OBGYN & Nursery Projects

Josh started OBGYN last week and he's been up to his elbows with all things baby at the hospital.  He even helped to deliver his first two babies today.  In case you read my blog solely for the purpose of medical school knowledge, then I'll inform you that the OBGYN rotation is easier than say Internal Medicine and Surgery in terms of hours spent at the hospital, but harder than Pediatrics.  During clinic days, he sees patients on a normal 8-5 schedule but takes about 2 L&D call days a week.  Some are day call while others are overnight call.  His impression after week one, well, it definitely won't be his career of choice.  But I sure find it interesting to hear about his day!

Because of this, I've been more motivated to continue on with nursery projects.  At seven months pregnant tomorrow, I probably need to kick it into high gear if everything is going to be done before Baby Girl gets here.


27 weeks

Over the weekend, Mom and I refinished the dresser.  This project was MUCH easier than refinishing the changing table.  It could be because we already had the supplies necessary and the practice.  Or, it could be because we got smarter and used the electric sander instead of doing it by hand.  Oh if we had only known!  I forgot to take a before picture, but let me tell you, it looks nothing like it did before.

And in case you had forgotten what the matching changing table looked like.

I also got to work on a shelf that I had gotten from Michael's for about $12.00.

Before

I pulled out the pegs, painted it, and added the cutest pink ceramic flower knobs from World Market.

After

 I LOVE how it turned out and it was so cheap and easy to do.  Most of the projects I have left to do are much smaller in comparison to the dresser and changing table.  Thank goodness.  Cause this girl's belly is starting to get in the way!

 

Surgery

Well people, the 12 week surgery rotation is almost, ALMOST, over.  Almost as in Josh is taking his oral exam today and will take his shelf exam next week, but the countdown has officially begun. 

While we've never been exactly thrilled that Josh got lucky enough to have Surgery back to back with his Internal Medicine rotation, it is pretty relieving to know that the two hardest and longest 3rd year rotations are just about done.  I hope we are not silly in thinking we can breath a sigh of relief and welcome some easier rotations from here through the end of 3rd year in early August.

Why has surgery been tough? 

Well, let me just preface this post by saying that Josh has really enjoyed surgery as a whole.  He is pretty much convinced that he will be entering the match to do some kind of surgery.  General, Orthopedics, and Trauma surgery, all round out the top 3 choices at this point.  So, it does give us some peace of mind to know what direction he THINKS he will be heading into come residency application time (which is only a mere 7 months away). Eeek!

With that in mind though, we are both glad to have a break from the grueling surgical schedule.  The past six weeks, Josh has gotten up EVERY day at 3:30am.  He gets to the hospital by about 4:15am where he rounds/writes notes on patients until it's time for everyone elses day to begin. There are days in the clinic and many a day in surgery.  He's seen and assisted in all kinds of surgeries, sutured,  given injections, splinted patient's apendages, uh...removed patient's apendages (yuck), and many more things that I probably don't care to know/wouldn't understand anyway.

Most days, he arrives home between 5:00 and 6:00pm, which doesn't sound half bad until you consider he started the day with a 4 on the clock and so that makes for a 14ish hour day.  The evening consists of scarfing some dinner, studying up for the next days surgeries, a quick shower, and getting in bed by 8pm.

You do catch a bit of a break, unlike Internal Medicine, surgery doesn't have many call days.  I think in the past 6 weeks, Josh has only had four call nights. Thank. The. Lord.

Pediatrics is up next followed by OBGYN.  It'll be good practice for him. :) Bring on the babies!

An Update About Internal Medicine

Remember back in September when I did THIS post about our first weeks in IM?  Well, we are in the home stretch people.  Josh takes his shelf exam on Thursday afternoon and then we have a break!  Okay, maybe it's not much of a break, really just a long weekend before 12 weeks of surgery start on Tuesday, but still, we're excited. 

So how have the last 8 or so weeks gone you ask?  Well, pretty much like the first four.  Josh worked, a lot (one week over 100 hours).  He learned, a lot.  And we are still happy with our decision to come to ARMC. 

Last week, he had his oral exam (20% of your grade) given by the attendings at Arrowhead.  This was much like a "round-robin" type of question and answer session.  Each student was asked a couple of questions by the attending in front of their fellow students.  The students were given a list of topics that they could be asked beforehand.  He said it went well, the questions were not meant to be tricky, and he knew the answer to every question asked. 

So Thursday is the shelf exam and the students have had this week off to study which they all appreciate, but unfortunately, they are required to study in the library at ARMC.  Which personally, I think is kind of silly, but I guess if you are a procrastinator then this forces you to prepare for the exam. 

What else have we learned?

Well, a few weeks ago, SGU's Office of Career and Guidance held a lengthy meeting about what to expect during the next year and a half as far as applying to residency, scheduling 4th year electives, and all that jazz.  It was helpful and if you are interested, most of the information talked about at the meeting can be found on their website. 

