I’m back!

From AMSA On Call

Post #8 of the "Back to the Wards" series focusing on the transition from research years back to the medical school and clinical rotations.

Yesterday marked the start of my outpatient pediatrics rotation, the first of my third year of medical school, and the end of this series of posts on my transition from doctoral work in the School of Public Health to my third year clerkships. As I interacted with my M3 colleagues during general orientation last week, and pediatrics orientation yesterday morning, I was struck by the overall high level of anxiety. In spite of my perception that everyone (except maybe the other returning MD/PhD students) should be calmer than me because of their more recent completion of things like clinical competency assessments and Step 1 of the USMLE, all of us were talking nervously about seeing real patients, presenting histories and physicals in the inpatient and outpatient setting. Many of us noted with some trepidation that we don’t do any pediatric exams during our first two years of medical school. While I still believe that many of my colleagues were much more prepared than they believed themselves to be, orientation was nonetheless an important reminder that no matter how large or small the period of time between the pre-clinical and the clinical years of medical school, the jump in expectations (both self-imposed and outlined in the ever present learning objectives for each rotation) is daunting. None of us felt truly ready for the challenges that Monday afternoon would bring.

Despite all this, Monday afternoon was great. I can only speak for myself, as I haven’t had much time to debrief with other students, but although I didn’t have all of the answers at my patients’ well-child exams, or ask all of the questions I needed to at sick visits, I made it through and presented what I did know to an understanding and friendly attending. I tried not to hesitate to ask questions and highlight the gaps in my own knowledge. In some ways, I think that doctoral work was great preparation for the wards. Who better, after all, than a PhD student to give a succinct outline of what is known, highlight the gaps, and attempt to make a conclusion anyway? At the same time, I felt myself struggling as I dusted off my medical vocabulary, only to find it a little rusty and perhaps a bit smaller than last time I trotted it out, and I often came up blank as I tried to expand my differential diagnosis.

Looking forward, I see a lot of reading and asking of clarifying questions as my rotation progresses. Just in the past few days I have absorbed a great deal in clinic, and am recognizing the value of applied and practical learning structured around the patients I see. I think my time away will ultimately make me a better doctor, but first, I’ve got to get to studying!

Home!

We made it safely home from Colombia, and I start orientation for my M3 year tomorrow. I’ve started writing some posts about the rest of our days in Medellín and Cali, and will continue to post them as I get a chance. In the flurry of errands I ran today, I picked up the following items:

• A bound copy of my dissertation
• New glasses
• Less than stunningly attractive but wildly comfortable (and wipe-offable) clogs

I’d consider the day a success, and am looking forward to tomorrow and getting a better sense of what I’m in for over the next year…

Dia 2: Bogota

Our second day in Bogota was really delightful. We went on a bike tour of the city led by "el gringo" Mike, a Californian ex-pat who has lived in Colombia for the past few years.

We saw a lot of the city, including a park created after the most notorious of Bogota's slums was bulldozed, a fruit market where we tried all kinds of exciting fruits that have no English translation, the bull fighting stadium, and the legal red light district which is limited to a restricted "area of high impact social activity," because it affects the neighbors substantially (no pictures of that)...

After we finished the bike tour, we joined up with another of the cyclists and headed up to the cable car up Monserrate, a hill on the edge of the city. With my deep love of public transit, I was quite excited to ride both the cable car (up) and the funicular (down) that run on Monserrate.



There is a church on top of the hill, and as it was Easter Sunday there was mass going on, but we were mostly interested in the stunning views of the city and of the mountains on the other side.

After we came down the hill, we were hungry for dinner and went by the Israeli restaurant that was closed when we pass it on Saturday. It was still closed, but we headed to another Middle Eastern restaurant for the Colombian take on shwarma:

Delicious!

Bienvenidos a Bogota!

We've been in Colombia since Friday, but I haven't had a chance to post before now. Here are a few highlights from our first few days in Bogota!

Starting the trip off right, we visited the Bogota Beer Company, the "cerveceria pequena mas grande de Bogota" - the biggest little brewery in Bogota. The beer was pretty good, and ending our travel day with delicious bar food was a nice transition for our trip.


After a blissfully restful night, we set out to explore part of the city. We rode the Transmilenio, Bogota's bus system masquerading as a metro, and did quite a lot of walking. We walked around the Candelaria, Bogota's historic city center.


