Monthly Archives: August 2011

A Brief Reprieve


The first exam is over! I can’t believe that I’ve finally broached and completed the first major assessment in medical school. I thought the three weeks before the first exam would pass slowly enough to allow me to worry about the exam but I have never experienced a quicker three weeks. Between trying to stay on top of all the material and determine the best study technique for my learning stye, I barely had time to count the days passing before the exam was literally upon us.

A glimpse at my study cube

The exam itself is somewhat of a blur. I took the practical portion first—the two-hour section was appropriately challenging: some of the identifications were simple, instant tags while others kept me guessing until the moment I turned my exam paper in to the TA. Our course directors posted the answers to the practical outside of the lab immediately following the written portion of the exam so I was able to go back to the lab and, based on what I remembered submitting, approximate my score. I liked being able to get a sense of how I did by checking the answers but I felt confident I had passed without having to check the key. I found myself counting my answers at rest stations throughout the practical; when I knew I had hit 35 correct answers, and thus the 60% passing mark, some of the pressure dissipated and I was able to really reason through the ones that were giving me trouble. I still don’t understand how I identified a lactiferous duct as a suspensory ligament but I think I’m just going to have to let that one go.

The written part came next: 4 ½ grueling hours of identifications, true and false, five short answer, and three full-length essays. I went through two mechanical pencils and may have initiated early-onset carpeltunnel. The exam was tough, no doubt about it. I felt I was able to at least intelligently write about every question asked but I wasn’t able to write everything I would have liked. While 4 ½ hours may seem like an excessive amount of time, I could have easily spent two hours on each full-length essay. I ended up delegating 40 minutes per essay and literally had to stop myself mid-sentence to stay on task. When I turned the exam in at the end of the time, I felt I had displayed a good amount of my knowledge but I won’t know my score for another week or so. Again, 60% is passing and I will be VERY satisfied with anything above that hallowed marker.

Perhaps the best part about taking a medical school exam is the promise of a relaxing weekend following the marathon testing session. This weekend I indulged in doing my laundry, dusting my room, sleeping in until nearly 10 AM, going out with friends, and watching television. I honestly felt self-indulgent and pampered. I went shopping with my friend Alexis at the Outlet Malls, drank several glasses of wine and spent another fun night in Harrisburg with the rest of the M1 and M2 class. Needless to say, I am beginning to live for every third weekend.

Alexis and me-Harrisburg is becoming the new "Big City"

I did do some studying this weekend (it’s becoming more normal to study than take a break) and I’m hoping I was able to get a jump-start on the next section of SBMP: abdominopelvic region. Should be an interesting three weeks filled with dissections of rotting gastrointestinal structures and more pathways of lymphatic drainage…I really don’t enjoy memorizing lymph drainage pathways. It’s an interesting way to start a new section though; our exams are not cumulative so all of the information we just committed for the lower extremity and thorax will need to be filed away (for Boards and such) while we try and learn a whole new region of the body. Most of my previous science courses have been cumulative and while Anatomy as a subject is cumulative in the way that everything interrelates, I think I’ll be able to maintain a better grasp on the new material without feeling pressured to review past information. A bright spot in an otherwise dark cloud of unknown material.

I’m anticipating the start of another tough three weeks so I’m going to sign off for now and go to sleep at the ridiculously early hour of 10:30 PM to relish these last moments of relaxation, devoid of guilt associated with neglecting new anatomic terms. I’m oddly excited to start another section…guess this is my new normal!

Thanks for reading, and for the good vibes sent my way this past Thursday…I definitely think they helped!

What I learned while taking a 7 ½ hour exam: putting icy hot on your hand and taking Tylenol prior to entering an exam is an excellent way to postpone cramping. See, I’m a doctor already!


