IM, WK 2-7: Inpatient

Oh hey there friends,

I’m back with a short 7-week update, lol.

I’m a little over halfway done with my internal medicine rotation and man have I learned so much in this short period of time. Trying to balance life with studying and rotations has been a challenge, especially in regards to keeping my sanity and mental stability but things eventually fell into place.

In the past 7 weeks, I’ve completed 2 weeks on the floors, 2 weeks in Nephrology, and 3 weeks in Ambulatory (outpatient medicine).

The 2 weeks on floors, I requested to be placed on the family medicine inpatient team because I’m really interested in family and thought it would be a great chance to show my face and get to know the residents in the program. Compared to the other “teams” on the floors for IM, the family medicine team took on a few more patients and was on call longer than the others, so I saw how overworked interns are in this aspect. I also noticed how robotic medicine has become due to the EMR. The residents wanted to check up on their patients more than just rounds, but their notes kept them busy way past sign-out. This is where medical students come in handy; since the residents had to work on paperwork, we would check up on the patients, contact the nurses, and collect blood for labs. I learned how the hospital functioned and where everything was mostly during these 2 weeks. I also really enjoyed working with the family med residents, felt like I belonged! I’m looking forward to my family medicine rotation in November when I get to work with them some more, but in the clinic!

After completing 2 weeks on the floors (AKA patients admitted in the hospital), I chose to do an elective in Nephrology. If I want to make myself seem like a studious individual, I’d say I chose Nephro because the kidneys aren’t my strongest system. But, if I’m being honest here (which I am), I chose this elective because it had the best hours and allowed me to catch up on all the studying I fell behind on during the floors lol. The attending expected me to be there from 11am-2pm (with a lunch break from 12-1:45), but I chose to come in around 9 to follow some of the patients with the residents so I could present. I actually enjoyed my time in Nephrology because the attending REALLY loved to teach. He would lecture us after our lunch on different topics but make it interactive, so we were engaged too. When I say we, I mean me, the 2 residents, and the 4thyear medical student that was also on the service. I walked out of Nephrology finally understanding how to calculate acid-base disorders, how to interpret lab values and the conditions/ concept of dialysis. Thus far, nephrology has been the most academically challenging and fulfilling- honestly worth my time.

Now I’m back on Ambulatory. I started off in the clinic when I first started rotations, and I’m back on until the end of this week. Coming back after completing inpatient services really showed me how much I LOVE the outpatient setting. Preventative medicine is something I’m extremely passionate about, and I feel the most fulfilled with the patients coming in for their primary care visit. The clinic has two aspects to it, the first being a med-student run clinic where we see the patients ourselves and present to the attending who has the final say. The second being a resident-run clinic where the medical students just shadow the residents. I obviously prefer the med student-run, but we have to do both every day. My favorite part of the clinic is being able to actually explain to the patients what is going on in their bodies so they can understand why compliance is so important- the hugs and kisses I get from them remind me why I chose this field every day. Also, knowing other languages have come in handy SO MUCH! I’ve had patients that I’ve spoken to in Punjabi and Hindi. Since I am able to communicate with them in their native language, it’s easier for me to convince them to take preventative measures (getting vaccinated, and lifestyle modifications). I’m working on learning some Spanish since we have a huge Spanish speaking population- let’s just say I have a loooooong way to go LOL. Also, working with AUC alumni is so much fun, we really look out for each other at this school, it’s no joke.

Outside of medicine, life has been chill. I’ve been getting time to relax and just enjoy life in New York… a part of me doesn’t want to leave this state-but that’s a story for some other day. Besides my indoor plants dying, life has been good. I see myself growing in different aspects every day. There have been bad days leaving me to cry in bathrooms to great days resulting in a random Amazon shopping frenzy. There have been days where I jump out of bed excited to get to work, and then those days where I just can’t do it anymore. Medicine truly is a challenging marathon that knocks you down every time you get back up, but it’s worth it.

So my first shelf is in about 4.5 weeks, I don’t know if I feel prepared or not, but I’ll just say that I’m not LOL.

Till next time…..

Stay Happy,

Preety 🙂

MEDICAL SCHOOL TIME-LINE

Hey there!

Many have asked what the typical medical school timeline looks like, and I wanted to do my utmost best  to provide some insight on this. In every country, the route to becoming a doctor varies and since I’m familiar with the US system the best, I will be discussing that below. If you’re from another country, and your system is different please feel free to share in the comments below!

