Saying Goodbye to 2nd Year

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Many people have said that the second year of medical school is the hardest and most grueling year of all.  I’ve heard countless people tell stories of how busy, exhausting, and completely consuming 3rd year is, but it is always followed up by the statement, “But I’d take just about anything, including getting hit by bus, over 2nd year.”

To be completely honest, this was in fact one of the most challenging years of my life for reasons that extended far beyond the rigorous course work that we were faced with each and every day and the ever-looming presence of Step 1 (the exam that makes even other medical licensing exams cry themselves to sleep out of fear).

HOWEVER, I can honestly say that despite the challenges that we faced this year, I will look back on 2nd year with fond memories and a never stronger sense of the presence of God’s guiding hand in my life.  Let me take you through a quick whirlwind tour of what the end of this year was like and what made it so challenging, but I promise there’s a light at the end of the tunnel so keep reading!

From January on, the only thing that 2nd year medical students across America have on their minds is Step 1. This is the mother of all exams; it is 8 hours long and covers all of the content that we have learned in the first 2 years of medical school – anatomy, physiology, cell & molecular biology, immunology, behavioral science, biostatistics, preventive medicine, biochemistry, pharmacology, pathology, pathophysiology, psychiatry, and neurology.  Now this test wouldn’t be such a big deal if it didn’t have so much weight toward which field of medicine we will ultimately be able to enter.  It’s basically the MCAT of residencies and our scores will either make us eligible for competitive specialties like surgery, ophthalmology, radiology, or not.  The saddest part, in my opinion, is that students who may excel in those fields because of their clinical skills and passions may not have the chance to experience those professions because this exam holds so much weight in residency applications.  This was one of the things that I struggled with the most near the end of the year.  I watched countless classmates, who I know will be incredible healers struggle beneath the weight of the pressure that this exam places on students.  The tensions were certainly high and at times the morale was low, however, I can say that the silver lining through it all was learning to trust more in the fact that God has called us to this place to serve in a profession that he will placed us in.  If he has gotten us all this far, then surely he will see us through to the end.

Despite the challenges that we faced during 2nd year, I promised that there would be a light at the end of the tunnel.  Medical school is a process that is so much more than simply learning how to be a doctor; it is a process that challenges people at the very core of who they are and I can honestly say that I have enjoyed that challenge.  I’ve been stretched and forced to grow in ways that I could have never imagined.  I have been required to search for the true reasons why I chose to enter this profession.  I have made the best friends of my life because of the common struggles that we have faced together.  I have been inspired to grow in my walk with God.  I have learned more than I ever thought was possible.  And I have been humbled by the realization that I will never be able to learn everything there is to know about the workings of the human body.  Although the process has been challenging, frustrating, and seemingly impossible at times, I now stand on the other side of the first two years of medical school and can say with confidence that I wouldn’t change anything and would do it all over again in a heartbeat.

 

I would be remiss if I did not take a moment to thank the incredible people who helped make this year both meaningful and enjoyable!:

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My study buddies, Scott and Justin.  We met both years for 2 hours almost every night, 6 hours every Sunday, and ran through at least 45,000 flashcards – about 15,000 cards times a minimum of 3 repetitions. I couldn’t be more blessed or more thankful to have had them by my side through this journey.

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My fellow “Carrelers,” Keri, Krisalyn, Melissa, Stephen, James, David, Linden, Casey (not all of whom are in this picture). I spent my afternoons studying with these wonderful friends in the Study Carrels of Alumni Hall throughout 2nd year.  I have been continuously inspired by each and every one of them and have been spiritually and emotionally uplifted by each of their friendships.

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Dr. Werner, our famed professor of Pathophysiology and the Dean for Medical Student Education to whom we owe our gratitude for continuously inspiring us to never stop learning and to be the absolute best physicians we can possibly be.

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And my classmates, who I love with all my heart!  Coming to Loma Linda and joining these incredible, talented, brilliant, God-fearing, and all-around absolutely wonderful people was the best decision of my life!

I have a pager and a white coat with my name on it???

Kristina, Third Year Medical Student

First year – check. Second year – check. Step 1 – check. Orientation week – check. Tomorrow, with white coat on and pager in hand, I step onto the wards.

It’s both exciting and scary that these mile markers for medical school have passed already. For so many years I have been learning from behind a desk, and now it is time to actually do things.

As I look back on the last two years, it is pretty incredible to see how I’ve changed and been molded to face the changes of medical school. The experience has enabled me to get to know myself in a more raw and vulnerable way. I’ve discovered strengths and weaknesses that I didn’t realize during my college years. If this has only happened in the first two years, I cannot even begin to imagine the changes I will experience in the last two years!