Also, as soon as you start 3rd year, consider writing your CV or Curriculum Vitae.  It's basically a resume that you give to attendings to use as a guide when writing your Letters of Recommendation and you also have to include it in your Master File at SGU.  There are guidelines on the OCG website for how to write it.

I say this because you may end up like Josh and want a LOR from your very first rotation and if you are a slacker too busy to think about writing it early, then your wife ends up writing it for you during your last week of the rotation while you are studying for your shelf exam. 

Wife of the Year Award right here. Just sayin.

Just get it done early.  Save yourself  your wife the stress.

Also, sign up at www.sguclinicals.com for up-to-date information regarding the clincial years.  It has definitely been a great resource for us me.

So that's it.  IM is almost over and what a great learning experience it has been for both of us!  Can't wait to tell you guys the details about surgery!

Internal Medicine

Josh is now well into his 12 week Internal Medicine rotation and I know that as an SO during his first and definitely during his second year of school I had so many questions about the clinical years.  It seemed that while there was an over abundance of information on how the basic science years went, there was an equally large lack of information regarding 3rd and 4th year.  I feel like we started year three blindly.  Yes, SGU had a couple of meetings during 5th term to inform us of the health criteria that needed to be met and the names and locations of hospitals that we could choose from but there was little to no information that explained what the day to day life of an MSIII might look like.

While I can't speak for every hospital that SGU is affiliated with, nor can I speak for different clinical rotations within each hospital, I can tell you some information about Internal Medicine at ARMC (Arrowhead Regional Medical Center). 

First of all, Josh is really enjoying the hospital.  He likes every intern, senior resident, and attending that he has worked with thus far.  At ARMC, students are placed on a "team" consisting of four student physicians (some may be 4th years), two interns (first or second year residents), a senior resident, and an attending.  If you are keeping track, that's an eight person team.  Four students, four MD's.  Pretty darn good ratio of students to MD's which is especially good for learning.

At the meetings during 5th term, SGU hammered into the heads of the students that what makes or breaks your time during clinicals is not so much the hospital, but the attending/residents that you are working with.  But, maybe you are thinking to yourself small teams are great but what if my student hates their attending, maybe your husband just got lucky.  Well, the good thing about IM at ARMC is that every four weeks, you switch teams.  So you get to be on a total of three teams.  You rotate with the same students, but your attending/resident team changes.  That way, if for some reason you didn't get along with your attending on Team 1, your grade isn't solely determined by that attending. 

Which brings me to grading.  How does it work?  And this can be said for all hospitals during clinicals.  Your final grade is broken up into categories.

80% of your grade is based on your attending(s):
          -20% medical knowledge
          -20% clinical skills
          -20% professional behavior
          -20% performance on end-of-clerkship oral exam (given by attending)
For the oral exam, the students at ARMC were given a list at the beginning of the clerkship with all the topics they could possibly be tested on.

The last 20% of your grade is the NBME clinical subject exam or shelf exam as you will hear it referred to.  This exam is the same for every SGU student in every hospital for each clerkship.

SGU expects that many/most students will get A's and B's in their clerkships. 

So how much will your student have to study?  Well, I suppose that all depends on your student.  So far, Josh has had mini assignments from his attending where he has come home to read up on certain topics or if there have been things he has seen in the hospital that he feels he is lacking knowledge in, he has come home to read about them.  But overall, his nose hasn't been in the books like it was first and second year.  Hallelujah!  At ARMC, in Internal Medicine, the students will get one week off at the end of the 12 weeks to study for the shelf exam. 

Okay, so he doesn't study much, but really, how BUSY is he?  The answer to that, extremely.  The students at ARMC in IM work A LOT.  Maybe more so then most SGU students at other hospitals.   Josh is taking two 28 hour call nights a week (about every 4 days) and when he's not taking call, he's going in at 7am and getting done around 3 or 4pm.  Those days aren't half bad, but when you are still lacking sleep from your last call night, it can be rough.  He's averaging about 80 hours a week in the hospital. 

I suppose you can look at this as a negative, but Josh and I are seeing it as a positive.  He has his own patients (since day 1) that he sees.  I'm talking Josh goes in the room by himself, no doctor, no resident, and sees patients and then chiefs it (reports to the attending).  It's actually pretty darn cool.  And because he is in the hospital so much, he is learning a ton!

We know that not every rotation will be this intense.  We can expect that Internal Medicine and Surgery will be especially time consuming, but that Family Medicine and Psychiatry will be a little less stressful.  Thankfully, we already know his schedule for the whole year.  Twelve weeks of IM, followed by Surgery, Pediatrics, OBGYN, Family Med, and then Psych.  I'm sure I'll be able to post the some information on those as they happen.  For now, we are taking one rotation/one week at a time.  Over two years in and this medical school thing is still a learning process!