Medical School Rotations: Emergency Medicine Clerkship

Saturday, August 15, 2015
*Disclaimer: My experience on every rotation is very site-specific. It may not necessarily apply to your clerkships. I hope you enjoy it nonetheless. IM, neuro and Emed will be shorter as I've done them on a delayed schedule, and forgotten a lot of my experiences.
What I liked:
Getting to see a large variety of cases. Since I was at a hospital that served mostly the uninsured, the people that walked in had very crazy pathologies! 
A team of residents that loved teaching. I've never seen so many people take time out of their shift to personally review important info with little ol' me (MI protocols, LOC differentials, etc). I was very lucky to work at one of the best EMED departments in the USA.
Depending on the attending, we were given a TON of responsibility or minimal. I mostly liked the former, where I got to see patients start to finish, put in orders, call the inpatient unit for transfers, or call specialists for consult, discharge, etc. 
Learning how to manage patients on every team (green/red/blue).
Getting to close all the lacerations on green team - seriously you guys, that was my jam. The doctors would just leave me in there, and I'd chat away with the patient whilst making sure everything was sutured perfectly. I even got it mentioned on my final evals. Lac-girl to the rescue!
Learning how to interview inmates with several officers in the room; that was an experience! It seemed to really skew what the patient would say, or he would be incredibly uncomfortable throughout the interaction.
The excited atmosphere in the ED during the final Blackhawks game when they won the Stanley Cup! There were whoops of cheer, lots of yelling, and then a huge sigh of relief that our shift ended right before the onslaught of drunkies. 

I had "the moment" of third year during this rotation: I took care of a patient for a rule-out ectopic pregnancy. She had a prior history, and came in with a + pregnancy test and abdominal pains. Her and her fiancee were very anxious and frightened, plus they REALLY wanted to have a baby. After several hours, imaging showed no ectopic & a viable intrauterine pregnancy. Guess who got to break the good news!? ME, MEEEEEEEE!! We jumped and cried and high-fived and I was put into a huge hugging circle, and it was the best day of medical school ever. I will never forget this day 'til I die!

What I didn't like:
Having a different attending every shift, and not knowing who he/she was until I arrived. I was perpetually nervous because I wasn't sure what this new attending liked, and how they coped under stress. I definitely prefer having the same set of doctors every day.
Shift work - I'm not very good at adjusting my schedule. However, it was great practice for intern year and residency when I'll have to do night float, 24 or 36hr shifts, etc. 
Not being able to continue patient care and rapport once they were discharged.
I didn't get to see any big trauma cases, because they were in a separate department. I definitely wanted to know how a gunshot wound was treated based on extent of damage.

How I studied for the clerkship:
EMED podcasts: EM Basic  
Resident teachings
OnlineMedEd videos

How I studied for the shelf exam:
EMED pretest x 2
UWORLD surgery - half of the questions.

     Hope that was helpful! Comment below with extra tips!

image source: uiowa

Medical School Rotations: Neurology Clerkship

Thursday, August 13, 2015
*Disclaimer: My experience on every rotation is very site-specific. It may not necessarily apply to your clerkships. I hope you enjoy it nonetheless. IM, neuro and Emed will be shorter as I've done them on a delayed schedule, and forgotten a lot of my experiences.

  What I liked:
We were treated like interns, so we had a lot of responsibilities. It felt great being an important member of the team, and the residents really relied on us to get all their work done for the day.
Having attendings who loved teaching; our hours were really long but the amount of information our doctors would pass onto us was incredible. There was a reason they were well-known in their field. Not only would they correct us when our differentials were off, they would draw out sketches, do quick mnemonics, and even tell us the latest research and upcoming treatments. It was great!
Getting to see the pt in the ED before the residents (most of the time); once we noticed a stroke was possible, and our timeline was correct, we'd run like the wind to find the neuro team and get tPA started. We also had a great ED team who would initiate tPA when they noticed a stroke and no contraindications were noted. Yay for inter-department team work!
Refining my radiology readings!
Seriously, the attendings and residents were great. Especially when they cracked dirty jokes.
Witnessing some of the best bedside manner I've ever seen by one of the younger attendings; no matter how late into rounds we were going, and no matter how frustrating the patient was, he always kept his cool with a big smile. AND he did great patient education too! Definitely an inspiration no matter what specialty any of his students go into!