With Step 1 (part one of three board exams that dot the path to becoming an MD) behind us, it’s so interesting to even see the changes my classmates went through in such intense stress. I saw some burning out, some are peaking just at the right time, some in a panic to get the highest score possible, and some at peace with just getting it over with. I realize that we have all come to this point in order to become physicians by mostly studying, studying, occasional OSCE…studying, studying, …and more studying. Yet this is one of the first mile markers of many that REALLY stays with us significantly into the future. I really try not to think of that too much as I wait for my score to arrive sometime in July.

Although it has been draining, I have gained some of the valuable things this year. One of the best things I have experienced is making new friendships and strengthening existing friendships like never before in my life. My friends that I have made in medical school are definitely ones that I will keep for the rest of my life. This is one thing that I have absolutely loved about second year of medical school. In college, I had a harder time getting and maintaining friendships. I’m not sure why. Maybe I spent too much time in the chemistry lab, or maybe I just wasn’t a friendly person! But this year, the hardships have made friendships stronger, and that is something that I will always treasure. Because it’s these friendships that get you through the rough times, and it’s these friendships that make the good times even MORE awesome.

Another thing I’ve really learned this year that has been VERY important for me to “turn off the chatter”. There are always people around you suggesting the newest and best resource for preparing for classes and step 1. The class nearly goes into a panic at the beginning of second year trying to find the best books and notes and flashcards and dropbox pdfs in order to succeed in classes/boards. Early on, I found that this kind of talk reallllly gets to my head. And even though I managed to turn the chatter off first year, I had to do it all over again second year. As a result, my days grew to be spent entirely at home with studying from 6am to 11am, working out, eating lunch, studying from 1pm-6pm (with an occasional 20 minute power nap thrown in), dinner break, then studying from 7pm till about 10pm. Repeat the next day. Yes, it did get a bit lonely at times, but I was MUCH more at peace and much more focused.

This past week we had orientation, which was…..interesting. We had a lot of lectures about smoking cessation, preventive medicine, ethics, and some about how to succeed on the wards. There were ups and downs in my attention span, I will admit.

Thursday night was the clinical commencement dinner for our class at Castaways restaurant. It was so awesome to see everyone in nice outfits, all done up for the occasion! But what I think I loved the most was seeing how relaxed everyone was. Seriously, I don’t think I’ve seen such relief on our faces in all my time here. Now, come our first presentation to our attendings in a few days, I don’t think that will be the case! But, I loved seeing so much happiness then.

The program consisted of a vocal rendition of “Let it go” by some of my classmates (Hans, Ben, Vincent, Jackson, Vanessa) and I along with an encouraging and educational speech given by Dr. Werner on how to succeed in third year (probably the most informative speech of all orientation week). It was an awesome evening of no studying, good food, awesome friends, and a gorgeous sunset.

So in short…third year starts tomorrow. Without a doubt, I am SO happy second year will be over and behind me. But about third year, I’m not going to even pretend like I know what is going to happen, because frankly, I have no idea! I’m sure I will miss the days that I could completely control my schedule and plan my fun activities around my studying. However, at the same time, I so appreciate the first two years of molding me into being a better doctor and a better friend. I have grown in my solitude of prayer and study this year, and now I’m ready to continue growing around patients, attendings, residents, and nurses.

And the saga continues…

Sincerely,

Kristina…now MS3

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Learnings

Leanna, Fourth Year Medical Student

In the past several weeks I’ve matched to USC’s internal medicine program, graduated medical school, and now am preparing for residency (i.e. filled out 100+ pages of paperwork and bought Pocket Medicine and new shoes). The things I learned about medicine, becoming a doctor, myself, and life during these last four years of medical school are far too many to confine to a blog post, but I’ll note some of the more entertaining and blog-able ones here.

MSI: First year – year of the basic sciences:

I learned that my new best friends would likely be the ones who made art projects with me, art projects with the titles of “Cell Lineage Cupcakes” and “Sandcastle Nephron: a beach study in the functional unit of the kidney”.

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I learned that in order to get decent grades in medical school you had to make huge sacrifices in all other realms of life, sacrifices that I did not have to make in undergrad and at first had a hard time making during this transition.

I learned that from the moment you tell someone, I’m studying to be a doctor, inevitably one of the next questions would be – Oh good, can you check this out for me and tell me if it’s anything serious? Or, sometimes his or her next odd question was, You mean, like a nurse?

Conclusion: I had no life, and far fewer friends than I was used to, but I was okay with it.

MSII: Second year – year of pathology/pathophysiology

I learned all the different ways a person can die (there are a lot).

I learned that pathophysiology is best studied as a group, with cookies.

