Secrets of the Medical Profession!

Apparently, the only 'secret' I know so far is already out:



... although sometimes, we are taking your pulse.

So, continuing along on my medical journey, I have had real interactions with real patients! We've been learning how to take medical histories, and after practicing on each other, our clinical skills teachers took us to their emerg department and found us some patients who were kind enough to let us take their histories. Without any knowledge of what is and isn't relevant, these histories take a LONG time. Working in pairs, we spent about 45 minutes finding out about a patient, and then reported our findings back to the teachers who then helped us puzzle out the relevant details and guess at what might be happening. I lucked out with an amazingly patient (haha) and helpful patient - although we ended up having no clue about the diagnosis. Apparently, the "House" of the hospital is on the case.

Yesterday morning, we had another chance to practice interviewing - this time with standardized patients (aka actors). After the real patient, this was much less intimidating. The focus this time was also on rapport-building/communication skills rather than detailed history-gathering, and according to feedback from my patient and the teachers, I did a pretty good job of it. Yay!

Yesterday was a really, really long day. We had to be on campus by 8 am (I had to leave home before 6:30! WOW!) for our first 'test' - questions that track how well we've been learning the main concepts during our tutorials. Of the three short-answer questions, I think I did pretty well on two of them, but mixed up obstructive and restrictive lung disease on the third (big oops there). Next was the patient, from 9-12, and the first 'exam' from 1-4. Everyone in the school writes the same 'exam,' whether they are in first or third year. As first years, we're expected to do poorly - but the 2% I got sill shocked and stung. Hearing about many others who got the same mark did help. Since I was only supposed to answer questions we've learned about, I was out of the exam after half an hour - giving me more time to read up for my tutorial 4-7 (and it went really well).

Afterward, I headed over to the health professionals recruitment fair, where I was able to check out some communities where I could do my big elective next summer (I'm thinking rural family medicine, up North or possibly overseas). It was saddening to see how desperate some of the communities were to recruit doctors (and other health professionals), especially the rural communities. Sadness aside, North Bay seems pretty awesome - their slogan had me cracking up everytime I saw it: "Just North enough to be perfect!" I guess there is a longitudinal scale of perfection running up Ontario.

All in all, yesterday was 12 hours on campus, and 15 hours away from home. My sleep-in today was the awesome-est ever.

Just in case you are wondering what science/medicine I am learning, here is a list of cases/diseases I have studied to date (all relating to the respiratory system):

-Opiod-induced respiratory failure
-Shallow-water blackout
-Effects of altitude/exercise on health
-Airway obstruction
-Croup
-Guillaum-Barre Syndrome
-Pneumonia
-Asthma
-and currently, chronic obstructive pulmonary disease

Sigh of relief

Med school is turning out to be everything I hoped it could be. Granted, I am very much in the "honeymoon" phase, but I am loving every minute of it. I'm pretty convinced that I've found the perfect program for me - all of my 'classes' are so interesting and so far, nothing has felt like work. I'm so lucky to have found a school where the emphasis is on self-directed learning, with topics interesting enough that self-motivation isn't an issue.

I had my first 12-hour day on Wednesday, and I had been dreading it. So many things to do, so few breaks - I expected utter exhaustion. Instead, I found exhilaration. The day started off with learning some clinical skills - we were presented with a 'patient' (an actor/volunteer) and learned how to take vital signs such as blood pressure, heart rate and respiratory rate. Next, got my line of credit (and a free Tim Horton's gift card! woo! Take THAT, massive debt load!), and had about 20 minutes to grab a sandwich before my first ever Anatomy lecture. We seem to be blessed with the most amazing profs - I could imagine that Anatomy runs the risk of being an extremely dry topic, but this was fascinating. The lecture was followed by a more hands on application session - we looked at chest cavities and lungs (surprisingly, I'm not bothered by the cadavers). I definitely felt like I didn't know anything, as so many people in my class came from Physiology programs and are anatomy pros, but I think I'll be able to catch up.

Next, a 20 minute break, and then another clinical skills session - this time with some first-year residents who, in their sleep-deprived states, will teach us the skills we need to not come across as ignorant fools when we first start dealing with patients. We talked about history-taking (apparently 95% of all diagnoses can be reached from an accurate patient history) and then got a tour of the emergency room! By the time we were done, it was 8:30 pm and I was not the slightest bit tired. Horray for exceeded hopes!

Real work...

I will not write a post until I've finished my first bit of research: today's topic is respiration, mechanics of breathing, CNS control of breathing and how analgesia can screw it up.