Sunday, July 24, 2011

Different way of making rural doctors:

This New York Times Article describes a new medical school opening in Salina, Kansas, with 8 students in their first class. In exchange for a debt-free medical education, these students will at least start their careers in rural areas. Although much has been made of an upcoming physician shortage in the US, it is only occasionally mentioned that there is already a grave shortage of physicians practicing in rural areas. Previous approaches to the problem are described in the article:

Some are using incentives like guaranteeing admission or forgiving loans to students who commit to practicing in small communities…Others are recruiting students from rural areas and giving their applications preference, in the hope that they will return after graduating. And a number of schools encourage students to spend one year or more training in rural areas.

I found the emphasis that the article made about being rooted in a community to be particularly insightful. They recognized that when students spend 4+ years training in a city, particularly during formative post-college years, they are likely to develop strong social ties (including finding spouses) to that area. I’ll be interested to follow how this small school in rural Kansas succeeds at training and retaining rural doctors.

Friday, July 22, 2011

Puppy Visit!

Approximately 2 days into my surgery rotation it became clear that I was not going to be able to lavish on Walter the love and attention that he requires. I have been spending 12-17 hours in the hospital (as I think I mentioned in my last post, sorry for the whining), and no matter how many people came over to walk him during the day, that still left him with too much time in his crate alone. I panicked a bit, but then called on the cast of thousands who have volunteered to help with him, and set up some puppy foster care for the month of July. He rotated with each my dad and mom for about a week each, and then came home to me on Tuesday. He’s heading over to Natalie’s house for next week, but his brief visit home has coincided brilliantly with my week of subspecialty urology rotation (read: week of awesome hours).

My family does a great job of wearing him out:

He’ll be spending most of August rotating around (I’ll be e-mailing this week… you know who you are…), but I’m really enjoying having him back…

Sunday, July 17, 2011

Biking during Surgery

From Dose of Reality:

While I do sometimes wish it were possible to actually be on my bike in the operating room, as I’d be a lot more comfortable if I were moving around, that is not the subject of this post. Instead, I’m finally admitting publically that although my dedication to physical fitness in general and to cycling in particular is quite strong, spending 13-17 hours/day in the hospital is enough to overcome that dedication. Here is a graph representing my ranking on Bike Journal since the second week of M3 year:imageYou will notice that during outpatient pediatrics there was a pretty good climb, indicating that I was, in general, biking more than the average person on the website. From early June until the end of June I stayed roughly the same, suggesting that I was keeping pace with the cyclists around me on the list, and then the 4th of July weekend showed a substantial spike. This was due to two long rides that led me to rack up nearly 90 miles in a single weekend!

First, on Saturday I rode to Chelsea with Morgan and Yorgos, two new M3 friends who love their bikes and share my love of delicious food. We rode through Dexter and into Chelsea, stopped for an early lunch and some ice cream, and then headed home. This was my first ride on new thinner, higher pressure tires, and it was awesome. We ate at Zou Zou's:

Second, on the Monday holiday Alicia and I reprised a bike ride we did back in 2008 and headed over to St. Clair to bike up the river and have lunch at the Quay Street Brewing Company in Port Huron.

Instead of returning by the same route as we did that time, we followed the entire recommended route for a total of just under 49 miles. It was delightful. On that same ride, my bike odometer turned to 2000 miles:

The following day I started my surgery rotation. This corresponds with the precipitous drop you see on my chart at the top. I did start riding my bike to the hospital last week, but that’s only 1 mile each way. Even on my days off I’m tired enough and have enough errands to run and laundry to do that long rides seem like a distant dream. I suppose it’s worth remembering that the saving grace here is that it’s July, and I dislike being hot and sweaty. My surgery rotation will continue through August, and it should get easier in terms of hours as it gets cooler through the fall. Here’s to a September and October full of long and wonderful rides…

Saturday, July 02, 2011

Obviously an oncoming train

From Dose of Reality:

I finished my pediatrics rotation on Friday, and I took my first shelf exam ever. I think that if I had to describe the test in one word it would be “random.” I had expected it to be challenging (which it was), and long (which it wasn’t, at least in my opinion), but I didn’t account for how disconcerting it would be to have all of the questions all jumbled up. All of my textbooks march neatly through the organ systems, and even the cumulative practice questions at the back of Pediatrics Blueprints didn’t seem nearly as random as the exam was. I have no good way to really self-assess my performance on the exam; I definitely didn’t get all of the questions right, but I’m optimistic that I did well enough to pass. I may have also spent a little time in the morning before the exam looking up the remediation policy just in case… Suffice it to say it’s pretty generous – I don’t think this would be the first time on this blog that I gave thanks that it is difficult to fail out of medical school. Once you’re in they really want you to finish, so you get second chances even when you mess stuff up. In any case, I would have to say that even without knowing my grade I would consider my first rotation was a success.I learned a lot about how the hospital works, as well as about how I work as a medical student, and I even learned a bit (I hope!) about pediatrics.

Now I’m enjoying my first switch weekend of M3 year, and while it feels like I’ve emerged from the dark into the beautiful sunlight of July, I know that this coming week is probably one of the bigger trains I’ll face in this tunnel of a year. Big enough to illuminate a whole weekend… I went on a 40 mile bike ride this morning with new med school friends, and have more outdoor fun planned for the rest of the weekend. On Tuesday, I have a full day of surgery orientation, and Wednesday will bring the start of a new rotation: a new schedule, a new set of objectives, and a new group of colleagues and instructors. I think I’ll wait and think about that on Wednesday…