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I learned that when a professor says, “This concept will be on Step 1”, the entire class wakes up and poises ready with their pencils/iPad note-taking software.

I learned that I could walk around the Drayson Center track for up to three hours at a time while listening to audio lectures.

I learned that while listening to audio lectures at Drayson Center track I ran the risk of getting hit in the head by a stray soccer ball [I learned this lesson twice].

I learned that some of the Step 1 study books had the stupidest study tips, such as, “Just remember the simple acronym AINBIBYXDYAHTGUVI for all the causes of liver failure and you’ll never forget ‘em!”

I learned that the best friends I made in first year were indeed still my best friends and fellow soldiers in the war against overwhelming exams and boards.

MSIII: Third year – year of clinical rotations and the beginning of the hospital hierarchy

I learned that all residents can be bribed, whether they are conscious of it or not – sometimes with food, sometimes with compliments.

I learned that the diseases that in prior years were confined to pages and chapters were infinitely more fascinating when seen up close in a living, hopefully breathing human being.

I learned to act quickly and seriously with the pregnant woman with a life-threatening lupus flare and for the man with a rupturing abdominal aneurysm, and how to lean towards empathy instead of apathy for the patient complaining of non-descript fatigue.

I learned that I loved internal medicine and family medicine and neurology and wilderness medicine and psychiatry and endocrinology and emergency medicine and cardiology and gynecology and critical care and pediatrics.

I learned that Hour #1 of a hernia repair and abdominal adhesion lysis surgery is fascinating, but Hour #9 is not (note that surgery did not make my aforementioned list of rotations and specialties that I love).

I learned that surgeons, upon finding out that I was moderately intelligent and strongly considering primary care as a career, had no inhibition when it came to constantly telling me that it would be a waste of my mind to go into primary care. And this was discouraging.

I learned that there was no possible way to describe my joy and relief with ending my surgery rotation other than this picture:

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I learned that a benevolent neurologist who lets multiple students practice the opthalmoscopic exam (imagine the Death Star killer beam that destroyed Alderaan in a single blast being emblazoned onto your retinas) on her, is a saint and I hope the Vatican City or the Catholic Church or whatever recognizes her as such eventually.

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I learned that as much as I liked doing rotations at White Memorial Medical Center, doing several months’ of rotations there instead of in Loma Linda distanced me from my fellow classmates and disintegrated what little social life I had.

Without a doubt I learned the most during third year. And as I looked back at the beginning of third year compared to the end of third year, I realized that maybe, just maybe, I was actually getting the hang of this doctor thing.

MSIV: Fourth year – year of marketing yourself to residencies and awkward spare time.

I learned that I would have a very hard time choosing between internal medicine and family medicine.

I learned that I loved diversity, puzzle-solving, variety, primary care, and hospitalist medicine, and because of that finally chose internal medicine as my residency path.

I learned that I would have A LOT of time off. What is time off? What do I do with it? Should I study? Should I sleep? Should I go to a pound and adopt another rabbit? Should I read War and Peace? I’ll bake some cupcakes.

I learned how to better practice grace and patience when a family member or friend tells me that they don’t “believe” in Western medicine and prefer only “natural” routes [Hint: arsenic, cyanide, and a variety of lethal mushroom are all “natural”…this could be a topic for a whole different post].

I learned how to be a wife, and in that taking on my husband’s last name of Wise, being called “Dr. Wise” sets quite a high threshold of excellence to which I will be held. Sometimes I wish his last name was Dumb, so that I could be Dr. Dumb and not too much would be expected of me.

I learned on the residency trail that an emphatic “Nope!” is a perfectly acceptable answer when asked if I have plans for specializing after residency.

I learned that Match Day is like a combination of eHarmony, the football draft, the Harry Potter sorting hat, and that part of the Hunger Games when teenagers are chosen to go fight to the death. The last comparison is the most accurate.

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I learned that I liked sushi.

I learned that graduation and all the festivities involved was going to feel extraordinarily surreal, almost joke-like. I’m – graduating? What?

I learned that graduation would be horribly bittersweet as the incredible people I’ve met over the last four years would be leaving to go their separate ways around the country.

In retrospect, I learned that all our well-meaning deans and administrators were morbidly incorrect when they told us during first year, Before you know it, the next four years will fly by and you’ll be graduating! No no no, the years creeped by like a elderly arthritic sloth pulling a wagon full of turtles. With slugs and snails and all other slow things cheering him on.

I learned of all the beautiful hiking trails in the immediate LA area and experienced many of them for myself, some of which for the first time.

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On May 22rd, 2014, I learned that I had officially completed all the requirements for my M.D., and May 25th, I walked with my best friends to receive my doctorate of medicine.

