Life In The Fast Lane

You know, I thought that the switch from Surgery to Family Medicine would be the most drastic turnaround of rotations that I would have all year. And to some extent, it still may be. However, the switch from Family Medicine to Emergency Medicine definitely comes at a close second. Although I knew that Emergency Medicine would be vastly different from clinic life in Family Medicine, I was still a bit frazzled on my first shift at just how fundamentally different it was from my previous rotation. If Family Medicine is like playing Family Feud in a chill environment with Steve Harvey, Emergency Med is like jumping through multiple rings of fire right before leaping on some chains hanging from a ceiling over water and swinging on them in order to get to the other side to do some more ridiculous stunts that you weren’t ready for on American Ninja Warrior.

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Okay I may have made the rings of fire part up, but you get the idea.

All eight hours of that first evening shift on Wednesday was literally wild from start to finish. I probably encountered like 10-15 patients on my own and saw a number of others with my upper-level resident. I thought that having two days to prepare for that shift would get me all ready for it.

It didn’t.

Well okay, I’m being dramatic. I definitely held my own (even with all the crazy things I saw and smelled 😳) and was able to engage with patients and present my findings as well as my differential and plan to the resident and attending. It’s just that I felt like I was making it pretty obvious that it was my first time working in the ED. Because I was trying to be quick with my patient encounters, I would forget to perform a couple of key physical exam maneuvers here and there and would also not think to ask a few key questions with some of my patients. Also, while my presentations were crafted pretty decently, it was clear that I was still in the Family Medicine mindset when it came to presenting patients. I learned quickly just how different presenting patients in the ED was. Because the patients in this environment need high acuity care, you need to frame your mind to rule out devastating diagnoses before working through the diagnoses that don’t require as much acuity to treat.

Also, there’s usually a thousand things going on at the same time as you try to interact with your patients, especially if they have just entered the ED. They usually need to get an EKG and chest x-ray if their symptoms are concerning enough, their airway, breathing and circulation needs to be assessed, their vitals need to be recorded, IV access needs to be obtained, etc, etc, etc. So you can imagine how chaotic the scene can be.

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And then after gathering the patient’s information, you have to find a way to gather your thoughts in this chaotic environment and then present them to your upper-level moments later. So yeah, you can see why I was a bit frazzled on my first night in the ED. I got great feedback overall though and was told that I was doing a good job so far. I was also told about specific things that I could improve on, which I’ve been working on ever since.

I was already showing signs of improvement during my next couple of evening shifts as well as during my required clinical coach session, which all occurred on Friday and Saturday. Outside of a three-hour period on Friday where the ED went berserk with an influx of patients, those shifts were overall calmer than my shift on Wednesday. Because I had begun to familiarize myself with this environment, I was starting to have more fun and I was also getting more proactive at taking advantage of learning opportunites. In addition, the teams that I was working with on both nights were simply fantastic. They really took the time to teach me various concepts and answered any questions that I had about anything concerning this field of medicine. The team members also gave me advice on how to give more effective presentations in the ED, what specific information to gather from patients with various complaints and even complimented my thought process whenever I talked through my differential and plan. In regards to my clinical coach session, it was very helpful and encouraging overall. After interviewing a patient in the ED, performing a physical exam on him and giving a patient presentation to my clinical coach, I was given specific feedback regarding my performance. The feedback was mainly positive and I was told to continue studying chief complaints and connecting what I studied in the text to real-life patients to further improve retention of that information, as well as to continue using my differential to help guide my HPI and physical exam. It’s been awesome to see how much I’ve been improving in such a short amount of time and I’ve been enjoying the huge amount of independence I’ve been given so far. I’m excited to continue this trajectory of improvement as I march through this rotation!

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Outside of my scheduled shifts, I’ve had to attend EM lectures, knock off multiple things on my to-do list and, of course, study. The lectures that I’ve attended have been very educational, interactive and memorable for the most part. There was a specific lecture that stuck with me though, where the physician emphasized how important it was to rearrange the way we thought about assessing and treating patients while on this rotation. He reassured us that we already have the skills necessary to be a successful medical student and that all we need to do now is to futher hone those skills in a way that breeds success in EM. Some of the examples he gave regarding the rearrangement of our thoughts included thinking about the disastrous diagnoses first when encountering patients before backing up and considering other diagnoses, and remembering that labs and imaging modalities should be used to support our thought processes as opposed to being used to make our decisions for us. It was a very well put-together lecture full of useful information that I’ve been sure to implement during my shifts!

And finally, I want to touch on a random yet meaningful lecture that I had the opportunity to attend early on last week. During my off-time, I decided at the last minute to go to a lecutre given by Dr. Deogratias “Deo” Niyizonkiza, who is the Founder and the CEO of Village Health Works in Burundi. During his talk, he touched on his experiences of living in rural Burundi, having to halt his medical school studies and move to America from there due to the horrific genocide and civil war occuring there at the time, suffering from homelessness and depression in New York City, attending both Columbia and Harvard University before continuing his medical education at the Geisel School of Medicine at Dartmouth, and returning to Burundi to help build a medical campus designed to care for the poor in his home country. The absurd conditions in which the people in that country lived in, and still live in to this day, is simply mind-blowing to me. Dr. Deo further illustrated these conditions by showing us multiple pictures of some of the country’s residents. He then showed us the progress that his company has made in the region and how people from neighboring regions come to his medical campus to receive adequate health care. It was a really inspiring talk, to say the least! He also has a book written about his life called Strength In What Remains if you’re interested in learning more about him! I’m glad that I ultimately decided to attend the talk. It really is wild just how drastically different someone’s life can be, simply based on where and when that person was born.

All done! Y’all be sure to have an awesome week and make sure to GO VOTE IN YOUR PRIMARY ELECTIONS!!!

“The trick is in what one emphasizes. We either make ourselves miserable, or we make ourselves strong. The amount of work is the same.” – Carlos Castaneda

– Black Man, M.D.