A True Second


Just a brief note to say that I am pulling through this intense week of studying and I am ready to take our first exam tomorrow! Ready, as in tired of studying and desperate to see what our course directors have in store for us. I think our class has reached the point where we have committed all of the information we will be able to retain for the exam and are now focusing on building our own confidence and reviewing key structures, essays, etc. Past exams, true and false questions, definitions, boundaries, relationships and some really odd mnemonics are playing on a loop in my brain right now. Mnemonics and crazy sentences like “A Duck Between Two Geese” “A Hot Dog in a Bun” “Four Ducks” “DATES and DERP” and my favorite mnemonic, which isn’t really a mnemonic but a string of nonsense words: “I TASRAT ALL REDT HRT” make studying hilarious and help hold my attention. Two cups of coffee and a caffeinated soda help too.

Our exam is split into two components: the practical exam in the cadaver lab lasts two hours and the written portion is approximately four hours. We start this marathon at 1 PM–by 8 PM I will be indulging in a delicious dinner, glass of wine and the prospect of going to bed before 1 AM. Tomorrow is going to be a wonderful day…I hope.

Living for tomorrow at 7 o’clock!


Fun fact I managed to learn while being kicked out of the library at midnight: the tetralogy of Fallot is not called “the tetralogy of Flow.” Good to know.

A Crazy Morning


Today I spent two hours taking a practice practical exam and I was oddly calm throughout! The awe-inspiring, second years set up a mock practical exam in our cadaver lab in preparation for our first exam this Thursday. There are 50 stations and we rotate every 90 seconds, urged on by the most high-pitched, irritating bell. Ding! You done messed that one up! It truly eggs you on.

90 seconds may seem like a really short time period but it’s more than enough time to identify the tag at hand and then proceed to question your answer, convince yourself you’ve identified an incorrect structure, and have a near panic attack. It’s just as much a test of endurance and resilience as it is a test of acquired knowledge. While there are 50 spots, there are 75 students, so after almost every other identification, you happen upon a “rest” stop. Those 90 seconds span what seems like hours as you review all of the structures you’ve seen and anticipate what is to come. I’m so glad we had the opportunity to experience the two-hour exam without having our grade at stake. Not only did it prepare me for what’s to come on Thursday, but it also gave me a good idea of what it is I need to address in terms of my studying and where my focus should be in the coming days.

I went back late this evening to look at some of the structures I had trouble identifying earlier in the day. You would think the cadaver lab would be an eerie, if not downright frightening place to be late at night but it’s oddly peaceful. Maybe there is desensitization creeping in to my attitude but there is such quiet and calm—there’s no frenzied activity or harried pace. It’s almost the only place you can find reprieve, so long as half of the class hasn’t beat you to the punch. I find myself moving slowly through the lab, finding what I need without feeling like I’m encroaching on someone’s space or using up valuable daytime studying hours. I always start with my lab group’s body and then move on to others. I’ve certainly developed a type of rapport, be it one-sided, with my cadaver. When she was tagged, twice, on our exam today, I felt instantly comfortable with the identifications because I was assured of my own knowledge concerning her anatomy. Our professors suggested that our cadavers are truly our first patients, and that we will learn more from them, and the gift they’ve bestowed, than all of our future patients combined. I think I finally realized what they have been saying when I approached our table during the practical today. Our cadaver has helped me become comfortable with terms, figures, and aspects of the human form that I couldn’t even name two weeks ago. She has taught me patience, care, concern, and selflessness. When we opened her rib cage the other day, and found extreme evidence of cancer, I couldn’t help but feel sad—I found myself hoping that she hadn’t suffered. This woman will forever be a part of my educational and personal development; I only wish I could find a way to better thank her.

I’ve finishing up studying, and this blog, prior to midnight. This is definitely an achievement for me; I may even be asleep before 1 AM. I welcome that. Tomorrow is another long day of studying before Monday hits and we only have two more lectures worth of material to cover before our exam. It’s the final push but only for this three-week stretch. 9 more weeks of anatomy to go!

Fun thing I learned while trying to memorize the lymph flow pattern in the breast:
The lingula, an extension of the left lung, “licks” the heart. Just a funky way of remembering its location!

