Technically I’ve only finished two weeks of surgery (one on breast, one on urology) and a week of anesthesiology.  But I’ve already decided that if I were to go into any sort of surgical field, it would be, without a doubt, urology.  No other field even comes close to the combination of amazing robotic/laser technology, variety of surgical procedures, and  relaxed lifestyle and chill personalities.  There’s even some medical management thrown in.  It’s too bad I’m not considering surgery.  But if I were, urology would be it.  Who would’ve thought?

Anyway, surgery has been not so bad at all, much to my surprise.  Of course, I’m on my electives month, so it’s easy to say now, and general surgery may kick my lazy ass.  But scrubbing in on procedures has been a lot of fun.  I love the delicacy involved in most surgical procedures (well, except for mastectomies, which just involve scooping out lots of breast tissue in as crude and primitive a way as possible).

I still find myself making mistakes in basic OR etiquette/protocol (e.g., I accidentally took off a glove BEFORE ripping off my gown).  Also, I tried to put in a Foley catheter during my first week of surgery after watching it done a couple of times.  It went in the vagina.  Embarrassing. Now you might think that you could never be capable of making such a mistake, but let me tell you something:  the female urethra can be seriously tiny.  The surgeon kindly told me a story afterward of a med student who called him when he (the surgeon) was a resident to tell him about a polyp he found during a colonoscopy.  The surgeon got excited and immediately went to check on it.  Turns out the student was in the vagina and was looking at the cervix, which he had mistaken for a polyp.

So glad to know that I am not the only med student capable of ridiculous mistakes.

This rotation has shaped up to be both gratifying and frustrating at the same time.  The frustrating part has to do with interns and residents who don’t quite know what to do with us med students.  In working at the community hospital, I was in the unenviable position of working on a team in which two of the residents were completely new to the hospital, and there was some unpleasant snipping and complaining by fellow residents about one another’s work/capabilities/personalities.   As a med student, I was neglected.  More than a few times, my team would forget to inform me that rounds were starting.  I would be reviewing patients’ charts only to turn around and realize that everyone on my team had already left the workroom.  I was as pleasant and helpful as I could, and I tried to be proactive (without being obnoxious or nagging) in trying to gain more responsibilities and play a larger role in patient care, but it was very, very difficult.  I envied a fellow medical student, whose team informed her from day 1 that she would be treated like an intern, thus giving her the chance to prove what she could do.  She got to feel like an integral member of the team, entrusted with genuine responsibilities and patient care.   In an ideal third-year rotation, the residents and interns would give the med student substantial responsibility for a patient or two (with supervision, of course) and make their expectations clear from the onset that he or she is an important member of the healthcare team.  However, that doesn’t always happen.

I’m glad to be back at the large academic medical center, if only because it is much less disorganized or pressed for time/space/resources as the small community hospital.  But I don’t want to sell that hospital short, as it really was doing a great job of treating underserved communities in poorer areas of NYC.  Overall, it was a very useful, if not always positive, experience in seeing how medicine is practiced in real-life settings rather than in an ivory tower bubble we’re used to.

As soon as I got the email that started off in the subject line with “SCORES”, I became tachycardic (for those of you who don’t speak medical-ese, it translates into “my heart started beating so hard and fast, I thought it would tear out of my chest”).  I kept envisioning myself doing family medicine in the Bible Belt.  Granted, I have full respect for those who want to do family medicine in the Bible Belt; it’s just not where I want to be.  I mean, who actually wants to be in the Bible Belt?  Ok, ok, I kid.  I’m sure there are plenty of good reasons to be in the Bible Belt, one of which is the warm(er) weather down there and the closeness to nature and all that jazz.

Anyway, it took me 16 hours from the initial email-induced episode of tachycardia to the time I actually opened up the website with my score on it.  After I came home from the hospital, my roommate found me huddled nervously at the dining room table, eating white rice out of a big vat and munching on garlic pickles, trying to pretending that there were NOT Step 1 board scores waiting for me at the click of a mouse.   Finally, my roommate and a classmate had to click on my score report for me and force my eyelids open in front of my laptop screen.  And it turns out, I did NOT fail!  In fact, I did just the opposite.  I passed, with some room to spare!

Needless to say, I’m ecstatic now.  I definitely have options in internal medicine; I am not limited to programs in the Bible Belt, which was my biggest fear (that, and falling into manhole covers while texting).  But this entire incident confirmed one thing for me:  I am a big, fat chicken.  I am such a huge chicken that I could serve as KFC’s sole supplier of chicken meat for a whole year.  I’d put entire chicken farms out of business.  I am chicken, hear me bawk!

I can only say that life after boards is like having a hot fudge banana split sundae after being forced to sit through a dinner of bean sprouts, dried meatloaf, and lumpy mashed potatoes.  Yup, that about sums it up.

How were the boards on Monday?  Well, they were slightly different than what I had expected.  I came out of the exam, not knowing how I did, but not feeling too terribly, but as more time passes, the more I’m convinced I did badly.  I keep mulling over all of those questions I wasn’t sure about, as well as the very real possibility of having made many stupid mistakes.  It may just be my neuroses speaking.  However, my lack of sleep the night before (2 hours!) may have hindered my performance considerably, in spite of all the Red Bull and caffeine mints and Sudafed I consumed to force my brain awake.  At this point, I’m consoling myself by saying that I’m not planning to go into a competitive field, and I’ll do research and make the right connections at the med school’s affiliate hospital (where I’d be happy to stay for residency anyway).  I won’t let a poor score get me down.  But we’ll see, I guess.

I forgot that people still read this blog, until I got a nice comment from a hopeful med school applicant.  I know, I know I need to be more consistent about this.  I also want to use this blog to look back on my journey and see how far I’ve come since I first made the fateful decision to become a doctor.

Most of my time has been spent studying for the USMLE Step 1, which I’ll be taking next Monday.  For those of you who aren’t familiar with Step 1, it’s an exam that med students take (usually in their 2nd year) that assimilates all of the basic sciences they’ve learned in the first two years of med school.  It’s a long exam, with 7 blocks of 50 questions each (with an hour to complete each block).  There’s also an hour of break time, which you can use throughout the day in any way you see fit.

Anyway, preparing for Step 1 has been intense.  I finally feel the information really coalescing in my head, but it has taken some long hours of studying and memorization.  My god, the amount of memorization was absurd.  For the past 4 weeks, I’d get to the library at 8am and leave around 10pm (and some classmates would stay even longer, till midnight or so).  I would take short lunch and dinner breaks, during which I’d end up watching an episode of “The Simpsons” or “Family Guy” or some other sort of mindless entertainment that wouldn’t use up too much of my brainpower (every bit of which was needed to memorize as much of First Aid as possible).

Unfortunately, I didn’t feel prepared enough a week before my original test date after a dismal performance on a practice exam, so I ended up postponing it.  I’m not the only one; a few others in my class had postponed, too.  I’m feeling much more confident now, but it still feels like there’s so much to learn and not enough time to learn it all, and my poor brain is just exhausted.  And I’ve gained weight.  And I haven’t gone grocery shopping in weeks.  And my exercising habits have really fallen off.  And I’ve been subsisting off of food that my parents brought over from NJ.  And I miss my friends terribly.

I can’t wait to be done with it all and move on with the rest of my life.  Next Monday, Step 1 will be OVER!