One Last Ride

I had to stop and take a moment this morning to fully take in the fact that my Step 2 CK scheduled exam date is exactly two months from today. TWO MONTHS. I actually didn’t realize how close we were to June, partly because up until about a week ago it had been so damn cold here. But now that it looks like spring is finally here to stay, I’m more acutely aware of how soon summer will be here, which means that I’ll be taking both parts of Step 2 pretty soon as well as starting my fourth-year electives and working on my residency applications.

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Man, that’s a lot to think about right now. I don’t think I’m prepared to be in Step Study Mode yet…it took so much out of me the first time around. But it just has to be done. I just gotta get myself mentally prepared for it. I just really hope that my decision to end my third year on the broad subjects of Family and Emergency Medicine ultimately pays off. 😅

Speaking of which, I’m really about to start my final rotation of third year tomorrow! Emergency Medicine is another four-week rotation and I have a strong feeling that these next four weeks will fly by just as fast as the month in Family Medicine did. I’ve heard only great things about this rotation, including the incredible amount of independence we as students enjoy while rotating in the Emergency Department. At this point in my medical school career, I’m beyond ready to take on patients on my own in order to assess their condition and to come up with a treatment plan for them. I’m looking forward to the wild experiences that I’m sure to come across in the ED, even though the pace is going to be vastly different from the relatively much calmer pace I enjoyed in the clinic this past month. My schedule looks pretty wild though. I have a bunch of evening shifts sprinkled sporadically throughout the month (my weekend days were not spared), a few day shifts, a good number of morning lectures, a couple of clinical coaching experiences, a Saturday overnight shift, and some other things that I’m going to learn more about in orientation tomorrow. I’ve heard that I can change shift days around though, which has been unheard of in other rotations. I might have to go on and look into doing that with some of my shifts, because I have a feeling that I’ll have a couple of time conflicts with other pre-scheduled events…we’ll see though.

As for my most recent shelf exam…I THINK I did okay overall. That mess was pretty challenging, even after all of that preparation I put into it. Even though I was uncertain about more questions than I would have liked, I believe it’s safe to say that it did NOT slap me sideways as I had feared! I finished the exam with some time to spare, allowing me to go over most of the questions that I didn’t feel too sure about. Hopefully I did better on it than I did on my Surgery shelf. That Surgery exam disrespected the hell outta me. Smh. And while I’m on the topic of Surgery, I finally got my rotation grade a couple of days ago. Not gonna lie, I wasn’t impressed with it. I actually was a bit bummed out because I had fallen short of the goal I had set for myself in that rotation, even after all the grueling hours I put into making sure that I performed well. I must say, the shelf exam didn’t really help me reach my goal either. But alas, what’s done is done. I did my best. All I can do is move on and use the lessons I learned along with the feedback I recieved to make me a better medical student and future physician. And besides, I have no desire to be a surgeon. So there’s that.

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I had a few clinic shifts to work leading up to exam day, including a couple of evening shifts. One of them was the Community Care Clinic, where I interviewed and assessed like five or six patients back to back. I definitely got a lot of practice in history-taking, patient presentation and document write-up there. The other shift was at the Delivering Equal Access to Care (DEAC) Free Clinic, where I was paired up with a first-year medical student in order to assess patients together. His main task was to gather a focused history from the patient while mine was to chart the patient and follow-up with any additional questions that I deemed necessary before going on to the physical exam. I was also responsible for presenting the patient to the attending physician. As I worked with the first-year that night, I was suddenly reminded of how far I’ve come as a medical student. I found myself casually using terms that he hadn’t learned yet, asking the patient very focused questions after the student gathered a great history in a style that I remember learning as a first-year, speaking with the attending about various medications and dosages to give to the patient, and teaching the student various things as we worked together through the shift. Although I’ve been aware of my overall growth as a student, I was still quite surprised at how much information I knew while I worked with him, and was even more surprised when the student commended me for being so knowledgeable. It was really cool to be in a position to teach him concepts that are now second-nature to me and to fully appreciate my exponential growth as a student in terms of knowledge base and comfortability in assessing patients.

The last things I’m going to talk about in this post are the two panels that I was invited to be a part of this past week. The first one was a MAPS panel at UNCG, where myself and a few other students from Wake and Duke talked to college students about our experiences in medical school. They were very appreciative of our honesty and that we all came from different backgrounds with different paths to medical school. I always love doing things like this, because seeing us talk about our experiences really helps to motivate them and shows them that they really can achieve whatever goals they set for themselves. Also, it humbles me and allows me to remember what it was like to be a college student striving to get into medical school.

The other panel was at a Narrative Medicine Symposium at Wake Forest yesterday and it involved me talking about how I use narrative medicine in my everyday life as a student in the field of healthcare. I sat on the panel with two other physicians and we all talked about the various ways we cope with the stresses of our lives. I mainly talked about why I started this blog in the first place, how I’ve been able to incorporate it into my everyday life and how I’ve expanded the platform overtime. I also touched on where my love for writing first started, how I’ve had to learn how to navigate writing about my clinical experiences without potentially violating the privacy of the patients that I encountered, and I even shared a few of the posts that I’ve written in the past with the audience! I’m so glad that I was invited to speak on the panel and that I was introduced to the notion of Narrative Medicine. It’s really wild to think about how many opportunities I’ve been able to capitalize on simply because I created this blog! And thanks to the support of each of you, I’ve been able to maintain this platform for as long as I have!

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Alright, I’m done word-vomiting. I’ve had a sort-of chill weekend but now I gotta gear back up and get ready for this last rotation of the school year. I also gotta get in on a couple of conference calls tonight for the SNMA. The grind never stops! I hope that your week is a delightful one! 😄

“If you can dream it, then you can achieve it. You will get all you want in life if you help enough other people get what they want.” – Zig Ziglar 

– Black Man, M.D.

P.S. – If you want to learn more about the disastrous situation in Syria, check out the “Cries From Syria” HBO documentary. I watched it last night and it really shook me. The atrocities happening to the Syrian citizens are absolutely horrendous. Trust me, you’ll learn a lot about the crisis and will also have a better understanding of the implications that their civil war will have on our immediate future. Just to warn you though, the documentary is very graphic.