We saw the Justice Palace, Congress Building, City Hall, and the Cathedral (pictured above). We also saw the Casa de Narino, the presidential palace, and it's fancy guards. Below is a photo demonstrating the awesomeness of my zoom lens, because we weren't allowed to get very close.


We were pleased to see lots of cyclists around (Colombia is known for amazing cycling performances on the mountain stages of road races), including the one below who stood out wearing the brighter versions of the colors on the houses:

The first museum of the day was the Botero Museum, brimming with his signature voluminous figures in paintings and bronze sculptures. I'd like to point out that Colombia's most famous artist was way ahead of his time in terms of his love of little birds:

After the Botero Museum and some lunch (hard won, I might add, as it was the Saturday before Easter and lot of things were closed), we headed to the Gold Museum. We had a great guide take us through one of the exhibits and tell us about the symbolism and cosmology of the early inhabitants of Colombia, as shown in the beautiful items in the museum. In addition to all kinds of body ornaments and containers, there were some beautiful spindles in the museum:

There are more pictures from Bogota to come, as well as updates about Medellin and Guatape (today's day trip)...

Delicious Chicago

I went to lovely Chicago this weekend for the National Conference of Physician Scholars in the Social Sciences and Humanities. Actually, Chicago was not lovely for most of the weekend, as it rained and generally was cold and wet, but the places I went in Chicago were still delightful. My hotel was right on the river downtown, which is nice for conference going (as the conference was in the same area), but not all that nice for eating or much anything else (other than maybe picture-taking.

I headed directly to Wicker Park to take in the yarn fumes at Nina, my favorite Chicago knit shop. I found some lovely souvenir yarn, as well as a project bag that reminded me of this video:

Put a bird on it!

I was starving by this point, and knew that I wouldn’t make it to dinner without eating something soon. I stopped at the Milk and Honey Cafe, which served a surprisingly spicy corn soup, and was located next to yet another trendy bird sign, causing the hipster index of this neighborhood to spike off the charts.

After a brief stop at the Verizon store to get a new phone charger, I headed back to the hotel to drop off my purchases and headed back west to try out Green Zebra, a fancy-pants vegetarian restaurant I’d been meaning to try for a while now. It proved to mostly live up to the hype!

The salad was mediocre at best. The menu promised roasted squash, but there was none to be found. Toward the end it was even a little grainy, making me wonder whether the lettuce and scallions had been properly washed. The fig dressing was delicious though…

Dinner was amazing. I ordered the Farm Egg, which was a perfectly poached egg on top of smoked creamed potatoes, with little toasts forming a house around the egg. The potatoes were some of the best I've ever had.

Dessert was also incredible, making me wonder whether it is, in fact, only vegetables that cause problems at this vegetarian restaurant… The crème fraiche ice cream was 100% a reason to continue eating dairy…

The rest of the weekend was consumed with the conference, which was, as it was two years ago, a great source for thought-provoking talks as well as some of the best career information I’ve ever received. I think Adam, one of the conference organizers, put it best when he said “this is the conference of my people.” I thoroughly enjoyed getting to meet and reconnect with the other MD/PhD students in the social sciences and humanities!

Another knitter…

I spoke on a panel for a class of nursing students today. It was similar to all of the other panels I’ve done over the past 8 years or so, talking about gender, sexuality, and healthcare, except for one thing. Right after we came into the room, as the other panelists and I were organizing ourselves, the instructor walked onto the stage, introduced herself, and then proceeded to explain that she was going to knit during the panel and that we shouldn’t interpret that disrespectfully. I was so pleased to find another knitter! I told her about my own class/meeting/conference knitting, and revealed that I had a sock in my bag that I had considered working on during the panel, but had decided would be too distracting while I was presenting…

Back in the saddle again

Today was beautiful in Ann Arbor! True to form, it seems that the weather here has leapfrogged over spring into summer, and it was nearly 80F this afternoon. To celebrate, I went on a bike ride with Alicia. It was only 9.6 miles, but my legs are tired… I’m about to start composing an optimistic training schedule, even though I know that it’s likely that much of it won’t happen once rotations begin. I might as well at least have a plan, though…

One small step for a current student, one giant leap for me

From AMSA On Call:

Post #7 of the "Back to the Wards" series focusing on the transition from research years back to the medical school and clinical rotations.

On Monday and Tuesday of this week, an incredibly gracious current M3 let me shadow him on the first two days of his inpatient pediatrics rotation. I would highly recommend this before returning from an extended absence, as it not only gives you a better sense of what will happen in the months to come, but gives the more advanced student a unique opportunity to demonstrate everything he/she has learned and to teach a newer student.

