Everything is Terrible on No One Knows Anything

Just kidding. When I thought about one sentence to sum up my third year of medicine so far, this is the first thought that came to my mind.

I haven’t written a single post in 6+ months. I’ve been pretty busy, but also extra lazy, and that combination doesn’t usually produce any meaningful posts. In my defense, there are at least 3 half finished drafts from those months that are mostly coherent, so I was making an effort to get stuff posted.

So while I intend to publish my “Survival Guide for the Clinical Years” very soon, I need to write a quick update of what I have done so far with my life as a clinical student.

OB-GYN:

I started out energetic, bright-eyed and bushy tailed on the OB-GYN service. Specifically, Labor and Delivery. We split our shifts between nights and days, working 12-14 hours per shift depending on how crazy the hospital was. I finished with rotations through Gynecologic Surgery and Gynecologic Oncology. I also pulled a rotation through the Emergency Room, but that’s a whole different story.

When I started medical school, the only thing I knew for sure was that I would not be a gynecologist. Much to my surprise (and disgust) I ended up liking this rotation quite a bit. I did completely horrible on the shelf exam because I broke Rule #1 of Being A Medical Student (more on that later as well), but I ended the rotation relatively happy.

Spoiler alert: I didn’t actually like Obstetrics or Gynecology. I liked being out of the classroom, I liked working with patients, and ultimately I liked the surgery that I was exposed to during my Oncology and Gyn Surg rotations. I just hadn’t figured that out yet.

Thankfully, my OB experience was pretty good. Because the hospital I worked in served a portion of the population I refer to as “Hoosiers” (not the basketball team….this is more like People of Walmart), I came away with a lot of great stories and met a lot of really cool people during the rotation.

Pediatrics:

This rotation is split into two halves. First, I spent a month on outpatient pediatrics. This was a total vacation since I had just come across town from 14 hour OB shifts and it was mid-summer, so outpatient visits were not exactly popular with kids on summer break. I often had the afternoon off to “study” and “read”, which I sometimes did. My second month was inpatient PEDS, working with the floor teams in our incredible, top notch children’s hospital. This was a great two weeks. My hours were reasonable (60 hrs a week, cover one day per weekend and one call night per week), and I had a lot of time to study. I have never had any intention of being a pediatrician, but kids are great and the vast majority of the pediatric doctors are incredible people, so this rotation was awesome. It helps that our pediatric hospital has an incredible cafeteria and nice facilities.

Surgery:

Disclaimer: surgery was easily the worst rotation I’ve experienced, and I think I will probably be a surgeon. This will take some explaining in a future post, but the main problem with surgery is that the actual surgery is awesome, but being a medical student in a surgery department is horrible. Surgeons have spent years cultivating bitterness and hate, combined with huge egos and fueled with long hours and crushing call schedules, and medical students (with our bumbling incompetence) are ideal targets for their scorn. Even if we aren’t abused directly, it tends to roll downhill from the attendings, the residents, the nurses, the janitor, or really anyone can then turn and yell at the medical student. Since we exist at the absolute bottom of the totem pole, there’s not much we can do about it, besides the usual crying yourself to sleep every night, but that’s par for the course. (just kidding…..a little)

My surgical experience was widespread. I did my first two weeks with this insane surgical oncologist who averaged about 6 words and maybe 3 emotions per week while operating 40+ hours each week. He managed this by doing 16 hour cases back to back on Thursday and Friday, then biking all day Saturday while we took call. The surgeries were “fascinating” and “interesting” (read that also as “exhausting” and “mind numbing”). Next up I did Orthopedics, which I loved and was literally the best possible rotation for medical students (all operating, no notes, no scut work), but that will get its own post down the road as well.

Next up was my trauma rotation. Important context is that our hospital is a Level 1 Trauma center serving an urban city center and about a gazillion square miles of rural farm country, so we see absolutely everything. Our trauma service is nationally recognized for being top notch and absolutely insane. We use a fun internal grading system on trauma to describe the severity of a trauma. On this scale, a 4 is something like scraping your knee. I’m not even sure what a 1 is. The only guy that got a 1 was shot 8 times and died before he made it to ER. We had a guy drive up to the doors and walk in the lobby with a 10 inch knife sticking out of his chest and he got a 2. We had another guy shoot himself in the face twice, bleeding out of every cranial orifice, and he also got a 2. Trust me when I tell you that this place is absolutely insane.

I learned a ton on trauma because I was the only medical student helping a service of 50+ patients with just one intern and one chief resident. I was able to act as a pseudo-resident and do all kinds of fun things (medical students don’t get to “do” a whole lot, sadly). I don’t know if I ever worked as hard as I did those two weeks, but I got an amazing review and recommendations from my team and realized how rewarding trauma can be. I also realized how exhausting it can be, and how difficult it will be to manage trauma responsibilities with family and having a social life as an attending someday in the future.

I finished with two weeks in Urology, which I liked quite a bit. I liked it so much that I did an additional three week elective in Pediatric Urology, as I thought I could be a good urologist someday, but I ended up deciding against it. This week I will finish up the final week of an elective and head to a nice break for Christmas, with Psychiatry and Neurology on board after the first of the year to get me started. I have a lot of other posts I need to write, most of which will include pictures and be a little more detailed. It continues to amaze me that people still read this every day even when I don’t post for months at a time.

As always, I’d be interested to hear from you at sortadrwordpress@gmail.com

 

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