Until next time (which may not be until after our first exam),
PS Cross your fingers for me on Thursday from 1-8. Yup, our exams are around 7 hours long. Why shouldn’t they be?!

A New Perspective


I’m hoping my absence from blogging will be an accurate representation of my lack of existence outside of studying right now! I’m sorry for the quiet; a post every other day may be just what I need to alleviate stress so I’m going to try and stick to that. For now….

I think I’ve found the trick to negotiating medical school (that sounds incredibly bold coming from someone who has only been at it for 2 weeks): I have to relinquish the need to know everything presented to me. I know that it seems counter-intuitive for a soon-to-be doctor to be choosing to actively ignore certain information or concepts but there is absolutely no way to master everything contained in the lectures and material we are given. Broad concepts, details and diagrams abound here and there’s only so much I can process. The faculty are constantly encouraging us to view medical school using the analogy that we’re trying to drink out of a fire plug. I think that’s an excellent analogy; I’m drowning, sopping wet and woefully uninformed about the availability of water fountains. Perfect. But in all seriousness, the analogy is true. We are being thrown material and we need to try and develop a big picture and recognize the details integral to processing the main tenets. Too bad everything seems incredibly important.

As of today, we have one week until our first exam and I have enough on my to do list of studying to last me three weeks. Condensing and consolidating-that’s the new plan. Fortunately we have access to past exams dating back almost 20 years. They’re an excellent tool for examining what material will be stressed but they don’t necessarily create a sense of ease. Instead, I feel literally bombarded by potential study tools. I think the first two exams, and intervening lecture and study time, are a test period. I’m still figuring out how to study, what materials to use, how to establish a balance…it’s really a process and I’m thinking I’ll figure out my own perfect balance in several weeks time.

I’ve noticed another medical school tendency (apparently I’ve become an observer since entering this institution): there are really good days and really bad days and it all depends on retention and the Socratic method. If I’m asked a question by a TA, peer, or professor and I can provide a response before they even finish the question, it’s a good day. I’ve retained information, been able to make connections and, most importantly, I’m able to sift through the absurd amount of knowledge I’ve crammed into my head without becoming overwhelmed. Bad days, though, are when I have no idea what anatomical structure someone is talking about or worse yet, I can’t even figure out what part of the body they’re referring to. At this point, we only have the thorax and lower extremity as options but that ain’t as limiting as you’d expect. Those moments are the absolute worst; they undercut every snippet of confidence or assurance you’ve established and push you headlong into hours of studying in the library…with no reprieve. It’s a very delicate balance between grasping the material and falling short and sometimes the boundary is so tenuous, it is tough to define. Maybe that’s the hardest part about medical school, not only realizing you can’t retain everything but actively accepting the fact that you won’t.

Up to this point, we’ve been immersed in a purely anatomical mindset regarding the approach to medicine and the body. Today we finally get to use the knowledge base we’ve established and start playing with stethoscopes and sphygmomanometer (blood pressure cuff). What a throwback to my first Playskool plastic diagnostic kit, complete with stethoscope, ophthalmoscope, and heart shaped band aids. I was always able to cure my sister; I have about the same capacity to heal now as I did then so I’m really excited to start learning something, anything, about the diagnostic process. Hopefully I’ll be able to find the pulse…gotta start somewhere.

Fun fact that I managed to learn while studying approximately six hours a day: rubella in newborn infants is often called the blueberry muffin syndrome. Don’t look up pictures-you’ll never feel the same about a muffin top again.

Until next time…

A True First


It’s the end of the first week…and I survived! Right now that feels like an enormous accomplishment. I wrote the following post last night in a sleep-deprived state but I will follow with another sometime this weekend during a break from hours of more studying. Welcome to Medical School weekends!