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I learned that the most fierce and profound last four years of academics have brought me to a point where I am entrusted with the well-being of others.

I learned that as a doctor, I am swearing to be a life-long observer, innovator, and of course, insatiable learner. My future patients are my new teachers, the exams will be based on the degree of my patients’ health and wellness, and the hospital and clinics are my full-time classrooms.

A deep gratitude to Loma Linda University for setting me on this path of learning, and to my God for sustaining me with so many blessings, and His promises for my future.

[For any folks who are interested, I plan to be blogging at wisemd.wordpress.com during residency]

Step1 | WSMRF | snowman

Janna, Second Year Medical StudentOne more day of tests! Then, second year will be officially 2/3 completed which means only 121 days 12 hrs and 29 minutes and 14 seconds til the looming Step 1. Step 1- it seems like the biggest test of my career. But then again, I felt that way for the SAT, MCAT, my weekly spelling tests in elementary, this set of tests I should be studying for right now, and basically every test I’ve ever taken… which means there will probably be another “biggest” test to come: Step 2?

On another note, I am excited to say I had the opportunity to present a poster and oral presentation at the WSMRF conference in Carmel, CA. There were over 20 students from my class at the conference and some of our mentors even came up like Dr. Blood. We had a great time learning from each other’s posters, attending presentations, and hanging out. It was a mini-vacation!

And, we have another mini-vacation after this test set. Our officers planned a retreat for our class at Camp Cedar Falls. I can’t wait to frolic in the snow with my classmates. Maybe we will build a snowman!

Disclaimer: I didn’t actually calculate the countdown to Step 1, but it’s around there. 🙂

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Nikoleta Brankov presenting her poster to fellow student Casey Harms.

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Michael Giang in front of captive pulmonologists.

 

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Anthony Yeo with mentor Dr. Blood.

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Me rolling up the poster.

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Olaf from Frozen. Maybe we will build a snowman at our Camp Cedar Falls retreat!

 

The Significance of September 15

Angie, Fourth Year Medical Student

It’s official––I am applying to Obstetrics-Gynecology residency! After lots of agonizing, internal debates and talks with those who know me best, I decided at the end of my third year that the specialty that specializes in women and has a love for new life (whether in bringing babies into this world or re-suspending pelvic organs back to Baden-Walker “0” to give women improved qualities of life) is the one for me!

I’ve taken my Step 2 Clinical Knowledge (the 9-block computerized exam at your local Prometric site) and Clinical Skills (the ridiculously overpriced 12-patient clinical exam), and have now recently finished the Gynecology-FPMRS 4-week elective aka “sub-internship” or “audition rotation.” I personally don’t like the term “audition rotation” as it sounds like I am putting on a performance.  I much rather prefer to call it a “sub-I” because it reminds me that I have more responsibilities to my patient and my team. As much as I’ve enjoyed my role as a 4th year student/sub-I, it can still be an awkward transition with Epic (the electronic medical record system) replacing a lot of the duties a medical student used to fulfill to help the residents. Nonetheless, I loved working with “the greats” in laparoscopy and robotic surgeries, as well as teaching knot-tying to and organizing the schedules for the third year students on the service.

So this week, I fortuitously had the week off before starting another elective in OB-GYN. I have been working on my residency application on ERAS, which consists of inputting everything significant to medicine since beginning college to generate a standard format curriculum vitae, completing your personal statement and FINALLY deciding that’s the last draft to upload, making sure your letters of recommendations are uploaded by the Dean’s office, and picking programs to apply to! It sounds pretty straightforward, but in reality as most who have been/are going through the process would probably agree, this has take a lot of mental and emotional preparation as well.

September 15 is a significant day for senior medical students; this is not a deadline, but the opening date of submitting your residency application on ERAS (deadlines are program specific, usually around Nov 1). As getting into residency spots has gotten even more competitive this year, most students (myself included) will be ready to certify and submit their ERAS application by the crack of dawn this Sunday for those on west coast time. After that, I will wait for Monday to come and for programs to actually start looking at my application and waiting for interview offers!

However, what else will I have to look forward to on September 15? Well, my September issue of Vogue informs me that 3.1 Philip Lim x Target collection will be available that day. Also, a quick google search found that September 15 is “International Day of Democracy”. As I try to have perspective during these critical months until ANOTHER critical day (March 21) in a medical student’s career, I am thankful for the freedom to pursue higher levels of education and the wonderful mentors in medicine who have encouraged me to come this far. Oh and for Tar-jay for offering “designer collections” at fractions of the cost for poor medical students.

Good lucks class of 2014! Look forward to hearing about your progress and meeting you on the interview trail!