In the United States and the well established  Caribbean medical schools,  you are required to have completed your pre-medical requirements with a bachelor’s degree and an MCAT score to apply for med school. Just like how your  pre-medical coursework was targeted to prepare you for the MCAT, the same goes with your coursework in medical school and board exams.

Medical school is 4 years,  two of those years are dedicated to basic sciences and the other 2 are dedicated to clinical rotations. In your 4th year of medical school, you prepare to apply for the Match, which, if qualified, places you in a hospital for a real job. This is when you finally start getting paid, after 8 years of higher education! Here’s the breakdown:

Years 1-2

  • Basic Sciences, in classroom learning
  • Subjects
    • Anatomy
    • Molecular biology
    • Cellular biology
    • Genetics
    • Histology
    • Embryology
    • Biochemistry
    • Immunology
    • Physiology
    • Microbiology
    • Pharmacology
    • Pathology
    • Biostatistics
    • Behavioral Sciences
  • Towards the end of your 2nd year, you will begin preparation for the USMLE Step 1, which is an accumulation of all the knowledge you have attained in your first 2 years of medical school (subjects listed above)

Year 3

  • Clinical Rotations
  • Once you have passed your USMLE Step 1, you are permitted to enter the hospitals and begin your clinical training.
  • Each school is different, but every school integrates the CORE rotations into your schedule
  • The CORE rotations have shelf exams at the end of each one. You are required to pass these exams to illustrate you have gained the necessary knowledge.
  • CORE Rotations
    • Family Medicine
    • Internal Medicine
    • Psychiatry
    • Surgery
    • Pediatrics
    • OB/GYN
    • *** Rotations beyond these vary b/w schools ***
  • Towards the end of your 3rd year, it is a good idea to Take the STEP 2 CK and STEP 2 CS, for it’s beneficial to have these scores in before ERAS opens (the Match application)
    • Step 2 CK tests your clinical knowledge, it will be another multiple choice exam taken at a testing center
    • Step 2 CS tests your clinical skills, and this will be taken at various locations around the US (depending on the test date you choose). This is NOT a multiple choice exam, instead, you will have 12 patient encounters in a 8 hour time span (with breaks of course). You will be examined on your interaction with the patient, the diagnosis, and of course, the patient notes.

Year 4

  • Apply for residency (ERAS)
    • Opens September 15, you want to submit your application as close to this date as possible!
    • You are able to work on your application earlier, but can’t submit until Sept. 15!
  • Residency interviews
  • ELECTIVE ROTATIONS
    • take advantage of getting your foot in the door at hospitals you’d like to work in, for if they see your face and positive work ethic you’re more likely to match!
  • Upon graduation, you finally will have a Medical Degree and can be titled Dr.

MATCH DAY

  • This occurs on the 3rd Friday in March of every year, it’s the most exciting day for medical students because they find out where they will continue their medical education!

Residency 

  • A DOCTOR’S FIRST JOB!
  • A resident is still being trained by attending’s in the specific field, but you finally get paid for the work you do- AKA start paying those students loans!
  • USMLE Step 3
    • usually taken after your 1st year of residency
    • The test spans the length of 2 days
    • It’s 500 questions testing everything you know about medicine
    • FINAL USMLE exam!
  • After the completion of USMLE STEP 3, you are on the road to finally being able to practice medicine without supervision (after completing your residency and passing your state licensing exams).

 

Medicine is long, hard journey filled with examination every STEP (haha) of the way. That is why it’s important to enter this field for the right reasons. If you’re thinking about medicine because you’ll be making money, sorry my friend, with the amount of schooling required- med school doesn’t really pay off as much! I hope this helps to provide some perspective on the road of becoming a Doctor in the United States.

 

Happy Studying,

Preety 🙂

How I studied for my NBME Final’s

Hello There!

It’s been a long time! I’ve been quite invested with medical school, and it’s been difficult leaving some brain power to write a blog post in the meantime, lol. Anyways, now that I have completed 3 semesters of coursework and am preparing to conquer my 4th semester followed by everyone’s “favorite” nightmare- USMLE Step 1, I thought I could write about how I have studied for my NBME’s- this time for Physiology, Pathology, and Microbiology.

For those not familiar with NBME- these are old, previously used USMLE questions that schools can buy and use for examination. My school’s curriculum is such that our final exams are cumulative NBME questions selected by the professors. Therefore, all the protocol and the software is exactly the same as the USMLE.

