Saturday, August 27, 2011

Rite of Passage

Well I made it through my first two weeks of med school and my first two exams. I would be lying if I said I haven’t been nervous about the material, the amount of material, and of course the exams.
Truthfully, the material itself is not overly complicated. In fact much of what we have gone through thus far is very similar to things I have already learned in my undergraduate degree, though there is a much greater emphasis placed on the clinical importance of those topics (as very rarely was any such importance placed on said information previously). I anticipate this trend to fall away in the future though as we get into more in depth topics, and of course anatomy, which is coming up soon, will be completely new for many of us, myself included.
However, the amount is substantially greater than what we are accustomed to from undergrad. It is no exaggeration to say that every day of class is equivalent to about a week of undergraduate classes. Meaning in the course of one week, we are expected to synthesize information that we would have been given five weeks to synthesize in the past. Of course, not only are we expected to get through and understand the material, we are also expected to study it in such a way that we will remember it clearly even after the test, as we will need this knowledge continuously throughout school, throughout residency, and onwards. It is a daunting task to say the least.
The fact that I made my way through university, including undergrad and a masters, by basically cramming for exams is somewhat worrisome. It meant that I would study and remember (at least briefly) the content of an entire course, being 12 weeks, in 1-2 days. On the plus side, I have learned to synthesize vast amounts of information in a very short amount of time. Yet the ability to recall that information reliably is scattered at best. I would like to say that I have managed to completely shift away from this practice, but I would be lying. As the saying goes, “old habits die hard”, though after writing my first set of exams I have promised myself that I will put in considerable effort to ensure that this habit ends up coming to an unfortunate, or in this case fortunate end.
Part of my problem is that I need pressure to motivate me. I love performing under pressure because I feel as if there are actual stakes involved in what I am doing, that there are actually consequences to not doing well. I would guess that I am not the only person in the field of medicine who possesses this trait, and likely part of the reason I want to go into surgery. Of course though, it gets me into trouble at times, such as when I should be studying for a test, and am having a hard time motivating myself to do so until there is very little time left. Going forward though, I intend to remind myself of the painful experience of studying for this test, should I have any trouble in being motivated to study each and every day.
So did I pass the test? Yes. We need to receive at least a 65, plus or minus the standard deviation for the test, which in reality likely means we need at least a 70 in a course to pass. Though our foundations of clinical medicine course, in which we learn how to interact with patients, perform a proper physical, and take a proper history requires at least an 80 to pass. I will not say exactly what my grades were, but I passed with a comfortable margin between what I got and what I need to pass.
Our program uses a pass/fail system, though the term they use is competency achieved or competency not achieved. I find the choice of wording to be particularly well suited to a class of future doctors, as it is likely the one quality all patients would prefer their doctors possess.
Overall, much of the nervousness I was experiencing previously has been assuaged by my experiences the past two weeks, and I feel reassured that I can and will be successful in my program. Yet, there is still what I would call a healthy amount of nervousness still hanging around. I intend to let it motivate me to remain focused on school and on my success in the thirty six or so exams left during my first year of medical school. I am however, both relieved and grateful to have made it through this initial rite of passage.

Sunday, August 14, 2011

Just one more day

As promised, I want to write about the weeks prior to me moving down to Virginia to start med school. I remember back at the beginning of July I felt like I had so much time until it would be August 8th and I would be starting orientation. I began to think of all the things I needed to get done, the things I wanted to do, and all the people I wanted to see before I left. I remember thinking that there was plenty of time to fit everything in...

As the weeks progressed, I actually did get quite a lot done in a short period of time, especially with regards to all the paperwork and preparations for med school. I somehow managed to schedule my time in a way that I was able to not only get everything ready, but also visit pretty much all the family and friends I had wanted to see before leaving, take my sister and my nephew to Canada's Wonderland on seperate occasions, attend two going away parties and a birthday celebration, and still continue to work with the autistic boy that I had been tutoring/mentoring for the past four years.

That being said, it meant me running around like a mad man most of the time. The last three weeks leading up to me leaving, I can only remember one day where I was home doing nothing for any length of time. Every other day I would wake up in the morning, get ready, leave for the day and usually get home at about 2 am before going to bed and getting up the next day to do it all over again. Surprisingly I wasn't all that worn out from doing this.

During the last two weeks though (end of July and beginning of August), everyday I would realize how quickly the day would arrive that I would be leaving. Whereas before I felt I had so much time, now I kept thinking that there wasn't enough. Even though I was doing everything that needed to be done, everything that I wanted to do, and seeing all the people I wanted to see, it wasn't enough...

As excited as I was to start my new life, to finally pursue my dream, I was having a hard time letting go of my old, familiar life. I am the kind of person who goes with the flow, and takes each day as it comes. I have no problem with change, and even crave it as I tend to get bored with routine. Yet, I have never had to deal with such a drastic change all at once. I have never had everything I am accustomed to come to an end and be replaced with all new people, places and situations.

