopefully get a chance to practice, effective communication and interactions between the physician and the patient.

I've been assigned to a physician who specializes in infectious disease and currently practices at an HIV clinic. He sees patients in his office, many of which have been returning for many years, and checks up on them to see if they have been taking their medication and to gauge the effectiveness of each patient's regimen.

I can't say that I necessarily enjoy the sessions, especially since I've been assigned to an off-site clinic and these visits cut into study time, but I have definitely been able to see the value in them and appreciate them.

Time Management

Time. Most people feel like they manage it inadequately. A popular prayer request is for "better time management." Why do people always feel like they're bad at time management? Do we all have so much to do that unless we carefully plan out each day in the most efficient way possible, we won't be able to get everything done?

I'll speak from my own experience. I definitely have a lot of time each day. Yes. Even as a medical student. Say I sleep for 6 hours (that's probably not enough for a lot of people, but I believe I can adequately get through the day with 6 hrs). I have about 6 hours of class + 1 hour of lunch each day. 1 hour for dinner. That leaves about 10 free hours left for each day. If I studied 10 hours each day, reviewing the day's material and perhaps pre-reading for the next day, I would most likely feel very ready before the next exam (or I would hope so!). However, this is definitely not that case. When it's weeks before an exam, I don't study even close to 10 hours each day, and once it's days before the exam, I sometimes feel like I'm running out of time!

Why is that?? Did I somehow mismanage my time? I honestly don't think I have a lack of it, so that's not the problem. Of course, my free hours aren't all dedicated to studying. Time is set aside for short naps, devotionals, and of course, working on this blog (and just dinking around on the web).

I think for one thing, it's hard for me to get motivated to study very diligently weeks in advance of an exam like I would a few days before exam day because there is very little immediate gratification to anticipate or experience. It's easy to get immediate gratification from looking for and watching entertaining YouTube videos, or playing a few games of StarCraft.

Musculoskel Final, Starcraft 2, redesign, and sleep

Finally finished the musculoskeleton block, which mainly dealt with upper and lower limb skeletal and muscle structures, innervations, and the mechanics of the nervous system with regards to the spinal cord and muscle action potentials. I was getting a little tired of memorizing muscle names, their attachments, and source of innervations, but looking back, I'm kind of amazed at the amount of information we've been able to cram in such a short amount of time!!

Anyways, with that done, we were all given a day off =) The night after the final, my friend and I finally got some Starcraft 2 playtime in. Unfortunately, his laptop was overheating and shutting down, which definitely doesn't work for online play, let alone enjoyable campaign play, so here's what we did. We went to the back of the campus library and found a window that wasn't locked closed. We pulled up a nearby desk against the wall with the open window. There, we set up our laptops, right next to a constant incoming freezing breeze. Our hands were freezing, our APM well below normal, but needless to say, we were happy to be playing some uninterrupted Starcraft 2 with no school work on our minds...

I also took some time today to improve the blog design! Hopefully you guys like it.

And I slept a lot.

Medical Student Burnout

Here is an article, "Medical Student Burnout and the Challenge to Patient Care", by Pauline W. Chen, MD, which got circulated around the Downstate '14 class. She wrote this article in response to a paper that she read, "Burnout and Suicidal Ideation Among U.S. Medical Students." She outlines some of the unshared feelings she had as she went through medical school.

Dr. Chen writes,

"Medical school was not easy for me. I knew that I wanted to become a doctor to help people, but I had given little thought to the process. I was poorly prepared for many things: the pressure to excel in ways that seemed so far from caring for people; rapidly mounting debts I signed off on every semester; a roller coaster existence from chronic lack of sleep; hazing from the more experienced students and residents; and the realities of patient suffering despite my best efforts."

Even only two months into medical school, we have been constantly reminded by faculty about the many student counseling services available to help us with any type of problems that we may be having, ranging from needing to improve study habits to having depression. Last week, we even had a lecture about how we should deal with stress, were informed again about the various student resources at school, and even touched on the subject of how to properly respond if we were to ever come across a situation where we knew that someone was contemplating suicide.

How do you spiritually prepare yourself for such an environment? On what foundations are your motivations founded? To where and whom would you turn to for help, guidance, and counsel? And what is your source of peace and contentment? I encourage you to think about these things, as you will be entering a very worldly academic environment where you must be careful to guard your heart against what the world has to offer in terms of peace and success and continue abide in Christ for peace and contentment.

Essentials of Clinical Medicine: Standardized Patients

So at SUNY Downstate, we have a course called Essentials of Clinical Medicine (ECM) that basically focuses on the social aspects of being a good physician. That includes developing good communication and the ability to respond correctly to a patient's culture, values, race, ethnicity, and anything else that makes the patient unique. It's also the course that teaches us how to take a patient's social history: age, where they live, career, financial status, insurance status, relationships, religion, diet, etc. Over the past weeks, we've had small group discussions in which we discussed our own experiences with our doctors and what we liked and didn't like. We also discussed different ethically challenging scenarios.

