Intra-OB Update

June 20, 2013

Helloooo Readers,

Time for another update. Since we last spoke, I’ve gotten further along into the OB curriculum. Turns out we didn’t have all 12 students in our rotation; some were doing electives and some stopped showing up, for whatever reason, so there ended up being 9 of us who showed up on a regular basis. Our Doc ended up cancelling quite a few lectures because of CME stuff and being on-call for medicine and OB services, so in order to compensate, we doubled the number of presentations. I had intended to update the blog earlier, but in trying to keep my study schedule and do 2-3 presentations weekly, it just kept getting pushed to the bottom of the to-do list.

Similarly to my experience in Internal Medicine, my attending has left for a long vacation abroad and I have been left with vague instructions as to what to do in her absence. We were told that one of the other docs had agreed to let us observe during his clinic hours (which was a blessing since the residents did all of the pelvic exams while we were in lecture) so I got the chance to see how outpatient visits work out. For once, I’m actually grateful for the required homework the school makes us complete weekly during our core rotations. The first patient encounter I got to observe involved post-menopausal bleeding and an endometrial biopsy. Thanks to a similar homework case from a couple of weeks ago, I knew ALL STEPS involved in the procedure, in addition to having recently reviewed the risk-factors for endometrial ca (which I was grilled on.) 🙂 Also, I had just completed a presentation for lecture the week before on methods of contraception, which included a lengthy section on IUDs. Low and behold, the next patient encounter I got to observe was the replacement of an IUD! So yet again, when I was grilled on the nitty gritty of IUDs–side effects, mechanism of action, duration, type, indications, etc., it was all familiar. This is the first rotation where I’ve really gotten to apply my knowledge like that DURING the rotation, rather than just on the shelf exam. Perhaps because comparatively, surgery and IM are so broad that it’s much less likely that you’ll be studying the same thing that you encounter in clinicals, in the same general period of time. Or in my case, remember all those details associated with the topic when you need them, on the spot.

So, let’s see…outside of clinicals what’s been going on? Well, still having quite a time setting up these electives. This new VSA (visiting student application) that the major teaching hospitals are using is really edging out the spots available for Caribbean students–you have to be at an LCME school in order to use it. Many places that previously accepted Caribbean kids have started stating that if we can’t submit a VSA, they’re not interested in taking us. The folks in the school’s clinicals department have a lovely, plush list of hospitals that have taken kids for electives before, however if you take the time to go through the list, most of the places no longer accept us. I’m not quite sure that the clinicals department knows this yet–with each of my communications with them, they seem to be puzzled as to why I don’t have more of a solid clinical schedule set up yet. Please–it’s not because I’m lazy! I’m trying, really I am!

Alongside the search and paperwork, the school has started requiring the submission of 3 somewhat-lengthy documents before they will approve students to sign up for the Step 2 CK. I was under the impression that this would not apply to students trying to actually sign up for the CK NOW in the current testing block that is ticking away, but I was mistaken. I painfully clicked submit, coughing up the $820 for my CK registration, then, rather than a scheduling permit, got an email from the school a couple of days later wanting to know where my planning documents were before they would approve me. “Aw mannnnnnnnnn” was my reaction. Every day that these documents were incomplete was another day the school would not approve my request, and another day that the available testing spots (for the 9-hour test) through the end of this testing block (through August 31) were being reserved by other students. I rushed home to complete the documents, tedious as it was. They want to know what subjects you’re studying, when you’re studying them, for how long, how many practice questions you’re completing, and what sources you’re using. Ack. Oh–and they want to know what distractions you have as well–like if you’re currently completing rotations or days that you’re taking off from studying for travel, shelf exams, etc. Everything except your bathroom schedule.

And that’s just the first of the documents; there is also another document wanting to know your elective plans. Finally the third, and unfortunately MANDATORY [as it would seem] document is a leave-of-absence request. Leave of what? But I’m not going to be absent…Generally speaking, if you’re going to have more than a 3-week gap between rotations, you must fill out the form and let the office know what you’re doing and why you’re not in a rotation. My core rotations were scheduled back-to-back and I was NOT planning on taking a break before CK as I’ve had ample down-time to study during my surgery rotation (and you’re required to explain breaks on your residency application). Not acceptable. I’ve been instructed to take a 6-week break between OB and Peds to have unencumbered time to study-for then take the CK, thus my peds rotation is being rescheduled. Crap, that means no peds rotation before the CK–I’m going to have to teach myself the pertinent peds info. Immunization schedule here I come! There is a silver lining–in the rescheduled peds rotation, I get to be off-site with the “really awesome” pediatrician, rather than the chain-smoking, frequently-cancelling grump (how can you be a pediatrician and grumpy–right?) on-site, however this puts me 6 weeks further behind and 6 weeks closer to not making the April graduation. Ugh. Yeah, I’m trying to be positive but I kinda feel like my wings have been clipped.

Meanwhile I’ve been scrambling to make arrangements to have my lease extended (to accommodate the extra time here that the rescheduled peds rotation is going to take), and to have my folks either fly me home or drive the car up here themselves so that I’ll have a way to get out to the ‘burbs to the peds rotation, eventually. I heard from other students somewhere that in morning traffic, it can take an hour and a half to get to the rotation by car. I shudder to think what that would take via public transportation. So as much as I’ve tried to make it in Chicago without a car, looks like I’ll have to have it for the last rotation. Oh well, will make moving easier. (Just googlemaps’d it–the office is not reachable without a car. It’s a 2-hour trip via public transportation and you still need a taxi to make it to the office. Yup, car is definitely necessary.)

On a happier, less stressful note, I completed my first 5k in the US. When I did the Nevis 5k, I couldn’t jog for more than a minute and ended up walking most of it, with an abysmal time that was just under an hour. My couch-to-5k program (which I graduated from!) has gotten me jogging respectable durations so that I was able to run for the majority of the race and came in at a time just under 45 minutes. Not bad for someone nearly 100 pounds overweight! Of course, since then my goal has been to keep going–to get the time lower and lower, so I’ve started a 10k training program which keeps me running the same 3 days per week [as the c25k program], but is increasing my distance and *hopefully* making my stride more efficient. In addition to the Color Me Rad run I have scheduled in July, I have a 5k this weekend. I’m excited. Running alongside other folks is so much different than just jogging along the lakefront trail with my music and the training program to push me. It’s much more intimidating, but in a good way–my race time was my personal best–so I guess the competition is good for me.