The logistics: The MD/PhD program identified a willing volunteer who was on an inpatient pediatrics rotation this month, which is what I’ll be doing in either May or June, and put me in touch with him. I decided not to go to orientation, as I knew I’d get my own orientation soon enough, but met up with him following orientation before rounds started for the day. I only spent a few hours with the team on Monday, but I got a good sense of how the team works in the hospital, and when I showed up for pre-rounding on Tuesday, I got a real sense of what medical students do with patients who’ve already been in the hospital for a while. I went on rounds again, saw the med students present, and helped with the tasks that followed.

The lessons: Do this! No amount of shadowing can prepare anyone completely for anything, but it can substantially decrease anxiety. I learned that even after eleven months of clinical rotations, there are still new things to learn and different approaches to adapt to on each service. I saw some great medical students in action, and learned that even folks who haven’t taken a break are constantly learning new things. I also learned that interns, residents, and even attendings are not scary (which should not have been surprising, as many of them were my med school classmates!), and are nice and helpful and willing to teach if you work hard, try new things, and aren’t afraid to ask questions. I also learned that “work hard” includes spending long hours at the hospital. I had a good sense before that this was the case, but spending just two half days in the hospital drove it home.

The bottom line: I need to start believing folks that this will all be fine! There will be long hours, and lots of work, but nothing insurmountable. I’m certain that as crazy as next month may be, at the end of it, I’ll join the chorus reassuring you that you too, will be fine.

Sometimes over-ambitious + under-prepared = good enough…

As some of you know, I’ve become a devotee of the Design*Sponge blog feature called Before & After. In this feature, wildly talented designers transform thrift store, basement, and dumpster finds into beautiful works of art. Some of them are quite pricey makeovers, but many simply use a yard or two of beautiful fabric to reupholster a chair, or a coat or two of paint or wood stain on a dresser. There is also a less frequent feature called Before & After Basics that demonstrates a wide range of techniques. Turning old (and often unattractive) pieces of furniture into beautiful things you’d want in your home appeals to me for so many reasons: it’s crafty, thrifty, and does not take 8 years to complete. Imagine my excitement when this lamp-and-side-table-combo showed up next to the dumpster in my apartment complex:

I initially grabbed the shade, thinking that it would work for a lamp I already had, and then when it became clear that it would not, I pulled the whole lamp inside. This is the point when I engaged in a healthy (?) dose of suspension of disbelief. In my head, a few short hours with some paint stripper, leftover bedroom wall paint, and some poly-acrylic finish would yield a table that was pale shiny finished wood with a delicate yellow border, with a matching base. Flash forward to the lamp and I in the bathtub, with me doing my darnedest to neither expose myself nor the municipal water system to the most eco-friendly paint stripper I could find. It became abundantly clear that I was not patient enough to get all of the paint off. Also, it seemed that the wood stain on the base of the lamp would have taken multiple applications of the stripper to remove. Tired and a little sore from hunching over and under the table, I cleaned everything up and let it all dry. Dreams of encountering a beautiful wood table dashed, I resigned myself to a yellow table with a yellow base. Three coats of paint later I was exhausted and it was time for bed. In the morning I applied two coats of water-based poly-acrylic finish, with only a little bit of dust and impatience leading to a less-than-perfect tabletop.

I set it next to my bed and am quite thrilled with the result, even if it’s not exactly what I dreamed.

Walter enjoyed snuggling in the blankets and pillows while I finished the lamp:

And then promptly posed for a photo when I tried to get a good picture:

Slow news day?

I find that on the slower news days, many of the things I’m actually interested in get covered. When there are no massive natural disasters, war is not declared (officially or unofficially), and celebrities are not making public their battles with substance use (officially or unofficially), questions about equity in terms of gender and sexuality are suddenly interesting fodder for discussion. It helps a bit that the Supreme Court has agreed to hear a case in which Wal-Mart claims that the women suing it for employment discrimination do not have enough in common to warrant a class-action suit. Although Wal-Mart would have you believe that the case has nothing to do with the sex discrimination the formed the basis of the case at the beginning, and that it is only about standing in the court, but I think it will be interesting (and maybe scary) to hear the discussion about whether or not having one’s sex and (former-)employer in common is enough to join up into a class-action suit. Below are a few other links I found interesting and though I’d share. Some of them are restricted (through the Chronicle of Higher Education), but even the little tidbits are interesting.