What I didn't like:
Working very long hours, 6 days a week. Many of the prior students had warned us about this particular site, but we were so busy I barely noticed the day went by. I was always surprised when I was dismissed for the day! 

How I studied for the clerkship:
Honestly, it was really difficult to get a lot of studying done outside of the clerkship. I learned as I went. The great part of being on this team was all the teaching-as-you-go the docs/residents did; it was invaluable. Also, and this is a big one, the attendings ALWAYS listened to our full H&P, differential diagnosis, and treatment plans. Their corrections were great for making the information stick (or you'd nail it, and they'd fist bump you!)

How I studied for the shelf exam:
UWORLD neuro w/ notes - x2 (there are very few questions in the qbank for neuro so I recommend another to supplement)
Pretest - Neurology: INVALUABLE! There were 500 q's for me to work through, and it covered a lot of material missed by UWorld that showed up on the test. I'm looking at you peds neuro and psych. 
Reviewing the notes I took during rounds - I still have nearly one moleskine per rotation. Can't wait to have a bookshelf full of these gems!
      Hope this was helpful! Drop any extra tips in the comments below!

img source: webmd

Professional Dresscode // Clinic Outfits #4

Wednesday, August 12, 2015
Hola everybody!
Here's another round of outfit inspiration for those of you who also work in a professional setting. This is my fourth installment- check out previous posts here: 1, 2, 3. Don't you just love summer? I've been getting so much use out of my wardrobe. Two more 'rotation in review' blogs will be coming this week. Catch you on the flipside!
office outfitsoffice outfits
Both images from fashioncuisine (a newly discovered blog on my end; great styling)

Flouncy top with slouchy trousers - kayture 
professional dresscode
Prints on pants - erikathomas 
office outfits
pastels on christine



Medical School Rotations: Internal Medicine Clerkship

Sunday, August 09, 2015
*Disclaimer: My experience on every rotation is very site-specific. It may not necessarily apply to your clerkships. I hope you enjoy it nonetheless. IM, neuro and Emed will be shorter as I've done them on a delayed schedule, and forgotten a lot of my experiences.
What I liked:
Lots of patient interaction
Tons of learning; IM is so broad you really need to take time at home to fully grasp the material before applying it to patient cases.
Working in the hospital!
Getting to see GI procedures in the afternoons, and occasionally joining in on IR procedures.
Morning review of The List: Our attending would go over each patient we were seeing, quiz us and then assign us patients.
Daily radiology lectures - finally all that black and white makes more sense.
Fantastic, funny attendings who love to teach.
Weekly lectures with the heme/onc doc, aka a 2 student seminar. It's so great being in a setting that's non-intimidating, and learning from a physician who knows so much about the latest treatments, and interesting findings.
The scribes: they are fountains of information!
The food - free buffet everyday!
Bi-weekly skype lectures: we would join in with two other class members at a different site, and their attending would do MKSAP with us. He had great mnemonics, and loved teaching.

What I didn't like:
The commute - I was at a hospital 1.5-2h away. Friends, the struggle is real on that drive home (Zzzzzz).
Pretty much enjoyed this whole rotation!

How I studied for the clerkship:
Reviewed my patient's diagnosis the evening after seeing him/her, and brought questions to our attending in the morning.
MKSAP sessions bi-weekly
Step Up To Medicine

How I studied for the shelf exam:
Did all of UWORLD IM section, took notes, and did all of the MKSAP questions twice with notes.
 If I had to do it again: I would have gone through UWORLD 2x.
      Hope this was helpful! Welcome to all the MS3's on the wards. It gets better!


img source: here