With that said, let me share how I decided to prepare for these exams. I decided to stick to the following resources:

  1. USMLE RX
  2. Pathoma
  3. Goljan Rapid Review for Pathology
  4. Sketchy Miro
  5. BRS
  6. Physeo

For professor written exams, I solely focus on class notes and flip through my First Aid to make sure I understand everything high yield. When finals roll around, I place my professors notes to the side because they are usually more detailed, and I don’t have enough brain space to go through all the detailed notes for my classes. Therefore, I first make a list of all the topics covered in each class throughout the semester, and split each topic into a few days of studying. Then, I watch the RX videos and annotate my first aid. I then do the flash facts related to the videos after covering all the material I wanted that day.

Pathology:

I watch Dr. Sattar’s videos that accompany the Pathoma textbook and annotate as I go. Once I complete the chapter, I read the blue indexed notes in Goljan Rapid Review. If I struggle grasping onto specific topics, I read the specific section in Goljan. Finally, I add all my notes into my pathoma textbook, for this will be my primary source. If I have time, I’ll watch some RX videos for pathology, but I usually just skim through the first aid for the specific topics.

Microbiology: 

SKETCHY MICRO. I can’t emphasize it enough, the creators of Sketchy are God-sent to all medical students. With all the information you need to remember for each of the microorganisms Sketchy  does a fabulous job condensing it into a picture story line for each one! In all honestly, during my exam I would figure out the organism being questioned, think of the sketchy picture, and then look at the answer choices to see what matches the picture. I also plan on using sketchy pharm for my pharmacology course this semester!

Physiology: 

I’m so thankful that I found Physeo before starting physiology, it’s like Pathoma for physiology, and they do a wonderful job explaining all the intricate details associated with system physiology, especially those graphs and tests! After watching the videos, I would skim through the BRS just to make sure I understand everything and finish off by doing the respective practice questions in BRS.

 

Week before exams:

A week before my exams, I focused on doing only practice questions from USMLE RX. I was able to finish all the Microbiology, Pathology, and most of the Physiology questions this time around. I usually create a test of 10 questions at a time, which is about 15 mins timed. Once I complete the ‘test’. I review all my correct and incorrect because sometimes I get something right but don’t actually understand how. What I love about USMLE RX is that it shows you the page in First Aid where that topic is covered so you can reference it while reviewing rather than wasting time flipping through pages. I created a word document where I started listing everything I was getting wrong. For example, I forgot Entamoeba histolytica engulfed red blood cells- so I wrote that on my document and attached a picture of how it looked under the microscope (P.S. This was a question on my exam, and I only knew it because of this method)! My document ended up being around 20 pages once I had completed the questions. I skimmed through it, and whatever information didn’t seem to stick even after reviewing it, I re-watched those specific videos for that topic.

I made it a goal to watch Pathoma and Sketchy at least 3 times (more for topics I was struggling with). I only did one pass of Physeo videos, but physiology just sticks quicker than other subjects for me. I’m not a fan of sharing my grades on social media because I want to avoid creating a competitive environment, but I will say I performed phenomenally on my NBME’s- better than my midterm averages! Even though I walked out of each exam thinking I bombed it, I was proven otherwise!

I would like to say that whatever studying method work for me may not work for others. I know some classmates that can’t understand Sketchy regardless of how many times they try watching it, and others studied only our class notes rather than board prep material. Everyone has their own method of studying that helps them become successful. I have shared my resources and my method but, by no means, am I saying this is the ONLY way to study.  This semester was one of my most challenging ones yet. I had to move apartments the day before my first midterm due to mold growth, and then my washer decided to flood my apartment the weekend before my 2nd midterm. I was faced with a ton of organizational commitments and meetings, which I couldn’t put to the side because I signed up for it. Followed by several celebrations in my group of friends. It was a hectic schedule that required major time management skills, but I managed to pull through and figure out how to organize my commitments best. I hope this helps gives a good idea into studying for NBME’s, it’s kind of like studying for a mini step!

Stay tuned for more Med School related posts! I’ve been tossing around ideas for vlogging or writing. I tried vlogging during my studying, but I noticed I didn’t enjoy editing the clips afterwards. Therefore, I’ve decided to stick to my blogging and instagram because I enjoy sharing my stories on these platforms.

Stay Motivated,

Preety 🙂

 

Why the Caribbean?

Hey Guys!

As many of you know, I am now a first year medical student and will be starting my first day September 6! I have been hesitant to talk about my medical school journey, where I’m going to school, and defending my decisions. I seem that it’s so easy for others to judge me incorrectly by looking at my decisions, rather than the story behind them.