As humans, we cling to familiarity because it feels comfortable, because it feels safe, because it just seems to fit. Its like an old worn in pair of shoes that just slip on so easily, and are so comfortable, that you hardly even realize you have them on. But here I was, having to get rid of those old worn in shoes, and replacing them with brand new stiff shoes that end up giving you a blister on your heel because they don't yield as you walk. But not only did I have to get new shoes, I had to get new pants, a new shirt, new socks, new underwear, new sunglasses, a new watch, a new hairstyle, well you get the idea. In the end it was almost starting to feel like I was no longer me. I think a large part of our identity is tied up in the places we choose to live and the people we choose to surround ourselves with. Take that away, and you lose a part of yourself. This is how I felt, and still do feel. While I am so glad to be here, I am beginning to really miss home, partly because I don't quite feel like myself.

In time I am sure I will figure out what these changes will mean as far as my identity is concerned, if they end up meaning anything. And if who I am is to change as a result, I only hope it is for the better. Yet, I just keep remembering those days leading up to me leaving and how I kept wishing then and still wish now, that I could have had just one more day...

Wednesday, August 10, 2011

Have a heart

So I know I said I would be recapping events previous to Orientation, but I have decided that I wanted to write about this while it is still fresh in my mind.

I have been looking at other medical student blogs, and upon further inspection I believe it should be fine for me to say what school I am attending. I will still refrain from ever saying my name or the names of anyone I mention to ensure that proper privacy is maintained.

So on that note, The school I am attending is Virginia Commonwealth University school of medicine, or VCU for short. The medical school itself though is reffered to as the Medical College of Virginia or MCV.

Today during orientation we were talking about Project H.E.A.R.T (which stands for Healing with Empathy, Acceptance, Respect and inTegrity) that we will be taking part in. It is a small group support system (I think), and the first sessions for all of us were supposed to be today, though some were postponed including  mine so don't know exactly what its about yet.

It is set up to ensure that we always have guidance as we progress through med school. That we always have support should we need it, and to remind us why it is we want to be doctors (hence the acronym).

As they told us about setting up this project, they explained that as a symbol of this support, they had begun years ago, to get this service group of wonderful women in the community to handstitch each of us our very own little plush hearts. They are all soft red fabric on one side, and then have a unique piece of quilt fabric stitched onto the other side, and are stuffed with a bit of cotton batting or something like that.

They passed around baskets of these hearts that had been made just for us, and each of us got to choose the one we wanted. Now some of you may think this is a bit touchy feely or cheesy, but I would disagree.

They told us that many 3rd and 4th year students as well as alumni kept their hearts in one of the breast pockets of their white doctors coats so that it was always with them. Serving as a reminder to always have a heart, to never stop caring, and to always know that there are those out there who love and care about us, just as we are caring for our patients.

*Censor Warning* - the following, while not descriptively graphic, may be emotionally difficult for some

After this, we began to watch a video about professionalism which flashed family pictures of a father and mother and their three children taking part in various family activites, full of love and happiness. The song that played in the background though eluded that this would not have a happy ending.

It then showed their car, totaled and off the road. and flashed to their one and a half year son in the hospital in critical condition swollen and full scrapes and stitches. This was followed with the father holding his son in the hopsital, and showed pictures of his son looking better, and it faded to black.

Then words flashed across the screen that due to the boy being given a lethal dose of a medication, he had passed away, and was now buried beside his mother who died in the crash.

It went on to show the father addressing the healthcare workers of the hopsital where this happened, basically thanking them for what it is that they do, but urging them to never forget how much what they are doing matters, and to make sure that they explain things honestly and simply, and to double and triple check everything because it is time well spent, it is time that can prevent things like this error from happening.

After the video, we were asked to voice those qualities we believed reflected the idea of professionilism in medicine, and were told these qualities would form our own private oath in addition to the Hippocratic oath which we would swear at the white coat ceremony later in the week.

Then right before we left we were asked that every time we hold or squeeze our hearts, we should remember that video, and remember the responsibility and power we will be given as doctors.

I intend to cherish this heart and carry it with me in the hopes that I will do just that. In the hopes that no matter how stressed and tired I may become, I will never forget, even for a second, that I am treating people. People with lives and families and hopes and dreams and fears. People who deserve my full attention. People who trust me to look after them.



Monday, August 8, 2011

Getting here...

Getting Here…

So August 8th has finally arrived. It came on a lot quicker than I expected. I had meant to post a couple more blogs before beginning my journey down here in the United States, but with all the running around the last few weeks, I just couldn’t seem to find the time. So I plan to backtrack a bit in the next couple entries and recap the events leading up to today. For now though, I want to talk about the present, at least in part.
As a quick aside however; I realized looking back, that for those who don’t know me, when I said I was leaving everything behind in my first post, it wouldn’t make much sense without some context.