For Women Seeking to Advance in Academe, Advice From 4 Who Made It to the Top

Taking the Gender Fight Worldwide

Leadership Spots Opening Up for Gay and Lesbian Academics

Gay Academics Find New Paths to the Top

Episode 13: An ‘All-American’ Student Leader’s Search for Identity

Your Electronic Thesis and Dissertation (ETD) submission was successful.

From Dose of Reality:

This is what my e-mail said this morning after my post-defense meeting at the graduate school to review the formatting of my dissertation, turn in the final approval document, and submit my dissertation online to the library. When I asked about the publication fee I knew was owed to the University, however, I was informed that because I was an MSTP student this fee would not be assessed until I finished my MD, and that if I am lucky, it will have disappeared by the time I graduate. Hopeful as I am to avoid the $70 fee, I do wish, at least a little bit, that my dissertation could be available online (and in a bound version in my department) before 2013. Apparently they don’t process anything really until the degree is conferred, which in my case is not for another couple of years.

Lesson #1: No matter how much you love the MSTP, it is impossible to also love all of the exercises in delayed gratification.

Lesson #2: Publish your work so that you are allowed to show it to your family and friends before you graduate.

Relaxing

As has been discussed in this forum previously, I’m not good at relaxing. Really not good at relaxing. As a result, my schedule last week did not include work related to my dissertation (except for finishing up my revisions on Friday), but did include approximately 1,000,000 other things that needed to get done. I also started a running list of other stuff that needed to be completed before returning to the medical school. This sort of thing usually calms me because I feel more organized, but by yesterday afternoon I had worked myself into such a state that I was completely overwhelmed. I quickly realized that this was not good, and vowed (again) to relax a bit.

Success! This morning, Walt and I stayed in bed and read until after 9am and it was really wonderful. Walt did less reading, but still enjoyed the relaxing morning. I finished Little Bee, a book my Aunt Elizabeth sent for my birthday, and thoroughly enjoyed it. It was a surprisingly easy read for the subject matter (asylum-seeking, oil wars, and serious mental health issues, among others) and very well written. I enjoyed the style so much I purchased the audiobook version of the author’s other book, Incendiary. This is the kind of morning we had:

I also worked through my list of stuff to do and partitioned it out over the days of this week. I’m feeling good about getting everything done, and have reminded myself 2-3 times already that I have a few more weeks left as well.

In closing, here is a photo of Walter attempting to sleep on every item on the futon all at once:

There are actually two pillows underneath him...

Winter of Detroit Warms Up

Last week Alicia and I headed down to the D to transition our Winter of Detroit into Spring of Detroit. (As an aside, clearly the Michigan weather is confused about that transition, but my hopes are high that it will really be spring soon…) I know I’d heard about Small Plates before, but had never tried it out. Alicia snagged a great Groupon, and we were on our way to distract me from my impending defense. It was really quite delicious. For those of you unfamiliar with it, they feature a variety of appetizers and easily divisible entrees, and your table comes set with a stack of, yes, small plates. Everyone shares in the slightly-fancier-than-family-style family style. What we ordered:

• Caesar Salad (small)
• Veggie Spring Rolls
• Garlic Shrimp
• Chicken-Something Lettuce Wraps (I didn’t eat these…)
• French Fries

The salad was great, as were the spring rolls and the shrimp. I’d have to say that I could take or leave the fries, which was a bit disappointing. Overall, it was an enjoyable dinner!

I did not remember to bring my camera, but will leave you with a disturbing phone photo of the graffiti I saw on the way in. (Please accept my apology for posting a picture of graffiti in a post about Detroit - it's overdone and annoying, but this one relates to my academic work!)

Nothing has ever inspired me to think and talk about masculinity and the criminal justice system quite like this.

The Fit!

As many of you know, I bought a car yesterday. I found it late last week, and reserved it then, but I actually purchased it yesterday. As ambivalent as I was about owning my own vehicle (as I much prefer the bus, my bike, and walking), I realized over the past month that being carless in Ann Arbor was much more difficult than I’d thought. I suspect that I could probably survive without a car, but having transportation after 7pm and on Sundays without having to rely on someone else is really useful!

My first view from the car on Wednesday:

(I was still safely in the parking lot, so no need to worry…)

Now that it’s sunny today, I present to you, the Fit. I don’t believe in naming cars, so that’s all it is…

Someday gets closer

Today was a relaxing day. I was happy with how my defense went yesterday, and even happier that it was over and finished. Here I am with the poster announcing my defense:
I don't officially get my degree until I finish the MD in 2013, but I like to think I have an unofficial doctorate. In any case, I had a fantastic time celebrating afterward with friends and family yesterday, and am particularly pleased to note that there are more celebrations already in the works. Carrying the celebrations into today, Ruti sent me beautiful flowers:

The box also contained chocolates, so she wins double (maybe even triple or quaduple) points.