It occurred to me this summer that there are few people that earn a seat in medical school the non-traditional route voicing their story on a social media platform. I found myself, at times, saddened and often deterred from my goals because others achieved something I worked so hard to get and didn’t.  The past year has been filled with ups and downs, emotionally and mentally. Thoughts constantly eating me inside “what will I do in my life”, “I don’t see myself doing any other profession”, or “Am I built for this career”.  A girl who was once so optimistic, goal- orientated, and professionally driven entered the storm of self-doubt. I’ve had 4 months off school, spent time with the people I love, and helped others grow out of their shell. In the past 4 months I found myself, that optimistic girl that’s out to change the world. I realized that I may not be the only individual in the world that has felt that way, so I decided to write this blog today as inspiration to someone that feels that they are stuck. Here is my story:

Becoming a physician has been a life-long dream, not because my parents forced it onto me, but for the lives I can change. As a child, one visit to the doctor’s office would make my fever or cold go away in a few days, it was magical! Obviously, growing older you learn that magic is called antibiotics- haha! I wanted to be that magician in a white coat that makes all pain and suffering go away with a smile and lollipop. In middle school and high school, I was your typical pre-med wannabe. Loaded up on AP courses, volunteered at health clinics, interned at family practices, national honors society, and competitive Bhangra performer (Punjabi folk dance)- perfect was never enough. In college, joining organizations, keeping up grades, having a social life, continuing dance, creating organizations, traveling abroad, researching and acing the MCAT all became a priority. Now, a practical individual would be like “impossible”, and it was. Making everything a priority made my performance horrible in every aspect. I decided to do a B.S in Psychology with a minor in Biology, if I could back I would change that- but that’s a different story. My resume was very strong but in the midst of making that my grades slipped and my MCAT score wasn’t competitive enough.

I took the MCAT a total of 3 times, the second being my best. I approached senior year of college knowing that my grades made getting accepted into medical school difficult, but not impossible. Therefore, I applied to a post-bac program associated with a medical school. My MCAT was on par, the extracurricular’s above par, but my GPA subpar, and I just had to meet the minimum GPA requirement for the post-bac program to be admitted into their medical school- I could easily do that, or so I thought.

To my surprise, the coursework in the program was actually first-year medical school courses, along with clinical based exam questions under a time limit. Expecting a program to help me transition into medical school, I fell into a trap of being in medical school but not actually a medical student. I barely passed my first course during the first semester, but I grew and learned how to study for medical courses and ACED that final exam to bring my grades up. The second semester was much easier for me because I knew how I learned best, that’s something I failed to understand the first semester- What works for others might not work for me.  For 8 months, all I did was study all day, every day, during every second, and it wasn’t enough. After receiving scores from the second-semester cumulative final, I learned I was 1 exam question, just 1 point, away from achieving the minimum GPA to enter the program. 1 point determined my future for me, 1 point.

I returned home depressed; sat on the couch all day watching Netflix, didn’t talk to anyone, and had a difficult time sleeping through the night. I kept thinking to myself what do I do now? Should I apply this cycle and wait a year to see if I’m accepted? Should I pick a new career where I wouldn’t be happy but could move on with life? Should I broaden my scope and try for the Caribbean schools with a good reputation in the US?

After a lot of researching, and self-reflection I decided to apply to Caribbean Medical Schools for several reasons, here are a few:

  1. I would get experience practicing medicine outside the US and be exposed to medical cases I probably would never see in the US
  2. I’ll learn about other cultures, as an aspiring family physician, I find it vital
  3. My clinical rotations will be in the US, so only 1.5 years on the island
  4. An MD is an MD at the end of the day

Will my path to residency be difficult compared to US graduates? Yes. Will I be able to fulfill my life goals and become the magician I’ve always wanted to be? Yes. Do I have any regrets so far, not at all. In fact, I feel blessed that I’m able to attend medical school in an environment where I won’t be snowed in all day, or won’t be able to enjoy nature, good food, or a different culture during my breaks. I’m excited about this new journey.  Where am I going you may be wondering? The American University of the Caribbean located in Sint Maarten, and yes I will go plane watching on Maho Beach!!

 

If you feel stranded or lost please, PLEASE, PLEASE, e-mail me. I would love to hear from you,  maybe lend a helping hand, and watch you succeed as well. My journey has taught me to never limit myself, never exclude possible situations, for life may have something else planned for you- so just go with the flow.

 

So there it is, that’s my story. Feel free to follow me on Instagram @foodiewithscrubs

 

Much Love,

Preety