Way Too Fast

This week flew by so fast man…like I was just in a plane typing up last week’s post. Then I blinked and now here I am typing up this post. I really couldn’t tell you where the time went. However, whenever I’m busy studying for an upcoming exam, time has the cruel tendency to speed up in an exponential fashion. So with that said, it makes sense as to why I feel like the hours in the day have been carelessly flying by. I’ve been getting a TON of necessary studying in via question format and have spent a lot of time reviewing the questions that I’ve answered. If you didn’t already know, there is SOOO much information to review in Family Medicine but because I’ve already seen about 95% of this specialty’s content in all of my previous rotations, it’s really not as overwhelming as it has the potential to be. To put it simply, this rotation is pretty much a crash course of everything that I’ve already learned. This is one of the huge pluses to having this rotation near the end of my third year!

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But even after having said this, I am very well aware of how hard the shelf can potentially be. I’m going to be tested on literally anything that I’ve learned all year long, almost as if it were a mini-Step 2 exam. This is why I’ve already powered through and reviewed 500+ questions, and will continue to power through and review a couple hundred more this week up until exam time on Friday afternoon. This test is NOT about to catch me slipping. If it ends up slapping me sideways anyway, at least I know that I put 100% of my effort in preparing for it. Let’s hope that the outcome is the other way around though lol.

Although I spent the vast majority of my free time this past week studying, I did have the time to participate in some clinical activities. I had an evening shift one night, a few day shifts, and a focused observed patient assessment where I was observed by a clinical coach via video recording as I interacted with a standardized patient. I also had the opportunity to meet with a clinical operations manager in order to learn more about the business side of healthcare and how money influences what goes on in this industry. As a result of this conversation, I got a better understanding of how salary payments are broken down in both an academic setting and a private practice setting, although I still don’t think I could fully explain it to someone else. At the very least, I made a friend who made herself available to me whenever I want to learn more about the financial operations of a hospital or clinic. I’ll surely be hitting her up more in the future!

And last but certainly not least, I’ve had the pleasure of attending the multiple noon conferences that the Family Medicine department hosts. The topics have been some very educational ones, but admittedly the best part of the lectures has been the phenomenal catering. Bruh, the free food that I’ve been able to enjoy in this rotation has been nothing short of spectacular. Like, where else would you get Jason’s Deli, pulled pork & beans with potato salad and grilled chicken, chicken noodle soup, and full house salads all in one week? And those are just the lunches that I can remember at the moment! There have been other awesome dishes that I have taken delightful joy in consuming. I’m definitely going to miss this about this rotation…

Speaking of, I don’t even understand how my time in Family Medicine is already almost up. It honestly wasn’t that long ago that I took my Surgery shelf exam. I’ve had such an awesome time with the residents and attendings here as well as the nurses, the certified medical assistants, and everyone in between. Everyone has been so genuine and kind, which has given me the confidence to take the extra mile to improve upon my history-taking skills as well as my physical exam maneuvers and my presentation technique. For example, I’ve been taking a minimal amount of notes, if any, while in the patient room and then presenting all of my findings to my preceptor from memory. By doing this, I’ve forced myself to not only organize my thoughts in a succinct and presentable fashion in my head but to also be fully engaged with the patient while interviewing him or her. In addition, by presentating information from the dome, I’m learning how to trust myself more and am building the necessary clinical confidence that will help carry me into fourth year and beyond. It’s not an easy thing to do, but I believe that it will help work wonders once I become proficient in this skill. Besides, I feel like this clerkship is a better time to practice something like this than any other time in third year!

Alright I gotta get back to studying like always. This is about to be a very busy week in terms of studying, and my clinic schedule this week isn’t the friendliest relatively speaking (got a couple of evening shifts, a full day of clinic and a half day), but there’s no way in hell I’m going to complain about it, especially if I think about what my days in Surgical Oncology looked like a couple of months ago. Good God.

Thanks for reading and I hope that your week is a fantastic one!

“The successful warrior is the average man, with laser-like focus.” – Bruce Lee

– Black Man, M.D.

P.S. – I was invited to be on a panel during an interdisciplinary symposium taking place at Wake Forest this Saturday titled, “Narrative Medicine: Resilience, Professionalism and Self-Care” because of the fact that I’ve been blogging about my experiences in medical school for almost three years now. The session that I’m going to be serving as a panelist on specifically focuses on how to integrate narrative medicine into one’s life, something that I had already been doing without realizing it! I’m looking forward to sharing my experiences in narrative medicine with the participants of the conference!

The Spirit of Ambition

Throughout my third-year, my classmates and friends had been telling me how great and wonderful the Family Medicine rotation was. After having heard all of these glorious praises on a continuous basis, I found myself itching to begin this rotation to see why everyone had loved it so much. Now that I’ve been in Family Medicine for a week, I can absolutely confirm how awesome this rotation is! The residents and attendings are incredibly kind, they get along extraordinarily well with the other members of the healthcare team (who have also been very friendly towards me), the work hours are very med student-friendly (thanks to the outpatient nature of the specialty), there is built-in study time in our schedule (LOOK AT GOD), all of the noon conferences have quality lunches, the student lectures have been interesting & informative, we’ve been able to receive faculty feedback from non-graded patient encounters, and there is unlimited free coffee in the lounge for us to drink! And those are just the things that I could think of off the top of my head!

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In addition, I’ve been able to take advantage of the opportunities I have to further improve my focused history-taking and physical exam skills as well as my assessment and plan-making abilities. I’ve received great feedback so far that has allowed me to understand what I’ve been doing really well and what I could continue to improve upon. (I apparently have the habit of filling mid-conversational silence with random words like “Great, great….awesome…” or “Okay, okay…nice…” while I’m talking to patients. Lol, I’ve never thought about that…) I welcome all the high-quality feedback that I can get because as you know, I’m actively working to become the best physician that I can be. I want to be beyond good at what I do; I want to be excellent at my craft. Far-reaching goals such as this have forced me to push myself harder than I would necessarily need to otherwise, and I’m, in most ways, proud of that.