Alicia and I also went to the opening gala of the Ann Arbor Film Festival, which was notable both for the films (which were great), and the people watching (which was amazing). I really enjoy events where the old hippies and the young hipsters mix and mingle.

There was also tasty food, including cupcakes, which made my day complete.

Tomorrow, I go and officially buy my car! (It is reserved for me and all the paperwork is done, but I have to actually buy it tomorrow…) Watch for the classic car ad photos of me in some kind of skimpy dress modeling on my car in the ice pellets we’re supposed to get tomorrow. Or not…

Delicious

Having finished most of the big things required for my PhD, I’ve made a little resolution to make sure I’m cooking more. It’s not that I was eating particularly unhealthfully in the traditional sense, but I would consider eating cereal for more than one meal per day more than 3-4 days per week to be unhealthy, even if there are lots of fruits and vegetables on the side. It is monotonous, and makes me feel a little desperate and somehow… mentally unhealthy. The best course of action when I’m feeling this way is to peruse some cookbooks. My go-to options are Mark Bittman’s How to Cook Everything and How to Cook Everything Vegetarian. Between those two, there is a recipe for just about everything a person could wish to eat, all of them are fairly easy, and many are flexible based on what is in my refrigerator/freezer. Every time I think I’ve found all of my favorite recipes, I find another. Today, I present to you a delicious way to use chick peas and all kinds of random vegetables. This is a serious refrigerator cleaner!

Stewed Chickpeas and Crazy Delicious Trimmings

adapted from How to Cook Everything by Mark Bittman

4 cups drained cooked or canned chickpeas
2 cups bean cooking liquid or stock (or some combination)
salt and pepper to taste
1 tablespoon grapeseed oil
1 zucchini, chopped (this is optional, or you could use eggplant or some other hearty vegetable you aren't sure what else to do with - I foresee this being very popular when the zucchini plants being producing more than your typical human can cope with)
1 package of chorizo flavored seitan, or some other delicious meat or non-meat protein (the original recipe uses chicken)
1 large onion, chopped
3 celery sticks, chopped
2 carrots, chopped
1 tablespoon minced garlic
1 teaspoon peeled and minced fresh ginger
1/2 teaspoon ground coriander
1 teaspoon ground cumin
1 28 oz. can tomatoes (drain more or less depending on how soupy your like your stew)
minced cilantro for garnish

Warm the beans in a large pot with the liquid; add salt and pepper. Adjust the heat so that the mixture bubbles very slowly.

Place the oil in a large skillet and turn the heat to medium-high. Brown the zucchini and fake chorizo, about 15 minutes. Transfer to a serving bowl, leaving any remaining oil in the pan.

Turn the heat to medium and add the onion, celery, and carrot, as well as a bit more oil if necessary. Cook, stirring occasionally, until the vegetables are the consistency you like your stew – mine were slightly crunchy. Add the garlic, ginger, coriander, cumin, and tomatoes and cook for 5 minutes more. Stir occasionally and scrape the bottom of the pan to loosen any brown bits. Add the mixture to the simmering beans and let simmer for a bit (5 minutes?), or longer if you like a less soupy stew.

To serve, ladle the stewed chick peas into a bowl, spoon over the zucchini and fake chorizo, and then garnish with chopped cilantro. So delicious!

Brain recovery…

Apparently my last post sounded despondent enough to concern my mother, so here I present to you the post of reassurance. In addition to freaking out a bit about returning to the hospital, I have been doing the following to recover from the stress of defense preparation:

1. Taking gratuitous pictures of the dog. Enough said…

2. Reading books that could in no way be construed as upsetting or stressful. I just finished reading Knit The Season by Kate Jacobs, the third book in the Friday Night Knitting Club series. It was great. The writing was perfectly acceptable, the plot was entertaining, and enjoying it took approximately no effort on my part.

3. Making new brains!

We have a long tradition of making chocolates for big events (graduations, weddings, green card approvals, etc) in our family, and even though I’m not actually getting the PhD for another few years, mom suggested that we make chocolates for my defense (with the promise of more chocolates when I actually graduate). After perusing Amazon’s dazzling array of chocolate molds, I found the brains. They proved to be somewhat larger than expected (the story of my family, I suppose…), but look pretty awesome.