As part of our gross anatomy course, we do a full cadaver dissection. We were prompted to write down our thoughts concerning beginning dissection and how we anticipated we would react to the somewhat incomprehensible experience. I’ve included some excerpts from my response for the course so you could have some insight into how I was feeling just prior to the first meeting with my cadaver and after the first cut. Note: Although my responses were not detailed about the dissection process, this may make you a little squeamish…

I’m really not sure of how I will respond to being in the presence of a dead body and working intimately with my cadaver. I’m fascinated by what we will be doing and in some ways I am repulsed. I’ve been skimming various dissections in our textbook and I already recognize several cuts that I don’t know how I will feel when required to proceed. Certain areas of the body seem so personal and sensitive that it is hard for me to imagine the destructive process of dissection occurring. I am approaching cadaver dissection with an open mind and also a great sense of respect and appreciation for those who donated their bodies to science. I am in awe of their contribution and I think my reverence for their donation will help me through the process. I can acknowledge a mixture of emotions right now from anxiety to excitement to fear. Ultimately, I am able to move my mind beyond the dissection, and the very physical and tactile nature of the process, and see the greater experience, which is the development of an intimate and expansive understanding of the human body. I think it is incredibly important to remain emotionally attached to our task—I don’t think I would be compromising my professionalism by remaining present and aware of the body in front of me. In fact, I think it would be incredibly unprofessional to become desensitized and disrespectful to the body. While I do hope I become more accustomed to the process, I don’t want to lose sight of what I am doing or work through the dissections without any emotional response. I don’t think that would allow for a complete experience.

I think one of the elements I am most concerned about is the development of our group dynamic and the structural organization of the team I am hoping to help create. Since we spend so much time with our anatomy group, I hope that we will be able to develop a cohesive unit focused more on working together and supporting one another than interpersonal competition and stress. The coursework and amount of material we are expected to master is extensive and stressful enough without adding pressure to impress peers. I really hope we can become a collective and learn to work seamlessly together, picking up where another left off or encouraging someone to try something new they are hesitant to undertake. I understand that the dynamic amongst groups of students in medical school can take a turn towards the competitive and away from the collaborative but I hope I will be able to push my group towards more positive interaction. I understand the need for competition but I think there is a great difference between competition for learning’s sake and mere competition to bolster self-pride. I recognize that we are all here to achieve the same end and hold similar values, which can drive competitiveness but I also appreciate how the very same elements should encourage us to support one another. I hope that my group will be a team devoid of aggressive behavior towards one another—instead, I hope we can funnel our competitiveness to push ourselves to greater achievements and fuel our desire to learn as much as we can.

After the first day of dissection, we were asked to briefly recount our experiences and emotions. I was shocked at my own cavalier attitude towards the dissection. I didn’t feel repulsed or unsure; I felt confident with the cuts I was making and with the help of the TA’s and faculty, I felt assured that I was handling the cadaver in a respectful and appropriate manner. I wasn’t hesitant or nervous as I expected I would be. The smell didn’t bother me as it did when I first entered the lab on Sunday and I quickly adjusted to the process of cleaning subcutaneous tissue and revealing key superficial structures. Overall, I felt myself focusing far more on the academic element of the dissection, which helped ease my fears and quell any anxiety I felt prior to the first cut.

I’m still getting used to the lab and the charge we’ve been given, but we spend up to three hours a day with our bodies so I’m slowly becoming used to the windowless laboratory and odd smell that seems to linger on my hands, scrubs, and everything else I touch. I am hoping to get some sleep tonight, I’m operating on very little from this past week, so I will leave you for now but check back sometime this weekend for a more in depth update about the first week!


A Quick Note


Oh my…
My perception of the passing of time has been entirely altered in my first two days in medical school. I only have a few brief moments, I’m in between lectures concerning Field Clinical Experience and History of Anatomy, but I want to share just a few thoughts on what have been two revolutionary days. 