However, I’ve also come to realize that because of my ambitious nature, I can be overly (and probably unnecessarily) critical of myself at times. Even though I know that I’m doing alright in the whole process of gathering data from a patient, coming up with an assessment, differential diagnosis and plan, and presenting the information to someone else in oral and written format, I just feel like I could be doing so much better. I know my skills will continue to improve with practice and time and all, but I guess I just want to already have the skillset and knowledge that the attendings around me have. I have to keep reminding myself that they were once in my shoes and that it took them a long time to get to where they’re at currently. Hell, they probably had the same thoughts that I’m having about badly wanting to better themselves and wanting to be as knowledgeable as their own attendings and upper-levels. With that said, I’m just gonna have to keep grinding and improving while making sure that I don’t criticize myself to the point where I become demoralized. I didn’t make it all the way to this point just to kick myself down…the fact that I’m a medical student continues to be an achievement in itself, and I must never forget that.

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Overall, it’s been a real chill week in the clinic and I love the positive vibes that I’ve been feeling in the air! Like, I was assigned an evening clinic shift and a Saturday morning clinic shift this past week and not only did I enjoy the time I spent with the residents, attending and patients there, but I actually found that I had stayed a little later than I needed to both times! I swear man, the people you work with can seriously make or break your experiences in any given rotation.

I have a few more things to say before I end this post but I also don’t want to spend the next hour typing when I could be studying for this notoriously difficult shelf exam (I feel like I’ve been saying that about every shelf exam I’ve ever taken) that’s coming up in less than three weeks. So in order to compromise both of my desires, I’m just going to quickly word vomit what I wanna say.

I attended a global health session where current fourth-year students talked about their experiences in various global health electives. I had gone to the session because I’m interested in taking a newly-formed immigrant health elective next year and the student who was in the trial run of the elective this year was going to speak about her experience in it. However, after listening to the experiences of the other students who went to countries such as Japan, Costa Rica, South Africa and Spain in order to complete a rotation in a specialty of their choice, I’m now more amenable to pursuing an elective in another country at some point next year! But then again, I may not. Who knows?

There was another session where the Chair of the Department of Family Medicine came to talk to us medical students on this rotation about health policy and advocacy. In our discussion, he talked about the incredible importance of being involved in legislature as healthcare providers due to the fact that there is very little representation of us in the government. He also touched on being an advocate for primary care and we discussed reasons as to why medical students may or may not choose to go into primary care. It was a thought-provoking conversation and made me more aware of the influence that we as medical students and future physicians can potentially have on decisions made in the government.

Okay, I’m pretty much done now. I’m excited to start another week of Family Medicine and to FINALLY fly over to California on Wednesday to attend AMEC!! I’ll be finishing up my remaining responsibilities as one of the National Future Leadership Project Fellows and will be assuming my position as a Co-Chair of the External Affairs Committee of the SNMA, a position that I was appointed to just last Monday! It’s LIT!! 😄😎🔥

“To understand the heart and mind of a person, look not at what (s)he has already achieved, but at what (s)he aspires to do.” – Kahlil Gibran

– Black Man, M.D.

P.S. – I got my Surgery shelf exam score back and although it wasn’t a bad score, it wasn’t as great of a performance as I would have liked, considering the fact that I poured a TON of energy into preparing for it. Sigh. C’est la vie.

Revvin’ Up The Momentum

And just like that, my Surgery rotation has come to an end! This marks the completion of my sixth rotation of third year, giving me only two more four-week rotations to engage in before I start my fourth year!

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I’m definitely starting to feel the end-of-the-year momentum! Also, with Match Day having occurred just this past Friday (shoutout to all the soon-to-be doctors across the nation!!), it’s starting to really hit me that at this point next year, I’m going to find out where I’ll be spending the next few years of my life! Having now attended the Match Day ceremony here three different times, I’m really looking forward to finally having my moment of truth on Match Day 2019. It’s so wild and so exciting at the same time!

Now to quickly recap on my last week of Surgery. I spent the majority of the week in the O.R. with various Anesthesia residents and attendings. While with them, I was afforded the opportunity to assist the staff in Neurosurgery, Interventional Radiology and Cardiothoracic operations. I also learned a lot of good information from them while we monitored the operations and saw some incredible procedures that I would have otherwise never been able to witness in person. When I wasn’t in the O.R. working with the Anesthesiologists, you could find me actively preparing for the Shelf exam while trying to get my life together. The exam itself started off tougher than I had expected, but then after about 20 questions or so I found myself finally getting into the groove of the exam and it became easier to answer the barrage of questions that were thrown at me. I hate it when the first questions end up being some of the hardest ones…it can really throw off your confidence and slow you down drastically. Thankfully, I ended up being able to power through it with adequate time left at the end to review my unsure answers! Overall, I think the exam went okay and I don’t have any regrets about my preparation for it, even though there were some questions on the test (WHAT A SURPRISE) that I would not have been ready for no matter how much I had studied…but I digress.

As always, I’m looking forward to being able to start off a new rotation! This rotation will be Family Medicine, which is going to be primarily an outpatient experience, meaning that I’ll miraculously won’t be in the hospital for a month. That’s pretty wild to me, considering the fact that I practically live there lol. I’ve heard so many great things about this rotation, which has only amplified my excitement about finally starting my experience! Another thing that I’m really hyped about is next week’s trip to San Fran for the SNMA’s Annual Medical Education Conference! I’ve been looking forward to this ever since I was told where this year’s conference would be taking place, which was almost a whole year ago. There are so many sessions that I want to attend, so many people I want to either meet or reconnect with, several activities that I want to lend a helping hand to, and if I have the time (probably won’t, let’s be honest), so many places that I want to visit in the city! With the hotel rooms having sold out over a month ago, I already know that it’s going to be a ton of fun! Plus, the networking opportunities will be unreal! Stay tuned for that post; it’s probably gonna be extra lol.