Let me explain. I was born in Ontario Canada and have lived there all my life. All my family and friends live there as well. However, I am now beginning to attend medical school in the States (I will not post the identity of the school, or its location, as this knowledge could eventually compromise the privacy of individuals who I may reference in this blog, though I will always do so in a vague, nondescript fashion).

The school I am attending is far enough away that it would be very difficult for me to go home every so often, assuming I had the time that is. The important thing is I am now a great distance from where I have lived my entire life, and all the people I care about.

This is why I said that the pursuit of this dream required leaving everything I know and love behind. It will definitely take some adjusting, as I am already beginning to miss the people back home. But I digress, now that I’ve clarified that, back to the present. 
Today was the first day of my week long orientation into medical school.  Up until today, it has all seemed sort of unreal. I almost expected I would go to sleep one night and when I woke up I would realize that I had not really gotten into med school and wasn’t moving away for four years.

Even after moving down here a couple days ago, I still couldn’t fully accept it. Today I think it is finally starting to sink in.

This afternoon, we were collected together for "roll call". One by one our names were called, and we were asked to briefly stand so they could ensure we were present. After they ran through the names of the entire class of 2015, the dean of admissions proceeded to congratulate us on the momumentous accomplishment of making it into med school. Instantly a chorus of clapping erupted, and in that moment it became real.
I have gotten into med school
I am now a med student
Given that I complete my studies, in four years I will be a doctor
Pretty amazing! Truly a moment I will always remember.
Along a similar vein; I am really looking forward to the white coat ceremony at the end of orientation. That symbolic gesture of “putting on” the medical profession as you don the white coat, or rather as the white coat is put on you by someone who has already completed the journey you are about to embark on.

Like a parent passing on an heirloom to their child once they have come of age, these doctors are placing their hope and faith in us that we can grow to become great future physicians.

I hope that I can live up to that lofty ideal as I continue on through med school, then residency, then fellowship and onwards into my career.
Now that I have babbled on for a full page or so, I should let you know that everything I have written so far isn’t really what this post is about.

As the title suggests, I want to write about getting here in the first place. I don’t mean the drive down, although that was an interesting adventure on its own, but rather the years leading up to me applying for medical school and being accepted. I began with the present, because I wanted to portray to you, as well as have fresh in my mind, what an honour it is for me to finally be attending med school.
It all began when I was 3 years old and heard my sister say she wanted to be a veterinarian when she grew up. I asked her what that was, and she explained that it was a doctor for animals. Partly because I looked up to her and wanted to be like her, and partly because I loved our dog Starra, I told her that I was going to be a veterinarian too. I know what you’re thinking, isn’t this supposed to be about med school? But wait, let me finish first.
My parents figured that along the way I would change my mind, my sister did. Yet throughout elementary and high school I never wavered on my decision to become a vet.

Going into university it was still my intention to pursue veterinary medicine, however in second year I began to lose all interest in school. For me, someone who has always been passionate about learning, it was a strange thing to be so apathetic about my studies.

There were some family problems that arose around this time, and I had thought that perhaps this was the cause. However, I had had to deal with family issues before this, and never before had it affected my academics.

So I continued trying to figure out what was wrong. It wasn’t until third year that I finally found some clarity, but as a result, my second year marks turned out to be the worst in my entire academic career.
The problem became apparent when I realized that it wasn’t school itself that I was apathetic too, but rather the goal I was working towards. For the first time in my life I realized I did not want to be a veterinarian. That is not to say that I was mistaken previously, but rather that my interests had shifted as I matured, and I realized that for me to be fulfilled, I needed to work more closely with people and have a greater impact in their lives. It was then that I decided to enter into the medical profession and become a doctor.
I wish I could say that it was simple from then on, but the truth was I knew very little about becoming a doctor. I had to scramble at the end of my third year to figure out all the details about how to apply and what is required and such. For those who don’t know, you need to apply a full year in advance of when you intend to begin medical school. So for someone who had just come to that realization, I was a bit unprepared.

I began to realize that if I had made the decision earlier, I could have taken advantage of my first and second years to get valuable volunteer and hospital experience. Yet even though I was lacking in some areas, at the end of third year I ended up applying to McMaster in Hamilton. They had a three year program, and at the time I felt I wanted to be done sooner than later. This would allow me to attend med school right after graduating fourth year, and so the timing seemed ideal.
About eight months later I received a letter in the mail informing me that I would not be invited for an interview and would no longer be considered for acceptance for the upcoming year. This was a difficult thing for me to deal with, as it was the first time in my life that I had had to deal with being rejected because my academics were not good enough.

