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May 23, 2010

And That Was That

Third year ended on Friday morning with a Psych shelf. I am now a fourth year medical student, a senior, a big girl on campus. I got home from my exam and asked Patrick, “So, how does it feel to be married to a FOURTH YEAR?” He replied that so far it was only slightly more annoying that being married to a third year. Probably true, as I was crowing for about an hour after I finished, so excited I was to be done with this year.

This has been a tough one, more so than I expected. All along, people have said that “you just have to make it to third year” and “things get so much better when you get to third year” and “third year makes it all worth it”. I don’t really feel any of those sentiments. Sure, third year is way better than studying for Step 1 (obviously), but third year is not better than being able to skip class and study in the park anytime I wanted or sleep in or have every single weekend off for the whole year. I never got to school before 5 am before third year, not even close. I pulled more all-nighters this year than I have in my entire life, and I am getting a little old for that.

But, to be truthful, this year was incredible. I have never worked so hard. I have never enjoyed working so hard so much, nor have I ever learned so much so fast. This was like a year of immersion. I’d done the Rosetta Stone version of medicine, but really, when you get down to it, there is nothing like getting on a plane and moving to Switzerland if you really want to learn both French and German as well as how to keep your life very, very organized.

In case you’ve forgotten, here is a break down of my year:

Pediatrics: I started with outpatient and found it mildly amusing but mostly really, excruciatingly boring. Kids are cute, for the most part, and fun to play with so I had a good time and could generally calm the parents down. Inpatient was at once devastatingly sad and completely great. I loved working with the families and the multi-disciplinary team on the Hematology-Oncology ward and had a really great attending that exemplified interaction with families and patients who are critically ill. It was a great month, one that would make me question my choice of OB because I loved it so much.

Vacation: Obviously awesome.

Family Medicine: Yuck. I was occasionally interested in some diagnostic process that we would refer to someone else or I was astounded at how poorly someone’s complicated medical issue was being handled. I looked forward to the OB checks and the well child checks, but all-in-all was really miserable on this rotation. After having such a good Peds rotation, I wondered if Family was the place for me so I could do both peds and OB. But… no.

Transplant Surgery: OMG SO COOL. Long hours and a lot of standing around in the OR, but awesome. Overall, great teachers and a good intern helped me see incredible anatomy, learn a little about caring for patients post operatively, and understand a lot about the intricacies of transplant qualification. An incredible experience.

Breast and Thyroid Surgery: Loved it. Could easily see myself become a breast surgeon if one was not required to survive a general surgery residency first. Again, and more so this time, with the great attendings. I was able to actually participate in surgery this time and got pretty good at closing and bovie-ing (I just made up that word) such that my attending told me that surgery was “in my blood”. Kind of gross, but awesome. Great month.

OB/GYN: Too bad this month was such a drag. After months of thinking about it, I finally decided that it was a combination of entirely too high expectations and bad timing. I was on OB over Christmas, when residents were on overnight call every other night and tired to the point of delirium. Since this time, I have actually received an apology by one of the residents for “anything that seemed rude or like we didn’t care. It’s not usually like that; we’re just so tired during that time.” I sure hope she’s right. I have decided to go into this specialty in spite of my experience on this rotation.

Internal Medicine: Starting with inpatient was definitely a good way to do this. I had a great team and was paired with a super smart and incredibly efficient intern so work was quick, educational, and meaningful. We did our work, learned what we could, and went home. The team dynamic was fun and I actually enjoyed the calls because of the camaraderie. Outpatient, on the other hand, nearly sucked my soul out of my eyes. Some of the specialty clinics were interesting, particularly the HIV clinic, but the month was downright torture.

Neurology: Snore. Not enough patients to go around coupled with a treatment strategy of Steroids vs. Wait-n-See makes Katie a sleepy girl. Cool residents and a team room with windows that open were the highlights of the month. The pathology is interesting to study, but I can’t understand going into a specialty that has nothing to offer a patient except bad news.

Psychiatry: I thought I would enjoy this one, as I like hospital medicine and find psychiatric topics absolutely fascinating to read about. Turns out that I really don’t like talking to (or talking at, as the case was) these patients. It is heartbreaking and painful to see people this way. I hate to say it, but I didn’t get the impression that the psychiatrists where I was were really all that necessary. They didn’t do anything medical with the patients. They didn’t watch the patients, or talk to them all that much. They didn’t even really know them that well. They write the prescriptions that they are told to write by the staff and go about their business. Not my idea of a career.

In fourth year, I’ll have a month of radiology and a month of emergency medicine, but other than that, I’ve seen all I’m going to see of other specialties. Fourth year is about honing as many skills as I can, learning all I can about conditions relevant to OB, and – most importantly – relaxing after this roller coaster of a year.

3 Readers rock!:

thepurplecoat said...

I've been reading your blog through xavier's one and just thought I'd say I was exactly the same with psych-loved reading all the theory but couldn't stand the ward-it took me a while to get over it, it wasn't what I thought it was at all. I guess it's always interesting in a bizarre way! I also didn't LOVE the clinical years that people said I would LOVE but so far I've really enjoyed working, much more than studetn rotations so I guess things work out well in your own way. All the best for 4th year too! izzy

~Ashley said...

you forgot one of the most important things about 4th year! interviewing for residency...it's fun (but overwhelming) to try to sift through ALL of the programs and figure out where you want to go...but, you may already know where you'll be, so maybe it's a moot point for you. but anyhow, i'm glad you have direction into your 4th year regarding your specialty...do you think you'll do an OB/GYN fellowship, or too early to tell? BTW, i'd totally let you deliver any baby of mine....next one will have to be maybe a VBAC, but still, i'd let you do it!

tracy said...

Real Psychiatrists in the real world who actually do therapy (getting rare) really do have relationships with patients and do the work. The hospital ones are usually hired out by the hospital, may see 50 or more patients a day for 2 or 3 min and are usually freaks with the small exception.

Congrats Fourth Year..."insanely" jealous!