That’s it from me today. Be sure to have a fantastic week! And R.I.P. to all of our brackets. March Madness this year has truly been maddening. By far the worst I’ve ever done with my brackets. But I can’t even be mad because the games have been thrilling, to say the absolute least!

“The only person you are destined to become is the person you decide to be.” – Ralph Waldo Emerson

– Black Man, M.D.

Time Is Of The Essence

Well, just like every other year, Daylight Savings got me all messed up this morning. It never seems to fail; I always know it’s coming up and I try to prepare myself for it but once the day finally arrives, I usually find myself mentally discombobulated as I begin to process the fact that I’ve lost a crucial hour of my day. Although I’ll be alright and will adjust accordingly, that hour would have been real nice as I continue to prepare for my Surgery shelf exam this Friday. But at least there will be more daylight throughout the day, which pretty much means to me that Spring is coming very, very soon! I’ve been over winter since like New Years lol.

Because my shelf exam is this Friday and I’ve already lost an hour of productivity, I’m not going to make this entry a long one. But then again as you know, I can sometimes get carried away in my thoughts…so we’ll see how this post pans out.

Throughout this rotation, I’ve had to do much more self-teaching than I usually do (that’s really saying a lot) due to the fact that I didn’t get the opportunity to rotate through a lot of the other services that Surgery has to offer (I only rotated through Surgical Oncology, Ophthalmology and Anesthesia). That’s just how the scheduling worked; it would be almost impossible to fit in the many sub-specialties of this specialty in an eight-week period, much less have a meaningful experience while trying to do so. We did have student conferences where each student gave a presentation on a topic, which was helpful in gaining a comprehensive understanding of the Surgery specialty. Even with the fact that I relied heavily on self-directed learning throughout these past seven weeks, I actually feel like I’m in a good place with my studies right now. There will be very little, if any, ophthalmology or anesthesia on the exam (you literally spent the last four weeks on these services…way to go Christel) but on the flip side I was allowed more time to study the material that I’ll actually see on the exam, thanks to the forgiving hours of these services. So by taking full advantage of that, I’ve been able to stick to the study schedule that I had prepared for myself. That being said though, I still need this final week to finish up my studying because I’m definitely not 100% ready for the test yet. 😅

I just finished up my first week of Anesthesiology, and it has turned out to be a pretty great experience so far. I’ve been able to learn some really cool things about this field of medicine, and have been able to engage in some exciting procedures. On my very first day of this service, I bag-valve-masked nine patients in one morning! Don’t worry, they weren’t dying or anything…they were getting Electroconvulsive Therapy, which are very quick 20-minute procedures. I felt like I had become a pro at bag-valve-masking by the end of the morning. Throughout the week, I got the opportunity to watch and learn how anesthesiologists administer medications in the operating room, watch the placement of a central venous catheter, watch multiple nerve blocks, assist in placing a brachial nerve block, watch multiple tonsillectomies, interview patients as they came to clinic for their pre-operative workup, attend informative student lectures, and attempt to place a peripheral IV catheter in a patient. In addition, I also learned how to find my own brachial plexus via ultrasound and practiced my intubation skills in a simulation lab!

And to top it all off, just about every anesthesiologist I’ve worked with so far has been fun to be around! I’m glad to have been given the opportunity to rotate through this specialty, and even though I most likely won’t be tested on anything I learned this past week or will learn this upcoming week, I do realize the importance of understanding this material. Plus, when else am I going to be able to do some of these cool procedures? Okay okay I admit, I’ll be able to do some more of them during the Anesthesiology Acting Internship I signed up to participate in during my fourth year.

Speaking of fourth year, as of last night I’ve actually officially scheduled all of my blocks for it!

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That being said though, my current schedule is far from being set in stone because we’re actually allowed to change it up as we go through the year. Pretty crazy huh? There’s a good chance that I’ll be making some big changes to some parts of my schedule, especially if I end up being blessed with the opportunity to participate in some funded away rotations at other institutions (I’m working on these applications as we speak, which is another reason why I’ve been so busy as of late. As a matter of fact, why am I still typing out this post??) But on the other hand, there are some blocks scheduled that are definitely not going to change, such as my first four blocks (Step 2 Study Period, Pediatric Chronic Illness – Summer Camp, NICU and Peds Heme/Onc Acting Internship). I’m also definitely doing my Anesthesiology Acting Internship later on in the year, and will be participating in a Radiology elective near the end of next year as well. And I’ve scheduled my two flex blocks (free blocks to do whatever you need to do outside of school) for the residency interview season (Fall-Winter 2018) and the very end of my fourth year. Now that I have a good idea of what my schedule is looking like so far, I’m even more excited to finish up third year and get to my final year of med school!

Alright I ended up typing out more than I had planned, per usual. But once I get in sync with my free-flowing thoughts and get the caffiene flowing through my veins, it’s hard for me to stop typing lol. On the bright side though, it didn’t take that long for me to type this all out!

I hope that you have an awesome week! Best of luck to you as you begin to fill out your March Madness brackets! And to all of you on spring break, I absolutely envy you. Have fun though!

“Either you run the day, or the day runs you.” – Jim Rohn

– Black Man, M.D.

P.S. – I finally gave my Ophthalmology patient presentation last week. It wasn’t my best presentation, but it was also far from my worst too. You don’t realize how hard it is to give a presentation about a topic you’ve only spent about three weeks actively learning about to a room full of physicians who specializes in that topic, until you get in front of them and actually do it. 😅

P.P.S. – Shoutout to Black Panther for grossing over $1 BILLION in just 26 DAYS!!! WAKANDA FOREVER!!!

High Noon

Okay, crunch time is officially here.