I reminded myself that I had rushed to get the application done and that I would be better prepared next year, and would be able to apply to a greater number of schools as well. So in fourth year I made sure to get in some more volunteering and hospital related experience, though not only because I thought it would help my application. I have always enjoyed volunteering my time and energy for the benefit of others. It is a key aspect of what drew me towards medicine.

At the end of fourth I applied to 5 of the 6 medical schools in Ontario, and also applied for a one year Masters program through coursework to keep myself occupied for the coming year, and to hopefully strengthen my application should I need to reapply in the event that I not get in once again.
One by one the Ontario schools rejected me, until one of them invited me for an interview. I went for the interview, and despite it being my first, I felt it went very well. However, it must not have been good enough as I was subsequently rejected from there as well.
I will just put this out there now. I am stubborn, very stubborn. When I put it in my mind to really do something, it is very difficult to convince me otherwise. So nearing completion of my Masters, I once again applied, this time to several med schools in other provinces in Canada as well. After finishing up my degree I began to work in a lab full time, Once again awaiting the decision of the dreaded med school admissions committees who had control over my future and my sanity.
This time I did not even receive a single invitation to interview. For the first time since I had begun down the road to becoming a doctor, I began to seriously doubt whether or not I could actually achieve this goal. I began to doubt whether or not I was smart enough, or good enough, or strong enough. For a short period of time I came close to giving up, until I remembered how much I wanted this, until I remembered that this was the only thing I wanted to do with my life. So once more I decided to reapply. Fourth time is the charm right?
I figured if I was going to reapply, I was going to go for broke. I had tried to apply in Ontario, no luck there. I had tried Canada, no luck there. So now I was going to cast a bigger net. I applied to Canada, the US, the Caribbean and Ireland. In total I applied to 59 schools. Yup… 59. How much did it cost? Well I won’t go into specifics, but a lot. Am I crazy? Yes, most definitely. Anyone who is willing to do 59 applications, plus the additional 41 secondary applications for the 41 US schools I applied to, must be nuts. And if I wasn’t crazy before, let me tell you, completing 100 applications is enough to drive anyone insane. In truth it was closer to 95, as a few American schools did not send out a secondary, but 100 sounds much better. In addition, I reapplied to my old university to take organic chemistry, since I never did in undergrad (as Ontario schools and most others in Canada don’t require it).
What came of all my efforts? I received interviews to several schools in the Caribbean, and to 3 schools in the US. I was accepted at one Caribbean school, declined the rest, was waitlisted at two of the US schools and rejected by the last, post interview.
Finally my dream of becoming a doctor would be a reality. It would mean living in the middle of nowhere, with little chance of being able to come back to Canada to do a residency, but I didn’t care. I would do whatever it took to achieve the goal I had set out for myself.
So I got everything set up to go to the Caribbean school, including having my flight booked and paying first semester tuition, and the day after I wired the money to them I find out I got in off the waitlist to one of the US schools. I was shocked, overjoyed, overwhelmed and upset all at the same time. I had had it set in my mind I would be attending the Caribbean school, and now it would mean getting my money back, cancelling a non-refundable flight, and completing a whole new slew of paperwork to be able to attend this US school. Of course I did it though. It would mean standing a decent chance of getting a residency back in Canada rather than almost no chance, and it was closer to home. Not to mention that I actually really liked the school itself and program. Their outlook and philosophy is very much in line with who I am and who I want to be.
So when all is said and done, if I am to be honest, I failed. I failed, and then failed again and again before ever succeeding. If you want to put it in numerical terms of schools, then I failed over 70 times trying to pursue my dream. I am a failure. Yet I never gave up, never fully gave in to fear or doubt, and went to great lengths to achieve this goal that I feel will greatly enrich my life, and make me a better person. In the end I got to where I was going. So it isn’t the number of times that I fell down that I will remember, but rather the number of times I got back up, dusted myself off and kept going.

Post 1.5

Well my second blog was supposed to be finished earlier then now and also posted on a different topic. You see, I had been working on what I wanted to write in a word file on my desktop, and was about one paragraph away from being done, so tonight I had planned to finish and post it.
However, I managed to get a virus in the master boot record on my computer. Now given what it is called, even without an in depth knowledge of computers, it is evident that it is an integral part of a working computer.
So after trying numerous ways to rid myself of the virus, the last of which almost rendering my computer about as useful as a pet rock, I was required to use a backup image I had stored on my external hard drive from four months ago to get it working again.
What this means is, anything I had downloaded, or updated, or worked on since then, such as the blog entry, were lost.
On the bright side though, my computer is working again! The funny thing is the last time I left Canada to go to another Country, I ended up getting a virus as soon as I arrived there as well. Although that one ended up killing my old laptop, resulting in me buying this one, and this time it was fixable, so all in all, things are looking up.