Starting to seem real

My defense is happening in a week in a half (in case you’ve been wondering why my posts have been, how shall we say, irregular recently), and it’s finally starting to seem like I’m going back to medical school.

I went and saw the Smoker last weekend, which is the University of Michigan Medical School’s student-conceived, –written, –directed, –acted, –danced, and –sung musical about the medical school and the hospital. It is always based on a movie or musical, and this year was a medical version of Mean Girls: Spleen Girls. Seeing it made me miss participating - I danced and had small non-speaking walk on roles in Orifice Space (Office Space), The Breakfast Clubbing, Cyanosis, and Edema (The Breakfast Club), Billy Medicine (Billy Madison), and Old Stool (Old School) – and also reminded me of how much UMMS trivia I have yet to learn as an M3!

I’ve also been thinking about some of the practical parts of going back to the medical school. I’m ordering a few extra white coats (so that I have some laundry leeway), thinking about my car situation (after my trusty ‘93 Escort died in December), and looking into dog sitters/walkers for Walt. It’s all a little overwhelming, so I’ve been reading, knitting, and sleeping to avoid addressing everything for a little bit… As it gets more real, however, it’s becoming unavoidable.

Meet Dr. Watson

From Dose of Reality:

Shortly after I heard about Watson the super computer’s debut on Jeopardy, I was talking on the bus with Abe and he asked what I thought about Watson’s next big challenge: medical diagnosis. I appreciated Abe’s assessment that I wouldn’t be upset at a question that cut directly to the issue of whether a human being is necessary in a typical medical visit, and had to admit that it was a disconcerting prospect. Adequate as I like to imagine my information processing capabilities are, I am not, at the risk of stating the obvious, a super computer. My constant connection to my BlackBerry doesn’t allow me the same level of internet search that Watson commands, and familiarity with statistical software and electronic medical records do not an instant meta-analyzer make. In spite of the nagging fears at the back of my mind that Watson would make a much more useful companion on rounds than I would, I couldn’t shake the sense that it had to be useful to have a human physician (or for that matter, a human nurse, physicians assistant, etc) for something. At that point I remembered a recent New York Times article by Abraham Verghese. Recently profiled in the NYTimes for his dedication to history taking skills and the physical exam, I knew that if anyone could justify a human presence in the consult room, he could. And he did. He pointed out that much of the value of a doctor’s visit is in the human interaction, noting:

I find that patients from almost any culture have deep expectations of a ritual when a doctor sees them, and they are quick to perceive when he or she gives those procedures short shrift by, say, placing the stethoscope on top of the gown instead of the skin, doing a cursory prod of the belly and wrapping up in 30 seconds.

He chastised the medical establishment for being “glued to [computer] like piglets at a sow’s teats.” He describes the creation of an “iPatient,” the collection of clinical records and test results that stand in for the patient, and emphasizes that “complaints…from patients, family and friends are never about the dearth of technology but about its excesses.”

We have yet to create appendages for Watson that function as well as the physician’s hands, ears, and eyes for assessing the physical state of the body, and it seems unlikely that he will develop the ability to empathize and connect with a human being anytime soon. Ultimately, it seems that although Watson may, in fact, make an excellent companion on the wards, he is unlikely to truly replace a skillful (human) history and physical exam.

It really does start to come back

From AMSA On Call:

Post #6 of the "Back to the Wards" series focusing on the transition from research years back to the medical school and clinical rotations.

It’s hard to believe I’m already at post #6 in this series. I’ve been averaging about one each month, which means that almost half a year has gone by. In that time I’ve done a lot of things to prepare me for my return to the medical school! I’ve scheduled a dissertation defense, written a dissertation (only edits and formatting left…), and worked with two different internal medicine attendings to try to remember how to be a medical student. Believe it or not, I think that the last item on that list has been the most anxiety provoking. Something I can tell you for sure, however, is that it really does come back. Something else I can tell you is that apparently anything can feel normal after you try it a few times. If you had told me just a few weeks ago that I would casually walk up to one of the nursing stations in University Hospital, have someone help me identify a patient, and then take a reasonably competent history and perform a slow and imperfect, but adequate physical exam, I would have laughed at you. If you had said that I would attempt to present this information to an attending I would have cried. So take heart, whether you are simply making the transition from the pre-clinical years to working on the wards, or you are working to regain the skills you had before a break, because it all really does come back.