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I have 11 days until my Surgery shelf exam, and I’m going to be losing an hour thanks to Daylight Savings Time next Sunday. Believe it or not, 11 days is not a lot of time to review all the material that I still need to get through in order to be comfortable enough to take that shelf exam. Although I’ve already completed a large portion of the questions that I need to get through, I still need to study the answers to them and further review the concepts that I don’t totally understand yet. In addition, I have to begin preparing for my cross-country trip to the SNMA’s Annual Medical Education Conference at the end of this month, where I’ll be playing a much larger role (thanks to my status as one of the National Future Leadership Project Fellows and as one of the members of the National Community Service Committee) than I did when I went for the first time last year. The conference will be taking place in San Francisco this year, which I’m very excited for because I have never been to Cali before!

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There are also emails that I need to send out and respond to (I’ve accepted the fact that this is going to be a never-ending problem), projects that I need to continue to coordinate, assignments that I need to complete and things I need to figure out as I continue to prepare for applying to residency programs and for my final year of medical school. There just always seems to be a cascade of things to do at any given moment and because of this, my mind has developed this habit of racing through tasks while at the same time calculating my next moves. Even as I type this post, I’m thinking about the many things that I need to get done before I go to sleep tonight while at the same time plotting out my plan of attack in preparing for my upcoming exam. It’s honestly remarkable how on most nights, I’m able to calm my mind down enough to go to sleep.

Speaking of, starting tonight, I’m going to have to go back to going to sleep real early because I have to be at the hospital by 6 AM tomorrow morning to begin the Anesthesiology portion of my Surgery rotation. I knew that these early mornings were coming back to rear their ugly heads, so I’ve been mentally preparing myself for it for weeks lol. But in any case, this service is going to be an interesting one and I’m certain that I’ll learn a lot of good information during these next two weeks as I rotate through this specialty. I’m apparently going to be in different places on different days in order to rotate through as many of the sub-specialty areas of Anesthesiology as I possibly can, so I gotta make sure that I have my schedule straight at all times. I’ve been at the wrong place at the wrong time on several occasions, and it’s certainly NOT a fun thing to have to go through. I’m also ready to start on this service because I have yet to meet an Anesthesiologist here at Wake who isn’t a chill person! The atmosphere that I’ve sensed from the physicians in this department so far gives me reason to look forward to working on this service for the next couple of weeks.

With the start of my last service on my Surgery rotation comes the end of my fascinating experience in the Ophthalmology department. During my last week on this service, I had the opportunity to work with Ophthalmologists who specialized in the cornea, the retina and the pediatric population. In addition, I was able to work with a resident who answered consults throughout the hospital, allowing me the opportunity to observe all kinds of patients who had some unique findings in their eyes that I had never seen before. I appreciated the things that I was able to see and do during this week, but something specific that I took note of was how the Pediatric Ophthalmologist interacted with his patients. He had the challenging task of examining and diagnosing children with ocular disorders, which meant that he had to ensure that these kids stayed patient enough to follow the specific directions that he gave them while he assessed them. It was incredible to watch how he used the tricks that he had up his sleeves to retrieve important information from his patients, and to realize just how knowledgeable he was about ophthalmology. I’m definitely going to have to borrow some of his clever tricks and use them with my own patients in the future!

All in all, even though the patient presentation that I was supposed to give during Grand Rounds last week got pushed to this week, I had a great and intellectually stimulating experience while on this service. There were times where I was tempted to reconsider pursuing this specialty again, but at this point I’m comfortable enough to say that I’m committed to a career in Pediatrics. Where this road will take me, I have absolutely no idea. But I do know that I’ve developed a very real passion about this specialty that I can’t shake off, and the opportunities that a career in Pediatrics presents truly excite me to no end. Who knew that it would have ever come to this? Apparently just about everyone but me 😅. They weren’t lying when they said that crazy things can happen during your clinical rotations!

Alright, gotta go now. Be sure to start your month off on a positive note! And remember to get yourself ready for the insanity that is March Madness…

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“If you have a positive attitude and constantly strive to give your best effort, eventually you will overcome your immediate problems and find you are ready for greater challenges.” – Pat Riley

– Black Man, M.D.

P.S. – The two presentations that I gave last week went well for the most part! Well, one of them went sort-of-well in my opinion, and I ended up doing a much better job with my other one!

Time Is Slipping Away…

Have you ever had one of those weeks where you actually need it to slow down for once, but the days ironically just keep flying by even faster?

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Like, I knew that I would be busy this past week, but man! I’ve barely been able to keep up with studying for the Shelf exam that I’ll be taking in less than three weeks, thanks to the three presentations that I’ve been working on all week. Yeah, three separate PowerPoint presentations. And I had to get them all done last week because I’m going to be presenting all three of them this week, pretty much back-to-back-to-back. It’s gonna be fun.

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Not only had I been working on those presentations, I had also been preparing for my Surgery Oral Exam all week long that I eventually took on Friday. Until last Friday, the last time that I had taken an official oral exam was during my college days, where I took them routinely (and painfully) in my Spanish classes. I didn’t like them then, and my feelings about them hadn’t changed much over the years. It also didn’t help that I had completely forgotten that I had an oral exam scheduled until a good friend reminded me about it a week before the exam date.

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Thankfully, we had been given a list of possible topics that the oral exam was going to be on, so my preparation was pretty focused on those topics. Even with my adequate preparation and reassurance from the clerkship director a few days before, I still was a bit anxious as I walked into my oral exam. I did my best to color my performance with pure confidence and attempted to prove to the director that I was indeed knowledgeable of the material that she was asking me about. After completing the 12-minute exam though, I had no idea what kind of grade I was going to get. Throughout my whole performace she hadn’t given away any hints of what her thoughts were, leaving me grasping for air as I tried to read her. As a result, although I felt like I answered the questions to the best of my knowledge, I left the room feeling like I could have done better in some way, shape or form. I surprisingly ended up getting my grade back later on in the afternoon and I must say, I was floored when I saw my grade. The grade that I recieved was much higher than I had anticipated! I guess I really did know what I was talking about!

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Needless to say, the rest of my day was made lol. Confidence is a very powerful thing y’all. A very powerful thing.