Beginning with my mention of time.  I don’t have control of time anymore-SBMP has eliminated the ownership on my own schedule-a now acknowledged luxury.  I barely have time to eat meals, check my email or even write down a sentence unrelated to gross anatomy. Due in part to our class schedule and time spent in lab, we are left with very little time for anything let alone the hours we all need, and crave, for studying the material thrown at us.  Yesterday was only the second day of medical school but in two days I have gathered over 200 new terms, an intimate understanding of the superior lower extremity, and a pretty constant headache. We started our gross anatomy course, also called SBMP, with the lower extremity. In two days we have covered the subinguinal region, anterior and medial thigh, and gluteal region. Layman terms? Below the groin, the front and side of the thigh, and the derrière. I can’t even quantify how much we’ve learned or how much I have been presented with in the past two days. Imagine all of the bones, muscles, nerves, arteries, veins, muscular attachments, and physiology associated with those deceptively small regions. Gluteus maximus isn’t just a funny way of saying butt anymore. 

Tuesday we had class from 7:30-11:30 and then a break during which I studied and ate lunch followed by lecture from 1-2:30 and lab from 2:30-6. A quick dinner and I found myself back in the library…until I got kicked out at midnight.  It ain’t easy but what tempers the anxiety of learning more in two days than previously learned in a year is how much I want to learn the material and how fascinating the material is for us science geeks. We are being given unbelievable opportunities to increase our knowledge and explore the human body in a way that few others will ever experience. So while just two days have been sufficiently overwhelming, I’m holding on to my interest in the material and excitement about this opportunity and trying to stave off the inevitable panic at conquering every element of the human body in three weeks.

I have written down my reflections on cadaver dissection for a course we’re taking and I think it would be interesting to share those here. I’ll post those as soon as I have a moment…or rather, as soon as I steal a moment of my now relinquished time back from lecture room B and my cadaver.

So far, I’m loving medical school. It is, in five adjectives, stressful, frightening, intense, competitive, and yet astonishingly wonderful at the same time. Okay, so 6 adjectives. My focus for this week: survive and figure out how best to study. I’ll keep you updated on that progress.

Don’t you wish you were here?

A White Coat


This past Friday we celebrated our entrance into the medical community with a white coat ceremony. Medical schools hold this meaningful right of passage at the beginning of every academic year. Family and friends of the entering class attend to witness the cloaking ceremony where eager first years receive the first tangible representation of the medical field—the short, white coat.

My friends and I all agreed that our white coat ceremony was inspiring, motivating, and intimidating all at the same time. I felt celebrated for what I’d accomplished up to this point but I also became acutely aware of all that’s to come. We may have donned our white coats but we have four years and endless learning to do prior to receiving  two key letters to follow our name.  Several Deans and faculty members spoke at the ceremony expressing their pride and excitement for the entering class of 2011. They encouraged us to reflect on what the white coat means-the responsibility that’s imparted by the cloaking ceremony and the significance of our undertaking. It truly was an inspiring ceremony. There’s a lot of metaphor associated with the white coat and I have come to better understand the requirements and developed a new attitude as a result. The white coat bestows authority, knowledge and leadership and as the recipient, I need to rise to the occasion, embody and espouse the values and charges associated.

A fourth year medical student pursuing vascular surgery addressed our class and qualified our excitement by explaining the transformation of the white coat from a mere accessory to an identifier. She explained the various paraphernalia we’d be carting around from stethoscopes to pocket medical diagnostic books and cautioned how residents would try and steal our pens adorning our jacket pockets. Eventually, the accessories would thin and we’d begin to look longingly at the longer coats distinguishing the residents and feel ready to move on to our next endeavor. I didn’t find myself wishing I was in her position-I know I will be there one day but I don’t want to rush the coming years. I need this knowledge and I want to challenge myself to conquer all of the material thrown our way.

The ceremony cemented my excitement and nervousness for tomorrow, the official start of classes. I know that tomorrow I start a monumental journey and a transformative process and I cannot wait to see how I adapt and change as a result. Sure, I’m worried about the impending stress and work but I’m also incredibly excited and, after our ceremony, eager and motivated. This first week may be sparse in terms of blogging but I promise to write by the end of the week about what is sure to be a fascinating five days. Until then, wish me luck!!

Courtesy of my wonderful sister; taken prior to the ceremony

Journey towards the first day of medical school is almost over!