Recently, we've gotten into doing standardized patient (SP) interviews. For those unfamiliar with SPs, they are actors who are specially trained in acting as patients, sometimes as a patient with nothing out of the ordinary, but also sometimes as patients with a deep and complicated story and personality. For our ECM small groups, each of us have taken turns being the medical student interviewing and SP to acquire a brief patient social profile. One student sits in a chair facing the SP sitting across from him while the rest of the small group sits at a distance to observe. This setup is definitely very artificial, but it is a safe place to at least go through once the motions of talking to a patient and getting peer feedback!

Med school update: 10/16/10

So it's been about two months since I started medical school at SUNY Downstate, and it's getting pretty cold! I'm curious about how it'll be once it starts snowing! It'll probably be really exciting on the first day, and then after that, just be a big pain and hassle.

Med school has been pretty good so far.  I really had no idea what to expect before I came, so I guess there isn't necessarily anything that failed to meet expectations. My place to stay in the campus apartments is definitely becoming homier, which is a definite plus, especially when I was a bit disappointed by the lack of carpet and small sized kitchen (I got spoiled at UCLA!).

We're currently studying the musculoskeletal system, which is quite more clinically applicable compared to the introductory/review block we had before this called "Genes to Cells".  We've also started anatomy lab, dissecting the relevant sections of the body dealing with the musculoskeletal system.  I actually feel a lot more disconnected from the whole experience of dissecting a human body than I expected.  I mean, I wasn't expecting it to bother me, but still, it is a human body. I guess it's partly because I just see our bodies as temporary vessels.  I am, though, very grateful to those who made the decision to donate their bodies to schools for medical education, especially after seeing how thoroughly they end up being dissected!  Some friends and I actually discussed about whether or not these people would have still wanted to donate their bodies after seeing an actual cadaver dissection!

Why I chose to attend medical school

Okay, I'm going to feel a little like I'm writing a pseudo-personal statement, but anyways.

Ever since I was really young, I always enjoyed science and math.  Okay, that sounds like a very typical thing to say.  It's either, "I really enjoyed science and math" or, "I hated them both!"  I really enjoyed science and math, and it was also definitely the areas which I excelled in more.  I liked learning "rules" and observations about why certain things happened the way they did in the world, and I liked being able to use this knowledge to come to more generalized conclusions about phenomena I experienced throughout my daily life!

Ever since I was born until high school, my dad actually pushed me a lot to go into medicine, but me, honestly having no idea what I wanted to do, always said no (more for the sake of saying no).  With working in the medical field came financial stability and an added bonus would be social respect.  What parent doesn't want such things for their son, right?

Testimony

"For all have sinned and fall short of the glory of God" -Romans 3:23 (NASB)

I grew up in a Christian family, was taught the gospel at the very young age, attended a Lutheran elementary school, and attended Sunday school every week.  I understood that we are all sinners, deserving of hell and eternal punishment.  I knew that Jesus Christ, God's one and only Son, died on the cross for the atonement of my sins, and conquered sin through His resurrection.  Although I knew all of these things, I admit that I lived a very "Christian" life because it was easy to do so in my very sheltered environment.  I was never challenged to stand up for my faith and it was rarely convenient to act contrary to what I knew was right.

I attended an independent, secular high school.  Here was where I realized the difference between the life of a Christian and that of a non-Christian.  It was a place where everyone was relatively tolerant of everyone else's views, values, and beliefs, and seldom did I feel an urge to make it known that I was Christian.  I had my beliefs, and everyone else had their own.  At this point, my priorities were very focused around succeeding in school, having fun with friends, and getting into the college of my choice, UC Berkeley.  It was a great school, and I wanted to stay close to home.  I was almost completely sure that I would be going there the following year as my stats pretty much matched those represented by the previously accepted class.  However, as March came, I was devastated.  I was devastated because things didn't work out as I had anticipated, and now, making the decision to attend UCLA instead, there would be a mess of uncertainties to come.

Why I decided to start this blog

I decided to blog about my medical education career in light of being a Christian. I’ve been asked numerous times by both guys and girls about whether or not it’s a good decision to go into medicine. Also, as a medical student now, I come across decisions every day that I need to either make now or think and pray about for the future. And with these decisions, I need to constantly make sure that I thinking clearly about them through the lens that is scripture.

With that, I hope that sharing some of my daily thoughts and experiences can be helpful to anyone who is either considering pursuing a medical career or is currently in school for a healthcare related career and is interested in my thoughts as a Christian medical student.

It is not only through my future career as a doctor that I must use for God’s glory, but also each and every day that I spend pursuing that career.

“Come now, you who say, ‘Today or tomorrow we will go to such and such a city, and spend a year there and engage in business and make a profit.’ Yet you do not know what your life will be like tomorrow. You are just a vapor that appears for a little while and then vanishes away. Instead, you ought to say, ‘If the Lord wills, we will live and also do this or that.’” -James 4:13-15