Outside of preparing for my presentations and my oral exam, I also participated in a patient interview session with a clinical coach who ended up giving me some very useful advice about assessing a patient’s environment and presenting patients in a more structured form, attended a meeting where advice about applying to residency programs was given (I’m really about to be applying to residency y’all 😮), and attended Wake’s annual BOUNCE event that I’ve gone to in years past to listen to stories from faculty members and residents about times where they’ve had to exhibit resilience and courage in their respective fields of medicine. (Check out Stepping Into Step and/or Growth, Control & Breaking Stereotypes if you’re interested in what I wrote about this event in the past.) As always, it was a fantastic event with a good amount of emotion involved and I’m glad that I had the opportunity to listen to the incredible stories shared there.

In regards to the second week of my experience on the Ophthalmology service, it has been pretty good overall. I’m continuing to learn more about various ocular pathologies and have gotten the chance to follow attendings who specialize in glaucoma, the cornea, the retina and oculoplastics. Like I said last week, there are a ton of things that can go wrong with the eye and so many different procedures that can be done on this small organ as well! I was even able to observe a Lasik procedure for the first time! That was quite fascinating, to say the least. I also had an encounter with a young man in clinic who seemed to be absolutely amazed with the way the eye works. He first asked me what dilating the eye meant, and then proceeded to unleash a barrage of questions on me after I piqued his interest with my answer. I surprisingly ended up giving him a mini-lesson about the eye, in which I told him about the eye’s basic layers, showed him what a retina looked like, discussed with him how we use tools such as the direct ophthalmoscope to look at someone’s retina, taught him what refractive error was, and answered whatever other questions he had for me before the resident came in to complete his assessment of the patient. It was pretty cool to be able to teach him basic things that I had come to take for granted, and I found myself becoming quite enthusiastic as I answered the many questions he had for me. Who knew teaching could be so fun?

Alright, back to the grind for me. Hopefully I can actually make time to adequately study for my shelf exam this week. As a matter of fact, I absolutely need to make time to study because crunch time is coming soon…very, very soon.

Wish me luck on my presentations! And make sure to march through this week in a spectacular fashion! 😄

“Keep your thoughts positive because your thoughts become your words. Keep your words positive because your words become your behavior. Keep your behavior positive because your behavior becomes your habits. Keep your habits positive because your habits become your values. Keep your values positive because your values become your destiny.” – Mahatma Gandhi

– Black Man, M.D.

Reshaping The Vision

First things first. If you haven’t seen Black Panther yet, you’re missing out on a real treat! I went to go see it last night and I gotta say, IT WAS SO DOPE!! It had me geeked literally from start to finish, and when the movie ended I couldn’t believe that I had been sitting there watching it for 2+ hours. Time really had flown by while I was appreciating not only the battle scenes, surperb acting, and advanced world of Wakanda, but also the multiple layers & dimensions that the movie unveiled via the engaging dialogue that the characters participated in. Also, for the first time in my life, I intentionally dressed up in a specific way for a movie outing. I just couldn’t help it, I had to show my support for my Wakandan brethren!

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Plus, it’s not everyday that I get to wear my traditional Cameroonian clothing lol. Judging by all the social media posts I saw this weekend, I expected about half of the people in the movie theater to be sporting dashikis in pride. So I’m sure you can understand just how surprised I was when I only counted a grand total of two people in traditional African clothing at the theater, including me. Go on and take a wild guess at who the other person was. Chances are you’re absolutely right. But that didn’t stop me from proudly walking around like a King from an advanced African nation! 😤 Lol but in all actuality, it’s not all too common that I watch a movie that really lives up to its hype plus more. It’s even less common that I’m able to deeply relate to a movie as successful as this one has already been. It hasn’t even been out for a full weekend and it’s already making history. This movie better get a rack of Academy Awards next year!

Okay now that I’ve gotten all that fandom off my chest, let’s talk more about the other updates of my life, including my first week on the Ophthalmology service. To start off, the difference between the working hours of this service and the previous one I was on is literally like night and day. With 8 AM start times on most days this past week and end times around 5 PM, I’ve been afforded quite a bit more free time in which I’ve been able to attend to other matters in my life and to study more for the upcoming Shelf exam. The amount of sleep I’ve been getting has been glorious, to say the least. In addition, I’ve already learned so many cool things about the eye and have also learned useful physical exam techniques when it comes to examining this organ. I’ve been able to get a lot of practice with using the slit-lamp on patients, assessing eye pressure via tonometry, and checking retinas via direct ophthalmoscopy. I even learned how to figure out one’s refractive error (a.k.a. glasses prescription) using retinoscopy!

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Although I’ve spent the majority of my time in the clinic so far, I did get the opporunity to scrub in for a day in the Operating Room, where I assisted (watered the cornea; it’s an extremely important job, don’t debate me) with multiple cataract surgeries. I never did get tired of watching the surgeon perform these operations. I also got the opportunity to go over to Greensboro for a day to volunteer with a vision van screening being held in conjunction with a health fair at UNCG! That was a great time, especially since I really got the opportunity to independently work on my ophthalmic skills. And lastly, I was able to sit in on an interesting guest lecture concering pediatric ophthalmology and the various pathologies that can be found in the eyes of younger populations. Let me just say, there are a LOT of things that can go wrong with your eyes/eyelids. Like, it’s baffling.

My experience in Ophthalmology overall has been a very positive one so far, and I’m definitely looking forward to these next two weeks on this service. It really is cool to be able to rotate through this specialty, because it’s allowing me to not only learn some important pathologies to watch out for as well as some great physical exam techniques to use in my future career as a Pediatrician, but to also get some closure after having spent a good number of years chasing down a career in this specialty. It’s still kind of wild how I ended up adjusting my career path; I’m actually still not used to saying that I’m going into Pediatrics. As a matter of fact, I’ve been asked by multiple Ophthalmologists this past week if I was interested in ophthalmology and I find it pretty ironic that I’m now telling the people in the very specialty that I’ve been gunning for all this time that although I still do like this field, I have interests in establishing a career in a different specialty. Some of them were understandably surprised to hear me say this, because they’ve known me for a while now. But regardless, the people in this department have been very willing to help integrate my interests while on this rotation by allowing me to work with a pediatric ophthalmologist and teaching me things about the eye that will be useful to me in my career. For that, I am very grateful.

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Alright now that I’ve said everything that I needed to say, it’s time for me to get back to studying, sending emails, and working on these presentations that I have to give next week. I hope that you have a marvelous week!

“Though no one can go back and make a brand new start, anyone can start from now and make a brand new ending.” – Carl Bard

– Black Man, M.D.

P.S. – For Valentine’s Day, my girlfriend got me a coupon book full of “coupons” she made up that I can use to get her to do specific tasks for me. How creative is that?? I just wanted to share that because it was such a great gift lol.

P.P.S. – I also wanted to say how much of a shame it is that on the same day as Ash Wednesday and Valentine’s Day, a terrorist/murderer decided to shoot up a school in a peaceful neighborhood in Parkland, Florida and take the lives of 17 innocent individuals while injuring a number of others. It’s just so sad and disgraceful how stubborn some of our government officials are when it comes to enforcing stricter gun control laws, even when so many lives have been unjustly taken by these terrorists. There’s just so much going wrong with this country, it’s almost impossible to wrap our heads around it all. Calling reps doesn’t seem to do anything, at least not in North Carolina. My donations are probably helping a bit, but not much at all to do anything substantial. I’m exercising my power to vote on a continual basis. I would march more and whatnot, but I’m in the hospital pretty much all the time. I can speak out on social media, but that only gets me so far. Trying to get the people currently in power to listen is like yelling at a brick wall. What a time. Maybe this latest mass shooting will spark some change, especially with the activism of the students at the school. But it’s looking like the only that will bring about any real change is removing the people that are hindering this country’s progress from office. Although it’s exhausting and can feel purposeless at times, I’ll keep doing my part and I hope you keep doing yours.

Setting Sights On Free Time

After three long, grueling, educational and interesting weeks, I’ve finally completed my experience on the Surgical Oncology service!

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The hours that I worked while on that service were some of the longest that I’ve ever worked while in medical school. However, I also saw some of the most intriguing things that I’ve ever witnessed during my time as a medical student and assisted with some of the operations in ways that I never thought I would be ever able to do as a student. Like, I was literally burning off connective tissue from the intestines at one point! (With guidance of course 😄) The operations that I got the opportunity to participate in ranged from simple and quick 30-minute procedures to complex and arduous 9-hour marathons. It was quite amazing to be able to cut open the body of a living person and appreciate the organs that keep all of us healthy on an everyday basis. Some of the tools that we would use during the surgeries were pretty cool too, almost extravagant even. I never knew there were so many surgical tools out there made specifically to burn flesh! Also, it never failed to blow my mind whenever we would see someone we performed a major operation on awake and speaking to us the very next day, as if we weren’t inside their body less than 24 hours prior. Of course they had to stay in the hospital for some time in order to recover, but it was still pretty wild to have full conversations with them shortly after having literally touched their guts.

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Overall, these past three weeks were hard yet fulfilling, and I experienced so much during my time on this service. The team I worked with this past week were filled with excellent people who allowed me to do more than I could’ve ever anticipated. I also felt like I had really gotten into the groove of things by the time Friday rolled around, and I could really feel just how much I had grown from when I first started Surg-Onc. For example, when one of my classmates joined me on the service early last week, I found myself informing her of how the service was run, how to perform tasks and present patients in a way that the team would appreciate, and the things that she could do to maximize her experience during her time in Surg-Onc. I surprised myself at how much I knew while I was talking with her, because I literally hadn’t known anything about Surgical Oncology when I first started just a couple weeks prior to our conversations. I’m glad that I got the opportunity to participate in this experience and am even more happy that it was the first service of my Surgery rotation, because now I can look forward to having some more free time to study and get other stuff done. That’s right, no more 4:15 AM alarms!! Well, only until I get to the Anesthesia service in three weeks. I’ll have to be at the hospital at 6 AM at that time, which means I’ll be back to waking up around 4:45 AM lol. But that’s still 30 more golden minutes of sleep than having to wake up at 4:15!

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Now that I’ve completed my Surgical Oncology experience, I can look forward to starting Ophthalmology tomorrow! I’m pretty pumped about these next three weeks because as you may or may not know, I’ve had a particular interest in vision care for a long time now. Although I’m now pretty set on a career in Pediatrics, I’m excited to be able to work alongside various Ophthalmologists and to fully immerse myself in a field that I had previously been pursuing for years. I’ll also have more free time on this service to adequately study for the Surgery shelf exam that I’ll be taking a little over a month from now. Now you might go and say, “Christel, that’s so far away! Are you really pressed about studying for that test now??” And my response to that would be, “Yeah I know it’s not coming up soon…but past experience in my previous rotations tells me that it’ll be here before I know it! Plus, I’ve barely had time to even think about it these past three weeks, let alone study for it!” I’ll definitely need all the free time I can get to prepare for it. I’ll also need this newfound free time to work on SNMA stuff in preparation for the Annual Medical Education Conference next month (I can’t believe AMEC is only a month away!!), to work on my fourth-year schedule, to work on this blog and to do other tasks that I’ve recently been forced to put off. I’ve already been able to use some free time this weekend to participate on a student panel at the annual Pre-Med conference that my school’s SNMA chapter organizes each year, and as with every panel I’ve ever participated on, I thoroughly enjoyed it and was reminded of how blessed I am to be where I’m at! Oh, and I’m definitely going to be using some of my free time to make up for the sleep that I lost these past few weeks! I have a feeling that these next few weeks will prove to be ones that were worth looking forward to! *knocks on wood*

That’s all I got for you today! Be sure to have a fantastic week and an affectionate Valentine’s/Single Awareness Day! And I don’t know about you, but I’m HYPED to go see Black Panther this upcoming weekend! Got my outfit planned and everything…😏

“Don’t judge each day by the harvest you reap, but by the seeds that you plant.” – Robert Louis Stevenson

– Black Man, M.D.